Hospital Flagstaff, AZ

Flagstaff Medical Center

Flagstaff Medical Center in Flagstaff, AZ publishes cash prices for 332 common procedures listed here, from its own machine-readable price file updated Feb 28, 2026. Compared with other hospitals in the state, its outpatient cash prices are above the Arizona median for 235 of 329 procedures and below it for 78. By typical cash price it ranks #34 of 53 Arizona hospitals, cheapest first. Select a procedure to compare it with other hospitals nearby.

1200 North Beaver Street, Flagstaff, AZ 86001 Collected Sep 23, 2026 Source price file Check a bill from this hospital (928) 779-3366

Acute care hospital Nonprofit hospital Emergency department CMS star rating 4 of 5 CCN 030023 · CMS hospital register NPI 1780635078

Financial assistance

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

Flagstaff Medical Center is a nonprofit hospital in the CMS register. Under section 501(r) of the federal tax code it must have a written Financial Assistance Policy with a free application, publish both on its website, and charge patients who qualify no more than the amounts generally billed to insured patients for emergency and other medically necessary care. Who qualifies depends on household income; the policy states the limits.

You can apply up to 240 days after the first bill. Before collection actions such as credit reporting or a lawsuit, the hospital must tell you about the policy and wait at least 120 days after that bill. Ask the billing office for the policy and the application before you pay, or search the hospital's website for “financial assistance”. Letters you can copy.

Source: IRS, section 501(r) requirements for nonprofit hospitals.

CMS price transparency record

The federal Centers for Medicare & Medicaid Services (CMS) enforces the rule that makes hospitals publish their prices. Its public enforcement list shows 4 actions for a hospital named Flagstaff Medical Center in Flagstaff, AZ:

Jan 30, 2023 Warning notice
May 8, 2023 Case closed
Oct 31, 2024 Warning notice
Jan 15, 2025 Case closed

Warning notice: CMS reviewed the hospital and told it that it had found possible violations of the price transparency rules. Case closed: CMS closed the case after the hospital addressed the problems.

A notice records a step in a CMS review; it is not a court finding. Source: CMS, Hospital Price Transparency Enforcement Activities and Outcomes, actions through Jul 31, 2026.

