Nemours Children's Hospital
Nemours Children's Hospital in Wilmington, DE publishes cash prices for 37 common procedures listed here, from its own machine-readable price file updated —. Click a procedure to compare it with other hospitals nearby.
1600 Rockland Rd, Wilmington, DE 19803 Collected Sep 23, 2026 Source price file
Scans and imaging
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT Ab & Pelvis With Contrast | $2,315.00 | $2,315.00 | — |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT Ab & Pelvis With Contrast | $2,315.00 | $2,315.00 | — |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT Ab & Pelvis With Contrast | $2,315.00 | $2,315.00 | — |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT Ab & Pelvis With Contrast | $2,315.00 | $2,315.00 | — |
| CT scan of the head or brain, no contrast dye CPT 70450 CT Head/Brain W/O Cont | $1,187.00 | $1,187.00 | — |
| CT scan of the head or brain, no contrast dye CPT 70450 CT Head/Brain W/O Cont | $1,187.00 | $1,187.00 | — |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT Head/Brain W/O Cont | $1,187.00 | $1,187.00 | — |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT Head/Brain W/O Cont | $1,187.00 | $1,187.00 | — |
| CT scan of the pelvis, with contrast dye CPT 72193 CT Pelvis W/ Cont | $3,409.00 | $3,409.00 | — |
| CT scan of the pelvis, with contrast dye CPT 72193 CT Pelvis W/ Cont | $3,409.00 | $3,409.00 | — |
| CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT Pelvis W/ Cont | $3,409.00 | $3,409.00 | — |
| CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT Pelvis W/ Cont | $3,409.00 | $3,409.00 | — |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 Lower Ext Joint W/O Cont | $1,158.00 | $1,158.00 | — |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 Lower Ext Joint W/O Cont | $1,158.00 | $1,158.00 | — |
| MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 Lower Ext Joint W/O Cont | $1,158.00 | $1,158.00 | — |
| MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 Lower Ext Joint W/O Cont | $1,158.00 | $1,158.00 | — |
| MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 MRI Lower Ext Join W/&W/O | $1,158.00 | $1,158.00 | — |
| MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 MRI Lower Ext Join W/&W/O | $1,158.00 | $1,158.00 | — |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 MRI Lower Ext Join W/&W/O | $1,158.00 | $1,158.00 | — |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 MRI Lower Ext Join W/&W/O | $1,158.00 | $1,158.00 | — |
| MRI of the brain, no contrast dye CPT 70551 MRI Brain W/O Contrast | $2,315.00 | $2,315.00 | — |
| MRI of the brain, no contrast dye CPT 70551 MRI Brain W/O Contrast | $2,315.00 | $2,315.00 | — |
| MRI of the brain, no contrast dye inpatient CPT 70551 MRI Brain W/O Contrast | $2,315.00 | $2,315.00 | — |
| MRI of the brain, no contrast dye inpatient CPT 70551 MRI Brain W/O Contrast | $2,315.00 | $2,315.00 | — |
| MRI of the brain, with and without contrast dye CPT 70553 MRI Brain W/ W/O Cont | $3,357.00 | $3,357.00 | — |
| MRI of the brain, with and without contrast dye CPT 70553 MRI Brain W/ W/O Cont | $3,357.00 | $3,357.00 | — |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI Brain W/ W/O Cont | $3,357.00 | $3,357.00 | — |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI Brain W/ W/O Cont | $3,357.00 | $3,357.00 | — |
| MRI of the lower back, no contrast dye CPT 72148 MRI Lumbar W/O Cont | $1,482.00 | $1,482.00 | — |
| MRI of the lower back, no contrast dye CPT 72148 MRI Lumbar W/O Cont | $1,482.00 | $1,482.00 | — |
| MRI of the lower back, no contrast dye inpatient CPT 72148 MRI Lumbar W/O Cont | $1,482.00 | $1,482.00 | — |
