Endeavor Health Highland Park Hospital
Listed in its price file as “Endeavor Health Clinical Operations”.
Endeavor Health Highland Park Hospital in Highland Park, IL publishes cash prices for 443 common procedures listed here, from its own machine-readable price file updated Apr 1, 2026. Compared with other hospitals in the state, its outpatient cash prices are above the Illinois median for 264 of 437 procedures and below it for 154. By typical cash price it ranks #63 of 114 Illinois hospitals and #38 of 62 hospitals in the Chicago, IL area, cheapest first. Select a procedure to compare it with other hospitals nearby.
777 Park Ave W, Highland Park, IL 60035 Collected Sep 27, 2026 Source price file Check a bill from this hospital
The price file shows no self-pay discount
For 1666 of the 1666 prices listed here, the cash price in Endeavor Health Highland Park Hospital's file equals its full list price (chargemaster), so the file publishes no self-pay discount. That is why it compares as expensive. Many hospitals still reduce bills for uninsured patients or offer financial assistance based on income: before a planned visit, ask the billing office for its self-pay rate and discount policy in writing. Other US hospitals whose cash price is their full list price.
Scans and imaging
| Procedure | Cash price | List price | Insurers pay | vs Illinois | Off list |
|---|---|---|---|---|---|
| Abdominal CT scan without and with contrast CPT 74170 HB CT ABDOMEN W&W/O CONTRAST | $3,725.00 | $3,725.00 | — | 32% above | — |
| Abdominal CT scan without and with contrast inpatient CPT 74170 HB CT ABDOMEN W&W/O CONTRAST | $3,725.00 | $3,725.00 | — | — | — |
| Abdominal X-ray, 2 views CPT 74019 HB X-RAY ABDOMEN 2 VIEWS | $566.00 | $566.00 | — | 72% above | — |
| Abdominal X-ray, 2 views inpatient CPT 74019 HB X-RAY ABDOMEN 2 VIEWS | $566.00 | $566.00 | — | — | — |
| Ankle X-ray, complete, 3 or more views CPT 73610 HB ANKLE, COMPL, MIN 3 VIEWS | $453.00 | $453.00 | — | 34% above | — |
| Ankle X-ray, complete, 3 or more views inpatient CPT 73610 HB ANKLE, COMPL, MIN 3 VIEWS | $453.00 | $453.00 | — | — | — |
| Ankle-brachial index (ABI), blood pressure test for leg arteries both sides CPT 93922 HB UPPER/LOWER EXT DOP/ART PRES-BILAT | $924.00 | $924.00 | — | — | — |
| Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient both sides CPT 93922 HB UPPER/LOWER EXT DOP/ART PRES-BILAT | $924.00 | $924.00 | — | — | — |
| Arm CT scan without contrast (shoulder to hand, any part) CPT 73200 HB CT UPR EXT W/O CONT | $2,293.00 | $2,293.00 | — | 25% above | — |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient CPT 73200 HB CT UPR EXT W/O CONT | $2,293.00 | $2,293.00 | — | — | — |
| Barium swallow (esophagus X-ray with contrast) CPT 74220 HB ESOPHAGUS X-RAY | $988.00 | $988.00 | — | 65% above | — |
| Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 HB ESOPHAGUS X-RAY | $988.00 | $988.00 | — | — | — |
| Bone scan, whole body (nuclear medicine) CPT 78306 HB BONE SCAN-WHOLE BODY | $3,337.00 | $3,337.00 | — | 112% above | — |
| Bone scan, whole body (nuclear medicine) inpatient CPT 78306 HB BONE SCAN-WHOLE BODY | $3,337.00 | $3,337.00 | — | — | — |
| Breast ultrasound, complete, one breast CPT 76641 HB US BREAST UNI REAL TIME W/ IMAGE COMP | $291.00 | $291.00 | — | 44% below | — |
| Breast ultrasound, complete, one breast inpatient CPT 76641 HB US BREAST UNI REAL TIME W/ IMAGE COMP | $291.00 | $291.00 | — | — | — |
| Breast ultrasound, limited (one breast or one area) CPT 76642 US BREAST UNI REAL TIME W/ IMAGE LIM | $163.00 | $163.00 | — | 63% below | — |
| Breast ultrasound, limited (one breast or one area) CPT 76642 HB US BREAST UNI REAL TIME W/ IMAGE LIM | $422.00 | $422.00 | — | 4% below | — |
| Breast ultrasound, limited (one breast or one area) inpatient CPT 76642 US BREAST UNI REAL TIME W/ IMAGE LIM | $163.00 | $163.00 | — | — | — |
| Breast ultrasound, limited (one breast or one area) inpatient CPT 76642 HB US BREAST UNI REAL TIME W/ IMAGE LIM | $422.00 | $422.00 | — | — | — |
| CT angiography (CTA) of the abdomen and pelvis CPT 74174 HB CTA ABD & PELVIS W/CONTRAST W/WO CNTRST IMGS | $3,521.00 | $3,521.00 | — | 5% below | — |
| CT angiography (CTA) of the abdomen and pelvis CPT 74174 HB CTV ABD & PELVIS W/ AND/OR W/O CONT | $3,521.00 | $3,521.00 | — | 5% below | — |
| CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174 HB CTV ABD & PELVIS W/ AND/OR W/O CONT | $3,521.00 | $3,521.00 | — | — | — |
| CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174 HB CTA ABD & PELVIS W/CONTRAST W/WO CNTRST IMGS | $3,521.00 | $3,521.00 | — | — | — |
| CT angiography (CTA) of the head CPT 70496 HB CTV HEAD W/O&W CONT | $2,619.00 | $2,619.00 | — | 2% above | — |
| CT angiography (CTA) of the head CPT 70496 HB CTA HEAD W/O & W CONTRAST | $2,619.00 | $2,619.00 | — | 2% above | — |
| CT angiography (CTA) of the head inpatient CPT 70496 HB CTA HEAD W/O & W CONTRAST | $2,619.00 | $2,619.00 | — | — | — |
| CT angiography (CTA) of the head inpatient CPT 70496 HB CTV HEAD W/O&W CONT | $2,619.00 | $2,619.00 | — | — | — |
| CT angiography (CTA) of the neck CPT 70498 HB CTV NECK W/O&W CONT | $3,056.00 | $3,056.00 | — | 18% above | — |
| CT angiography (CTA) of the neck CPT 70498 HB CTA NECK W/O & W CONTRAST | $3,056.00 | $3,056.00 | — | 18% above | — |
| CT angiography (CTA) of the neck inpatient CPT 70498 HB CTA NECK W/O & W CONTRAST | $3,056.00 | $3,056.00 | — | — | — |
| CT angiography (CTA) of the neck inpatient CPT 70498 HB CTV NECK W/O&W CONT | $3,056.00 | $3,056.00 | — | — | — |
| CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 HB CTA CHEST W/O & W CONTRAST | $3,317.00 | $3,317.00 | — | 13% above | — |
| CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 HB CTV CHEST W/O AND/OR W CONT | $3,317.00 | $3,317.00 | — | 13% above | — |
| CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 HB CTV CHEST W/O AND/OR W CONT | $3,317.00 | $3,317.00 | — | — | — |
| CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 HB CTA CHEST W/O & W CONTRAST | $3,317.00 | $3,317.00 | — | — | — |
| CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 HB CTA HRT CRNRY ART/BYP GRF W/CON 3D ST | $2,441.00 | $2,441.00 | — | 38% above | — |
| CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score inpatient CPT 75574 HB CTA HRT CRNRY ART/BYP GRF W/CON 3D ST | $2,441.00 | $2,441.00 | — | — | — |
| CT of the heart without contrast dye to measure coronary calcium CPT 75571 HB CT CARDIAC SCORING | $25.00 | $25.00 | — | 89% below | — |
| CT of the heart without contrast dye to measure coronary calcium inpatient CPT 75571 HB CT CARDIAC SCORING | $25.00 | $25.00 | — | — | — |
| CT scan of abdomen and pelvis, no contrast dye CPT 74176 HB CT ABD & PELVIS; W/O CONTRAST | $3,726.00 | $3,726.00 | — | 2% above | — |
| CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 HB CT ABD & PELVIS; W/O CONTRAST | $3,726.00 | $3,726.00 | — | — | — |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 HB CT ABD & PELVIS; W/CONTRAST | $4,692.00 | $4,692.00 | — | 6% above | — |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 HB CT ABD & PELVIS; W/CONTRAST | $4,692.00 | $4,692.00 | — | — | — |
| CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 HB CT ABD & PELVIS; W/O & W CONTRAST | $6,865.00 | $6,865.00 | — | 38% above | — |
| CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 HB CT ABD & PELVIS; W/O & W CONTRAST | $6,865.00 | $6,865.00 | — | — | — |
| CT scan of the abdomen with contrast CPT 74160 HB CT ABDOMEN W/CONTRAST | $3,164.00 | $3,164.00 | — | 39% above | — |
| CT scan of the abdomen with contrast inpatient CPT 74160 HB CT ABDOMEN W/CONTRAST | $3,164.00 | $3,164.00 | — | — | — |
| CT scan of the abdomen without contrast CPT 74150 HB CT ABDOMEN W/O CONTRAST | $2,587.00 | $2,587.00 | — | 35% above | — |
| CT scan of the abdomen without contrast inpatient CPT 74150 HB CT ABDOMEN W/O CONTRAST | $2,587.00 | $2,587.00 | — | — | — |
| CT scan of the face and sinuses, no contrast dye CPT 70486 HB CT SINUS(SCREENING) W/O CONTRAST-REDUCED | $1,893.00 | $1,893.00 | — | 12% above | — |
| CT scan of the face and sinuses, no contrast dye CPT 70486 HB CT SINUS MAX FACIAL W/O CON | $1,893.00 | $1,893.00 | — | 12% above | — |
| CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 HB CT SINUS(SCREENING) W/O CONTRAST-REDUCED | $1,893.00 | $1,893.00 | — | — | — |
| CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 HB CT SINUS MAX FACIAL W/O CON | $1,893.00 | $1,893.00 | — | — | — |
| CT scan of the head or brain, no contrast dye CPT 70450 HB CT HEAD W/O CONTRAST | $2,063.00 | $2,063.00 | — | 12% above | — |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 HB CT HEAD W/O CONTRAST | $2,063.00 | $2,063.00 | — | — | — |
| CT scan of the head with contrast CPT 70460 HB CT HEAD WITH CONTRAST | $2,453.00 | $2,453.00 | — | 27% above | — |
| CT scan of the head with contrast inpatient CPT 70460 HB CT HEAD WITH CONTRAST | $2,453.00 | $2,453.00 | — | — | — |
| CT scan of the head without and with contrast CPT 70470 HB CT HEAD W & W/O CONTRAST | $3,403.00 | $3,403.00 | — | 40% above | — |
| CT scan of the head without and with contrast inpatient CPT 70470 HB CT HEAD W & W/O CONTRAST | $3,403.00 | $3,403.00 | — | — | — |
| CT scan of the lower back (lumbar spine) without contrast CPT 72131 HB CT LUMBAR SPINE W/O CONTRAST | $2,841.00 | $2,841.00 | — | 29% above | — |
| CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 HB CT LUMBAR SPINE W/O CONTRAST | $2,841.00 | $2,841.00 | — | — | — |
| CT scan of the neck (cervical spine), no contrast dye CPT 72125 HB CT CERVICAL SPINE W/O CONTR | $2,579.00 | $2,579.00 | — | 11% above | — |
| CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 HB CT CERVICAL SPINE W/O CONTR | $2,579.00 | $2,579.00 | — | — | — |
| CT scan of the pelvis, with contrast dye CPT 72193 HB CT PELVIS W/CONTRAST | $2,737.00 | $2,737.00 | — | 27% above | — |
| CT scan of the pelvis, with contrast dye inpatient CPT 72193 HB CT PELVIS W/CONTRAST | $2,737.00 | $2,737.00 | — | — | — |
| Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 HB DUPLEX SCAN ECA COMP, BILAT | $1,936.00 | $1,936.00 | — | — | — |
| Carotid artery ultrasound (duplex), both sides of the neck inpatient both sides CPT 93880 HB DUPLEX SCAN ECA COMP, BILAT | $1,936.00 | $1,936.00 | — | — | — |
| Chest CT scan without and with contrast CPT 71270 HB CT CHEST W & W/OT CONTRAST | $3,848.00 | $3,848.00 | — | 36% above | — |
| Chest CT scan without and with contrast inpatient CPT 71270 HB CT CHEST W & W/OT CONTRAST | $3,848.00 | $3,848.00 | — | — | — |
| Chest X-ray, 2 views CPT 71046 HB CHEST,FRONTAL & LATERAL | $453.00 | $453.00 | — | 47% above | — |
| Chest X-ray, 2 views CPT 71046 HB CHEST 2 VIEWS | $453.00 | $453.00 | — | 47% above | — |
| Chest X-ray, 2 views inpatient CPT 71046 HB CHEST 2 VIEWS | $453.00 | $453.00 | — | — | — |
| Chest X-ray, 2 views inpatient CPT 71046 HB CHEST,FRONTAL & LATERAL | $453.00 | $453.00 | — | — | — |
| Chest X-ray, single view CPT 71045 HB CHEST,FRONTAL, SINGLE VIEW | $369.00 | $369.00 | — | 45% above | — |
| Chest X-ray, single view inpatient CPT 71045 HB CHEST,FRONTAL, SINGLE VIEW | $369.00 | $369.00 | — | — | — |
| Collarbone (clavicle) X-ray, complete CPT 73000 HB CLAVICLE COMPLETE | $436.00 | $436.00 | — | 67% above | — |
| Collarbone (clavicle) X-ray, complete inpatient CPT 73000 HB CLAVICLE COMPLETE | $436.00 | $436.00 | — | — | — |
| Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 HB US RETROPERITONEUM COMPLETE | $1,115.00 | $1,115.00 | — | 36% above | — |
| Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 HB US RETROPERITONEUM COMPLETE | $1,115.00 | $1,115.00 | — | — | — |
| DEXA bone density scan of the hip, pelvis or spine CPT 77080 HB BONE DENSITY DXA, 1+ SITES, AXIAL | $596.00 | $596.00 | — | 25% above | — |
| DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 HB BONE DENSITY DXA, 1+ SITES, AXIAL | $596.00 | $596.00 | — | — | — |
| DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 HB BONE DENSITY DXA 1/>SITES APPENDICLR | $235.00 | $235.00 | — | at median | — |
| DEXA bone density scan of the wrist, heel or finger (peripheral) inpatient CPT 77081 HB BONE DENSITY DXA 1/>SITES APPENDICLR | $235.00 | $235.00 | — | — | — |
| Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 HB LEVEL II/ANOMALY SCAN, 1ST FETUS | $1,289.00 | $1,289.00 | — | 32% above | — |
| Detailed fetal anatomy ultrasound, through the belly, one baby inpatient CPT 76811 HB LEVEL II/ANOMALY SCAN, 1ST FETUS | $1,289.00 | $1,289.00 | — | — | — |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 HB CT CHEST LOW DOSE | $835.00 | $835.00 | — | 55% below | — |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 HB CT CHEST W/O CONTRAST | $2,851.00 | $2,851.00 | — | 54% above | — |
| Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 HB CT CHEST LOW DOSE | $835.00 | $835.00 | — | — | — |
| Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 HB CT CHEST W/O CONTRAST | $2,851.00 | $2,851.00 | — | — | — |
| Diagnostic CT scan of the chest, with contrast dye CPT 71260 HB CT CHEST W/CONTRAST | $3,156.00 | $3,156.00 | — | 32% above | — |
| Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 HB CT CHEST W/CONTRAST | $3,156.00 | $3,156.00 | — | — | — |
| Diagnostic mammogram, both breasts both sides CPT 77066 HB MAM,DIAGNOSTIC BILAT DIGITAL | $542.00 | $542.00 | — | — | — |
| Diagnostic mammogram, both breasts inpatient both sides CPT 77066 HB MAM,DIAGNOSTIC BILAT DIGITAL | $542.00 | $542.00 | — | — | — |
| Diagnostic mammogram, one breast CPT 77065 HB MAM, DIAGNOSTIC DIGITAL | $411.00 | $411.00 | — | 34% above | — |
| Diagnostic mammogram, one breast inpatient CPT 77065 HB MAM, DIAGNOSTIC DIGITAL | $411.00 | $411.00 | — | — | — |
| Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 HB ARTERIAL DUPLEX LE-BILATERAL | $1,934.00 | $1,934.00 | — | — | — |
| Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 HB ARTERIAL DUPLEX LE-BILATERAL | $1,934.00 | $1,934.00 | — | — | — |
| Duplex ultrasound of the leg veins, both legs both sides CPT 93970 HB VENOUS DUPLEX IMAGING EXT BILATERAL | $2,609.00 | $2,609.00 | — | — | — |
| Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 HB VENOUS DUPLEX IMAGING EXT BILATERAL | $2,609.00 | $2,609.00 | — | — | — |
| Echocardiogram through the chest wall, complete, with Doppler CPT 93306 HB TTE W/DOPPLER, COMPLETE | $3,756.00 | $3,756.00 | — | 77% above | — |
| Echocardiogram through the chest wall, complete, with Doppler CPT 93306 HB TTE CMPL SPC&CLR FLOW DPLR ECHO | $3,756.00 | $3,756.00 | — | 77% above | — |
| Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 HB TTE W/DOPPLER, COMPLETE | $3,756.00 | $3,756.00 | — | — | — |
| Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 HB TTE CMPL SPC&CLR FLOW DPLR ECHO | $3,756.00 | $3,756.00 | — | — | — |
| Elbow X-ray, 2 views CPT 73070 HB ELBOW 2 VIEWS | $385.00 | $385.00 | — | 40% above | — |
| Elbow X-ray, 2 views inpatient CPT 73070 HB ELBOW 2 VIEWS | $385.00 | $385.00 | — | — | — |
| Elbow X-ray, complete, 3 or more views CPT 73080 HB ELBOW COMP 3+ VIEWS | $472.00 | $472.00 | — | 39% above | — |
| Elbow X-ray, complete, 3 or more views inpatient CPT 73080 HB ELBOW COMP 3+ VIEWS | $472.00 | $472.00 | — | — | — |
| Eye socket (orbit) CT scan without contrast CPT 70480 HB CT ORBIT,SELLA,POST FOSSA W/O CONTRAST | $2,134.00 | $2,134.00 | — | 28% above | — |
| Eye socket (orbit) CT scan without contrast inpatient CPT 70480 HB CT ORBIT,SELLA,POST FOSSA W/O CONTRAST | $2,134.00 | $2,134.00 | — | — | — |
| Facial bones X-ray, complete, 3 or more views CPT 70150 HB FACIAL BONES COMPLETE 3+ VIEWS | $711.00 | $711.00 | — | 73% above | — |
| Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 HB FACIAL BONES COMPLETE 3+ VIEWS | $711.00 | $711.00 | — | — | — |
| Forearm X-ray (radius and ulna), 2 views CPT 73090 HB FOREARM MIN 2 VIEWS | $420.00 | $420.00 | — | 32% above | — |
| Forearm X-ray (radius and ulna), 2 views inpatient CPT 73090 HB FOREARM MIN 2 VIEWS | $420.00 | $420.00 | — | — | — |
| HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 HB HEPATOBILIARY SYST IMG W/GALLBLADDER | $1,643.00 | $1,643.00 | — | 9% above | — |
| HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 HB HEPATOBILIARY SYST IMG W/GALLBLADDER | $1,643.00 | $1,643.00 | — | — | — |
| Hand X-ray, 2 views CPT 73120 HB HAND 2 VIEWS | $300.00 | $300.00 | — | 8% above | — |
| Hand X-ray, 2 views inpatient CPT 73120 HB HAND 2 VIEWS | $300.00 | $300.00 | — | — | — |
| Heel bone (calcaneus) X-ray, 2 or more views CPT 73650 HB CALCANEOUS MIN 2 VIEWS | $417.00 | $417.00 | — | 73% above | — |
| Heel bone (calcaneus) X-ray, 2 or more views inpatient CPT 73650 HB CALCANEOUS MIN 2 VIEWS | $417.00 | $417.00 | — | — | — |
| Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 HB SLEEP STD AIRFLOW HRT RATE&O2 SAT EFFORT UNATT | $1,402.00 | $1,402.00 | — | 108% above | — |
| Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 HB APNEA MONITORING | $1,402.00 | $1,402.00 | — | 108% above | — |
| Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 HB SLEEP STDVENT-ECG-O2 SAT<6HRS | $1,402.00 | $1,402.00 | — | 108% above | — |
| Home sleep apnea test, unattended, recording breathing and oxygen inpatient CPT 95806 HB SLEEP STD AIRFLOW HRT RATE&O2 SAT EFFORT UNATT | $1,402.00 | $1,402.00 | — | — | — |
| Home sleep apnea test, unattended, recording breathing and oxygen inpatient CPT 95806 HB SLEEP STDVENT-ECG-O2 SAT<6HRS | $1,402.00 | $1,402.00 | — | — | — |
| Home sleep apnea test, unattended, recording breathing and oxygen inpatient CPT 95806 HB APNEA MONITORING | $1,402.00 | $1,402.00 | — | — | — |
| In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 HB SLEEP-POLYSOMNOGRAPHY W/CPAP | $5,021.00 | $5,021.00 | — | 7% above | — |
| In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 HB SLEEP-POLYSOMNOGRAPHY W/CPAP | $5,021.00 | $5,021.00 | — | — | — |
| Knee X-ray, 3 views CPT 73562 HB KNEE 3 VIEWS | $426.00 | $426.00 | — | 22% above | — |
| Knee X-ray, 3 views inpatient CPT 73562 HB KNEE 3 VIEWS | $426.00 | $426.00 | — | — | — |
| Knee X-ray, complete, 4 or more views CPT 73564 HB KNEE COMPL 4+ VIEWS | $503.00 | $503.00 | — | 14% above | — |
| Knee X-ray, complete, 4 or more views inpatient CPT 73564 HB KNEE COMPL 4+ VIEWS | $503.00 | $503.00 | — | — | — |
| Leg CT scan without contrast (hip to foot, any part) CPT 73700 HB CT LOWER EXT W/O CONTRAST | $2,567.00 | $2,567.00 | — | 41% above | — |
| Leg CT scan without contrast (hip to foot, any part) CPT 73700 HB CT WEIGHT BEARING LOWER EXT W/O CONT | $2,567.00 | $2,567.00 | — | 41% above | — |
| Leg CT scan without contrast (hip to foot, any part) inpatient CPT 73700 HB CT WEIGHT BEARING LOWER EXT W/O CONT | $2,567.00 | $2,567.00 | — | — | — |
| Leg CT scan without contrast (hip to foot, any part) inpatient CPT 73700 HB CT LOWER EXT W/O CONTRAST | $2,567.00 | $2,567.00 | — | — | — |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US ABDOMINAL RTIME W/IMAGE DOC;LTD | $253.00 | $253.00 | — | 64% below | — |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 HB US ABDOMEN LIMITED | $861.00 | $861.00 | — | 23% above | — |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US ABDOMINAL RTIME W/IMAGE DOC;LTD | $253.00 | $253.00 | — | — | — |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 HB US ABDOMEN LIMITED | $861.00 | $861.00 | — | — | — |
| Limited ultrasound of an arm or leg (non-vascular) CPT 76882 US EXTREMITY NONVASCULAR; LTD, SITE SPECIFIC | $118.00 | $118.00 | — | 62% below | — |
| Limited ultrasound of an arm or leg (non-vascular) CPT 76882 HB US EXTREMITY NON-VASCULAR; LIMITED | $529.00 | $529.00 | — | 72% above | — |
| Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 US EXTREMITY NONVASCULAR; LTD, SITE SPECIFIC | $118.00 | $118.00 | — | — | — |
| Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 HB US EXTREMITY NON-VASCULAR; LIMITED | $529.00 | $529.00 | — | — | — |
| Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 HB LOW DOSE CT SCAN LUNG CANCER SCREEN | $550.00 | $550.00 | — | 3% below | — |
| Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 HB LOW DOSE CT SCAN LUNG CANCER SCREEN | $550.00 | $550.00 | — | — | — |
| Lower leg X-ray (tibia and fibula), 2 views CPT 73590 HB TIBIA/FIBULA 2 VIEWS | $425.00 | $425.00 | — | 31% above | — |
| Lower leg X-ray (tibia and fibula), 2 views inpatient CPT 73590 HB TIBIA/FIBULA 2 VIEWS | $425.00 | $425.00 | — | — | — |
| MR angiography (MRA) of the head without contrast CPT 70544 HB MRA HEAD W/O CONTRAST | $3,382.00 | $3,382.00 | — | 27% above | — |
| MR angiography (MRA) of the head without contrast inpatient CPT 70544 HB MRA HEAD W/O CONTRAST | $3,382.00 | $3,382.00 | — | — | — |
| MRI of both breasts, without and then with contrast dye both sides CPT 77049 HB MRI BREAST W/O & W/CONT, BILAT INCL CAD | $2,397.00 | $2,397.00 | — | — | — |
| MRI of both breasts, without and then with contrast dye inpatient both sides CPT 77049 HB MRI BREAST W/O & W/CONT, BILAT INCL CAD | $2,397.00 | $2,397.00 | — | — | — |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 HB MRI LWR EXTR JT W/O CONT | $3,669.00 | $3,669.00 | — | 30% above | — |
| MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 HB MRI LWR EXTR JT W/O CONT | $3,669.00 | $3,669.00 | — | — | — |
| MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 HB MRI LWR EXT JT W/O&W CON | $4,743.00 | $4,743.00 | — | 38% above | — |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 HB MRI LWR EXT JT W/O&W CON | $4,743.00 | $4,743.00 | — | — | — |
| MRI of the abdomen without contrast CPT 74181 HB MRI ABD W/O CONTRAST | $3,301.00 | $3,301.00 | — | 19% above | — |
| MRI of the abdomen without contrast inpatient CPT 74181 HB MRI ABD W/O CONTRAST | $3,301.00 | $3,301.00 | — | — | — |
| MRI of the abdomen, without and then with contrast dye CPT 74183 HB MRI ABDOMEN SCN W/O&W CONTR | $4,175.00 | $4,175.00 | — | 12% above | — |
| MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 HB MRI ABDOMEN SCN W/O&W CONTR | $4,175.00 | $4,175.00 | — | — | — |
| MRI of the brain, no contrast dye CPT 70551 HB MRI BRAIN W/O CONTRAST | $3,787.00 | $3,787.00 | — | 35% above | — |
| MRI of the brain, no contrast dye inpatient CPT 70551 HB MRI BRAIN W/O CONTRAST | $3,787.00 | $3,787.00 | — | — | — |
| MRI of the brain, with and without contrast dye CPT 70553 HB MRI BRAIN W&W/O CONTRAST | $4,990.00 | $4,990.00 | — | 23% above | — |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 HB MRI BRAIN W&W/O CONTRAST | $4,990.00 | $4,990.00 | — | — | — |
| MRI of the lower back, no contrast dye CPT 72148 HB MRI LUMBAR W/O CONTRAST | $3,908.00 | $3,908.00 | — | 35% above | — |
| MRI of the lower back, no contrast dye inpatient CPT 72148 HB MRI LUMBAR W/O CONTRAST | $3,908.00 | $3,908.00 | — | — | — |
| MRI of the lower back, without and then with contrast dye CPT 72158 HB MRI LUMBAR SPINE W&W/O CONTR | $5,628.00 | $5,628.00 | — | 38% above | — |
| MRI of the lower back, without and then with contrast dye inpatient CPT 72158 HB MRI LUMBAR SPINE W&W/O CONTR | $5,628.00 | $5,628.00 | — | — | — |
| MRI of the mid back (thoracic spine), no contrast dye CPT 72146 HB MRI THOR SPINE W/O CONTRAST | $4,397.00 | $4,397.00 | — | 53% above | — |
| MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 HB MRI THOR SPINE W/O CONTRAST | $4,397.00 | $4,397.00 | — | — | — |
| MRI of the neck (cervical spine) without and with contrast CPT 72156 HB MRI CERV SPINE W&W/O CONTR | $5,532.00 | $5,532.00 | — | 38% above | — |
| MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 HB MRI CERV SPINE W&W/O CONTR | $5,532.00 | $5,532.00 | — | — | — |
| MRI of the neck (cervical spine), no contrast dye CPT 72141 HB MRI,CERVICAL SPINE W/O CONTRST | $3,974.00 | $3,974.00 | — | 36% above | — |
| MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 HB MRI,CERVICAL SPINE W/O CONTRST | $3,974.00 | $3,974.00 | — | — | — |
| MRI of the pelvis without and with contrast CPT 72197 HB MRI PELVIS W/O & W CONTRAST | $4,014.00 | $4,014.00 | — | 12% above | — |
| MRI of the pelvis without and with contrast inpatient CPT 72197 HB MRI PELVIS W/O & W CONTRAST | $4,014.00 | $4,014.00 | — | — | — |
| MRI of the pelvis, no contrast dye CPT 72195 HB MRI PELVIS W/O CONTRAST | $3,414.00 | $3,414.00 | — | 28% above | — |
| MRI of the pelvis, no contrast dye inpatient CPT 72195 HB MRI PELVIS W/O CONTRAST | $3,414.00 | $3,414.00 | — | — | — |
| MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 HB MRI UPR EXT JOINT W/O CON | $3,680.00 | $3,680.00 | — | 31% above | — |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 HB MRI UPR EXT JOINT W/O CON | $3,680.00 | $3,680.00 | — | — | — |
| Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 HB SPINE CERVICAL, 4 -5 VIEWS | $731.00 | $731.00 | — | 33% above | — |
| Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 HB SPINE CERVICAL, 4 -5 VIEWS | $731.00 | $731.00 | — | — | — |
| Neck soft tissue CT scan with contrast CPT 70491 HB CT NECK(SOFT TISS) W/ CONTRAST | $2,999.00 | $2,999.00 | — | 40% above | — |
| Neck soft tissue CT scan with contrast inpatient CPT 70491 HB CT NECK(SOFT TISS) W/ CONTRAST | $2,999.00 | $2,999.00 | — | — | — |
| Neck soft tissue CT scan without contrast CPT 70490 HB CT NECK(SOFT TISS) W/O CON | $2,786.00 | $2,786.00 | — | 59% above | — |
| Neck soft tissue CT scan without contrast inpatient CPT 70490 HB CT NECK(SOFT TISS) W/O CON | $2,786.00 | $2,786.00 | — | — | — |
| Neck soft tissue X-ray CPT 70360 HB NECK SOFT TISSUE | $462.00 | $462.00 | — | 76% above | — |
| Neck soft tissue X-ray inpatient CPT 70360 HB NECK SOFT TISSUE | $462.00 | $462.00 | — | — | — |
| Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 HB CARDIAC TOMOGRAPHIC (SPECT) MULTIPLE STRESS/REST SCAN | $7,131.00 | $7,131.00 | — | 79% above | — |
| Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 HB CARDIAC TOMOGRAPHIC (SPECT) MULTIPLE STRESS/REST SCAN | $7,131.00 | $7,131.00 | — | — | — |
| OCT scan of the retina (optical coherence tomography) CPT 92134 CMPTR EYE SCAN DX IMG POST SEG; RETINA | $70.00 | $70.00 | — | 25% below | — |
| OCT scan of the retina (optical coherence tomography) inpatient CPT 92134 CMPTR EYE SCAN DX IMG POST SEG; RETINA | $70.00 | $70.00 | — | — | — |
| PET/CT scan from the base of the skull to mid-thigh CPT 78815 HB NM PET CHIN TO THIGH | $10,422.00 | $10,422.00 | — | 76% above | — |