Scans and imaging

Procedure	Cash price	List price	Insurers pay	vs Arizona	Off list
Abdominal CT scan without and with contrast CPT 74170 CT Abdomen w/wo Contrast	$2,048.01	$4,096.01	$172.92–$5,000.00	32% above	50%
Abdominal CT scan without and with contrast inpatient CPT 74170 CT Abdomen w/wo Contrast	$2,048.01	$4,096.01	$1,433.60–$4,096.01	—	50%
Abdominal X-ray, 2 views CPT 74019 XR Abdomen Flat & Upright	$310.50	$621.00	$60.00–$5,000.00	45% above	50%
Abdominal X-ray, 2 views inpatient CPT 74019 XR Abdomen Flat & Upright	$310.50	$621.00	$217.35–$621.00	—	50%
Ankle X-ray, complete, 3 or more views one side CPT 73610 XR Ankle Complete 3 Views Rt	$288.56	$577.12	$60.00–$5,000.00	86% above	50%
Ankle X-ray, complete, 3 or more views one side CPT 73610 XR Ankle Complete 3 Views Lt	$288.56	$577.12	$60.00–$5,000.00	86% above	50%
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 XR Ankle Complete 3 Views Lt	$288.56	$577.12	$201.99–$577.12	—	50%
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 XR Ankle Complete 3 Views Rt	$288.56	$577.12	$201.99–$577.12	—	50%
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 Art. Studies, Bil, Single Level	$509.22	$1,018.44	$108.41–$5,000.00	36% above	50%
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 US ABI Extremity	$509.22	$1,018.44	$108.41–$5,000.00	36% above	50%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 Art. Studies, Bil, Single Level	$509.22	$1,018.44	$356.45–$1,018.44	—	50%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 US ABI Extremity	$509.22	$1,018.44	$356.45–$1,018.44	—	50%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Ext Upper w/o Contrast Lt	$1,245.15	$2,490.30	$105.52–$5,000.00	35% above	50%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Ext Upper w/o Contrast Rt	$1,245.15	$2,490.30	$105.52–$5,000.00	35% above	50%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT Ext Upper w/o Contrast Lt	$1,245.15	$2,490.30	$871.61–$2,490.30	—	50%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT Ext Upper w/o Contrast Rt	$1,245.15	$2,490.30	$871.61–$2,490.30	—	50%
Barium swallow (esophagus X-ray with contrast) CPT 74220 XR Esophagus w/o Air Contrast	$439.85	$879.69	$60.00–$5,000.00	22% above	50%
Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 XR Esophagus w/o Air Contrast	$439.85	$879.69	$307.89–$879.69	—	50%
Bone scan, whole body (nuclear medicine) CPT 78306 NM Bone Scan Whole Body	$1,670.74	$3,341.48	$365.22–$5,000.00	7% above	50%
Bone scan, whole body (nuclear medicine) inpatient CPT 78306 NM Bone Scan Whole Body	$1,670.74	$3,341.48	$1,169.52–$3,341.48	—	50%
Breast ultrasound, complete, one breast one side CPT 76641 US Breast Complete Rt includes Axilla	$176.85	$353.70	$105.52–$5,000.00	29% below	50%
Breast ultrasound, complete, one breast one side CPT 76641 US Breast Complete Lt includes Axilla	$176.85	$353.70	$105.52–$5,000.00	29% below	50%
Breast ultrasound, complete, one breast inpatient one side CPT 76641 US Breast Complete Lt includes Axilla	$176.85	$353.70	$123.79–$353.70	—	50%
Breast ultrasound, complete, one breast inpatient one side CPT 76641 US Breast Complete Rt includes Axilla	$176.85	$353.70	$123.79–$353.70	—	50%
Breast ultrasound, limited (one breast or one area) CPT 76642 US Breast Ltd Uni-Rad Onc	$176.85	$353.70	$78.35–$5,000.00	14% below	50%
Breast ultrasound, limited (one breast or one area) one side CPT 76642 US Breast Ltd Rt includes Axilla	$176.85	$353.70	$78.35–$5,000.00	14% below	50%
Breast ultrasound, limited (one breast or one area) one side CPT 76642 US Breast Ltd Lt includes Axilla	$176.85	$353.70	$78.35–$5,000.00	14% below	50%
Breast ultrasound, limited (one breast or one area) inpatient CPT 76642 US Breast Ltd Uni-Rad Onc	$176.85	$353.70	$123.79–$353.70	—	50%
Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 US Breast Ltd Lt includes Axilla	$176.85	$353.70	$123.79–$353.70	—	50%
Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 US Breast Ltd Rt includes Axilla	$176.85	$353.70	$123.79–$353.70	—	50%
CT angiography (CTA) of the abdomen and pelvis CPT 74174 CT CTA Abd/Pelvis w/wo Contrast	$3,769.17	$7,538.34	$250.00–$7,538.34	126% above	50%
CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174 CT CTA Abd/Pelvis w/wo Contrast	$3,769.17	$7,538.34	$2,638.42–$7,538.34	—	50%
CT angiography (CTA) of the head CPT 70496 CT CTA Head w/wo Contrast	$2,188.28	$4,376.56	$172.92–$5,000.00	86% above	50%
CT angiography (CTA) of the head inpatient CPT 70496 CT CTA Head w/wo Contrast	$2,188.28	$4,376.56	$1,531.80–$4,376.56	—	50%
CT angiography (CTA) of the neck CPT 70498 CT CTA Neck w/wo Contrast	$2,314.06	$4,628.12	$172.92–$5,000.00	96% above	50%
CT angiography (CTA) of the neck inpatient CPT 70498 CT CTA Neck w/wo Contrast	$2,314.06	$4,628.12	$1,619.84–$4,628.12	—	50%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT CTA Chest (non-coronary) w/wo	$2,101.48	$4,202.95	$172.92–$5,000.00	60% above	50%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CT CTA Chest (non-coronary) w/wo	$2,101.48	$4,202.95	$1,471.03–$4,202.95	—	50%
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 CTA Coronary Arteries W/Wo	$2,142.21	$4,284.42	$172.92–$5,000.00	158% above	50%
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score inpatient CPT 75574 CTA Coronary Arteries W/Wo	$2,142.21	$4,284.42	$1,499.55–$4,284.42	—	50%
CT of the heart without contrast dye to measure coronary calcium CPT 75571 CT Coronary w Calcium Eval wo Contrast	$119.12	$238.24	$78.35–$5,000.00	64% below	50%
CT of the heart without contrast dye to measure coronary calcium inpatient CPT 75571 CT Coronary w Calcium Eval wo Contrast	$119.12	$238.24	$83.38–$238.24	—	50%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT Abdomen & Pelvis w/o Contrast	$3,346.86	$6,693.72	$222.87–$6,693.72	155% above	50%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT Abdomen & Pelvis w/o Contrast	$3,346.86	$6,693.72	$2,342.80–$6,693.72	—	50%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT Abdomen & Pelvis with Contrast	$3,505.84	$7,011.67	$250.00–$7,011.67	73% above	50%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT Abdomen & Pelvis with Contrast	$3,505.84	$7,011.67	$2,454.08–$7,011.67	—	50%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT Abdomen & Pelvis w & w/o Contrast	$5,482.26	$10,964.52	$250.00–$10,964.52	133% above	50%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT Abdomen & Pelvis w & w/o Contrast	$5,482.26	$10,964.52	$3,837.58–$10,964.52	—	50%
CT scan of the abdomen with contrast CPT 74160 CT Abdomen w/ Contrast	$1,665.64	$3,331.27	$172.92–$5,000.00	32% above	50%
CT scan of the abdomen with contrast inpatient CPT 74160 CT Abdomen w/ Contrast	$1,665.64	$3,331.27	$1,165.94–$3,331.27	—	50%
CT scan of the abdomen without contrast CPT 74150 CT Abdomen wo Contrast	$1,589.76	$3,179.52	$105.52–$5,000.00	81% above	50%
CT scan of the abdomen without contrast inpatient CPT 74150 CT Abdomen wo Contrast	$1,589.76	$3,179.52	$1,112.83–$3,179.52	—	50%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT Sinuses Ltd	$1,255.19	$2,510.38	$105.52–$5,000.00	57% above	50%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT Maxillofacial w/o Contrast	$1,255.19	$2,510.38	$105.52–$5,000.00	57% above	50%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT Sinuses Ltd	$1,255.19	$2,510.38	$878.63–$2,510.38	—	50%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT Maxillofacial w/o Contrast	$1,255.19	$2,510.38	$878.63–$2,510.38	—	50%
CT scan of the head or brain, no contrast dye CPT 70450 CT Head w/o Contrast	$1,099.59	$2,199.17	$105.52–$5,000.00	20% above	50%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT Head w/o Contrast	$1,099.59	$2,199.17	$769.71–$2,199.17	—	50%
CT scan of the head with contrast CPT 70460 CT Head w/ Contrast	$1,277.34	$2,554.68	$172.92–$5,000.00	8% above	50%
CT scan of the head with contrast inpatient CPT 70460 CT Head w/ Contrast	$1,277.34	$2,554.68	$894.14–$2,554.68	—	50%
CT scan of the head without and with contrast CPT 70470 CT Head w/wo Contrast	$2,055.49	$4,110.97	$172.92–$5,000.00	45% above	50%
CT scan of the head without and with contrast inpatient CPT 70470 CT Head w/wo Contrast	$2,055.49	$4,110.97	$1,438.84–$4,110.97	—	50%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT Spine Lumbar w/o Contrast	$1,397.99	$2,795.97	$105.52–$5,000.00	23% above	50%
CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 CT Spine Lumbar w/o Contrast	$1,397.99	$2,795.97	$978.59–$2,795.97	—	50%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT Spine Cervical w/o Contrast	$1,644.93	$3,289.86	$105.52–$5,000.00	45% above	50%
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CT Spine Cervical w/o Contrast	$1,644.93	$3,289.86	$1,151.45–$3,289.86	—	50%
CT scan of the pelvis, with contrast dye CPT 72193 CT Pelvis w/ Contrast	$1,388.03	$2,776.06	$172.92–$5,000.00	25% above	50%
CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT Pelvis w/ Contrast	$1,388.03	$2,776.06	$971.62–$2,776.06	—	50%
Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 US Dup Carotid Art Bilat	$949.33	$1,898.65	$222.87–$5,000.00	—	50%
Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 Dup Carotid Art Bilat	$949.33	$1,898.65	$222.87–$5,000.00	—	50%
Carotid artery ultrasound (duplex), both sides of the neck inpatient both sides CPT 93880 US Dup Carotid Art Bilat	$949.33	$1,898.65	$664.53–$1,898.65	—	50%
Carotid artery ultrasound (duplex), both sides of the neck inpatient both sides CPT 93880 Dup Carotid Art Bilat	$949.33	$1,898.65	$664.53–$1,898.65	—	50%
Chest CT scan without and with contrast CPT 71270 CT Chest w/wo Contrast	$1,718.96	$3,437.92	$172.92–$5,000.00	25% above	50%
Chest CT scan without and with contrast inpatient CPT 71270 CT Chest w/wo Contrast	$1,718.96	$3,437.92	$1,203.27–$3,437.92	—	50%
Chest X-ray, 2 views CPT 71046 XR Chest 2view To Include Abd (Nursery)	$145.62	$291.24	$60.00–$5,000.00	17% below	50%
Chest X-ray, 2 views CPT 71046 XR Chest Inspiration/Expiration	$145.62	$291.24	$60.00–$5,000.00	17% below	50%
Chest X-ray, 2 views CPT 71046 XR Chest Pa/Lat 2 View	$145.62	$291.24	$60.00–$5,000.00	17% below	50%
Chest X-ray, 2 views inpatient CPT 71046 XR Chest Pa/Lat 2 View	$145.62	$291.24	$101.93–$291.24	—	50%
Chest X-ray, 2 views inpatient CPT 71046 XR Chest 2view To Include Abd (Nursery)	$145.62	$291.24	$101.93–$291.24	—	50%
Chest X-ray, 2 views inpatient CPT 71046 XR Chest Inspiration/Expiration	$145.62	$291.24	$101.93–$291.24	—	50%
Chest X-ray, single view CPT 71045 XR Chest Single View	$142.91	$285.82	$60.00–$5,000.00	27% above	50%
Chest X-ray, single view inpatient CPT 71045 XR Chest Single View	$142.91	$285.82	$100.04–$285.82	—	50%
Collarbone (clavicle) X-ray, complete one side CPT 73000 XR Clavicle Rt	$177.66	$355.31	$60.00–$5,000.00	7% below	50%
Collarbone (clavicle) X-ray, complete one side CPT 73000 XR Clavicle Lt	$177.66	$355.31	$60.00–$5,000.00	7% below	50%
Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 XR Clavicle Lt	$177.66	$355.31	$124.36–$355.31	—	50%
Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 XR Clavicle Rt	$177.66	$355.31	$124.36–$355.31	—	50%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US Retroperitoneum, Complete	$766.59	$1,533.18	$105.52–$5,000.00	82% above	50%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US Retroperitoneum - Cardiology	$766.59	$1,533.18	$105.52–$5,000.00	82% above	50%
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US Retroperitoneum - Cardiology	$766.59	$1,533.18	$536.61–$1,533.18	—	50%
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US Retroperitoneum, Complete	$766.59	$1,533.18	$536.61–$1,533.18	—	50%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 XR Bone Density Spine/Pelvic/Hips	$215.58	$431.16	$60.00–$5,000.00	29% below	50%
DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 XR Bone Density Spine/Pelvic/Hips	$215.58	$431.16	$150.91–$431.16	—	50%
DEXA bone density scan of the wrist, heel or finger (peripheral) one side CPT 77081 XR Bone Density Extremity Rt	$214.13	$428.25	$60.00–$5,000.00	4% above	50%
DEXA bone density scan of the wrist, heel or finger (peripheral) one side CPT 77081 XR Bone Density Extremity Lt	$214.13	$428.25	$60.00–$5,000.00	4% above	50%
DEXA bone density scan of the wrist, heel or finger (peripheral) inpatient one side CPT 77081 XR Bone Density Extremity Lt	$214.13	$428.25	$149.89–$428.25	—	50%
DEXA bone density scan of the wrist, heel or finger (peripheral) inpatient one side CPT 77081 XR Bone Density Extremity Rt	$214.13	$428.25	$149.89–$428.25	—	50%
Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 US OB Fetal Ex Level 2 (1st Fetus) - LD	$673.20	$1,346.39	$222.87–$5,000.00	73% above	50%
Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 US Ob Complete - LD	$673.20	$1,346.39	$222.87–$5,000.00	73% above	50%
Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 US OB Fetal Ex Level 2 (1st Fetus)	$673.20	$1,346.39	$222.87–$5,000.00	73% above	50%
Detailed fetal anatomy ultrasound, through the belly, one baby inpatient CPT 76811 US OB Fetal Ex Level 2 (1st Fetus)	$673.20	$1,346.39	$471.24–$1,346.39	—	50%
Detailed fetal anatomy ultrasound, through the belly, one baby inpatient CPT 76811 US OB Fetal Ex Level 2 (1st Fetus) - LD	$673.20	$1,346.39	$471.24–$1,346.39	—	50%
Detailed fetal anatomy ultrasound, through the belly, one baby inpatient CPT 76811 US Ob Complete - LD	$673.20	$1,346.39	$471.24–$1,346.39	—	50%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT Chest wo Contrast	$1,272.19	$2,544.37	$105.52–$5,000.00	43% above	50%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT Chest wo Contrast	$1,272.19	$2,544.37	$890.53–$2,544.37	—	50%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT Chest w/ Contrast	$1,338.11	$2,676.22	$172.92–$5,000.00	8% above	50%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT Chest w/ Contrast	$1,338.11	$2,676.22	$936.68–$2,676.22	—	50%
Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 US Dup Lower Ext Art Bilat	$936.68	$1,873.35	$222.87–$5,000.00	—	50%
Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 Dup Lower Ext Art Bilat	$936.68	$1,873.35	$222.87–$5,000.00	—	50%
Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 US Dup Lower Ext Art Bilat	$936.68	$1,873.35	$655.67–$1,873.35	—	50%
Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 Dup Lower Ext Art Bilat	$936.68	$1,873.35	$655.67–$1,873.35	—	50%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 Vein Mapping Bilateral	$652.33	$1,304.65	$222.87–$5,000.00	—	50%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 US Dup Ext Veins Bilat	$652.33	$1,304.65	$222.87–$5,000.00	—	50%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 US Vein Mapping Bilateral	$652.33	$1,304.65	$222.87–$5,000.00	—	50%
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 US Vein Mapping Bilateral	$652.33	$1,304.65	$456.63–$1,304.65	—	50%
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 Vein Mapping Bilateral	$652.33	$1,304.65	$456.63–$1,304.65	—	50%
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 US Dup Ext Veins Bilat	$652.33	$1,304.65	$456.63–$1,304.65	—	50%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 Echocardiogram/2D/Doppler/Color Doppler	$2,247.80	$4,495.60	$467.67–$5,000.00	124% above	50%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 Echocardiogram/2D/Doppler/Color Doppler	$2,247.80	$4,495.60	$1,573.46–$4,495.60	—	50%
Elbow X-ray, 2 views one side CPT 73070 XR Elbow 2 Views Lt	$124.26	$248.51	$60.00–$5,000.00	34% below	50%
Elbow X-ray, 2 views one side CPT 73070 XR Elbow 2 Views Rt	$124.26	$248.51	$60.00–$5,000.00	34% below	50%
Elbow X-ray, 2 views inpatient one side CPT 73070 XR Elbow 2 Views Lt	$124.26	$248.51	$86.98–$248.51	—	50%
Elbow X-ray, 2 views inpatient one side CPT 73070 XR Elbow 2 Views Rt	$124.26	$248.51	$86.98–$248.51	—	50%
Elbow X-ray, complete, 3 or more views one side CPT 73080 XR Elbow 3 Views Lt	$232.08	$464.15	$60.00–$5,000.00	65% above	50%
Elbow X-ray, complete, 3 or more views one side CPT 73080 XR Elbow 3 Views Rt	$232.08	$464.15	$60.00–$5,000.00	65% above	50%
Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 XR Elbow 3 Views Lt	$232.08	$464.15	$162.45–$464.15	—	50%
Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 XR Elbow 3 Views Rt	$232.08	$464.15	$162.45–$464.15	—	50%
Eye socket (orbit) CT scan without contrast CPT 70480 CT Orbit Inner Ear Sella w/o	$1,255.19	$2,510.38	$105.52–$5,000.00	37% above	50%
Eye socket (orbit) CT scan without contrast inpatient CPT 70480 CT Orbit Inner Ear Sella w/o	$1,255.19	$2,510.38	$878.63–$2,510.38	—	50%
Facial bones X-ray, complete, 3 or more views CPT 70150 XR Facial Bones Complete Min 3 Views	$256.72	$513.44	$60.00–$5,000.00	1% above	50%
Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 XR Facial Bones Complete Min 3 Views	$256.72	$513.44	$179.70–$513.44	—	50%
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 XR Forearm 2 Views Rt	$124.26	$248.51	$60.00–$5,000.00	29% below	50%
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 XR Forearm 2 Views Lt	$124.26	$248.51	$60.00–$5,000.00	29% below	50%
Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 XR Forearm 2 Views Lt	$124.26	$248.51	$86.98–$248.51	—	50%
Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 XR Forearm 2 Views Rt	$124.26	$248.51	$86.98–$248.51	—	50%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 NM Biliary Scan	$918.12	$1,836.23	$365.22–$5,000.00	8% below	50%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 NM Biliary Scan	$918.12	$1,836.23	$642.68–$1,836.23	—	50%
Hand X-ray, 2 views one side CPT 73120 XR Hand 2 Views Lt	$164.30	$328.60	$60.00–$5,000.00	46% above	50%
Hand X-ray, 2 views one side CPT 73120 XR Hand 2 Views Rt	$164.30	$328.60	$60.00–$5,000.00	46% above	50%
Hand X-ray, 2 views inpatient one side CPT 73120 XR Hand 2 Views Lt	$164.30	$328.60	$115.01–$328.60	—	50%
Hand X-ray, 2 views inpatient one side CPT 73120 XR Hand 2 Views Rt	$164.30	$328.60	$115.01–$328.60	—	50%
Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 XR Calcaneus 2 Views Lt	$177.66	$355.31	$60.00–$5,000.00	47% above	50%
Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 XR Calcaneus 2 Views Rt	$177.66	$355.31	$60.00–$5,000.00	47% above	50%
Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 XR Calcaneus 2 Views Lt	$177.66	$355.31	$124.36–$355.31	—	50%
Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 XR Calcaneus 2 Views Rt	$177.66	$355.31	$124.36–$355.31	—	50%
Knee X-ray, 3 views one side CPT 73562 XR Knee 3 Views Rt	$277.26	$554.51	$60.00–$5,000.00	35% above	50%
Knee X-ray, 3 views one side CPT 73562 XR Knee 3 Views Lt	$277.26	$554.51	$60.00–$5,000.00	35% above	50%
Knee X-ray, 3 views inpatient one side CPT 73562 XR Knee 3 Views Lt	$277.26	$554.51	$194.08–$554.51	—	50%
Knee X-ray, 3 views inpatient one side CPT 73562 XR Knee 3 Views Rt	$277.26	$554.51	$194.08–$554.51	—	50%
Knee X-ray, complete, 4 or more views one side CPT 73564 XR Knee 4 Or More Views Lt	$294.86	$589.72	$60.00–$5,000.00	7% above	50%
Knee X-ray, complete, 4 or more views one side CPT 73564 XR Knee 4 Or More Views Rt	$294.86	$589.72	$60.00–$5,000.00	7% above	50%
Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 XR Knee 4 Or More Views Rt	$294.86	$589.72	$206.40–$589.72	—	50%
Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 XR Knee 4 Or More Views Lt	$294.86	$589.72	$206.40–$589.72	—	50%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Ext Lower w/o Contrast Rt	$1,418.17	$2,836.34	$105.52–$5,000.00	31% above	50%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Ext Lower w/o Contrast Lt	$1,418.17	$2,836.34	$105.52–$5,000.00	31% above	50%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT Ext Lower w/o Contrast Lt	$1,418.17	$2,836.34	$992.72–$2,836.34	—	50%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT Ext Lower w/o Contrast Rt	$1,418.17	$2,836.34	$992.72–$2,836.34	—	50%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US Abdomen Limited-ED	$450.70	$901.40	$105.52–$5,000.00	16% above	50%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US Appendix	$450.70	$901.40	$105.52–$5,000.00	16% above	50%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US Abdomen Limited	$450.70	$901.40	$105.52–$5,000.00	16% above	50%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 IR US Abdomen Limited	$450.70	$901.40	$105.52–$5,000.00	16% above	50%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US Abdomen Limited	$450.70	$901.40	$315.49–$901.40	—	50%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US Appendix	$450.70	$901.40	$315.49–$901.40	—	50%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US Abdomen Limited-ED	$450.70	$901.40	$315.49–$901.40	—	50%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 IR US Abdomen Limited	$450.70	$901.40	$315.49–$901.40	—	50%
Limited ultrasound of an arm or leg (non-vascular) CPT 76882 US Extremity Non-Vascular Ltd Specify	$306.54	$613.07	$105.52–$5,000.00	58% above	50%
Limited ultrasound of an arm or leg (non-vascular) CPT 76882 IR US Extremity Non-Vascular Ltd Specify	$306.54	$613.07	$105.52–$5,000.00	58% above	50%
Limited ultrasound of an arm or leg (non-vascular) CPT 76882 US Extremity Non-Vasular - ED	$306.54	$613.07	$105.52–$5,000.00	58% above	50%
Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 IR US Extremity Non-Vascular Ltd Specify	$306.54	$613.07	$214.57–$613.07	—	50%
Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 US Extremity Non-Vascular Ltd Specify	$306.54	$613.07	$214.57–$613.07	—	50%
Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 US Extremity Non-Vasular - ED	$306.54	$613.07	$214.57–$613.07	—	50%
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 CT Chest w/o Screening (Tobacco)	$97.75	$195.50	$68.42–$5,000.00	30% below	50%
Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 CT Chest w/o Screening (Tobacco)	$97.75	$195.50	$68.42–$195.50	—	50%
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 XR Tibia/Fibula 2 Views Rt	$155.07	$310.13	$60.00–$5,000.00	23% above	50%
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 XR Tibia/Fibula 2 Views Lt	$155.07	$310.13	$60.00–$5,000.00	23% above	50%
Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 XR Tibia/Fibula 2 Views Lt	$155.07	$310.13	$108.55–$310.13	—	50%
Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 XR Tibia/Fibula 2 Views Rt	$155.07	$310.13	$108.55–$310.13	—	50%
MR angiography (MRA) of the head without contrast CPT 70544 MRI MRA Head w/o Contrast	$1,562.44	$3,124.87	$222.87–$5,000.00	36% above	50%
