Hospital Cincinnati, OH-KY-IN

West Chester Hospital

West Chester Hospital in West Chester, OH publishes cash prices for 457 common procedures listed here, from its own machine-readable price file updated Jul 1, 2026. Compared with other hospitals in the state, its outpatient cash prices are above the Ohio median for 332 of 454 procedures and below it for 109. By typical cash price it ranks #128 of 139 Ohio hospitals and #14 of 15 hospitals in the Cincinnati, OH area, cheapest first. Select a procedure to compare it with other hospitals nearby.

7700 University Drive, West Chester, OH 45069 Collected Sep 23, 2026 Source price file Check a bill from this hospital (513) 298-7701

Acute care hospital Nonprofit hospital Emergency department CMS star rating 3 of 5 CCN 360354 · CMS hospital register NPI 1851549273

Financial assistance

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

West Chester Hospital 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.

State law

This state limits hospital bills for lower-income patients

Ohio's Hospital Care Assurance Program (HCAP): Ohio residents who are not on Medicaid and whose income is at or below 100% of the federal poverty level get basic, medically necessary hospital services free at hospitals in the program; physician bills are not included. Ask the hospital's billing office for an HCAP application. Other states' laws.

Scans and imaging

Procedure	Cash price	List price	Insurers pay	vs Ohio	Off list
Abdominal CT scan without and with contrast CPT 74170 Hc Ct Abdomen W&W/O Contrast	$1,378.80	$2,298.00	—	4% above	40%
Abdominal CT scan without and with contrast inpatient CPT 74170 Hc Ct Abdomen W&W/O Contrast	$1,378.80	$2,298.00	—	—	40%
Abdominal X-ray, 2 views CPT 74019 Hc Diag Abdomen 2 Views	$381.00	$635.00	—	13% above	40%
Abdominal X-ray, 2 views inpatient CPT 74019 Hc Diag Abdomen 2 Views	$381.00	$635.00	—	—	40%
Ankle X-ray, complete, 3 or more views CPT 73610 Hc Diag Ankle - Min 3 Views	$483.60	$806.00	—	51% above	40%
Ankle X-ray, complete, 3 or more views inpatient CPT 73610 Hc Diag Ankle - Min 3 Views	$483.60	$806.00	—	—	40%
Ankle-brachial index (ABI), blood pressure test for leg arteries both sides CPT 93922 Hc Abi W/Pvr Sngl Lvl Bilateral	$746.40	$1,244.00	—	—	40%
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 Hc Tcpo2/Co2 Spotcheck	$746.40	$1,244.00	—	55% above	40%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient both sides CPT 93922 Hc Abi W/Pvr Sngl Lvl Bilateral	$746.40	$1,244.00	—	—	40%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 Hc Tcpo2/Co2 Spotcheck	$746.40	$1,244.00	—	—	40%
Arm CT scan without contrast (shoulder to hand, any part) CPT 73200 Hc Ct Upper Extremity W/O Contrast	$955.20	$1,592.00	—	1% above	40%
Arm CT scan without contrast (shoulder to hand, any part) inpatient CPT 73200 Hc Ct Upper Extremity W/O Contrast	$955.20	$1,592.00	—	—	40%
Barium swallow (esophagus X-ray with contrast) CPT 74220 Hc Diag Esophagram	$588.00	$980.00	—	33% above	40%
Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 Hc Diag Esophagram	$588.00	$980.00	—	—	40%
Bone scan, whole body (nuclear medicine) CPT 78306 Hc Nm Bone Imaging Whole Body	$1,988.40	$3,314.00	—	30% above	40%
Bone scan, whole body (nuclear medicine) inpatient CPT 78306 Hc Nm Bone Imaging Whole Body	$1,988.40	$3,314.00	—	—	40%
Breast ultrasound, complete, one breast CPT 76641 Hc Us Breast Uni With Axilla Complete	$974.40	$1,624.00	—	104% above	40%
Breast ultrasound, complete, one breast inpatient CPT 76641 Hc Us Breast Uni With Axilla Complete	$974.40	$1,624.00	—	—	40%
Breast ultrasound, limited (one breast or one area) CPT 76642 Hc Us Breast Uni With Axilla Limited	$729.60	$1,216.00	—	78% above	40%
Breast ultrasound, limited (one breast or one area) inpatient CPT 76642 Hc Us Breast Uni With Axilla Limited	$729.60	$1,216.00	—	—	40%
CT angiography (CTA) of the abdomen and pelvis CPT 74174 Hc Ct Angio Abd & Pelvis W &/Or Wo	$931.20	$1,552.00	—	57% below	40%
CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174 Hc Ct Angio Abd & Pelvis W &/Or Wo	$931.20	$1,552.00	—	—	40%
CT angiography (CTA) of the head CPT 70496 Hc Ct Angiography Head W &/Or Wo	$1,154.40	$1,924.00	—	14% below	40%
CT angiography (CTA) of the head CPT 70496 Hc Ct Angiography Head W &/Or Wo With Viz Lvo	$1,154.40	$1,924.00	—	14% below	40%
CT angiography (CTA) of the head inpatient CPT 70496 Hc Ct Angiography Head W &/Or Wo With Viz Lvo	$1,154.40	$1,924.00	—	—	40%
CT angiography (CTA) of the head inpatient CPT 70496 Hc Ct Angiography Head W &/Or Wo	$1,154.40	$1,924.00	—	—	40%
CT angiography (CTA) of the neck CPT 70498 Hc Ct Angiography Neck W &/Or Wo	$1,146.60	$1,911.00	—	12% below	40%
CT angiography (CTA) of the neck inpatient CPT 70498 Hc Ct Angiography Neck W &/Or Wo	$1,146.60	$1,911.00	—	—	40%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 Hc Ct Angiography Chest W &/Or Wo	$1,465.80	$2,443.00	—	3% above	40%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 Hc Ct Angiography Chest W &/Or Wo	$1,465.80	$2,443.00	—	—	40%
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 Hc Ct-Heart Vasc Stk/Morph/Funct	$487.20	$812.00	—	70% below	40%
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score inpatient CPT 75574 Hc Ct-Heart Vasc Stk/Morph/Funct	$487.20	$812.00	—	—	40%
CT of the heart without contrast dye to measure coronary calcium CPT 75571 Hc Ct Coronary Calcium Scoring Scrn	$120.00	$200.00	—	57% below	40%
CT of the heart without contrast dye to measure coronary calcium inpatient CPT 75571 Hc Ct Coronary Calcium Scoring Scrn	$120.00	$200.00	—	—	40%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 Hc Ct-Abdomen And Pelvis Wo Contrast	$1,492.20	$2,487.00	—	6% below	40%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 Hc Ct-Abdomen And Pelvis Wo Contrast	$1,492.20	$2,487.00	—	—	40%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 Hc Ct-Abdomen And Pelvis With Contrast	$1,729.80	$2,883.00	—	13% below	40%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 Hc Ct-Abdomen And Pelvis With Contrast	$1,729.80	$2,883.00	—	—	40%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 Hc Ct-Abdomen And Pelvis W/Wo Contrast	$1,969.20	$3,282.00	—	16% below	40%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 Hc Ct-Abdomen And Pelvis W/Wo Contrast	$1,969.20	$3,282.00	—	—	40%
CT scan of the abdomen with contrast CPT 74160 Hc Ct Abdomen W Contrast	$1,156.80	$1,928.00	—	1% below	40%
CT scan of the abdomen with contrast inpatient CPT 74160 Hc Ct Abdomen W Contrast	$1,156.80	$1,928.00	—	—	40%
CT scan of the abdomen without contrast CPT 74150 Hc Ct Abdomen W/O Contrast	$936.00	$1,560.00	—	11% below	40%
CT scan of the abdomen without contrast inpatient CPT 74150 Hc Ct Abdomen W/O Contrast	$936.00	$1,560.00	—	—	40%
CT scan of the face and sinuses, no contrast dye CPT 70486 Hc Cone Beam Ct Interp Both Jaw Dental	$237.60	$396.00	—	73% below	40%
CT scan of the face and sinuses, no contrast dye CPT 70486 Hc Cone Beam Ct Capt & Interp Dental	$237.60	$396.00	—	73% below	40%
CT scan of the face and sinuses, no contrast dye CPT 70486 Hc Cone Beam Ct Interp Man Dental	$237.60	$396.00	—	73% below	40%
CT scan of the face and sinuses, no contrast dye CPT 70486 Hc Cone Beam Ct Interp Max Dental	$237.60	$396.00	—	73% below	40%
CT scan of the face and sinuses, no contrast dye CPT 70486 Hc Cone Beam Ct Interp Tmj Dental	$237.60	$396.00	—	73% below	40%
CT scan of the face and sinuses, no contrast dye CPT 70486 Hc Cone Beam Ct Capture Ltd Dental	$237.60	$396.00	—	73% below	40%
CT scan of the face and sinuses, no contrast dye CPT 70486 Hc Cone Beam Ct Capt Mandible Dental	$237.60	$396.00	—	73% below	40%
CT scan of the face and sinuses, no contrast dye CPT 70486 Hc Cone Beam Ct Capt Maxilla Dental	$237.60	$396.00	—	73% below	40%
CT scan of the face and sinuses, no contrast dye CPT 70486 Hc Cone Beam Ct Both Jaws Dental	$237.60	$396.00	—	73% below	40%
CT scan of the face and sinuses, no contrast dye CPT 70486 Hc Cone Beam Ct Capture Tmj Dental	$237.60	$396.00	—	73% below	40%
CT scan of the face and sinuses, no contrast dye CPT 70486 Hc Interp Diagnostic Image Dental	$237.60	$396.00	—	73% below	40%
CT scan of the face and sinuses, no contrast dye CPT 70486 Hc Ct Maxillofacial W/O Contrast	$954.60	$1,591.00	—	9% above	40%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 Hc Cone Beam Ct Capture Ltd Dental	$237.60	$396.00	—	—	40%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 Hc Cone Beam Ct Capt Mandible Dental	$237.60	$396.00	—	—	40%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 Hc Cone Beam Ct Interp Tmj Dental	$237.60	$396.00	—	—	40%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 Hc Cone Beam Ct Capt Maxilla Dental	$237.60	$396.00	—	—	40%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 Hc Cone Beam Ct Both Jaws Dental	$237.60	$396.00	—	—	40%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 Hc Cone Beam Ct Interp Both Jaw Dental	$237.60	$396.00	—	—	40%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 Hc Cone Beam Ct Interp Max Dental	$237.60	$396.00	—	—	40%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 Hc Cone Beam Ct Capture Tmj Dental	$237.60	$396.00	—	—	40%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 Hc Interp Diagnostic Image Dental	$237.60	$396.00	—	—	40%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 Hc Cone Beam Ct Capt & Interp Dental	$237.60	$396.00	—	—	40%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 Hc Cone Beam Ct Interp Man Dental	$237.60	$396.00	—	—	40%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 Hc Ct Maxillofacial W/O Contrast	$954.60	$1,591.00	—	—	40%
CT scan of the head or brain, no contrast dye CPT 70450 Hc Ct Head W/O Contrast	$769.20	$1,282.00	—	8% below	40%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 Hc Ct Head W/O Contrast	$769.20	$1,282.00	—	—	40%
CT scan of the head with contrast CPT 70460 Hc Ct Head With Contrast	$1,000.20	$1,667.00	—	1% below	40%
CT scan of the head with contrast inpatient CPT 70460 Hc Ct Head With Contrast	$1,000.20	$1,667.00	—	—	40%
CT scan of the head without and with contrast CPT 70470 Hc Ct Head W&Wo Contrast	$1,125.00	$1,875.00	—	6% below	40%
CT scan of the head without and with contrast inpatient CPT 70470 Hc Ct Head W&Wo Contrast	$1,125.00	$1,875.00	—	—	40%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 Hc Ct L Spine W/O Contrast	$1,093.80	$1,823.00	—	1% below	40%
CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 Hc Ct L Spine W/O Contrast	$1,093.80	$1,823.00	—	—	40%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 Hc Ct C-Spine W/O Contrast	$972.60	$1,621.00	—	9% below	40%
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 Hc Ct C-Spine W/O Contrast	$972.60	$1,621.00	—	—	40%
CT scan of the pelvis, with contrast dye CPT 72193 Hc Ct Pelvis W Contrast	$1,100.40	$1,834.00	—	10% below	40%
CT scan of the pelvis, with contrast dye inpatient CPT 72193 Hc Ct Pelvis W Contrast	$1,100.40	$1,834.00	—	—	40%
Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 Hc Us Duplex Extracran Art Bilat Complete	$957.60	$1,596.00	—	—	40%
Carotid artery ultrasound (duplex), both sides of the neck inpatient both sides CPT 93880 Hc Us Duplex Extracran Art Bilat Complete	$957.60	$1,596.00	—	—	40%
Chest CT scan without and with contrast CPT 71270 Hc Ct Chest W & W/O Contrast	$1,405.20	$2,342.00	—	7% below	40%
Chest CT scan without and with contrast inpatient CPT 71270 Hc Ct Chest W & W/O Contrast	$1,405.20	$2,342.00	—	—	40%
Chest X-ray, 2 views CPT 71046 Hc Diag Chest 2 Views	$324.00	$540.00	—	23% above	40%
Chest X-ray, 2 views inpatient CPT 71046 Hc Diag Chest 2 Views	$324.00	$540.00	—	—	40%
Chest X-ray, single view CPT 71045 Hc Diag Chest 1 View	$280.20	$467.00	—	25% above	40%
Chest X-ray, single view inpatient CPT 71045 Hc Diag Chest 1 View	$280.20	$467.00	—	—	40%
Collarbone (clavicle) X-ray, complete CPT 73000 Hc Diag Clavicle	$511.20	$852.00	—	89% above	40%
Collarbone (clavicle) X-ray, complete inpatient CPT 73000 Hc Diag Clavicle	$511.20	$852.00	—	—	40%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 Hc Us Retroperitoneal Complete	$1,257.00	$2,095.00	—	77% above	40%
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 Hc Us Retroperitoneal Complete	$1,257.00	$2,095.00	—	—	40%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 Hc Dxa Scan Axial Skeleton	$883.80	$1,473.00	—	95% above	40%
DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 Hc Dxa Scan Axial Skeleton	$883.80	$1,473.00	—	—	40%
DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 Hc Dxa Scan Peripheral	$844.80	$1,408.00	—	229% above	40%
DEXA bone density scan of the wrist, heel or finger (peripheral) inpatient CPT 77081 Hc Dxa Scan Peripheral	$844.80	$1,408.00	—	—	40%
Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 Hc Us Ob W Detailed First Gest	$1,407.60	$2,346.00	—	66% above	40%
Detailed fetal anatomy ultrasound, through the belly, one baby inpatient CPT 76811 Hc Us Ob W Detailed First Gest	$1,407.60	$2,346.00	—	—	40%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 Hc Ct Chest W/O Contrast	$874.20	$1,457.00	—	7% below	40%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 Hc Ct Chest W/O Contrast	$874.20	$1,457.00	—	—	40%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 Hc Ct Chest W Contrast	$1,003.20	$1,672.00	—	17% below	40%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 Hc Ct Chest W Contrast	$1,003.20	$1,672.00	—	—	40%
Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 Hc Us Duplex Low Ext Art Bilateral Complete	$2,066.40	$3,444.00	—	—	40%
Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 Hc Us Duplex Low Ext Art Bilateral Complete	$2,066.40	$3,444.00	—	—	40%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 Hc Us Duplex Ext Veins Bilateral Complete	$2,254.80	$3,758.00	—	—	40%
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 Hc Us Duplex Ext Veins Bilateral Complete	$2,254.80	$3,758.00	—	—	40%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 Hc Echo W Doppler/Color	$1,819.80	$3,033.00	—	8% above	40%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 Hc Echo W Doppler/Color	$1,819.80	$3,033.00	—	—	40%
Elbow X-ray, 2 views CPT 73070 Hc Diag Elbow 2 Views	$438.00	$730.00	—	68% above	40%
Elbow X-ray, 2 views inpatient CPT 73070 Hc Diag Elbow 2 Views	$438.00	$730.00	—	—	40%
Elbow X-ray, complete, 3 or more views CPT 73080 Hc Diag Elbow Min 3 Views	$541.20	$902.00	—	72% above	40%
Elbow X-ray, complete, 3 or more views inpatient CPT 73080 Hc Diag Elbow Min 3 Views	$541.20	$902.00	—	—	40%
Eye socket (orbit) CT scan without contrast CPT 70480 Hc Ct Orbits/Sella/Iac/Pfossa W/O Contrast	$844.20	$1,407.00	—	2% below	40%
Eye socket (orbit) CT scan without contrast inpatient CPT 70480 Hc Ct Orbits/Sella/Iac/Pfossa W/O Contrast	$844.20	$1,407.00	—	—	40%
Facial bones X-ray, complete, 3 or more views CPT 70150 Hc Diag Facial Bones Min 3 Views	$790.20	$1,317.00	—	110% above	40%
Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 Hc Diag Facial Bones Min 3 Views	$790.20	$1,317.00	—	—	40%
Forearm X-ray (radius and ulna), 2 views CPT 73090 Hc Diag Forearm 2 Views	$474.60	$791.00	—	74% above	40%
Forearm X-ray (radius and ulna), 2 views inpatient CPT 73090 Hc Diag Forearm 2 Views	$474.60	$791.00	—	—	40%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 Hc Hepatobiliary Imaging	$2,100.60	$3,501.00	—	32% above	40%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 Hc Hepatobiliary Imaging	$2,100.60	$3,501.00	—	—	40%
Hand X-ray, 2 views CPT 73120 Hc Diag Hand 2 Views	$483.60	$806.00	—	81% above	40%
Hand X-ray, 2 views inpatient CPT 73120 Hc Diag Hand 2 Views	$483.60	$806.00	—	—	40%
Heel bone (calcaneus) X-ray, 2 or more views CPT 73650 Hc Diag Os Calcis Heel	$444.00	$740.00	—	63% above	40%
Heel bone (calcaneus) X-ray, 2 or more views inpatient CPT 73650 Hc Diag Os Calcis Heel	$444.00	$740.00	—	—	40%
Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 Hc Sleep Study Unattended Simul Record Hr/O2 Sat/Resp Flow/Resp Eff	$1,171.80	$1,953.00	—	67% above	40%
Home sleep apnea test, unattended, recording breathing and oxygen inpatient CPT 95806 Hc Sleep Study Unattended Simul Record Hr/O2 Sat/Resp Flow/Resp Eff	$1,171.80	$1,953.00	—	—	40%
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 Hc Polysomnography With Nasal Cpap	$5,877.00	$9,795.00	—	43% above	40%
In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 Hc Polysomnography With Nasal Cpap	$5,877.00	$9,795.00	—	—	40%
Knee X-ray, 3 views CPT 73562 Hc Diag Knee 3 Views	$573.00	$955.00	—	62% above	40%
Knee X-ray, 3 views inpatient CPT 73562 Hc Diag Knee 3 Views	$573.00	$955.00	—	—	40%
Knee X-ray, complete, 4 or more views CPT 73564 Hc Diag Knee Min 4 Views	$661.80	$1,103.00	—	68% above	40%
Knee X-ray, complete, 4 or more views inpatient CPT 73564 Hc Diag Knee Min 4 Views	$661.80	$1,103.00	—	—	40%
Leg CT scan without contrast (hip to foot, any part) CPT 73700 Hc Ct Lower Extremity W/O Contrast	$951.60	$1,586.00	—	1% above	40%
Leg CT scan without contrast (hip to foot, any part) inpatient CPT 73700 Hc Ct Lower Extremity W/O Contrast	$951.60	$1,586.00	—	—	40%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 Hc Us Abdomen Limited	$1,157.40	$1,929.00	—	110% above	40%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 Hc Us Abdomen Limited	$1,157.40	$1,929.00	—	—	40%
Limited ultrasound of an arm or leg (non-vascular) CPT 76882 Hc Us-Extremity Limited	$792.00	$1,320.00	—	66% above	40%
Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 Hc Us-Extremity Limited	$792.00	$1,320.00	—	—	40%
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 Hc Ct Thorax Lung Cancer Scr C	$101.40	$169.00	—	66% below	40%
Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 Hc Ct Thorax Lung Cancer Scr C	$101.40	$169.00	—	—	40%
Lower leg X-ray (tibia and fibula), 2 views CPT 73590 Hc Diag Tibia And Fibula 2 Views	$506.40	$844.00	—	85% above	40%
Lower leg X-ray (tibia and fibula), 2 views inpatient CPT 73590 Hc Diag Tibia And Fibula 2 Views	$506.40	$844.00	—	—	40%
MR angiography (MRA) of the head without contrast CPT 70544 Hc Mri Angio Head W/O Contrast	$1,991.40	$3,319.00	—	37% above	40%
MR angiography (MRA) of the head without contrast inpatient CPT 70544 Hc Mri Angio Head W/O Contrast	$1,991.40	$3,319.00	—	—	40%
MRI of knee or other lower-limb joint, no contrast dye CPT 73721 Hc Mri Lowr Extremity Joint W/O Contrast	$2,758.20	$4,597.00	—	57% above	40%
MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 Hc Mri Lowr Extremity Joint W/O Contrast	$2,758.20	$4,597.00	—	—	40%
MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 Hc Mri Lower Ext Joint W/Wo Contrast	$3,289.20	$5,482.00	—	38% above	40%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 Hc Mri Lower Ext Joint W/Wo Contrast	$3,289.20	$5,482.00	—	—	40%
MRI of the abdomen without contrast CPT 74181 Hc Mri Abdomen W/O Contrast	$2,758.20	$4,597.00	—	50% above	40%
MRI of the abdomen without contrast inpatient CPT 74181 Hc Mri Abdomen W/O Contrast	$2,758.20	$4,597.00	—	—	40%
MRI of the abdomen, without and then with contrast dye CPT 74183 Hc Mri Abdomen W/Wo Contrast	$3,685.80	$6,143.00	—	61% above	40%
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 Hc Mri Abdomen W/Wo Contrast	$3,685.80	$6,143.00	—	—	40%
MRI of the brain, no contrast dye CPT 70551 Hc Mri Head W/O Contrast	$1,991.40	$3,319.00	—	24% above	40%
MRI of the brain, no contrast dye inpatient CPT 70551 Hc Mri Head W/O Contrast	$1,991.40	$3,319.00	—	—	40%
MRI of the brain, with and without contrast dye CPT 70553 Hc Mri Head W/Wo Contrast	$2,740.20	$4,567.00	—	25% above	40%
MRI of the brain, with and without contrast dye inpatient CPT 70553 Hc Mri Head W/Wo Contrast	$2,740.20	$4,567.00	—	—	40%
MRI of the lower back, no contrast dye CPT 72148 Hc Mri L-Spine W/O Contrast	$2,365.80	$3,943.00	—	42% above	40%
MRI of the lower back, no contrast dye inpatient CPT 72148 Hc Mri L-Spine W/O Contrast	$2,365.80	$3,943.00	—	—	40%
MRI of the lower back, without and then with contrast dye CPT 72158 Hc Mri L-Spine W/Wo Contrast	$3,393.60	$5,656.00	—	45% above	40%
MRI of the lower back, without and then with contrast dye inpatient CPT 72158 Hc Mri L-Spine W/Wo Contrast	$3,393.60	$5,656.00	—	—	40%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 Hc Mri T-Spine W/O Contrast	$2,464.20	$4,107.00	—	47% above	40%
MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 Hc Mri T-Spine W/O Contrast	$2,464.20	$4,107.00	—	—	40%
MRI of the neck (cervical spine) without and with contrast CPT 72156 Hc Mri C-Spine W/Wo Contrast	$2,752.20	$4,587.00	—	22% above	40%
MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 Hc Mri C-Spine W/Wo Contrast	$2,752.20	$4,587.00	—	—	40%
MRI of the neck (cervical spine), no contrast dye CPT 72141 Hc Mri C-Spine W/O Contrast	$1,998.00	$3,330.00	—	21% above	40%
MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 Hc Mri C-Spine W/O Contrast	$1,998.00	$3,330.00	—	—	40%
MRI of the pelvis without and with contrast CPT 72197 Hc Mri Pelvis W/Wo Contrast	$3,015.60	$5,026.00	—	54% above	40%
MRI of the pelvis without and with contrast inpatient CPT 72197 Hc Mri Pelvis W/Wo Contrast	$3,015.60	$5,026.00	—	—	40%
MRI of the pelvis, no contrast dye CPT 72195 Hc Mri Pelvis W/O Contrast	$2,464.20	$4,107.00	—	62% above	40%
MRI of the pelvis, no contrast dye inpatient CPT 72195 Hc Mri Pelvis W/O Contrast	$2,464.20	$4,107.00	—	—	40%
MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 Hc Mri Upper Extremity Jnt W/O Contrast	$2,433.00	$4,055.00	—	61% above	40%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 Hc Mri Upper Extremity Jnt W/O Contrast	$2,433.00	$4,055.00	—	—	40%
Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 Hc Diag C Spine Min 4 Views	$808.80	$1,348.00	—	80% above	40%
Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 Hc Diag C Spine Min 4 Views	$808.80	$1,348.00	—	—	40%
Neck soft tissue CT scan with contrast CPT 70491 Hc Ct Neck W Contrast	$973.20	$1,622.00	—	18% below	40%
Neck soft tissue CT scan with contrast inpatient CPT 70491 Hc Ct Neck W Contrast	$973.20	$1,622.00	—	—	40%