| PET/CT scan from the base of the skull to mid-thigh CPT 78815 HB PET REGISTRY | $10,422.00 | $10,422.00 | — | 76% above | — |
| PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 HB PET REGISTRY | $10,422.00 | $10,422.00 | — | — | — |
| PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 HB NM PET CHIN TO THIGH | $10,422.00 | $10,422.00 | — | — | — |
| Pelvic CT scan without contrast CPT 72192 HB CT PELVIC W/O CONTRAST | $2,114.00 | $2,114.00 | — | 11% above | — |
| Pelvic CT scan without contrast inpatient CPT 72192 HB CT PELVIC W/O CONTRAST | $2,114.00 | $2,114.00 | — | — | — |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 HB US PELVIS LIMIT-F/U | $829.00 | $829.00 | — | 54% above | — |
| Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 HB US PELVIS LIMIT-F/U | $829.00 | $829.00 | — | — | — |
| Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 ULTRA SOUND PELVIS+ | $291.00 | $291.00 | — | 63% below | — |
| Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 HB US PELVIC AREA NON-OB COMPLETE | $1,024.00 | $1,024.00 | — | 29% above | — |
| Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 ULTRA SOUND PELVIS+ | $291.00 | $291.00 | — | — | — |
| Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 HB US PELVIC AREA NON-OB COMPLETE | $1,024.00 | $1,024.00 | — | — | — |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US EXAM, PG UTERUS, COMPL | $257.00 | $257.00 | — | 65% below | — |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 HB US OB COMPLETE, 1ST FETUS | $729.00 | $729.00 | — | 2% below | — |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US EXAM, PG UTERUS, COMPL | $257.00 | $257.00 | — | — | — |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 HB US OB COMPLETE, 1ST FETUS | $729.00 | $729.00 | — | — | — |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 HB 1ST TRIMESTER GENETIC US | $745.00 | $745.00 | — | 11% above | — |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 HB US,EARLY PREG UTERUS COMP | $745.00 | $745.00 | — | 11% above | — |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 HB US,EARLY PREG UTERUS COMP | $745.00 | $745.00 | — | — | — |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 HB 1ST TRIMESTER GENETIC US | $745.00 | $745.00 | — | — | — |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 ULTRA SND, MULT AFT 1ST TRI - PBB ONLY | $179.00 | $179.00 | — | 66% below | — |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 HB US, AMNIO FLD CK/LTD SCAN,1+ FETUS | $756.00 | $756.00 | — | 44% above | — |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 ULTRA SND, MULT AFT 1ST TRI - PBB ONLY | $179.00 | $179.00 | — | — | — |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 HB US, AMNIO FLD CK/LTD SCAN,1+ FETUS | $756.00 | $756.00 | — | — | — |
| Rib X-ray, one side, 2 views one side CPT 71100 HB RIBS, 2 VIEWS UNILATERAL | $539.00 | $539.00 | — | 56% above | — |
| Rib X-ray, one side, 2 views inpatient one side CPT 71100 HB RIBS, 2 VIEWS UNILATERAL | $539.00 | $539.00 | — | — | — |
| Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 HB RIBS UNILATERAL, INCL PA CHEST, MIN 3 VIEWS | $632.00 | $632.00 | — | 31% above | — |
| Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 HB RIBS UNILATERAL, INCL PA CHEST, MIN 3 VIEWS | $632.00 | $632.00 | — | — | — |
| Screening mammogram, both breasts CPT 77067 HB MAM,SCREENING DIGITAL | $422.00 | $422.00 | — | 54% above | — |
| Screening mammogram, both breasts inpatient CPT 77067 HB MAM,SCREENING DIGITAL | $422.00 | $422.00 | — | — | — |
| Shoulder X-ray, complete, 2 or more views CPT 73030 HB SHOULDER COMP 2+ VIEWS | $491.00 | $491.00 | — | 37% above | — |
| Shoulder X-ray, complete, 2 or more views inpatient CPT 73030 HB SHOULDER COMP 2+ VIEWS | $491.00 | $491.00 | — | — | — |
| Sinus X-ray, complete, 3 or more views CPT 70220 HB SINUSES PARANASAL COMPLETE 3+ VIEWS | $738.00 | $738.00 | — | 95% above | — |
| Sinus X-ray, complete, 3 or more views inpatient CPT 70220 HB SINUSES PARANASAL COMPLETE 3+ VIEWS | $738.00 | $738.00 | — | — | — |
| Skull X-ray, fewer than 4 views CPT 70250 HB SKULL LESS THAN 4 VIEWS | $542.00 | $542.00 | — | 76% above | — |
| Skull X-ray, fewer than 4 views inpatient CPT 70250 HB SKULL LESS THAN 4 VIEWS | $542.00 | $542.00 | — | — | — |
| Sleep study in a lab (polysomnography) CPT 95810 HB POLYSOMNOGRAM - INCOMPLETE | $4,927.00 | $4,927.00 | — | 28% above | — |
| Sleep study in a lab (polysomnography) CPT 95810 HB SLEEP-POLYSOMNOGRAPHY W/ 4+ ADDL PARAMETERS | $4,927.00 | $4,927.00 | — | 28% above | — |
| Sleep study in a lab (polysomnography) inpatient CPT 95810 HB POLYSOMNOGRAM - INCOMPLETE | $4,927.00 | $4,927.00 | — | — | — |
| Sleep study in a lab (polysomnography) inpatient CPT 95810 HB SLEEP-POLYSOMNOGRAPHY W/ 4+ ADDL PARAMETERS | $4,927.00 | $4,927.00 | — | — | — |
| Swallow study (modified barium swallow, video X-ray) CPT 74230 HB VIDEO SPEECH SWALLOW STUDY | $932.00 | $932.00 | — | 53% above | — |
| Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 HB VIDEO SPEECH SWALLOW STUDY | $932.00 | $932.00 | — | — | — |
| Thigh bone (femur) X-ray, 2 or more views CPT 73552 HB FEMUR MIN 2 VIEWS | $446.00 | $446.00 | — | 58% above | — |
| Thigh bone (femur) X-ray, 2 or more views inpatient CPT 73552 HB FEMUR MIN 2 VIEWS | $446.00 | $446.00 | — | — | — |
| Thoracic spine (mid back) CT scan without contrast CPT 72128 HB CT THORACIC SPINE W/O CONTRAS | $2,401.00 | $2,401.00 | — | 11% above | — |
| Thoracic spine (mid back) CT scan without contrast inpatient CPT 72128 HB CT THORACIC SPINE W/O CONTRAS | $2,401.00 | $2,401.00 | — | — | — |
| Toe X-ray, 2 or more views CPT 73660 HB TOE(S) MIN 2 VIEWS | $344.00 | $344.00 | — | 51% above | — |
| Toe X-ray, 2 or more views inpatient CPT 73660 HB TOE(S) MIN 2 VIEWS | $344.00 | $344.00 | — | — | — |
| Transvaginal pelvic ultrasound CPT 76830 ULTRASOUND, TRANSVAGINAL | $287.00 | $287.00 | — | 55% below | — |
| Transvaginal pelvic ultrasound CPT 76830 HB US TRANSVAGINAL NON-OB | $584.00 | $584.00 | — | 9% below | — |
| Transvaginal pelvic ultrasound inpatient CPT 76830 ULTRASOUND, TRANSVAGINAL | $287.00 | $287.00 | — | — | — |
| Transvaginal pelvic ultrasound inpatient CPT 76830 HB US TRANSVAGINAL NON-OB | $584.00 | $584.00 | — | — | — |
| Transvaginal ultrasound during pregnancy CPT 76817 ULTRA S PREG UTERUS TRANSVAGINAL | $139.00 | $139.00 | — | 74% below | — |
| Transvaginal ultrasound during pregnancy CPT 76817 HB US, PREG UTERUS TRANSVAGINAL | $596.00 | $596.00 | — | 12% above | — |
| Transvaginal ultrasound during pregnancy inpatient CPT 76817 ULTRA S PREG UTERUS TRANSVAGINAL | $139.00 | $139.00 | — | — | — |
| Transvaginal ultrasound during pregnancy inpatient CPT 76817 HB US, PREG UTERUS TRANSVAGINAL | $596.00 | $596.00 | — | — | — |
| Ultrasound of the abdomen, complete CPT 76700 HB US ABDOMEN COMPLETE | $1,276.00 | $1,276.00 | — | 24% above | — |
| Ultrasound of the abdomen, complete inpatient CPT 76700 HB US ABDOMEN COMPLETE | $1,276.00 | $1,276.00 | — | — | — |
| Ultrasound of the scrotum and testicles CPT 76870 US EXAM, SCROTUM | $242.00 | $242.00 | — | 68% below | — |
| Ultrasound of the scrotum and testicles CPT 76870 HB US SCROTUM & CONTENTS | $1,169.00 | $1,169.00 | — | 56% above | — |
| Ultrasound of the scrotum and testicles inpatient CPT 76870 US EXAM, SCROTUM | $242.00 | $242.00 | — | — | — |
| Ultrasound of the scrotum and testicles inpatient CPT 76870 HB US SCROTUM & CONTENTS | $1,169.00 | $1,169.00 | — | — | — |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US EXAM-HEAD/NECK/THY | $281.00 | $281.00 | — | 59% below | — |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 HB US SOFT TISSUE HEAD & NECK | $987.00 | $987.00 | — | 45% above | — |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US EXAM-HEAD/NECK/THY | $281.00 | $281.00 | — | — | — |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 HB US SOFT TISSUE HEAD & NECK | $987.00 | $987.00 | — | — | — |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 HB UGI SINGLE CONTRAST W OR W/O KUB | $935.00 | $935.00 | — | 35% above | — |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 HB UGI SINGLE CONTRAST W OR W/O KUB | $935.00 | $935.00 | — | — | — |
| Upper arm X-ray (humerus), 2 views CPT 73060 HB HUMERUS, MIN 2 VIEWS | $453.00 | $453.00 | — | 54% above | — |
| Upper arm X-ray (humerus), 2 views inpatient CPT 73060 HB HUMERUS, MIN 2 VIEWS | $453.00 | $453.00 | — | — | — |
| Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 DUPLEX EXTREM VENOUS,UNI OR LTD | $314.00 | $314.00 | — | 56% below | — |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 HB VENOUS DUPLEX IMAGING EXT-RT | $1,168.00 | $1,168.00 | — | 65% above | — |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 HB US DOP EX VEINS LTD/UNILAT | $1,168.00 | $1,168.00 | — | 65% above | — |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 HB VENOUS DUPLEX IMAGING EXT-LT | $1,168.00 | $1,168.00 | — | 65% above | — |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 DUPLEX EXTREM VENOUS,UNI OR LTD | $314.00 | $314.00 | — | — | — |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 HB US DOP EX VEINS LTD/UNILAT | $1,168.00 | $1,168.00 | — | — | — |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 HB VENOUS DUPLEX IMAGING EXT-RT | $1,168.00 | $1,168.00 | — | — | — |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 HB VENOUS DUPLEX IMAGING EXT-LT | $1,168.00 | $1,168.00 | — | — | — |
| Wrist X-ray, 2 views CPT 73100 HB WRIST 2VIEWS | $331.00 | $331.00 | — | 24% above | — |
| Wrist X-ray, 2 views inpatient CPT 73100 HB WRIST 2VIEWS | $331.00 | $331.00 | — | — | — |
| Wrist X-ray, complete, 3 or more views CPT 73110 HB WRIST COMP MIN 3 VIEWS | $407.00 | $407.00 | — | 24% above | — |
| Wrist X-ray, complete, 3 or more views inpatient CPT 73110 HB WRIST COMP MIN 3 VIEWS | $407.00 | $407.00 | — | — | — |
| X-ray of one hip, 2 or 3 views, with the pelvis when included CPT 73502 HB HIP&PEL,MIN 2-3 VWS,INFNT/CHILD | $453.00 | $453.00 | — | 50% above | — |
| X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 HB HIP COMPLETE 2-3 VIEWS UNILATERAL | $453.00 | $453.00 | — | 50% above | — |
| X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient CPT 73502 HB HIP&PEL,MIN 2-3 VWS,INFNT/CHILD | $453.00 | $453.00 | — | — | — |
| X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 HB HIP COMPLETE 2-3 VIEWS UNILATERAL | $453.00 | $453.00 | — | — | — |
| X-ray of the abdomen, 1 view CPT 74018 HB ABDOMEN INFANT | $460.00 | $460.00 | — | 73% above | — |
| X-ray of the abdomen, 1 view CPT 74018 HB ABDOMEN (KUB) ONE VIEW | $460.00 | $460.00 | — | 73% above | — |
| X-ray of the abdomen, 1 view inpatient CPT 74018 HB ABDOMEN INFANT | $460.00 | $460.00 | — | — | — |
| X-ray of the abdomen, 1 view inpatient CPT 74018 HB ABDOMEN (KUB) ONE VIEW | $460.00 | $460.00 | — | — | — |
| X-ray of the ankle, 2 views CPT 73600 HB ANKLE 2 VIEWS | $352.00 | $352.00 | — | 28% above | — |
| X-ray of the ankle, 2 views inpatient CPT 73600 HB ANKLE 2 VIEWS | $352.00 | $352.00 | — | — | — |
| X-ray of the finger(s), 2 or more views CPT 73140 HB FINGER(S) MIN 2 VWS | $341.00 | $341.00 | — | 31% above | — |
| X-ray of the finger(s), 2 or more views inpatient CPT 73140 HB FINGER(S) MIN 2 VWS | $341.00 | $341.00 | — | — | — |
| X-ray of the foot, 2 views CPT 73620 HB FOOT 2 VIEWS | $318.00 | $318.00 | — | 16% above | — |
| X-ray of the foot, 2 views inpatient CPT 73620 HB FOOT 2 VIEWS | $318.00 | $318.00 | — | — | — |
| X-ray of the foot, complete, 3 or more views CPT 73630 HB FOOT COMPL MIN 3 VIEWS | $453.00 | $453.00 | — | 31% above | — |
| X-ray of the foot, complete, 3 or more views inpatient CPT 73630 HB FOOT COMPL MIN 3 VIEWS | $453.00 | $453.00 | — | — | — |
| X-ray of the hand, 3 or more views CPT 73130 HB HAND MIN 3 VIEWS | $453.00 | $453.00 | — | 31% above | — |
| X-ray of the hand, 3 or more views inpatient CPT 73130 HB HAND MIN 3 VIEWS | $453.00 | $453.00 | — | — | — |
| X-ray of the knee, 1 or 2 views CPT 73560 HB KNEE 1-2 VIEWS | $396.00 | $396.00 | — | 37% above | — |
| X-ray of the knee, 1 or 2 views inpatient CPT 73560 HB KNEE 1-2 VIEWS | $396.00 | $396.00 | — | — | — |
| X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 HB SPINE L/S 2-3 VIEWS | $506.00 | $506.00 | — | 14% above | — |
| X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 HB SPINE L/S 2-3 VIEWS | $506.00 | $506.00 | — | — | — |
| X-ray of the lower back, 4 or more views CPT 72110 HB SPINE L/S, MIN 4 VIEWS | $694.00 | $694.00 | — | 20% above | — |
| X-ray of the lower back, 4 or more views inpatient CPT 72110 HB SPINE L/S, MIN 4 VIEWS | $694.00 | $694.00 | — | — | — |
| X-ray of the mid back (thoracic spine), 2 views CPT 72070 HB SPINE, THORACIC, 2 VIEWS | $465.00 | $465.00 | — | 27% above | — |
| X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 HB SPINE, THORACIC, 2 VIEWS | $465.00 | $465.00 | — | — | — |
| X-ray of the nasal bones, 3 or more views CPT 70160 HB NASAL BONES COMPLETE 3+ VIEWS | $503.00 | $503.00 | — | 68% above | — |
| X-ray of the nasal bones, 3 or more views inpatient CPT 70160 HB NASAL BONES COMPLETE 3+ VIEWS | $503.00 | $503.00 | — | — | — |
| X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 HB SPINE CERVICAL 2-3 VIEWS | $514.00 | $514.00 | — | 44% above | — |
| X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 HB SPINE CERVICAL 2-3 VIEWS | $514.00 | $514.00 | — | — | — |
| X-ray of the pelvis, 1 or 2 views CPT 72170 HB PELVIS 1-2 VIEWS | $435.00 | $435.00 | — | 26% above | — |
| X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 HB PELVIS 1-2 VIEWS | $435.00 | $435.00 | — | — | — |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 HB SACRUM AND COCCYX X-RAY | $491.00 | $491.00 | — | 43% above | — |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 HB SACRUM AND COCCYX X-RAY | $491.00 | $491.00 | — | — | — |
Lab tests
| Procedure | Cash price | List price | Insurers pay | vs Illinois | Off list |
|---|---|---|---|---|---|
| ACTH blood test CPT 82024 HB R ACTH | $464.00 | $464.00 | — | 132% above | — |
| ACTH blood test inpatient CPT 82024 HB R ACTH | $464.00 | $464.00 | — | — | — |
| ALT (alanine aminotransferase) liver enzyme test CPT 84460 ALANINE AMINO (ALT)(SGPT)OFFICE PERFORMED | $16.00 | $16.00 | — | 71% below | — |
| ALT (alanine aminotransferase) liver enzyme test CPT 84460 HB SGP TRAUSAMINASE (ALT)* (P) | $70.00 | $70.00 | — | 27% above | — |
| ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 ALANINE AMINO (ALT)(SGPT)OFFICE PERFORMED | $16.00 | $16.00 | — | — | — |
| ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 HB SGP TRAUSAMINASE (ALT)* (P) | $70.00 | $70.00 | — | — | — |
| AST (aspartate aminotransferase) enzyme test CPT 84450 TRANS SEP,AMINO (AST)(SGOT)OFFICE PERFORMED | $15.00 | $15.00 | — | 73% below | — |
| AST (aspartate aminotransferase) enzyme test CPT 84450 HB SGO TRAUSAMINASE (AST)* (P) | $70.00 | $70.00 | — | 27% above | — |
| AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 TRANS SEP,AMINO (AST)(SGOT)OFFICE PERFORMED | $15.00 | $15.00 | — | — | — |
| AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 HB SGO TRAUSAMINASE (AST)* (P) | $70.00 | $70.00 | — | — | — |
| Acute hepatitis panel (hepatitis A, B and C) CPT 80074 HB R HEPATITIS ACUTE PANEL | $212.00 | $212.00 | — | 19% below | — |
| Acute hepatitis panel (hepatitis A, B and C) CPT 80074 HB ACUTE HEPATITIS PANEL | $556.00 | $556.00 | — | 112% above | — |
| Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 HB R HEPATITIS ACUTE PANEL | $212.00 | $212.00 | — | — | — |
| Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 HB ACUTE HEPATITIS PANEL | $556.00 | $556.00 | — | — | — |
| Albumin blood test CPT 82040 HB R ALBUMIN SERUM | $15.00 | $15.00 | — | 65% below | — |
| Albumin blood test CPT 82040 HB ALBUMIN, SERUM (P) | $76.00 | $76.00 | — | 77% above | — |
| Albumin blood test CPT 82040 HB ALBUMIN, SERUM* (P) | $76.00 | $76.00 | — | 77% above | — |
| Albumin blood test inpatient CPT 82040 HB R ALBUMIN SERUM | $15.00 | $15.00 | — | — | — |
| Albumin blood test inpatient CPT 82040 HB ALBUMIN, SERUM (P) | $76.00 | $76.00 | — | — | — |
| Albumin blood test inpatient CPT 82040 HB ALBUMIN, SERUM* (P) | $76.00 | $76.00 | — | — | — |
| Aldosterone blood test CPT 82088 HB R ALDOSTERONE URINE | $412.00 | $412.00 | — | 150% above | — |
| Aldosterone blood test CPT 82088 HB R ALDOSTERONE | $424.00 | $424.00 | — | 157% above | — |
| Aldosterone blood test inpatient CPT 82088 HB R ALDOSTERONE URINE | $412.00 | $412.00 | — | — | — |
| Aldosterone blood test inpatient CPT 82088 HB R ALDOSTERONE | $424.00 | $424.00 | — | — | — |
| Alkaline phosphatase (ALP) blood test CPT 84075 HB R ALKALINE PHOSPHATASE | $16.00 | $16.00 | — | 71% below | — |
| Alkaline phosphatase (ALP) blood test CPT 84075 HB ALKALINE PHOSPHATASE * (P) | $65.00 | $65.00 | — | 18% above | — |
| Alkaline phosphatase (ALP) blood test inpatient CPT 84075 HB R ALKALINE PHOSPHATASE | $16.00 | $16.00 | — | — | — |
| Alkaline phosphatase (ALP) blood test inpatient CPT 84075 HB ALKALINE PHOSPHATASE * (P) | $65.00 | $65.00 | — | — | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 HB ALLERGEN SPECIFIC IGE QUANT OR QUAL EA | $26.00 | $26.00 | — | 5% below | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 HB ALLRGN SPECIFIC IGE, QUANT/SEMI-QUANT, EA | $26.00 | $26.00 | — | 5% below | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 HB R RAST ALLERGEN 1 | $59.00 | $59.00 | — | 115% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 HB R RAST ALLERGEN 2 | $64.00 | $64.00 | — | 133% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 HB R RAST ALLERGEN 3 | $74.00 | $74.00 | — | 169% above | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HB ALLRGN SPECIFIC IGE, QUANT/SEMI-QUANT, EA | $26.00 | $26.00 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HB ALLERGEN SPECIFIC IGE QUANT OR QUAL EA | $26.00 | $26.00 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HB R RAST ALLERGEN 1 | $59.00 | $59.00 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HB R RAST ALLERGEN 2 | $64.00 | $64.00 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HB R RAST ALLERGEN 3 | $74.00 | $74.00 | — | — | — |
| Alpha-fetoprotein (AFP) blood test CPT 82105 HB AFP TUMOR MARKER* | $238.00 | $238.00 | — | 118% above | — |
| Alpha-fetoprotein (AFP) blood test CPT 82105 HB AFP(ALPHA FETO PROTEIN), SERUM | $238.00 | $238.00 | — | 118% above | — |
| Alpha-fetoprotein (AFP) blood test CPT 82105 HB ALPHA-FETO PROTEIN, MATERNAL SERUM | $238.00 | $238.00 | — | 118% above | — |
| Alpha-fetoprotein (AFP) blood test CPT 82105 HB ALPHA-FETOPROTEIN, SERUM (P) | $238.00 | $238.00 | — | 118% above | — |
| Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 HB ALPHA-FETOPROTEIN, SERUM (P) | $238.00 | $238.00 | — | — | — |
| Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 HB AFP TUMOR MARKER* | $238.00 | $238.00 | — | — | — |
| Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 HB ALPHA-FETO PROTEIN, MATERNAL SERUM | $238.00 | $238.00 | — | — | — |
| Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 HB AFP(ALPHA FETO PROTEIN), SERUM | $238.00 | $238.00 | — | — | — |
| Ammonia blood test CPT 82140 HB AMMONIA* | $193.00 | $193.00 | — | 74% above | — |
| Ammonia blood test CPT 82140 HB R AMMONIA; URINE (P) | $228.00 | $228.00 | — | 105% above | — |
| Ammonia blood test inpatient CPT 82140 HB AMMONIA* | $193.00 | $193.00 | — | — | — |
| Ammonia blood test inpatient CPT 82140 HB R AMMONIA; URINE (P) | $228.00 | $228.00 | — | — | — |
| Amylase blood test CPT 82150 HB AMYLASE URINE* (P) | $107.00 | $107.00 | — | 33% above | — |
| Amylase blood test CPT 82150 HB AMYLASE, SERUM * (P) | $110.00 | $110.00 | — | 37% above | — |
| Amylase blood test CPT 82150 HB R AMYLASE ISOENZYMES (P) | $144.00 | $144.00 | — | 79% above | — |
| Amylase blood test inpatient CPT 82150 HB AMYLASE URINE* (P) | $107.00 | $107.00 | — | — | — |
| Amylase blood test inpatient CPT 82150 HB AMYLASE, SERUM * (P) | $110.00 | $110.00 | — | — | — |
| Amylase blood test inpatient CPT 82150 HB R AMYLASE ISOENZYMES (P) | $144.00 | $144.00 | — | — | — |
| Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 HB CCP ANTIBODIES* | $199.00 | $199.00 | — | 137% above | — |
| Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 HB CCP ANTIBODIES | $226.00 | $226.00 | — | 169% above | — |
| Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 HB CCP ANTIBODIES* | $199.00 | $199.00 | — | — | — |
| Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 HB CCP ANTIBODIES | $226.00 | $226.00 | — | — | — |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 HB R ANA SCRN, IFA | $45.00 | $45.00 | — | 51% below | — |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 HB ANA REFLEX | $171.00 | $171.00 | — | 85% above | — |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 HB ANA SCREEN* | $171.00 | $171.00 | — | 85% above | — |
| Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 HB R ANA SCRN, IFA | $45.00 | $45.00 | — | — | — |
| Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 HB ANA REFLEX | $171.00 | $171.00 | — | — | — |
| Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 HB ANA SCREEN* | $171.00 | $171.00 | — | — | — |
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 HB BRAIN NATRIURETIC PEPTIDE* | $234.00 | $234.00 | — | 24% above | — |
| BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 HB BRAIN NATRIURETIC PEPTIDE* | $234.00 | $234.00 | — | — | — |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HB SPUTUM CULTURE* | $192.00 | $192.00 | — | 119% above | — |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HB CULTURE BRONCHOSCOPY* | $192.00 | $192.00 | — | 119% above | — |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HB CULTURE THROAT/NOSE* | $192.00 | $192.00 | — | 119% above | — |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HB CULTURE GENITAL* | $192.00 | $192.00 | — | 119% above | — |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HB CULTURE THROAT* | $192.00 | $192.00 | — | 119% above | — |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HB CULTURE RESPIRATORY, CYSTIC FIBROSIS* | $192.00 | $192.00 | — | 119% above | — |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HB CULTURE NASAL* | $192.00 | $192.00 | — | 119% above | — |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HB CULTURE AEROBIC* (P) | $192.00 | $192.00 | — | 119% above | — |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HB CULTURE CSF* | $192.00 | $192.00 | — | 119% above | — |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HB SW EEH CULTURE BACTERIAL BODY FLUID | $340.00 | $340.00 | — | 288% above | — |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 HB CULTURE NASAL* | $192.00 | $192.00 | — | — | — |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 HB CULTURE GENITAL* | $192.00 | $192.00 | — | — | — |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 HB CULTURE AEROBIC* (P) | $192.00 | $192.00 | — | — | — |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 HB CULTURE THROAT* | $192.00 | $192.00 | — | — | — |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 HB SPUTUM CULTURE* | $192.00 | $192.00 | — | — | — |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 HB CULTURE BRONCHOSCOPY* | $192.00 | $192.00 | — | — | — |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 HB CULTURE RESPIRATORY, CYSTIC FIBROSIS* | $192.00 | $192.00 | — | — | — |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 HB CULTURE CSF* | $192.00 | $192.00 | — | — | — |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 HB CULTURE THROAT/NOSE* | $192.00 | $192.00 | — | — | — |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 HB SW EEH CULTURE BACTERIAL BODY FLUID | $340.00 | $340.00 | — | — | — |
| Basic metabolic panel (blood test) CPT 80048 HB BASIC METABOLIC PANEL* (P) | $162.00 | $162.00 | — | 26% above | — |
| Basic metabolic panel (blood test) inpatient CPT 80048 HB BASIC METABOLIC PANEL* (P) | $162.00 | $162.00 | — | — | — |
| Bilirubin blood test, total CPT 82247 HB BILIRUBIN TOTAL, NEONATAL* (P) | $69.00 | $69.00 | — | 12% above | — |
| Bilirubin blood test, total CPT 82247 HB BILIRUBIN, TOTAL* (P) | $69.00 | $69.00 | — | 12% above | — |
| Bilirubin blood test, total CPT 82247 HB BILIRUBIN TOTAL, WHOLE BLOOD | $104.00 | $104.00 | — | 69% above | — |
| Bilirubin blood test, total inpatient CPT 82247 HB BILIRUBIN TOTAL, NEONATAL* (P) | $69.00 | $69.00 | — | — | — |
| Bilirubin blood test, total inpatient CPT 82247 HB BILIRUBIN, TOTAL* (P) | $69.00 | $69.00 | — | — | — |
| Bilirubin blood test, total inpatient CPT 82247 HB BILIRUBIN TOTAL, WHOLE BLOOD | $104.00 | $104.00 | — | — | — |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 HB SW PATHOLOGY LEVEL IV | $471.00 | $471.00 | — | 92% above | — |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 HB PATHOLOGY DIAG,CELL BLOCK* | $484.00 | $484.00 | — | 98% above | — |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 HB PATHOLOGY DIAGNOSIS, LEVEL-4* | $484.00 | $484.00 | — | 98% above | — |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 HB GROSS EXAMINATION TISSUE LEVEL IV (P) | $484.00 | $484.00 | — | 98% above | — |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 HB CYTOLOGY,CELL BLOCK | $484.00 | $484.00 | — | 98% above | — |
| Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 HB SW PATHOLOGY LEVEL IV | $471.00 | $471.00 | — | — | — |
| Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 HB PATHOLOGY DIAGNOSIS, LEVEL-4* | $484.00 | $484.00 | — | — | — |
| Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 HB CYTOLOGY,CELL BLOCK | $484.00 | $484.00 | — | — | — |
| Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 HB PATHOLOGY DIAG,CELL BLOCK* | $484.00 | $484.00 | — | — | — |
| Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 HB GROSS EXAMINATION TISSUE LEVEL IV (P) | $484.00 | $484.00 | — | — | — |
| Blood culture for bacteria CPT 87040 HB CULTURE BLOOD* | $297.00 | $297.00 | — | 105% above | — |
| Blood culture for bacteria CPT 87040 HB CULTURE DONOR UNIT | $297.00 | $297.00 | — | 105% above | — |
| Blood culture for bacteria CPT 87040 HB BLOOD CULTURE, ISOLATOR METHOD* | $297.00 | $297.00 | — | 105% above | — |
| Blood culture for bacteria inpatient CPT 87040 HB CULTURE BLOOD* | $297.00 | $297.00 | — | — | — |
| Blood culture for bacteria inpatient CPT 87040 HB BLOOD CULTURE, ISOLATOR METHOD* | $297.00 | $297.00 | — | — | — |