MR angiography (MRA) of the head without contrast inpatient CPT 70544 MRI MRA Head w/o Contrast	$1,562.44	$3,124.87	$1,093.70–$3,124.87	—	50%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Lower Ext Jt Wo Rt	$1,381.65	$2,763.29	$222.87–$5,000.00	8% below	50%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Lower Ext Jt Wo Lt	$1,381.65	$2,763.29	$222.87–$5,000.00	8% below	50%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI Lower Ext Jt Wo Lt	$1,381.65	$2,763.29	$967.15–$2,763.29	—	50%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI Lower Ext Jt Wo Rt	$1,381.65	$2,763.29	$967.15–$2,763.29	—	50%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Lower Ext Jt w/wo Rt	$2,377.23	$4,754.45	$356.51–$5,000.00	13% above	50%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Lower Ext Jt w/wo Lt	$2,377.23	$4,754.45	$356.51–$5,000.00	13% above	50%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI Lower Ext Jt w/wo Lt	$2,377.23	$4,754.45	$1,664.06–$4,754.45	—	50%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI Lower Ext Jt w/wo Rt	$2,377.23	$4,754.45	$1,664.06–$4,754.45	—	50%
MRI of the abdomen without contrast CPT 74181 MRI Cholangio-Pancreatography (MRCP)	$2,101.38	$4,202.75	$222.87–$5,000.00	85% above	50%
MRI of the abdomen without contrast CPT 74181 MRI Abdomen Wo Contrast	$2,101.38	$4,202.75	$222.87–$5,000.00	85% above	50%
MRI of the abdomen without contrast inpatient CPT 74181 MRI Cholangio-Pancreatography (MRCP)	$2,101.38	$4,202.75	$1,470.96–$4,202.75	—	50%
MRI of the abdomen without contrast inpatient CPT 74181 MRI Abdomen Wo Contrast	$2,101.38	$4,202.75	$1,470.96–$4,202.75	—	50%
MRI of the abdomen, without and then with contrast dye CPT 74183 MRI Abdomen w/wo Contrast	$2,820.51	$5,641.02	$356.51–$5,641.02	28% above	50%
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MRI Abdomen w/wo Contrast	$2,820.51	$5,641.02	$1,974.36–$5,641.02	—	50%
MRI of the brain, no contrast dye CPT 70551 MRI Brain w/o Contrast	$2,086.68	$4,173.36	$222.87–$5,000.00	59% above	50%
MRI of the brain, no contrast dye inpatient CPT 70551 MRI Brain w/o Contrast	$2,086.68	$4,173.36	$1,460.68–$4,173.36	—	50%
MRI of the brain, with and without contrast dye CPT 70553 MRI Brain w/wo Contrast	$3,130.24	$6,260.47	$356.51–$6,260.47	66% above	50%
MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI Brain w/wo Contrast	$3,130.24	$6,260.47	$2,191.16–$6,260.47	—	50%
MRI of the lower back, no contrast dye CPT 72148 MRI Lumbar Spine w/o Contrast	$1,841.58	$3,683.16	$222.87–$5,000.00	5% above	50%
MRI of the lower back, no contrast dye inpatient CPT 72148 MRI Lumbar Spine w/o Contrast	$1,841.58	$3,683.16	$1,289.11–$3,683.16	—	50%
MRI of the lower back, without and then with contrast dye CPT 72158 MRI Lumbar Spine w/wo Con	$2,956.68	$5,913.35	$356.51–$5,913.35	20% above	50%
MRI of the lower back, without and then with contrast dye inpatient CPT 72158 MRI Lumbar Spine w/wo Con	$2,956.68	$5,913.35	$2,069.67–$5,913.35	—	50%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI Thoracic Spine w/o Contrast	$2,315.27	$4,630.54	$222.87–$5,000.00	28% above	50%
MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 MRI Thoracic Spine w/o Contrast	$2,315.27	$4,630.54	$1,620.69–$4,630.54	—	50%
MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI Cervical Spine w/wo Contrast	$3,083.85	$6,167.69	$356.51–$6,167.69	39% above	50%
MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 MRI Cervical Spine w/wo Contrast	$3,083.85	$6,167.69	$2,158.69–$6,167.69	—	50%
MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI Cervical Spine w/o Contrast	$2,437.12	$4,874.24	$222.87–$5,000.00	69% above	50%
MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 MRI Cervical Spine w/o Contrast	$2,437.12	$4,874.24	$1,705.98–$4,874.24	—	50%
MRI of the pelvis without and with contrast CPT 72197 MRI Pelvis w/wo Contrast	$2,442.23	$4,884.46	$356.51–$5,000.00	24% above	50%
MRI of the pelvis without and with contrast inpatient CPT 72197 MRI Pelvis w/wo Contrast	$2,442.23	$4,884.46	$1,709.56–$4,884.46	—	50%
MRI of the pelvis, no contrast dye CPT 72195 MRI Pelvis Wo Contrast	$1,242.01	$2,484.01	$222.87–$5,000.00	2% below	50%
MRI of the pelvis, no contrast dye inpatient CPT 72195 MRI Pelvis Wo Contrast	$1,242.01	$2,484.01	$869.40–$2,484.01	—	50%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI Upper Ext Jt Wo Lt	$1,381.65	$2,763.29	$222.87–$5,000.00	5% below	50%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI Upper Ext Jt Wo Rt	$1,381.65	$2,763.29	$222.87–$5,000.00	5% below	50%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI Upper Ext Jt Wo Lt	$1,381.65	$2,763.29	$967.15–$2,763.29	—	50%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI Upper Ext Jt Wo Rt	$1,381.65	$2,763.29	$967.15–$2,763.29	—	50%
Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 XR Spine Cervical 4 or 5 Views	$291.64	$583.27	$60.00–$5,000.00	4% above	50%
Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 XR Spine Cervical 4 or 5 Views	$291.64	$583.27	$204.14–$583.27	—	50%
Neck soft tissue CT scan with contrast CPT 70491 CT Neck Soft Tissue w/ contrast	$1,679.37	$3,358.73	$172.92–$5,000.00	40% above	50%
Neck soft tissue CT scan with contrast inpatient CPT 70491 CT Neck Soft Tissue w/ contrast	$1,679.37	$3,358.73	$1,175.56–$3,358.73	—	50%
Neck soft tissue CT scan without contrast CPT 70490 CT Neck Soft Tissue w/o contrast	$1,589.04	$3,178.08	$105.52–$5,000.00	76% above	50%
Neck soft tissue CT scan without contrast inpatient CPT 70490 CT Neck Soft Tissue w/o contrast	$1,589.04	$3,178.08	$1,112.33–$3,178.08	—	50%
Neck soft tissue X-ray CPT 70360 XR Neck Soft Tissue	$199.86	$399.72	$60.00–$5,000.00	13% above	50%
Neck soft tissue X-ray inpatient CPT 70360 XR Neck Soft Tissue	$199.86	$399.72	$139.90–$399.72	—	50%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 NM Cardiac Rest/Stress Spect multiple	$2,814.28	$5,628.56	$1,264.75–$5,628.56	5% above	50%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 NM Cardiac Viability	$2,814.28	$5,628.56	$1,264.75–$5,628.56	5% above	50%
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 NM Cardiac Rest/Stress Spect multiple	$2,814.28	$5,628.56	$1,970.00–$5,628.56	—	50%
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 NM Cardiac Viability	$2,814.28	$5,628.56	$1,970.00–$5,628.56	—	50%
Pelvic CT scan without contrast CPT 72192 CT Pelvis w/o Contrast	$1,384.08	$2,768.16	$105.52–$5,000.00	31% above	50%
Pelvic CT scan without contrast inpatient CPT 72192 CT Pelvis w/o Contrast	$1,384.08	$2,768.16	$968.86–$2,768.16	—	50%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US Pelvis LTD/Repeat-ED	$323.47	$646.94	$105.52–$5,000.00	1% above	50%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US Pelvis (Limited/Repeat)	$323.47	$646.94	$105.52–$5,000.00	1% above	50%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US Pelvis LTD/Repeat-ED	$323.47	$646.94	$226.43–$646.94	—	50%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US Pelvis (Limited/Repeat)	$323.47	$646.94	$226.43–$646.94	—	50%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US Pelvis	$540.88	$1,081.75	$105.52–$5,000.00	31% above	50%
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 US Pelvis	$540.88	$1,081.75	$378.61–$1,081.75	—	50%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US Ob Complete	$648.93	$1,297.85	$105.52–$5,000.00	55% above	50%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US OB > 14wks single/1st fetus - LD	$648.93	$1,297.85	$105.52–$5,000.00	55% above	50%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US OB > 14wks single/1st fetus	$648.93	$1,297.85	$105.52–$5,000.00	55% above	50%
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US Ob Complete	$648.93	$1,297.85	$454.25–$1,297.85	—	50%
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US OB > 14wks single/1st fetus - LD	$648.93	$1,297.85	$454.25–$1,297.85	—	50%
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US OB > 14wks single/1st fetus	$648.93	$1,297.85	$454.25–$1,297.85	—	50%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 US OB <14 wks Single/1st Fetus	$648.93	$1,297.85	$105.52–$5,000.00	92% above	50%
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 US OB <14 wks Single/1st Fetus	$648.93	$1,297.85	$454.25–$1,297.85	—	50%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 Sonogram	$413.05	$826.09	$105.52–$5,000.00	30% above	50%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US OB LTD-ED	$413.05	$826.09	$105.52–$5,000.00	30% above	50%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US Ob(Limited) - LD	$413.05	$826.09	$105.52–$5,000.00	30% above	50%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US Ob(Limited)	$413.05	$826.09	$105.52–$5,000.00	30% above	50%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 US OB LTD-ED	$413.05	$826.09	$289.13–$826.09	—	50%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 Sonogram	$413.05	$826.09	$289.13–$826.09	—	50%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 US Ob(Limited) - LD	$413.05	$826.09	$289.13–$826.09	—	50%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 US Ob(Limited)	$413.05	$826.09	$289.13–$826.09	—	50%
Rib X-ray, one side, 2 views one side CPT 71100 XR Ribs Unilateral 2 Views Lt	$261.09	$522.17	$60.00–$5,000.00	84% above	50%
Rib X-ray, one side, 2 views one side CPT 71100 XR Ribs Unilateral 2 Views Rt	$261.09	$522.17	$60.00–$5,000.00	84% above	50%
Rib X-ray, one side, 2 views inpatient one side CPT 71100 XR Ribs Unilateral 2 Views Rt	$261.09	$522.17	$182.76–$522.17	—	50%
Rib X-ray, one side, 2 views inpatient one side CPT 71100 XR Ribs Unilateral 2 Views Lt	$261.09	$522.17	$182.76–$522.17	—	50%
Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 XR Ribs Unilat Chest Pa 3 Views Lt	$263.91	$527.82	$60.00–$5,000.00	13% below	50%
Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 XR Ribs Unilat Chest Pa 3 Views Rt	$263.91	$527.82	$60.00–$5,000.00	13% below	50%
Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 XR Ribs Unilat Chest Pa 3 Views Lt	$263.91	$527.82	$184.74–$527.82	—	50%
Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 XR Ribs Unilat Chest Pa 3 Views Rt	$263.91	$527.82	$184.74–$527.82	—	50%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 XR Shoulder Complete 2 Or More Views Lt	$232.08	$464.15	$60.00–$5,000.00	47% above	50%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 XR Shoulder Complete 2 Or More Views Rt	$232.08	$464.15	$60.00–$5,000.00	47% above	50%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 XR Shoulder Complete 2 Or More Views Lt	$232.08	$464.15	$162.45–$464.15	—	50%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 XR Shoulder Complete 2 Or More Views Rt	$232.08	$464.15	$162.45–$464.15	—	50%
Sinus X-ray, complete, 3 or more views CPT 70220 XR Sinuses Complete Min 4 Views	$246.64	$493.27	$60.00–$5,000.00	45% above	50%
Sinus X-ray, complete, 3 or more views inpatient CPT 70220 XR Sinuses Complete Min 4 Views	$246.64	$493.27	$172.64–$493.27	—	50%
Skull X-ray, fewer than 4 views CPT 70250 XR Skull Limited Less Than 4 Views	$193.40	$386.79	$60.00–$5,000.00	13% below	50%
Skull X-ray, fewer than 4 views inpatient CPT 70250 XR Skull Limited Less Than 4 Views	$193.40	$386.79	$135.38–$386.79	—	50%
Swallow study (modified barium swallow, video X-ray) CPT 74230 XR Esophagus With Speech Therapy	$438.14	$876.27	$60.00–$5,000.00	8% above	50%
Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 XR Esophagus With Speech Therapy	$438.14	$876.27	$306.69–$876.27	—	50%
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 XR Femur 2 Views Lt	$212.22	$424.44	$60.00–$5,000.00	17% above	50%
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 XR Femur 2 Views Rt	$212.22	$424.44	$60.00–$5,000.00	17% above	50%
Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 XR Femur 2 Views Rt	$212.22	$424.44	$148.55–$424.44	—	50%
Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 XR Femur 2 Views Lt	$212.22	$424.44	$148.55–$424.44	—	50%
Thoracic spine (mid back) CT scan without contrast CPT 72128 CT Spine/Thoracic w/o Contrast	$2,044.09	$4,088.17	$105.52–$5,000.00	81% above	50%
Thoracic spine (mid back) CT scan without contrast inpatient CPT 72128 CT Spine/Thoracic w/o Contrast	$2,044.09	$4,088.17	$1,430.86–$4,088.17	—	50%
Transvaginal pelvic ultrasound CPT 76830 US Transvaginal-ED	$422.14	$844.28	$105.52–$5,000.00	12% above	50%
Transvaginal pelvic ultrasound CPT 76830 US Transvaginal Non-Obstetrical	$422.14	$844.28	$105.52–$5,000.00	12% above	50%
Transvaginal pelvic ultrasound inpatient CPT 76830 US Transvaginal-ED	$422.14	$844.28	$295.50–$844.28	—	50%
Transvaginal pelvic ultrasound inpatient CPT 76830 US Transvaginal Non-Obstetrical	$422.14	$844.28	$295.50–$844.28	—	50%
Transvaginal ultrasound during pregnancy CPT 76817 US OB Transvaginal - LD	$569.48	$1,138.96	$105.52–$5,000.00	63% above	50%
Transvaginal ultrasound during pregnancy CPT 76817 US OB Transvaginal, Ltd - ED	$569.48	$1,138.96	$105.52–$5,000.00	63% above	50%
Transvaginal ultrasound during pregnancy CPT 76817 US OB Transvaginal	$569.48	$1,138.96	$105.52–$5,000.00	63% above	50%
Transvaginal ultrasound during pregnancy inpatient CPT 76817 US OB Transvaginal	$569.48	$1,138.96	$398.64–$1,138.96	—	50%
Transvaginal ultrasound during pregnancy inpatient CPT 76817 US OB Transvaginal, Ltd - ED	$569.48	$1,138.96	$398.64–$1,138.96	—	50%
Transvaginal ultrasound during pregnancy inpatient CPT 76817 US OB Transvaginal - LD	$569.48	$1,138.96	$398.64–$1,138.96	—	50%
Ultrasound of the abdomen, complete CPT 76700 US Abdomen Complete	$562.73	$1,125.46	$105.52–$5,000.00	11% above	50%
Ultrasound of the abdomen, complete inpatient CPT 76700 US Abdomen Complete	$562.73	$1,125.46	$393.91–$1,125.46	—	50%
Ultrasound of the scrotum and testicles CPT 76870 US Scrotum	$504.79	$1,009.57	$105.52–$5,000.00	32% above	50%
Ultrasound of the scrotum and testicles inpatient CPT 76870 US Scrotum	$504.79	$1,009.57	$353.35–$1,009.57	—	50%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US Soft Tissues of Head & Neck - ED	$449.18	$898.36	$105.52–$5,000.00	35% above	50%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US Soft Tissue Head	$449.18	$898.36	$105.52–$5,000.00	35% above	50%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US Thyroid/Neck/Head	$449.18	$898.36	$105.52–$5,000.00	35% above	50%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US Soft Tissues of Head & Neck - ED	$449.18	$898.36	$314.43–$898.36	—	50%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US Soft Tissue Head	$449.18	$898.36	$314.43–$898.36	—	50%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US Thyroid/Neck/Head	$449.18	$898.36	$314.43–$898.36	—	50%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 XR UGI w/o Air	$593.79	$1,187.58	$60.00–$5,000.00	50% above	50%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 XR UGI w/o Air	$593.79	$1,187.58	$415.65–$1,187.58	—	50%
Upper arm X-ray (humerus), 2 views one side CPT 73060 XR Humerus 2 views Lt	$296.90	$593.80	$60.00–$5,000.00	33% above	50%
Upper arm X-ray (humerus), 2 views one side CPT 73060 XR Humerus 2 views Rt	$296.90	$593.80	$60.00–$5,000.00	33% above	50%
Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 XR Humerus 2 views Lt	$296.90	$593.80	$207.83–$593.80	—	50%
Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 XR Humerus 2 views Rt	$296.90	$593.80	$207.83–$593.80	—	50%
Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 US Dup Ext Veins LTD-ED	$414.22	$828.44	$105.52–$5,000.00	at median	50%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US Vein Mapping Ltd Lt	$414.22	$828.44	$105.52–$5,000.00	at median	50%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US Dup Ext Veins Ltd Rt	$414.22	$828.44	$105.52–$5,000.00	at median	50%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US Dup Ext Veins Ltd Lt	$414.22	$828.44	$105.52–$5,000.00	at median	50%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US Vein Mapping Ltd Rt	$414.22	$828.44	$105.52–$5,000.00	at median	50%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 US Dup Ext Veins LTD-ED	$414.22	$828.44	$289.95–$828.44	—	50%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US Vein Mapping Ltd Lt	$414.22	$828.44	$289.95–$828.44	—	50%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US Vein Mapping Ltd Rt	$414.22	$828.44	$289.95–$828.44	—	50%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US Dup Ext Veins Ltd Lt	$414.22	$828.44	$289.95–$828.44	—	50%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US Dup Ext Veins Ltd Rt	$414.22	$828.44	$289.95–$828.44	—	50%
Wrist X-ray, 2 views one side CPT 73100 XR Wrist 2 Views Rt	$154.15	$308.29	$60.00–$5,000.00	at median	50%
Wrist X-ray, 2 views one side CPT 73100 XR Wrist 2 Views Lt	$154.15	$308.29	$60.00–$5,000.00	at median	50%
Wrist X-ray, 2 views inpatient one side CPT 73100 XR Wrist 2 Views Rt	$154.15	$308.29	$107.90–$308.29	—	50%
Wrist X-ray, 2 views inpatient one side CPT 73100 XR Wrist 2 Views Lt	$154.15	$308.29	$107.90–$308.29	—	50%
Wrist X-ray, complete, 3 or more views one side CPT 73110 XR Wrist 3 Views Rt	$184.84	$369.67	$60.00–$5,000.00	16% below	50%
Wrist X-ray, complete, 3 or more views one side CPT 73110 XR Wrist 3 Views Lt	$184.84	$369.67	$60.00–$5,000.00	16% below	50%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 XR Wrist 3 Views Rt	$184.84	$369.67	$129.38–$369.67	—	50%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 XR Wrist 3 Views Lt	$184.84	$369.67	$129.38–$369.67	—	50%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR Hip 2 Views Rt	$477.74	$955.47	$60.00–$5,000.00	95% above	50%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR Hip 2 Views Lt	$477.74	$955.47	$60.00–$5,000.00	95% above	50%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 XR Hip 2 Views Rt	$477.74	$955.47	$334.41–$955.47	—	50%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 XR Hip 2 Views Lt	$477.74	$955.47	$334.41–$955.47	—	50%
X-ray of the abdomen, 1 view CPT 74018 XR Abdomen 1 View Ap (Kub)	$219.93	$439.85	$60.00–$5,000.00	14% above	50%
X-ray of the abdomen, 1 view CPT 74018 XR Small Bowel (KUB)	$219.93	$439.85	$60.00–$5,000.00	14% above	50%
X-ray of the abdomen, 1 view inpatient CPT 74018 XR Abdomen 1 View Ap (Kub)	$219.93	$439.85	$153.95–$439.85	—	50%
X-ray of the abdomen, 1 view inpatient CPT 74018 XR Small Bowel (KUB)	$219.93	$439.85	$153.95–$439.85	—	50%
X-ray of the ankle, 2 views one side CPT 73600 XR Ankle 2 Views Lt	$177.66	$355.31	$60.00–$5,000.00	23% above	50%
X-ray of the ankle, 2 views one side CPT 73600 XR Ankle 2 Views Rt	$177.66	$355.31	$60.00–$5,000.00	23% above	50%
X-ray of the ankle, 2 views inpatient one side CPT 73600 XR Ankle 2 Views Rt	$177.66	$355.31	$124.36–$355.31	—	50%
X-ray of the ankle, 2 views inpatient one side CPT 73600 XR Ankle 2 Views Lt	$177.66	$355.31	$124.36–$355.31	—	50%
X-ray of the foot, 2 views one side CPT 73620 XR Foot 2 Views Rt	$155.07	$310.13	$60.00–$5,000.00	69% above	50%
X-ray of the foot, 2 views one side CPT 73620 XR Foot 2 Views Lt	$155.07	$310.13	$60.00–$5,000.00	69% above	50%
X-ray of the foot, 2 views inpatient one side CPT 73620 XR Foot 2 Views Lt	$155.07	$310.13	$108.55–$310.13	—	50%
X-ray of the foot, 2 views inpatient one side CPT 73620 XR Foot 2 Views Rt	$155.07	$310.13	$108.55–$310.13	—	50%
X-ray of the foot, complete, 3 or more views one side CPT 73630 XR Foot 3 Views Lt	$184.84	$369.67	$60.00–$5,000.00	58% above	50%
X-ray of the foot, complete, 3 or more views one side CPT 73630 XR Foot 3 Views Rt	$184.84	$369.67	$60.00–$5,000.00	58% above	50%
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 XR Foot 3 Views Rt	$184.84	$369.67	$129.38–$369.67	—	50%
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 XR Foot 3 Views Lt	$184.84	$369.67	$129.38–$369.67	—	50%
X-ray of the hand, 3 or more views one side CPT 73130 XR Hand 3 Views Lt	$184.84	$369.67	$60.00–$5,000.00	9% below	50%
X-ray of the hand, 3 or more views one side CPT 73130 XR Hand 3 Views Rt	$184.84	$369.67	$60.00–$5,000.00	9% below	50%
X-ray of the hand, 3 or more views inpatient one side CPT 73130 XR Hand 3 Views Lt	$184.84	$369.67	$129.38–$369.67	—	50%
X-ray of the hand, 3 or more views inpatient one side CPT 73130 XR Hand 3 Views Rt	$184.84	$369.67	$129.38–$369.67	—	50%
X-ray of the knee, 1 or 2 views one side CPT 73560 XR Knee 1 Or 2 Views Lt	$155.07	$310.13	$60.00–$5,000.00	at median	50%
X-ray of the knee, 1 or 2 views one side CPT 73560 XR Knee 1 Or 2 Views Rt	$155.07	$310.13	$60.00–$5,000.00	at median	50%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 XR Knee 1 Or 2 Views Lt	$155.07	$310.13	$108.55–$310.13	—	50%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 XR Knee 1 Or 2 Views Rt	$155.07	$310.13	$108.55–$310.13	—	50%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 XR Spine Lumbosacral 2 Or 3 Views	$291.64	$583.27	$60.00–$5,000.00	52% above	50%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 XR Spine Lumbosacral 2 Or 3 Views	$291.64	$583.27	$204.14–$583.27	—	50%
X-ray of the lower back, 4 or more views CPT 72110 XR Spine Lumbar Complete 4-5 Views	$485.43	$970.85	$60.00–$5,000.00	43% above	50%
X-ray of the lower back, 4 or more views inpatient CPT 72110 XR Spine Lumbar Complete 4-5 Views	$485.43	$970.85	$339.80–$970.85	—	50%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 XR Spine Thoracic Ap/Lat 2 View	$264.94	$529.87	$60.00–$5,000.00	8% above	50%
X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 XR Spine Thoracic Ap/Lat 2 View	$264.94	$529.87	$185.45–$529.87	—	50%
X-ray of the nasal bones, 3 or more views CPT 70160 XR Nasal Bones Complete Min 3 Views	$296.90	$593.80	$60.00–$5,000.00	166% above	50%
X-ray of the nasal bones, 3 or more views inpatient CPT 70160 XR Nasal Bones Complete Min 3 Views	$296.90	$593.80	$207.83–$593.80	—	50%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 XR Spine Cervical 2 Or 3 Views	$217.70	$435.40	$60.00–$5,000.00	at median	50%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 XR Spine Cervical 2 Or 3 Views	$217.70	$435.40	$152.39–$435.40	—	50%
X-ray of the pelvis, 1 or 2 views CPT 72170 XR Pelvis 1 Or 2views	$184.84	$369.67	$60.00–$5,000.00	3% below	50%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 XR Pelvis 1 Or 2views	$184.84	$369.67	$129.38–$369.67	—	50%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 XR Sacrum/Coccyx 2 View	$280.73	$561.45	$60.00–$5,000.00	118% above	50%
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 XR Sacrum/Coccyx 2 View	$280.73	$561.45	$196.51–$561.45	—	50%