Neck soft tissue CT scan without contrast CPT 70490 Hc Ct Neck W/O Contrast	$846.00	$1,410.00	—	8% below	40%
Neck soft tissue CT scan without contrast inpatient CPT 70490 Hc Ct Neck W/O Contrast	$846.00	$1,410.00	—	—	40%
Neck soft tissue X-ray CPT 70360 Hc Diag Neck-Soft Tissue	$300.00	$500.00	—	16% above	40%
Neck soft tissue X-ray inpatient CPT 70360 Hc Diag Neck-Soft Tissue	$300.00	$500.00	—	—	40%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 Hc Nm-Myocardial Perf Multi Spect	$5,979.60	$9,966.00	—	49% above	40%
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 Hc Nm-Myocardial Perf Multi Spect	$5,979.60	$9,966.00	—	—	40%
OCT scan of the retina (optical coherence tomography) CPT 92134 Hc Scan Computerized Ophthalmic Retina	$208.80	$348.00	—	165% above	40%
OCT scan of the retina (optical coherence tomography) inpatient CPT 92134 Hc Scan Computerized Ophthalmic Retina	$208.80	$348.00	—	—	40%
PET/CT scan from the base of the skull to mid-thigh CPT 78815 Hc Pet/Ct Tumor Image Skull To Mid-Thigh	$5,014.80	$8,358.00	—	3% above	40%
PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 Hc Pet/Ct Tumor Image Skull To Mid-Thigh	$5,014.80	$8,358.00	—	—	40%
Pelvic CT scan without contrast CPT 72192 Hc Ct Pelvis W/O Contrast	$966.60	$1,611.00	—	4% below	40%
Pelvic CT scan without contrast inpatient CPT 72192 Hc Ct Pelvis W/O Contrast	$966.60	$1,611.00	—	—	40%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 Hc Us Pelvis Non-Ob Limited	$860.40	$1,434.00	—	98% above	40%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 Hc Us Pelvis Non-Ob Limited	$860.40	$1,434.00	—	—	40%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 Hc Us Pelvis Non-Ob Complete	$1,127.40	$1,879.00	—	124% above	40%
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 Hc Us Pelvis Non-Ob Complete	$1,127.40	$1,879.00	—	—	40%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 Hc Us Ob >=14 Weeks First Gest	$1,117.20	$1,862.00	—	86% above	40%
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 Hc Us Ob >=14 Weeks First Gest	$1,117.20	$1,862.00	—	—	40%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 Hc Us Ob <14 Weeks First Gestation	$974.40	$1,624.00	—	77% above	40%
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 Hc Us Ob <14 Weeks First Gestation	$974.40	$1,624.00	—	—	40%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 Hc Us Ob Limited	$724.80	$1,208.00	—	52% above	40%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 Hc Us Ob Limited	$724.80	$1,208.00	—	—	40%
Rib X-ray, one side, 2 views CPT 71100 Hc Diag Ribs 2 Views	$555.60	$926.00	—	83% above	40%
Rib X-ray, one side, 2 views inpatient CPT 71100 Hc Diag Ribs 2 Views	$555.60	$926.00	—	—	40%
Rib X-ray, one side, with a chest view, 3 or more views CPT 71101 Hc Diag Ribs & Pa Chest Minimum 3 Views	$561.00	$935.00	—	47% above	40%
Rib X-ray, one side, with a chest view, 3 or more views inpatient CPT 71101 Hc Diag Ribs & Pa Chest Minimum 3 Views	$561.00	$935.00	—	—	40%
Shoulder X-ray, complete, 2 or more views CPT 73030 Hc Diag Shoulder Min 2 Views	$544.80	$908.00	—	62% above	40%
Shoulder X-ray, complete, 2 or more views inpatient CPT 73030 Hc Diag Shoulder Min 2 Views	$544.80	$908.00	—	—	40%
Sinus X-ray, complete, 3 or more views CPT 70220 Hc Diag Paranasal Sinuses Min 3 Views	$717.60	$1,196.00	—	99% above	40%
Sinus X-ray, complete, 3 or more views inpatient CPT 70220 Hc Diag Paranasal Sinuses Min 3 Views	$717.60	$1,196.00	—	—	40%
Skull X-ray, fewer than 4 views CPT 70250 Hc Diag Skull Less Than Four Views	$543.00	$905.00	—	88% above	40%
Skull X-ray, fewer than 4 views inpatient CPT 70250 Hc Diag Skull Less Than Four Views	$543.00	$905.00	—	—	40%
Sleep study in a lab (polysomnography) CPT 95810 Hc Polysomnography - Home	$3,615.60	$6,026.00	—	1% above	40%
Sleep study in a lab (polysomnography) CPT 95810 Hc Polysomnography 4 Or More Addl Pa	$5,028.00	$8,380.00	—	40% above	40%
Sleep study in a lab (polysomnography) inpatient CPT 95810 Hc Polysomnography - Home	$3,615.60	$6,026.00	—	—	40%
Sleep study in a lab (polysomnography) inpatient CPT 95810 Hc Polysomnography 4 Or More Addl Pa	$5,028.00	$8,380.00	—	—	40%
Stress echocardiogram, complete, including the stress test and supervision CPT 93351 Hc Dse/Tse/Bse W/Exeise Ecg	$2,319.60	$3,866.00	—	13% above	40%
Stress echocardiogram, complete, including the stress test and supervision inpatient CPT 93351 Hc Dse/Tse/Bse W/Exeise Ecg	$2,319.60	$3,866.00	—	—	40%
Swallow study (modified barium swallow, video X-ray) CPT 74230 Hc Diag Modified Barium Swallow	$608.40	$1,014.00	—	20% above	40%
Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 Hc Diag Modified Barium Swallow	$608.40	$1,014.00	—	—	40%
Thigh bone (femur) X-ray, 2 or more views CPT 73552 Hc Diag Femur Min 2 Views	$555.60	$926.00	—	105% above	40%
Thigh bone (femur) X-ray, 2 or more views inpatient CPT 73552 Hc Diag Femur Min 2 Views	$555.60	$926.00	—	—	40%
Thoracic spine (mid back) CT scan without contrast CPT 72128 Hc Ct T-Spine W/O Contrast	$1,093.80	$1,823.00	—	21% above	40%
Thoracic spine (mid back) CT scan without contrast inpatient CPT 72128 Hc Ct T-Spine W/O Contrast	$1,093.80	$1,823.00	—	—	40%
Toe X-ray, 2 or more views CPT 73660 Hc Diag Toe(S)Min 2 Views	$391.20	$652.00	—	57% above	40%
Toe X-ray, 2 or more views inpatient CPT 73660 Hc Diag Toe(S)Min 2 Views	$391.20	$652.00	—	—	40%
Transvaginal pelvic ultrasound CPT 76830 Hc Ultrasound Transvaginal	$1,425.60	$2,376.00	—	153% above	40%
Transvaginal pelvic ultrasound inpatient CPT 76830 Hc Ultrasound Transvaginal	$1,425.60	$2,376.00	—	—	40%
Transvaginal ultrasound during pregnancy CPT 76817 Hc Us Ob Transvaginal	$1,051.80	$1,753.00	—	110% above	40%
Transvaginal ultrasound during pregnancy inpatient CPT 76817 Hc Us Ob Transvaginal	$1,051.80	$1,753.00	—	—	40%
Ultrasound of the abdomen, complete CPT 76700 Hc Us Abdomen-Complete	$1,517.40	$2,529.00	—	142% above	40%
Ultrasound of the abdomen, complete inpatient CPT 76700 Hc Us Abdomen-Complete	$1,517.40	$2,529.00	—	—	40%
Ultrasound of the scrotum and testicles CPT 76870 Hc Us Scrotum	$1,162.80	$1,938.00	—	117% above	40%
Ultrasound of the scrotum and testicles inpatient CPT 76870 Hc Us Scrotum	$1,162.80	$1,938.00	—	—	40%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 Hc Us Thyroid/Neck/Head	$1,215.60	$2,026.00	—	112% above	40%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 Hc Us Thyroid/Neck/Head	$1,215.60	$2,026.00	—	—	40%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 Hc Diag-Ugi W/O Abd	$593.40	$989.00	—	at median	40%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 Hc Diag-Ugi W/O Abd	$593.40	$989.00	—	—	40%
Upper arm X-ray (humerus), 2 views CPT 73060 Hc Diag Humerus Minimum 2 Views	$490.80	$818.00	—	78% above	40%
Upper arm X-ray (humerus), 2 views inpatient CPT 73060 Hc Diag Humerus Minimum 2 Views	$490.80	$818.00	—	—	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 Hc Vasci Vessel Mapping For Hemo Access	$1,471.80	$2,453.00	—	100% above	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 Hc Duplex Extremity Veins Unil Or Ltd	$1,554.60	$2,591.00	—	111% above	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 Hc Vasci Vessel Mapping For Hemo Access	$1,471.80	$2,453.00	—	—	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 Hc Duplex Extremity Veins Unil Or Ltd	$1,554.60	$2,591.00	—	—	40%
Wrist X-ray, 2 views CPT 73100 Hc Diag Wrist 2 Views	$426.00	$710.00	—	63% above	40%
Wrist X-ray, 2 views inpatient CPT 73100 Hc Diag Wrist 2 Views	$426.00	$710.00	—	—	40%
Wrist X-ray, complete, 3 or more views CPT 73110 Hc Diag Wrist Min 3 Views	$477.00	$795.00	—	43% above	40%
Wrist X-ray, complete, 3 or more views inpatient CPT 73110 Hc Diag Wrist Min 3 Views	$477.00	$795.00	—	—	40%
X-ray of one hip, 2 or 3 views, with the pelvis when included CPT 73502 Hc Diag Hip 2-3 Views Incl Ap Pelvis	$687.00	$1,145.00	—	123% above	40%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient CPT 73502 Hc Diag Hip 2-3 Views Incl Ap Pelvis	$687.00	$1,145.00	—	—	40%
X-ray of the abdomen, 1 view CPT 74018 Hc Diag Abdomen 1 View	$288.00	$480.00	—	12% above	40%
X-ray of the abdomen, 1 view inpatient CPT 74018 Hc Diag Abdomen 1 View	$288.00	$480.00	—	—	40%
X-ray of the ankle, 2 views CPT 73600 Hc Diag Ankle 2 Views	$441.60	$736.00	—	78% above	40%
X-ray of the ankle, 2 views inpatient CPT 73600 Hc Diag Ankle 2 Views	$441.60	$736.00	—	—	40%
X-ray of the finger(s), 2 or more views CPT 73140 Hc Diag Finger(S) Min 2 Views	$399.60	$666.00	—	55% above	40%
X-ray of the finger(s), 2 or more views inpatient CPT 73140 Hc Diag Finger(S) Min 2 Views	$399.60	$666.00	—	—	40%
X-ray of the foot, 2 views CPT 73620 Hc Diag Foot 2 Views	$441.00	$735.00	—	90% above	40%
X-ray of the foot, 2 views inpatient CPT 73620 Hc Diag Foot 2 Views	$441.00	$735.00	—	—	40%
X-ray of the foot, complete, 3 or more views CPT 73630 Hc Diag Foot Min 3 Views	$476.40	$794.00	—	56% above	40%
X-ray of the foot, complete, 3 or more views inpatient CPT 73630 Hc Diag Foot Min 3 Views	$476.40	$794.00	—	—	40%
X-ray of the hand, 3 or more views CPT 73130 Hc Diag Hand Min 3 Views	$513.00	$855.00	—	57% above	40%
X-ray of the hand, 3 or more views inpatient CPT 73130 Hc Diag Hand Min 3 Views	$513.00	$855.00	—	—	40%
X-ray of the knee, 1 or 2 views CPT 73560 Hc Diag Knee 1 Or 2 Views	$431.40	$719.00	—	58% above	40%
X-ray of the knee, 1 or 2 views inpatient CPT 73560 Hc Diag Knee 1 Or 2 Views	$431.40	$719.00	—	—	40%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 Hc Diag Ls Spine 2 Or 3 Views	$544.80	$908.00	—	69% above	40%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 Hc Diag Ls Spine 2 Or 3 Views	$544.80	$908.00	—	—	40%
X-ray of the lower back, 4 or more views CPT 72110 Hc Diag Ls Spine Min 4 Views	$808.80	$1,348.00	—	72% above	40%
X-ray of the lower back, 4 or more views inpatient CPT 72110 Hc Diag Ls Spine Min 4 Views	$808.80	$1,348.00	—	—	40%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 Hc Diag T Spine 2 Views	$582.60	$971.00	—	93% above	40%
X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 Hc Diag T Spine 2 Views	$582.60	$971.00	—	—	40%
X-ray of the nasal bones, 3 or more views CPT 70160 Hc Diag Nasal Bones Min 3 Views	$581.40	$969.00	—	99% above	40%
X-ray of the nasal bones, 3 or more views inpatient CPT 70160 Hc Diag Nasal Bones Min 3 Views	$581.40	$969.00	—	—	40%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 Hc Diag C Spine 2 Or 3 Views	$522.60	$871.00	—	56% above	40%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 Hc Diag C Spine 2 Or 3 Views	$522.60	$871.00	—	—	40%
X-ray of the pelvis, 1 or 2 views CPT 72170 Hc Diag Pelvis 1 Or 2 Views	$466.80	$778.00	—	86% above	40%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 Hc Diag Pelvis 1 Or 2 Views	$466.80	$778.00	—	—	40%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 Hc Diag Sacrum & Coccyx Min 2 Views	$576.60	$961.00	—	94% above	40%
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 Hc Diag Sacrum & Coccyx Min 2 Views	$576.60	$961.00	—	—	40%