| MRI of the lower back, no contrast dye inpatient CPT 72148 MRI Lumbar W/O Cont | $1,482.00 | $1,482.00 | — |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 Uls OB Uterus Ftl/Mtrnl Eval Transabdo After 1st Tri Single/First Gest | $1,371.00 | $1,371.00 | — |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 Uls OB Uterus Ftl/Mtrnl Eval Transabdo After 1st Tri Single/First Gest | $1,371.00 | $1,371.00 | — |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 Uls OB Uterus Ftl/Mtrnl Eval Transabdo After 1st Tri Single/First Gest | $1,371.00 | $1,371.00 | — |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 Uls OB Uterus Ftl/Mtrnl Eval Transabdo After 1st Tri Single/First Gest | $1,371.00 | $1,371.00 | — |
| Sleep study in a lab (polysomnography) CPT 95810 Polysom > 6 Y/O With Sleep Stage /8+Param/Initiate Study/Score | $9,545.00 | $9,545.00 | — |
| Sleep study in a lab (polysomnography) CPT 95810 Polysom > 6 Y/O With Sleep Stage /8+Param/Initiate Study/Score | $9,545.00 | $9,545.00 | — |
| Sleep study in a lab (polysomnography) inpatient CPT 95810 Polysom > 6 Y/O With Sleep Stage /8+Param/Initiate Study/Score | $9,545.00 | $9,545.00 | — |
| Sleep study in a lab (polysomnography) inpatient CPT 95810 Polysom > 6 Y/O With Sleep Stage /8+Param/Initiate Study/Score | $9,545.00 | $9,545.00 | — |
| Transvaginal pelvic ultrasound CPT 76830 Uls Transvaginal | $1,147.00 | $1,147.00 | — |
| Transvaginal pelvic ultrasound CPT 76830 Uls Transvaginal | $1,147.00 | $1,147.00 | — |
| Transvaginal pelvic ultrasound inpatient CPT 76830 Uls Transvaginal | $1,147.00 | $1,147.00 | — |
| Transvaginal pelvic ultrasound inpatient CPT 76830 Uls Transvaginal | $1,147.00 | $1,147.00 | — |
| Ultrasound of the abdomen, complete CPT 76700 Uls Abdominal Complete | $1,205.00 | $1,205.00 | — |
| Ultrasound of the abdomen, complete CPT 76700 Uls Abdominal Complete | $1,205.00 | $1,205.00 | — |
| Ultrasound of the abdomen, complete inpatient CPT 76700 Uls Abdominal Complete | $1,205.00 | $1,205.00 | — |
| Ultrasound of the abdomen, complete inpatient CPT 76700 Uls Abdominal Complete | $1,205.00 | $1,205.00 | — |
| X-ray of the lower back, 4 or more views CPT 72110 Lumbosacral Min 4 Vw | $579.00 | $579.00 | — |
| X-ray of the lower back, 4 or more views CPT 72110 Lumbosacral Min 4 Vw | $579.00 | $579.00 | — |
| X-ray of the lower back, 4 or more views inpatient CPT 72110 Lumbosacral Min 4 Vw | $579.00 | $579.00 | — |
| X-ray of the lower back, 4 or more views inpatient CPT 72110 Lumbosacral Min 4 Vw | $579.00 | $579.00 | — |
Lab tests
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Basic metabolic panel (blood test) CPT 80048 Basic Metabolic Panel | $314.00 | $314.00 | — |
| Basic metabolic panel (blood test) CPT 80048 Basic Metabolic Panel | $314.00 | $314.00 | — |
| Basic metabolic panel (blood test) inpatient CPT 80048 Basic Metabolic Panel | $314.00 | $314.00 | — |
| Basic metabolic panel (blood test) inpatient CPT 80048 Basic Metabolic Panel | $314.00 | $314.00 | — |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Lipid Fractionation | $332.00 | $332.00 | — |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Lipid Fractionation | $332.00 | $332.00 | — |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 Lipid Fractionation | $332.00 | $332.00 | — |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 Lipid Fractionation | $332.00 | $332.00 | — |
| Complete blood count (CBC) with differential CPT 85025 Cbc With Differential | $124.00 | $124.00 | — |
| Complete blood count (CBC) with differential CPT 85025 Cbc With Differential | $124.00 | $124.00 | — |
| Complete blood count (CBC) with differential inpatient CPT 85025 Cbc With Differential | $124.00 | $124.00 | — |
| Complete blood count (CBC) with differential inpatient CPT 85025 Cbc With Differential | $124.00 | $124.00 | — |
| Complete blood count (CBC), no differential CPT 85027 Cbc Complete | $98.00 | $98.00 | — |
| Complete blood count (CBC), no differential CPT 85027 Cbc Complete | $98.00 | $98.00 | — |
| Complete blood count (CBC), no differential CPT 85027 Cbc Complete (D-Hemogram) | $211.00 | $211.00 | — |
| Complete blood count (CBC), no differential CPT 85027 Cbc Complete (D-Hemogram) | $211.00 | $211.00 | — |
| Complete blood count (CBC), no differential inpatient CPT 85027 Cbc Complete | $98.00 | $98.00 | — |