Lab tests

Procedure	Cash price	List price	Insurers pay	vs Arizona	Off list
ACTH blood test CPT 82024 REF Adrenocorticotropic Hormone	$203.30	$406.60	$37.37–$5,000.00	140% above	50%
ACTH blood test inpatient CPT 82024 REF Adrenocorticotropic Hormone	$203.30	$406.60	$142.31–$406.60	—	50%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 Alanine Aminotransferase	$23.71	$47.41	$5.13–$5,000.00	at median	50%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 Alanine Aminotransferase	$23.71	$47.41	$16.59–$47.41	—	50%
AST (aspartate aminotransferase) enzyme test CPT 84450 Aspartate Aminotransferase	$25.67	$51.33	$5.01–$5,000.00	4% below	50%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 Aspartate Aminotransferase	$25.67	$51.33	$17.97–$51.33	—	50%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 Hep Acute Panel	$250.35	$500.70	$46.09–$5,000.00	163% above	50%
Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 Hep Acute Panel	$250.35	$500.70	$175.24–$500.70	—	50%
Albumin blood test CPT 82040 REF Albumin (QUEST)	$9.43	$18.86	$4.79–$5,000.00	36% below	50%
Albumin blood test CPT 82040 Albumin Level	$18.25	$36.49	$4.79–$5,000.00	24% above	50%
Albumin blood test inpatient CPT 82040 REF Albumin (QUEST)	$9.43	$18.86	$6.60–$18.86	—	50%
Albumin blood test inpatient CPT 82040 Albumin Level	$18.25	$36.49	$12.77–$36.49	—	50%
Aldosterone blood test CPT 82088 REF Aldosterone	$188.82	$377.63	$39.43–$5,000.00	123% above	50%
Aldosterone blood test inpatient CPT 82088 REF Aldosterone	$188.82	$377.63	$132.17–$377.63	—	50%
Alkaline phosphatase (ALP) blood test CPT 84075 Alkaline Phosphatase	$18.30	$36.59	$5.01–$5,000.00	10% above	50%
Alkaline phosphatase (ALP) blood test inpatient CPT 84075 Alkaline Phosphatase	$18.30	$36.59	$12.81–$36.59	—	50%
Allergy blood test, specific IgE, per allergen CPT 86003 REF Cat Epithelium IgE	$6.00	$12.00	$4.20–$5,000.00	49% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 REF Box Eld/Maple IgE	$6.00	$12.00	$4.20–$5,000.00	49% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 REF Mulberry IgE	$51.87	$103.74	$5.05–$5,000.00	339% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 REF Red Sorrel IgE	$51.87	$103.74	$5.05–$5,000.00	339% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 REF Oat IgE	$51.87	$103.74	$5.05–$5,000.00	339% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 REF Tomato IgE	$51.87	$103.74	$5.05–$5,000.00	339% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 REF Egg White IgE	$51.87	$103.74	$5.05–$5,000.00	339% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 REF Milk IgE	$51.87	$103.74	$5.05–$5,000.00	339% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 REF Codfish IgE	$51.87	$103.74	$5.05–$5,000.00	339% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 REF Wheat IgE	$51.87	$103.74	$5.05–$5,000.00	339% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 REF Corn-Food IgE	$51.87	$103.74	$5.05–$5,000.00	339% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 REF Peanut IgE	$51.87	$103.74	$5.05–$5,000.00	339% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 REF Soybean IgE	$51.87	$103.74	$5.05–$5,000.00	339% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 REF Crab IgE	$51.87	$103.74	$5.05–$5,000.00	339% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 REF Shrimp IgE	$51.87	$103.74	$5.05–$5,000.00	339% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 REF Pork IgE	$51.87	$103.74	$5.05–$5,000.00	339% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 REF Beef IgE	$51.87	$103.74	$5.05–$5,000.00	339% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 REF Tuna IgE	$51.87	$103.74	$5.05–$5,000.00	339% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 REF Strawberry IgE	$51.87	$103.74	$5.05–$5,000.00	339% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 REF Carrot IgE	$51.87	$103.74	$5.05–$5,000.00	339% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 REF Orange IgE	$51.87	$103.74	$5.05–$5,000.00	339% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 REF White Potato IgE	$51.87	$103.74	$5.05–$5,000.00	339% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 REF Baker's Yeast IgE	$51.87	$103.74	$5.05–$5,000.00	339% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 REF Apple IgE	$51.87	$103.74	$5.05–$5,000.00	339% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 REF Egg Yolk IgE	$51.87	$103.74	$5.05–$5,000.00	339% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 REF Almond IgE	$51.87	$103.74	$5.05–$5,000.00	339% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 REF Walnut-Food IgE	$51.87	$103.74	$5.05–$5,000.00	339% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 REF Cashew IgE	$51.87	$103.74	$5.05–$5,000.00	339% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 REF Hazelnut-Food IgE	$51.87	$103.74	$5.05–$5,000.00	339% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 REF Salmon IgE	$51.87	$103.74	$5.05–$5,000.00	339% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 REF Scallops IgE	$51.87	$103.74	$5.05–$5,000.00	339% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 REF Sesame Seed IgE	$51.87	$103.74	$5.05–$5,000.00	339% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 REF Alternaria Tenuis IgE	$51.87	$103.74	$5.05–$5,000.00	339% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 REF Aspergillus Fumigatus IgE	$51.87	$103.74	$5.05–$5,000.00	339% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 REF Bermuda Grass IgE	$51.87	$103.74	$5.05–$5,000.00	339% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 REF Cat Epithilium IgE	$51.87	$103.74	$5.05–$5,000.00	339% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 REF Mountain Cedar IgE	$51.87	$103.74	$5.05–$5,000.00	339% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 REF Cladosporium IgE	$51.87	$103.74	$5.05–$5,000.00	339% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 REF Cockroach IgE	$51.87	$103.74	$5.05–$5,000.00	339% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 REF Cottonwood IgE	$51.87	$103.74	$5.05–$5,000.00	339% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 REF House Dust Mites/D.F. IgE	$51.87	$103.74	$5.05–$5,000.00	339% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 REF Dog Dander IgE	$51.87	$103.74	$5.05–$5,000.00	339% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 REF House Dust Mites/D.P. IgE	$51.87	$103.74	$5.05–$5,000.00	339% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 REF Beta Lactoglobulin IgE	$51.87	$103.74	$5.05–$5,000.00	339% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 REF IgE Quant	$51.87	$103.74	$5.05–$5,000.00	339% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 REF Mouse Urine Protein IgE	$51.87	$103.74	$5.05–$5,000.00	339% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 REF Mugwort IgE	$51.87	$103.74	$5.05–$5,000.00	339% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 REF Oak IgE	$51.87	$103.74	$5.05–$5,000.00	339% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 REF Olive-Tree IgE	$51.87	$103.74	$5.05–$5,000.00	339% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 REF Penicillium IgE	$51.87	$103.74	$5.05–$5,000.00	339% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 REF Rough Pigweed IgE	$51.87	$103.74	$5.05–$5,000.00	339% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 REF Timoth Grass IgE	$51.87	$103.74	$5.05–$5,000.00	339% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 REF Stemphylium IgE	$51.87	$103.74	$5.05–$5,000.00	339% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 REF Phoma Betae IgE	$51.87	$103.74	$5.05–$5,000.00	339% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 REF Mucor IgE	$51.87	$103.74	$5.05–$5,000.00	339% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 REF Helminthosporium Halodes IgE	$51.87	$103.74	$5.05–$5,000.00	339% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 REF Candida Albicans IgE	$51.87	$103.74	$5.05–$5,000.00	339% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 REF Aureobasidium Pullulans IgE	$51.87	$103.74	$5.05–$5,000.00	339% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 REF Latex IgE Antibody (RAST)	$51.87	$103.74	$5.05–$5,000.00	339% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 REF Whey IgE	$51.87	$103.74	$5.05–$5,000.00	339% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 REF Russian Thistle IgE	$51.87	$103.74	$5.05–$5,000.00	339% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 REF Short Ragweed IgE	$51.87	$103.74	$5.05–$5,000.00	339% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 REF Peanut IgE with Reflex	$51.87	$103.74	$5.05–$5,000.00	339% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 REF Lime IgE	$51.87	$103.74	$5.05–$5,000.00	339% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 REF House Dust Panel	$51.87	$103.74	$5.05–$5,000.00	339% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 REF Lemon IgE	$51.87	$103.74	$5.05–$5,000.00	339% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 REF Alfalfa IgE	$51.87	$103.74	$5.05–$5,000.00	339% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 REF Grapefruit IgE	$51.87	$103.74	$5.05–$5,000.00	339% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 REF Elm IgE	$51.87	$103.74	$5.05–$5,000.00	339% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 REF Lamb's Quarter IgE	$51.87	$103.74	$5.05–$5,000.00	339% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 REF Alpha Lactalbumin IgE	$51.87	$103.74	$5.05–$5,000.00	339% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 REF Mesquite IgE	$51.87	$103.74	$5.05–$5,000.00	339% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 REF Melon IgE	$51.87	$103.74	$5.05–$5,000.00	339% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 REF Sage IgE	$51.87	$103.74	$5.05–$5,000.00	339% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 REF Mango IgE	$51.87	$103.74	$5.05–$5,000.00	339% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 REF Wingscale IgE	$51.87	$103.74	$5.05–$5,000.00	339% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 REF Kiwi IgE	$51.87	$103.74	$5.05–$5,000.00	339% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 REF Fusarium moniliforme IgE	$51.87	$103.74	$5.05–$5,000.00	339% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 REF Pistachio IgE	$51.87	$103.74	$5.05–$5,000.00	339% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 REF White Ash IgE	$51.87	$103.74	$5.05–$5,000.00	339% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 REF Pecan-Food IgE	$51.87	$103.74	$5.05–$5,000.00	339% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 REF White Pine IgE	$51.87	$103.74	$5.05–$5,000.00	339% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 REF Coconut, IgE	$51.87	$103.74	$5.05–$5,000.00	339% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 REF Acacia IgE	$51.87	$103.74	$5.05–$5,000.00	339% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 REF Brazil Nut IgE	$51.87	$103.74	$5.05–$5,000.00	339% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 REF Johnson Grass IgE	$51.87	$103.74	$5.05–$5,000.00	339% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 REF Rye Grass IgE	$51.87	$103.74	$5.05–$5,000.00	339% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 REF Timothy Grass IgE	$51.87	$103.74	$5.05–$5,000.00	339% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 REF Grey Alder IgE	$51.87	$103.74	$5.05–$5,000.00	339% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 REF Box Elder/Maple IgE	$51.87	$103.74	$5.05–$5,000.00	339% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 REF Casein IgE	$51.87	$103.74	$5.05–$5,000.00	339% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 REF Cocklebur IgE	$51.87	$103.74	$5.05–$5,000.00	339% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 REF Rough Marsh Elder IgE	$51.87	$103.74	$5.05–$5,000.00	339% above	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 REF Cat Epithelium IgE	$6.00	$12.00	$4.20–$12.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 REF Box Eld/Maple IgE	$6.00	$12.00	$4.20–$12.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 REF Cladosporium IgE	$51.87	$103.74	$36.31–$103.74	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 REF Timoth Grass IgE	$51.87	$103.74	$36.31–$103.74	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 REF Stemphylium IgE	$51.87	$103.74	$36.31–$103.74	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 REF Phoma Betae IgE	$51.87	$103.74	$36.31–$103.74	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 REF Mucor IgE	$51.87	$103.74	$36.31–$103.74	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 REF Helminthosporium Halodes IgE	$51.87	$103.74	$36.31–$103.74	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 REF Candida Albicans IgE	$51.87	$103.74	$36.31–$103.74	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 REF Aureobasidium Pullulans IgE	$51.87	$103.74	$36.31–$103.74	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 REF Whey IgE	$51.87	$103.74	$36.31–$103.74	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 REF Lime IgE	$51.87	$103.74	$36.31–$103.74	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 REF Lemon IgE	$51.87	$103.74	$36.31–$103.74	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 REF Grapefruit IgE	$51.87	$103.74	$36.31–$103.74	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 REF Casein IgE	$51.87	$103.74	$36.31–$103.74	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 REF Beta Lactoglobulin IgE	$51.87	$103.74	$36.31–$103.74	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 REF Alpha Lactalbumin IgE	$51.87	$103.74	$36.31–$103.74	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 REF Melon IgE	$51.87	$103.74	$36.31–$103.74	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 REF Mango IgE	$51.87	$103.74	$36.31–$103.74	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 REF Kiwi IgE	$51.87	$103.74	$36.31–$103.74	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 REF Pistachio IgE	$51.87	$103.74	$36.31–$103.74	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 REF Pecan-Food IgE	$51.87	$103.74	$36.31–$103.74	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 REF Coconut, IgE	$51.87	$103.74	$36.31–$103.74	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 REF Brazil Nut IgE	$51.87	$103.74	$36.31–$103.74	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 REF Short Ragweed IgE	$51.87	$103.74	$36.31–$103.74	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 REF Russian Thistle IgE	$51.87	$103.74	$36.31–$103.74	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 REF Rough Pigweed IgE	$51.87	$103.74	$36.31–$103.74	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 REF Penicillium IgE	$51.87	$103.74	$36.31–$103.74	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 REF Olive-Tree IgE	$51.87	$103.74	$36.31–$103.74	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 REF Oak IgE	$51.87	$103.74	$36.31–$103.74	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 REF Mugwort IgE	$51.87	$103.74	$36.31–$103.74	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 REF Mouse Urine Protein IgE	$51.87	$103.74	$36.31–$103.74	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 REF IgE Quant	$51.87	$103.74	$36.31–$103.74	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 REF Elm IgE	$51.87	$103.74	$36.31–$103.74	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 REF House Dust Mites/D.P. IgE	$51.87	$103.74	$36.31–$103.74	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 REF Dog Dander IgE	$51.87	$103.74	$36.31–$103.74	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 REF House Dust Mites/D.F. IgE	$51.87	$103.74	$36.31–$103.74	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 REF Cottonwood IgE	$51.87	$103.74	$36.31–$103.74	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 REF Cockroach IgE	$51.87	$103.74	$36.31–$103.74	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 REF Mountain Cedar IgE	$51.87	$103.74	$36.31–$103.74	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 REF Cat Epithilium IgE	$51.87	$103.74	$36.31–$103.74	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 REF Bermuda Grass IgE	$51.87	$103.74	$36.31–$103.74	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 REF Aspergillus Fumigatus IgE	$51.87	$103.74	$36.31–$103.74	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 REF Alternaria Tenuis IgE	$51.87	$103.74	$36.31–$103.74	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 REF Sesame Seed IgE	$51.87	$103.74	$36.31–$103.74	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 REF Scallops IgE	$51.87	$103.74	$36.31–$103.74	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 REF Salmon IgE	$51.87	$103.74	$36.31–$103.74	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 REF Hazelnut-Food IgE	$51.87	$103.74	$36.31–$103.74	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 REF Cashew IgE	$51.87	$103.74	$36.31–$103.74	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 REF Walnut-Food IgE	$51.87	$103.74	$36.31–$103.74	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 REF Almond IgE	$51.87	$103.74	$36.31–$103.74	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 REF Egg Yolk IgE	$51.87	$103.74	$36.31–$103.74	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 REF Apple IgE	$51.87	$103.74	$36.31–$103.74	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 REF Baker's Yeast IgE	$51.87	$103.74	$36.31–$103.74	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 REF White Potato IgE	$51.87	$103.74	$36.31–$103.74	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 REF Orange IgE	$51.87	$103.74	$36.31–$103.74	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 REF Carrot IgE	$51.87	$103.74	$36.31–$103.74	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 REF Strawberry IgE	$51.87	$103.74	$36.31–$103.74	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 REF Tuna IgE	$51.87	$103.74	$36.31–$103.74	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 REF Beef IgE	$51.87	$103.74	$36.31–$103.74	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 REF Pork IgE	$51.87	$103.74	$36.31–$103.74	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 REF Shrimp IgE	$51.87	$103.74	$36.31–$103.74	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 REF Crab IgE	$51.87	$103.74	$36.31–$103.74	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 REF Soybean IgE	$51.87	$103.74	$36.31–$103.74	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 REF Peanut IgE	$51.87	$103.74	$36.31–$103.74	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 REF Corn-Food IgE	$51.87	$103.74	$36.31–$103.74	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 REF Wheat IgE	$51.87	$103.74	$36.31–$103.74	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 REF Codfish IgE	$51.87	$103.74	$36.31–$103.74	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 REF Milk IgE	$51.87	$103.74	$36.31–$103.74	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 REF Egg White IgE	$51.87	$103.74	$36.31–$103.74	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 REF Tomato IgE	$51.87	$103.74	$36.31–$103.74	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 REF Oat IgE	$51.87	$103.74	$36.31–$103.74	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 REF Red Sorrel IgE	$51.87	$103.74	$36.31–$103.74	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 REF Mulberry IgE	$51.87	$103.74	$36.31–$103.74	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 REF Box Elder/Maple IgE	$51.87	$103.74	$36.31–$103.74	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 REF Grey Alder IgE	$51.87	$103.74	$36.31–$103.74	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 REF Timothy Grass IgE	$51.87	$103.74	$36.31–$103.74	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 REF Rye Grass IgE	$51.87	$103.74	$36.31–$103.74	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 REF Johnson Grass IgE	$51.87	$103.74	$36.31–$103.74	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 REF Acacia IgE	$51.87	$103.74	$36.31–$103.74	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 REF White Pine IgE	$51.87	$103.74	$36.31–$103.74	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 REF White Ash IgE	$51.87	$103.74	$36.31–$103.74	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 REF Fusarium moniliforme IgE	$51.87	$103.74	$36.31–$103.74	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 REF Wingscale IgE	$51.87	$103.74	$36.31–$103.74	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 REF Sage IgE	$51.87	$103.74	$36.31–$103.74	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 REF Mesquite IgE	$51.87	$103.74	$36.31–$103.74	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 REF Lamb's Quarter IgE	$51.87	$103.74	$36.31–$103.74	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 REF Cocklebur IgE	$51.87	$103.74	$36.31–$103.74	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 REF Rough Marsh Elder IgE	$51.87	$103.74	$36.31–$103.74	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 REF Alfalfa IgE	$51.87	$103.74	$36.31–$103.74	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 REF House Dust Panel	$51.87	$103.74	$36.31–$103.74	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 REF Peanut IgE with Reflex	$51.87	$103.74	$36.31–$103.74	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 REF Latex IgE Antibody (RAST)	$51.87	$103.74	$36.31–$103.74	—	50%
Alpha-fetoprotein (AFP) blood test CPT 82105 REF Alpha Fetoprotein Tumor Marker	$100.89	$201.78	$16.23–$5,000.00	155% above	50%
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 REF Alpha Fetoprotein Tumor Marker	$100.89	$201.78	$70.62–$201.78	—	50%
Ammonia blood test CPT 82140 Ammonia Level	$126.60	$253.20	$14.10–$5,000.00	94% above	50%
Ammonia blood test inpatient CPT 82140 Ammonia Level	$126.60	$253.20	$88.62–$253.20	—	50%
Amylase blood test CPT 82150 Amylase Peritoneal Fluid	$88.81	$177.61	$6.27–$5,000.00	582% above	50%
Amylase blood test CPT 82150 Amylase Body Fluid	$88.81	$177.61	$6.27–$5,000.00	582% above	50%
Amylase blood test CPT 82150 Amylase Pancreatic Cyst	$88.81	$177.61	$6.27–$5,000.00	582% above	50%
Amylase blood test CPT 82150 Amylase Urine	$88.81	$177.61	$6.27–$5,000.00	582% above	50%
Amylase blood test CPT 82150 Amylase	$88.81	$177.61	$6.27–$5,000.00	582% above	50%
Amylase blood test CPT 82150 Amylase Isoenzymes	$88.81	$177.61	$6.27–$5,000.00	582% above	50%
Amylase blood test CPT 82150 Amylase Pleural Fluid	$88.81	$177.61	$6.27–$5,000.00	582% above	50%
Amylase blood test CPT 82150 Amylase, 2 hour Urine	$88.81	$177.61	$6.27–$5,000.00	582% above	50%
Amylase blood test CPT 82150 Amylase 24 Hour Urine	$88.81	$177.61	$6.27–$5,000.00	582% above	50%
Amylase blood test inpatient CPT 82150 Amylase Pleural Fluid	$88.81	$177.61	$62.16–$177.61	—	50%
Amylase blood test inpatient CPT 82150 Amylase Peritoneal Fluid	$88.81	$177.61	$62.16–$177.61	—	50%
Amylase blood test inpatient CPT 82150 Amylase	$88.81	$177.61	$62.16–$177.61	—	50%
Amylase blood test inpatient CPT 82150 Amylase 24 Hour Urine	$88.81	$177.61	$62.16–$177.61	—	50%
Amylase blood test inpatient CPT 82150 Amylase Body Fluid	$88.81	$177.61	$62.16–$177.61	—	50%
Amylase blood test inpatient CPT 82150 Amylase Urine	$88.81	$177.61	$62.16–$177.61	—	50%
Amylase blood test inpatient CPT 82150 Amylase Isoenzymes	$88.81	$177.61	$62.16–$177.61	—	50%
Amylase blood test inpatient CPT 82150 Amylase, 2 hour Urine	$88.81	$177.61	$62.16–$177.61	—	50%
Amylase blood test inpatient CPT 82150 Amylase Pancreatic Cyst	$88.81	$177.61	$62.16–$177.61	—	50%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 REF Cyclic Citrullinated Peptide Antibody	$39.75	$79.49	$12.53–$5,000.00	35% above	50%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 REF Cyclic Citrullinated Peptide Antibody	$39.75	$79.49	$27.82–$79.49	—	50%
Antinuclear antibody (ANA) blood test, screen CPT 86038 REF Connective Tissue Disease Cascade	$110.92	$221.83	$11.70–$5,000.00	305% above	50%
Antinuclear antibody (ANA) blood test, screen CPT 86038 REF ANA Cascade	$110.92	$221.83	$11.70–$5,000.00	305% above	50%
Antinuclear antibody (ANA) blood test, screen CPT 86038 REF Antinuclear Antibody Screen	$110.92	$221.83	$11.70–$5,000.00	305% above	50%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 REF Connective Tissue Disease Cascade	$110.92	$221.83	$77.64–$221.83	—	50%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 REF Antinuclear Antibody Screen	$110.92	$221.83	$77.64–$221.83	—	50%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 REF ANA Cascade	$110.92	$221.83	$77.64–$221.83	—	50%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 BNP	$186.25	$372.49	$37.99–$5,000.00	141% above	50%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 NT proBNP	$186.25	$372.49	$37.99–$5,000.00	141% above	50%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 NT proBNP	$186.25	$372.49	$130.37–$372.49	—	50%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 BNP	$186.25	$372.49	$130.37–$372.49	—	50%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Culture Medical Device	$111.69	$223.37	$8.34–$5,000.00	83% above	50%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Culture Wound Superficial	$111.69	$223.37	$8.34–$5,000.00	83% above	50%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Culture CSF	$111.69	$223.37	$8.34–$5,000.00	83% above	50%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Culture Respiratory Upper	$111.69	$223.37	$8.34–$5,000.00	83% above	50%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Culture Body Fluid	$111.69	$223.37	$8.34–$5,000.00	83% above	50%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Culture Tissue/Bone	$111.69	$223.37	$8.34–$5,000.00	83% above	50%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Culture Wound Deep	$111.69	$223.37	$8.34–$5,000.00	83% above	50%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Culture Respiratory Lower	$111.69	$223.37	$8.34–$5,000.00	83% above	50%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Tissue/Bone Culture Extended	$111.69	$223.37	$8.34–$5,000.00	83% above	50%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Culture Environmental	$111.69	$223.37	$8.34–$5,000.00	83% above	50%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Body Fluid Culture Extended	$111.69	$223.37	$8.34–$5,000.00	83% above	50%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Tissue/Bone Culture Extended	$111.69	$223.37	$78.18–$223.37	—	50%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Culture CSF	$111.69	$223.37	$78.18–$223.37	—	50%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Culture Wound Deep	$111.69	$223.37	$78.18–$223.37	—	50%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Culture Body Fluid	$111.69	$223.37	$78.18–$223.37	—	50%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Body Fluid Culture Extended	$111.69	$223.37	$78.18–$223.37	—	50%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Culture Environmental	$111.69	$223.37	$78.18–$223.37	—	50%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Culture Tissue/Bone	$111.69	$223.37	$78.18–$223.37	—	50%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Culture Respiratory Lower	$111.69	$223.37	$78.18–$223.37	—	50%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Culture Respiratory Upper	$111.69	$223.37	$78.18–$223.37	—	50%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Culture Medical Device	$111.69	$223.37	$78.18–$223.37	—	50%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Culture Wound Superficial	$111.69	$223.37	$78.18–$223.37	—	50%