| Blood culture for bacteria inpatient CPT 87040 HB CULTURE DONOR UNIT | $297.00 | $297.00 | — | — | — |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 VENIPUNCTURE BLOOD DRAW | $31.00 | $31.00 | — | 32% above | — |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 HB PHLEBOTOMY CHARGE | $31.00 | $31.00 | — | 32% above | — |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 HB BLOOD DRAW PHLEBOTOMY | $31.00 | $31.00 | — | 32% above | — |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 HB VENIPUNCTURE LAB DRAW-ENDO LAB | $31.00 | $31.00 | — | 32% above | — |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 HB VENIPUNCTURE LAB DRAW-ENDO LAB | $31.00 | $31.00 | — | — | — |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 VENIPUNCTURE BLOOD DRAW | $31.00 | $31.00 | — | — | — |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 HB BLOOD DRAW PHLEBOTOMY | $31.00 | $31.00 | — | — | — |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 HB PHLEBOTOMY CHARGE | $31.00 | $31.00 | — | — | — |
| Blood glucose (sugar) test CPT 82947 ASSAY QUANTITATIVE,GLUCOSE OFFICE PERFORMED | $32.00 | $32.00 | — | 22% below | — |
| Blood glucose (sugar) test CPT 82947 HB GLUCOSE, I-STAT (P) | $73.00 | $73.00 | — | 78% above | — |
| Blood glucose (sugar) test CPT 82947 HB GLUCOSE-WHOLE BLOOD(P) | $73.00 | $73.00 | — | 78% above | — |
| Blood glucose (sugar) test CPT 82947 HB GLUCOSE 1HR POST MEAL* | $73.00 | $73.00 | — | 78% above | — |
| Blood glucose (sugar) test CPT 82947 HB GLUCOSE * (P) | $73.00 | $73.00 | — | 78% above | — |
| Blood glucose (sugar) test inpatient CPT 82947 ASSAY QUANTITATIVE,GLUCOSE OFFICE PERFORMED | $32.00 | $32.00 | — | — | — |
| Blood glucose (sugar) test inpatient CPT 82947 HB GLUCOSE 1HR POST MEAL* | $73.00 | $73.00 | — | — | — |
| Blood glucose (sugar) test inpatient CPT 82947 HB GLUCOSE-WHOLE BLOOD(P) | $73.00 | $73.00 | — | — | — |
| Blood glucose (sugar) test inpatient CPT 82947 HB GLUCOSE, I-STAT (P) | $73.00 | $73.00 | — | — | — |
| Blood glucose (sugar) test inpatient CPT 82947 HB GLUCOSE * (P) | $73.00 | $73.00 | — | — | — |
| Blood lead test CPT 83655 ASSAY FOR LEAD | $26.00 | $26.00 | — | 53% below | — |
| Blood lead test CPT 83655 HB R LEAD | $52.00 | $52.00 | — | 5% below | — |
| Blood lead test CPT 83655 HB LEAD LEVEL* | $133.00 | $133.00 | — | 143% above | — |
| Blood lead test CPT 83655 HB R LEAD HAIR | $158.00 | $158.00 | — | 189% above | — |
| Blood lead test CPT 83655 HB R LEAD (UR) | $184.00 | $184.00 | — | 236% above | — |
| Blood lead test inpatient CPT 83655 ASSAY FOR LEAD | $26.00 | $26.00 | — | — | — |
| Blood lead test inpatient CPT 83655 HB R LEAD | $52.00 | $52.00 | — | — | — |
| Blood lead test inpatient CPT 83655 HB LEAD LEVEL* | $133.00 | $133.00 | — | — | — |
| Blood lead test inpatient CPT 83655 HB R LEAD HAIR | $158.00 | $158.00 | — | — | — |
| Blood lead test inpatient CPT 83655 HB R LEAD (UR) | $184.00 | $184.00 | — | — | — |
| Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 CHORIONIC GONADOTROPIN ASSAY OFFICE PERFORM | $16.00 | $16.00 | — | 82% below | — |
| Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 HB SW EEH GONADOTROPIN CHORIONIC (HCG) QUAL | $108.00 | $108.00 | — | 20% above | — |
| Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 CHORIONIC GONADOTROPIN ASSAY OFFICE PERFORM | $16.00 | $16.00 | — | — | — |
| Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 HB SW EEH GONADOTROPIN CHORIONIC (HCG) QUAL | $108.00 | $108.00 | — | — | — |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 HB BLOOD GROUP (ABO)* (P) | $64.00 | $64.00 | — | 24% below | — |
| Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 HB BLOOD GROUP (ABO)* (P) | $64.00 | $64.00 | — | — | — |
| Blood urea nitrogen (BUN) test CPT 84520 HB BUN POST DIALYSIS* | $88.00 | $88.00 | — | 82% above | — |
| Blood urea nitrogen (BUN) test CPT 84520 HB UREA NITROGEN (BUN)* (P) | $88.00 | $88.00 | — | 82% above | — |
| Blood urea nitrogen (BUN) test inpatient CPT 84520 HB BUN POST DIALYSIS* | $88.00 | $88.00 | — | — | — |
| Blood urea nitrogen (BUN) test inpatient CPT 84520 HB UREA NITROGEN (BUN)* (P) | $88.00 | $88.00 | — | — | — |
| C-peptide blood test CPT 84681 HB R C-PEPTIDE,URINE | $183.00 | $183.00 | — | 77% above | — |
| C-peptide blood test CPT 84681 HB R C-PEPTIDE LAB | $214.00 | $214.00 | — | 107% above | — |
| C-peptide blood test CPT 84681 HB C-PEPTIDE | $214.00 | $214.00 | — | 107% above | — |
| C-peptide blood test inpatient CPT 84681 HB R C-PEPTIDE,URINE | $183.00 | $183.00 | — | — | — |
| C-peptide blood test inpatient CPT 84681 HB C-PEPTIDE | $214.00 | $214.00 | — | — | — |
| C-peptide blood test inpatient CPT 84681 HB R C-PEPTIDE LAB | $214.00 | $214.00 | — | — | — |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 HB R C-REACTIVE PROTEIN | $35.00 | $35.00 | — | 50% below | — |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 HB C-REACTIVE PROTEIN* (P) | $119.00 | $119.00 | — | 69% above | — |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 HB R C-REACTIVE PROTEIN | $35.00 | $35.00 | — | — | — |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 HB C-REACTIVE PROTEIN* (P) | $119.00 | $119.00 | — | — | — |
| C. difficile toxin gene test (stool PCR) CPT 87493 HB C DIFFICILE DETECTION PCR | $180.00 | $180.00 | — | 2% below | — |
| C. difficile toxin gene test (stool PCR) CPT 87493 HB C. DIFFICILE ADMISSION SCREEN | $180.00 | $180.00 | — | 2% below | — |
| C. difficile toxin gene test (stool PCR) inpatient CPT 87493 HB C. DIFFICILE ADMISSION SCREEN | $180.00 | $180.00 | — | — | — |
| C. difficile toxin gene test (stool PCR) inpatient CPT 87493 HB C DIFFICILE DETECTION PCR | $180.00 | $180.00 | — | — | — |
| CA 19-9 blood test (tumor marker) CPT 86301 HB CA 19 -9 | $97.00 | $97.00 | — | 13% below | — |
| CA 19-9 blood test (tumor marker) CPT 86301 HB R CA-19-9 | $269.00 | $269.00 | — | 140% above | — |
| CA 19-9 blood test (tumor marker) inpatient CPT 86301 HB CA 19 -9 | $97.00 | $97.00 | — | — | — |
| CA 19-9 blood test (tumor marker) inpatient CPT 86301 HB R CA-19-9 | $269.00 | $269.00 | — | — | — |
| CA-125 blood test (ovarian cancer marker) CPT 86304 HB CA-125* | $298.00 | $298.00 | — | 85% above | — |
| CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 HB CA-125* | $298.00 | $298.00 | — | — | — |
| COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 HB LIAT SARS-COV-2 AMP PRB TCHNQ | $167.00 | $167.00 | — | 45% above | — |
| COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 HB R 2019 NOVEL CORONAVIRUS COVID-19, NAA | $175.00 | $175.00 | — | 52% above | — |
| COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 HB COVID19 (CORONAVIRUS), HI THROUGHPUT, NON CDC | $230.00 | $230.00 | — | 99% above | — |
| COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 HB LIAT SARS-COV-2 AMP PRB TCHNQ | $167.00 | $167.00 | — | — | — |
| COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 HB R 2019 NOVEL CORONAVIRUS COVID-19, NAA | $175.00 | $175.00 | — | — | — |
| COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 HB COVID19 (CORONAVIRUS), HI THROUGHPUT, NON CDC | $230.00 | $230.00 | — | — | — |
| Calcium blood test, total CPT 82310 HB R CALCIUM; TOTAL (P) | $67.00 | $67.00 | — | 53% above | — |
| Calcium blood test, total CPT 82310 HB CALCIUM * (P) | $67.00 | $67.00 | — | 53% above | — |
| Calcium blood test, total inpatient CPT 82310 HB R CALCIUM; TOTAL (P) | $67.00 | $67.00 | — | — | — |
| Calcium blood test, total inpatient CPT 82310 HB CALCIUM * (P) | $67.00 | $67.00 | — | — | — |
| Carcinoembryonic antigen (CEA) test CPT 82378 HB CEA-CARCINOEMBRYONIC ANTIGE* | $252.00 | $252.00 | — | 76% above | — |
| Carcinoembryonic antigen (CEA) test inpatient CPT 82378 HB CEA-CARCINOEMBRYONIC ANTIGE* | $252.00 | $252.00 | — | — | — |
| Chickenpox (varicella) immunity blood test CPT 86787 HB R VZV-IG M | $152.00 | $152.00 | — | 110% above | — |
| Chickenpox (varicella) immunity blood test CPT 86787 HB VARICELLA ZOSTER VIRUS-IGG* | $152.00 | $152.00 | — | 110% above | — |
| Chickenpox (varicella) immunity blood test inpatient CPT 86787 HB VARICELLA ZOSTER VIRUS-IGG* | $152.00 | $152.00 | — | — | — |
| Chickenpox (varicella) immunity blood test inpatient CPT 86787 HB R VZV-IG M | $152.00 | $152.00 | — | — | — |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 HB CHLAMYDIA DNA-PCR* (P) | $183.00 | $183.00 | — | 48% above | — |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 HB CHLAMYDIA DNA-PCR* (P) | $183.00 | $183.00 | — | — | — |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PANEL OFFICE PERFORMED | $43.00 | $43.00 | — | 66% below | — |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 HB LIPID PANEL* | $141.00 | $141.00 | — | 12% above | — |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PANEL OFFICE PERFORMED | $43.00 | $43.00 | — | — | — |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 HB LIPID PANEL* | $141.00 | $141.00 | — | — | — |
| Complete blood count (CBC) with differential CPT 85025 HB HEMOGRAM/AUTO DIFF* | $106.00 | $106.00 | — | 29% above | — |
| Complete blood count (CBC) with differential inpatient CPT 85025 HB HEMOGRAM/AUTO DIFF* | $106.00 | $106.00 | — | — | — |
| Complete blood count (CBC), no differential CPT 85027 HB CBC/PLATELET* (P) | $64.00 | $64.00 | — | 2% below | — |
| Complete blood count (CBC), no differential inpatient CPT 85027 HB CBC/PLATELET* (P) | $64.00 | $64.00 | — | — | — |
| Comprehensive metabolic panel (blood test) CPT 80053 CARDIO OFFICE PERFORMED/RESULTED CMP LAB TEST | $45.00 | $45.00 | — | 71% below | — |
| Comprehensive metabolic panel (blood test) CPT 80053 HB COMPREHENSIVE METABOLIC PANEL* | $190.00 | $190.00 | — | 23% above | — |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 CARDIO OFFICE PERFORMED/RESULTED CMP LAB TEST | $45.00 | $45.00 | — | — | — |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 HB COMPREHENSIVE METABOLIC PANEL* | $190.00 | $190.00 | — | — | — |
| Cortisol blood test, total CPT 82533 HB R CORTISOL, SALIVA | $129.00 | $129.00 | — | 15% above | — |
| Cortisol blood test, total CPT 82533 HB CORTISOL TOTAL, SERUM* (P) | $230.00 | $230.00 | — | 104% above | — |
| Cortisol blood test, total CPT 82533 HB R CORTISOL, TOTAL (P) | $314.00 | $314.00 | — | 179% above | — |
| Cortisol blood test, total inpatient CPT 82533 HB R CORTISOL, SALIVA | $129.00 | $129.00 | — | — | — |
| Cortisol blood test, total inpatient CPT 82533 HB CORTISOL TOTAL, SERUM* (P) | $230.00 | $230.00 | — | — | — |
| Cortisol blood test, total inpatient CPT 82533 HB R CORTISOL, TOTAL (P) | $314.00 | $314.00 | — | — | — |
| Creatine kinase (CK) blood test, total CPT 82550 HB R CREATINE KINASE (CPK) | $37.00 | $37.00 | — | 40% below | — |
| Creatine kinase (CK) blood test, total CPT 82550 HB CREATINE KINASE (CPK)* | $105.00 | $105.00 | — | 71% above | — |
| Creatine kinase (CK) blood test, total inpatient CPT 82550 HB R CREATINE KINASE (CPK) | $37.00 | $37.00 | — | — | — |
| Creatine kinase (CK) blood test, total inpatient CPT 82550 HB CREATINE KINASE (CPK)* | $105.00 | $105.00 | — | — | — |
| Creatinine blood test CPT 82565 HB CREATININE * (P) | $77.00 | $77.00 | — | 62% above | — |
| Creatinine blood test CPT 82565 HB CREATININE POC | $78.00 | $78.00 | — | 64% above | — |
| Creatinine blood test CPT 82565 HB R CREATININE; BLOOD (P) | $85.00 | $85.00 | — | 79% above | — |
| Creatinine blood test inpatient CPT 82565 HB CREATININE * (P) | $77.00 | $77.00 | — | — | — |
| Creatinine blood test inpatient CPT 82565 HB CREATININE POC | $78.00 | $78.00 | — | — | — |
| Creatinine blood test inpatient CPT 82565 HB R CREATININE; BLOOD (P) | $85.00 | $85.00 | — | — | — |
| Cytomegalovirus (CMV) antibody test CPT 86644 HB R CYTOMEGALOVIRUS (CMV) IGG | $169.00 | $169.00 | — | 93% above | — |
| Cytomegalovirus (CMV) antibody test CPT 86644 HB CMV-IGG* (P) | $262.00 | $262.00 | — | 199% above | — |
| Cytomegalovirus (CMV) antibody test inpatient CPT 86644 HB R CYTOMEGALOVIRUS (CMV) IGG | $169.00 | $169.00 | — | — | — |
| Cytomegalovirus (CMV) antibody test inpatient CPT 86644 HB CMV-IGG* (P) | $262.00 | $262.00 | — | — | — |
| D-dimer blood test (blood clot marker) CPT 85379 HB D-DIMER, QUANT* | $142.00 | $142.00 | — | 19% above | — |
| D-dimer blood test (blood clot marker) inpatient CPT 85379 HB D-DIMER, QUANT* | $142.00 | $142.00 | — | — | — |
| DHEA sulfate (DHEA-S) blood test CPT 82627 HB R DHEA SULFATE (P) | $461.00 | $461.00 | — | 319% above | — |
| DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 HB R DHEA SULFATE (P) | $461.00 | $461.00 | — | — | — |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 HB PHENYLCYLIDINE (PCP)* (P) | $71.00 | $71.00 | — | 29% below | — |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 HB OPIATES* (P) | $71.00 | $71.00 | — | 29% below | — |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 HB BARBITURATES SCREEN* (P) | $71.00 | $71.00 | — | 29% below | — |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 HB DRUG SCREEN, METHADONE* (P) | $71.00 | $71.00 | — | 29% below | — |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 HB BENZODIAZEPINES SCREEN* (P) | $71.00 | $71.00 | — | 29% below | — |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 HB AMPHETAMINES SCREEN* (P) | $71.00 | $71.00 | — | 29% below | — |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 HB COCAINE METAB. SCREEN* (P) | $71.00 | $71.00 | — | 29% below | — |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 HB MARIJUANA SCREEN* (P) | $71.00 | $71.00 | — | 29% below | — |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 HB R PAIN CLINIC IMMUNOASSY PANEL, UR | $88.00 | $88.00 | — | 12% below | — |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 HB R CORD PHOSPHATIDYL | $117.00 | $117.00 | — | 17% above | — |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 HB R AMPHETAMINE TOXASSURE UR | $126.00 | $126.00 | — | 26% above | — |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 HB SALICYLATE ASSAY* | $131.00 | $131.00 | — | 31% above | — |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 HB R DRG SCN MULT DRG BLD OR UR | $155.00 | $155.00 | — | 55% above | — |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 HB ALCOHOL/ETHANOL* | $195.00 | $195.00 | — | 95% above | — |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 HB R ETHYL GLUCURONIDE SCREEN, UR | $214.00 | $214.00 | — | 114% above | — |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 HB R DRUG SCREEN, DIURETIC | $275.00 | $275.00 | — | 175% above | — |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 HB R CORD DRUG SCRN - 5 CMPNT PNL | $282.00 | $282.00 | — | 182% above | — |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 HB ACETAMINOPHEN/TYLENOL ASSAY* | $295.00 | $295.00 | — | 195% above | — |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 HB R CORD DRUG SCRN - 7 CMPNT PNL | $330.00 | $330.00 | — | 230% above | — |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 HB R GAMMA-HYDROXYBUTYRIC ACID, SERUM/URINE | $356.00 | $356.00 | — | 256% above | — |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 HB R KETAMINE W METABOLITES SCREEN, SERUM | $363.00 | $363.00 | — | 263% above | — |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 HB R CANNABINOIDS, SYNTHETIC | $363.00 | $363.00 | — | 263% above | — |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 HB R CANNABINOIDS, WHOLE BLOOD | $363.00 | $363.00 | — | 263% above | — |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 HB R CORD DRUG SCRN - 9 CMPNT PNL | $384.00 | $384.00 | — | 284% above | — |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 HB R KETAMINE W METABOLITES, CNFRM, URINE | $398.00 | $398.00 | — | 298% above | — |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 HB URINE DRUG ABUSE PNL 6 | $400.00 | $400.00 | — | 300% above | — |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 HB R CORD DRUG SCRN - 12 CMPNT PNL | $408.00 | $408.00 | — | 308% above | — |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 HB R DRG SCN MULT DRG,BLD | $431.00 | $431.00 | — | 331% above | — |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 HB R MECONIUM DRUG ABUSE SCREEN | $436.00 | $436.00 | — | 336% above | — |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 HB R DRG SCN MULT DRG CLS,GASTRI | $439.00 | $439.00 | — | 339% above | — |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 HB R CORD DRUG SCRN - 13 CMPNT PNL | $460.00 | $460.00 | — | 360% above | — |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 HB SW URINE DRUG ABUSE PNL COC | $497.00 | $497.00 | — | 397% above | — |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 HB URINE DRUG ABUSE PNL 8 | $512.00 | $512.00 | — | 412% above | — |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 HB R CORD TISSUE DRUG SCRN 15 CMPNT PNL | $587.00 | $587.00 | — | 487% above | — |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 HB R DRG SCN MULT DRG CLS,BLD,UR | $615.00 | $615.00 | — | 515% above | — |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HB BARBITURATES SCREEN* (P) | $71.00 | $71.00 | — | — | — |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HB OPIATES* (P) | $71.00 | $71.00 | — | — | — |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HB MARIJUANA SCREEN* (P) | $71.00 | $71.00 | — | — | — |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HB PHENYLCYLIDINE (PCP)* (P) | $71.00 | $71.00 | — | — | — |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HB COCAINE METAB. SCREEN* (P) | $71.00 | $71.00 | — | — | — |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HB AMPHETAMINES SCREEN* (P) | $71.00 | $71.00 | — | — | — |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HB DRUG SCREEN, METHADONE* (P) | $71.00 | $71.00 | — | — | — |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HB BENZODIAZEPINES SCREEN* (P) | $71.00 | $71.00 | — | — | — |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HB R PAIN CLINIC IMMUNOASSY PANEL, UR | $88.00 | $88.00 | — | — | — |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HB R CORD PHOSPHATIDYL | $117.00 | $117.00 | — | — | — |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HB R AMPHETAMINE TOXASSURE UR | $126.00 | $126.00 | — | — | — |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HB SALICYLATE ASSAY* | $131.00 | $131.00 | — | — | — |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HB R DRG SCN MULT DRG BLD OR UR | $155.00 | $155.00 | — | — | — |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HB ALCOHOL/ETHANOL* | $195.00 | $195.00 | — | — | — |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HB R ETHYL GLUCURONIDE SCREEN, UR | $214.00 | $214.00 | — | — | — |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HB R DRUG SCREEN, DIURETIC | $275.00 | $275.00 | — | — | — |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HB R CORD DRUG SCRN - 5 CMPNT PNL | $282.00 | $282.00 | — | — | — |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HB ACETAMINOPHEN/TYLENOL ASSAY* | $295.00 | $295.00 | — | — | — |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HB R CORD DRUG SCRN - 7 CMPNT PNL | $330.00 | $330.00 | — | — | — |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HB R GAMMA-HYDROXYBUTYRIC ACID, SERUM/URINE | $356.00 | $356.00 | — | — | — |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HB R CANNABINOIDS, WHOLE BLOOD | $363.00 | $363.00 | — | — | — |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HB R KETAMINE W METABOLITES SCREEN, SERUM | $363.00 | $363.00 | — | — | — |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HB R CANNABINOIDS, SYNTHETIC | $363.00 | $363.00 | — | — | — |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HB R CORD DRUG SCRN - 9 CMPNT PNL | $384.00 | $384.00 | — | — | — |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HB R KETAMINE W METABOLITES, CNFRM, URINE | $398.00 | $398.00 | — | — | — |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HB URINE DRUG ABUSE PNL 6 | $400.00 | $400.00 | — | — | — |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HB R CORD DRUG SCRN - 12 CMPNT PNL | $408.00 | $408.00 | — | — | — |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HB R DRG SCN MULT DRG,BLD | $431.00 | $431.00 | — | — | — |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HB R MECONIUM DRUG ABUSE SCREEN | $436.00 | $436.00 | — | — | — |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HB R DRG SCN MULT DRG CLS,GASTRI | $439.00 | $439.00 | — | — | — |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HB R CORD DRUG SCRN - 13 CMPNT PNL | $460.00 | $460.00 | — | — | — |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HB SW URINE DRUG ABUSE PNL COC | $497.00 | $497.00 | — | — | — |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HB URINE DRUG ABUSE PNL 8 | $512.00 | $512.00 | — | — | — |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HB R CORD TISSUE DRUG SCRN 15 CMPNT PNL | $587.00 | $587.00 | — | — | — |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HB R DRG SCN MULT DRG CLS,BLD,UR | $615.00 | $615.00 | — | — | — |
| Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 HB ELECTROLYTES* | $149.00 | $149.00 | — | 54% above | — |
| Electrolyte panel (sodium, potassium, chloride, CO2) inpatient CPT 80051 HB ELECTROLYTES* | $149.00 | $149.00 | — | — | — |
| Epstein-Barr virus (EBV) antibody test CPT 86665 HB R EBV-VCA (P) | $240.00 | $240.00 | — | 122% above | — |
| Epstein-Barr virus (EBV) antibody test CPT 86665 HB EBV VIRAL CAPSID (VCA) | $247.00 | $247.00 | — | 129% above | — |
| Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 HB R EBV-VCA (P) | $240.00 | $240.00 | — | — | — |
| Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 HB EBV VIRAL CAPSID (VCA) | $247.00 | $247.00 | — | — | — |
| Estradiol blood test CPT 82670 HB ESTRADIOL* | $259.00 | $259.00 | — | 142% above | — |
| Estradiol blood test CPT 82670 HB R ESTRADOL-ICMA (P) | $310.00 | $310.00 | — | 190% above | — |
| Estradiol blood test inpatient CPT 82670 HB ESTRADIOL* | $259.00 | $259.00 | — | — | — |
| Estradiol blood test inpatient CPT 82670 HB R ESTRADOL-ICMA (P) | $310.00 | $310.00 | — | — | — |
| FSH (follicle-stimulating hormone) test CPT 83001 GONADOTROPIN (FSH) OFFICE PERFORMED | $48.00 | $48.00 | — | 60% below | — |
| FSH (follicle-stimulating hormone) test CPT 83001 HB FOLLICLE STIMULATING HORMONE* | $242.00 | $242.00 | — | 103% above | — |
| FSH (follicle-stimulating hormone) test CPT 83001 HB R FSH-ICMA (P) | $316.00 | $316.00 | — | 165% above | — |
| FSH (follicle-stimulating hormone) test inpatient CPT 83001 GONADOTROPIN (FSH) OFFICE PERFORMED | $48.00 | $48.00 | — | — | — |
| FSH (follicle-stimulating hormone) test inpatient CPT 83001 HB FOLLICLE STIMULATING HORMONE* | $242.00 | $242.00 | — | — | — |
| FSH (follicle-stimulating hormone) test inpatient CPT 83001 HB R FSH-ICMA (P) | $316.00 | $316.00 | — | — | — |
| Fecal calprotectin (stool inflammation test) CPT 83993 HB CALPROTECTIN STOOL | $63.00 | $63.00 | — | 64% below | — |
| Fecal calprotectin (stool inflammation test) CPT 83993 HB R CALPROTECTIN STOOL | $380.00 | $380.00 | — | 117% above | — |
| Fecal calprotectin (stool inflammation test) inpatient CPT 83993 HB CALPROTECTIN STOOL | $63.00 | $63.00 | — | — | — |
| Fecal calprotectin (stool inflammation test) inpatient CPT 83993 HB R CALPROTECTIN STOOL | $380.00 | $380.00 | — | — | — |
| Ferritin blood test (iron stores) CPT 82728 HB FERRITIN* | $198.00 | $198.00 | — | 52% above | — |
| Ferritin blood test (iron stores) CPT 82728 HB R FERRITIN (P) | $242.00 | $242.00 | — | 86% above | — |
| Ferritin blood test (iron stores) inpatient CPT 82728 HB FERRITIN* | $198.00 | $198.00 | — | — | — |
| Ferritin blood test (iron stores) inpatient CPT 82728 HB R FERRITIN (P) | $242.00 | $242.00 | — | — | — |
| Fibrinogen blood test CPT 85384 HB FIBRINOGEN ACTIVITY* (P) | $88.00 | $88.00 | — | 5% above | — |
| Fibrinogen blood test inpatient CPT 85384 HB FIBRINOGEN ACTIVITY* (P) | $88.00 | $88.00 | — | — | — |
| Folate (folic acid) blood test CPT 82746 HB FOLIC ACID/FOLATE* | $189.00 | $189.00 | — | 68% above | — |
| Folate (folic acid) blood test inpatient CPT 82746 HB FOLIC ACID/FOLATE* | $189.00 | $189.00 | — | — | — |
| Free T3 thyroid hormone test CPT 84481 HB R T3 FREE BY DIALYSIS LC-MS | $80.00 | $80.00 | — | 34% below | — |
| Free T3 thyroid hormone test CPT 84481 HB FREE T3* | $200.00 | $200.00 | — | 65% above | — |
| Free T3 thyroid hormone test inpatient CPT 84481 HB R T3 FREE BY DIALYSIS LC-MS | $80.00 | $80.00 | — | — | — |
| Free T3 thyroid hormone test inpatient CPT 84481 HB FREE T3* | $200.00 | $200.00 | — | — | — |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 HB THYROXINE, FREE* | $177.00 | $177.00 | — | 53% above | — |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 HB R THYROXINE (T4); FREE BY DIALYSIS (P) | $177.00 | $177.00 | — | 53% above | — |
| Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 HB R THYROXINE (T4); FREE BY DIALYSIS (P) | $177.00 | $177.00 | — | — | — |
| Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 HB THYROXINE, FREE* | $177.00 | $177.00 | — | — | — |
| Free testosterone test CPT 84402 HB R TESTOSTERONE, FREE (P) | $230.00 | $230.00 | — | 84% above | — |
| Free testosterone test CPT 84402 HB R TESTOSTERONE, FREE (P) | $237.00 | $237.00 | — | 90% above | — |
| Free testosterone test inpatient CPT 84402 HB R TESTOSTERONE, FREE (P) | $230.00 | $230.00 | — | — | — |
| Free testosterone test inpatient CPT 84402 HB R TESTOSTERONE, FREE (P) | $237.00 | $237.00 | — | — | — |
| Gamma-glutamyl transferase (GGT) blood test CPT 82977 HB GAMMA GLUTOMYLTRANSFERASE* | $78.00 | $78.00 | — | 35% above | — |
| Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 HB GAMMA GLUTOMYLTRANSFERASE* | $78.00 | $78.00 | — | — | — |
| General health panel: metabolic panel, blood count and TSH in one order CPT 80050 HB GENERAL HEALTH PANEL | $377.00 | $377.00 | — | 25% above | — |
| General health panel: metabolic panel, blood count and TSH in one order inpatient CPT 80050 HB GENERAL HEALTH PANEL | $377.00 | $377.00 | — | — | — |
| Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GLUCOSE TEST OFFICE PERFORMED | $15.00 | $15.00 | — | 75% below | — |
| Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 HB GLUCOSE 1HR PP* | $91.00 | $91.00 | — | 52% above | — |
| Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 HB GLUCOSE 2HR PP* | $91.00 | $91.00 | — | 52% above | — |
| Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 HB GLUCOSE 2HR POST MEAL* | $91.00 | $91.00 | — | 52% above | — |
| Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 GLUCOSE TEST OFFICE PERFORMED | $15.00 | $15.00 | — | — | — |
| Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 HB GLUCOSE 2HR PP* | $91.00 | $91.00 | — | — | — |
| Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 HB GLUCOSE 2HR POST MEAL* | $91.00 | $91.00 | — | — | — |
| Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 HB GLUCOSE 1HR PP* | $91.00 | $91.00 | — | — | — |
| Glucose tolerance test, 3 samples CPT 82951 GLUCOSE TOLERANCE TEST OFFICE PERFORMED | $40.00 | $40.00 | — | 70% below | — |
| Glucose tolerance test, 3 samples CPT 82951 HB GLUCOSE TOLERANCE-3 SPEC* (P) | $175.00 | $175.00 | — | 30% above | — |
| Glucose tolerance test, 3 samples CPT 82951 HB LACTOSE TOLERANCE-3 SPEC* | $175.00 | $175.00 | — | 30% above | — |
| Glucose tolerance test, 3 samples inpatient CPT 82951 GLUCOSE TOLERANCE TEST OFFICE PERFORMED | $40.00 | $40.00 | — | — | — |
| Glucose tolerance test, 3 samples inpatient CPT 82951 HB GLUCOSE TOLERANCE-3 SPEC* (P) | $175.00 | $175.00 | — | — | — |
| Glucose tolerance test, 3 samples inpatient CPT 82951 HB LACTOSE TOLERANCE-3 SPEC* | $175.00 | $175.00 | — | — | — |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 HB NEISSERIA GONORRHEA DNA PCR (P) | $172.00 | $172.00 | — | 42% above | — |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 HB NEISSERIA GONORRHEA DNA PCR (P) | $172.00 | $172.00 | — | — | — |
| H. pylori antibody blood test CPT 86677 HB HELICOBACTOR PYLORI AB* | $176.00 | $176.00 | — | 51% above | — |
| H. pylori antibody blood test inpatient CPT 86677 HB HELICOBACTOR PYLORI AB* | $176.00 | $176.00 | — | — | — |
| H. pylori stool antigen test CPT 87338 HB H PYLORI AG STOOL | $79.00 | $79.00 | — | 32% below | — |
| H. pylori stool antigen test CPT 87338 HB R HELICOBACTER PYLORI ANTIGEN, STOOL | $224.00 | $224.00 | — | 93% above | — |
| H. pylori stool antigen test inpatient CPT 87338 HB H PYLORI AG STOOL | $79.00 | $79.00 | — | — | — |
| H. pylori stool antigen test inpatient CPT 87338 HB R HELICOBACTER PYLORI ANTIGEN, STOOL | $224.00 | $224.00 | — | — | — |
| HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HB R HIV-1 RNA DETECT, PCR | $255.00 | $255.00 | — | 25% below | — |
| HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HB HIV-1 QUANTITATION | $424.00 | $424.00 | — | 25% above | — |
| HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HB R HIV-1 RNA DETECT, ULTRASENS, PCR | $527.00 | $527.00 | — | 55% above | — |
| HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HB R HIV-1 RNA DETECT, PCR | $255.00 | $255.00 | — | — | — |
| HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HB HIV-1 QUANTITATION | $424.00 | $424.00 | — | — | — |
| HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HB R HIV-1 RNA DETECT, ULTRASENS, PCR | $527.00 | $527.00 | — | — | — |
| HIV-1 and HIV-2 antibody test CPT 86703 HB HIV 1/2 AB WITHOUT INTERP.* (P) | $167.00 | $167.00 | — | 42% above | — |
| HIV-1 and HIV-2 antibody test inpatient CPT 86703 HB HIV 1/2 AB WITHOUT INTERP.* (P) | $167.00 | $167.00 | — | — | — |
| HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HB HIV 1/2 AB AND AG | $119.00 | $119.00 | — | 3% above | — |
| HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HB HIV 1/2 AB AND AG | $119.00 | $119.00 | — | — | — |
| HPV test for high-risk types, one combined (pooled) result CPT 87624 HB HPV RISK GROUP B (P)* | $210.00 | $210.00 | — | 45% above | — |
| HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HB HPV RISK GROUP B (P)* | $210.00 | $210.00 | — | — | — |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 GLYCOSYLATED HB/HGB AIC,BL OFFICE PERFORMED | $30.00 | $30.00 | — | 66% below | — |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HB GLYCOSYLATED HEMOGLOBIN* | $165.00 | $165.00 | — | 85% above | — |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HB POC - HEMOGLOBIN A1C | $165.00 | $165.00 | — | 85% above | — |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 GLYCOSYLATED HB/HGB AIC,BL OFFICE PERFORMED | $30.00 | $30.00 | — | — | — |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HB GLYCOSYLATED HEMOGLOBIN* | $165.00 | $165.00 | — | — | — |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HB POC - HEMOGLOBIN A1C | $165.00 | $165.00 | — | — | — |
| Hemoglobin blood test CPT 85018 HEMOGLOBIN OFFICE PERFORMED | $9.00 | $9.00 | — | 71% below | — |
| Hemoglobin blood test CPT 85018 HB HEMOGLOBIN* (P) | $53.00 | $53.00 | — | 70% above | — |
| Hemoglobin blood test CPT 85018 HB TOTAL HEMOGLOBIN | $53.00 | $53.00 | — | 70% above | — |
| Hemoglobin blood test CPT 85018 HB HEMOCUE HEMOGLOB. ER | $53.00 | $53.00 | — | 70% above | — |
| Hemoglobin blood test CPT 85018 HB HEMOGLOBIN POC | $53.00 | $53.00 | — | 70% above | — |
| Hemoglobin blood test inpatient CPT 85018 HEMOGLOBIN OFFICE PERFORMED | $9.00 | $9.00 | — | — | — |
| Hemoglobin blood test inpatient CPT 85018 HB TOTAL HEMOGLOBIN | $53.00 | $53.00 | — | — | — |
| Hemoglobin blood test inpatient CPT 85018 HB HEMOGLOBIN POC | $53.00 | $53.00 | — | — | — |
| Hemoglobin blood test inpatient CPT 85018 HB HEMOGLOBIN* (P) | $53.00 | $53.00 | — | — | — |
| Hemoglobin blood test inpatient CPT 85018 HB HEMOCUE HEMOGLOB. ER | $53.00 | $53.00 | — | — | — |
| Hepatitis B core antibody test (total) CPT 86704 HB R HEPATITIS B CORE AB, TOTAL | $54.00 | $54.00 | — | 32% below | — |
| Hepatitis B core antibody test (total) CPT 86704 HB HEPATITIS B CORE AB, TOTAL | $69.00 | $69.00 | — | 14% below | — |
| Hepatitis B core antibody test (total) CPT 86704 HB R HEPATITIS B CORE-IGG & IGM | $272.00 | $272.00 | — | 240% above | — |
| Hepatitis B core antibody test (total) inpatient CPT 86704 HB R HEPATITIS B CORE AB, TOTAL | $54.00 | $54.00 | — | — | — |
| Hepatitis B core antibody test (total) inpatient CPT 86704 HB HEPATITIS B CORE AB, TOTAL | $69.00 | $69.00 | — | — | — |
| Hepatitis B core antibody test (total) inpatient CPT 86704 HB R HEPATITIS B CORE-IGG & IGM | $272.00 | $272.00 | — | — | — |
| Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HB R HEPATITIS B SURFACE AB | $47.00 | $47.00 | — | 50% below | — |
| Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HB HEPATITIS B SURF. AB* (P) | $160.00 | $160.00 | — | 71% above | — |
| Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HB HEPATITIS B SURFACE AB.QUANT | $179.00 | $179.00 | — | 91% above | — |
| Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HB R HEPATITIS B SURFACE AB | $47.00 | $47.00 | — | — | — |
| Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HB HEPATITIS B SURF. AB* (P) | $160.00 | $160.00 | — | — | — |
| Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HB HEPATITIS B SURFACE AB.QUANT | $179.00 | $179.00 | — | — | — |
| Hepatitis B surface antigen (HBsAg) test CPT 87340 HB R HEPATITIS B SURFACE AG | $45.00 | $45.00 | — | 49% below | — |
| Hepatitis B surface antigen (HBsAg) test CPT 87340 HB HEPATITIS B SURF. AG* (P) | $192.00 | $192.00 | — | 119% above | — |
| Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HB R HEPATITIS B SURFACE AG | $45.00 | $45.00 | — | — | — |
| Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HB HEPATITIS B SURF. AG* (P) | $192.00 | $192.00 | — | — | — |
| Hepatitis C antibody blood test (screening) CPT 86803 HB R HEPATITIS C AB | $64.00 | $64.00 | — | 43% below | — |
| Hepatitis C antibody blood test (screening) CPT 86803 HB HEPATITIS C ANTIBODY DIAGNOSTIC | $212.00 | $212.00 | — | 89% above | — |
| Hepatitis C antibody blood test (screening) inpatient CPT 86803 HB R HEPATITIS C AB | $64.00 | $64.00 | — | — | — |
| Hepatitis C antibody blood test (screening) inpatient CPT 86803 HB HEPATITIS C ANTIBODY DIAGNOSTIC | $212.00 | $212.00 | — | — | — |
| Hepatitis C viral load (HCV RNA) test CPT 87522 HB R HCV RNA DETECT, QUANT, PCR | $195.00 | $195.00 | — | 26% below | — |
| Hepatitis C viral load (HCV RNA) test CPT 87522 HB HCV RNA DETECT QUANT | $312.00 | $312.00 | — | 18% above | — |
| Hepatitis C viral load (HCV RNA) test CPT 87522 HB R HCV RNA DETECT, QUANT | $540.00 | $540.00 | — | 104% above | — |
| Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HB R HCV RNA DETECT, QUANT, PCR | $195.00 | $195.00 | — | — | — |
| Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HB HCV RNA DETECT QUANT | $312.00 | $312.00 | — | — | — |
| Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HB R HCV RNA DETECT, QUANT | $540.00 | $540.00 | — | — | — |
| Herpes blood test, HSV-1 antibody CPT 86695 HB R HSV IGG TYPE 1 (P) | $95.00 | $95.00 | — | 41% above | — |
| Herpes blood test, HSV-1 antibody inpatient CPT 86695 HB R HSV IGG TYPE 1 (P) | $95.00 | $95.00 | — | — | — |
| Herpes blood test, HSV-2 antibody CPT 86696 HB R HSV-IGG TYPE 2 (P) | $107.00 | $107.00 | — | 20% above | — |
| Herpes blood test, HSV-2 antibody inpatient CPT 86696 HB R HSV-IGG TYPE 2 (P) | $107.00 | $107.00 | — | — | — |
| High-sensitivity CRP (hs-CRP) test CPT 86141 HB CRP, HIGH SENSITIVITY (HSCRP)* | $124.00 | $124.00 | — | 34% above | — |
| High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 HB CRP, HIGH SENSITIVITY (HSCRP)* | $124.00 | $124.00 | — | — | — |
| Homocysteine blood test CPT 83090 HB R HOMOCYSTEINE | $75.00 | $75.00 | — | 38% below | — |
| Homocysteine blood test CPT 83090 HB HOMOCYSTEINE* | $222.00 | $222.00 | — | 84% above | — |
| Homocysteine blood test CPT 83090 HB R HOMOCYSTINE, TOTAL URINE | $298.00 | $298.00 | — | 147% above | — |
| Homocysteine blood test inpatient CPT 83090 HB R HOMOCYSTEINE | $75.00 | $75.00 | — | — | — |
| Homocysteine blood test inpatient CPT 83090 HB HOMOCYSTEINE* | $222.00 | $222.00 | — | — | — |
| Homocysteine blood test inpatient CPT 83090 HB R HOMOCYSTINE, TOTAL URINE | $298.00 | $298.00 | — | — | — |
| Insulin blood test CPT 83525 HB INSULIN, TOTAL* (P) | $124.00 | $124.00 | — | 70% above | — |
| Insulin blood test CPT 83525 HB R INSULIN,TOTAL (P) | $143.00 | $143.00 | — | 96% above | — |
| Insulin blood test inpatient CPT 83525 HB INSULIN, TOTAL* (P) | $124.00 | $124.00 | — | — | — |
| Insulin blood test inpatient CPT 83525 HB R INSULIN,TOTAL (P) | $143.00 | $143.00 | — | — | — |
| Iron blood test (serum iron) CPT 83540 HB IRON * | $106.00 | $106.00 | — | 37% above | — |
| Iron blood test (serum iron) CPT 83540 HB R IRON, URINE | $106.00 | $106.00 | — | 37% above | — |
| Iron blood test (serum iron) inpatient CPT 83540 HB R IRON, URINE | $106.00 | $106.00 | — | — | — |
| Iron blood test (serum iron) inpatient CPT 83540 HB IRON * | $106.00 | $106.00 | — | — | — |
| Iron-binding capacity (TIBC) test CPT 83550 HB TOTAL IRON BINDING CAPACITY* | $130.00 | $130.00 | — | 65% above | — |
| Iron-binding capacity (TIBC) test inpatient CPT 83550 HB TOTAL IRON BINDING CAPACITY* | $130.00 | $130.00 | — | — | — |
| Kidney function blood test panel CPT 80069 HB RENAL FUNCTION PANEL* | $238.00 | $238.00 | — | 60% above | — |
| Kidney function blood test panel inpatient CPT 80069 HB RENAL FUNCTION PANEL* | $238.00 | $238.00 | — | — | — |
| LH (luteinizing hormone) test CPT 83002 GONADOTROPHIN OFFICE PERFORMED | $48.00 | $48.00 | — | 58% below | — |
| LH (luteinizing hormone) test CPT 83002 HB LUTEINIZING HORMONE* | $265.00 | $265.00 | — | 131% above | — |
| LH (luteinizing hormone) test CPT 83002 HB R LH-ICMA (P) | $305.00 | $305.00 | — | 166% above | — |
| LH (luteinizing hormone) test inpatient CPT 83002 GONADOTROPHIN OFFICE PERFORMED | $48.00 | $48.00 | — | — | — |
| LH (luteinizing hormone) test inpatient CPT 83002 HB LUTEINIZING HORMONE* | $265.00 | $265.00 | — | — | — |
| LH (luteinizing hormone) test inpatient CPT 83002 HB R LH-ICMA (P) | $305.00 | $305.00 | — | — | — |
| Lactate (lactic acid) blood test CPT 83605 LACTIC ACID ASSAY OFFICE PERFORMED | $23.00 | $23.00 | — | 74% below | — |
| Lactate (lactic acid) blood test CPT 83605 HB LACTIC ACID/LACTATE* | $165.00 | $165.00 | — | 84% above | — |
| Lactate (lactic acid) blood test CPT 83605 HB LACTIC ACID (P) | $189.00 | $189.00 | — | 110% above | — |
| Lactate (lactic acid) blood test inpatient CPT 83605 LACTIC ACID ASSAY OFFICE PERFORMED | $23.00 | $23.00 | — | — | — |
| Lactate (lactic acid) blood test inpatient CPT 83605 HB LACTIC ACID/LACTATE* | $165.00 | $165.00 | — | — | — |
| Lactate (lactic acid) blood test inpatient CPT 83605 HB LACTIC ACID (P) | $189.00 | $189.00 | — | — | — |
| Lactate dehydrogenase (LDH) blood test CPT 83615 HB LDH * | $71.00 | $71.00 | — | 32% above | — |
| Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 HB LDH * | $71.00 | $71.00 | — | — | — |
| Lipase blood test (pancreas enzyme) CPT 83690 HB LIPASE* | $123.00 | $123.00 | — | 38% above | — |
| Lipase blood test (pancreas enzyme) inpatient CPT 83690 HB LIPASE* | $123.00 | $123.00 | — | — | — |
| Liver function blood test panel CPT 80076 HB HEPATIC FUNCTION PANEL* | $172.00 | $172.00 | — | 24% above | — |
| Liver function blood test panel inpatient CPT 80076 HB HEPATIC FUNCTION PANEL* | $172.00 | $172.00 | — | — | — |
| Lyme disease antibody test CPT 86618 LYME DISEASE ANTIBODY OFFICE PERFORMED | $46.00 | $46.00 | — | 37% below | — |
| Lyme disease antibody test CPT 86618 HB R LYME DISEASE AB, IGG | $71.00 | $71.00 | — | 2% below | — |
| Lyme disease antibody test CPT 86618 HB R BORRELIA B IGG/M AB PANEL (P) | $179.00 | $179.00 | — | 147% above | — |
| Lyme disease antibody test CPT 86618 HB R LYME DISEASE AB | $343.00 | $343.00 | — | 373% above | — |
| Lyme disease antibody test inpatient CPT 86618 LYME DISEASE ANTIBODY OFFICE PERFORMED | $46.00 | $46.00 | — | — | — |
| Lyme disease antibody test inpatient CPT 86618 HB R LYME DISEASE AB, IGG | $71.00 | $71.00 | — | — | — |
| Lyme disease antibody test inpatient CPT 86618 HB R BORRELIA B IGG/M AB PANEL (P) | $179.00 | $179.00 | — | — | — |
| Lyme disease antibody test inpatient CPT 86618 HB R LYME DISEASE AB | $343.00 | $343.00 | — | — | — |
| Magnesium blood test CPT 83735 HB MAGNESIUM URINE* | $110.00 | $110.00 | — | 62% above | — |
| Magnesium blood test CPT 83735 HB MAGNESIUM * | $118.00 | $118.00 | — | 74% above | — |
| Magnesium blood test CPT 83735 HB R MAGNESIUM (P) | $123.00 | $123.00 | — | 81% above | — |
| Magnesium blood test CPT 83735 HB R FECAL MAGNESIUM (P) | $123.00 | $123.00 | — | 81% above | — |
| Magnesium blood test CPT 83735 HB R RBC MAGNESIUM | $129.00 | $129.00 | — | 90% above | — |
| Magnesium blood test inpatient CPT 83735 HB MAGNESIUM URINE* | $110.00 | $110.00 | — | — | — |
| Magnesium blood test inpatient CPT 83735 HB MAGNESIUM * | $118.00 | $118.00 | — | — | — |
| Magnesium blood test inpatient CPT 83735 HB R FECAL MAGNESIUM (P) | $123.00 | $123.00 | — | — | — |
| Magnesium blood test inpatient CPT 83735 HB R MAGNESIUM (P) | $123.00 | $123.00 | — | — | — |
| Magnesium blood test inpatient CPT 83735 HB R RBC MAGNESIUM | $129.00 | $129.00 | — | — | — |
| Measles (rubeola) antibody test CPT 86765 HB R MEASLES (RUBEOLA) AB, IGM | $57.00 | $57.00 | — | 24% below | — |
| Measles (rubeola) antibody test CPT 86765 HB MEASLES-IGG BY EIA* | $74.00 | $74.00 | — | 1% below | — |
| Measles (rubeola) antibody test inpatient CPT 86765 HB R MEASLES (RUBEOLA) AB, IGM | $57.00 | $57.00 | — | — | — |
| Measles (rubeola) antibody test inpatient CPT 86765 HB MEASLES-IGG BY EIA* | $74.00 | $74.00 | — | — | — |
| Mono test (heterophile antibody, Monospot) CPT 86308 HETEROPHILE ANTIBODIES,SCREEN OFFICE PERFOR | $16.00 | $16.00 | — | 79% below | — |
| Mono test (heterophile antibody, Monospot) CPT 86308 HB INF. MONO SLIDE* | $81.00 | $81.00 | — | 5% above | — |
| Mono test (heterophile antibody, Monospot) inpatient CPT 86308 HETEROPHILE ANTIBODIES,SCREEN OFFICE PERFOR | $16.00 | $16.00 | — | — | — |
| Mono test (heterophile antibody, Monospot) inpatient CPT 86308 HB INF. MONO SLIDE* | $81.00 | $81.00 | — | — | — |
| Mumps immunity blood test CPT 86735 HB R MUMPS AB, IGM | $59.00 | $59.00 | — | 21% below | — |
| Mumps immunity blood test CPT 86735 HB MUMPS-IG G* | $83.00 | $83.00 | — | 11% above | — |
| Mumps immunity blood test inpatient CPT 86735 HB R MUMPS AB, IGM | $59.00 | $59.00 | — | — | — |
| Mumps immunity blood test inpatient CPT 86735 HB MUMPS-IG G* | $83.00 | $83.00 | — | — | — |
| Obstetric blood test panel CPT 80055 HB OBSTETRIC PANEL* | $324.00 | $324.00 | — | 54% above | — |
| Obstetric blood test panel inpatient CPT 80055 HB OBSTETRIC PANEL* | $324.00 | $324.00 | — | — | — |
| PSA (prostate-specific antigen) blood test, free CPT 84154 HB PSA, FREE (P) | $158.00 | $158.00 | — | 62% above | — |
| PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 HB PSA, FREE (P) | $158.00 | $158.00 | — | — | — |
| PSA (prostate-specific antigen) blood test, total CPT 84153 HB PSA SCREENING* | $85.00 | $85.00 | — | 25% below | — |
| PSA (prostate-specific antigen) blood test, total CPT 84153 HB PSA DIAGNOSTIC* (P) | $238.00 | $238.00 | — | 110% above | — |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 HB PSA SCREENING* | $85.00 | $85.00 | — | — | — |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 HB PSA DIAGNOSTIC* (P) | $238.00 | $238.00 | — | — | — |
| Pap test (liquid-based, automated screening with review) CPT 88175 HB THIN PREP PAP SCREENING/AUTO SCRN | $160.00 | $160.00 | — | 21% above | — |
| Pap test (liquid-based, automated screening with review) CPT 88175 HB THIN PREP PAP DIAGNOSTIC/AUTO SCRN | $174.00 | $174.00 | — | 31% above | — |
| Pap test (liquid-based, automated screening with review) inpatient CPT 88175 HB THIN PREP PAP SCREENING/AUTO SCRN | $160.00 | $160.00 | — | — | — |
| Pap test (liquid-based, automated screening with review) inpatient CPT 88175 HB THIN PREP PAP DIAGNOSTIC/AUTO SCRN | $174.00 | $174.00 | — | — | — |
| Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 HB THIN PREP PAP DIAGNOSTIC/MANUAL SCRN | $160.00 | $160.00 | — | 42% above | — |
| Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 HB THIN PREP PAP SCREENING/MANUAL SCRN | $160.00 | $160.00 | — | 42% above | — |
| Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 HB THIN PREP PAP SCREENING/MANUAL SCRN | $160.00 | $160.00 | — | — | — |
| Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 HB THIN PREP PAP DIAGNOSTIC/MANUAL SCRN | $160.00 | $160.00 | — | — | — |
| Parathyroid hormone (PTH) blood test CPT 83970 HB PARATHORMONE (PTH) INTACT* (P) | $358.00 | $358.00 | — | 59% above | — |
| Parathyroid hormone (PTH) blood test inpatient CPT 83970 HB PARATHORMONE (PTH) INTACT* (P) | $358.00 | $358.00 | — | — | — |
| Partial thromboplastin time (PTT) clotting test CPT 85730 HB HEPARIN ABSORBED APTT* | $115.00 | $115.00 | — | 77% above | — |
| Partial thromboplastin time (PTT) clotting test CPT 85730 HB PTT(PART THROM TIME)* (P) | $123.00 | $123.00 | — | 89% above | — |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 HB HEPARIN ABSORBED APTT* | $115.00 | $115.00 | — | — | — |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 HB PTT(PART THROM TIME)* (P) | $123.00 | $123.00 | — | — | — |
| Phosphorus (phosphate) blood test CPT 84100 HB PHOSPHORUS * | $55.00 | $55.00 | — | 6% below | — |
| Phosphorus (phosphate) blood test CPT 84100 HB R PHOSPHORUS; INORGANIC (PHOSPHATE) (P) | $72.00 | $72.00 | — | 23% above | — |
| Phosphorus (phosphate) blood test CPT 84100 HB R PHOSPHORUS, STOOL | $72.00 | $72.00 | — | 23% above | — |
| Phosphorus (phosphate) blood test inpatient CPT 84100 HB PHOSPHORUS * | $55.00 | $55.00 | — | — | — |
| Phosphorus (phosphate) blood test inpatient CPT 84100 HB R PHOSPHORUS; INORGANIC (PHOSPHATE) (P) | $72.00 | $72.00 | — | — | — |
| Phosphorus (phosphate) blood test inpatient CPT 84100 HB R PHOSPHORUS, STOOL | $72.00 | $72.00 | — | — | — |
| Potassium blood test CPT 84132 HB R POTASSIUM; SERUM (P) | $66.00 | $66.00 | — | 53% above | — |
| Potassium blood test CPT 84132 HB POTASSIUM, WHOLE BLOOD* | $67.00 | $67.00 | — | 55% above | — |
| Potassium blood test CPT 84132 HB POTASSIUM EMER CSU LAB (P) | $67.00 | $67.00 | — | 55% above | — |
| Potassium blood test CPT 84132 HB POTASSIUM, I-STAT (P) | $67.00 | $67.00 | — | 55% above | — |
| Potassium blood test CPT 84132 HB POTASSIUM * (P) | $67.00 | $67.00 | — | 55% above | — |
| Potassium blood test inpatient CPT 84132 HB R POTASSIUM; SERUM (P) | $66.00 | $66.00 | — | — | — |
| Potassium blood test inpatient CPT 84132 HB POTASSIUM EMER CSU LAB (P) | $67.00 | $67.00 | — | — | — |
| Potassium blood test inpatient CPT 84132 HB POTASSIUM, I-STAT (P) | $67.00 | $67.00 | — | — | — |
| Potassium blood test inpatient CPT 84132 HB POTASSIUM * (P) | $67.00 | $67.00 | — | — | — |
| Potassium blood test inpatient CPT 84132 HB POTASSIUM, WHOLE BLOOD* | $67.00 | $67.00 | — | — | — |
| Progesterone blood test CPT 84144 HB PROGESTERONE* | $170.00 | $170.00 | — | 21% above | — |
| Progesterone blood test CPT 84144 HB R PROGESTERONE (P) | $218.00 | $218.00 | — | 56% above | — |
| Progesterone blood test inpatient CPT 84144 HB PROGESTERONE* | $170.00 | $170.00 | — | — | — |
| Progesterone blood test inpatient CPT 84144 HB R PROGESTERONE (P) | $218.00 | $218.00 | — | — | — |
| Prolactin blood test CPT 84146 HB R MACROPROLACTIN | $140.00 | $140.00 | — | 9% above | — |
| Prolactin blood test CPT 84146 HB PROLACTIN* | $213.00 | $213.00 | — | 66% above | — |
| Prolactin blood test CPT 84146 HB R PROLACTIN (P) | $242.00 | $242.00 | — | 89% above | — |
| Prolactin blood test inpatient CPT 84146 HB R MACROPROLACTIN | $140.00 | $140.00 | — | — | — |
| Prolactin blood test inpatient CPT 84146 HB PROLACTIN* | $213.00 | $213.00 | — | — | — |
| Prolactin blood test inpatient CPT 84146 HB R PROLACTIN (P) | $242.00 | $242.00 | — | — | — |
| Prothrombin time (PT/INR) clotting test CPT 85610 PT(PROTHROMBIN TIME),BL OFFICE PERFORMED | $12.00 | $12.00 | — | 71% below | — |
| Prothrombin time (PT/INR) clotting test CPT 85610 HB POC - INR | $53.00 | $53.00 | — | 26% above | — |
| Prothrombin time (PT/INR) clotting test CPT 85610 HB POC INR - RX | $53.00 | $53.00 | — | 26% above | — |
| Prothrombin time (PT/INR) clotting test CPT 85610 HB PT(PROTHROMBIN TIME)* (P) | $53.00 | $53.00 | — | 26% above | — |
| Prothrombin time (PT/INR) clotting test CPT 85610 HB PT/INR-TAU | $53.00 | $53.00 | — | 26% above | — |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PT(PROTHROMBIN TIME),BL OFFICE PERFORMED | $12.00 | $12.00 | — | — | — |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 HB POC - INR | $53.00 | $53.00 | — | — | — |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 HB PT(PROTHROMBIN TIME)* (P) | $53.00 | $53.00 | — | — | — |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 HB PT/INR-TAU | $53.00 | $53.00 | — | — | — |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 HB POC INR - RX | $53.00 | $53.00 | — | — | — |
| Rapid flu test (influenza antigen) CPT 87804 INFLUENZA ASSAY W/OPTIC OFFICE PERFORMED | $35.00 | $35.00 | — | 51% below | — |
| Rapid flu test (influenza antigen) inpatient CPT 87804 INFLUENZA ASSAY W/OPTIC OFFICE PERFORMED | $35.00 | $35.00 | — | — | — |
| Rapid strep A antigen test from a throat swab, read visually CPT 87880 STREP A ASSAY W/OPTIC OFFICE PERFORMED | $49.00 | $49.00 | — | 19% below | — |
| Rapid strep A antigen test from a throat swab, read visually CPT 87880 HB STREP SCREEN ONLY-ER | $116.00 | $116.00 | — | 92% above | — |
| Rapid strep A antigen test from a throat swab, read visually CPT 87880 HB RAPID STREP A TEST IN OFFICE | $116.00 | $116.00 | — | 92% above | — |
| Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 STREP A ASSAY W/OPTIC OFFICE PERFORMED | $49.00 | $49.00 | — | — | — |
| Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 HB STREP SCREEN ONLY-ER | $116.00 | $116.00 | — | — | — |
| Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 HB RAPID STREP A TEST IN OFFICE | $116.00 | $116.00 | — | — | — |
| Renin blood test CPT 84244 HB R RENIN | $226.00 | $226.00 | — | 97% above | — |
| Renin blood test inpatient CPT 84244 HB R RENIN | $226.00 | $226.00 | — | — | — |
| Rh blood typing CPT 86901 HB RH TYPE* (P) | $75.00 | $75.00 | — | 10% above | — |
| Rh blood typing inpatient CPT 86901 HB RH TYPE* (P) | $75.00 | $75.00 | — | — | — |
| Rheumatoid factor (RF) test CPT 86431 HB RHEUMATOID FACTOR, QUANT* | $130.00 | $130.00 | — | 108% above | — |
| Rheumatoid factor (RF) test inpatient CPT 86431 HB RHEUMATOID FACTOR, QUANT* | $130.00 | $130.00 | — | — | — |
| Rubella antibody test (immunity check) CPT 86762 HB RUBELLA IGG* | $156.00 | $156.00 | — | 109% above | — |
| Rubella antibody test (immunity check) CPT 86762 HB RUBELLA IG M | $163.00 | $163.00 | — | 118% above | — |
| Rubella antibody test (immunity check) inpatient CPT 86762 HB RUBELLA IGG* | $156.00 | $156.00 | — | — | — |
| Rubella antibody test (immunity check) inpatient CPT 86762 HB RUBELLA IG M | $163.00 | $163.00 | — | — | — |
| Semen analysis: volume, sperm count, motility and morphology CPT 89320 HB R SEMEN ANALYSIS, COMPLETE | $225.00 | $225.00 | — | 54% above | — |
| Semen analysis: volume, sperm count, motility and morphology inpatient CPT 89320 HB R SEMEN ANALYSIS, COMPLETE | $225.00 | $225.00 | — | — | — |
| Sodium blood test CPT 84295 HB SODIUM * (P) | $78.00 | $78.00 | — | 59% above | — |
| Sodium blood test CPT 84295 HB SODIUM, I-STAT (P) | $78.00 | $78.00 | — | 59% above | — |
| Sodium blood test CPT 84295 HB R SODIUM; SERUM (P) | $78.00 | $78.00 | — | 59% above | — |
| Sodium blood test CPT 84295 HB SODIUM,EMER,CSU LAB (P) | $123.00 | $123.00 | — | 151% above | — |
| Sodium blood test inpatient CPT 84295 HB R SODIUM; SERUM (P) | $78.00 | $78.00 | — | — | — |
| Sodium blood test inpatient CPT 84295 HB SODIUM, I-STAT (P) | $78.00 | $78.00 | — | — | — |
| Sodium blood test inpatient CPT 84295 HB SODIUM * (P) | $78.00 | $78.00 | — | — | — |
| Sodium blood test inpatient CPT 84295 HB SODIUM,EMER,CSU LAB (P) | $123.00 | $123.00 | — | — | — |
| Stool ova and parasites exam CPT 87177 HB PARASITE IDENTIFICATION | $185.00 | $185.00 | — | 151% above | — |
| Stool ova and parasites exam CPT 87177 HB PARASITE EXAM* | $208.00 | $208.00 | — | 182% above | — |
| Stool ova and parasites exam inpatient CPT 87177 HB PARASITE IDENTIFICATION | $185.00 | $185.00 | — | — | — |
| Stool ova and parasites exam inpatient CPT 87177 HB PARASITE EXAM* | $208.00 | $208.00 | — | — | — |
| Stool test for hidden blood (guaiac FOBT) CPT 82270 OCCULT BLOOD,FECES (OFFICE PERFORMED) | $10.00 | $10.00 | — | 65% below | — |