| Complete blood count (CBC), no differential inpatient CPT 85027 Cbc Complete | $98.00 | $98.00 | — |
| Complete blood count (CBC), no differential inpatient CPT 85027 Cbc Complete (D-Hemogram) | $211.00 | $211.00 | — |
| Complete blood count (CBC), no differential inpatient CPT 85027 Cbc Complete (D-Hemogram) | $211.00 | $211.00 | — |
| Comprehensive metabolic panel (blood test) CPT 80053 Comprehensive Metabolic Panel | $432.00 | $432.00 | — |
| Comprehensive metabolic panel (blood test) CPT 80053 Comprehensive Metabolic Panel | $432.00 | $432.00 | — |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 Comprehensive Metabolic Panel | $432.00 | $432.00 | — |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 Comprehensive Metabolic Panel | $432.00 | $432.00 | — |
| Kidney function blood test panel CPT 80069 Renal Function Panel | $793.00 | $793.00 | — |
| Kidney function blood test panel CPT 80069 Renal Function Panel | $793.00 | $793.00 | — |
| Kidney function blood test panel inpatient CPT 80069 Renal Function Panel | $793.00 | $793.00 | — |
| Kidney function blood test panel inpatient CPT 80069 Renal Function Panel | $793.00 | $793.00 | — |
| Liver function blood test panel CPT 80076 Hepatic Function Panel | $336.00 | $336.00 | — |
| Liver function blood test panel CPT 80076 Hepatic Function Panel | $336.00 | $336.00 | — |
| Liver function blood test panel inpatient CPT 80076 Hepatic Function Panel | $336.00 | $336.00 | — |
| Liver function blood test panel inpatient CPT 80076 Hepatic Function Panel | $336.00 | $336.00 | — |
| PSA (prostate-specific antigen) blood test, total CPT 84153 Psa Total Referred | $20.00 | $20.00 | — |
| PSA (prostate-specific antigen) blood test, total CPT 84153 Psa Total Referred | $20.00 | $20.00 | — |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 Psa Total Referred | $20.00 | $20.00 | — |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 Psa Total Referred | $20.00 | $20.00 | — |
| Partial thromboplastin time (PTT) clotting test CPT 85730 Lupus Anticoagulant Profile Component 3 | $43.00 | $43.00 | — |
| Partial thromboplastin time (PTT) clotting test CPT 85730 Lupus Anticoagulant Profile Component 3 | $43.00 | $43.00 | — |
| Partial thromboplastin time (PTT) clotting test CPT 85730 Activated Partial Prothrombin Cchs | $107.00 | $107.00 | — |
| Partial thromboplastin time (PTT) clotting test CPT 85730 Thrombo Time, Partial (Ptt) | $107.00 | $107.00 | — |
| Partial thromboplastin time (PTT) clotting test CPT 85730 Thrombo Time, Partial (Ptt) | $107.00 | $107.00 | — |
| Partial thromboplastin time (PTT) clotting test CPT 85730 Activated Partial Prothrombin Cchs | $107.00 | $107.00 | — |
| Partial thromboplastin time (PTT) clotting test CPT 85730 Heparin Extracted Ptt | $223.00 | $223.00 | — |
| Partial thromboplastin time (PTT) clotting test CPT 85730 Activated Partial Prothrombin | $223.00 | $223.00 | — |
| Partial thromboplastin time (PTT) clotting test CPT 85730 Activated Partial Prothrombin | $223.00 | $223.00 | — |
| Partial thromboplastin time (PTT) clotting test CPT 85730 Heparin Extracted Ptt | $223.00 | $223.00 | — |
| Partial thromboplastin time (PTT) clotting test CPT 85730 Silica Clotting Time Cchs | $906.00 | $906.00 | — |
| Partial thromboplastin time (PTT) clotting test CPT 85730 Silica Clotting Time Cchs | $906.00 | $906.00 | — |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 Lupus Anticoagulant Profile Component 3 | $43.00 | $43.00 | — |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 Lupus Anticoagulant Profile Component 3 | $43.00 | $43.00 | — |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 Activated Partial Prothrombin Cchs | $107.00 | $107.00 | — |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 Activated Partial Prothrombin Cchs | $107.00 | $107.00 | — |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 Thrombo Time, Partial (Ptt) | $107.00 | $107.00 | — |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 Thrombo Time, Partial (Ptt) | $107.00 | $107.00 | — |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 Activated Partial Prothrombin | $223.00 | $223.00 | — |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 Activated Partial Prothrombin | $223.00 | $223.00 | — |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 Heparin Extracted Ptt | $223.00 | $223.00 | — |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 Heparin Extracted Ptt | $223.00 | $223.00 | — |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 Silica Clotting Time Cchs | $906.00 | $906.00 | — |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 Silica Clotting Time Cchs | $906.00 | $906.00 | — |
| Prothrombin time (PT/INR) clotting test CPT 85610 Lupus Anticoagulant Profile Component 1 | $43.00 | $43.00 | — |
| Prothrombin time (PT/INR) clotting test CPT 85610 Lupus Anticoagulant Profile Component 1 | $43.00 | $43.00 | — |
| Prothrombin time (PT/INR) clotting test CPT 85610 Prothrombin Time-Cchs | $97.00 | $97.00 | — |
| Prothrombin time (PT/INR) clotting test CPT 85610 Prothrombin Time-Cchs | $97.00 | $97.00 | — |
| Prothrombin time (PT/INR) clotting test CPT 85610 Prothrombin Time | $223.00 | $223.00 | — |
| Prothrombin time (PT/INR) clotting test CPT 85610 Prothrombin Time | $223.00 | $223.00 | — |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 Lupus Anticoagulant Profile Component 1 | $43.00 | $43.00 | — |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 Lupus Anticoagulant Profile Component 1 | $43.00 | $43.00 | — |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 Prothrombin Time-Cchs | $97.00 | $97.00 | — |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 Prothrombin Time-Cchs | $97.00 | $97.00 | — |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 Prothrombin Time | $223.00 | $223.00 | — |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 Prothrombin Time | $223.00 | $223.00 | — |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 Thyroid-Stimulating Hormone-Sensitive (S-Tsh) Serum | $74.00 | $74.00 | — |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 Thyroid-Stimulating Hormone-Sensitive (S-Tsh) Serum | $74.00 | $74.00 | — |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH | $413.00 | $413.00 | — |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH | $413.00 | $413.00 | — |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 Thyroid-Stimulating Hormone-Sensitive (S-Tsh) Serum | $74.00 | $74.00 | — |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 Thyroid-Stimulating Hormone-Sensitive (S-Tsh) Serum | $74.00 | $74.00 | — |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH | $413.00 | $413.00 | — |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH | $413.00 | $413.00 | — |
| Urinalysis with microscope exam, automated CPT 81001 Urinalysis, Automated W/ Micro | $202.00 | $202.00 | — |
| Urinalysis with microscope exam, automated CPT 81001 Urinalysis, Automated W/ Micro | $202.00 | $202.00 | — |
| Urinalysis with microscope exam, automated inpatient CPT 81001 Urinalysis, Automated W/ Micro | $202.00 | $202.00 | — |
| Urinalysis with microscope exam, automated inpatient CPT 81001 Urinalysis, Automated W/ Micro | $202.00 | $202.00 | — |
| Urinalysis without microscope exam, automated CPT 81003 Urinalysis Automated W/O Micro | $183.00 | $183.00 | — |
| Urinalysis without microscope exam, automated CPT 81003 Urinalysis Automated W/O Micro | $183.00 | $183.00 | — |
| Urinalysis without microscope exam, automated CPT 81003 Glucose - Urine | $223.00 | $223.00 | — |
| Urinalysis without microscope exam, automated CPT 81003 Glucose - Urine | $223.00 | $223.00 | — |
| Urinalysis without microscope exam, automated inpatient CPT 81003 Urinalysis Automated W/O Micro | $183.00 | $183.00 | — |
| Urinalysis without microscope exam, automated inpatient CPT 81003 Urinalysis Automated W/O Micro | $183.00 | $183.00 | — |
| Urinalysis without microscope exam, automated inpatient CPT 81003 Glucose - Urine | $223.00 | $223.00 | — |