Basic metabolic panel (blood test) CPT 80048 Basic Metabolic Panel Total Calcium	$133.29	$266.57	$8.19–$5,000.00	86% above	50%
Basic metabolic panel (blood test) inpatient CPT 80048 Basic Metabolic Panel Total Calcium	$133.29	$266.57	$93.30–$266.57	—	50%
Bilirubin blood test, total CPT 82247 Bilirubin Total	$18.74	$37.48	$4.86–$5,000.00	7% below	50%
Bilirubin blood test, total CPT 82247 Fractionated Bilirubin Adult	$46.03	$92.06	$4.86–$5,000.00	128% above	50%
Bilirubin blood test, total CPT 82247 Neonatal Bilirubin	$46.03	$92.06	$4.86–$5,000.00	128% above	50%
Bilirubin blood test, total inpatient CPT 82247 Bilirubin Total	$18.74	$37.48	$13.12–$37.48	—	50%
Bilirubin blood test, total inpatient CPT 82247 Neonatal Bilirubin	$46.03	$92.06	$32.22–$92.06	—	50%
Bilirubin blood test, total inpatient CPT 82247 Fractionated Bilirubin Adult	$46.03	$92.06	$32.22–$92.06	—	50%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 REF Bill CY Cell Block	$90.16	$180.31	$36.43–$5,000.00	5% above	50%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 Bill SO Muscle Bx, LM	$90.16	$180.31	$36.43–$5,000.00	5% above	50%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 Bill AP, Medium Surg Path Level IV Complexity	$90.16	$180.31	$36.43–$5,000.00	5% above	50%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 Bill AP, Prostate Biopsy Surg Path Level IV Comple	$103.68	$207.36	$36.43–$5,000.00	21% above	50%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 REF Bill SO Kidney Bx, LM	$175.94	$351.88	$36.43–$5,000.00	105% above	50%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 Bill AP, Medium Surg Path Level IV Complexity	$90.16	$180.31	$63.11–$180.31	—	50%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 REF Bill CY Cell Block	$90.16	$180.31	$63.11–$180.31	—	50%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 Bill SO Muscle Bx, LM	$90.16	$180.31	$63.11–$180.31	—	50%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 Bill AP, Prostate Biopsy Surg Path Level IV Comple	$103.68	$207.36	$72.58–$207.36	—	50%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 REF Bill SO Kidney Bx, LM	$175.94	$351.88	$123.16–$351.88	—	50%
Blood culture for bacteria CPT 87040 Culture Blood	$164.93	$329.86	$9.99–$5,000.00	30% above	50%
Blood culture for bacteria CPT 87040 Blood Culture Less Than 27kg	$164.93	$329.86	$9.99–$5,000.00	30% above	50%
Blood culture for bacteria inpatient CPT 87040 Blood Culture Less Than 27kg	$164.93	$329.86	$115.45–$329.86	—	50%
Blood culture for bacteria inpatient CPT 87040 Culture Blood	$164.93	$329.86	$115.45–$329.86	—	50%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 Draw only	$8.50	$17.00	$3.03–$5,000.00	49% below	50%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 Collection Venous Draw	$8.50	$17.00	$3.03–$5,000.00	49% below	50%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 Collection Venous Draw	$8.50	$17.00	$5.95–$17.00	—	50%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 Draw only	$8.50	$17.00	$5.95–$17.00	—	50%
Blood glucose (sugar) test CPT 82947 Glucose O'Sullivan	$30.93	$61.85	$3.80–$5,000.00	32% below	50%
Blood glucose (sugar) test CPT 82947 Glucose 4 Hour	$30.93	$61.85	$3.80–$5,000.00	32% below	50%
Blood glucose (sugar) test CPT 82947 Glucose 5 Hour	$30.93	$61.85	$3.80–$5,000.00	32% below	50%
Blood glucose (sugar) test CPT 82947 Glucose 2 Hour Post Prandial	$30.93	$61.85	$3.80–$5,000.00	32% below	50%
Blood glucose (sugar) test CPT 82947 Glucose 6 Hour	$30.93	$61.85	$3.80–$5,000.00	32% below	50%
Blood glucose (sugar) test CPT 82947 Glucose 1 Hour Post Prandial	$30.93	$61.85	$3.80–$5,000.00	32% below	50%
Blood glucose (sugar) test CPT 82947 Glucose Fasting	$30.93	$61.85	$3.80–$5,000.00	32% below	50%
Blood glucose (sugar) test CPT 82947 Glucose Level	$30.93	$61.85	$3.80–$5,000.00	32% below	50%
Blood glucose (sugar) test inpatient CPT 82947 Glucose 2 Hour Post Prandial	$30.93	$61.85	$21.65–$61.85	—	50%
Blood glucose (sugar) test inpatient CPT 82947 Glucose Level	$30.93	$61.85	$21.65–$61.85	—	50%
Blood glucose (sugar) test inpatient CPT 82947 Glucose 1 Hour Post Prandial	$30.93	$61.85	$21.65–$61.85	—	50%
Blood glucose (sugar) test inpatient CPT 82947 Glucose O'Sullivan	$30.93	$61.85	$21.65–$61.85	—	50%
Blood glucose (sugar) test inpatient CPT 82947 Glucose 4 Hour	$30.93	$61.85	$21.65–$61.85	—	50%
Blood glucose (sugar) test inpatient CPT 82947 Glucose 5 Hour	$30.93	$61.85	$21.65–$61.85	—	50%
Blood glucose (sugar) test inpatient CPT 82947 Glucose 6 Hour	$30.93	$61.85	$21.65–$61.85	—	50%
Blood glucose (sugar) test inpatient CPT 82947 Glucose Fasting	$30.93	$61.85	$21.65–$61.85	—	50%
Blood lead test CPT 83655 REF U Lead/Creat. Ratio	$32.44	$64.87	$11.72–$5,000.00	25% above	50%
Blood lead test CPT 83655 REF Lead Level Venous	$83.76	$167.51	$11.72–$5,000.00	223% above	50%
Blood lead test inpatient CPT 83655 REF U Lead/Creat. Ratio	$32.44	$64.87	$22.70–$64.87	—	50%
Blood lead test inpatient CPT 83655 REF Lead Level Venous	$83.76	$167.51	$58.63–$167.51	—	50%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 Beta Human Chorionic Gonadotropin Qualitative	$99.21	$198.42	$7.28–$5,000.00	48% above	50%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 Beta Human Chorionic Gonadotropin Qualitative	$99.21	$198.42	$69.45–$198.42	—	50%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 REF Bill BB ABO Typing	$36.37	$72.73	$3.02–$5,000.00	55% below	50%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 Anti A	$110.53	$221.05	$3.02–$5,000.00	36% above	50%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 Group and Type	$110.53	$221.05	$3.02–$5,000.00	36% above	50%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 Anti-A	$110.53	$221.05	$3.02–$5,000.00	36% above	50%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 Group and Type (Newborn)	$110.53	$221.05	$3.02–$5,000.00	36% above	50%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 REF Bill BB ABO Typing	$36.37	$72.73	$25.46–$72.73	—	50%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 Anti-A	$110.53	$221.05	$77.37–$221.05	—	50%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 Anti A	$110.53	$221.05	$77.37–$221.05	—	50%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 Group and Type	$110.53	$221.05	$77.37–$221.05	—	50%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 Group and Type (Newborn)	$110.53	$221.05	$77.37–$221.05	—	50%
Blood urea nitrogen (BUN) test CPT 84520 Blood Urea Nitrogen	$28.24	$56.48	$3.82–$5,000.00	74% above	50%
Blood urea nitrogen (BUN) test inpatient CPT 84520 Blood Urea Nitrogen	$28.24	$56.48	$19.77–$56.48	—	50%
C-peptide blood test CPT 84681 REF C-Peptide	$100.31	$200.61	$20.14–$5,000.00	76% above	50%
C-peptide blood test inpatient CPT 84681 REF C-Peptide	$100.31	$200.61	$70.21–$200.61	—	50%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C Reactive Protein Extended SMC	$44.28	$88.55	$5.01–$5,000.00	8% below	50%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C Reactive Protein	$44.28	$88.55	$5.01–$5,000.00	8% below	50%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 C Reactive Protein	$44.28	$88.55	$30.99–$88.55	—	50%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 C Reactive Protein Extended SMC	$44.28	$88.55	$30.99–$88.55	—	50%
C. difficile toxin gene test (stool PCR) CPT 87493 C. diff Toxin by PCR	$106.03	$212.06	$36.07–$5,000.00	44% above	50%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 C. diff Toxin by PCR	$106.03	$212.06	$74.22–$212.06	—	50%
CA 19-9 blood test (tumor marker) CPT 86301 REF Carbohydrate Antigen 19-9	$23.29	$46.58	$16.30–$5,000.00	17% below	50%
CA 19-9 blood test (tumor marker) inpatient CPT 86301 REF Carbohydrate Antigen 19-9	$23.29	$46.58	$16.30–$46.58	—	50%
CA-125 blood test (ovarian cancer marker) CPT 86304 REF Cancer Antigen 125	$20.46	$40.91	$14.32–$5,000.00	70% below	50%
CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 REF Cancer Antigen 125	$20.46	$40.91	$14.32–$40.91	—	50%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 REF SARS-CoV-2 RNA Quest	$102.00	$204.00	$49.65–$5,000.00	57% above	50%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 SARS-CoV-2 PCR NAH	$109.26	$218.52	$49.65–$5,000.00	69% above	50%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 SARS-CoV-2 POC	$109.26	$218.52	$49.65–$5,000.00	69% above	50%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 REF SARS-CoV-2 RNA Varies	$117.50	$235.00	$49.65–$5,000.00	81% above	50%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 REF SARS-CoV-2 RNA Quest	$102.00	$204.00	$71.40–$204.00	—	50%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 SARS-CoV-2 PCR NAH	$109.26	$218.52	$76.48–$218.52	—	50%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 SARS-CoV-2 POC	$109.26	$218.52	$76.48–$218.52	—	50%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 REF SARS-CoV-2 RNA Varies	$117.50	$235.00	$82.25–$235.00	—	50%
Calcium blood test, total CPT 82310 Calcium Level Total	$30.78	$61.55	$4.99–$5,000.00	105% above	50%
Calcium blood test, total inpatient CPT 82310 Calcium Level Total	$30.78	$61.55	$21.54–$61.55	—	50%
Carcinoembryonic antigen (CEA) test CPT 82378 CEA Pancreatic Cyst	$91.60	$183.20	$18.35–$5,000.00	59% above	50%
Carcinoembryonic antigen (CEA) test CPT 82378 Carcinoembryonic Antigen	$91.60	$183.20	$18.35–$5,000.00	59% above	50%
Carcinoembryonic antigen (CEA) test inpatient CPT 82378 Carcinoembryonic Antigen	$91.60	$183.20	$64.12–$183.20	—	50%
Carcinoembryonic antigen (CEA) test inpatient CPT 82378 CEA Pancreatic Cyst	$91.60	$183.20	$64.12–$183.20	—	50%
Chickenpox (varicella) immunity blood test CPT 86787 REF Varicella Zoster IgG Convalescent Titer	$54.00	$108.00	$12.46–$5,000.00	161% above	50%
Chickenpox (varicella) immunity blood test CPT 86787 REF Varicella Zoster IgG CSF	$54.00	$108.00	$12.46–$5,000.00	161% above	50%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 REF Varicella Zoster IgG CSF	$54.00	$108.00	$37.80–$108.00	—	50%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 REF Varicella Zoster IgG Convalescent Titer	$54.00	$108.00	$37.80–$108.00	—	50%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 REF C. trach Misc Amplified RNA	$112.53	$225.05	$33.96–$5,000.00	82% above	50%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 REF Chlamydia trachomatis RNA	$213.12	$426.24	$33.96–$5,000.00	244% above	50%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 REF C. trach Misc Amplified RNA	$112.53	$225.05	$78.77–$225.05	—	50%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 REF Chlamydia trachomatis RNA	$213.12	$426.24	$149.18–$426.24	—	50%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Lipid Panel	$97.90	$195.80	$12.96–$5,000.00	149% above	50%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 Lipid Panel	$97.90	$195.80	$68.53–$195.80	—	50%
Complete blood count (CBC) with differential CPT 85025 Complete Blood Count with Diff	$93.01	$186.02	$7.52–$5,000.00	55% above	50%
Complete blood count (CBC) with differential CPT 85025 Complete Blood Count	$93.01	$186.02	$7.52–$5,000.00	55% above	50%
Complete blood count (CBC) with differential CPT 85025 CBC Peds-Neonate	$93.01	$186.02	$7.52–$5,000.00	55% above	50%
Complete blood count (CBC) with differential inpatient CPT 85025 Complete Blood Count	$93.01	$186.02	$65.11–$186.02	—	50%
Complete blood count (CBC) with differential inpatient CPT 85025 CBC Peds-Neonate	$93.01	$186.02	$65.11–$186.02	—	50%
Complete blood count (CBC) with differential inpatient CPT 85025 Complete Blood Count with Diff	$93.01	$186.02	$65.11–$186.02	—	50%
Complete blood count (CBC), no differential CPT 85027 Hemogram	$24.70	$49.40	$6.26–$5,000.00	49% below	50%
Complete blood count (CBC), no differential inpatient CPT 85027 Hemogram	$24.70	$49.40	$17.29–$49.40	—	50%
Comprehensive metabolic panel (blood test) CPT 80053 Comprehensive Metabolic Panel	$190.58	$381.16	$10.22–$5,000.00	45% above	50%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 Comprehensive Metabolic Panel	$190.58	$381.16	$133.41–$381.16	—	50%
Cortisol blood test, total CPT 82533 REF Cortisol, Saliva	$66.00	$132.00	$15.77–$5,000.00	61% above	50%
Cortisol blood test, total CPT 82533 Cortisol	$120.10	$240.20	$15.77–$5,000.00	193% above	50%
Cortisol blood test, total inpatient CPT 82533 REF Cortisol, Saliva	$66.00	$132.00	$46.20–$132.00	—	50%
Cortisol blood test, total inpatient CPT 82533 Cortisol	$120.10	$240.20	$84.07–$240.20	—	50%
Creatine kinase (CK) blood test, total CPT 82550 Creatine Kinase	$28.66	$57.32	$6.30–$5,000.00	104% above	50%
Creatine kinase (CK) blood test, total inpatient CPT 82550 Creatine Kinase	$28.66	$57.32	$20.06–$57.32	—	50%
Creatinine blood test CPT 82565 Creatinine Body Fluid	$40.14	$80.28	$4.95–$5,000.00	167% above	50%
Creatinine blood test CPT 82565 Creatinine	$40.14	$80.28	$4.95–$5,000.00	167% above	50%
Creatinine blood test inpatient CPT 82565 Creatinine Body Fluid	$40.14	$80.28	$28.10–$80.28	—	50%
Creatinine blood test inpatient CPT 82565 Creatinine	$40.14	$80.28	$28.10–$80.28	—	50%
Cytomegalovirus (CMV) antibody test CPT 86644 REF CMV Ab IgG	$26.20	$52.40	$13.93–$5,000.00	15% below	50%
Cytomegalovirus (CMV) antibody test CPT 86644 CMV Negative	$26.57	$53.13	$13.93–$5,000.00	14% below	50%
Cytomegalovirus (CMV) antibody test CPT 86644 REF Cytomegalovirus IgG Convalescent Titer	$57.51	$115.02	$13.93–$5,000.00	87% above	50%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 REF CMV Ab IgG	$26.20	$52.40	$18.34–$52.40	—	50%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 CMV Negative	$26.57	$53.13	$18.60–$53.13	—	50%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 REF Cytomegalovirus IgG Convalescent Titer	$57.51	$115.02	$40.26–$115.02	—	50%
D-dimer blood test (blood clot marker) CPT 85379 D Dimer HS	$225.35	$450.70	$9.85–$5,000.00	122% above	50%
D-dimer blood test (blood clot marker) CPT 85379 D-Dimer	$225.35	$450.70	$9.85–$5,000.00	122% above	50%
D-dimer blood test (blood clot marker) inpatient CPT 85379 D-Dimer	$225.35	$450.70	$157.74–$450.70	—	50%
D-dimer blood test (blood clot marker) inpatient CPT 85379 D Dimer HS	$225.35	$450.70	$157.74–$450.70	—	50%
DHEA sulfate (DHEA-S) blood test CPT 82627 REF Dehydroepiandrosterone Sulfate	$79.32	$158.63	$21.51–$5,000.00	50% above	50%
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 REF Dehydroepiandrosterone Sulfate	$79.32	$158.63	$55.52–$158.63	—	50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Toxicology Drug Screen Ea. Drug	$84.37	$168.73	$59.06–$5,000.00	at median	50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Toxicology Drug Screen Urine	$84.37	$168.73	$59.06–$5,000.00	at median	50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Amphet Confirm Urine	$84.37	$168.73	$59.06–$5,000.00	at median	50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Fentanyl Urine	$84.37	$168.73	$59.06–$5,000.00	at median	50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 REF List patient's current meds (MAYO)	$94.62	$189.24	$60.13–$5,000.00	12% above	50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 REF Drug Screen Meconium each drug	$222.37	$444.73	$60.13–$5,000.00	164% above	50%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Amphet Confirm Urine	$84.37	$168.73	$59.06–$168.73	—	50%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Toxicology Drug Screen Urine	$84.37	$168.73	$59.06–$168.73	—	50%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Toxicology Drug Screen Ea. Drug	$84.37	$168.73	$59.06–$168.73	—	50%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Fentanyl Urine	$84.37	$168.73	$59.06–$168.73	—	50%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 REF List patient's current meds (MAYO)	$94.62	$189.24	$66.23–$189.24	—	50%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 REF Drug Screen Meconium each drug	$222.37	$444.73	$155.66–$444.73	—	50%
Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 Electrolyte Panel	$30.87	$61.73	$6.78–$5,000.00	45% below	50%
Electrolyte panel (sodium, potassium, chloride, CO2) inpatient CPT 80051 Electrolyte Panel	$30.87	$61.73	$21.61–$61.73	—	50%
Epstein-Barr virus (EBV) antibody test CPT 86665 REF Epstein Barr Virus Viral Capsid Antigen IgM	$13.94	$27.88	$9.76–$5,000.00	35% below	50%
Epstein-Barr virus (EBV) antibody test CPT 86665 REF Epstein Barr Virus VCA IgM Ab	$14.52	$29.04	$10.16–$5,000.00	33% below	50%
Epstein-Barr virus (EBV) antibody test CPT 86665 REF Epstein Barr Virus VCA IgG Ab	$14.52	$29.04	$10.16–$5,000.00	33% below	50%
Epstein-Barr virus (EBV) antibody test CPT 86665 Epstein Barr IgM Acute Titer	$92.10	$184.20	$17.55–$5,000.00	326% above	50%
Epstein-Barr virus (EBV) antibody test CPT 86665 Epstein Barr Viral Capsid Antigen	$92.10	$184.20	$17.55–$5,000.00	326% above	50%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 REF Epstein Barr Virus Viral Capsid Antigen IgM	$13.94	$27.88	$9.76–$27.88	—	50%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 REF Epstein Barr Virus VCA IgM Ab	$14.52	$29.04	$10.16–$29.04	—	50%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 REF Epstein Barr Virus VCA IgG Ab	$14.52	$29.04	$10.16–$29.04	—	50%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 Epstein Barr Viral Capsid Antigen	$92.10	$184.20	$64.47–$184.20	—	50%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 Epstein Barr IgM Acute Titer	$92.10	$184.20	$64.47–$184.20	—	50%
Estradiol blood test CPT 82670 REF Estradiol Level	$65.80	$131.60	$27.04–$5,000.00	3% above	50%
Estradiol blood test inpatient CPT 82670 REF Estradiol Level	$65.80	$131.60	$46.06–$131.60	—	50%
FSH (follicle-stimulating hormone) test CPT 83001 REF Follicle Stimulating Hormone	$98.25	$196.50	$17.98–$5,000.00	68% above	50%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 REF Follicle Stimulating Hormone	$98.25	$196.50	$68.77–$196.50	—	50%
Fecal calprotectin (stool inflammation test) CPT 83993 REF Calprotectin Fecal	$248.40	$496.80	$19.00–$5,000.00	400% above	50%
Fecal calprotectin (stool inflammation test) inpatient CPT 83993 REF Calprotectin Fecal	$248.40	$496.80	$173.88–$496.80	—	50%
Ferritin blood test (iron stores) CPT 82728 Ferritin	$132.93	$265.86	$13.19–$5,000.00	69% above	50%
Ferritin blood test (iron stores) inpatient CPT 82728 Ferritin	$132.93	$265.86	$93.05–$265.86	—	50%
Fibrinogen blood test CPT 85384 Fibrinogen	$87.49	$174.97	$9.41–$5,000.00	80% above	50%
Fibrinogen blood test CPT 85384 TEG Trauma CFF MA	$87.49	$174.97	$9.41–$5,000.00	80% above	50%
Fibrinogen blood test CPT 85384 TEG Cardiac CFFH MA	$87.49	$174.97	$9.41–$5,000.00	80% above	50%
Fibrinogen blood test inpatient CPT 85384 Fibrinogen	$87.49	$174.97	$61.24–$174.97	—	50%
Fibrinogen blood test inpatient CPT 85384 TEG Cardiac CFFH MA	$87.49	$174.97	$61.24–$174.97	—	50%
Fibrinogen blood test inpatient CPT 85384 TEG Trauma CFF MA	$87.49	$174.97	$61.24–$174.97	—	50%
Folate (folic acid) blood test CPT 82746 Folate Level	$84.20	$168.40	$14.23–$5,000.00	1% below	50%
Folate (folic acid) blood test inpatient CPT 82746 Folate Level	$84.20	$168.40	$58.94–$168.40	—	50%
Free T3 thyroid hormone test CPT 84481 REF T3 Free	$23.34	$46.68	$16.34–$5,000.00	42% below	50%
Free T3 thyroid hormone test inpatient CPT 84481 REF T3 Free	$23.34	$46.68	$16.34–$46.68	—	50%
Free T4 (free thyroxine) thyroid blood test CPT 84439 Thyroxine Free	$113.40	$226.80	$8.73–$5,000.00	111% above	50%
Free T4 (free thyroxine) thyroid blood test CPT 84439 T4, Free, Direct Dialysis	$113.40	$226.80	$8.73–$5,000.00	111% above	50%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 Thyroxine Free	$113.40	$226.80	$79.38–$226.80	—	50%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 T4, Free, Direct Dialysis	$113.40	$226.80	$79.38–$226.80	—	50%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 Gamma Glutamyl Transferase	$45.42	$90.83	$6.97–$5,000.00	58% above	50%
Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 Gamma Glutamyl Transferase	$45.42	$90.83	$31.79–$90.83	—	50%
Glucose tolerance test, 3 samples CPT 82951 Glucose 30 Minutes	$76.85	$153.70	$12.45–$5,000.00	24% below	50%
Glucose tolerance test, 3 samples CPT 82951 Glucose 1 Hour	$76.85	$153.70	$12.45–$5,000.00	24% below	50%
Glucose tolerance test, 3 samples CPT 82951 Glucose Baseline	$76.85	$153.70	$12.45–$5,000.00	24% below	50%
Glucose tolerance test, 3 samples inpatient CPT 82951 Glucose Baseline	$76.85	$153.70	$53.79–$153.70	—	50%
Glucose tolerance test, 3 samples inpatient CPT 82951 Glucose 1 Hour	$76.85	$153.70	$53.79–$153.70	—	50%
Glucose tolerance test, 3 samples inpatient CPT 82951 Glucose 30 Minutes	$76.85	$153.70	$53.79–$153.70	—	50%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 REF U N. gonorrhoeae RNA, TMA	$36.20	$72.40	$25.34–$5,000.00	40% below	50%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 REF GC DNA	$45.00	$90.00	$31.50–$5,000.00	26% below	50%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 REF N. gonorr Misc Amplified RNA	$109.59	$219.17	$33.96–$5,000.00	81% above	50%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 REF N. gonorr Amplified RNA	$128.11	$256.22	$33.96–$5,000.00	112% above	50%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 REF U N. gonorrhoeae RNA, TMA	$36.20	$72.40	$25.34–$72.40	—	50%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 REF GC DNA	$45.00	$90.00	$31.50–$90.00	—	50%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 REF N. gonorr Misc Amplified RNA	$109.59	$219.17	$76.71–$219.17	—	50%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 REF N. gonorr Amplified RNA	$128.11	$256.22	$89.68–$256.22	—	50%
H. pylori stool antigen test CPT 87338 Helicobacter Pylori Antigen, Stool	$117.21	$234.41	$13.92–$5,000.00	171% above	50%
H. pylori stool antigen test inpatient CPT 87338 Helicobacter Pylori Antigen, Stool	$117.21	$234.41	$82.04–$234.41	—	50%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 REF HIV 1 RNA PCR Quantitative	$121.71	$243.41	$82.35–$5,000.00	at median	50%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 REF HIV 1 RNA PCR Quantitative	$121.71	$243.41	$85.19–$243.41	—	50%
HIV-1 and HIV-2 antibody test CPT 86703 HIV 1 + 2	$73.75	$147.49	$13.27–$5,000.00	93% above	50%
HIV-1 and HIV-2 antibody test inpatient CPT 86703 HIV 1 + 2	$73.75	$147.49	$51.62–$147.49	—	50%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 REF HIV 1/2 Ag/Ab	$67.50	$135.00	$23.30–$5,000.00	65% above	50%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV Ag/Ab Combo	$70.72	$141.43	$23.30–$5,000.00	73% above	50%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 REF HIV 1/2 Ag/Ab	$67.50	$135.00	$47.25–$135.00	—	50%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HIV Ag/Ab Combo	$70.72	$141.43	$49.50–$141.43	—	50%
HPV test for high-risk types, one combined (pooled) result CPT 87624 REF HPV with Genotyping PCR ThinPrep	$96.75	$193.50	$33.96–$5,000.00	76% above	50%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 REF HPV with Genotyping PCR ThinPrep	$96.75	$193.50	$67.72–$193.50	—	50%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 Hemoglobin A1c	$70.96	$141.92	$9.40–$5,000.00	46% above	50%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 REF Hgb A1c Conf	$70.96	$141.92	$9.40–$5,000.00	46% above	50%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 REF Hgb A1c Conf	$70.96	$141.92	$49.67–$141.92	—	50%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 Hemoglobin A1c	$70.96	$141.92	$49.67–$141.92	—	50%
Hemoglobin blood test CPT 85018 Hemoglobin	$15.53	$31.05	$2.29–$5,000.00	40% below	50%
Hemoglobin blood test inpatient CPT 85018 Hemoglobin	$15.53	$31.05	$10.87–$31.05	—	50%
Hepatitis B core antibody test (total) CPT 86704 REF Hepatitis B Core Antibody (Total)	$51.95	$103.89	$11.66–$5,000.00	90% above	50%
Hepatitis B core antibody test (total) inpatient CPT 86704 REF Hepatitis B Core Antibody (Total)	$51.95	$103.89	$36.36–$103.89	—	50%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 Hepatitis B Surface Antibody	$91.76	$183.51	$10.39–$5,000.00	215% above	50%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 Hepatitis B Surface Antibody	$91.76	$183.51	$64.23–$183.51	—	50%
Hepatitis B surface antigen (HBsAg) test CPT 87340 Hepatitis B Surface Antigen	$71.85	$143.70	$10.00–$5,000.00	225% above	50%
Hepatitis B surface antigen (HBsAg) test CPT 87340 Hep Bs Ag Confirmation	$71.85	$143.70	$10.00–$5,000.00	225% above	50%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 Hep Bs Ag Confirmation	$71.85	$143.70	$50.29–$143.70	—	50%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 Hepatitis B Surface Antigen	$71.85	$143.70	$50.29–$143.70	—	50%
Hepatitis C antibody blood test (screening) CPT 86803 Hepatitis C Antibody	$72.76	$145.52	$13.81–$5,000.00	91% above	50%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 Hepatitis C Antibody	$72.76	$145.52	$50.93–$145.52	—	50%
Hepatitis C viral load (HCV RNA) test CPT 87522 REF Hepatitis C RNA PCR Quantitative	$137.43	$274.85	$41.46–$5,000.00	55% above	50%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 REF Hepatitis C RNA PCR Quantitative	$137.43	$274.85	$96.20–$274.85	—	50%
Herpes blood test, HSV-1 antibody CPT 86695 HERPES SIMPLEX TEST	$31.66	$63.32	$12.76–$5,000.00	3% above	50%
Herpes blood test, HSV-1 antibody CPT 86695 REF HSV-1 IgG	$39.06	$78.12	$12.76–$5,000.00	27% above	50%
Herpes blood test, HSV-1 antibody CPT 86695 REF Herpes Type I IgG Convalescent Titer	$131.06	$262.11	$12.76–$5,000.00	326% above	50%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 REF HSV-1 IgG	$39.06	$78.12	$27.34–$78.12	—	50%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 REF Herpes Type I IgG Convalescent Titer	$131.06	$262.11	$91.74–$262.11	—	50%
Herpes blood test, HSV-2 antibody CPT 86696 HERPES SIMPLEX TYPE 2 TEST	$33.19	$66.38	$18.72–$5,000.00	at median	50%
Herpes blood test, HSV-2 antibody CPT 86696 REF HSV-2 IgG	$46.50	$93.00	$18.72–$5,000.00	40% above	50%
Herpes blood test, HSV-2 antibody CPT 86696 REF Herpes Type II IgG Convalescent Titer	$192.28	$384.56	$18.72–$5,000.00	479% above	50%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 REF HSV-2 IgG	$46.50	$93.00	$32.55–$93.00	—	50%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 REF Herpes Type II IgG Convalescent Titer	$192.28	$384.56	$134.60–$384.56	—	50%
High-sensitivity CRP (hs-CRP) test CPT 86141 REF CRP High Sensitivity	$61.78	$123.56	$12.53–$5,000.00	12% above	50%
High-sensitivity CRP (hs-CRP) test CPT 86141 C-Reactive Protein	$71.05	$142.09	$12.53–$5,000.00	28% above	50%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 REF CRP High Sensitivity	$61.78	$123.56	$43.25–$123.56	—	50%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 C-Reactive Protein	$71.05	$142.09	$49.73–$142.09	—	50%