Lab tests

Procedure	Cash price	List price	Insurers pay	vs Ohio	Off list
ACTH blood test CPT 82024 Hc Acth	$325.20	$542.00	—	146% above	40%
ACTH blood test inpatient CPT 82024 Hc Acth	$325.20	$542.00	—	—	40%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 Hc Sgpt (Alt)	$43.20	$72.00	—	55% above	40%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 Hc Sgpt (Alt)	$43.20	$72.00	—	—	40%
AST (aspartate aminotransferase) enzyme test CPT 84450 Hc Sgot (Ast)	$43.20	$72.00	—	71% above	40%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 Hc Sgot (Ast)	$43.20	$72.00	—	—	40%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 Hc Acute Hepatitis Panel (2000)	$582.00	$970.00	—	167% above	40%
Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 Hc Acute Hepatitis Panel (2000)	$582.00	$970.00	—	—	40%
Albumin blood test CPT 82040 Hc Albumin	$41.40	$69.00	—	87% above	40%
Albumin blood test CPT 82040 Hc Albumin Serum S/O	$41.40	$69.00	—	87% above	40%
Albumin blood test inpatient CPT 82040 Hc Albumin	$41.40	$69.00	—	—	40%
Albumin blood test inpatient CPT 82040 Hc Albumin Serum S/O	$41.40	$69.00	—	—	40%
Aldosterone blood test CPT 82088 Hc Aldosterone Urine 24Hr	$188.40	$314.00	—	35% above	40%
Aldosterone blood test CPT 82088 Hc Aldosterone Serum	$343.80	$573.00	—	146% above	40%
Aldosterone blood test inpatient CPT 82088 Hc Aldosterone Urine 24Hr	$188.40	$314.00	—	—	40%
Aldosterone blood test inpatient CPT 82088 Hc Aldosterone Serum	$343.80	$573.00	—	—	40%
Alkaline phosphatase (ALP) blood test CPT 84075 Hc Alkaline Phosph0Tase	$43.20	$72.00	—	80% above	40%
Alkaline phosphatase (ALP) blood test inpatient CPT 84075 Hc Alkaline Phosph0Tase	$43.20	$72.00	—	—	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Hc Allergen Specific-Ige Each Allergen	$51.60	$86.00	—	121% above	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Hc Allergen Specific-Ige Each Allergen	$51.60	$86.00	—	—	40%
Alpha-fetoprotein (AFP) blood test CPT 82105 Hc Afp Tumor Mk	$141.00	$235.00	—	133% above	40%
Alpha-fetoprotein (AFP) blood test CPT 82105 Hc Alpha-Fetoprotein Serum	$141.00	$235.00	—	133% above	40%
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 Hc Alpha-Fetoprotein Serum	$141.00	$235.00	—	—	40%
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 Hc Afp Tumor Mk	$141.00	$235.00	—	—	40%
Ammonia blood test CPT 82140 Hc Ammonia Blood	$123.00	$205.00	—	125% above	40%
Ammonia blood test inpatient CPT 82140 Hc Ammonia Blood	$123.00	$205.00	—	—	40%
Amylase blood test CPT 82150 Hc Amylase	$54.00	$90.00	—	13% above	40%
Amylase blood test CPT 82150 Hc Amylase Serum	$54.00	$90.00	—	13% above	40%
Amylase blood test CPT 82150 Hc Amylase Urine	$54.00	$90.00	—	13% above	40%
Amylase blood test inpatient CPT 82150 Hc Amylase Serum	$54.00	$90.00	—	—	40%
Amylase blood test inpatient CPT 82150 Hc Amylase	$54.00	$90.00	—	—	40%
Amylase blood test inpatient CPT 82150 Hc Amylase Urine	$54.00	$90.00	—	—	40%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 Hc Cyclic Citrullinated Polypeptide	$127.20	$212.00	—	120% above	40%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 Hc Cyclic Citrullinated Polypeptide	$127.20	$212.00	—	—	40%
Antinuclear antibody (ANA) blood test, screen CPT 86038 Hc Ana(Anti-Nuclear Antibody)	$118.80	$198.00	—	115% above	40%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 Hc Ana(Anti-Nuclear Antibody)	$118.80	$198.00	—	—	40%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 Hc Poc Bnp	$286.20	$477.00	—	92% above	40%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 Hc Assay Of Natriuretic Peptide	$286.20	$477.00	—	92% above	40%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 Hc Assay Of Natriuretic Peptide	$286.20	$477.00	—	—	40%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 Hc Poc Bnp	$286.20	$477.00	—	—	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Hc Culture Throat	$82.80	$138.00	—	25% above	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Hc Culture Routine	$82.80	$138.00	—	25% above	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Hc Culture Spinal Fluid	$82.80	$138.00	—	25% above	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Hc Culture Naso-Pharyngeal	$82.80	$138.00	—	25% above	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Hc Culture Wound	$82.80	$138.00	—	25% above	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Hc Culture Tissue	$82.80	$138.00	—	25% above	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Hc Culture Genital	$82.80	$138.00	—	25% above	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Hc Culture Bronchial Washings	$82.80	$138.00	—	25% above	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Hc Culture Eye	$82.80	$138.00	—	25% above	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Hc Culture Fluid	$82.80	$138.00	—	25% above	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Hc Culture Sputum	$82.80	$138.00	—	25% above	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Hc Culture Tissue	$82.80	$138.00	—	—	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Hc Culture Sputum	$82.80	$138.00	—	—	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Hc Culture Spinal Fluid	$82.80	$138.00	—	—	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Hc Culture Genital	$82.80	$138.00	—	—	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Hc Culture Wound	$82.80	$138.00	—	—	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Hc Culture Throat	$82.80	$138.00	—	—	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Hc Culture Bronchial Washings	$82.80	$138.00	—	—	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Hc Culture Routine	$82.80	$138.00	—	—	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Hc Culture Fluid	$82.80	$138.00	—	—	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Hc Culture Naso-Pharyngeal	$82.80	$138.00	—	—	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Hc Culture Eye	$82.80	$138.00	—	—	40%
Basic metabolic panel (blood test) CPT 80048 Hc Basic Metabolic	$94.20	$157.00	—	43% above	40%
Basic metabolic panel (blood test) inpatient CPT 80048 Hc Basic Metabolic	$94.20	$157.00	—	—	40%
Bilirubin blood test, total CPT 82247 Hc Bilirubin - Total	$33.00	$55.00	—	38% above	40%
Bilirubin blood test, total CPT 82247 Hc Bilirubin - Newborn	$33.00	$55.00	—	38% above	40%
Bilirubin blood test, total inpatient CPT 82247 Hc Bilirubin - Total	$33.00	$55.00	—	—	40%
Bilirubin blood test, total inpatient CPT 82247 Hc Bilirubin - Newborn	$33.00	$55.00	—	—	40%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 Hc Cytopath Cell Block	$235.80	$393.00	—	16% above	40%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 Hc Surg Path Bone Marrow Section	$237.60	$396.00	—	17% above	40%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 Hc Surg Path Level Iv Gross & Micro	$255.60	$426.00	—	26% above	40%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 Hc Cytopath Cell Block	$235.80	$393.00	—	—	40%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 Hc Surg Path Bone Marrow Section	$237.60	$396.00	—	—	40%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 Hc Surg Path Level Iv Gross & Micro	$255.60	$426.00	—	—	40%
Blood culture for bacteria CPT 87040 Hc B87 Sterility	$99.00	$165.00	—	6% above	40%
Blood culture for bacteria CPT 87040 Hc Culture Blood	$116.40	$194.00	—	24% above	40%
Blood culture for bacteria inpatient CPT 87040 Hc B87 Sterility	$99.00	$165.00	—	—	40%
Blood culture for bacteria inpatient CPT 87040 Hc Culture Blood	$116.40	$194.00	—	—	40%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 Hc Phlebotomy	$18.60	$31.00	—	17% above	40%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 Hc Phlebotomy	$18.60	$31.00	—	—	40%
Blood glucose (sugar) test CPT 82947 Hc Poc/Glucose Quant Blood Except Reg Strip	$33.00	$55.00	—	40% above	40%
Blood glucose (sugar) test CPT 82947 Hc Glucose Serum	$33.00	$55.00	—	40% above	40%
Blood glucose (sugar) test inpatient CPT 82947 Hc Poc/Glucose Quant Blood Except Reg Strip	$33.00	$55.00	—	—	40%
Blood glucose (sugar) test inpatient CPT 82947 Hc Glucose Serum	$33.00	$55.00	—	—	40%
Blood lead test CPT 83655 Hc Assay Of Lead Poc Testing	$61.80	$103.00	—	27% above	40%
Blood lead test CPT 83655 Hc Lead - Blood	$100.80	$168.00	—	107% above	40%
Blood lead test CPT 83655 Hc Lead - Urine	$100.80	$168.00	—	107% above	40%
Blood lead test inpatient CPT 83655 Hc Assay Of Lead Poc Testing	$61.80	$103.00	—	—	40%
Blood lead test inpatient CPT 83655 Hc Lead - Urine	$100.80	$168.00	—	—	40%
Blood lead test inpatient CPT 83655 Hc Lead - Blood	$100.80	$168.00	—	—	40%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 Hc Hcg Qual Serum	$63.00	$105.00	—	16% above	40%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 Hc Hcg Qual Serum	$63.00	$105.00	—	—	40%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 Hc Abo Type	$21.60	$36.00	—	64% below	40%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 Hc Abo Type	$21.60	$36.00	—	—	40%
Blood urea nitrogen (BUN) test CPT 84520 Hc Poc Urea Nitrogen Quant	$33.00	$55.00	—	41% above	40%
Blood urea nitrogen (BUN) test CPT 84520 Hc Urea Nitrogen - Quant (Bun)	$33.00	$55.00	—	41% above	40%
Blood urea nitrogen (BUN) test inpatient CPT 84520 Hc Poc Urea Nitrogen Quant	$33.00	$55.00	—	—	40%