| Urinalysis without microscope exam, automated inpatient CPT 81003 Glucose - Urine | $223.00 | $223.00 | — |
Surgery and procedures
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Left heart catheterization, diagnostic one side CPT 93452 Left Hrt Cath W/Ventrclogrphy | $24,762.00 | $24,762.00 | — |
| Left heart catheterization, diagnostic one side CPT 93452 Left Hrt Cath W/Ventrclogrphy | $24,762.00 | $24,762.00 | — |
| Left heart catheterization, diagnostic inpatient one side CPT 93452 Left Hrt Cath W/Ventrclogrphy | $24,762.00 | $24,762.00 | — |
| Left heart catheterization, diagnostic inpatient one side CPT 93452 Left Hrt Cath W/Ventrclogrphy | $24,762.00 | $24,762.00 | — |
| Lower-back epidural injection, with imaging guidance CPT 62323 Inject Dx/Ther Not Incl Neuro W/ Ndl/Cath Plcmt Lumbar/Sacral W/Image | $3,144.00 | $3,144.00 | — |
| Lower-back epidural injection, with imaging guidance CPT 62323 Inject Dx/Ther Not Incl Neuro W/ Ndl/Cath Plcmt Lumbar/Sacral W/Image | $3,144.00 | $3,144.00 | — |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 Inject Dx/Ther Not Incl Neuro W/ Ndl/Cath Plcmt Lumbar/Sacral W/Image | $3,144.00 | $3,144.00 | — |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 Inject Dx/Ther Not Incl Neuro W/ Ndl/Cath Plcmt Lumbar/Sacral W/Image | $3,144.00 | $3,144.00 | — |
| Lower-back epidural injection, without imaging guidance CPT 62322 Inject Dx/Ther Not Incl Neuro W/ Ndl/Cath Plcmt Lumbr/Sacr W/Out Image | $3,350.00 | $3,350.00 | — |
| Lower-back epidural injection, without imaging guidance CPT 62322 Inject Dx/Ther Not Incl Neuro W/ Ndl/Cath Plcmt Lumbr/Sacr W/Out Image | $3,350.00 | $3,350.00 | — |
| Lower-back epidural injection, without imaging guidance inpatient CPT 62322 Inject Dx/Ther Not Incl Neuro W/ Ndl/Cath Plcmt Lumbr/Sacr W/Out Image | $3,350.00 | $3,350.00 | — |
| Lower-back epidural injection, without imaging guidance inpatient CPT 62322 Inject Dx/Ther Not Incl Neuro W/ Ndl/Cath Plcmt Lumbr/Sacr W/Out Image | $3,350.00 | $3,350.00 | — |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 Inj Anes/Ster,Transforaminal Epidural,W/Img Guid;Lumbar/Sacral,Single | $4,810.00 | $4,810.00 | — |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 Inj Anes/Ster,Transforaminal Epidural,W/Img Guid;Lumbar/Sacral,Single | $4,810.00 | $4,810.00 | — |
| Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 Inj Anes/Ster,Transforaminal Epidural,W/Img Guid;Lumbar/Sacral,Single | $4,810.00 | $4,810.00 | — |
| Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 Inj Anes/Ster,Transforaminal Epidural,W/Img Guid;Lumbar/Sacral,Single | $4,810.00 | $4,810.00 | — |
| Upper endoscopy (EGD) with biopsy CPT 43239 Esophagogastroduodenoscopy Flex Transoral W/Biopsy Single/Multiple | $4,812.00 | $4,812.00 | — |
| Upper endoscopy (EGD) with biopsy CPT 43239 Esophagogastroduodenoscopy Flex Transoral W/Biopsy Single/Multiple | $4,812.00 | $4,812.00 | — |
| Upper endoscopy (EGD) with biopsy inpatient CPT 43239 Esophagogastroduodenoscopy Flex Transoral W/Biopsy Single/Multiple | $4,812.00 | $4,812.00 | — |
| Upper endoscopy (EGD) with biopsy inpatient CPT 43239 Esophagogastroduodenoscopy Flex Transoral W/Biopsy Single/Multiple | $4,812.00 | $4,812.00 | — |
| Upper endoscopy (EGD), diagnostic CPT 43235 Esophagogastroduodenoscopy Flex Transoral Incl Coll Spec Brush/Wash | $4,812.00 | $4,812.00 | — |
| Upper endoscopy (EGD), diagnostic CPT 43235 Esophagogastroduodenoscopy Flex Transoral Incl Coll Spec Brush/Wash | $4,812.00 | $4,812.00 | — |
| Upper endoscopy (EGD), diagnostic inpatient CPT 43235 Esophagogastroduodenoscopy Flex Transoral Incl Coll Spec Brush/Wash | $4,812.00 | $4,812.00 | — |
| Upper endoscopy (EGD), diagnostic inpatient CPT 43235 Esophagogastroduodenoscopy Flex Transoral Incl Coll Spec Brush/Wash | $4,812.00 | $4,812.00 | — |
Doctor visits and therapy
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| New patient office visit, about 30 minutes CPT 99203 New Office Visit Level Three | $144.00 | $144.00 | — |