Homocysteine blood test CPT 83090 Homocystine	$87.63	$175.26	$17.34–$5,000.00	37% below	50%
Homocysteine blood test inpatient CPT 83090 Homocystine	$87.63	$175.26	$61.34–$175.26	—	50%
Insulin blood test CPT 83525 REF Insulin Level	$34.81	$69.61	$11.06–$5,000.00	27% above	50%
Insulin blood test inpatient CPT 83525 REF Insulin Level	$34.81	$69.61	$24.36–$69.61	—	50%
Iron blood test (serum iron) CPT 83540 REF Bill SO Liver Tissue Iron	$59.06	$118.11	$6.26–$5,000.00	56% above	50%
Iron blood test (serum iron) CPT 83540 Iron Level	$70.87	$141.73	$6.26–$5,000.00	88% above	50%
Iron blood test (serum iron) inpatient CPT 83540 REF Bill SO Liver Tissue Iron	$59.06	$118.11	$41.34–$118.11	—	50%
Iron blood test (serum iron) inpatient CPT 83540 Iron Level	$70.87	$141.73	$49.61–$141.73	—	50%
Iron-binding capacity (TIBC) test CPT 83550 Iron Binding Capacity Total	$55.08	$110.16	$8.46–$5,000.00	32% below	50%
Iron-binding capacity (TIBC) test inpatient CPT 83550 Iron Binding Capacity Total	$55.08	$110.16	$38.56–$110.16	—	50%
Kidney function blood test panel CPT 80069 Renal Panel	$184.98	$369.96	$8.40–$5,000.00	113% above	50%
Kidney function blood test panel inpatient CPT 80069 Renal Panel	$184.98	$369.96	$129.49–$369.96	—	50%
LH (luteinizing hormone) test CPT 83002 REF Luteinizing Hormone	$69.40	$138.79	$17.92–$5,000.00	16% above	50%
LH (luteinizing hormone) test inpatient CPT 83002 REF Luteinizing Hormone	$69.40	$138.79	$48.58–$138.79	—	50%
Lactate (lactic acid) blood test CPT 83605 Lactic Acid Cerebrospinal Fluid	$106.92	$213.83	$11.20–$5,000.00	276% above	50%
Lactate (lactic acid) blood test CPT 83605 Lactic Acid	$106.92	$213.83	$11.20–$5,000.00	276% above	50%
Lactate (lactic acid) blood test CPT 83605 Lactic Sepsis	$106.92	$213.83	$11.20–$5,000.00	276% above	50%
Lactate (lactic acid) blood test inpatient CPT 83605 Lactic Sepsis	$106.92	$213.83	$74.84–$213.83	—	50%
Lactate (lactic acid) blood test inpatient CPT 83605 Lactic Acid Cerebrospinal Fluid	$106.92	$213.83	$74.84–$213.83	—	50%
Lactate (lactic acid) blood test inpatient CPT 83605 Lactic Acid	$106.92	$213.83	$74.84–$213.83	—	50%
Lactate dehydrogenase (LDH) blood test CPT 83615 LDH Pericardial Fluid	$65.92	$131.84	$5.84–$5,000.00	104% above	50%
Lactate dehydrogenase (LDH) blood test CPT 83615 LDH Synovial Fluid	$65.92	$131.84	$5.84–$5,000.00	104% above	50%
Lactate dehydrogenase (LDH) blood test CPT 83615 Lactate Dehydrogenase Cerebrospinal Fluid	$65.92	$131.84	$5.84–$5,000.00	104% above	50%
Lactate dehydrogenase (LDH) blood test CPT 83615 Lactate Dehydrogenase Body Fluid	$65.92	$131.84	$5.84–$5,000.00	104% above	50%
Lactate dehydrogenase (LDH) blood test CPT 83615 LDH Peritoneal Fluid	$65.92	$131.84	$5.84–$5,000.00	104% above	50%
Lactate dehydrogenase (LDH) blood test CPT 83615 LDH Pleural Fluid	$65.92	$131.84	$5.84–$5,000.00	104% above	50%
Lactate dehydrogenase (LDH) blood test CPT 83615 Lactate Dehydrogenase	$65.92	$131.84	$5.84–$5,000.00	104% above	50%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 Lactate Dehydrogenase Cerebrospinal Fluid	$65.92	$131.84	$46.14–$131.84	—	50%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 LDH Synovial Fluid	$65.92	$131.84	$46.14–$131.84	—	50%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 Lactate Dehydrogenase Body Fluid	$65.92	$131.84	$46.14–$131.84	—	50%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 LDH Peritoneal Fluid	$65.92	$131.84	$46.14–$131.84	—	50%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 LDH Pericardial Fluid	$65.92	$131.84	$46.14–$131.84	—	50%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 LDH Pleural Fluid	$65.92	$131.84	$46.14–$131.84	—	50%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 Lactate Dehydrogenase	$65.92	$131.84	$46.14–$131.84	—	50%
Lipase blood test (pancreas enzyme) CPT 83690 Lipase	$109.20	$218.39	$6.67–$5,000.00	303% above	50%
Lipase blood test (pancreas enzyme) CPT 83690 Lipase Body Fluid	$109.20	$218.39	$6.67–$5,000.00	303% above	50%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 Lipase	$109.20	$218.39	$76.44–$218.39	—	50%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 Lipase Body Fluid	$109.20	$218.39	$76.44–$218.39	—	50%
Liver function blood test panel CPT 80076 Hepatic Function Panel	$35.93	$71.85	$7.91–$5,000.00	55% below	50%
Liver function blood test panel inpatient CPT 80076 Hepatic Function Panel	$35.93	$71.85	$25.15–$71.85	—	50%
Lyme disease antibody test CPT 86618 REF Lyme Antibody	$135.24	$270.47	$16.48–$5,000.00	287% above	50%
Lyme disease antibody test inpatient CPT 86618 REF Lyme Antibody	$135.24	$270.47	$94.66–$270.47	—	50%
Magnesium blood test CPT 83735 REF Urine Magnesium	$13.82	$27.63	$6.48–$5,000.00	at median	50%
Magnesium blood test CPT 83735 Magnesium Level	$28.80	$57.60	$6.48–$5,000.00	108% above	50%
Magnesium blood test CPT 83735 Magnesium Level 24 Hour Urine	$28.80	$57.60	$6.48–$5,000.00	108% above	50%
Magnesium blood test inpatient CPT 83735 REF Urine Magnesium	$13.82	$27.63	$9.67–$27.63	—	50%
Magnesium blood test inpatient CPT 83735 Magnesium Level	$28.80	$57.60	$20.16–$57.60	—	50%
Magnesium blood test inpatient CPT 83735 Magnesium Level 24 Hour Urine	$28.80	$57.60	$20.16–$57.60	—	50%
Measles (rubeola) antibody test CPT 86765 REF Measles Ab, IgG	$16.68	$33.36	$11.68–$5,000.00	at median	50%
Measles (rubeola) antibody test CPT 86765 REF Measles Ab, IgG (MAYO)	$16.68	$33.36	$11.68–$5,000.00	at median	50%
Measles (rubeola) antibody test CPT 86765 REF Measles Ab, IgM	$25.55	$51.10	$12.46–$5,000.00	53% above	50%
Measles (rubeola) antibody test CPT 86765 REF Measles Ab, IgM (MAYO)	$25.55	$51.10	$12.46–$5,000.00	53% above	50%
Measles (rubeola) antibody test CPT 86765 Rubeola IgG Convalescent Titer	$51.98	$103.96	$12.46–$5,000.00	212% above	50%
Measles (rubeola) antibody test CPT 86765 EH MMR Panel FMC	$51.98	$103.96	$12.46–$5,000.00	212% above	50%
Measles (rubeola) antibody test inpatient CPT 86765 REF Measles Ab, IgG	$16.68	$33.36	$11.68–$33.36	—	50%
Measles (rubeola) antibody test inpatient CPT 86765 REF Measles Ab, IgG (MAYO)	$16.68	$33.36	$11.68–$33.36	—	50%
Measles (rubeola) antibody test inpatient CPT 86765 REF Measles Ab, IgM	$25.55	$51.10	$17.88–$51.10	—	50%
Measles (rubeola) antibody test inpatient CPT 86765 REF Measles Ab, IgM (MAYO)	$25.55	$51.10	$17.88–$51.10	—	50%
Measles (rubeola) antibody test inpatient CPT 86765 EH MMR Panel FMC	$51.98	$103.96	$36.39–$103.96	—	50%
Measles (rubeola) antibody test inpatient CPT 86765 Rubeola IgG Convalescent Titer	$51.98	$103.96	$36.39–$103.96	—	50%
Mono test (heterophile antibody, Monospot) CPT 86308 Mononucleosis Screen	$76.25	$152.50	$5.01–$5,000.00	2% above	50%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 Mononucleosis Screen	$76.25	$152.50	$53.38–$152.50	—	50%
Mumps immunity blood test CPT 86735 Mumps IgM Acute Titer	$211.76	$423.52	$12.63–$5,000.00	616% above	50%
Mumps immunity blood test CPT 86735 Mumps IgG Convalescent Titer	$211.76	$423.52	$12.63–$5,000.00	616% above	50%
Mumps immunity blood test inpatient CPT 86735 Mumps IgM Acute Titer	$211.76	$423.52	$148.23–$423.52	—	50%
Mumps immunity blood test inpatient CPT 86735 Mumps IgG Convalescent Titer	$211.76	$423.52	$148.23–$423.52	—	50%
PSA (prostate-specific antigen) blood test, free CPT 84154 REF Prostate Specific Antigen Free	$111.56	$223.12	$17.80–$5,000.00	103% above	50%
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 REF Prostate Specific Antigen Free	$111.56	$223.12	$78.09–$223.12	—	50%
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA Total	$71.47	$142.94	$17.80–$5,000.00	21% above	50%
PSA (prostate-specific antigen) blood test, total CPT 84153 REF Prostate Specific Antigen	$71.47	$142.94	$17.80–$5,000.00	21% above	50%
PSA (prostate-specific antigen) blood test, total CPT 84153 REF Prostate Specific Total	$71.47	$142.94	$17.80–$5,000.00	21% above	50%
PSA (prostate-specific antigen) blood test, total CPT 84153 REF PSA Total Screen	$71.47	$142.94	$17.80–$5,000.00	21% above	50%
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA Total Diagnostic NAH	$85.77	$171.53	$17.80–$5,000.00	45% above	50%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 REF PSA Total Screen	$71.47	$142.94	$50.03–$142.94	—	50%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA Total	$71.47	$142.94	$50.03–$142.94	—	50%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 REF Prostate Specific Antigen	$71.47	$142.94	$50.03–$142.94	—	50%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 REF Prostate Specific Total	$71.47	$142.94	$50.03–$142.94	—	50%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA Total Diagnostic NAH	$85.77	$171.53	$60.04–$171.53	—	50%
Pap test (liquid-based, automated screening with review) CPT 88175 Bill SO Cytopathology C/V Auto Fluid Rescreen	$38.65	$77.30	$25.75–$5,000.00	3% below	50%
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 Bill SO Cytopathology C/V Auto Fluid Rescreen	$38.65	$77.30	$27.05–$77.30	—	50%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 *REF ThinPrep with HPV Co-Test-Screen	$36.72	$73.44	$19.61–$5,000.00	37% above	50%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 REF ThinPrep Screen HPV Reflex	$36.72	$73.44	$19.61–$5,000.00	37% above	50%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 Bill SO Cytopathology C/V Thin Layer Prep	$38.56	$77.11	$19.61–$5,000.00	44% above	50%
Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 REF ThinPrep Screen HPV Reflex	$36.72	$73.44	$25.70–$73.44	—	50%
Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 *REF ThinPrep with HPV Co-Test-Screen	$36.72	$73.44	$25.70–$73.44	—	50%
Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 Bill SO Cytopathology C/V Thin Layer Prep	$38.56	$77.11	$26.99–$77.11	—	50%
Parathyroid hormone (PTH) blood test CPT 83970 Parathyroid Hormone Intact	$217.35	$434.69	$39.95–$5,000.00	177% above	50%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 Parathyroid Hormone Intact	$217.35	$434.69	$152.14–$434.69	—	50%
Partial thromboplastin time (PTT) clotting test CPT 85730 REF PTT-LA	$18.90	$37.80	$5.82–$5,000.00	at median	50%
Partial thromboplastin time (PTT) clotting test CPT 85730 REF APTT	$22.71	$45.41	$5.82–$5,000.00	20% above	50%
Partial thromboplastin time (PTT) clotting test CPT 85730 Partial Thromboplastin Time	$67.23	$134.45	$5.82–$5,000.00	256% above	50%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 REF PTT-LA	$18.90	$37.80	$13.23–$37.80	—	50%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 REF APTT	$22.71	$45.41	$15.89–$45.41	—	50%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 Partial Thromboplastin Time	$67.23	$134.45	$47.06–$134.45	—	50%
Phosphorus (phosphate) blood test CPT 84100 Phosphorus Level	$26.63	$53.26	$4.59–$5,000.00	18% above	50%
Phosphorus (phosphate) blood test inpatient CPT 84100 Phosphorus Level	$26.63	$53.26	$18.64–$53.26	—	50%
Potassium blood test CPT 84132 Potassium Level	$15.53	$31.05	$4.61–$5,000.00	39% below	50%
Potassium blood test inpatient CPT 84132 Potassium Level	$15.53	$31.05	$10.87–$31.05	—	50%
Progesterone blood test CPT 84144 REF Progesterone Level	$49.13	$98.26	$20.19–$5,000.00	41% below	50%
Progesterone blood test inpatient CPT 84144 REF Progesterone Level	$49.13	$98.26	$34.39–$98.26	—	50%
Prolactin blood test CPT 84146 REF Prolactin Level	$13.55	$27.09	$9.48–$5,000.00	74% below	50%
Prolactin blood test inpatient CPT 84146 REF Prolactin Level	$13.55	$27.09	$9.48–$27.09	—	50%
Prothrombin time (PT/INR) clotting test CPT 85610 REF Prothrombin Time	$13.50	$27.00	$4.15–$5,000.00	28% below	50%
Prothrombin time (PT/INR) clotting test CPT 85610 Prothrombin Time	$44.75	$89.49	$4.15–$5,000.00	137% above	50%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 REF Prothrombin Time	$13.50	$27.00	$9.45–$27.00	—	50%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 Prothrombin Time	$44.75	$89.49	$31.32–$89.49	—	50%
Renin blood test CPT 84244 REF Renin Activity	$150.92	$301.83	$21.28–$5,000.00	152% above	50%
Renin blood test inpatient CPT 84244 REF Renin Activity	$150.92	$301.83	$105.64–$301.83	—	50%
Rh blood typing CPT 86901 REF Bill BB Rh(D) Typing	$24.64	$49.27	$3.02–$5,000.00	45% below	50%
Rh blood typing CPT 86901 Anti-D	$48.09	$96.17	$3.02–$5,000.00	7% above	50%
Rh blood typing CPT 86901 Rh Type	$48.09	$96.17	$3.02–$5,000.00	7% above	50%
Rh blood typing inpatient CPT 86901 REF Bill BB Rh(D) Typing	$24.64	$49.27	$17.24–$49.27	—	50%
Rh blood typing inpatient CPT 86901 Rh Type	$48.09	$96.17	$33.66–$96.17	—	50%
Rh blood typing inpatient CPT 86901 Anti-D	$48.09	$96.17	$33.66–$96.17	—	50%
Rheumatoid factor (RF) test CPT 86431 Rheumatoid Factor	$52.22	$104.44	$5.49–$5,000.00	232% above	50%
Rheumatoid factor (RF) test inpatient CPT 86431 Rheumatoid Factor	$52.22	$104.44	$36.55–$104.44	—	50%
Rubella antibody test (immunity check) CPT 86762 RUBELLA ANTIBODY	$93.77	$187.54	$13.93–$5,000.00	244% above	50%
Rubella antibody test (immunity check) CPT 86762 Rubella IgG	$93.77	$187.54	$13.93–$5,000.00	244% above	50%
Rubella antibody test (immunity check) inpatient CPT 86762 Rubella IgG	$93.77	$187.54	$65.64–$187.54	—	50%
Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 Sedimentation Rate Auto	$57.72	$115.43	$2.61–$5,000.00	9% below	50%
Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 Sedimentation Rate Auto	$57.72	$115.43	$40.40–$115.43	—	50%
Sodium blood test CPT 84295 Sodium Level	$21.18	$42.35	$4.65–$5,000.00	9% above	50%
Sodium blood test inpatient CPT 84295 Sodium Level	$21.18	$42.35	$14.82–$42.35	—	50%
Stool ova and parasites exam CPT 87177 REF Ova and Parasites Stool	$92.20	$184.40	$8.61–$5,000.00	227% above	50%
Stool ova and parasites exam inpatient CPT 87177 REF Ova and Parasites Stool	$92.20	$184.40	$64.54–$184.40	—	50%
Stool test for hidden blood (guaiac FOBT) CPT 82270 Occult Blood Stool	$40.22	$80.44	$4.24–$5,000.00	47% above	50%
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 Occult Blood Stool	$40.22	$80.44	$28.15–$80.44	—	50%
Syphilis antibody test (Treponema pallidum) CPT 86780 REF Syphilis IgG	$51.77	$103.53	$12.81–$5,000.00	100% above	50%
Syphilis antibody test (Treponema pallidum) CPT 86780 Fluorescent Treponemal Antibody-Absorption	$59.53	$119.06	$12.81–$5,000.00	130% above	50%
Syphilis antibody test (Treponema pallidum) CPT 86780 Syphilis Ab Total	$59.53	$119.06	$12.81–$5,000.00	130% above	50%
Syphilis antibody test (Treponema pallidum) CPT 86780 Fluorescent Treponemal Antibody-Absorption CSF	$59.53	$119.06	$12.81–$5,000.00	130% above	50%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 REF Syphilis IgG	$51.77	$103.53	$36.24–$103.53	—	50%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 Fluorescent Treponemal Antibody-Absorption	$59.53	$119.06	$41.67–$119.06	—	50%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 Syphilis Ab Total	$59.53	$119.06	$41.67–$119.06	—	50%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 Fluorescent Treponemal Antibody-Absorption CSF	$59.53	$119.06	$41.67–$119.06	—	50%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 REF VDRL Cerebrospinal Fluid	$32.64	$65.28	$4.13–$5,000.00	151% above	50%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 REF Rapid Plasma Reagin Test	$32.64	$65.28	$4.13–$5,000.00	151% above	50%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 REF Rapid Plasma Reagin Test	$32.64	$65.28	$22.85–$65.28	—	50%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 REF VDRL Cerebrospinal Fluid	$32.64	$65.28	$22.85–$65.28	—	50%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 REF Quantiferon TB Gold	$107.46	$214.91	$59.98–$5,000.00	48% above	50%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 REF Quantiferon TB Gold	$107.46	$214.91	$75.22–$214.91	—	50%
Testosterone blood test, total (not free testosterone) CPT 84403 REF Testosterone,Total males	$11.15	$22.30	$7.80–$5,000.00	68% below	50%
Testosterone blood test, total (not free testosterone) CPT 84403 REF Testosterone Total	$84.22	$168.44	$24.98–$5,000.00	144% above	50%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 REF Testosterone,Total males	$11.15	$22.30	$7.80–$22.30	—	50%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 REF Testosterone Total	$84.22	$168.44	$58.95–$168.44	—	50%
Thyroid peroxidase (TPO) antibody test CPT 86376 REF Liver/Kidney Microsome Type 1 Ab	$26.40	$52.80	$14.08–$5,000.00	16% above	50%
Thyroid peroxidase (TPO) antibody test CPT 86376 REF Antithyroid Peroxidase Antibody	$95.73	$191.45	$14.08–$5,000.00	322% above	50%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 REF Liver/Kidney Microsome Type 1 Ab	$26.40	$52.80	$18.48–$52.80	—	50%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 REF Antithyroid Peroxidase Antibody	$95.73	$191.45	$67.01–$191.45	—	50%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH with Relfex Free T4	$75.82	$151.64	$16.26–$5,000.00	23% above	50%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 Thyroid Stimulating Hormone	$75.82	$151.64	$16.26–$5,000.00	23% above	50%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 REF Thyroid Stimulating Hormone Sensitive	$230.16	$460.32	$16.26–$5,000.00	274% above	50%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 Thyroid Stimulating Hormone	$75.82	$151.64	$53.07–$151.64	—	50%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH with Relfex Free T4	$75.82	$151.64	$53.07–$151.64	—	50%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 REF Thyroid Stimulating Hormone Sensitive	$230.16	$460.32	$161.11–$460.32	—	50%
Total IgE blood test CPT 82785 REF IgE Quant	$16.80	$33.60	$11.76–$5,000.00	38% below	50%
Total IgE blood test CPT 82785 REF IgE	$102.27	$204.53	$15.93–$5,000.00	275% above	50%
Total IgE blood test inpatient CPT 82785 REF IgE Quant	$16.80	$33.60	$11.76–$33.60	—	50%
Total IgE blood test inpatient CPT 82785 REF IgE	$102.27	$204.53	$71.59–$204.53	—	50%
Total cholesterol blood test CPT 82465 REF Cholesterol	$12.20	$24.40	$4.21–$5,000.00	42% below	50%
Total cholesterol blood test CPT 82465 Cholesterol Total	$28.79	$57.58	$4.21–$5,000.00	37% above	50%
Total cholesterol blood test CPT 82465 Cholesterol Total, CDC	$28.79	$57.58	$4.21–$5,000.00	37% above	50%
Total cholesterol blood test inpatient CPT 82465 REF Cholesterol	$12.20	$24.40	$8.54–$24.40	—	50%
Total cholesterol blood test inpatient CPT 82465 Cholesterol Total, CDC	$28.79	$57.58	$20.15–$57.58	—	50%
Total cholesterol blood test inpatient CPT 82465 Cholesterol Total	$28.79	$57.58	$20.15–$57.58	—	50%
Total thyroxine (T4) blood test CPT 84436 Thyroxine	$50.16	$100.32	$6.65–$5,000.00	60% above	50%
Total thyroxine (T4) blood test inpatient CPT 84436 Thyroxine	$50.16	$100.32	$35.11–$100.32	—	50%
Total triiodothyronine (T3) blood test CPT 84480 REF Triiodothyronine	$100.00	$200.00	$13.72–$5,000.00	2% below	50%
Total triiodothyronine (T3) blood test inpatient CPT 84480 REF Triiodothyronine	$100.00	$200.00	$70.00–$200.00	—	50%
Transferrin blood test CPT 84466 REF Transferrin	$92.55	$185.09	$12.35–$5,000.00	53% above	50%
Transferrin blood test inpatient CPT 84466 REF Transferrin	$92.55	$185.09	$64.78–$185.09	—	50%
Trichomonas test (NAAT) CPT 87661 REF Trichomonas vaginalis RNA	$177.36	$354.72	$33.96–$5,000.00	254% above	50%
Trichomonas test (NAAT) inpatient CPT 87661 REF Trichomonas vaginalis RNA	$177.36	$354.72	$124.15–$354.72	—	50%
Triglycerides blood test CPT 84478 REF Triglyceride	$16.11	$32.21	$5.55–$5,000.00	8% below	50%
Triglycerides blood test CPT 84478 Triglyceride Body Fluid	$32.84	$65.67	$5.55–$5,000.00	87% above	50%
Triglycerides blood test CPT 84478 Triglycerides Total, CDC	$32.84	$65.67	$5.55–$5,000.00	87% above	50%
Triglycerides blood test CPT 84478 Triglyceride	$32.84	$65.67	$5.55–$5,000.00	87% above	50%
Triglycerides blood test inpatient CPT 84478 REF Triglyceride	$16.11	$32.21	$11.27–$32.21	—	50%
Triglycerides blood test inpatient CPT 84478 Triglycerides Total, CDC	$32.84	$65.67	$22.98–$65.67	—	50%
Triglycerides blood test inpatient CPT 84478 Triglyceride	$32.84	$65.67	$22.98–$65.67	—	50%
Triglycerides blood test inpatient CPT 84478 Triglyceride Body Fluid	$32.84	$65.67	$22.98–$65.67	—	50%
Troponin test, quantitative CPT 84484 Troponin I High Sensitivity	$143.26	$286.52	$12.07–$5,000.00	196% above	50%
Troponin test, quantitative CPT 84484 Troponin T High Sensitivity	$143.26	$286.52	$12.07–$5,000.00	196% above	50%
Troponin test, quantitative CPT 84484 Troponin T	$143.26	$286.52	$12.07–$5,000.00	196% above	50%
Troponin test, quantitative inpatient CPT 84484 Troponin T	$143.26	$286.52	$100.28–$286.52	—	50%
Troponin test, quantitative inpatient CPT 84484 Troponin I High Sensitivity	$143.26	$286.52	$100.28–$286.52	—	50%
Troponin test, quantitative inpatient CPT 84484 Troponin T High Sensitivity	$143.26	$286.52	$100.28–$286.52	—	50%
Uric acid blood test CPT 84550 Uric Acid	$39.83	$79.65	$4.37–$5,000.00	44% below	50%
Uric acid blood test CPT 84550 Uric Acid Rasburicase	$39.83	$79.65	$4.37–$5,000.00	44% below	50%
Uric acid blood test inpatient CPT 84550 Uric Acid	$39.83	$79.65	$27.88–$79.65	—	50%
Uric acid blood test inpatient CPT 84550 Uric Acid Rasburicase	$39.83	$79.65	$27.88–$79.65	—	50%
Urinalysis with microscope exam, automated CPT 81001 Urinalysis, by dip stick or tablet reagent for bil	$60.78	$121.56	$3.07–$5,000.00	58% above	50%
Urinalysis with microscope exam, automated CPT 81001 Urinalysis, Automated with Microscopic	$60.78	$121.56	$3.07–$5,000.00	58% above	50%
Urinalysis with microscope exam, automated CPT 81001 Urinalysis w/ Microscopy No Reflex to Culture	$60.78	$121.56	$3.07–$5,000.00	58% above	50%
Urinalysis with microscope exam, automated CPT 81001 Urinalysis,automated w/microscopy	$60.78	$121.56	$3.07–$5,000.00	58% above	50%
Urinalysis with microscope exam, automated inpatient CPT 81001 Urinalysis w/ Microscopy No Reflex to Culture	$60.78	$121.56	$42.55–$121.56	—	50%
Urinalysis with microscope exam, automated inpatient CPT 81001 Urinalysis, by dip stick or tablet reagent for bil	$60.78	$121.56	$42.55–$121.56	—	50%
Urinalysis with microscope exam, automated inpatient CPT 81001 Urinalysis,automated w/microscopy	$60.78	$121.56	$42.55–$121.56	—	50%
Urinalysis with microscope exam, automated inpatient CPT 81001 Urinalysis, Automated with Microscopic	$60.78	$121.56	$42.55–$121.56	—	50%
Urinalysis without microscope exam, automated CPT 81003 Specific Gravity Urine Automated	$18.48	$36.96	$2.18–$5,000.00	4% below	50%
Urinalysis without microscope exam, automated CPT 81003 Urinalysis, dipstick, no micro	$18.48	$36.96	$2.18–$5,000.00	4% below	50%
Urinalysis without microscope exam, automated CPT 81003 Urinalysis, Automated no Microscopic	$18.48	$36.96	$2.18–$5,000.00	4% below	50%
Urinalysis without microscope exam, automated CPT 81003 Urinalysis	$18.48	$36.96	$2.18–$5,000.00	4% below	50%
Urinalysis without microscope exam, automated CPT 81003 pH Urine Dipstick	$18.48	$36.96	$2.18–$5,000.00	4% below	50%
Urinalysis without microscope exam, automated inpatient CPT 81003 Urinalysis	$18.48	$36.96	$12.94–$36.96	—	50%
Urinalysis without microscope exam, automated inpatient CPT 81003 Urinalysis, Automated no Microscopic	$18.48	$36.96	$12.94–$36.96	—	50%
Urinalysis without microscope exam, automated inpatient CPT 81003 Specific Gravity Urine Automated	$18.48	$36.96	$12.94–$36.96	—	50%
Urinalysis without microscope exam, automated inpatient CPT 81003 pH Urine Dipstick	$18.48	$36.96	$12.94–$36.96	—	50%
Urinalysis without microscope exam, automated inpatient CPT 81003 Urinalysis, dipstick, no micro	$18.48	$36.96	$12.94–$36.96	—	50%
Urinalysis without microscope exam, manual CPT 81002 Specific Gravity Urine Dipstick	$23.91	$47.82	$3.37–$5,000.00	232% above	50%
Urinalysis without microscope exam, manual CPT 81002 Urine Dipstick	$23.91	$47.82	$3.37–$5,000.00	232% above	50%
Urinalysis without microscope exam, manual inpatient CPT 81002 Specific Gravity Urine Dipstick	$23.91	$47.82	$16.74–$47.82	—	50%
Urinalysis without microscope exam, manual inpatient CPT 81002 Urine Dipstick	$23.91	$47.82	$16.74–$47.82	—	50%
Urine culture for bacteria, with colony count CPT 87086 Colony Count	$26.57	$53.14	$7.81–$5,000.00	51% below	50%
Urine culture for bacteria, with colony count inpatient CPT 87086 Colony Count	$26.57	$53.14	$18.60–$53.14	—	50%
Urine microalbumin (albumin) test CPT 82043 Microalbumin Urine	$84.69	$169.38	$5.59–$5,000.00	234% above	50%
Urine microalbumin (albumin) test CPT 82043 Microalbumin 24 Hour Urine	$84.69	$169.38	$5.59–$5,000.00	234% above	50%
Urine microalbumin (albumin) test inpatient CPT 82043 Microalbumin Urine	$84.69	$169.38	$59.28–$169.38	—	50%
Urine microalbumin (albumin) test inpatient CPT 82043 Microalbumin 24 Hour Urine	$84.69	$169.38	$59.28–$169.38	—	50%
Urine pregnancy test, read by color change CPT 81025 Beta Human Chorionic Gonadotropin Qualitative Uri	$107.86	$215.71	$8.33–$5,000.00	106% above	50%
Urine pregnancy test, read by color change inpatient CPT 81025 Beta Human Chorionic Gonadotropin Qualitative Uri	$107.86	$215.71	$75.50–$215.71	—	50%
Vitamin B12 (cobalamin) blood test CPT 82607 Vitamin B12 Level	$110.78	$221.55	$14.59–$5,000.00	71% above	50%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 Vitamin B12 Level	$110.78	$221.55	$77.54–$221.55	—	50%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 Vitamin D 25 Hydroxy Total	$103.89	$207.77	$28.64–$5,000.00	54% above	50%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 Vitamin D 25 Hydroxy Total	$103.89	$207.77	$72.72–$207.77	—	50%
Vitamin D, 1,25-dihydroxy blood test CPT 82652 REF Vitamin D 1,25 Dihydroxy Level	$82.08	$164.16	$37.26–$5,000.00	1% below	50%
Vitamin D, 1,25-dihydroxy blood test inpatient CPT 82652 REF Vitamin D 1,25 Dihydroxy Level	$82.08	$164.16	$57.46–$164.16	—	50%
Zinc blood test CPT 84630 REF Zinc Serum	$39.09	$78.17	$11.02–$5,000.00	61% above	50%
Zinc blood test CPT 84630 REF Zinc, 24-Hour Urine	$43.82	$87.63	$11.02–$5,000.00	80% above	50%
Zinc blood test CPT 84630 REF Zinc, Random U (QUEST)	$46.75	$93.50	$11.02–$5,000.00	92% above	50%
Zinc blood test CPT 84630 REF Zinc, Plasma	$62.10	$124.20	$11.02–$5,000.00	156% above	50%
Zinc blood test CPT 84630 REF Zinc Level Urine	$119.15	$238.30	$11.02–$5,000.00	390% above	50%
Zinc blood test inpatient CPT 84630 REF Zinc Serum	$39.09	$78.17	$27.36–$78.17	—	50%
Zinc blood test inpatient CPT 84630 REF Zinc, 24-Hour Urine	$43.82	$87.63	$30.67–$87.63	—	50%
Zinc blood test inpatient CPT 84630 REF Zinc, Random U (QUEST)	$46.75	$93.50	$32.73–$93.50	—	50%
Zinc blood test inpatient CPT 84630 REF Zinc, Plasma	$62.10	$124.20	$43.47–$124.20	—	50%
Zinc blood test inpatient CPT 84630 REF Zinc Level Urine	$119.15	$238.30	$83.41–$238.30	—	50%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HCG Tumor Marker	$168.42	$336.83	$14.56–$5,000.00	530% above	50%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 Beta Human Chorionic Gonadotropin Quantitative	$168.42	$336.83	$14.56–$5,000.00	530% above	50%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 Beta Human Chorionic Gonadotropin Quantitative	$168.42	$336.83	$117.89–$336.83	—	50%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HCG Tumor Marker	$168.42	$336.83	$117.89–$336.83	—	50%