Blood urea nitrogen (BUN) test inpatient CPT 84520 Hc Urea Nitrogen - Quant (Bun)	$33.00	$55.00	—	—	40%
C-peptide blood test CPT 84681 Hc C-Peptide Serum	$176.40	$294.00	—	123% above	40%
C-peptide blood test inpatient CPT 84681 Hc C-Peptide Serum	$176.40	$294.00	—	—	40%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 Hc C Reactive Protein	$51.60	$86.00	—	3% above	40%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 Hc C Reactive Protein	$51.60	$86.00	—	—	40%
C. difficile toxin gene test (stool PCR) CPT 87493 Hc C.Diff Dna Amplification	$342.00	$570.00	—	162% above	40%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 Hc C.Diff Dna Amplification	$342.00	$570.00	—	—	40%
CA 19-9 blood test (tumor marker) CPT 86301 Hc Ca19-9 Carbohydrate Antig	$141.60	$236.00	—	94% above	40%
CA 19-9 blood test (tumor marker) inpatient CPT 86301 Hc Ca19-9 Carbohydrate Antig	$141.60	$236.00	—	—	40%
CA-125 blood test (ovarian cancer marker) CPT 86304 Hc Ca-125 (Cancer Antigen)	$141.60	$236.00	—	51% above	40%
CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 Hc Ca-125 (Cancer Antigen)	$141.60	$236.00	—	—	40%
Calcium blood test, total CPT 82310 Hc Calcium Serum	$42.60	$71.00	—	35% above	40%
Calcium blood test, total inpatient CPT 82310 Hc Calcium Serum	$42.60	$71.00	—	—	40%
Carcinoembryonic antigen (CEA) test CPT 82378 Hc Cea (Carcinoembryonic Antigen)	$160.80	$268.00	—	85% above	40%
Carcinoembryonic antigen (CEA) test inpatient CPT 82378 Hc Cea (Carcinoembryonic Antigen)	$160.80	$268.00	—	—	40%
Chickenpox (varicella) immunity blood test CPT 86787 Hc Varicella Zoster Ab	$126.60	$211.00	—	119% above	40%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 Hc Varicella Zoster Ab	$126.60	$211.00	—	—	40%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Hc Chlamydia - Dna Probe	$336.60	$561.00	—	264% above	40%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 Hc Chlamydia - Dna Probe	$336.60	$561.00	—	—	40%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Hc Lipid Profile	$163.80	$273.00	—	210% above	40%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 Hc Lipid Profile	$163.80	$273.00	—	—	40%
Complete blood count (CBC) with differential CPT 85025 Hc Cbc W. Differential - Automated	$81.00	$135.00	—	123% above	40%
Complete blood count (CBC) with differential inpatient CPT 85025 Hc Cbc W. Differential - Automated	$81.00	$135.00	—	—	40%
Complete blood count (CBC), no differential CPT 85027 Hc Cbc W/O Differential	$67.20	$112.00	—	98% above	40%
Complete blood count (CBC), no differential inpatient CPT 85027 Hc Cbc W/O Differential	$67.20	$112.00	—	—	40%
Comprehensive metabolic panel (blood test) CPT 80053 Hc Comprehensive Metabolic	$135.60	$226.00	—	113% above	40%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 Hc Comprehensive Metabolic	$135.60	$226.00	—	—	40%
Cortisol blood test, total CPT 82533 Hc Cortisol	$135.60	$226.00	—	87% above	40%
Cortisol blood test, total inpatient CPT 82533 Hc Cortisol	$135.60	$226.00	—	—	40%
Creatine kinase (CK) blood test, total CPT 82550 Hc Ck (Cpk)	$55.20	$92.00	—	56% above	40%
Creatine kinase (CK) blood test, total inpatient CPT 82550 Hc Ck (Cpk)	$55.20	$92.00	—	—	40%
Creatinine blood test CPT 82565 Hc Creatinine Serum	$42.60	$71.00	—	72% above	40%
Creatinine blood test CPT 82565 Hc Poc Creatinine	$42.60	$71.00	—	72% above	40%
Creatinine blood test inpatient CPT 82565 Hc Poc Creatinine	$42.60	$71.00	—	—	40%
Creatinine blood test inpatient CPT 82565 Hc Creatinine Serum	$42.60	$71.00	—	—	40%
Cytomegalovirus (CMV) antibody test CPT 86644 Hc Cytomegalovirus Igg	$141.60	$236.00	—	106% above	40%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 Hc Cytomegalovirus Igg	$141.60	$236.00	—	—	40%
D-dimer blood test (blood clot marker) CPT 85379 Hc D Dimer; Quantitative	$86.40	$144.00	—	24% above	40%
D-dimer blood test (blood clot marker) inpatient CPT 85379 Hc D Dimer; Quantitative	$86.40	$144.00	—	—	40%
DHEA sulfate (DHEA-S) blood test CPT 82627 Hc Dhea Sulfate Serum	$187.20	$312.00	—	88% above	40%
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 Hc Dhea Sulfate Serum	$187.20	$312.00	—	—	40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Hc Drug Test Prsmv Chem Anlyzr	$247.80	$413.00	—	159% above	40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Hc Drug Test Prsmv Chem Anlyzr	$247.80	$413.00	—	—	40%
Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 Hc Electrolyte Profile 2	$58.20	$97.00	—	22% above	40%
Electrolyte panel (sodium, potassium, chloride, CO2) inpatient CPT 80051 Hc Electrolyte Profile 2	$58.20	$97.00	—	—	40%
Epstein-Barr virus (EBV) antibody test CPT 86665 Hc Epstein-Barr Viral Capsid	$136.80	$228.00	—	110% above	40%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 Hc Epstein-Barr Viral Capsid	$136.80	$228.00	—	—	40%
Estradiol blood test CPT 82670 Hc Estradiol	$235.20	$392.00	—	110% above	40%
Estradiol blood test inpatient CPT 82670 Hc Estradiol	$235.20	$392.00	—	—	40%
FSH (follicle-stimulating hormone) test CPT 83001 Hc Fsh - Serum	$157.80	$263.00	—	84% above	40%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 Hc Fsh - Serum	$157.80	$263.00	—	—	40%
Fecal calprotectin (stool inflammation test) CPT 83993 Hc Calprotectin Fecal	$138.00	$230.00	—	8% below	40%
Fecal calprotectin (stool inflammation test) inpatient CPT 83993 Hc Calprotectin Fecal	$138.00	$230.00	—	—	40%
Ferritin blood test (iron stores) CPT 82728 Hc Ferritin	$115.20	$192.00	—	51% above	40%
Ferritin blood test (iron stores) inpatient CPT 82728 Hc Ferritin	$115.20	$192.00	—	—	40%
Fibrinogen blood test CPT 85384 Hc Fibrinogen	$88.20	$147.00	—	96% above	40%
Fibrinogen blood test inpatient CPT 85384 Hc Fibrinogen	$88.20	$147.00	—	—	40%
Folate (folic acid) blood test CPT 82746 Hc Folic Acid	$123.60	$206.00	—	83% above	40%
Folate (folic acid) blood test inpatient CPT 82746 Hc Folic Acid	$123.60	$206.00	—	—	40%
Free T3 thyroid hormone test CPT 84481 Hc T3 Free	$142.80	$238.00	—	88% above	40%
Free T3 thyroid hormone test inpatient CPT 84481 Hc T3 Free	$142.80	$238.00	—	—	40%
Free T4 (free thyroxine) thyroid blood test CPT 84439 Hc T4 - Free	$74.40	$124.00	—	75% above	40%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 Hc T4 - Free	$74.40	$124.00	—	—	40%
Free testosterone test CPT 84402 Hc Free Testosterone	$214.80	$358.00	—	121% above	40%
Free testosterone test inpatient CPT 84402 Hc Free Testosterone	$214.80	$358.00	—	—	40%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 Hc Ggtp (Gamma Glutamyl Transferase)	$62.40	$104.00	—	46% above	40%
Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 Hc Ggtp (Gamma Glutamyl Transferase)	$62.40	$104.00	—	—	40%
General health panel: metabolic panel, blood count and TSH in one order CPT 80050 Hc General Health Panel	$350.40	$584.00	—	58% above	40%
General health panel: metabolic panel, blood count and TSH in one order inpatient CPT 80050 Hc General Health Panel	$350.40	$584.00	—	—	40%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 Hc Gluc Postprand 1 Hr	$39.60	$66.00	—	3% above	40%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 Hc Gluc Postprand 2 Hr	$39.60	$66.00	—	3% above	40%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 Hc Gluc Postprand 2 Hr	$39.60	$66.00	—	—	40%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 Hc Gluc Postprand 1 Hr	$39.60	$66.00	—	—	40%
Glucose tolerance test, 3 samples CPT 82951 Hc Glucose Tolerance Test 2 Hrs-No 1/	$84.00	$140.00	—	25% above	40%
Glucose tolerance test, 3 samples CPT 82951 Hc Glucose Tolerance Test	$84.00	$140.00	—	25% above	40%
Glucose tolerance test, 3 samples inpatient CPT 82951 Hc Glucose Tolerance Test 2 Hrs-No 1/	$84.00	$140.00	—	—	40%
Glucose tolerance test, 3 samples inpatient CPT 82951 Hc Glucose Tolerance Test	$84.00	$140.00	—	—	40%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 Hc Gonorrhea Dna Probe	$336.60	$561.00	—	262% above	40%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 Hc Gonorrhea Dna Probe	$336.60	$561.00	—	—	40%
H. pylori antibody blood test CPT 86677 Hc Helicobactor Pylori	$142.80	$238.00	—	89% above	40%
H. pylori antibody blood test inpatient CPT 86677 Hc Helicobactor Pylori	$142.80	$238.00	—	—	40%
H. pylori stool antigen test CPT 87338 Hc Helicobacter Pylori Antigen	$162.60	$271.00	—	133% above	40%
H. pylori stool antigen test inpatient CPT 87338 Hc Helicobacter Pylori Antigen	$162.60	$271.00	—	—	40%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 Hc Hiv Quant By Pcr	$817.20	$1,362.00	—	128% above	40%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 Hc Hiv Quant By Pcr	$817.20	$1,362.00	—	—	40%
HIV-1 and HIV-2 antibody test CPT 86703 Hc Hiv 1/2 Antibody Scrn W/Reflex Wb	$135.00	$225.00	—	119% above	40%
HIV-1 and HIV-2 antibody test inpatient CPT 86703 Hc Hiv 1/2 Antibody Scrn W/Reflex Wb	$135.00	$225.00	—	—	40%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 Hc Hiv-1 Ag W/Hiv-1 & Hiv-2 Ab	$169.20	$282.00	—	128% above	40%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 Hc Hiv-1 Ag W/Hiv-1 & Hiv-2 Ab	$169.20	$282.00	—	—	40%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 Hc Poc Glycosylated (Hgb A1C)	$80.40	$134.00	—	76% above	40%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 Hc Glycohemoglogin (Hgb A1C)	$80.40	$134.00	—	76% above	40%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 Hc Glycohemoglogin (Hgb A1C)	$80.40	$134.00	—	—	40%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 Hc Poc Glycosylated (Hgb A1C)	$80.40	$134.00	—	—	40%