| New patient office visit, about 30 minutes CPT 99203 New Office Visit Level Three | $144.00 | $144.00 | — |
| New patient office visit, about 30 minutes inpatient CPT 99203 New Office Visit Level Three | $144.00 | $144.00 | — |
| New patient office visit, about 30 minutes inpatient CPT 99203 New Office Visit Level Three | $144.00 | $144.00 | — |
| New patient office visit, about 45 minutes CPT 99204 New Office Visit Level Four | $144.00 | $144.00 | — |
| New patient office visit, about 45 minutes CPT 99204 New Office Visit Level Four | $144.00 | $144.00 | — |
| New patient office visit, about 45 minutes inpatient CPT 99204 New Office Visit Level Four | $144.00 | $144.00 | — |
| New patient office visit, about 45 minutes inpatient CPT 99204 New Office Visit Level Four | $144.00 | $144.00 | — |
| New patient office visit, about 60 minutes CPT 99205 New Office Visit Level Five | $144.00 | $144.00 | — |
| New patient office visit, about 60 minutes CPT 99205 New Office Visit Level Five | $144.00 | $144.00 | — |
| New patient office visit, about 60 minutes inpatient CPT 99205 New Office Visit Level Five | $144.00 | $144.00 | — |
| New patient office visit, about 60 minutes inpatient CPT 99205 New Office Visit Level Five | $144.00 | $144.00 | — |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 Ther Ex OP Pt | $198.00 | $198.00 | — |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 Ther Ex IP Pt | $198.00 | $198.00 | — |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 Ther Ex OP Ot | $198.00 | $198.00 | — |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 Ther Ex OP Pt | $198.00 | $198.00 | — |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 Ther Ex Rhb Pt | $198.00 | $198.00 | — |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 Ther Ex Rhb Pt | $198.00 | $198.00 | — |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 Ther Ex Rhb Ot | $198.00 | $198.00 | — |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 Ther Ex IP Pt | $198.00 | $198.00 | — |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 Ther Ex Rhb Ot | $198.00 | $198.00 | — |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 Ther Ex OP Ot | $198.00 | $198.00 | — |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 Ther Ex IP Ot | $198.00 | $198.00 | — |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 Ther Ex IP Ot | $198.00 | $198.00 | — |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 Ther Ex IP Ot | $198.00 | $198.00 | — |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 Ther Ex OP Ot | $198.00 | $198.00 | — |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 Ther Ex OP Ot | $198.00 | $198.00 | — |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 Ther Ex OP Pt | $198.00 | $198.00 | — |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 Ther Ex OP Pt | $198.00 | $198.00 | — |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 Ther Ex Rhb Pt | $198.00 | $198.00 | — |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 Ther Ex Rhb Pt | $198.00 | $198.00 | — |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 Ther Ex Rhb Ot | $198.00 | $198.00 | — |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 Ther Ex Rhb Ot | $198.00 | $198.00 | — |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 Ther Ex IP Pt | $198.00 | $198.00 | — |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 Ther Ex IP Pt | $198.00 | $198.00 | — |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 Ther Ex IP Ot | $198.00 | $198.00 | — |
| Preventive checkup, new patient aged 18–39 CPT 99385 Preventative Visit New 18 Through 39 Years | $144.00 | $144.00 | — |
| Preventive checkup, new patient aged 18–39 CPT 99385 Preventative Visit New 18 Through 39 Years | $144.00 | $144.00 | — |
| Preventive checkup, new patient aged 18–39 inpatient CPT 99385 Preventative Visit New 18 Through 39 Years | $144.00 | $144.00 | — |
| Preventive checkup, new patient aged 18–39 inpatient CPT 99385 Preventative Visit New 18 Through 39 Years | $144.00 | $144.00 | — |