Surgery and procedures

Procedure	Cash price	List price	Insurers pay	vs Arizona	Off list
Cardiac catheterization with coronary angiogram CPT 93458 L HRT ARTERY/VENTRICLE ANGIO	$13,895.97	$27,791.94	$2,807.59–$27,791.94	70% above	50%
Cardioversion, elective (restoring heart rhythm) CPT 92960 Cardioversion/Cardiology	$1,684.30	$3,368.59	$544.18–$5,000.00	82% above	50%
Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION ELECTRIC, EXT	$1,684.30	$3,368.59	$544.18–$5,000.00	82% above	50%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 Cardioversion/Cardiology	$1,684.30	$3,368.59	$1,179.01–$3,368.59	—	50%
Catheter ablation for atrial fibrillation CPT 93656 COMPRE EP EVAL ABLTJ ATR FIB	$23,698.30	$47,396.59	$5,000.00–$47,396.59	29% below	50%
Coronary stent placement, one artery CPT 92928 PRQ CARD STENT W/ANGIO 1 VSL	$14,061.21	$28,122.41	$5,000.00–$28,122.41	4% above	50%
Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 NJX INTERLAMINAR CRV/THRC	$1,198.53	$2,397.06	$614.58–$5,000.00	15% below	50%
Facet joint injection, lower back, one level, with imaging guidance CPT 64493 INJ PARAVERT F JNT L/S 1 LEV	$474.45	$948.89	$332.11–$5,000.00	60% below	50%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 CATHETER FOR HYSTEROGRAPHY	$105.30	$210.60	$27.42–$5,000.00	55% below	50%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 INJECT TENDON/LIGAMENT/CYST	$394.73	$789.46	$252.94–$5,000.00	5% above	50%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 DRAIN/INJECT, JOINT/BURSA	$567.43	$1,134.85	$252.94–$5,000.00	at median	50%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 DRAIN/INJECT, JOINT/BURSA	$560.23	$1,120.45	$252.94–$5,000.00	27% above	50%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 DRAIN/INJECT, JOINT/BURSA	$419.16	$838.32	$252.94–$5,000.00	16% above	50%
Left heart catheterization, diagnostic one side CPT 93452 LEFT HRT CATH W/VENTRCLGRPHY	$7,986.51	$15,973.02	$2,807.59–$15,973.02	106% above	50%
Lower-back epidural injection, with imaging guidance CPT 62323 NJX INTERLAMINAR LMBR/SAC	$1,191.56	$2,383.11	$614.58–$5,000.00	13% below	50%
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 INJ FORAMEN EPIDURAL L/S	$1,207.64	$2,415.28	$796.51–$5,000.00	10% above	50%
Occipital nerve block (injection for headaches) CPT 64405 INJECTION FOR NERVE BLOCK	$358.85	$717.70	$251.19–$5,000.00	at median	50%
Pacemaker implant (dual chamber) CPT 33208 INSERTION OF HEART PACEMAKER	$13,614.02	$27,228.04	$5,000.00–$27,228.04	8% below	50%
Paracentesis with imaging guidance CPT 49083 ABD PARACENTESIS W/IMAGING	$1,041.57	$2,083.13	$729.10–$5,000.00	30% below	50%
Thoracentesis with imaging guidance CPT 32555 ASPIRATE PLEURA W/ IMAGING	$1,487.16	$2,974.32	$524.53–$5,000.00	27% above	50%
Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 BX BREAST 1ST LESION US IMAG	$979.97	$1,959.94	$685.98–$5,000.00	56% below	50%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 Debrid SubQ Tissue 1st 20 cm	$628.16	$1,256.32	$85.00–$5,000.00	13% below	50%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 Debrid SubQ Tissue 1st 20 cm	$628.16	$1,256.32	$439.71–$1,256.32	—	50%