| Stool test for hidden blood (guaiac FOBT) CPT 82270 HB OCCULT BLOOD, FECES; COLORCTAL NEOPLSM SCREEN | $58.00 | $58.00 | — | 101% above | — |
| Stool test for hidden blood (guaiac FOBT) CPT 82270 HB OCCULT BLOOD, STOOL | $58.00 | $58.00 | — | 101% above | — |
| Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 OCCULT BLOOD,FECES (OFFICE PERFORMED) | $10.00 | $10.00 | — | — | — |
| Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 HB OCCULT BLOOD, FECES; COLORCTAL NEOPLSM SCREEN | $58.00 | $58.00 | — | — | — |
| Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 HB OCCULT BLOOD, STOOL | $58.00 | $58.00 | — | — | — |
| Stool test for hidden blood by immunoassay (FIT) CPT 82274 HB FECAL OCCLT BLD IMMUNOCHEMICAL-DIAGNOSTIC | $76.00 | $76.00 | — | 2% above | — |
| Stool test for hidden blood by immunoassay (FIT) CPT 82274 HB FECAL OCCLT BLD IMMUNOCHEMICAL-SCREEN | $76.00 | $76.00 | — | 2% above | — |
| Stool test for hidden blood by immunoassay (FIT) CPT 82274 HB R FECAL OCC BLD SCREENING IMMUNOCHEMICAL | $229.00 | $229.00 | — | 207% above | — |
| Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 HB FECAL OCCLT BLD IMMUNOCHEMICAL-SCREEN | $76.00 | $76.00 | — | — | — |
| Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 HB FECAL OCCLT BLD IMMUNOCHEMICAL-DIAGNOSTIC | $76.00 | $76.00 | — | — | — |
| Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 HB R FECAL OCC BLD SCREENING IMMUNOCHEMICAL | $229.00 | $229.00 | — | — | — |
| Syphilis antibody test (Treponema pallidum) CPT 86780 HB SYPHILIS AB | $61.00 | $61.00 | — | 8% below | — |
| Syphilis antibody test (Treponema pallidum) CPT 86780 HB R SYPHILIS AB | $76.00 | $76.00 | — | 14% above | — |
| Syphilis antibody test (Treponema pallidum) CPT 86780 HB R IMMUNOASSAY; TREPONEMA PALLIDUM | $121.00 | $121.00 | — | 82% above | — |
| Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 HB SYPHILIS AB | $61.00 | $61.00 | — | — | — |
| Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 HB R SYPHILIS AB | $76.00 | $76.00 | — | — | — |
| Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 HB R IMMUNOASSAY; TREPONEMA PALLIDUM | $121.00 | $121.00 | — | — | — |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 HB RPR* | $80.00 | $80.00 | — | 57% above | — |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 HB R VDRL-CSF | $108.00 | $108.00 | — | 111% above | — |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 HB RPR* | $80.00 | $80.00 | — | — | — |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 HB R VDRL-CSF | $108.00 | $108.00 | — | — | — |
| TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 HB QUANTIFERON TB GOLD | $202.00 | $202.00 | — | 9% below | — |
| TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 HB R QUANTIFERON TB GOLD | $249.00 | $249.00 | — | 13% above | — |
| TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 HB QUANTIFERON TB GOLD | $202.00 | $202.00 | — | — | — |
| TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 HB R QUANTIFERON TB GOLD | $249.00 | $249.00 | — | — | — |
| Testosterone blood test, total (not free testosterone) CPT 84403 HB TESTOSTERONE, TOTAL* | $266.00 | $266.00 | — | 110% above | — |
| Testosterone blood test, total (not free testosterone) CPT 84403 HB R TESTOSTERONE, TOTAL (P) | $271.00 | $271.00 | — | 114% above | — |
| Testosterone blood test, total (not free testosterone) CPT 84403 HB R TESTOSTERONE,TOTAL (P) | $427.00 | $427.00 | — | 237% above | — |
| Testosterone blood test, total (not free testosterone) inpatient CPT 84403 HB TESTOSTERONE, TOTAL* | $266.00 | $266.00 | — | — | — |
| Testosterone blood test, total (not free testosterone) inpatient CPT 84403 HB R TESTOSTERONE, TOTAL (P) | $271.00 | $271.00 | — | — | — |
| Testosterone blood test, total (not free testosterone) inpatient CPT 84403 HB R TESTOSTERONE,TOTAL (P) | $427.00 | $427.00 | — | — | — |
| Thyroid peroxidase (TPO) antibody test CPT 86376 HB ANTI TPO-IGG* | $165.00 | $165.00 | — | 108% above | — |
| Thyroid peroxidase (TPO) antibody test CPT 86376 HB R ATA AB PANEL 2 / ANTI-TPO (P) | $207.00 | $207.00 | — | 161% above | — |
| Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 HB ANTI TPO-IGG* | $165.00 | $165.00 | — | — | — |
| Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 HB R ATA AB PANEL 2 / ANTI-TPO (P) | $207.00 | $207.00 | — | — | — |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 HB THYROID STIMULATING HORMONE/* | $202.00 | $202.00 | — | 71% above | — |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 HB THYROID STIMULATING HORMONE/* | $202.00 | $202.00 | — | — | — |
| Total IgE blood test CPT 82785 HB GAMMAGLOBULIN IGE | $73.00 | $73.00 | — | 17% below | — |
| Total IgE blood test CPT 82785 HB R IMMUNOGLOBULIN,IGE,SER,QT | $247.00 | $247.00 | — | 182% above | — |
| Total IgE blood test inpatient CPT 82785 HB GAMMAGLOBULIN IGE | $73.00 | $73.00 | — | — | — |
| Total IgE blood test inpatient CPT 82785 HB R IMMUNOGLOBULIN,IGE,SER,QT | $247.00 | $247.00 | — | — | — |
| Total cholesterol blood test CPT 82465 ASSAY SERUM CHOLESTEROL OFFICE PERFORMED | $9.00 | $9.00 | — | 79% below | — |
| Total cholesterol blood test CPT 82465 HB CHOLESTEROL * | $71.00 | $71.00 | — | 66% above | — |
| Total cholesterol blood test inpatient CPT 82465 ASSAY SERUM CHOLESTEROL OFFICE PERFORMED | $9.00 | $9.00 | — | — | — |
| Total cholesterol blood test inpatient CPT 82465 HB CHOLESTEROL * | $71.00 | $71.00 | — | — | — |
| Total thyroxine (T4) blood test CPT 84436 HB THYROXINE (T4); TOTAL (P) | $126.00 | $126.00 | — | 54% above | — |
| Total thyroxine (T4) blood test CPT 84436 HB THYROXINE/T4* | $130.00 | $130.00 | — | 59% above | — |
| Total thyroxine (T4) blood test inpatient CPT 84436 HB THYROXINE (T4); TOTAL (P) | $126.00 | $126.00 | — | — | — |
| Total thyroxine (T4) blood test inpatient CPT 84436 HB THYROXINE/T4* | $130.00 | $130.00 | — | — | — |
| Total triiodothyronine (T3) blood test CPT 84480 HB T3 TOTAL* | $196.00 | $196.00 | — | 105% above | — |
| Total triiodothyronine (T3) blood test inpatient CPT 84480 HB T3 TOTAL* | $196.00 | $196.00 | — | — | — |
| Transferrin blood test CPT 84466 HB TRANSFERRIN* | $113.00 | $113.00 | — | 20% above | — |
| Transferrin blood test inpatient CPT 84466 HB TRANSFERRIN* | $113.00 | $113.00 | — | — | — |
| Trichomonas test (NAAT) CPT 87661 HB TRICHOMONAS VAGINALIS, AMPL PRB | $53.00 | $53.00 | — | 57% below | — |
| Trichomonas test (NAAT) CPT 87661 HB R TRICH VAGINALIS DETECT NAA | $156.00 | $156.00 | — | 25% above | — |
| Trichomonas test (NAAT) inpatient CPT 87661 HB TRICHOMONAS VAGINALIS, AMPL PRB | $53.00 | $53.00 | — | — | — |
| Trichomonas test (NAAT) inpatient CPT 87661 HB R TRICH VAGINALIS DETECT NAA | $156.00 | $156.00 | — | — | — |
| Triglycerides blood test CPT 84478 ASSAY TRIGLYCERIDES,BL OFFICE PERFORMED | $15.00 | $15.00 | — | 68% below | — |
| Triglycerides blood test CPT 84478 HB TRIGLYCERIDES * | $79.00 | $79.00 | — | 66% above | — |
| Triglycerides blood test inpatient CPT 84478 ASSAY TRIGLYCERIDES,BL OFFICE PERFORMED | $15.00 | $15.00 | — | — | — |
| Triglycerides blood test inpatient CPT 84478 HB TRIGLYCERIDES * | $79.00 | $79.00 | — | — | — |
| Troponin test, quantitative CPT 84484 HB TROPONIN I QUANT* (P) | $248.00 | $248.00 | — | 63% above | — |
| Troponin test, quantitative CPT 84484 HB TROPONIN T | $248.00 | $248.00 | — | 63% above | — |
| Troponin test, quantitative inpatient CPT 84484 HB TROPONIN T | $248.00 | $248.00 | — | — | — |
| Troponin test, quantitative inpatient CPT 84484 HB TROPONIN I QUANT* (P) | $248.00 | $248.00 | — | — | — |
| Uric acid blood test CPT 84550 HB R URIC ACID; BLOOD (P) | $75.00 | $75.00 | — | 7% above | — |
| Uric acid blood test CPT 84550 HB URIC ACID * | $75.00 | $75.00 | — | 7% above | — |
| Uric acid blood test inpatient CPT 84550 HB R URIC ACID; BLOOD (P) | $75.00 | $75.00 | — | — | — |
| Uric acid blood test inpatient CPT 84550 HB URIC ACID * | $75.00 | $75.00 | — | — | — |
| Urinalysis with microscope exam, automated CPT 81001 HB UA AUTO W/MICROSCOPIC* | $92.00 | $92.00 | — | 44% above | — |
| Urinalysis with microscope exam, automated inpatient CPT 81001 HB UA AUTO W/MICROSCOPIC* | $92.00 | $92.00 | — | — | — |
| Urinalysis with microscope exam, manual CPT 81000 UADIP STK/TBLT RGT;NONAUTO/MICRO | $9.00 | $9.00 | — | 60% below | — |
| Urinalysis with microscope exam, manual CPT 81000 HB UA MACRO (NON-AUTO) W/MIRCROSCOPIC* | $52.00 | $52.00 | — | 131% above | — |
| Urinalysis with microscope exam, manual inpatient CPT 81000 UADIP STK/TBLT RGT;NONAUTO/MICRO | $9.00 | $9.00 | — | — | — |
| Urinalysis with microscope exam, manual inpatient CPT 81000 HB UA MACRO (NON-AUTO) W/MIRCROSCOPIC* | $52.00 | $52.00 | — | — | — |
| Urinalysis without microscope exam, automated CPT 81003 URINE DIPSTICK AUTO OFFICE PERFORMED | $9.00 | $9.00 | — | 64% below | — |
| Urinalysis without microscope exam, automated CPT 81003 HB UA AUTO, MACRO ONLY* | $68.00 | $68.00 | — | 171% above | — |
| Urinalysis without microscope exam, automated CPT 81003 HB URINALYSIS DIPSTICK AUTO | $68.00 | $68.00 | — | 171% above | — |
| Urinalysis without microscope exam, automated inpatient CPT 81003 URINE DIPSTICK AUTO OFFICE PERFORMED | $9.00 | $9.00 | — | — | — |
| Urinalysis without microscope exam, automated inpatient CPT 81003 HB UA AUTO, MACRO ONLY* | $68.00 | $68.00 | — | — | — |
| Urinalysis without microscope exam, automated inpatient CPT 81003 HB URINALYSIS DIPSTICK AUTO | $68.00 | $68.00 | — | — | — |
| Urinalysis without microscope exam, manual CPT 81002 OP URINE DIPSTICK NONAUTO OFFICE PERFORMED | $9.00 | $9.00 | — | 60% below | — |
| Urinalysis without microscope exam, manual CPT 81002 HB UA MACRO SCRN, NON-AUTO | $42.00 | $42.00 | — | 87% above | — |
| Urinalysis without microscope exam, manual CPT 81002 HB SPECIFIC GRAVITY, URINE* | $42.00 | $42.00 | — | 87% above | — |
| Urinalysis without microscope exam, manual CPT 81002 HB UA NON-AUTO MACRO ONLY | $42.00 | $42.00 | — | 87% above | — |
| Urinalysis without microscope exam, manual inpatient CPT 81002 OP URINE DIPSTICK NONAUTO OFFICE PERFORMED | $9.00 | $9.00 | — | — | — |
| Urinalysis without microscope exam, manual inpatient CPT 81002 HB UA MACRO SCRN, NON-AUTO | $42.00 | $42.00 | — | — | — |
| Urinalysis without microscope exam, manual inpatient CPT 81002 HB UA NON-AUTO MACRO ONLY | $42.00 | $42.00 | — | — | — |
| Urinalysis without microscope exam, manual inpatient CPT 81002 HB SPECIFIC GRAVITY, URINE* | $42.00 | $42.00 | — | — | — |
| Urine culture for bacteria, with colony count CPT 87086 HB CULTURE URINE* | $141.00 | $141.00 | — | 54% above | — |
| Urine culture for bacteria, with colony count inpatient CPT 87086 HB CULTURE URINE* | $141.00 | $141.00 | — | — | — |
| Urine microalbumin (albumin) test CPT 82043 HB R MICRO ALBUMIN UR | $38.00 | $38.00 | — | 41% below | — |
| Urine microalbumin (albumin) test CPT 82043 HB MICROALBUMIN URINE QUANT* (P) | $130.00 | $130.00 | — | 102% above | — |
| Urine microalbumin (albumin) test inpatient CPT 82043 HB R MICRO ALBUMIN UR | $38.00 | $38.00 | — | — | — |
| Urine microalbumin (albumin) test inpatient CPT 82043 HB MICROALBUMIN URINE QUANT* (P) | $130.00 | $130.00 | — | — | — |
| Urine pregnancy test, read by color change CPT 81025 URINE PREGNANCY TEST OFFICE PERFORMED | $20.00 | $20.00 | — | 73% below | — |
| Urine pregnancy test, read by color change CPT 81025 HB URINE PREGNANCY TEST | $114.00 | $114.00 | — | 54% above | — |
| Urine pregnancy test, read by color change CPT 81025 HB PREGNANCY URINE COLOR COMP | $114.00 | $114.00 | — | 54% above | — |
| Urine pregnancy test, read by color change CPT 81025 HB PREGNANCY URINE, COLOR COMP* | $114.00 | $114.00 | — | 54% above | — |
| Urine pregnancy test, read by color change CPT 81025 HB PREGNANCY, UR, COLOR COMP | $114.00 | $114.00 | — | 54% above | — |
| Urine pregnancy test, read by color change inpatient CPT 81025 URINE PREGNANCY TEST OFFICE PERFORMED | $20.00 | $20.00 | — | — | — |
| Urine pregnancy test, read by color change inpatient CPT 81025 HB PREGNANCY URINE, COLOR COMP* | $114.00 | $114.00 | — | — | — |
| Urine pregnancy test, read by color change inpatient CPT 81025 HB URINE PREGNANCY TEST | $114.00 | $114.00 | — | — | — |
| Urine pregnancy test, read by color change inpatient CPT 81025 HB PREGNANCY, UR, COLOR COMP | $114.00 | $114.00 | — | — | — |
| Urine pregnancy test, read by color change inpatient CPT 81025 HB PREGNANCY URINE COLOR COMP | $114.00 | $114.00 | — | — | — |
| Vitamin B12 (cobalamin) blood test CPT 82607 HB VITAMIN B12* | $199.00 | $199.00 | — | 54% above | — |
| Vitamin B12 (cobalamin) blood test inpatient CPT 82607 HB VITAMIN B12* | $199.00 | $199.00 | — | — | — |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 HB VITAMIN D | $193.00 | $193.00 | — | 5% above | — |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 HB VITAMIN D25 HYDROXY* | $193.00 | $193.00 | — | 5% above | — |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 HB VITAMIN D | $193.00 | $193.00 | — | — | — |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 HB VITAMIN D25 HYDROXY* | $193.00 | $193.00 | — | — | — |
| Vitamin D, 1,25-dihydroxy blood test CPT 82652 HB R DIHYDROXY VIT D-1,25 | $278.00 | $278.00 | — | 44% above | — |
| Vitamin D, 1,25-dihydroxy blood test inpatient CPT 82652 HB R DIHYDROXY VIT D-1,25 | $278.00 | $278.00 | — | — | — |
| Zinc blood test CPT 84630 HB R ZINC (UR) | $108.00 | $108.00 | — | 50% above | — |
| Zinc blood test CPT 84630 HB R ZINC LAB | $111.00 | $111.00 | — | 54% above | — |
| Zinc blood test inpatient CPT 84630 HB R ZINC (UR) | $108.00 | $108.00 | — | — | — |
| Zinc blood test inpatient CPT 84630 HB R ZINC LAB | $111.00 | $111.00 | — | — | — |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HB PREGNANCY SERUM, QUANT | $134.00 | $134.00 | — | 25% above | — |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HB HCG TUMOR MARKER | $205.00 | $205.00 | — | 91% above | — |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HB BETA-HCG QUANT.* (P) | $205.00 | $205.00 | — | 91% above | — |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HB FREE BETA HCG | $233.00 | $233.00 | — | 117% above | — |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HB R HCG TUMOR MARKER | $291.00 | $291.00 | — | 171% above | — |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HB R 1ST TRIMESTER BHCG, QUANT (P) | $291.00 | $291.00 | — | 171% above | — |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HB R ALPHA SUBUNIT | $291.00 | $291.00 | — | 171% above | — |
| hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HB PREGNANCY SERUM, QUANT | $134.00 | $134.00 | — | — | — |
| hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HB BETA-HCG QUANT.* (P) | $205.00 | $205.00 | — | — | — |
| hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HB HCG TUMOR MARKER | $205.00 | $205.00 | — | — | — |
| hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HB FREE BETA HCG | $233.00 | $233.00 | — | — | — |
| hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HB R HCG TUMOR MARKER | $291.00 | $291.00 | — | — | — |
| hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HB R 1ST TRIMESTER BHCG, QUANT (P) | $291.00 | $291.00 | — | — | — |
| hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HB R ALPHA SUBUNIT | $291.00 | $291.00 | — | — | — |
Surgery and procedures
| Procedure | Cash price | List price | Insurers pay | vs Illinois | Off list |
|---|---|---|---|---|---|
| Botox injections for chronic migraine CPT 64615 CHEMODERV FACIAL/TRIGEM/CERV MUSLC MIGRAINE | $339.00 | $339.00 | — | 11% below | — |
| Botox injections for chronic migraine CPT 64615 HB CHEMODERV FACIAL/TRIGEM/CERV MUSLC MIGRAINE | $808.00 | $808.00 | — | 113% above | — |
| Botox injections for chronic migraine inpatient CPT 64615 CHEMODERV FACIAL/TRIGEM/CERV MUSLC MIGRAINE | $339.00 | $339.00 | — | — | — |
| Botox injections for chronic migraine inpatient CPT 64615 HB CHEMODERV FACIAL/TRIGEM/CERV MUSLC MIGRAINE | $808.00 | $808.00 | — | — | — |
| Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion CPT 19081 HB BX BREAST W/DEV 1ST LESION STEREOTACTIC GUIDE | $4,584.00 | $4,584.00 | — | 49% above | — |
| Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion inpatient CPT 19081 HB BX BREAST W/DEV 1ST LESION STEREOTACTIC GUIDE | $4,584.00 | $4,584.00 | — | — | — |
| Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 CLOSED RX DIST FIBULA FX | $236.00 | $236.00 | — | 44% below | — |
| Broken ankle (outer ankle bone) treatment without surgery or setting inpatient CPT 27786 CLOSED RX DIST FIBULA FX | $236.00 | $236.00 | — | — | — |
| Cardiac catheterization with coronary angiogram one side CPT 93458 HB CORONRY ART ANG W/LT HRT CATH & L VNTGRPHY | $21,689.00 | $21,689.00 | — | 111% above | — |
| Cardiac catheterization with coronary angiogram inpatient one side CPT 93458 HB CORONRY ART ANG W/LT HRT CATH & L VNTGRPHY | $21,689.00 | $21,689.00 | — | — | — |
| Cardioversion, elective (restoring heart rhythm) CPT 92960 HB CARDIOVERSION EXTERNAL | $2,439.00 | $2,439.00 | — | 103% above | — |
| Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 HB CARDIOVERSION EXTERNAL | $2,439.00 | $2,439.00 | — | — | — |
| Catheter ablation for atrial fibrillation CPT 93656 HB EP EVL TRNSEPTAL TX ATRIAL FIB ISOLAT PULM VEIN | $42,847.00 | $42,847.00 | — | 52% above | — |
| Catheter ablation for atrial fibrillation inpatient CPT 93656 HB EP EVL TRNSEPTAL TX ATRIAL FIB ISOLAT PULM VEIN | $42,847.00 | $42,847.00 | — | — | — |
| Cervical biopsy CPT 57500 BIOPSY/EXCIS CERVICAL LESN | $804.00 | $804.00 | — | 15% below | — |
| Cervical biopsy CPT 57500 HB BIOPSY CERVIX | $1,586.00 | $1,586.00 | — | 67% above | — |
| Cervical biopsy inpatient CPT 57500 BIOPSY/EXCIS CERVICAL LESN | $804.00 | $804.00 | — | — | — |
| Cervical biopsy inpatient CPT 57500 HB BIOPSY CERVIX | $1,586.00 | $1,586.00 | — | — | — |
| Circumcision by surgical excision, older than 28 days (children and adults) CPT 54161 CIRCUMCISION >28 DAYS | $2,329.00 | $2,329.00 | — | at median | — |
| Circumcision by surgical excision, older than 28 days (children and adults) inpatient CPT 54161 CIRCUMCISION >28 DAYS | $2,329.00 | $2,329.00 | — | — | — |
| Circumcision, surgical, older than a newborn CPT 54160 HB CIRCUMCISION | $1,156.00 | $1,156.00 | — | at median | — |
| Circumcision, surgical, older than a newborn inpatient CPT 54160 HB CIRCUMCISION | $1,156.00 | $1,156.00 | — | — | — |
| Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 HB CLTX DSTL RADIAL FX/EPIPHYSL SEP W/O MANJ | $1,199.00 | $1,199.00 | — | 131% above | — |
| Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 HB CLTX DSTL RADIAL FX/EPIPHYSL SEP W/O MANJ | $1,199.00 | $1,199.00 | — | — | — |
| Colposcopy with LEEP (loop electrosurgical excision) CPT 57460 COLPOSCOPY,LOOP ELECTRD CERVIX EXCIS | $3,128.00 | $3,128.00 | — | at median | — |
| Colposcopy with LEEP (loop electrosurgical excision) CPT 57460 HB COLPOSCOPY CERVIX W/LOOP ELECTRODE BX CRVX | $5,112.00 | $5,112.00 | — | 63% above | — |
| Colposcopy with LEEP (loop electrosurgical excision) inpatient CPT 57460 COLPOSCOPY,LOOP ELECTRD CERVIX EXCIS | $3,128.00 | $3,128.00 | — | — | — |
| Colposcopy with LEEP (loop electrosurgical excision) inpatient CPT 57460 HB COLPOSCOPY CERVIX W/LOOP ELECTRODE BX CRVX | $5,112.00 | $5,112.00 | — | — | — |
| Colposcopy with cervical biopsy and scraping of the cervical canal CPT 57454 COLPOSCOPY,BX CERVIX/ENDOCERV CURR | $321.00 | $321.00 | — | 33% below | — |
| Colposcopy with cervical biopsy and scraping of the cervical canal CPT 57454 HB COLPOSCOPY CERVIX W/BX(S) CRVX & ENDOCRV CURET | $1,507.00 | $1,507.00 | — | 214% above | — |
| Colposcopy with cervical biopsy and scraping of the cervical canal inpatient CPT 57454 COLPOSCOPY,BX CERVIX/ENDOCERV CURR | $321.00 | $321.00 | — | — | — |
| Colposcopy with cervical biopsy and scraping of the cervical canal inpatient CPT 57454 HB COLPOSCOPY CERVIX W/BX(S) CRVX & ENDOCRV CURET | $1,507.00 | $1,507.00 | — | — | — |
| Coronary stent placement, one artery CPT 92928 HB CARDIAC STENT SINGLE VESSEL | $31,704.00 | $31,704.00 | — | 126% above | — |
| Coronary stent placement, one artery inpatient CPT 92928 HB CARDIAC STENT SINGLE VESSEL | $31,704.00 | $31,704.00 | — | — | — |
| Cystoscopy with ureteral stent placement CPT 52332 HB CYSTOURETHROSCOPY W/INSERT URET STENT | $6,662.00 | $6,662.00 | — | 59% above | — |
| Cystoscopy with ureteral stent placement inpatient CPT 52332 HB CYSTOURETHROSCOPY W/INSERT URET STENT | $6,662.00 | $6,662.00 | — | — | — |
| Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 CYSTOURETHROSCOPY | $781.00 | $781.00 | — | 38% below | — |
| Cystoscopy, diagnostic look inside the bladder and urethra inpatient CPT 52000 CYSTOURETHROSCOPY | $781.00 | $781.00 | — | — | — |
| Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 DESTRUCT PREMALG LESION | $200.00 | $200.00 | — | 19% above | — |
| Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 HB DESTRUCT PRE-MALIG LESIONS 1ST | $491.00 | $491.00 | — | 191% above | — |
| Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 DESTRUCT PREMALG LESION | $200.00 | $200.00 | — | — | — |
| Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 HB DESTRUCT PRE-MALIG LESIONS 1ST | $491.00 | $491.00 | — | — | — |
| Ear tube placement (tympanostomy) with local anesthesia, one ear CPT 69433 CREATE EARDRUM OPENING,LOCAL ANESTH | $550.00 | $550.00 | — | at median | — |
| Ear tube placement (tympanostomy) with local anesthesia, one ear inpatient CPT 69433 CREATE EARDRUM OPENING,LOCAL ANESTH | $550.00 | $550.00 | — | — | — |
| Earwax removal by irrigation (rinsing), one ear one side CPT 69209 REMOVAL IMPACTED EAR WAX IRRIGATION/LVG UNILAT | $61.00 | $61.00 | — | 47% below | — |
| Earwax removal by irrigation (rinsing), one ear one side CPT 69209 HB REMOVAL IMPACTED EAR WAX IRRIGATN/LVG UNILAT | $285.00 | $285.00 | — | 147% above | — |
| Earwax removal by irrigation (rinsing), one ear inpatient one side CPT 69209 REMOVAL IMPACTED EAR WAX IRRIGATION/LVG UNILAT | $61.00 | $61.00 | — | — | — |
| Earwax removal by irrigation (rinsing), one ear inpatient one side CPT 69209 HB REMOVAL IMPACTED EAR WAX IRRIGATN/LVG UNILAT | $285.00 | $285.00 | — | — | — |
| Earwax removal with instruments, one ear CPT 69210 REMOVE IMPACTED EAR WAX | $61.00 | $61.00 | — | 51% below | — |
| Earwax removal with instruments, one ear CPT 69210 HB REMOVAL INPACT CERUMEN (WAX);1-2 EARS | $212.00 | $212.00 | — | 70% above | — |
| Earwax removal with instruments, one ear inpatient CPT 69210 REMOVE IMPACTED EAR WAX | $61.00 | $61.00 | — | — | — |
| Earwax removal with instruments, one ear inpatient CPT 69210 HB REMOVAL INPACT CERUMEN (WAX);1-2 EARS | $212.00 | $212.00 | — | — | — |
| Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 BIOPSY OF UTERUS LINING | $199.00 | $199.00 | — | 43% below | — |
| Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 HB ENDOMETRIAL BIOPSY W/O CERVICAL DILATE | $1,245.00 | $1,245.00 | — | 258% above | — |
| Endometrial biopsy (uterine lining sample) without dilating the cervix inpatient CPT 58100 BIOPSY OF UTERUS LINING | $199.00 | $199.00 | — | — | — |
| Endometrial biopsy (uterine lining sample) without dilating the cervix inpatient CPT 58100 HB ENDOMETRIAL BIOPSY W/O CERVICAL DILATE | $1,245.00 | $1,245.00 | — | — | — |
| Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 HB INJ EPIDURAL CERV/THOR W/ IMAGE GUIDE | $3,139.00 | $3,139.00 | — | 73% above | — |
| Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 HB INJ EPIDURAL CERV/THOR W/IMAGE GUIDE | $3,139.00 | $3,139.00 | — | 73% above | — |
| Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 HB INJ EPIDURAL CERV/THOR W/ IMAGE GUIDE | $3,139.00 | $3,139.00 | — | — | — |
| Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 HB INJ EPIDURAL CERV/THOR W/IMAGE GUIDE | $3,139.00 | $3,139.00 | — | — | — |
| Eye injection into the vitreous (intravitreal injection) CPT 67028 INJECT INTRAVITREAL PHARMCOLOGIC | $387.00 | $387.00 | — | 43% below | — |
| Eye injection into the vitreous (intravitreal injection) CPT 67028 HB MACUGEN,INTRAVITREAL INJECTION | $1,536.00 | $1,536.00 | — | 126% above | — |
| Eye injection into the vitreous (intravitreal injection) inpatient CPT 67028 INJECT INTRAVITREAL PHARMCOLOGIC | $387.00 | $387.00 | — | — | — |
| Eye injection into the vitreous (intravitreal injection) inpatient CPT 67028 HB MACUGEN,INTRAVITREAL INJECTION | $1,536.00 | $1,536.00 | — | — | — |
| Facet joint injection, lower back, one level, with imaging guidance CPT 64493 HB INJ PARAVERT FACET JT LUMB/SACRL 1ST LVL | $2,955.00 | $2,955.00 | — | 91% above | — |
| Facet joint injection, lower back, one level, with imaging guidance CPT 64493 HB INJ, PV FACET JNT/NRV; LUMB/SACRAL 1 LEVEL | $2,955.00 | $2,955.00 | — | 91% above | — |
| Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 HB INJ, PV FACET JNT/NRV; LUMB/SACRAL 1 LEVEL | $2,955.00 | $2,955.00 | — | — | — |
| Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 HB INJ PARAVERT FACET JT LUMB/SACRL 1ST LVL | $2,955.00 | $2,955.00 | — | — | — |
| Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 SIGMOIDOSCOPY,DIAGNOSTIC | $914.00 | $914.00 | — | 14% below | — |
| Flexible sigmoidoscopy, diagnostic (lower colon only) inpatient CPT 45330 SIGMOIDOSCOPY,DIAGNOSTIC | $914.00 | $914.00 | — | — | — |
| Hemorrhoid banding (rubber band ligation) CPT 46221 LIGATION OF HEMORRHOID(S) | $914.00 | $914.00 | — | at median | — |
| Hemorrhoid banding (rubber band ligation) inpatient CPT 46221 LIGATION OF HEMORRHOID(S) | $914.00 | $914.00 | — | — | — |
| Hemorrhoidectomy (internal and external), one area CPT 46255 HEMORRHOIDECTOMY,INT/EXT,SIMPLE; SINGLE | $2,809.00 | $2,809.00 | — | at median | — |
| Hemorrhoidectomy (internal and external), one area inpatient CPT 46255 HEMORRHOIDECTOMY,INT/EXT,SIMPLE; SINGLE | $2,809.00 | $2,809.00 | — | — | — |
| Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 HB SALINE INFSN HYSTEROSALPINGOGRAPHY | $1,146.00 | $1,146.00 | — | 196% above | — |
| Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes inpatient CPT 58340 HB SALINE INFSN HYSTEROSALPINGOGRAPHY | $1,146.00 | $1,146.00 | — | — | — |
| Hysteroscopy with endometrial ablation CPT 58563 HYSTEROSCOPY, ABLATION | $4,976.00 | $4,976.00 | — | 18% below | — |
| Hysteroscopy with endometrial ablation inpatient CPT 58563 HYSTEROSCOPY, ABLATION | $4,976.00 | $4,976.00 | — | — | — |