Hemoglobin blood test CPT 85018 Hc Hemoglobin	$25.80	$43.00	—	59% above	40%
Hemoglobin blood test CPT 85018 Hc Poc Hemoglobin	$25.80	$43.00	—	59% above	40%
Hemoglobin blood test inpatient CPT 85018 Hc Hemoglobin	$25.80	$43.00	—	—	40%
Hemoglobin blood test inpatient CPT 85018 Hc Poc Hemoglobin	$25.80	$43.00	—	—	40%
Hepatitis B core antibody test (total) CPT 86704 Hc Hepatitis B Core Antibody	$118.80	$198.00	—	120% above	40%
Hepatitis B core antibody test (total) inpatient CPT 86704 Hc Hepatitis B Core Antibody	$118.80	$198.00	—	—	40%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 Hc Hepatitis B Surface Antibody	$105.60	$176.00	—	118% above	40%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 Hc Hepatitis B Surface Antibody	$105.60	$176.00	—	—	40%
Hepatitis B surface antigen (HBsAg) test CPT 87340 Hc Hepatitis B Surface Antigen	$88.80	$148.00	—	88% above	40%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 Hc Hepatitis B Surface Antigen	$88.80	$148.00	—	—	40%
Hepatitis C antibody blood test (screening) CPT 86803 Hc Hepatitis C Antibody	$130.80	$218.00	—	104% above	40%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 Hc Hepatitis C Antibody	$130.80	$218.00	—	—	40%
Hepatitis C viral load (HCV RNA) test CPT 87522 Hc Hep C Quantification	$409.80	$683.00	—	113% above	40%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 Hc Hep C Quantification	$409.80	$683.00	—	—	40%
Herpes blood test, HSV-1 antibody CPT 86695 Hc Hsv Type 1 Ab Igg	$130.80	$218.00	—	121% above	40%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 Hc Hsv Type 1 Ab Igg	$130.80	$218.00	—	—	40%
Herpes blood test, HSV-2 antibody CPT 86696 Hc Herpes Simplex Type 2	$191.40	$319.00	—	189% above	40%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 Hc Herpes Simplex Type 2	$191.40	$319.00	—	—	40%
High-sensitivity CRP (hs-CRP) test CPT 86141 Hc Crp High Sensitivity	$127.20	$212.00	—	88% above	40%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 Hc Crp High Sensitivity	$127.20	$212.00	—	—	40%
Homocysteine blood test CPT 83090 Hc Homocysteine	$142.80	$238.00	—	77% above	40%
Homocysteine blood test inpatient CPT 83090 Hc Homocysteine	$142.80	$238.00	—	—	40%
Insulin blood test CPT 83525 Hc Insulin Total	$95.40	$159.00	—	86% above	40%
Insulin blood test inpatient CPT 83525 Hc Insulin Total	$95.40	$159.00	—	—	40%
Iron blood test (serum iron) CPT 83540 Hc Iron	$54.00	$90.00	—	42% above	40%
Iron blood test (serum iron) inpatient CPT 83540 Hc Iron	$54.00	$90.00	—	—	40%
Iron-binding capacity (TIBC) test CPT 83550 Hc Iron Binding Capacity	$73.20	$122.00	—	88% above	40%
Iron-binding capacity (TIBC) test inpatient CPT 83550 Hc Iron Binding Capacity	$73.20	$122.00	—	—	40%
Kidney function blood test panel CPT 80069 Hc Renal Function Panel	$111.00	$185.00	—	54% above	40%
Kidney function blood test panel inpatient CPT 80069 Hc Renal Function Panel	$111.00	$185.00	—	—	40%
LH (luteinizing hormone) test CPT 83002 Hc Luteinizing Hormone (Lh)	$157.20	$262.00	—	65% above	40%
LH (luteinizing hormone) test inpatient CPT 83002 Hc Luteinizing Hormone (Lh)	$157.20	$262.00	—	—	40%
Lactate (lactic acid) blood test CPT 83605 Hc Lactic Acid Blood (Lactate)	$90.00	$150.00	—	73% above	40%
Lactate (lactic acid) blood test inpatient CPT 83605 Hc Lactic Acid Blood (Lactate)	$90.00	$150.00	—	—	40%
Lactate dehydrogenase (LDH) blood test CPT 83615 Hc Ldh - Total	$51.60	$86.00	—	89% above	40%
Lactate dehydrogenase (LDH) blood test CPT 83615 Hc Ldh Csf	$51.60	$86.00	—	89% above	40%
Lactate dehydrogenase (LDH) blood test CPT 83615 Hc Ldh Serum	$51.60	$86.00	—	89% above	40%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 Hc Ldh Csf	$51.60	$86.00	—	—	40%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 Hc Ldh - Total	$51.60	$86.00	—	—	40%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 Hc Ldh Serum	$51.60	$86.00	—	—	40%
Lipase blood test (pancreas enzyme) CPT 83690 Hc Lipase	$58.20	$97.00	—	at median	40%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 Hc Lipase	$58.20	$97.00	—	—	40%
Liver function blood test panel CPT 80076 Hc Hepatic Panel	$81.00	$135.00	—	34% above	40%
Liver function blood test panel inpatient CPT 80076 Hc Hepatic Panel	$81.00	$135.00	—	—	40%
Lyme disease antibody test CPT 86618 Hc Lyme Disease	$168.60	$281.00	—	120% above	40%
Lyme disease antibody test inpatient CPT 86618 Hc Lyme Disease	$168.60	$281.00	—	—	40%
Magnesium blood test CPT 83735 Hc Magnesium Serum	$50.40	$84.00	—	49% above	40%
Magnesium blood test CPT 83735 Hc Magnesium Urine	$50.40	$84.00	—	49% above	40%
Magnesium blood test inpatient CPT 83735 Hc Magnesium Serum	$50.40	$84.00	—	—	40%
Magnesium blood test inpatient CPT 83735 Hc Magnesium Urine	$50.40	$84.00	—	—	40%
Measles (rubeola) antibody test CPT 86765 Hc Rubeola Antibody	$126.60	$211.00	—	122% above	40%
Measles (rubeola) antibody test inpatient CPT 86765 Hc Rubeola Antibody	$126.60	$211.00	—	—	40%
Mono test (heterophile antibody, Monospot) CPT 86308 Hc Mono Test	$51.60	$86.00	—	3% below	40%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 Hc Mono Test	$51.60	$86.00	—	—	40%
Mumps immunity blood test CPT 86735 Hc Mumps	$127.20	$212.00	—	117% above	40%
Mumps immunity blood test inpatient CPT 86735 Hc Mumps	$127.20	$212.00	—	—	40%
Obstetric blood test panel CPT 80055 Hc Obstetric Panel	$441.00	$735.00	—	106% above	40%
Obstetric blood test panel inpatient CPT 80055 Hc Obstetric Panel	$441.00	$735.00	—	—	40%
PSA (prostate-specific antigen) blood test, free CPT 84154 Hc Psa Free Sendout	$155.40	$259.00	—	88% above	40%
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 Hc Psa Free Sendout	$155.40	$259.00	—	—	40%
PSA (prostate-specific antigen) blood test, total CPT 84153 Hc Prostatic Specific Antigen (Psa)	$155.40	$259.00	—	97% above	40%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 Hc Prostatic Specific Antigen (Psa)	$155.40	$259.00	—	—	40%
Pap test (liquid-based, automated screening with review) CPT 88175 Hc Pap Liquid Base By Image Diag	$241.20	$402.00	—	147% above	40%
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 Hc Pap Liquid Base By Image Diag	$241.20	$402.00	—	—	40%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 Hc Pap Liquid Base Diagnostic	$279.60	$466.00	—	207% above	40%
Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 Hc Pap Liquid Base Diagnostic	$279.60	$466.00	—	—	40%
Parathyroid hormone (PTH) blood test CPT 83970 Hc Pth Intact	$346.80	$578.00	—	145% above	40%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 Hc Pth Intact	$346.80	$578.00	—	—	40%
Partial thromboplastin time (PTT) clotting test CPT 85730 Hc Partial Thromboplastin Time	$63.00	$105.00	—	68% above	40%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 Hc Partial Thromboplastin Time	$63.00	$105.00	—	—	40%
Phosphorus (phosphate) blood test CPT 84100 Hc Phosphorus Serum	$39.60	$66.00	—	11% above	40%
Phosphorus (phosphate) blood test inpatient CPT 84100 Hc Phosphorus Serum	$39.60	$66.00	—	—	40%
Potassium blood test CPT 84132 Hc Potassium Serum	$39.00	$65.00	—	67% above	40%
Potassium blood test CPT 84132 Hc Poc Potassium	$39.00	$65.00	—	67% above	40%
Potassium blood test inpatient CPT 84132 Hc Poc Potassium	$39.00	$65.00	—	—	40%
Potassium blood test inpatient CPT 84132 Hc Potassium Serum	$39.00	$65.00	—	—	40%
Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) CPT 81420 Hc Sequenom Maternit21 Plus	$806.40	$1,344.00	—	45% below	40%
Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) CPT 81420 Hc Labcorp Maternit21 Plus81420	$923.40	$1,539.00	—	37% below	40%
Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) CPT 81420 Hc Labcorp Maternit Genome81420	$923.40	$1,539.00	—	37% below	40%
Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) inpatient CPT 81420 Hc Sequenom Maternit21 Plus	$806.40	$1,344.00	—	—	40%
Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) inpatient CPT 81420 Hc Labcorp Maternit21 Plus81420	$923.40	$1,539.00	—	—	40%
Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) inpatient CPT 81420 Hc Labcorp Maternit Genome81420	$923.40	$1,539.00	—	—	40%
Progesterone blood test CPT 84144 Hc Progesterone - Diag	$162.00	$270.00	—	100% above	40%
Progesterone blood test inpatient CPT 84144 Hc Progesterone - Diag	$162.00	$270.00	—	—	40%
Prolactin blood test CPT 84146 Hc Prolactin	$163.80	$273.00	—	88% above	40%
Prolactin blood test inpatient CPT 84146 Hc Prolactin	$163.80	$273.00	—	—	40%
Prothrombin time (PT/INR) clotting test CPT 85610 Hc Prothrombin Time	$39.60	$66.00	—	65% above	40%
Prothrombin time (PT/INR) clotting test CPT 85610 Hc Poc Prothrombin Time Inr Poc	$39.60	$66.00	—	65% above	40%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 Hc Prothrombin Time	$39.60	$66.00	—	—	40%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 Hc Poc Prothrombin Time Inr Poc	$39.60	$66.00	—	—	40%
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 Hc Drug Test Prsmv Dir Opt Obs	$46.20	$77.00	—	20% below	40%
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 Hc Drug Test Prsmv Read Direct Optical Obs Pr Date	$116.40	$194.00	—	101% above	40%
Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 Hc Drug Test Prsmv Dir Opt Obs	$46.20	$77.00	—	—	40%
Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 Hc Drug Test Prsmv Read Direct Optical Obs Pr Date	$116.40	$194.00	—	—	40%
Rapid flu test (influenza antigen) CPT 87804 Hc Rapid Influenza A	$115.20	$192.00	—	75% above	40%
Rapid flu test (influenza antigen) inpatient CPT 87804 Hc Rapid Influenza A	$115.20	$192.00	—	—	40%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 Hc Streptococcus Group A	$115.20	$192.00	—	101% above	40%
Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 Hc Streptococcus Group A	$115.20	$192.00	—	—	40%
Renin blood test CPT 84244 Hc Renin Activity S/O	$148.20	$247.00	—	73% above	40%
Renin blood test inpatient CPT 84244 Hc Renin Activity S/O	$148.20	$247.00	—	—	40%
Rh blood typing CPT 86901 Hc Rh	$21.60	$36.00	—	42% below	40%
Rh blood typing inpatient CPT 86901 Hc Rh	$21.60	$36.00	—	—	40%
Rheumatoid factor (RF) test CPT 86431 Hc Rheumatoid Factor Quant	$56.40	$94.00	—	70% above	40%
Rheumatoid factor (RF) test inpatient CPT 86431 Hc Rheumatoid Factor Quant	$56.40	$94.00	—	—	40%
Rubella antibody test (immunity check) CPT 86762 Hc Rubella Antibody	$141.60	$236.00	—	188% above	40%
Rubella antibody test (immunity check) inpatient CPT 86762 Hc Rubella Antibody	$141.60	$236.00	—	—	40%
Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 Hc Sedimentation Rate (Esr)	$28.80	$48.00	—	24% below	40%
Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 Hc Sedimentation Rate (Esr)	$28.80	$48.00	—	—	40%
Sodium blood test CPT 84295 Hc Sodium Serum	$40.80	$68.00	—	50% above	40%
Sodium blood test CPT 84295 Hc Poc Sodium	$40.80	$68.00	—	50% above	40%
Sodium blood test inpatient CPT 84295 Hc Poc Sodium	$40.80	$68.00	—	—	40%
Sodium blood test inpatient CPT 84295 Hc Sodium Serum	$40.80	$68.00	—	—	40%
Stool ova and parasites exam CPT 87177 Hc Ova & Parasite	$85.80	$143.00	—	116% above	40%
Stool ova and parasites exam inpatient CPT 87177 Hc Ova & Parasite	$85.80	$143.00	—	—	40%
Stool test for hidden blood (guaiac FOBT) CPT 82270 Hc Occult Blood Stool Screening	$28.80	$48.00	—	at median	40%
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 Hc Occult Blood Stool Screening	$28.80	$48.00	—	—	40%
Stool test for hidden blood by immunoassay (FIT) CPT 82274 Hc Fecal Globin Insure Medicare	$134.40	$224.00	—	151% above	40%
Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 Hc Fecal Globin Insure Medicare	$134.40	$224.00	—	—	40%
Syphilis antibody test (Treponema pallidum) CPT 86780 Hc Antibody Treponema Pallidum	$130.80	$218.00	—	126% above	40%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 Hc Antibody Treponema Pallidum	$130.80	$218.00	—	—	40%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 Hc Rpr Qualitative	$42.00	$70.00	—	76% above	40%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 Hc Rpr Qualitative	$42.00	$70.00	—	—	40%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 Hc Quantiferon Tb Gold	$611.40	$1,019.00	—	422% above	40%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 Hc Quantiferon Tb Gold	$611.40	$1,019.00	—	—	40%
Testosterone blood test, total (not free testosterone) CPT 84403 Hc Total Testosterone	$171.60	$286.00	—	86% above	40%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 Hc Total Testosterone	$171.60	$286.00	—	—	40%
Thyroid peroxidase (TPO) antibody test CPT 86376 Hc Microsomal Antibodies Each	$144.60	$241.00	—	122% above	40%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 Hc Microsomal Antibodies Each	$144.60	$241.00	—	—	40%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 Hc Tsh (Thyroid Stimulating Hormone)	$141.00	$235.00	—	88% above	40%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 Hc Tsh (Thyroid Stimulating Hormone)	$141.00	$235.00	—	—	40%
Total IgE blood test CPT 82785 Hc Ige Total	$139.20	$232.00	—	125% above	40%
Total IgE blood test inpatient CPT 82785 Hc Ige Total	$139.20	$232.00	—	—	40%
Total cholesterol blood test CPT 82465 Hc Cholesterol	$36.60	$61.00	—	at median	40%
Total cholesterol blood test inpatient CPT 82465 Hc Cholesterol	$36.60	$61.00	—	—	40%
Total thyroxine (T4) blood test CPT 84436 Hc T4 - Total	$58.20	$97.00	—	39% above	40%
Total thyroxine (T4) blood test inpatient CPT 84436 Hc T4 - Total	$58.20	$97.00	—	—	40%
Total triiodothyronine (T3) blood test CPT 84480 Hc T3 Total	$120.00	$200.00	—	100% above	40%
Total triiodothyronine (T3) blood test inpatient CPT 84480 Hc T3 Total	$120.00	$200.00	—	—	40%
Transferrin blood test CPT 84466 Hc Transferrin	$100.80	$168.00	—	36% above	40%
Transferrin blood test inpatient CPT 84466 Hc Transferrin	$100.80	$168.00	—	—	40%
Trichomonas test (NAAT) CPT 87661 Hc Iadna Trichomonas Vaginalis Amplified Probe Tech	$133.20	$222.00	—	54% above	40%
Trichomonas test (NAAT) inpatient CPT 87661 Hc Iadna Trichomonas Vaginalis Amplified Probe Tech	$133.20	$222.00	—	—	40%
Triglycerides blood test CPT 84478 Hc Triglyceride	$50.40	$84.00	—	46% above	40%
Triglycerides blood test inpatient CPT 84478 Hc Triglyceride	$50.40	$84.00	—	—	40%
Troponin test, quantitative CPT 84484 Hc Poc Troponin	$84.00	$140.00	—	at median	40%
Troponin test, quantitative CPT 84484 Hc Troponin I	$84.00	$140.00	—	at median	40%
Troponin test, quantitative inpatient CPT 84484 Hc Troponin I	$84.00	$140.00	—	—	40%
Troponin test, quantitative inpatient CPT 84484 Hc Poc Troponin	$84.00	$140.00	—	—	40%
Uric acid blood test CPT 84550 Hc Uric Acid	$39.00	$65.00	—	11% above	40%
Uric acid blood test inpatient CPT 84550 Hc Uric Acid	$39.00	$65.00	—	—	40%
Urinalysis with microscope exam, automated CPT 81001 Hc Urinalysis W/ Microscopic	$42.60	$71.00	—	58% above	40%
Urinalysis with microscope exam, automated inpatient CPT 81001 Hc Urinalysis W/ Microscopic	$42.60	$71.00	—	—	40%
Urinalysis with microscope exam, manual CPT 81000 Hc Urinalysis Nonauto W Scope	$42.60	$71.00	—	134% above	40%
Urinalysis with microscope exam, manual inpatient CPT 81000 Hc Urinalysis Nonauto W Scope	$42.60	$71.00	—	—	40%
Urinalysis without microscope exam, automated CPT 81003 Hc Poc Urinalysis	$33.00	$55.00	—	41% above	40%
Urinalysis without microscope exam, automated CPT 81003 Hc Urinalysis W/O Microscopic	$33.00	$55.00	—	41% above	40%
Urinalysis without microscope exam, automated inpatient CPT 81003 Hc Urinalysis W/O Microscopic	$33.00	$55.00	—	—	40%
Urinalysis without microscope exam, automated inpatient CPT 81003 Hc Poc Urinalysis	$33.00	$55.00	—	—	40%
Urinalysis without microscope exam, manual CPT 81002 Hc Urine Dipstick Without Microscopy	$33.60	$56.00	—	107% above	40%
Urinalysis without microscope exam, manual CPT 81002 Hc Poc Urinalysis By Dipstick	$33.60	$56.00	—	107% above	40%
Urinalysis without microscope exam, manual inpatient CPT 81002 Hc Poc Urinalysis By Dipstick	$33.60	$56.00	—	—	40%
Urinalysis without microscope exam, manual inpatient CPT 81002 Hc Urine Dipstick Without Microscopy	$33.60	$56.00	—	—	40%
Urine culture for bacteria, with colony count CPT 87086 Hc Culture Urine	$76.80	$128.00	—	35% above	40%
Urine culture for bacteria, with colony count inpatient CPT 87086 Hc Culture Urine	$76.80	$128.00	—	—	40%
Urine microalbumin (albumin) test CPT 82043 Hc Micro Albumin	$50.40	$84.00	—	1% below	40%
Urine microalbumin (albumin) test inpatient CPT 82043 Hc Micro Albumin	$50.40	$84.00	—	—	40%
Urine pregnancy test, read by color change CPT 81025 Hc Hcg Qual Urine Pregnancy	$87.00	$145.00	—	79% above	40%
Urine pregnancy test, read by color change CPT 81025 Hc Urine Preg Test/Visual Color Comparison	$87.00	$145.00	—	79% above	40%
Urine pregnancy test, read by color change CPT 81025 Hc Poc Hcg Qual Urine	$87.00	$145.00	—	79% above	40%
Urine pregnancy test, read by color change inpatient CPT 81025 Hc Urine Preg Test/Visual Color Comparison	$87.00	$145.00	—	—	40%
Urine pregnancy test, read by color change inpatient CPT 81025 Hc Poc Hcg Qual Urine	$87.00	$145.00	—	—	40%
Urine pregnancy test, read by color change inpatient CPT 81025 Hc Hcg Qual Urine Pregnancy	$87.00	$145.00	—	—	40%
Vitamin B12 (cobalamin) blood test CPT 82607 Hc Vitamin B12	$125.40	$209.00	—	69% above	40%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 Hc Vitamin B12	$125.40	$209.00	—	—	40%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 Hc Vitamin D 25 Hydroxy (Cal	$250.20	$417.00	—	165% above	40%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 Hc Vitamin D 25 Hydroxy (Cal	$250.20	$417.00	—	—	40%
Vitamin D, 1,25-dihydroxy blood test CPT 82652 Hc Dihydroxyvitamin D	$324.00	$540.00	—	110% above	40%
Vitamin D, 1,25-dihydroxy blood test inpatient CPT 82652 Hc Dihydroxyvitamin D	$324.00	$540.00	—	—	40%
Zinc blood test CPT 84630 Hc Zinc Serum	$95.40	$159.00	—	86% above	40%
Zinc blood test inpatient CPT 84630 Hc Zinc Serum	$95.40	$159.00	—	—	40%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 Hc B-Hcg Tumor	$125.40	$209.00	—	86% above	40%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 Hc Hcg Quantitative	$125.40	$209.00	—	86% above	40%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 Hc B-Hcg Tumor	$125.40	$209.00	—	—	40%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 Hc Hcg Quantitative	$125.40	$209.00	—	—	40%