Doctor visits and therapy

Procedure	Cash price	List price	Insurers pay	vs Arizona	Off list
Blood transfusion (giving blood or blood components) CPT 36430 Blood Administration	$739.32	$1,478.63	$384.54–$5,000.00	37% above	50%
Blood transfusion (giving blood or blood components) CPT 36430 Transfusion; blood or blood components	$739.32	$1,478.63	$384.54–$5,000.00	37% above	50%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Transfusion; blood or blood components	$739.32	$1,478.63	$517.52–$1,478.63	—	50%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Blood Administration	$739.32	$1,478.63	$517.52–$1,478.63	—	50%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Inhalation Treatment Initial	$222.89	$445.77	$156.02–$5,000.00	14% below	50%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Small Volume Nebulizer/Inhaler Treatment	$222.89	$445.77	$156.02–$5,000.00	14% below	50%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Small Volume Nebulizer/Inhaler Treatment	$222.89	$445.77	$156.02–$445.77	—	50%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Inhalation Treatment Initial	$222.89	$445.77	$156.02–$445.77	—	50%
Chemotherapy IV infusion, first hour CPT 96413 Chemo Administration 1st hr.	$451.42	$902.83	$300.94–$5,000.00	2% above	50%
Chemotherapy IV infusion, first hour CPT 96413 Chemo IV Infusion; 1st Hour	$451.42	$902.83	$300.94–$5,000.00	2% above	50%
Chemotherapy IV infusion, first hour inpatient CPT 96413 Chemo Administration 1st hr.	$451.42	$902.83	$315.99–$902.83	—	50%
Chemotherapy IV infusion, first hour inpatient CPT 96413 Chemo IV Infusion; 1st Hour	$451.42	$902.83	$315.99–$902.83	—	50%
Critical care, first 30 to 74 minutes CPT 99291 ED Visit Level CC 1st Hour	$2,950.07	$5,900.13	$670.82–$5,900.13	6% above	50%
Critical care, first 30 to 74 minutes CPT 99291 99291 Critical Care	$2,950.07	$5,900.13	$670.82–$5,900.13	6% above	50%
Critical care, first 30 to 74 minutes CPT 99291 ED Level V Crit Care 1st Hr	$2,950.07	$5,900.13	$670.82–$5,900.13	6% above	50%
Critical care, first 30 to 74 minutes inpatient CPT 99291 ED Level V Crit Care 1st Hr	$2,950.07	$5,900.13	$2,065.05–$5,900.13	—	50%
Critical care, first 30 to 74 minutes inpatient CPT 99291 ED Visit Level CC 1st Hour	$2,950.07	$5,900.13	$2,065.05–$5,900.13	—	50%
Critical care, first 30 to 74 minutes inpatient CPT 99291 99291 Critical Care	$2,950.07	$5,900.13	$2,065.05–$5,900.13	—	50%
EEG (brain wave test), awake and drowsy, routine CPT 95816 EEG Awake/Drowsy	$935.89	$1,871.78	$230.41–$5,000.00	60% above	50%
EEG (brain wave test), awake and drowsy, routine inpatient CPT 95816 EEG Awake/Drowsy	$935.89	$1,871.78	$655.12–$1,871.78	—	50%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 Electrocardiogram - 12 Lead	$331.84	$663.67	$34.72–$5,000.00	156% above	50%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 Electrocardiogram - 15 Lead	$331.84	$663.67	$34.72–$5,000.00	156% above	50%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 Electrocardiogram - 15 Lead	$331.84	$663.67	$232.28–$663.67	—	50%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 Electrocardiogram - 12 Lead	$331.84	$663.67	$232.28–$663.67	—	50%
Electroconvulsive therapy (ECT), one session CPT 90870 Electro Convulsive Therapy	$973.73	$1,947.46	$472.40–$5,000.00	4% above	50%
Electroconvulsive therapy (ECT), one session CPT 90870 ECT	$973.73	$1,947.46	$472.40–$5,000.00	4% above	50%
Electroconvulsive therapy (ECT), one session inpatient CPT 90870 Electro Convulsive Therapy	$973.73	$1,947.46	$681.61–$1,947.46	—	50%
Electroconvulsive therapy (ECT), one session inpatient CPT 90870 ECT	$973.73	$1,947.46	$681.61–$1,947.46	—	50%
Exercise stress test, tracing only, the hospital charge CPT 93017 Stress Test Chemical	$1,149.29	$2,298.58	$230.41–$5,000.00	78% above	50%
Exercise stress test, tracing only, the hospital charge CPT 93017 Stress Test - Treadmill	$1,149.29	$2,298.58	$230.41–$5,000.00	78% above	50%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 Stress Test - Treadmill	$1,149.29	$2,298.58	$804.50–$2,298.58	—	50%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 Stress Test Chemical	$1,149.29	$2,298.58	$804.50–$2,298.58	—	50%
Family therapy with the patient, 50 minutes CPT 90847 Family Therapy W/Pt	$129.22	$258.44	$90.45–$5,000.00	17% below	50%
Family therapy with the patient, 50 minutes CPT 90847 BH Family Therapy with Patient	$129.22	$258.44	$90.45–$5,000.00	17% below	50%
Family therapy with the patient, 50 minutes CPT 90847 Family Therapy with Patient BH - Office	$129.22	$258.44	$90.45–$5,000.00	17% below	50%
Family therapy with the patient, 50 minutes inpatient CPT 90847 Family Therapy with Patient BH - Office	$129.22	$258.44	$90.45–$258.44	—	50%
Family therapy with the patient, 50 minutes inpatient CPT 90847 BH Family Therapy with Patient	$129.22	$258.44	$90.45–$258.44	—	50%
Family therapy with the patient, 50 minutes inpatient CPT 90847 Family Therapy W/Pt	$129.22	$258.44	$90.45–$258.44	—	50%
Family therapy without the patient, 50 minutes CPT 90846 Family Therapy without Patient BH - Office	$142.89	$285.78	$100.02–$5,000.00	8% below	50%
Family therapy without the patient, 50 minutes CPT 90846 Family Therapy W/Out Pt	$142.89	$285.78	$100.02–$5,000.00	8% below	50%
Family therapy without the patient, 50 minutes CPT 90846 BH Family Therapy without Patient	$142.89	$285.78	$100.02–$5,000.00	8% below	50%
Family therapy without the patient, 50 minutes inpatient CPT 90846 Family Therapy W/Out Pt	$142.89	$285.78	$100.02–$285.78	—	50%
Family therapy without the patient, 50 minutes inpatient CPT 90846 Family Therapy without Patient BH - Office	$142.89	$285.78	$100.02–$285.78	—	50%
Family therapy without the patient, 50 minutes inpatient CPT 90846 BH Family Therapy without Patient	$142.89	$285.78	$100.02–$285.78	—	50%
Group psychotherapy session CPT 90853 BH Group Therapy	$245.43	$490.85	$72.51–$5,000.00	85% above	50%
Group psychotherapy session CPT 90853 Group Therapy BH - Office	$245.43	$490.85	$72.51–$5,000.00	85% above	50%
Group psychotherapy session CPT 90853 Group Therapy	$245.43	$490.85	$72.51–$5,000.00	85% above	50%
Group psychotherapy session inpatient CPT 90853 Group Therapy BH - Office	$245.43	$490.85	$171.80–$490.85	—	50%
Group psychotherapy session inpatient CPT 90853 BH Group Therapy	$245.43	$490.85	$171.80–$490.85	—	50%
Group psychotherapy session inpatient CPT 90853 Group Therapy	$245.43	$490.85	$171.80–$490.85	—	50%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV Hydration, first hour	$144.05	$288.09	$100.83–$5,000.00	23% below	50%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV Hydration, Initial 31min to 1hr	$144.05	$288.09	$100.83–$5,000.00	23% below	50%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV Hydration,Initial 31min to 1hr	$144.05	$288.09	$100.83–$5,000.00	23% below	50%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV Hydration, first hour	$144.05	$288.09	$100.83–$288.09	—	50%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV Hydration,Initial 31min to 1hr	$144.05	$288.09	$100.83–$288.09	—	50%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV Hydration, Initial 31min to 1hr	$144.05	$288.09	$100.83–$288.09	—	50%
IV infusion of a medicine, first hour CPT 96365 IV Infusion,Ther/Proph; 1st Hour	$145.83	$291.65	$102.08–$5,000.00	44% below	50%
IV infusion of a medicine, first hour CPT 96365 IV Infusion, Ther/Proph; 1st Hour	$145.83	$291.65	$102.08–$5,000.00	44% below	50%
IV infusion of a medicine, first hour CPT 96365 IV Therapy 1st Hour	$145.83	$291.65	$102.08–$5,000.00	44% below	50%
IV infusion of a medicine, first hour inpatient CPT 96365 IV Infusion, Ther/Proph; 1st Hour	$145.83	$291.65	$102.08–$291.65	—	50%
IV infusion of a medicine, first hour inpatient CPT 96365 IV Therapy 1st Hour	$145.83	$291.65	$102.08–$291.65	—	50%
IV infusion of a medicine, first hour inpatient CPT 96365 IV Infusion,Ther/Proph; 1st Hour	$145.83	$291.65	$102.08–$291.65	—	50%
IV push of a medicine, first drug CPT 96374 Injection,Ther/Propy/Dx; IVPush Initial	$112.28	$224.56	$78.60–$5,000.00	31% below	50%
IV push of a medicine, first drug CPT 96374 IV Injection, Initial	$112.28	$224.56	$78.60–$5,000.00	31% below	50%
IV push of a medicine, first drug CPT 96374 Injection IV - Endo less than 30 minutes	$112.28	$224.56	$112.28–$5,000.00	31% below	50%
IV push of a medicine, first drug CPT 96374 Injection, Ther/Proph/Dx; IVPush Initial	$112.28	$224.56	$78.60–$5,000.00	31% below	50%
IV push of a medicine, first drug inpatient CPT 96374 Injection IV - Endo less than 30 minutes	$112.28	$224.56	$78.60–$224.56	—	50%
IV push of a medicine, first drug inpatient CPT 96374 IV Injection, Initial	$112.28	$224.56	$78.60–$224.56	—	50%
IV push of a medicine, first drug inpatient CPT 96374 Injection, Ther/Proph/Dx; IVPush Initial	$112.28	$224.56	$78.60–$224.56	—	50%
IV push of a medicine, first drug inpatient CPT 96374 Injection,Ther/Propy/Dx; IVPush Initial	$112.28	$224.56	$78.60–$224.56	—	50%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 Injection, Ther/Proph/Dx; SUBQ/IM	$93.41	$186.81	$65.38–$5,000.00	35% above	50%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 Injection,Ther/Proph/Dx; SubQ/IM	$93.41	$186.81	$65.38–$5,000.00	35% above	50%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 Inj, Ther/Proph/Dx; SubQ/IM	$93.41	$186.81	$65.38–$5,000.00	35% above	50%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 Injection,Ther/Proph/Dx; SubQ/IM	$93.41	$186.81	$65.38–$186.81	—	50%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 Injection, Ther/Proph/Dx; SUBQ/IM	$93.41	$186.81	$65.38–$186.81	—	50%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 Inj, Ther/Proph/Dx; SubQ/IM	$93.41	$186.81	$65.38–$186.81	—	50%
Mental health diagnostic evaluation (intake), without medical services CPT 90791 BH Psycho-Diagnostic Interview	$284.00	$567.99	$129.41–$5,000.00	30% above	50%
Mental health diagnostic evaluation (intake), without medical services CPT 90791 Psycho-Diagnostic Interview BH - Office	$284.00	$567.99	$129.41–$5,000.00	30% above	50%
Mental health diagnostic evaluation (intake), without medical services CPT 90791 Psycho-diagnostic Interview	$284.00	$567.99	$129.41–$5,000.00	30% above	50%
Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 Psycho-diagnostic Interview	$284.00	$567.99	$198.80–$567.99	—	50%
Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 BH Psycho-Diagnostic Interview	$284.00	$567.99	$198.80–$567.99	—	50%
Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 Psycho-Diagnostic Interview BH - Office	$284.00	$567.99	$198.80–$567.99	—	50%
Nerve conduction study, 7 or 8 nerve studies CPT 95910 Nerve Conduction Studies, motor/sensory 7-8	$423.30	$846.60	$256.11–$5,000.00	112% above	50%
Nerve conduction study, 7 or 8 nerve studies inpatient CPT 95910 Nerve Conduction Studies, motor/sensory 7-8	$423.30	$846.60	$296.31–$846.60	—	50%
New patient office visit, about 30 minutes CPT 99203 New Pt Office Visit (Intermediate)	$224.02	$448.04	$28.48–$5,000.00	23% above	50%
New patient office visit, about 30 minutes CPT 99203 New Pt Office Visit - Level 3	$224.02	$448.04	$28.48–$5,000.00	23% above	50%
New patient office visit, about 30 minutes inpatient CPT 99203 New Pt Office Visit - Level 3	$224.02	$448.04	$156.81–$448.04	—	50%
New patient office visit, about 30 minutes inpatient CPT 99203 New Pt Office Visit (Intermediate)	$224.02	$448.04	$156.81–$448.04	—	50%
New patient office visit, about 45 minutes CPT 99204 New Pt Office Visit (Comprehensive)	$198.07	$396.14	$32.63–$5,000.00	at median	50%
New patient office visit, about 45 minutes CPT 99204 New Pt. Office Visit - Level 4	$198.07	$396.14	$32.63–$5,000.00	at median	50%
New patient office visit, about 45 minutes inpatient CPT 99204 New Pt. Office Visit - Level 4	$198.07	$396.14	$138.65–$396.14	—	50%
New patient office visit, about 45 minutes inpatient CPT 99204 New Pt Office Visit (Comprehensive)	$198.07	$396.14	$138.65–$396.14	—	50%
New patient office visit, about 60 minutes CPT 99205 New Pt. Office Visit - Level 5	$238.28	$476.56	$38.08–$5,000.00	5% above	50%
New patient office visit, about 60 minutes CPT 99205 New Pt Office Visit (Complex)	$238.28	$476.56	$38.08–$5,000.00	5% above	50%
New patient office visit, about 60 minutes CPT 99205 New Pt. Clinic Visit - Level 5	$238.28	$476.56	$38.08–$5,000.00	5% above	50%
New patient office visit, about 60 minutes inpatient CPT 99205 New Pt. Clinic Visit - Level 5	$238.28	$476.56	$166.80–$476.56	—	50%
New patient office visit, about 60 minutes inpatient CPT 99205 New Pt. Office Visit - Level 5	$238.28	$476.56	$166.80–$476.56	—	50%
New patient office visit, about 60 minutes inpatient CPT 99205 New Pt Office Visit (Complex)	$238.28	$476.56	$166.80–$476.56	—	50%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 New Pt. Office Visit - Level 2	$106.93	$213.86	$23.67–$5,000.00	28% below	50%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 New Pt Office Visit (Simple)	$106.93	$213.86	$23.67–$5,000.00	28% below	50%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 New Pt Office Visit (Limited)	$106.93	$213.86	$23.67–$5,000.00	28% below	50%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 New Pt. Office Visit - Level 1	$106.93	$213.86	$23.67–$5,000.00	28% below	50%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 New Pt. Clinic Visit - Level 2	$106.93	$213.86	$23.67–$5,000.00	28% below	50%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 New Pt Office Visit (Simple)	$106.93	$213.86	$74.85–$213.86	—	50%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 New Pt. Office Visit - Level 2	$106.93	$213.86	$74.85–$213.86	—	50%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 New Pt. Office Visit - Level 1	$106.93	$213.86	$74.85–$213.86	—	50%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 New Pt Office Visit (Limited)	$106.93	$213.86	$74.85–$213.86	—	50%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 New Pt. Clinic Visit - Level 2	$106.93	$213.86	$74.85–$213.86	—	50%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 Medical Nutrition Initial Assess	$30.74	$61.48	$8.00–$5,000.00	79% below	50%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 Med Nutrition Initial Therapy 15 minutes	$30.74	$61.48	$8.00–$5,000.00	79% below	50%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 Medical Nutrition Initial Assess	$30.74	$61.48	$21.52–$61.48	—	50%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 Med Nutrition Initial Therapy 15 minutes	$30.74	$61.48	$21.52–$61.48	—	50%
Psychological testing evaluation by a psychologist or physician, first hour CPT 96130 BH Psychological Test Eval 1st Hour	$429.51	$859.02	$230.41–$5,000.00	46% above	50%
Psychological testing evaluation by a psychologist or physician, first hour CPT 96130 Psychological Test Eval 1st Hour	$429.51	$859.02	$230.41–$5,000.00	46% above	50%
Psychological testing evaluation by a psychologist or physician, first hour CPT 96130 Psychological Test Eval 1st Hr BH - Office	$429.51	$859.02	$230.41–$5,000.00	46% above	50%
Psychological testing evaluation by a psychologist or physician, first hour inpatient CPT 96130 Psychological Test Eval 1st Hour	$429.51	$859.02	$300.66–$859.02	—	50%
Psychological testing evaluation by a psychologist or physician, first hour inpatient CPT 96130 BH Psychological Test Eval 1st Hour	$429.51	$859.02	$300.66–$859.02	—	50%
Psychological testing evaluation by a psychologist or physician, first hour inpatient CPT 96130 Psychological Test Eval 1st Hr BH - Office	$429.51	$859.02	$300.66–$859.02	—	50%
Psychotherapy for crisis, first 60 minutes CPT 90839 Psychotherapy for crisis 60 minutes	$310.74	$621.47	$80.91–$5,000.00	43% above	50%
Psychotherapy for crisis, first 60 minutes CPT 90839 Psychotherapy for Crisis 60 Min BH - Office	$310.74	$621.47	$80.91–$5,000.00	43% above	50%
Psychotherapy for crisis, first 60 minutes CPT 90839 BH Psychotherapy for crisis 60 Min	$310.74	$621.47	$80.91–$5,000.00	43% above	50%
Psychotherapy for crisis, first 60 minutes inpatient CPT 90839 BH Psychotherapy for crisis 60 Min	$310.74	$621.47	$217.51–$621.47	—	50%
Psychotherapy for crisis, first 60 minutes inpatient CPT 90839 Psychotherapy for Crisis 60 Min BH - Office	$310.74	$621.47	$217.51–$621.47	—	50%
Psychotherapy for crisis, first 60 minutes inpatient CPT 90839 Psychotherapy for crisis 60 minutes	$310.74	$621.47	$217.51–$621.47	—	50%
Psychotherapy session, 30 minutes CPT 90832 Psychotherapy 30 Min BH - Office	$255.59	$511.18	$129.41–$5,000.00	65% above	50%
Psychotherapy session, 30 minutes CPT 90832 Psychotherapy 30 min	$255.59	$511.18	$129.41–$5,000.00	65% above	50%
Psychotherapy session, 30 minutes CPT 90832 BH Psychotherapy 30 Min	$255.59	$511.18	$129.41–$5,000.00	65% above	50%
Psychotherapy session, 30 minutes inpatient CPT 90832 BH Psychotherapy 30 Min	$255.59	$511.18	$178.91–$511.18	—	50%
Psychotherapy session, 30 minutes inpatient CPT 90832 Psychotherapy 30 min	$255.59	$511.18	$178.91–$511.18	—	50%
Psychotherapy session, 30 minutes inpatient CPT 90832 Psychotherapy 30 Min BH - Office	$255.59	$511.18	$178.91–$511.18	—	50%
Psychotherapy session, 45 minutes CPT 90834 Psychotherapy 45 Min	$294.17	$588.34	$129.41–$5,000.00	62% above	50%
Psychotherapy session, 45 minutes CPT 90834 Psychotherapy 45 Min BH - Office	$294.17	$588.34	$129.41–$5,000.00	62% above	50%
Psychotherapy session, 45 minutes CPT 90834 BH Psychotherapy 45 Min	$294.17	$588.34	$129.41–$5,000.00	62% above	50%
Psychotherapy session, 45 minutes inpatient CPT 90834 Psychotherapy 45 Min BH - Office	$294.17	$588.34	$205.92–$588.34	—	50%
Psychotherapy session, 45 minutes inpatient CPT 90834 BH Psychotherapy 45 Min	$294.17	$588.34	$205.92–$588.34	—	50%
Psychotherapy session, 45 minutes inpatient CPT 90834 Psychotherapy 45 Min	$294.17	$588.34	$205.92–$588.34	—	50%
Psychotherapy session, 60 minutes CPT 90837 BH Psychotherapy 60 Min	$286.66	$573.32	$129.41–$5,000.00	38% above	50%
Psychotherapy session, 60 minutes CPT 90837 Psychotherapy 60 Min	$286.66	$573.32	$129.41–$5,000.00	38% above	50%
Psychotherapy session, 60 minutes CPT 90837 Psychotherapy 60 Min BH - Office	$286.66	$573.32	$129.41–$5,000.00	38% above	50%
Psychotherapy session, 60 minutes inpatient CPT 90837 Psychotherapy 60 Min	$286.66	$573.32	$200.66–$573.32	—	50%
Psychotherapy session, 60 minutes inpatient CPT 90837 Psychotherapy 60 Min BH - Office	$286.66	$573.32	$200.66–$573.32	—	50%
Psychotherapy session, 60 minutes inpatient CPT 90837 BH Psychotherapy 60 Min	$286.66	$573.32	$200.66–$573.32	—	50%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 Smoking Cessation Education 4-10 Min	$34.34	$68.68	$8.94–$5,000.00	11% above	50%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 Smoking Cessation Education 4 - 10 min.	$34.34	$68.68	$8.94–$5,000.00	11% above	50%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 Smoking Cessation Education 4 - 10 Min	$34.34	$68.68	$8.94–$5,000.00	11% above	50%
Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 Smoking Cessation Education 4 - 10 Min	$34.34	$68.68	$24.04–$68.68	—	50%
Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 Smoking Cessation Education 4-10 Min	$34.34	$68.68	$24.04–$68.68	—	50%
Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 Smoking Cessation Education 4 - 10 min.	$34.34	$68.68	$24.04–$68.68	—	50%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 Estab Pt Office Visit - Level 5	$269.78	$539.55	$35.19–$5,000.00	23% above	50%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 Estab Pt Clinic Visit - Level 5	$269.78	$539.55	$35.19–$5,000.00	23% above	50%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 Estab Pt Office Visit - Level 5	$269.78	$539.55	$188.84–$539.55	—	50%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 Estab Pt Clinic Visit - Level 5	$269.78	$539.55	$188.84–$539.55	—	50%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 Estab Pt Clinic Visit - Level 3	$181.12	$362.23	$24.01–$5,000.00	29% above	50%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 Estab Pt Clinic Visit - Level 3	$181.12	$362.23	$126.78–$362.23	—	50%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 Estab Pt Office Visit - Level 4	$239.92	$479.83	$29.76–$5,000.00	at median	50%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 Estab Pt Clinic Visit - Level 4	$239.92	$479.83	$29.76–$5,000.00	at median	50%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 Estab Pt Office Visit - Level 4	$239.92	$479.83	$167.94–$479.83	—	50%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 Estab Pt Clinic Visit - Level 4	$239.92	$479.83	$167.94–$479.83	—	50%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 Estab Pt Office Visit - Level 2	$156.13	$312.26	$20.47–$5,000.00	11% above	50%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 Estab Pt Office Visit - Level 2	$156.13	$312.26	$109.29–$312.26	—	50%
Specialist consultation, low complexity or 30+ minutes CPT 99243 Office Consultation - Level 3	$99.30	$198.59	$25.85–$5,000.00	at median	50%
Specialist consultation, low complexity or 30+ minutes CPT 99243 Office Consultation - Endo Level 3	$99.30	$198.59	$25.85–$5,000.00	at median	50%
Specialist consultation, low complexity or 30+ minutes inpatient CPT 99243 Office Consultation - Endo Level 3	$99.30	$198.59	$69.51–$198.59	—	50%
Specialist consultation, low complexity or 30+ minutes inpatient CPT 99243 Office Consultation - Level 3	$99.30	$198.59	$69.51–$198.59	—	50%
Specialist consultation, moderate complexity or 40+ minutes CPT 99244 Office Consultation - Endo Level 4	$136.49	$272.97	$35.54–$5,000.00	2% above	50%
Specialist consultation, moderate complexity or 40+ minutes CPT 99244 Office Consultation - Level 4	$136.49	$272.97	$35.54–$5,000.00	2% above	50%
Specialist consultation, moderate complexity or 40+ minutes inpatient CPT 99244 Office Consultation - Endo Level 4	$136.49	$272.97	$95.54–$272.97	—	50%
Specialist consultation, moderate complexity or 40+ minutes inpatient CPT 99244 Office Consultation - Level 4	$136.49	$272.97	$95.54–$272.97	—	50%
Speech therapy session, individual CPT 92507 Treatment of Speech Charge-OUTPT	$299.53	$599.05	$73.90–$5,000.00	9% below	50%
Speech therapy session, individual CPT 92507 Treatment of Speech Charge-INPT	$299.53	$599.05	$73.90–$5,000.00	9% below	50%
Speech therapy session, individual inpatient CPT 92507 Treatment of Speech Charge-OUTPT	$299.53	$599.05	$209.67–$599.05	—	50%
Speech therapy session, individual inpatient CPT 92507 Treatment of Speech Charge-INPT	$299.53	$599.05	$209.67–$599.05	—	50%
Spirometry (breathing test) CPT 94010 Spirometry Chg	$260.79	$521.58	$135.14–$5,000.00	35% above	50%
Spirometry (breathing test) CPT 94010 Spirometry	$260.79	$521.58	$135.14–$5,000.00	35% above	50%
Spirometry (breathing test) inpatient CPT 94010 Spirometry Chg	$260.79	$521.58	$182.55–$521.58	—	50%
Spirometry (breathing test) inpatient CPT 94010 Spirometry	$260.79	$521.58	$182.55–$521.58	—	50%
Spirometry before and after a bronchodilator CPT 94060 Spirometry Pre and Post Bronchodilator	$555.15	$1,110.30	$256.11–$5,000.00	81% above	50%
Spirometry before and after a bronchodilator CPT 94060 Spirometry Pre and Post Bronchodilator Chg	$555.15	$1,110.30	$256.11–$5,000.00	81% above	50%
Spirometry before and after a bronchodilator inpatient CPT 94060 Spirometry Pre and Post Bronchodilator Chg	$555.15	$1,110.30	$388.60–$1,110.30	—	50%
Spirometry before and after a bronchodilator inpatient CPT 94060 Spirometry Pre and Post Bronchodilator	$555.15	$1,110.30	$388.60–$1,110.30	—	50%
TMS (transcranial magnetic stimulation), first session with mapping CPT 90867 Repet TMS Tx Initial	$324.27	$648.54	$226.99–$5,000.00	30% below	50%
TMS (transcranial magnetic stimulation), first session with mapping CPT 90867 BH Transcranial Magn Stim Tx Plan	$324.27	$648.54	$226.99–$5,000.00	30% below	50%
TMS (transcranial magnetic stimulation), first session with mapping CPT 90867 Transcranial Magn Stim Tx Plan BH - Office	$324.27	$648.54	$226.99–$5,000.00	30% below	50%
TMS (transcranial magnetic stimulation), first session with mapping inpatient CPT 90867 BH Transcranial Magn Stim Tx Plan	$324.27	$648.54	$226.99–$648.54	—	50%
TMS (transcranial magnetic stimulation), first session with mapping inpatient CPT 90867 Repet TMS Tx Initial	$324.27	$648.54	$226.99–$648.54	—	50%
TMS (transcranial magnetic stimulation), first session with mapping inpatient CPT 90867 Transcranial Magn Stim Tx Plan BH - Office	$324.27	$648.54	$226.99–$648.54	—	50%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 Phlebotomy Therapeutic	$201.50	$403.00	$108.41–$5,000.00	27% below	50%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 Phlebotomy Therapeutic - Nursing	$201.50	$403.00	$108.41–$5,000.00	27% below	50%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 Phlebotomy Therapeutic - Infusion Clinic	$201.50	$403.00	$108.41–$5,000.00	27% below	50%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 Phlebotomy Therapeutic - Patient Room	$201.50	$403.00	$108.41–$5,000.00	27% below	50%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 Phlebotomy Therapeutic - Acute Care Transfer	$201.50	$403.00	$108.41–$5,000.00	27% below	50%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 Phlebotomy Therapeutic - Infusion Clinic	$201.50	$403.00	$141.05–$403.00	—	50%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 Phlebotomy Therapeutic - Nursing	$201.50	$403.00	$141.05–$403.00	—	50%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 Phlebotomy Therapeutic	$201.50	$403.00	$141.05–$403.00	—	50%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 Phlebotomy Therapeutic - Acute Care Transfer	$201.50	$403.00	$141.05–$403.00	—	50%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 Phlebotomy Therapeutic - Patient Room	$201.50	$403.00	$141.05–$403.00	—	50%

Vaccines

Procedure	Cash price	List price	Insurers pay	vs Arizona	Off list
Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 Varicella (Varivax) vaccine 0.5mL inj	$359.36	$718.72	$203.64–$5,000.00	24% above	50%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 Clinic Vaccine DPT (ADACEL)	$87.93	$175.86	$39.53–$5,000.00	28% above	50%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 DTaP (Infanrix) vaccine 0.5mL inj	$139.10	$278.19	$39.53–$5,000.00	103% above	50%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 inpatient CPT 90700 Clinic Vaccine DPT (ADACEL)	$87.93	$175.86	$61.55–$175.86	—	50%
DTaP, hepatitis B and polio combination vaccine (Pediarix) CPT 90723 DTaP-Hep B-IPV (Pediarix) vaccine 0.5mL inj	$195.05	$390.10	$109.84–$5,000.00	at median	50%
Flu shot, recombinant, egg-free (Flublok) CPT 90673 Influenza (Egg Free) Trivalent Vacc PF Inj 0.5 mL	$317.42	$634.83	$24.88–$5,000.00	2% above	50%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 Influenza Trivalent Vacc PF Inj 0.5 mL	$102.99	$205.97	$8.08–$5,000.00	16% above	50%
Hepatitis A vaccine, adult dose CPT 90632 Clinic Vaccine Hepatitis A (VAQTA)	$120.81	$241.62	$84.57–$5,000.00	24% above	50%
Hepatitis A vaccine, adult dose inpatient CPT 90632 Clinic Vaccine Hepatitis A (VAQTA)	$120.81	$241.62	$84.57–$241.62	—	50%
Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 Hepatitis A ped (Vaqta) vaccine 0.5mL inj	$202.87	$405.73	$52.27–$5,000.00	80% above	50%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 Clinic Vaccine Hepatitis B (Engeris-B)	$156.74	$313.47	$12.29–$5,000.00	107% above	50%
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 Clinic Vaccine Hepatitis B (Engeris-B)	$156.74	$313.47	$109.71–$313.47	—	50%
Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 Hepatitis B ped (Engerix-B) vaccine 0.5mL PF inj	$161.88	$323.76	$12.69–$5,000.00	109% above	50%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) CPT 90648 Hib (PRP-T) (ActHIB/Hiberix) vaccine 0.5mL inj	$81.43	$162.85	$17.59–$5,000.00	117% above	50%
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 Influenza HIGH-Dose Trivalent Vaccine PF Inj 0.5 m	$317.42	$634.83	$24.88–$5,000.00	372% above	50%
MMR vaccine (measles, mumps and rubella), live CPT 90707 MMR II vaccine 0.5mL inj	$457.78	$915.55	$127.17–$5,000.00	159% above	50%
Meningococcal ACWY (MenACWY) vaccine CPT 90734 Meningococcal MCV4P (Menactra) vaccine 0.5mL inj	$542.70	$1,085.39	$176.75–$5,000.00	40% above	50%
Meningococcal ACWY vaccine (MenQuadfi) CPT 90619 Meningococcal MenACWY-TT (MenQuadfi) vaccine 0.5 m	$572.46	$1,144.92	$182.29–$5,000.00	10% below	50%
Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 Meningococcal B 4C (Bexsero) vaccine 0.5mL inj	$1,039.35	$2,078.69	$251.35–$5,000.00	79% above	50%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 Pneumococcal PCV20 (Prevnar 20) vaccine 0.5mL inj	$1,149.38	$2,298.76	$90.11–$5,000.00	113% above	50%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 Clinic Vaccine Pneumococcal (Prevnar)	$74.98	$149.96	$5.88–$5,000.00	2% above	50%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 Clinic Vaccine Pneumococcal (Pneumovac)	$74.98	$149.96	$5.88–$5,000.00	2% above	50%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 Pneumococcal PPV23 (Pneumovax23) vaccine 0.5mL inj	$584.65	$1,169.29	$45.83–$5,000.00	698% above	50%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 Clinic Vaccine Pneumococcal (Pneumovac)	$74.98	$149.96	$52.49–$149.96	—	50%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 Clinic Vaccine Pneumococcal (Prevnar)	$74.98	$149.96	$52.49–$149.96	—	50%
Polio vaccine, inactivated (IPV) CPT 90713 Poliovirus (IPV) (Ipol) vaccine 5mL inj	$226.48	$452.95	$59.75–$5,000.00	325% above	50%
RSV antibody shot for infants and toddlers, larger dose (1 mL, 100 mg) CPT 90381 Nirsevimab-ALIP 100 mg/ mL PF Inj	$1,865.16	$3,730.31	$589.50–$5,000.00	468% above	50%
RSV antibody shot for infants, seasonal dose (0.5 mL) CPT 90380 Nirsevimab-ALIP 50 mg/0.5 mL PF Inj	$1,775.06	$3,550.11	$589.50–$5,000.00	530% above	50%
Rabies vaccine, one dose CPT 90675 Rabies (RabAvert) vaccine 2.5 IntlUnits/1mL inj	$558.39	$1,116.78	$335.20–$5,000.00	52% above	50%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 Td (Tenivac) adult toxoid 0.5mL PF inj	$150.46	$300.92	$37.37–$5,000.00	42% above	50%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 Tdap (Adacel) adult vaccine 0.5mL inj	$187.82	$375.64	$53.18–$5,000.00	38% above	50%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Immun Admin IM/SQ/ID, 1 vaccine	$85.24	$170.47	$59.66–$5,000.00	55% above	50%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Immunization injection	$85.24	$170.47	$59.66–$5,000.00	55% above	50%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Vaccine Admin IM/SQ/ID, 1 vaccine	$85.24	$170.47	$59.66–$5,000.00	55% above	50%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Immunization injection	$85.24	$170.47	$59.66–$170.47	—	50%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Vaccine Admin IM/SQ/ID, 1 vaccine	$85.24	$170.47	$59.66–$170.47	—	50%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Immun Admin IM/SQ/ID, 1 vaccine	$85.24	$170.47	$59.66–$170.47	—	50%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Vaccine Admin IM/SQ/ID, Ea Addl	$69.98	$139.95	$34.80–$5,000.00	98% above	50%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Immun Admin IM/SQ/ID, Ea Addl	$69.98	$139.95	$34.80–$5,000.00	98% above	50%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 Vaccine Admin IM/SQ/ID, Ea Addl	$69.98	$139.95	$48.98–$139.95	—	50%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 Immun Admin IM/SQ/ID, Ea Addl	$69.98	$139.95	$48.98–$139.95	—	50%

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.nahealth.com/wp-content/uploads/2026/03/860110232_FLAGSTAFFMEDICALCENTER_standardcharges.zip