| Hysteroscopy with uterine lining sampling and/or polyp removal CPT 58558 HYSTEROSCOPY,W/ENDO BX | $3,128.00 | $3,128.00 | — | 9% below | — |
| Hysteroscopy with uterine lining sampling and/or polyp removal inpatient CPT 58558 HYSTEROSCOPY,W/ENDO BX | $3,128.00 | $3,128.00 | — | — | — |
| IUD insertion (the device itself billed separately) CPT 58300 HB INSERTION OF IUD | $189.00 | $189.00 | — | 48% below | — |
| IUD insertion (the device itself billed separately) inpatient CPT 58300 HB INSERTION OF IUD | $189.00 | $189.00 | — | — | — |
| Incision and drainage of a simple or single skin abscess CPT 10060 DRAIN SKIN ABSCESS SIMPLE | $200.00 | $200.00 | — | 50% below | — |
| Incision and drainage of a simple or single skin abscess CPT 10060 HB INCISION/DRAIN ABSCESS;SINGLE/SIMPLE | $752.00 | $752.00 | — | 89% above | — |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 DRAIN SKIN ABSCESS SIMPLE | $200.00 | $200.00 | — | — | — |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 HB INCISION/DRAIN ABSCESS;SINGLE/SIMPLE | $752.00 | $752.00 | — | — | — |
| Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 INJECT TENDON/LIGAMENT/CYST | $296.00 | $296.00 | — | 31% below | — |
| Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 HB INJ SINGLE TEND SHEATH,LIG,GANG CYST | $1,047.00 | $1,047.00 | — | 143% above | — |
| Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 HB INJ TENDON/LIGAM/CYST | $1,047.00 | $1,047.00 | — | 143% above | — |
| Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 INJECT TENDON/LIGAMENT/CYST | $296.00 | $296.00 | — | — | — |
| Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 HB INJ SINGLE TEND SHEATH,LIG,GANG CYST | $1,047.00 | $1,047.00 | — | — | — |
| Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 HB INJ TENDON/LIGAM/CYST | $1,047.00 | $1,047.00 | — | — | — |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 DRAIN/INJECT LARGE JOINT/BURSA | $296.00 | $296.00 | — | 41% below | — |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 HB ARTHROCENTESIS ASP/INJ MAJOR JOINT/BURSA W/O US | $1,198.00 | $1,198.00 | — | 137% above | — |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 HB ARTHROCENTESIS ASP/INJ MAJOR JOINT/BURSA | $1,198.00 | $1,198.00 | — | 137% above | — |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 DRAIN/INJECT LARGE JOINT/BURSA | $296.00 | $296.00 | — | — | — |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 HB ARTHROCENTESIS ASP/INJ MAJOR JOINT/BURSA W/O US | $1,198.00 | $1,198.00 | — | — | — |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 HB ARTHROCENTESIS ASP/INJ MAJOR JOINT/BURSA | $1,198.00 | $1,198.00 | — | — | — |
| Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 INSERTION, NON-BIODEGRAD DRUG DELIVERY IMPL | $128.00 | $128.00 | — | 54% below | — |
| Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 HB INSJ NON-BIODEGRADABLE DRUG DELIVERY IMPLANT | $226.00 | $226.00 | — | 19% below | — |
| Insertion of a drug-delivery implant, such as the arm birth control implant inpatient CPT 11981 INSERTION, NON-BIODEGRAD DRUG DELIVERY IMPL | $128.00 | $128.00 | — | — | — |
| Insertion of a drug-delivery implant, such as the arm birth control implant inpatient CPT 11981 HB INSJ NON-BIODEGRADABLE DRUG DELIVERY IMPLANT | $226.00 | $226.00 | — | — | — |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 DRAIN/INJECT MEDIUM JOINT/BURSA | $296.00 | $296.00 | — | 29% below | — |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 HB ARTHROCENTESIS ASP/INJ MEDIUM JOINT/BURSA W/O US | $859.00 | $859.00 | — | 107% above | — |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 HB ARTHROCENTESIS ASP/INJ MEDIUM JOINT/BURSA | $859.00 | $859.00 | — | 107% above | — |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 DRAIN/INJECT MEDIUM JOINT/BURSA | $296.00 | $296.00 | — | — | — |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 HB ARTHROCENTESIS ASP/INJ MEDIUM JOINT/BURSA | $859.00 | $859.00 | — | — | — |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 HB ARTHROCENTESIS ASP/INJ MEDIUM JOINT/BURSA W/O US | $859.00 | $859.00 | — | — | — |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 DRAIN/INJECT SMALL JOINT/BURSA | $296.00 | $296.00 | — | 5% below | — |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 HB ARTHROCENTESIS ASP/INJ SMALL JOINT/BURSA W/O US | $679.00 | $679.00 | — | 117% above | — |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 HB ARTHROCENTESIS ASP/INJ SMALL JOINT/BURSA | $679.00 | $679.00 | — | 117% above | — |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 DRAIN/INJECT SMALL JOINT/BURSA | $296.00 | $296.00 | — | — | — |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 HB ARTHROCENTESIS ASP/INJ SMALL JOINT/BURSA | $679.00 | $679.00 | — | — | — |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 HB ARTHROCENTESIS ASP/INJ SMALL JOINT/BURSA W/O US | $679.00 | $679.00 | — | — | — |
| Laser treatment of clouding after cataract surgery (YAG) CPT 66821 YAG-LASER CAPSULOTOMY 1+STG | $665.00 | $665.00 | — | 1% below | — |
| Laser treatment of clouding after cataract surgery (YAG) CPT 66821 HB YAG-CAPSULOTOMY | $2,620.00 | $2,620.00 | — | 290% above | — |
| Laser treatment of clouding after cataract surgery (YAG) inpatient CPT 66821 YAG-LASER CAPSULOTOMY 1+STG | $665.00 | $665.00 | — | — | — |
| Laser treatment of clouding after cataract surgery (YAG) inpatient CPT 66821 HB YAG-CAPSULOTOMY | $2,620.00 | $2,620.00 | — | — | — |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 LAYR CLOS WND TRUNK,ARM,LEG <2.5CM | $399.00 | $399.00 | — | 34% below | — |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 HB LAYER CLOSURE WOUND EXT < = 2.5CM | $1,013.00 | $1,013.00 | — | 68% above | — |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 LAYR CLOS WND TRUNK,ARM,LEG <2.5CM | $399.00 | $399.00 | — | — | — |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 HB LAYER CLOSURE WOUND EXT < = 2.5CM | $1,013.00 | $1,013.00 | — | — | — |
| Left heart catheterization, diagnostic one side CPT 93452 HB LT HEART CATH W/INJS LT VENTRICLGRAPHY | $13,382.00 | $13,382.00 | — | 84% above | — |
| Left heart catheterization, diagnostic inpatient one side CPT 93452 HB LT HEART CATH W/INJS LT VENTRICLGRAPHY | $13,382.00 | $13,382.00 | — | — | — |
| Lower-back epidural injection, with imaging guidance CPT 62323 HB INJ EPIDURAL LUMBR/SAC W/IMAGE GUIDE | $2,915.00 | $2,915.00 | — | 99% above | — |
| Lower-back epidural injection, with imaging guidance CPT 62323 HB INJ EPIDURAL LUMBR/SAC W/ IMAGE GUIDE | $2,915.00 | $2,915.00 | — | 99% above | — |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 HB INJ EPIDURAL LUMBR/SAC W/IMAGE GUIDE | $2,915.00 | $2,915.00 | — | — | — |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 HB INJ EPIDURAL LUMBR/SAC W/ IMAGE GUIDE | $2,915.00 | $2,915.00 | — | — | — |
| Lower-back epidural injection, without imaging guidance CPT 62322 HB INJECT SPINE, L/S (CD) W/O IMAGE GUIDE | $2,228.00 | $2,228.00 | — | 53% above | — |
| Lower-back epidural injection, without imaging guidance inpatient CPT 62322 HB INJECT SPINE, L/S (CD) W/O IMAGE GUIDE | $2,228.00 | $2,228.00 | — | — | — |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 HB INJ TRANSFORAMIN EPIDURAL; LUMB/SACRAL 1 LVL | $2,157.00 | $2,157.00 | — | 52% above | — |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 HB INJECT FORAMEN EPIDURAL L/S | $2,157.00 | $2,157.00 | — | 52% above | — |
| Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 HB INJ TRANSFORAMIN EPIDURAL; LUMB/SACRAL 1 LVL | $2,157.00 | $2,157.00 | — | — | — |
| Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 HB INJECT FORAMEN EPIDURAL L/S | $2,157.00 | $2,157.00 | — | — | — |
| Mohs surgery for skin cancer, first stage, head, neck, hands, feet or genitals CPT 17311 MOHS, 1 STAGE, H/N/HF/G | $900.00 | $900.00 | — | 20% above | — |
| Mohs surgery for skin cancer, first stage, head, neck, hands, feet or genitals inpatient CPT 17311 MOHS, 1 STAGE, H/N/HF/G | $900.00 | $900.00 | — | — | — |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 EXC SKIN BENIG <5MM TRUNK,ARM,LEG | $704.00 | $704.00 | — | at median | — |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 EXC SKIN BENIG <5MM TRUNK,ARM,LEG | $704.00 | $704.00 | — | — | — |
| Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 EXC SKIN BENIG <5MM FACE,FACIAL | $704.00 | $704.00 | — | 3% above | — |
| Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 EXC SKIN BENIG <5MM FACE,FACIAL | $704.00 | $704.00 | — | — | — |
| Nail removal (partial or complete), one nail CPT 11730 REMOVAL OF NAIL PLATE | $200.00 | $200.00 | — | 31% below | — |
| Nail removal (partial or complete), one nail CPT 11730 HB AVULSM OF NAIL PLATE;PRTL/COMP;SIMP/SING | $612.00 | $612.00 | — | 112% above | — |
| Nail removal (partial or complete), one nail CPT 11730 HB AVULSION OF NAIL PLATE;PRTL/COMP;SIMPLE | $612.00 | $612.00 | — | 112% above | — |
| Nail removal (partial or complete), one nail inpatient CPT 11730 REMOVAL OF NAIL PLATE | $200.00 | $200.00 | — | — | — |
| Nail removal (partial or complete), one nail inpatient CPT 11730 HB AVULSM OF NAIL PLATE;PRTL/COMP;SIMP/SING | $612.00 | $612.00 | — | — | — |
| Nail removal (partial or complete), one nail inpatient CPT 11730 HB AVULSION OF NAIL PLATE;PRTL/COMP;SIMPLE | $612.00 | $612.00 | — | — | — |
| Occipital nerve block (injection for headaches) CPT 64405 HB INJECT NERVE BK. GREAT OCCIPIT | $772.00 | $772.00 | — | 50% above | — |
| Occipital nerve block (injection for headaches) inpatient CPT 64405 HB INJECT NERVE BK. GREAT OCCIPIT | $772.00 | $772.00 | — | — | — |
| Pacemaker implant (dual chamber) CPT 33208 HB PERM PACEMAKER INSERT GEN & LEAD-DDD | $27,836.00 | $27,836.00 | — | 141% above | — |
| Pacemaker implant (dual chamber) inpatient CPT 33208 HB PERM PACEMAKER INSERT GEN & LEAD-DDD | $27,836.00 | $27,836.00 | — | — | — |
| Paracentesis with imaging guidance CPT 49083 HB ABDM PARACENTESIS DX/THER WITH IMAGE GUIDANCE | $3,038.00 | $3,038.00 | — | 109% above | — |
| Paracentesis with imaging guidance inpatient CPT 49083 HB ABDM PARACENTESIS DX/THER WITH IMAGE GUIDANCE | $3,038.00 | $3,038.00 | — | — | — |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 REMOVE NAIL BED PARTIAL/COMPL | $399.00 | $399.00 | — | 36% below | — |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 HB REMOVE NAIL BED PRTL/COMP | $1,883.00 | $1,883.00 | — | 200% above | — |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 HB EXCISION OF NAIL AND MATRIX | $1,883.00 | $1,883.00 | — | 200% above | — |
| Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 REMOVE NAIL BED PARTIAL/COMPL | $399.00 | $399.00 | — | — | — |
| Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 HB REMOVE NAIL BED PRTL/COMP | $1,883.00 | $1,883.00 | — | — | — |
| Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 HB EXCISION OF NAIL AND MATRIX | $1,883.00 | $1,883.00 | — | — | — |
| Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 HB DEST NEURO AGNT, PVFACET JNT/NRV; L/S 1 FCT JONT | $3,513.00 | $3,513.00 | — | 26% above | — |
| Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 HB DESTRUCT NEURO AG, PV FACET;L/S 1ST LVL | $3,513.00 | $3,513.00 | — | 26% above | — |
| Radiofrequency ablation of facet joint nerves, lower back, one level inpatient CPT 64635 HB DEST NEURO AGNT, PVFACET JNT/NRV; L/S 1 FCT JONT | $3,513.00 | $3,513.00 | — | — | — |
| Radiofrequency ablation of facet joint nerves, lower back, one level inpatient CPT 64635 HB DESTRUCT NEURO AG, PV FACET;L/S 1ST LVL | $3,513.00 | $3,513.00 | — | — | — |
| Removal of a foreign object under the skin, simple CPT 10120 REMOVE FOREIGN BODY SIMPLE | $399.00 | $399.00 | — | 17% below | — |
| Removal of a foreign object under the skin, simple CPT 10120 HB REMOVAL OF FB SIMPLE | $712.00 | $712.00 | — | 48% above | — |
| Removal of a foreign object under the skin, simple CPT 10120 HB IR INCISION AND REMOVAL OF FOREIGN BODY | $712.00 | $712.00 | — | 48% above | — |
| Removal of a foreign object under the skin, simple inpatient CPT 10120 REMOVE FOREIGN BODY SIMPLE | $399.00 | $399.00 | — | — | — |
| Removal of a foreign object under the skin, simple inpatient CPT 10120 HB REMOVAL OF FB SIMPLE | $712.00 | $712.00 | — | — | — |
| Removal of a foreign object under the skin, simple inpatient CPT 10120 HB IR INCISION AND REMOVAL OF FOREIGN BODY | $712.00 | $712.00 | — | — | — |
| Short arm cast (elbow to hand) CPT 29075 APPLY FOREARM CAST | $269.00 | $269.00 | — | 16% below | — |
| Short arm cast (elbow to hand) CPT 29075 HB CAST APPLICATION SHORT ARM | $831.00 | $831.00 | — | 160% above | — |
| Short arm cast (elbow to hand) inpatient CPT 29075 APPLY FOREARM CAST | $269.00 | $269.00 | — | — | — |
| Short arm cast (elbow to hand) inpatient CPT 29075 HB CAST APPLICATION SHORT ARM | $831.00 | $831.00 | — | — | — |
| Short arm splint (forearm and hand) CPT 29125 APPLY FOREARM SPLINT,STATIC | $128.00 | $128.00 | — | 49% below | — |
| Short arm splint (forearm and hand) CPT 29125 HB SPLINT APPLICATION SHORT ARM; STATIC | $567.00 | $567.00 | — | 125% above | — |
| Short arm splint (forearm and hand) inpatient CPT 29125 APPLY FOREARM SPLINT,STATIC | $128.00 | $128.00 | — | — | — |
| Short arm splint (forearm and hand) inpatient CPT 29125 HB SPLINT APPLICATION SHORT ARM; STATIC | $567.00 | $567.00 | — | — | — |
| Short leg cast (below the knee) CPT 29405 APPLY SHORT LEG CAST | $269.00 | $269.00 | — | 24% below | — |
| Short leg cast (below the knee) inpatient CPT 29405 APPLY SHORT LEG CAST | $269.00 | $269.00 | — | — | — |
| Short leg splint (calf to foot) CPT 29515 APPLY LOWER LEG SPLINT | $158.00 | $158.00 | — | 40% below | — |
| Short leg splint (calf to foot) CPT 29515 HB SPLINT APPLICATION SHORT LEG | $534.00 | $534.00 | — | 102% above | — |
| Short leg splint (calf to foot) inpatient CPT 29515 APPLY LOWER LEG SPLINT | $158.00 | $158.00 | — | — | — |
| Short leg splint (calf to foot) inpatient CPT 29515 HB SPLINT APPLICATION SHORT LEG | $534.00 | $534.00 | — | — | — |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 REPR SUPERF WND BODY <2.5CM | $200.00 | $200.00 | — | 46% below | — |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 HB WOUND REPAIR SIMPLE UP TO 2.5CM | $862.00 | $862.00 | — | 135% above | — |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 REPR SUPERF WND BODY <2.5CM | $200.00 | $200.00 | — | — | — |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 HB WOUND REPAIR SIMPLE UP TO 2.5CM | $862.00 | $862.00 | — | — | — |
| Skin biopsy, punch, one lesion CPT 11104 PUNCH BIOPSY SKIN SINGLE LESION | $399.00 | $399.00 | — | 7% above | — |
| Skin biopsy, punch, one lesion CPT 11104 HB PUNCH BIOPSY OF SKIN, SINGLE LESION | $996.00 | $996.00 | — | 168% above | — |
| Skin biopsy, punch, one lesion inpatient CPT 11104 PUNCH BIOPSY SKIN SINGLE LESION | $399.00 | $399.00 | — | — | — |
| Skin biopsy, punch, one lesion inpatient CPT 11104 HB PUNCH BIOPSY OF SKIN, SINGLE LESION | $996.00 | $996.00 | — | — | — |
| Skin cancer removal (excision), body, arms or legs, up to 0.5 cm CPT 11600 EXC SKIN MALIG <5MM TRUNK,ARM,LEG | $704.00 | $704.00 | — | 24% above | — |
| Skin cancer removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11600 EXC SKIN MALIG <5MM TRUNK,ARM,LEG | $704.00 | $704.00 | — | — | — |
| Skin tag removal, up to 15 tags CPT 11200 REMOVAL OF SKIN TAGS | $200.00 | $200.00 | — | 20% below | — |
| Skin tag removal, up to 15 tags CPT 11200 HB REMOVAL SKIN TAGS ANY AREA 1-15 LESIONS | $426.00 | $426.00 | — | 70% above | — |
| Skin tag removal, up to 15 tags inpatient CPT 11200 REMOVAL OF SKIN TAGS | $200.00 | $200.00 | — | — | — |
| Skin tag removal, up to 15 tags inpatient CPT 11200 HB REMOVAL SKIN TAGS ANY AREA 1-15 LESIONS | $426.00 | $426.00 | — | — | — |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 SPINAL PUNCTURE,LUMBAR,DIAGNOSTIC | $692.00 | $692.00 | — | 27% below | — |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 HB LUMBAR SPINAL PUNCTURE; DIAGNOSTIC | $1,671.00 | $1,671.00 | — | 75% above | — |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 HB SPINAL TAP, DIAGNOSTIC | $1,671.00 | $1,671.00 | — | 75% above | — |
| Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 SPINAL PUNCTURE,LUMBAR,DIAGNOSTIC | $692.00 | $692.00 | — | — | — |
| Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 HB SPINAL TAP, DIAGNOSTIC | $1,671.00 | $1,671.00 | — | — | — |
| Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 HB LUMBAR SPINAL PUNCTURE; DIAGNOSTIC | $1,671.00 | $1,671.00 | — | — | — |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 REPR SUP NPTERF WND BODY 2.6-7.5 | $200.00 | $200.00 | — | 52% below | — |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 HB WOUND REPAIR SIMPLE 2.6-7.5 CM | $888.00 | $888.00 | — | 114% above | — |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 REPR SUP NPTERF WND BODY 2.6-7.5 | $200.00 | $200.00 | — | — | — |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 HB WOUND REPAIR SIMPLE 2.6-7.5 CM | $888.00 | $888.00 | — | — | — |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 REPR SUPERF WND FACE <2.5CM | $200.00 | $200.00 | — | 50% below | — |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 HB FACIAL REPAIR SIMPLE UP TO 2.5 CM | $860.00 | $860.00 | — | 114% above | — |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 REPR SUPERF WND FACE <2.5CM | $200.00 | $200.00 | — | — | — |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 HB FACIAL REPAIR SIMPLE UP TO 2.5 CM | $860.00 | $860.00 | — | — | — |
| Tangential (shave-style) skin biopsy, one lesion CPT 11102 TANGENTIAL BIOPSY SKIN SINGLE LESION | $200.00 | $200.00 | — | 33% below | — |
| Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 TANGENTIAL BIOPSY SKIN SINGLE LESION | $200.00 | $200.00 | — | — | — |
| Thoracentesis with imaging guidance CPT 32555 THORACENTESIS NEEDLE/CATH PLEURA W/IMAG | $628.00 | $628.00 | — | 50% below | — |
| Thoracentesis with imaging guidance CPT 32555 HB THORACENTESIS NEEDLE/CATH PLEURA W/IMAG | $3,431.00 | $3,431.00 | — | 174% above | — |
| Thoracentesis with imaging guidance inpatient CPT 32555 THORACENTESIS NEEDLE/CATH PLEURA W/IMAG | $628.00 | $628.00 | — | — | — |
| Thoracentesis with imaging guidance inpatient CPT 32555 HB THORACENTESIS NEEDLE/CATH PLEURA W/IMAG | $3,431.00 | $3,431.00 | — | — | — |
| Trigger point injections, 1 or 2 muscles CPT 20552 INJECT TRIGGER POINT, 1 OR 2 | $296.00 | $296.00 | — | 43% below | — |
| Trigger point injections, 1 or 2 muscles CPT 20552 HB INJ TRIGGER PTS,1-2MUSCLE GROUPS | $1,063.00 | $1,063.00 | — | 104% above | — |
| Trigger point injections, 1 or 2 muscles inpatient CPT 20552 INJECT TRIGGER POINT, 1 OR 2 | $296.00 | $296.00 | — | — | — |
| Trigger point injections, 1 or 2 muscles inpatient CPT 20552 HB INJ TRIGGER PTS,1-2MUSCLE GROUPS | $1,063.00 | $1,063.00 | — | — | — |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 BX BREAST W/ DEV 1ST LESION US GUIDE | $1,622.00 | $1,622.00 | — | 34% below | — |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 HB BX BREAST W/DEV 1ST LESION US GUIDE | $4,651.00 | $4,651.00 | — | 89% above | — |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient CPT 19083 BX BREAST W/ DEV 1ST LESION US GUIDE | $1,622.00 | $1,622.00 | — | — | — |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient CPT 19083 HB BX BREAST W/DEV 1ST LESION US GUIDE | $4,651.00 | $4,651.00 | — | — | — |
| Vaginal delivery, including prenatal and postpartum care CPT 59400 HB DR/OR/LDR VAGINAL-1ST HR | $7,038.00 | $7,038.00 | — | 52% above | — |
| Vaginal delivery, including prenatal and postpartum care inpatient CPT 59400 HB DR/OR/LDR VAGINAL-1ST HR | $7,038.00 | $7,038.00 | — | — | — |
| Vein ablation, radiofrequency, first vein CPT 36475 HB RFA VEIN ABLATION THER W/GUIDE 1ST VEIN | $8,990.00 | $8,990.00 | — | 73% above | — |
| Vein ablation, radiofrequency, first vein inpatient CPT 36475 HB RFA VEIN ABLATION THER W/GUIDE 1ST VEIN | $8,990.00 | $8,990.00 | — | — | — |
| Wart removal, up to 14 warts CPT 17110 DESTRUCT BENIGN LESION, 1-14 | $200.00 | $200.00 | — | 17% below | — |
| Wart removal, up to 14 warts CPT 17110 HB WART REMOV, BENIGN LESIONS UPTO 1-14 | $537.00 | $537.00 | — | 124% above | — |
| Wart removal, up to 14 warts inpatient CPT 17110 DESTRUCT BENIGN LESION, 1-14 | $200.00 | $200.00 | — | — | — |
| Wart removal, up to 14 warts inpatient CPT 17110 HB WART REMOV, BENIGN LESIONS UPTO 1-14 | $537.00 | $537.00 | — | — | — |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 CLEANSING OF SKIN/TISSUE | $399.00 | $399.00 | — | 42% below | — |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 HB DEBRIDEMENT SKIN/TISSUE | $1,357.00 | $1,357.00 | — | 97% above | — |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 HB DEBRIDE SUBQ, 1ST 20 SQ CM OR < | $1,357.00 | $1,357.00 | — | 97% above | — |
| Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 CLEANSING OF SKIN/TISSUE | $399.00 | $399.00 | — | — | — |
| Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 HB DEBRIDE SUBQ, 1ST 20 SQ CM OR < | $1,357.00 | $1,357.00 | — | — | — |
| Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 HB DEBRIDEMENT SKIN/TISSUE | $1,357.00 | $1,357.00 | — | — | — |
Doctor visits and therapy
| Procedure | Cash price | List price | Insurers pay | vs Illinois | Off list |
|---|---|---|---|---|---|
| Blood transfusion (giving blood or blood components) CPT 36430 BLOOD TRANSFUSION SERVICE | $434.00 | $434.00 | — | 51% below | — |
| Blood transfusion (giving blood or blood components) CPT 36430 HB TRANSFUSION | $1,282.00 | $1,282.00 | — | 45% above | — |
| Blood transfusion (giving blood or blood components) CPT 36430 HB BLOOD TRANSFUSION | $1,282.00 | $1,282.00 | — | 45% above | — |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD TRANSFUSION SERVICE | $434.00 | $434.00 | — | — | — |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 HB BLOOD TRANSFUSION | $1,282.00 | $1,282.00 | — | — | — |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 HB TRANSFUSION | $1,282.00 | $1,282.00 | — | — | — |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 AIRWAY INHALATION TREATMENT | $213.00 | $213.00 | — | 11% above | — |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HB INHALATION THERAPY | $229.00 | $229.00 | — | 19% above | — |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HB INHALATION TREATMENT - SUBSEQ | $229.00 | $229.00 | — | 19% above | — |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 AIRWAY INHALATION TREATMENT | $213.00 | $213.00 | — | — | — |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HB INHALATION THERAPY | $229.00 | $229.00 | — | — | — |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HB INHALATION TREATMENT - SUBSEQ | $229.00 | $229.00 | — | — | — |
| Chemotherapy IV infusion, first hour CPT 96413 CHEMOTX IV ADMIN 1ST HR SNGL/1ST DRUG | $390.00 | $390.00 | — | 39% below | — |
| Chemotherapy IV infusion, first hour CPT 96413 HB CHEMO IV INFUSION UP TO 1 HR | $1,099.00 | $1,099.00 | — | 72% above | — |
| Chemotherapy IV infusion, first hour inpatient CPT 96413 CHEMOTX IV ADMIN 1ST HR SNGL/1ST DRUG | $390.00 | $390.00 | — | — | — |
| Chemotherapy IV infusion, first hour inpatient CPT 96413 HB CHEMO IV INFUSION UP TO 1 HR | $1,099.00 | $1,099.00 | — | — | — |
| Comprehensive eye exam by an eye doctor, new patient CPT 92004 OPHTHALMOLOGICAL, NEW/PT, COMPREHENSIVE | $132.00 | $132.00 | — | 3% below | — |
| Comprehensive eye exam by an eye doctor, new patient inpatient CPT 92004 OPHTHALMOLOGICAL, NEW/PT, COMPREHENSIVE | $132.00 | $132.00 | — | — | — |
| Comprehensive eye exam, returning patient CPT 92014 OPHTHALMOLOGICAL, ESTAB/PT, COMPREHENSIVE | $132.00 | $132.00 | — | 5% above | — |
| Comprehensive eye exam, returning patient inpatient CPT 92014 OPHTHALMOLOGICAL, ESTAB/PT, COMPREHENSIVE | $132.00 | $132.00 | — | — | — |
| Comprehensive hearing test: tone and speech audiometry, both ears CPT 92557 COMPREHENSIVE HEARING TEST | $156.00 | $156.00 | — | 39% below | — |
| Comprehensive hearing test: tone and speech audiometry, both ears inpatient CPT 92557 COMPREHENSIVE HEARING TEST | $156.00 | $156.00 | — | — | — |
| Critical care, first 30 to 74 minutes CPT 99291 HB ER VISIT LEVEL 6 | $4,851.00 | $4,851.00 | — | 134% above | — |
| Critical care, first 30 to 74 minutes inpatient CPT 99291 HB ER VISIT LEVEL 6 | $4,851.00 | $4,851.00 | — | — | — |
| EEG (brain wave test), awake and drowsy, routine CPT 95816 HB EEG AWAKE/DROWSY | $1,452.00 | $1,452.00 | — | 67% above | — |
| EEG (brain wave test), awake and drowsy, routine inpatient CPT 95816 HB EEG AWAKE/DROWSY | $1,452.00 | $1,452.00 | — | — | — |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 ORDER ROUTINE EKG | $81.00 | $81.00 | — | 65% below | — |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG ROUTINE OFFICE PERFORMED | $81.00 | $81.00 | — | 65% below | — |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 HB EKG ROUTINE | $355.00 | $355.00 | — | 53% above | — |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG ROUTINE OFFICE PERFORMED | $81.00 | $81.00 | — | — | — |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 ORDER ROUTINE EKG | $81.00 | $81.00 | — | — | — |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 HB EKG ROUTINE | $355.00 | $355.00 | — | — | — |
| Electroconvulsive therapy (ECT), one session CPT 90870 HB ELECTRIC CONVULSIVE THERAPY | $1,800.00 | $1,800.00 | — | 99% above | — |
| Electroconvulsive therapy (ECT), one session inpatient CPT 90870 HB ELECTRIC CONVULSIVE THERAPY | $1,800.00 | $1,800.00 | — | — | — |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 HB ER VISIT LEVEL 1 | $462.00 | $462.00 | — | 106% above | — |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 HB ER VISIT LEVEL 1 | $462.00 | $462.00 | — | — | — |
| Emergency room visit, level 2 of 5, straightforward problem CPT 99282 HB ER VISIT LEVEL 2 | $965.00 | $965.00 | — | 141% above | — |
| Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 HB ER VISIT LEVEL 2 | $965.00 | $965.00 | — | — | — |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 HB ER VISIT LEVEL 3 | $1,748.00 | $1,748.00 | — | 150% above | — |
| Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 HB ER VISIT LEVEL 3 | $1,748.00 | $1,748.00 | — | — | — |
| Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 HB ER VISIT LEVEL 4 | $2,835.00 | $2,835.00 | — | 148% above | — |
| Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 HB ER VISIT LEVEL 4 | $2,835.00 | $2,835.00 | — | — | — |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 HB ER VISIT LEVEL 5 | $4,066.00 | $4,066.00 | — | 155% above | — |
| Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 HB ER VISIT LEVEL 5 | $4,066.00 | $4,066.00 | — | — | — |
| Exercise stress test, tracing only, the hospital charge CPT 93017 CARDIAC STRESS TST,TRACING ONLY | $314.00 | $314.00 | — | 67% below | — |
| Exercise stress test, tracing only, the hospital charge CPT 93017 HB CARDIAC STRESS TEST TRACE ONLY | $1,765.00 | $1,765.00 | — | 85% above | — |
| Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 CARDIAC STRESS TST,TRACING ONLY | $314.00 | $314.00 | — | — | — |
| Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 HB CARDIAC STRESS TEST TRACE ONLY | $1,765.00 | $1,765.00 | — | — | — |
| Eye exam, returning patient, intermediate CPT 92012 OPHTHALMOLOGICAL, ESTAB/PT, INTERMEDIATE | $132.00 | $132.00 | — | 6% above | — |
| Eye exam, returning patient, intermediate inpatient CPT 92012 OPHTHALMOLOGICAL, ESTAB/PT, INTERMEDIATE | $132.00 | $132.00 | — | — | — |
| Family therapy with the patient, 50 minutes CPT 90847 FAMILY PSYCHOTHERAPY W PHYS | $172.00 | $172.00 | — | 4% below | — |
| Family therapy with the patient, 50 minutes CPT 90847 HB PSYCHOTHERAPY FAMILY W/PT - MC | $302.00 | $302.00 | — | 69% above | — |
| Family therapy with the patient, 50 minutes CPT 90847 HB PSYCHOTHERAPY FAMILY W/PT | $302.00 | $302.00 | — | 69% above | — |
| Family therapy with the patient, 50 minutes CPT 90847 HB FAMILY PSYCHOTHERAPY W/PT 50+ MINS | $302.00 | $302.00 | — | 69% above | — |
| Family therapy with the patient, 50 minutes inpatient CPT 90847 FAMILY PSYCHOTHERAPY W PHYS | $172.00 | $172.00 | — | — | — |
| Family therapy with the patient, 50 minutes inpatient CPT 90847 HB PSYCHOTHERAPY FAMILY W/PT - MC | $302.00 | $302.00 | — | — | — |
| Family therapy with the patient, 50 minutes inpatient CPT 90847 HB FAMILY PSYCHOTHERAPY W/PT 50+ MINS | $302.00 | $302.00 | — | — | — |
| Family therapy with the patient, 50 minutes inpatient CPT 90847 HB PSYCHOTHERAPY FAMILY W/PT | $302.00 | $302.00 | — | — | — |
| Family therapy without the patient, 50 minutes CPT 90846 FAMILY PSYCHOTHERAPY,NO PT | $172.00 | $172.00 | — | 6% below | — |
| Family therapy without the patient, 50 minutes CPT 90846 HB FAMILY PSYCHOTHERAPY W/O PT 1-50 MINS | $277.00 | $277.00 | — | 51% above | — |
| Family therapy without the patient, 50 minutes CPT 90846 HB FAMILY PSYCHOTX W/O PT | $372.00 | $372.00 | — | 103% above | — |
| Family therapy without the patient, 50 minutes CPT 90846 HB FAMILY PSYCHOTHERAPY W/O PT 50+ MINS | $520.00 | $520.00 | — | 183% above | — |
| Family therapy without the patient, 50 minutes inpatient CPT 90846 FAMILY PSYCHOTHERAPY,NO PT | $172.00 | $172.00 | — | — | — |
| Family therapy without the patient, 50 minutes inpatient CPT 90846 HB FAMILY PSYCHOTHERAPY W/O PT 1-50 MINS | $277.00 | $277.00 | — | — | — |
| Family therapy without the patient, 50 minutes inpatient CPT 90846 HB FAMILY PSYCHOTX W/O PT | $372.00 | $372.00 | — | — | — |
| Family therapy without the patient, 50 minutes inpatient CPT 90846 HB FAMILY PSYCHOTHERAPY W/O PT 50+ MINS | $520.00 | $520.00 | — | — | — |
| Group psychotherapy session CPT 90853 GROUP PSYCHOTHERAPY | $89.00 | $89.00 | — | 31% below | — |
| Group psychotherapy session CPT 90853 HB AFTERCARE GROUP PSYCHOTHERAPY | $201.00 | $201.00 | — | 56% above | — |
| Group psychotherapy session CPT 90853 HB GROUP PSYCHOTHERAPY - MC | $243.00 | $243.00 | — | 89% above | — |
| Group psychotherapy session CPT 90853 HB GROUP PSYCHOTHERAPY | $243.00 | $243.00 | — | 89% above | — |
| Group psychotherapy session CPT 90853 HB ADOLESCENT DAY SCHOOL ONLY | $436.00 | $436.00 | — | 239% above | — |
| Group psychotherapy session inpatient CPT 90853 GROUP PSYCHOTHERAPY | $89.00 | $89.00 | — | — | — |
| Group psychotherapy session inpatient CPT 90853 HB AFTERCARE GROUP PSYCHOTHERAPY | $201.00 | $201.00 | — | — | — |
| Group psychotherapy session inpatient CPT 90853 HB GROUP PSYCHOTHERAPY | $243.00 | $243.00 | — | — | — |
| Group psychotherapy session inpatient CPT 90853 HB GROUP PSYCHOTHERAPY - MC | $243.00 | $243.00 | — | — | — |
| Group psychotherapy session inpatient CPT 90853 HB ADOLESCENT DAY SCHOOL ONLY | $436.00 | $436.00 | — | — | — |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 HYDRATION IV INFUSE,INT 31-60MINS | $250.00 | $250.00 | — | 26% below | — |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 HB IV INFUSION-HYDRATION 31 MIN - 1 HR | $606.00 | $606.00 | — | 79% above | — |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 HYDRATION IV INFUSE,INT 31-60MINS | $250.00 | $250.00 | — | — | — |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 HB IV INFUSION-HYDRATION 31 MIN - 1 HR | $606.00 | $606.00 | — | — | — |
| IV infusion of a medicine, first hour CPT 96365 IV INFUSE THER/PRO/DX 1ST >1HR | $304.00 | $304.00 | — | 25% below | — |
| IV infusion of a medicine, first hour CPT 96365 HB IV INFUSION-THERAPEUTIC/DX/PRO UP TO 1 HR | $675.00 | $675.00 | — | 66% above | — |
| IV infusion of a medicine, first hour inpatient CPT 96365 IV INFUSE THER/PRO/DX 1ST >1HR | $304.00 | $304.00 | — | — | — |
| IV infusion of a medicine, first hour inpatient CPT 96365 HB IV INFUSION-THERAPEUTIC/DX/PRO UP TO 1 HR | $675.00 | $675.00 | — | — | — |
| IV push of a medicine, first drug CPT 96374 TX/PRO/DX INJ IVPUSH 1ST DRG/SUB | $215.00 | $215.00 | — | at median | — |
| IV push of a medicine, first drug CPT 96374 HB INJ IV PUSH-TDP SING/INIT SUB | $359.00 | $359.00 | — | 67% above | — |
| IV push of a medicine, first drug inpatient CPT 96374 TX/PRO/DX INJ IVPUSH 1ST DRG/SUB | $215.00 | $215.00 | — | — | — |
| IV push of a medicine, first drug inpatient CPT 96374 HB INJ IV PUSH-TDP SING/INIT SUB | $359.00 | $359.00 | — | — | — |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 TX/PRO/DX INJ SUBQ/IM | $70.00 | $70.00 | — | 36% below | — |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 HB IM/SC INJECTION TX/PRO/DX | $204.00 | $204.00 | — | 87% above | — |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 TX/PRO/DX INJ SUBQ/IM | $70.00 | $70.00 | — | — | — |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 HB IM/SC INJECTION TX/PRO/DX | $204.00 | $204.00 | — | — | — |
| Mental health diagnostic evaluation (intake), without medical services CPT 90791 PSYCHIATRIC DIAGNOSTIC EVAL | $160.00 | $160.00 | — | 40% below | — |
| Mental health diagnostic evaluation (intake), without medical services CPT 90791 HB PSYCH ASSESSMENT - 60MINUTES - MC | $335.00 | $335.00 | — | 26% above | — |
| Mental health diagnostic evaluation (intake), without medical services CPT 90791 HB PSYCH ASSESSMENT - 60MINUTES | $335.00 | $335.00 | — | 26% above | — |
| Mental health diagnostic evaluation (intake), without medical services CPT 90791 HB PSYCH ASSESSMENT - 90MINUTES - MC | $369.00 | $369.00 | — | 38% above | — |
| Mental health diagnostic evaluation (intake), without medical services CPT 90791 HB PSYCH ASSESSMENT - 90MINUTES | $369.00 | $369.00 | — | 38% above | — |
| Mental health diagnostic evaluation (intake), without medical services CPT 90791 HB PSYCH ASSESSMENT - 30MINUTES - MC | $421.00 | $421.00 | — | 58% above | — |
| Mental health diagnostic evaluation (intake), without medical services CPT 90791 HB PSYCH ASSESSMENT - 30MINUTES | $421.00 | $421.00 | — | 58% above | — |
| Mental health diagnostic evaluation (intake), without medical services CPT 90791 HB PSYCH ASSESSMENT - 120 MINUTES | $594.00 | $594.00 | — | 123% above | — |
| Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 PSYCHIATRIC DIAGNOSTIC EVAL | $160.00 | $160.00 | — | — | — |
| Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 HB PSYCH ASSESSMENT - 60MINUTES - MC | $335.00 | $335.00 | — | — | — |
| Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 HB PSYCH ASSESSMENT - 60MINUTES | $335.00 | $335.00 | — | — | — |
| Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 HB PSYCH ASSESSMENT - 90MINUTES - MC | $369.00 | $369.00 | — | — | — |
| Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 HB PSYCH ASSESSMENT - 90MINUTES | $369.00 | $369.00 | — | — | — |
| Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 HB PSYCH ASSESSMENT - 30MINUTES | $421.00 | $421.00 | — | — | — |
| Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 HB PSYCH ASSESSMENT - 30MINUTES - MC | $421.00 | $421.00 | — | — | — |
| Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 HB PSYCH ASSESSMENT - 120 MINUTES | $594.00 | $594.00 | — | — | — |
| Nerve conduction study, 7 or 8 nerve studies CPT 95910 NERVE CONDUCTION 7-8 STUDIES | $314.00 | $314.00 | — | 57% below | — |
| Nerve conduction study, 7 or 8 nerve studies CPT 95910 HB NERVE CONDUCTION STUDIES 7-8 STUDIES | $470.00 | $470.00 | — | 35% below | — |
| Nerve conduction study, 7 or 8 nerve studies inpatient CPT 95910 NERVE CONDUCTION 7-8 STUDIES | $314.00 | $314.00 | — | — | — |
| Nerve conduction study, 7 or 8 nerve studies inpatient CPT 95910 HB NERVE CONDUCTION STUDIES 7-8 STUDIES | $470.00 | $470.00 | — | — | — |
| Neuromuscular re-education, 15 minutes CPT 97112 HB PT NEURO RE-EDUC 15 MIN | $165.00 | $165.00 | — | 39% above | — |
| Neuromuscular re-education, 15 minutes CPT 97112 HB OT NEURO RE-EDUC 15 MIN | $165.00 | $165.00 | — | 39% above | — |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 HB OT NEURO RE-EDUC 15 MIN | $165.00 | $165.00 | — | — | — |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 HB PT NEURO RE-EDUC 15 MIN | $165.00 | $165.00 | — | — | — |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 HB MNT,INITIAL ASSES&INTERV/15MIN | $46.00 | $46.00 | — | 14% below | — |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 HB MNT,INITIAL ASSES&INTERV/15MIN | $46.00 | $46.00 | — | — | — |
| Occupational therapy evaluation, low complexity CPT 97165 HB OT EVALUATION LOW COMPLEX 30 MINS | $327.00 | $327.00 | — | 28% above | — |
| Occupational therapy evaluation, low complexity inpatient CPT 97165 HB OT EVALUATION LOW COMPLEX 30 MINS | $327.00 | $327.00 | — | — | — |
| Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 HB PT EVALUATION HIGH COMPLEX 45 MINS | $402.00 | $402.00 | — | 17% above | — |
| Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 HB PT EVALUATION HIGH COMPLEX 45 MINS | $402.00 | $402.00 | — | — | — |
| Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 HB PT EVALUATION LOW COMPLEX 20 MINS | $327.00 | $327.00 | — | 45% above | — |
| Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 HB PT EVALUATION LOW COMPLEX 20 MINS | $327.00 | $327.00 | — | — | — |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 HB PT EVALUATION MODERATE COMPLEX 30 MINS | $376.00 | $376.00 | — | 23% above | — |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 HB PT EVALUATION MODERATE COMPLEX 30 MINS | $376.00 | $376.00 | — | — | — |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 HB PT MANUAL THERAPY 15 MIN | $141.00 | $141.00 | — | 6% above | — |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 HB OT MANUAL THERAPY 15 MIN | $141.00 | $141.00 | — | 6% above | — |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 HB PT MANUAL THERAPY 15 MIN | $141.00 | $141.00 | — | — | — |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 HB OT MANUAL THERAPY 15 MIN | $141.00 | $141.00 | — | — | — |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HB OT THER EX-15 MIN | $142.00 | $142.00 | — | 27% above | — |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HB PT THER EX-15 MIN | $142.00 | $142.00 | — | 27% above | — |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 HB OT THER EX-15 MIN | $142.00 | $142.00 | — | — | — |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 HB PT THER EX-15 MIN | $142.00 | $142.00 | — | — | — |
| Preventive checkup, new patient aged 18–39 CPT 99385 HB PREV.MED,NEW PT, 18-39 YRS | $301.00 | $301.00 | — | 21% above | — |
| Preventive checkup, new patient aged 18–39 inpatient CPT 99385 HB PREV.MED,NEW PT, 18-39 YRS | $301.00 | $301.00 | — | — | — |
| Preventive checkup, new patient aged 40–64 CPT 99386 HB PREVENTIVE VISIT,NEW,40-64 | $384.00 | $384.00 | — | 57% above | — |
| Preventive checkup, new patient aged 40–64 inpatient CPT 99386 HB PREVENTIVE VISIT,NEW,40-64 | $384.00 | $384.00 | — | — | — |
| Preventive checkup, returning patient aged 18–39 CPT 99395 HB PREV MED,EST PT, 18-39 YRS | $298.00 | $298.00 | — | 58% above | — |
| Preventive checkup, returning patient aged 18–39 inpatient CPT 99395 HB PREV MED,EST PT, 18-39 YRS | $298.00 | $298.00 | — | — | — |
| Preventive checkup, returning patient aged 40–64 CPT 99396 HB PREVENTIVE VISIT,EST,40-64 | $329.00 | $329.00 | — | 55% above | — |
| Preventive checkup, returning patient aged 40–64 inpatient CPT 99396 HB PREVENTIVE VISIT,EST,40-64 | $329.00 | $329.00 | — | — | — |
| Preventive checkup, returning patient aged 65 or older CPT 99397 HB PREVENTIVE VISIT EST 65 & OVER | $348.00 | $348.00 | — | 52% above | — |
| Preventive checkup, returning patient aged 65 or older inpatient CPT 99397 HB PREVENTIVE VISIT EST 65 & OVER | $348.00 | $348.00 | — | — | — |
| Psychiatric evaluation with medical services CPT 90792 PSYCHIATRIC DIAGNOSTIC EVAL W/MEDICAL SRVCS | $160.00 | $160.00 | — | 55% below | — |
| Psychiatric evaluation with medical services CPT 90792 HB PSYCH DIAGNOSTIC EVAL W/MEDICAL SERVICES | $646.00 | $646.00 | — | 81% above | — |
| Psychiatric evaluation with medical services inpatient CPT 90792 PSYCHIATRIC DIAGNOSTIC EVAL W/MEDICAL SRVCS | $160.00 | $160.00 | — | — | — |
| Psychiatric evaluation with medical services inpatient CPT 90792 HB PSYCH DIAGNOSTIC EVAL W/MEDICAL SERVICES | $646.00 | $646.00 | — | — | — |
| Psychological testing evaluation by a psychologist or physician, first hour CPT 96130 PSYCHOLOGICAL TESTING EVAL SVCS PHYS/QHP 1ST HR | $314.00 | $314.00 | — | at median | — |
| Psychological testing evaluation by a psychologist or physician, first hour inpatient CPT 96130 PSYCHOLOGICAL TESTING EVAL SVCS PHYS/QHP 1ST HR | $314.00 | $314.00 | — | — | — |
| Psychotherapy for crisis, first 60 minutes CPT 90839 PSYCHOTHERAPY CRISIS INITIAL 60 MINUTES | $160.00 | $160.00 | — | 36% below | — |
| Psychotherapy for crisis, first 60 minutes CPT 90839 HB CRISIS PSYCHOTHERAPY - INITIAL 60 MINS | $304.00 | $304.00 | — | 22% above | — |
| Psychotherapy for crisis, first 60 minutes inpatient CPT 90839 PSYCHOTHERAPY CRISIS INITIAL 60 MINUTES | $160.00 | $160.00 | — | — | — |
| Psychotherapy for crisis, first 60 minutes inpatient CPT 90839 HB CRISIS PSYCHOTHERAPY - INITIAL 60 MINS | $304.00 | $304.00 | — | — | — |
| Psychotherapy session, 30 minutes CPT 90832 PSYCHOTHERAPY PT &/OR FAMILY 30 MIN | $160.00 | $160.00 | — | 15% below | — |
| Psychotherapy session, 30 minutes CPT 90832 HB PSYCHOTHERAPY W/PT &/OR FAMILY 30 MINS - MC | $216.00 | $216.00 | — | 14% above | — |
| Psychotherapy session, 30 minutes CPT 90832 PSYCHOTHERAPY W/PT &/OR FAMILY 30 MINS | $216.00 | $216.00 | — | 14% above | — |
| Psychotherapy session, 30 minutes inpatient CPT 90832 PSYCHOTHERAPY PT &/OR FAMILY 30 MIN | $160.00 | $160.00 | — | — | — |
| Psychotherapy session, 30 minutes inpatient CPT 90832 PSYCHOTHERAPY W/PT &/OR FAMILY 30 MINS | $216.00 | $216.00 | — | — | — |
| Psychotherapy session, 30 minutes inpatient CPT 90832 HB PSYCHOTHERAPY W/PT &/OR FAMILY 30 MINS - MC | $216.00 | $216.00 | — | — | — |
| Psychotherapy session, 45 minutes CPT 90834 PSYCHOTHERAPY PT &/OR FAMILY 45 MINUTES | $160.00 | $160.00 | — | 17% below | — |
| Psychotherapy session, 45 minutes CPT 90834 HB PSYCHOTHERAPY W/PT &/OR FAMILY 45 MINS - MC | $346.00 | $346.00 | — | 79% above | — |
| Psychotherapy session, 45 minutes CPT 90834 HB PSYCHOTHERAPY W/PT &/OR FAMILY 45 MINS | $346.00 | $346.00 | — | 79% above | — |
| Psychotherapy session, 45 minutes inpatient CPT 90834 PSYCHOTHERAPY PT &/OR FAMILY 45 MINUTES | $160.00 | $160.00 | — | — | — |
| Psychotherapy session, 45 minutes inpatient CPT 90834 HB PSYCHOTHERAPY W/PT &/OR FAMILY 45 MINS | $346.00 | $346.00 | — | — | — |
| Psychotherapy session, 45 minutes inpatient CPT 90834 HB PSYCHOTHERAPY W/PT &/OR FAMILY 45 MINS - MC | $346.00 | $346.00 | — | — | — |
| Psychotherapy session, 60 minutes CPT 90837 PSYCHOTHERAPY PT &/OR FAMILY 60 MINUTES | $160.00 | $160.00 | — | 44% below | — |
| Psychotherapy session, 60 minutes CPT 90837 HB PSYCHOTHERAPY W/PT &/OR FAMILY 60 MINS | $419.00 | $419.00 | — | 46% above | — |
| Psychotherapy session, 60 minutes CPT 90837 HB PSYCHOTHERAPY W/PT &/OR FAMILY 60 MINS - MC | $419.00 | $419.00 | — | 46% above | — |
| Psychotherapy session, 60 minutes inpatient CPT 90837 PSYCHOTHERAPY PT &/OR FAMILY 60 MINUTES | $160.00 | $160.00 | — | — | — |
| Psychotherapy session, 60 minutes inpatient CPT 90837 HB PSYCHOTHERAPY W/PT &/OR FAMILY 60 MINS - MC | $419.00 | $419.00 | — | — | — |
| Psychotherapy session, 60 minutes inpatient CPT 90837 HB PSYCHOTHERAPY W/PT &/OR FAMILY 60 MINS | $419.00 | $419.00 | — | — | — |
| Quit-smoking counseling, 3 to 10 minutes CPT 99406 BEHAV CHNG SMOKING 3-10 MIN | $34.00 | $34.00 | — | 17% below | — |
| Quit-smoking counseling, 3 to 10 minutes CPT 99406 HB SMOKE/TOB USE CESSATION INTERMED 3-10 MINS | $106.00 | $106.00 | — | 159% above | — |
| Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 BEHAV CHNG SMOKING 3-10 MIN | $34.00 | $34.00 | — | — | — |
| Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 HB SMOKE/TOB USE CESSATION INTERMED 3-10 MINS | $106.00 | $106.00 | — | — | — |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 OFFICE/OUTPT VISIT,EST,LEVL V (>46MIN) | $132.00 | $132.00 | — | 52% below | — |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 HB LEVEL 5 COLPOSCOPY EST PT VISIT | $465.00 | $465.00 | — | 68% above | — |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 HB LEVEL 5 EST PT VISIT | $465.00 | $465.00 | — | 68% above | — |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 HB OPD LEVEL 5 EST PT VISIT | $465.00 | $465.00 | — | 68% above | — |
| Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 OFFICE/OUTPT VISIT,EST,LEVL V (>46MIN) | $132.00 | $132.00 | — | — | — |
| Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 HB OPD LEVEL 5 EST PT VISIT | $465.00 | $465.00 | — | — | — |
| Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 HB LEVEL 5 EST PT VISIT | $465.00 | $465.00 | — | — | — |
| Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 HB LEVEL 5 COLPOSCOPY EST PT VISIT | $465.00 | $465.00 | — | — | — |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 OFFICE/OUTPT VISIT,EST,LEVL III (16-30MIN) | $132.00 | $132.00 | — | 13% below | — |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 HB LEVEL 3 COLPOSCOPY EST PT VISIT | $318.00 | $318.00 | — | 109% above | — |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 HB OPD LEVEL 3 EST PT VISIT | $318.00 | $318.00 | — | 109% above | — |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 HB LEVEL 3 EST PT VISIT | $318.00 | $318.00 | — | 109% above | — |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 OFFICE/OUTPT VISIT,EST,LEVL III (16-30MIN) | $132.00 | $132.00 | — | — | — |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 HB LEVEL 3 EST PT VISIT | $318.00 | $318.00 | — | — | — |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 HB LEVEL 3 COLPOSCOPY EST PT VISIT | $318.00 | $318.00 | — | — | — |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 HB OPD LEVEL 3 EST PT VISIT | $318.00 | $318.00 | — | — | — |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 OFFICE/OUTPT VISIT,EST,LEVL IV (31-45MIN) | $132.00 | $132.00 | — | 29% below | — |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 HB LEVEL 4 EST PT VISIT | $427.00 | $427.00 | — | 131% above | — |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 HB LEVEL 4 COLPOSCOPY EST PT VISIT | $427.00 | $427.00 | — | 131% above | — |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 HB OPD LEVEL 4 EST PT VISIT | $427.00 | $427.00 | — | 131% above | — |
| Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 OFFICE/OUTPT VISIT,EST,LEVL IV (31-45MIN) | $132.00 | $132.00 | — | — | — |
| Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 HB LEVEL 4 COLPOSCOPY EST PT VISIT | $427.00 | $427.00 | — | — | — |
| Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 HB OPD LEVEL 4 EST PT VISIT | $427.00 | $427.00 | — | — | — |
| Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 HB LEVEL 4 EST PT VISIT | $427.00 | $427.00 | — | — | — |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 OFFICE/OUTPT VISIT,EST,LEVL II (1-15MIN) | $132.00 | $132.00 | — | 6% above | — |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 HB LEVEL 2 EST PT VISIT | $267.00 | $267.00 | — | 114% above | — |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 HB LEVEL 2 COLPOSCOPY EST PT VISIT | $267.00 | $267.00 | — | 114% above | — |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 HB OPD LEVEL 2 EST PT VISIT | $267.00 | $267.00 | — | 114% above | — |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 OFFICE/OUTPT VISIT,EST,LEVL II (1-15MIN) | $132.00 | $132.00 | — | — | — |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 HB LEVEL 2 EST PT VISIT | $267.00 | $267.00 | — | — | — |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 HB OPD LEVEL 2 EST PT VISIT | $267.00 | $267.00 | — | — | — |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 HB LEVEL 2 COLPOSCOPY EST PT VISIT | $267.00 | $267.00 | — | — | — |
| Speech and language evaluation CPT 92523 HB SP EVAL SPEECH SOUND PRODUCT LANG COMPREHENSION | $530.00 | $530.00 | — | 53% above | — |
| Speech and language evaluation inpatient CPT 92523 HB SP EVAL SPEECH SOUND PRODUCT LANG COMPREHENSION | $530.00 | $530.00 | — | — | — |
| Speech therapy session, individual CPT 92507 HB SP LANG THER INDIVIDUAL TX | $355.00 | $355.00 | — | 107% above | — |
| Speech therapy session, individual inpatient CPT 92507 HB SP LANG THER INDIVIDUAL TX | $355.00 | $355.00 | — | — | — |
| Spirometry (breathing test) CPT 94010 BREATHING CAPACITY TEST | $166.00 | $166.00 | — | 45% below | — |
| Spirometry (breathing test) CPT 94010 HB PULMONARY FUNC/FVC | $569.00 | $569.00 | — | 88% above | — |
| Spirometry (breathing test) inpatient CPT 94010 BREATHING CAPACITY TEST | $166.00 | $166.00 | — | — | — |
| Spirometry (breathing test) inpatient CPT 94010 HB PULMONARY FUNC/FVC | $569.00 | $569.00 | — | — | — |
| Spirometry before and after a bronchodilator CPT 94060 EVAL OF BRONCHOSPASM | $314.00 | $314.00 | — | 42% below | — |
| Spirometry before and after a bronchodilator CPT 94060 HB BRONCHOSPASM EVALUATION | $1,014.00 | $1,014.00 | — | 86% above | — |
| Spirometry before and after a bronchodilator inpatient CPT 94060 EVAL OF BRONCHOSPASM | $314.00 | $314.00 | — | — | — |
| Spirometry before and after a bronchodilator inpatient CPT 94060 HB BRONCHOSPASM EVALUATION | $1,014.00 | $1,014.00 | — | — | — |
| TMS (transcranial magnetic stimulation), first session with mapping CPT 90867 REPET TMS TX INITL W/MAP/MOTR THRESHLD/DEL&M | $314.00 | $314.00 | — | 1% below | — |
| TMS (transcranial magnetic stimulation), first session with mapping inpatient CPT 90867 REPET TMS TX INITL W/MAP/MOTR THRESHLD/DEL&M | $314.00 | $314.00 | — | — | — |
| Therapeutic activities (functional training), 15 minutes CPT 97530 HB PT FUNCTIONAL ACTIVITIES-15 MIN | $221.00 | $221.00 | — | 77% above | — |
| Therapeutic activities (functional training), 15 minutes CPT 97530 HB OT FUNCTIONAL ACTIVITIES-15 MIN | $221.00 | $221.00 | — | 77% above | — |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 HB OT FUNCTIONAL ACTIVITIES-15 MIN | $221.00 | $221.00 | — | — | — |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 HB PT FUNCTIONAL ACTIVITIES-15 MIN | $221.00 | $221.00 | — | — | — |
| Therapeutic phlebotomy (removing blood as treatment) CPT 99195 HB THERAPEUTIC BLEEDING PHLEBOTOMY | $280.00 | $280.00 | — | 30% above | — |
| Therapeutic phlebotomy (removing blood as treatment) CPT 99195 HB THERAPEUTIC PHLEBOTOMY (P) | $281.00 | $281.00 | — | 31% above | — |
| Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 HB THERAPEUTIC BLEEDING PHLEBOTOMY | $280.00 | $280.00 | — | — | — |
| Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 HB THERAPEUTIC PHLEBOTOMY (P) | $281.00 | $281.00 | — | — | — |
| Visual field test, extended CPT 92083 VISUAL FIELD EXAM,EXTENDED | $146.00 | $146.00 | — | at median | — |
| Visual field test, extended inpatient CPT 92083 VISUAL FIELD EXAM,EXTENDED | $146.00 | $146.00 | — | — | — |
Vaccines
| Procedure | Cash price | List price | Insurers pay | vs Illinois | Off list |
|---|---|---|---|---|---|
| Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older CPT 90653 INFLUENZA VAC (IIV) INACTV SUBUNIT ADJUVANTD IM | $180.00 | $180.00 | — | 49% above | — |
| Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older inpatient CPT 90653 INFLUENZA VAC (IIV) INACTV SUBUNIT ADJUVANTD IM | $180.00 | $180.00 | — | — | — |
| COVID-19 vaccine (Moderna), age 12 and older CPT 91322 SARSCOV2 VACC 50 MCG/0.5ML 12+YRS | $314.00 | $314.00 | — | 54% above | — |
| COVID-19 vaccine (Moderna), age 12 and older inpatient CPT 91322 SARSCOV2 VACC 50 MCG/0.5ML 12+YRS | $314.00 | $314.00 | — | — | — |
| COVID-19 vaccine (Pfizer-BioNTech), age 12 and older CPT 91320 SARSCOV2 VACC 30MCG/0.3ML TRIS-SUCROSE 12+YRS | $292.00 | $292.00 | — | 19% above | — |
| COVID-19 vaccine (Pfizer-BioNTech), age 12 and older CPT 91320 NDC Description Not Available | $546.86 | $546.86 | — | 124% above | — |
| COVID-19 vaccine (Pfizer-BioNTech), age 12 and older inpatient CPT 91320 SARSCOV2 VACC 30MCG/0.3ML TRIS-SUCROSE 12+YRS | $292.00 | $292.00 | — | — | — |
| COVID-19 vaccine (Pfizer-BioNTech), age 12 and older inpatient CPT 91320 NDC Description Not Available | $546.86 | $546.86 | — | — | — |
| Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 VARICELLA VACCINE,LIVE,SUBCUT (OUTPT) | $316.00 | $316.00 | — | 14% above | — |
| Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 VARICELLA VACCINE,LIVE,SUBCUT (OUTPT) | $316.00 | $316.00 | — | — | — |
| DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) CPT 90696 DTAP-IPV VACC 4-6 YR IM (QUADRACEL) | $107.00 | $107.00 | — | 5% above | — |
| DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) inpatient CPT 90696 DTAP-IPV VACC 4-6 YR IM (QUADRACEL) | $107.00 | $107.00 | — | — | — |
| DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 DTAP IMMUNIZATION, IM (OUTPT) < 7 YRS | $50.00 | $50.00 | — | 21% below | — |
| DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 inpatient CPT 90700 DTAP IMMUNIZATION, IM (OUTPT) < 7 YRS | $50.00 | $50.00 | — | — | — |
| DTaP, hepatitis B and polio combination vaccine (Pediarix) CPT 90723 DTAP/HEPB/IPV VACCINE,IM | $210.00 | $210.00 | — | 32% above | — |
| DTaP, hepatitis B and polio combination vaccine (Pediarix) inpatient CPT 90723 DTAP/HEPB/IPV VACCINE,IM | $210.00 | $210.00 | — | — | — |
| DTaP, polio and Hib combination vaccine (Pentacel) CPT 90698 DTAP-HIB-IP VAC (PENTACEL) IM | $175.00 | $175.00 | — | 2% below | — |
| DTaP, polio and Hib combination vaccine (Pentacel) inpatient CPT 90698 DTAP-HIB-IP VAC (PENTACEL) IM | $175.00 | $175.00 | — | — | — |
| Flu shot, recombinant, egg-free (Flublok) CPT 90673 INFLUENZA VIRUS VACC TRIVALENT RIV3 PRSR FR IM | $180.00 | $180.00 | — | 75% above | — |
| Flu shot, recombinant, egg-free (Flublok) inpatient CPT 90673 INFLUENZA VIRUS VACC TRIVALENT RIV3 PRSR FR IM | $180.00 | $180.00 | — | — | — |
| Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 INFLUENZA VAC SPLIT PRSRV FR 3+YRS IM | $48.00 | $48.00 | — | 34% above | — |
| Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 NDC Description Not Available | $127.95 | $127.95 | — | 258% above | — |
| Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 INFLUENZA VAC SPLIT PRSRV FR 3+YRS IM | $48.00 | $48.00 | — | — | — |
| Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 NDC Description Not Available | $127.95 | $127.95 | — | — | — |
| HPV vaccine, 9-valent (Gardasil 9) CPT 90651 HPV HUMAN PAPILLOMA VIRUS VAC 9 VAL 2 OR 3 DSE IM | $503.00 | $503.00 | — | 3% above | — |
| HPV vaccine, 9-valent (Gardasil 9) CPT 90651 Gardasil 9: 10 Syringe, Glass In 1 Carton (0006-4121-02) / .5 Ml In 1 Syringe, Glass (0006-4121-01) | $1,000.73 | $1,000.73 | — | 104% above | — |
| HPV vaccine, 9-valent (Gardasil 9) inpatient CPT 90651 HPV HUMAN PAPILLOMA VIRUS VAC 9 VAL 2 OR 3 DSE IM | $503.00 | $503.00 | — | — | — |
| HPV vaccine, 9-valent (Gardasil 9) inpatient CPT 90651 Gardasil 9: 10 Syringe, Glass In 1 Carton (0006-4121-02) / .5 Ml In 1 Syringe, Glass (0006-4121-01) | $1,000.73 | $1,000.73 | — | — | — |
| Hepatitis A and B combination vaccine, adult (Twinrix) CPT 90636 HEPA/HEPB VACCINE ADULT IM | $195.00 | $195.00 | — | 4% below | — |
| Hepatitis A and B combination vaccine, adult (Twinrix) inpatient CPT 90636 HEPA/HEPB VACCINE ADULT IM | $195.00 | $195.00 | — | — | — |
| Hepatitis A vaccine, adult dose CPT 90632 HEPATITIS A VACCINE,ADULT,IM (OUTPT) | $152.00 | $152.00 | — | 26% above | — |
| Hepatitis A vaccine, adult dose CPT 90632 NDC Description Not Available | $369.34 | $369.34 | — | 207% above | — |
| Hepatitis A vaccine, adult dose inpatient CPT 90632 HEPATITIS A VACCINE,ADULT,IM (OUTPT) | $152.00 | $152.00 | — | — | — |
| Hepatitis A vaccine, adult dose inpatient CPT 90632 NDC Description Not Available | $369.34 | $369.34 | — | — | — |
| Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 HEPA VACCINE PED/ADOL-2 DOSE (OUTPT) | $83.00 | $83.00 | — | at median | — |
| Hepatitis A vaccine, child and teen dose (2-dose schedule) inpatient CPT 90633 HEPA VACCINE PED/ADOL-2 DOSE (OUTPT) | $83.00 | $83.00 | — | — | — |
| Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 HEPATITIS B VACCINE,ADULT,IM (OUTPT) | $151.00 | $151.00 | — | 40% above | — |
| Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 Engerix-B: 10 Vial In 1 Carton (58160-821-11) / 1 Ml In 1 Vial (58160-821-01) | $244.29 | $244.29 | — | 126% above | — |
| Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 HEPATITIS B VACCINE,ADULT,IM (OUTPT) | $151.00 | $151.00 | — | — | — |
| Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 Engerix-B: 10 Vial In 1 Carton (58160-821-11) / 1 Ml In 1 Vial (58160-821-01) | $244.29 | $244.29 | — | — | — |
| Hepatitis B vaccine, adult, 2-dose schedule (Heplisav-B) CPT 90739 HEPATITIS B VACC ADULT 2 DOSE IM | $362.00 | $362.00 | — | 61% above | — |
| Hepatitis B vaccine, adult, 2-dose schedule (Heplisav-B) inpatient CPT 90739 HEPATITIS B VACC ADULT 2 DOSE IM | $362.00 | $362.00 | — | — | — |
| Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 HEP B VACCINE,PED/ADOL-3 DOSE, IM (OUTPT) | $66.00 | $66.00 | — | 24% below | — |
| Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 Recombivax Hb: 10 Vial, Single-Dose In 1 Carton (0006-4981-00) / .5 Ml In 1 Vial, Single-Dose (0006-4981-01) | $103.93 | $103.93 | — | 20% above | — |
| Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 Engerix-B: 10 Syringe In 1 Carton (58160-820-52) / .5 Ml In 1 Syringe (58160-820-43) | $128.64 | $128.64 | — | 48% above | — |
| Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 Recombivax Hb: 10 Syringe In 1 Carton (0006-4093-02) / .5 Ml In 1 Syringe (0006-4093-01) | $145.21 | $145.21 | — | 67% above | — |
| Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 Recombivax Hb: 10 Vial, Single-Dose In 1 Carton (0006-4995-41) / 1 Ml In 1 Vial, Single-Dose (0006-4995-01) | $157.07 | $157.07 | — | 81% above | — |
| Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 Recombivax Hb: 10 Syringe In 1 Carton (0006-4094-02) / 1 Ml In 1 Syringe (0006-4094-01) | $171.79 | $171.79 | — | 98% above | — |
| Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 HEP B VACCINE,PED/ADOL-3 DOSE, IM (OUTPT) | $66.00 | $66.00 | — | — | — |
| Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 Recombivax Hb: 10 Vial, Single-Dose In 1 Carton (0006-4981-00) / .5 Ml In 1 Vial, Single-Dose (0006-4981-01) | $103.93 | $103.93 | — | — | — |
| Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 Engerix-B: 10 Syringe In 1 Carton (58160-820-52) / .5 Ml In 1 Syringe (58160-820-43) | $128.64 | $128.64 | — | — | — |
| Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 Recombivax Hb: 10 Syringe In 1 Carton (0006-4093-02) / .5 Ml In 1 Syringe (0006-4093-01) | $145.21 | $145.21 | — | — | — |
| Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 Recombivax Hb: 10 Vial, Single-Dose In 1 Carton (0006-4995-41) / 1 Ml In 1 Vial, Single-Dose (0006-4995-01) | $157.07 | $157.07 | — | — | — |
| Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 Recombivax Hb: 10 Syringe In 1 Carton (0006-4094-02) / 1 Ml In 1 Syringe (0006-4094-01) | $171.79 | $171.79 | — | — | — |
| Hib vaccine (Haemophilus influenzae type b), 3-dose schedule (PedvaxHIB) CPT 90647 HIB-PEDVAX VACCINE,PRP-OMP, IM (OUTPT) | $62.00 | $62.00 | — | at median | — |
| Hib vaccine (Haemophilus influenzae type b), 3-dose schedule (PedvaxHIB) inpatient CPT 90647 HIB-PEDVAX VACCINE,PRP-OMP, IM (OUTPT) | $62.00 | $62.00 | — | — | — |
| Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) CPT 90648 HIB/OMNI VACCINE, PRP-T, IM (OUTPT) | $53.00 | $53.00 | — | at median | — |
| Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) CPT 90648 Acthib: 1 Kit In 1 Carton (49281-545-03) * .5 Ml In 1 Vial, Single-Dose (49281-547-58) * .6 Ml In 1 Vial, Single-Dose (49281-546-58) | $74.84 | $74.84 | — | 41% above | — |
| Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) CPT 90648 NDC Description Not Available | $101.43 | $101.43 | — | 91% above | — |
| Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) inpatient CPT 90648 HIB/OMNI VACCINE, PRP-T, IM (OUTPT) | $53.00 | $53.00 | — | — | — |
| Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) inpatient CPT 90648 Acthib: 1 Kit In 1 Carton (49281-545-03) * .5 Ml In 1 Vial, Single-Dose (49281-547-58) * .6 Ml In 1 Vial, Single-Dose (49281-546-58) | $74.84 | $74.84 | — | — | — |
| Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) inpatient CPT 90648 NDC Description Not Available | $101.43 | $101.43 | — | — | — |
| High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 HB FLU VACC SPLIT PRSV FREE INC ANTIG IM | $55.00 | $55.00 | — | 29% below | — |
| High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 FLU VACC PRSV FREE INC ANTIG | $180.00 | $180.00 | — | 134% above | — |
| High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 NDC Description Not Available | $349.51 | $349.51 | — | 354% above | — |
| High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 HB FLU VACC SPLIT PRSV FREE INC ANTIG IM | $55.00 | $55.00 | — | — | — |
| High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 FLU VACC PRSV FREE INC ANTIG | $180.00 | $180.00 | — | — | — |
| High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 NDC Description Not Available | $349.51 | $349.51 | — | — | — |
| MMR vaccine (measles, mumps and rubella), live CPT 90707 MMR VIRUS IMMUNIZATION, SUBCUT (OUTPT) | $193.00 | $193.00 | — | 1% below | — |
| MMR vaccine (measles, mumps and rubella), live CPT 90707 M-M-R Ii: 10 Vial, Single-Dose In 1 Carton (0006-4681-00) / .5 Ml In 1 Vial, Single-Dose (0006-4681-01) | $406.47 | $406.47 | — | 110% above | — |
| MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 MMR VIRUS IMMUNIZATION, SUBCUT (OUTPT) | $193.00 | $193.00 | — | — | — |
| MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 M-M-R Ii: 10 Vial, Single-Dose In 1 Carton (0006-4681-00) / .5 Ml In 1 Vial, Single-Dose (0006-4681-01) | $406.47 | $406.47 | — | — | — |
| MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) CPT 90710 COMBINED VACCINE, MMR+ VARICELLA,SQ | $523.00 | $523.00 | — | 26% above | — |
| MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) inpatient CPT 90710 COMBINED VACCINE, MMR+ VARICELLA,SQ | $523.00 | $523.00 | — | — | — |
| Meningococcal ACWY (MenACWY) vaccine CPT 90734 MENINGOCOCCAL CONJ VAC, 4VALIM | $266.00 | $266.00 | — | 7% above | — |
| Meningococcal ACWY (MenACWY) vaccine CPT 90734 MENINGOCOCCAL CONJ VAC, 4VAL IM-MENVEO | $297.00 | $297.00 | — | 20% above | — |
| Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 MENINGOCOCCAL CONJ VAC, 4VALIM | $266.00 | $266.00 | — | — | — |
| Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 MENINGOCOCCAL CONJ VAC, 4VAL IM-MENVEO | $297.00 | $297.00 | — | — | — |
| Meningococcal ACWY vaccine (MenQuadfi) CPT 90619 MENACWY-TT CONJ VACCINE SEROGRPS ACWY - IM USE | $251.00 | $251.00 | — | 2% below | — |
| Meningococcal ACWY vaccine (MenQuadfi) CPT 90619 Menquadfi: 5 Vial, Single-Dose In 1 Carton (49281-590-05) / .5 Ml In 1 Vial, Single-Dose (49281-590-58) | $436.96 | $436.96 | — | 71% above | — |
| Meningococcal ACWY vaccine (MenQuadfi) CPT 90619 NDC Description Not Available | $776.44 | $776.44 | — | 205% above | — |
| Meningococcal ACWY vaccine (MenQuadfi) inpatient CPT 90619 MENACWY-TT CONJ VACCINE SEROGRPS ACWY - IM USE | $251.00 | $251.00 | — | — | — |
| Meningococcal ACWY vaccine (MenQuadfi) inpatient CPT 90619 Menquadfi: 5 Vial, Single-Dose In 1 Carton (49281-590-05) / .5 Ml In 1 Vial, Single-Dose (49281-590-58) | $436.96 | $436.96 | — | — | — |
| Meningococcal ACWY vaccine (MenQuadfi) inpatient CPT 90619 NDC Description Not Available | $776.44 | $776.44 | — | — | — |
| Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 MENB RECOMBINANT PROT W/O MEMBR VESIC VACC IM | $383.00 | $383.00 | — | 6% above | — |
| Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 NDC Description Not Available | $1,040.43 | $1,040.43 | — | 188% above | — |
| Meningococcal B vaccine (Bexsero), 2-dose schedule inpatient CPT 90620 MENB RECOMBINANT PROT W/O MEMBR VESIC VACC IM | $383.00 | $383.00 | — | — | — |
| Meningococcal B vaccine (Bexsero), 2-dose schedule inpatient CPT 90620 NDC Description Not Available | $1,040.43 | $1,040.43 | — | — | — |
| Meningococcal B vaccine (Trumenba) CPT 90621 MENB RECOMBINANT LIPOPROTEIN VACCINE IM | $316.00 | $316.00 | — | at median | — |
| Meningococcal B vaccine (Trumenba) CPT 90621 NDC Description Not Available | $350.55 | $350.55 | — | 11% above | — |
| Meningococcal B vaccine (Trumenba) inpatient CPT 90621 MENB RECOMBINANT LIPOPROTEIN VACCINE IM | $316.00 | $316.00 | — | — | — |
| Meningococcal B vaccine (Trumenba) inpatient CPT 90621 NDC Description Not Available | $350.55 | $350.55 | — | — | — |
| Nasal spray flu vaccine, live (FluMist) CPT 90660 INFLUENZA VIRUS VAC, LIVE, INTRANASAL USE | $62.00 | $62.00 | — | 127% above | — |
| Nasal spray flu vaccine, live (FluMist) inpatient CPT 90660 INFLUENZA VIRUS VAC, LIVE, INTRANASAL USE | $62.00 | $62.00 | — | — | — |
| Pneumonia vaccine, 13-valent conjugate (Prevnar 13) CPT 90670 PNEUMO CONJ VAC 13 VALENT IM | $555.00 | $555.00 | — | 53% above | — |
| Pneumonia vaccine, 13-valent conjugate (Prevnar 13) inpatient CPT 90670 PNEUMO CONJ VAC 13 VALENT IM | $555.00 | $555.00 | — | — | — |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 PNEUMO CONJUGATE VACC 20 VALENT (PCV20) IM | $641.00 | $641.00 | — | 44% above | — |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 Prevnar 20: 10 Syringe In 1 Carton (0005-2000-10) / .5 Ml In 1 Syringe (0005-2000-01) | $840.32 | $840.32 | — | 89% above | — |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 Prevnar 20: 1 Syringe In 1 Carton (0005-2000-02) / .5 Ml In 1 Syringe (0005-2000-01) | $888.92 | $888.92 | — | 100% above | — |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 NDC Description Not Available | $1,180.79 | $1,180.79 | — | 166% above | — |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 PNEUMO CONJUGATE VACC 20 VALENT (PCV20) IM | $641.00 | $641.00 | — | — | — |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 Prevnar 20: 10 Syringe In 1 Carton (0005-2000-10) / .5 Ml In 1 Syringe (0005-2000-01) | $840.32 | $840.32 | — | — | — |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 Prevnar 20: 1 Syringe In 1 Carton (0005-2000-02) / .5 Ml In 1 Syringe (0005-2000-01) | $888.92 | $888.92 | — | — | — |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 NDC Description Not Available | $1,180.79 | $1,180.79 | — | — | — |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 HB PNEUMOCOCCAL VACCINE 2+ YR OLD | $116.00 | $116.00 | — | 38% below | — |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PNEUMOCOCCAL-23 VACCINE (OUTPT) | $287.00 | $287.00 | — | 53% above | — |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 HB PNEUMOCOCCAL VACCINE 2+ YR OLD | $116.00 | $116.00 | — | — | — |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 PNEUMOCOCCAL-23 VACCINE (OUTPT) | $287.00 | $287.00 | — | — | — |
| Polio vaccine, inactivated (IPV) CPT 90713 POLIOMYELITIS IMMUNIZATN,INACTV,SQ/IM (OUTPT) | $72.00 | $72.00 | — | 49% below | — |
| Polio vaccine, inactivated (IPV) CPT 90713 Ipol: 1 Vial, Multi-Dose In 1 Package (49281-860-10) / 5 Ml In 1 Vial, Multi-Dose (49281-860-78) | $131.09 | $131.09 | — | 7% below | — |
| Polio vaccine, inactivated (IPV) CPT 90713 NDC Description Not Available | $146.88 | $146.88 | — | 4% above | — |
| Polio vaccine, inactivated (IPV) inpatient CPT 90713 POLIOMYELITIS IMMUNIZATN,INACTV,SQ/IM (OUTPT) | $72.00 | $72.00 | — | — | — |
| Polio vaccine, inactivated (IPV) inpatient CPT 90713 Ipol: 1 Vial, Multi-Dose In 1 Package (49281-860-10) / 5 Ml In 1 Vial, Multi-Dose (49281-860-78) | $131.09 | $131.09 | — | — | — |
| Polio vaccine, inactivated (IPV) inpatient CPT 90713 NDC Description Not Available | $146.88 | $146.88 | — | — | — |
| RSV antibody shot for infants and toddlers, larger dose (1 mL, 100 mg) CPT 90381 Beyfortus: 5 Syringe In 1 Carton (49281-574-15) / 1 Ml In 1 Syringe | $536.78 | $536.78 | — | 37% below | — |
| RSV antibody shot for infants and toddlers, larger dose (1 mL, 100 mg) CPT 90381 RSV MONOCOLONAL AB SEASONAL 1 ML DOSE IM USE | $1,238.00 | $1,238.00 | — | 44% above | — |
| RSV antibody shot for infants and toddlers, larger dose (1 mL, 100 mg) CPT 90381 Beyfortus: 1 Syringe In 1 Carton (49281-574-88) / 1 Ml In 1 Syringe | $1,477.46 | $1,477.46 | — | 72% above | — |
| RSV antibody shot for infants and toddlers, larger dose (1 mL, 100 mg) inpatient CPT 90381 Beyfortus: 5 Syringe In 1 Carton (49281-574-15) / 1 Ml In 1 Syringe | $536.78 | $536.78 | — | — | — |
| RSV antibody shot for infants and toddlers, larger dose (1 mL, 100 mg) inpatient CPT 90381 RSV MONOCOLONAL AB SEASONAL 1 ML DOSE IM USE | $1,238.00 | $1,238.00 | — | — | — |
| RSV antibody shot for infants and toddlers, larger dose (1 mL, 100 mg) inpatient CPT 90381 Beyfortus: 1 Syringe In 1 Carton (49281-574-88) / 1 Ml In 1 Syringe | $1,477.46 | $1,477.46 | — | — | — |
| RSV antibody shot for infants, seasonal dose (0.5 mL) CPT 90380 RSV MONOCOLONAL AB SEASONAL 0.5 ML DOSE IM USE | $1,238.00 | $1,238.00 | — | 23% above | — |
| RSV antibody shot for infants, seasonal dose (0.5 mL) CPT 90380 Beyfortus: 5 Syringe In 1 Carton (49281-575-15) / .5 Ml In 1 Syringe | $1,835.66 | $1,835.66 | — | 82% above | — |
| RSV antibody shot for infants, seasonal dose (0.5 mL) CPT 90380 Beyfortus: 1 Syringe In 1 Carton (49281-575-00) / .5 Ml In 1 Syringe | $2,351.43 | $2,351.43 | — | 133% above | — |
| RSV antibody shot for infants, seasonal dose (0.5 mL) inpatient CPT 90380 RSV MONOCOLONAL AB SEASONAL 0.5 ML DOSE IM USE | $1,238.00 | $1,238.00 | — | — | — |
| RSV antibody shot for infants, seasonal dose (0.5 mL) inpatient CPT 90380 Beyfortus: 5 Syringe In 1 Carton (49281-575-15) / .5 Ml In 1 Syringe | $1,835.66 | $1,835.66 | — | — | — |
| RSV antibody shot for infants, seasonal dose (0.5 mL) inpatient CPT 90380 Beyfortus: 1 Syringe In 1 Carton (49281-575-00) / .5 Ml In 1 Syringe | $2,351.43 | $2,351.43 | — | — | — |
| Rabies vaccine, one dose CPT 90675 RABIES VACCINE, IM (OUTPT) | $753.00 | $753.00 | — | at median | — |
| Rabies vaccine, one dose CPT 90675 Rabavert: 1 Kit In 1 Carton (50632-010-01) * 1 Ml In 1 Syringe (50632-011-01) * 1 Ml In 1 Vial, Glass (50632-013-01) | $1,030.51 | $1,030.51 | — | 36% above | — |
| Rabies vaccine, one dose CPT 90675 NDC Description Not Available | $1,842.79 | $1,842.79 | — | 144% above | — |
| Rabies vaccine, one dose inpatient CPT 90675 RABIES VACCINE, IM (OUTPT) | $753.00 | $753.00 | — | — | — |
| Rabies vaccine, one dose inpatient CPT 90675 Rabavert: 1 Kit In 1 Carton (50632-010-01) * 1 Ml In 1 Syringe (50632-011-01) * 1 Ml In 1 Vial, Glass (50632-013-01) | $1,030.51 | $1,030.51 | — | — | — |
| Rabies vaccine, one dose inpatient CPT 90675 NDC Description Not Available | $1,842.79 | $1,842.79 | — | — | — |
| Rotavirus vaccine, oral, 2-dose schedule (Rotarix) CPT 90681 ROTAVIRUS VACCINE, 2 DOSE, ORAL | $326.00 | $326.00 | — | 45% above | — |
| Rotavirus vaccine, oral, 2-dose schedule (Rotarix) inpatient CPT 90681 ROTAVIRUS VACCINE, 2 DOSE, ORAL | $326.00 | $326.00 | — | — | — |
| Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) CPT 90680 ROTAVIRUS VACCINE, ORAL | $210.00 | $210.00 | — | 42% above | — |
| Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) inpatient CPT 90680 ROTAVIRUS VACCINE, ORAL | $210.00 | $210.00 | — | — | — |
| Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TETANUS & DIP (TD)>7YRS IM | $94.00 | $94.00 | — | 22% above | — |
| Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 Tenivac: 10 Syringe In 1 Package (49281-215-15) / .5 Ml In 1 Syringe (49281-215-88) | $194.16 | $194.16 | — | 152% above | — |
| Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 TETANUS & DIP (TD)>7YRS IM | $94.00 | $94.00 | — | — | — |
| Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 Tenivac: 10 Syringe In 1 Package (49281-215-15) / .5 Ml In 1 Syringe (49281-215-88) | $194.16 | $194.16 | — | — | — |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 ADACEL | $90.00 | $90.00 | — | 14% below | — |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 HB TDAP VACCINE IM 7+ YEARS | $126.00 | $126.00 | — | 20% above | — |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 HB TDAP VACCINE 7 YRS/> IM | $126.00 | $126.00 | — | 20% above | — |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 NDC Description Not Available | $147.30 | $147.30 | — | 41% above | — |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 Adacel Tdap: 10 Vial In 1 Package (49281-400-10) / .5 Ml In 1 Vial (49281-400-58) | $162.09 | $162.09 | — | 55% above | — |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 TDAP VACCINE FOR >7YRS IM | $181.00 | $181.00 | — | 73% above | — |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 Adacel Tdap: 5 Syringe In 1 Package (49281-400-20) / .5 Ml In 1 Syringe (49281-400-89) | $243.93 | $243.93 | — | 133% above | — |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 ADACEL | $90.00 | $90.00 | — | — | — |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 HB TDAP VACCINE IM 7+ YEARS | $126.00 | $126.00 | — | — | — |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 HB TDAP VACCINE 7 YRS/> IM | $126.00 | $126.00 | — | — | — |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 NDC Description Not Available | $147.30 | $147.30 | — | — | — |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 Adacel Tdap: 10 Vial In 1 Package (49281-400-10) / .5 Ml In 1 Vial (49281-400-58) | $162.09 | $162.09 | — | — | — |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 TDAP VACCINE FOR >7YRS IM | $181.00 | $181.00 | — | — | — |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 Adacel Tdap: 5 Syringe In 1 Package (49281-400-20) / .5 Ml In 1 Syringe (49281-400-89) | $243.93 | $243.93 | — | — | — |
| Typhoid vaccine, injectable (Vi polysaccharide) CPT 90691 TYPHOID VACCINE, IM (OUTPT) | $211.00 | $211.00 | — | 1% above | — |
| Typhoid vaccine, injectable (Vi polysaccharide) inpatient CPT 90691 TYPHOID VACCINE, IM (OUTPT) | $211.00 | $211.00 | — | — | — |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMIN | $70.00 | $70.00 | — | 22% above | — |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 HB FLU VACCINE ADMINISTRATION | $86.00 | $86.00 | — | 49% above | — |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 HB PNEUMOCOCCAL VACCINE ADMIN | $86.00 | $86.00 | — | 49% above | — |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 HB IMMUNIZATION ADM, ONE VACCINE | $86.00 | $86.00 | — | 49% above | — |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMIN | $70.00 | $70.00 | — | — | — |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 HB IMMUNIZATION ADM, ONE VACCINE | $86.00 | $86.00 | — | — | — |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 HB FLU VACCINE ADMINISTRATION | $86.00 | $86.00 | — | — | — |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 HB PNEUMOCOCCAL VACCINE ADMIN | $86.00 | $86.00 | — | — | — |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMUNIZ,ADMIN,EACH ADDL | $33.00 | $33.00 | — | 15% below | — |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 HB PNEUMOCOCCAL VACCINE ADMIN IN ADDITION TO FLU | $45.00 | $45.00 | — | 16% above | — |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 HB IMMUNIZATION ADM, EA ADD VACC | $45.00 | $45.00 | — | 16% above | — |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 IMMUNIZ,ADMIN,EACH ADDL | $33.00 | $33.00 | — | — | — |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 HB PNEUMOCOCCAL VACCINE ADMIN IN ADDITION TO FLU | $45.00 | $45.00 | — | — | — |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 HB IMMUNIZATION ADM, EA ADD VACC | $45.00 | $45.00 | — | — | — |
Dental
| Procedure | Cash price | List price | Insurers pay | vs Illinois | Off list |
|---|---|---|---|---|---|
| Deep cleaning (scaling and root planing), 4 or more teeth in one quadrant CDT D4341 HB SCALING & ROOT PLANE 4+ TEETH PER QUAD | $360.00 | $360.00 | — | at median | — |
| Deep cleaning (scaling and root planing), 4 or more teeth in one quadrant inpatient CDT D4341 HB SCALING & ROOT PLANE 4+ TEETH PER QUAD | $360.00 | $360.00 | — | — | — |
| Porcelain crown CDT D2740 HB ALL CERAMIC CROWN-PER VISIT | $795.00 | $795.00 | — | at median | — |
| Porcelain crown inpatient CDT D2740 HB ALL CERAMIC CROWN-PER VISIT | $795.00 | $795.00 | — | — | — |
| Root canal treatment on a molar (back tooth), not including the final crown one side CDT D3330 HB ENDO TX RT CANAL MOLAR/VISIT | $1,458.00 | $1,458.00 | — | at median | — |
| Root canal treatment on a molar (back tooth), not including the final crown inpatient one side CDT D3330 HB ENDO TX RT CANAL MOLAR/VISIT | $1,458.00 | $1,458.00 | — | — | — |
| Routine teeth cleaning (prophylaxis), adult or teen CDT D1110 HB PROPHYLAXIS-ADULT-PER VISIT | $166.00 | $166.00 | — | at median | — |
| Routine teeth cleaning (prophylaxis), adult or teen inpatient CDT D1110 HB PROPHYLAXIS-ADULT-PER VISIT | $166.00 | $166.00 | — | — | — |
| Simple extraction of a tooth or exposed root that is above the gum one side CDT D7140 HB EXTRAC ERPTD TOOTH/EXPSD RT | $255.00 | $255.00 | — | 22% below | — |
| Simple extraction of a tooth or exposed root that is above the gum inpatient one side CDT D7140 HB EXTRAC ERPTD TOOTH/EXPSD RT | $255.00 | $255.00 | — | — | — |
Procedure The service, with its billing code (CPT or HCPCS) and, in small type, the line exactly as the hospital wrote it in its price file. More
Cash price The hospital's own price for a patient paying without insurance (“discounted cash” in its price file). Hospitals must publish it under federal law, 45 CFR 180.50. Call to confirm it before booking. More
List price The hospital's full chargemaster price (“gross charge”) before any discount. Almost nobody pays it; the gap to the cash price shows what the self-pay discount is worth. More
Insurers pay The lowest and highest rates this hospital has agreed with insurance plans for the same item, from its price file. If the cash price is below what your plan pays and you have not met your deductible, paying cash can cost you less. More
Against the state median This hospital's cash price compared with the median cash price of hospitals in the state for the same code. Shown when at least three hospitals in the state price it.
Off list How much lower the cash price is than the list price.
No cash discount This line's cash price equals the hospital's full list price. Many hospitals still reduce bills for uninsured patients: ask the billing office for its self-pay discount in writing. More
At or below Medicare This cash price is at or below what Medicare pays a hospital for the same service, which is unusually low. It is what the hospital's file says; confirm it and what it includes before booking. More
Check the item The description in the hospital file looks like a supply or device (a catheter, a brace, an implant), not this procedure. The hospital may have filed it under the wrong code: ask before relying on this price.
Source file: https://www.endeavorhealth.org:443/362167060_1609817220_endeavor-health-clinical-operations_standardcharges.json