Surgery and procedures

Procedure	Cash price	List price	Insurers pay	vs Ohio	Off list
Balloon dilation of the maxillary sinus opening, one side CPT 31295 Hc Max Sinus Endo W/Balloon Dil	$19,625.40	$32,709.00	—	at median	40%
Balloon dilation of the maxillary sinus opening, one side inpatient CPT 31295 Hc Max Sinus Endo W/Balloon Dil	$19,625.40	$32,709.00	—	—	40%
Botox injections for chronic migraine CPT 64615 Hc Chemodenercation Of Muscle(S)	$1,218.00	$2,030.00	—	120% above	40%
Botox injections for chronic migraine inpatient CPT 64615 Hc Chemodenercation Of Muscle(S)	$1,218.00	$2,030.00	—	—	40%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion CPT 19081 Hc Mammo Bx W Clip Lesion Stereo Loc	$4,008.60	$6,681.00	—	at median	40%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion inpatient CPT 19081 Hc Mammo Bx W Clip Lesion Stereo Loc	$4,008.60	$6,681.00	—	—	40%
Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 Hc Closed Rx Dist Fibula Fx	$1,305.60	$2,176.00	—	245% above	40%
Broken ankle (outer ankle bone) treatment without surgery or setting inpatient CPT 27786 Hc Closed Rx Dist Fibula Fx	$1,305.60	$2,176.00	—	—	40%
Broken foot (metatarsal) treatment without surgery or setting CPT 28470 Hc Closed Rx Metatarsal Fx	$1,248.60	$2,081.00	—	243% above	40%
Broken foot (metatarsal) treatment without surgery or setting inpatient CPT 28470 Hc Closed Rx Metatarsal Fx	$1,248.60	$2,081.00	—	—	40%
Cardiac catheterization with coronary angiogram CPT 93458 Hc Coronary & Lhc +/- Lv Gram	$14,577.60	$24,296.00	—	21% above	40%
Cardiac catheterization with coronary angiogram inpatient CPT 93458 Hc Coronary & Lhc +/- Lv Gram	$14,577.60	$24,296.00	—	—	40%
Cardioversion, elective (restoring heart rhythm) CPT 92960 Hc Cardioversion Elective External	$5,331.60	$8,886.00	—	159% above	40%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 Hc Cardioversion Elective External	$5,331.60	$8,886.00	—	—	40%
Carpal tunnel release, open surgery CPT 64721 Hc Carpal Tunnel Surgery	$7,135.80	$11,893.00	—	14% below	40%
Carpal tunnel release, open surgery inpatient CPT 64721 Hc Carpal Tunnel Surgery	$7,135.80	$11,893.00	—	—	40%
Catheter ablation for atrial fibrillation CPT 93656 Hc Ablation A Fib Eps Transseptal La Record	$27,778.80	$46,298.00	—	18% below	40%
Catheter ablation for atrial fibrillation inpatient CPT 93656 Hc Ablation A Fib Eps Transseptal La Record	$27,778.80	$46,298.00	—	—	40%
Cervical biopsy CPT 57500 Hc Bx Cervix	$2,322.60	$3,871.00	—	33% above	40%
Cervical biopsy inpatient CPT 57500 Hc Bx Cervix	$2,322.60	$3,871.00	—	—	40%
Circumcision by surgical excision, older than 28 days (children and adults) CPT 54161 Hc Circumcision > 28 Days Old	$9,735.00	$16,225.00	—	59% above	40%
Circumcision by surgical excision, older than 28 days (children and adults) inpatient CPT 54161 Hc Circumcision > 28 Days Old	$9,735.00	$16,225.00	—	—	40%
Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 Hc Circumcision General Newborn	$2,962.80	$4,938.00	—	68% above	40%
Circumcision with a clamp or device and a numbing nerve block, usually newborns inpatient CPT 54150 Hc Circumcision General Newborn	$2,962.80	$4,938.00	—	—	40%
Circumcision, surgical, older than a newborn CPT 54160 Hc Circumcision Neonate	$1,372.80	$2,288.00	—	31% below	40%
Circumcision, surgical, older than a newborn inpatient CPT 54160 Hc Circumcision Neonate	$1,372.80	$2,288.00	—	—	40%
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 Hc Closed Rx Dist Rad/Ulna Fx	$1,337.40	$2,229.00	—	227% above	40%
Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 Hc Closed Rx Dist Rad/Ulna Fx	$1,337.40	$2,229.00	—	—	40%
Colonoscopy with polyp removal CPT 45385 Hc Colsc Flx W/Rmvl Of Tumor Polyp Lesion Snare Tq	$3,163.20	$5,272.00	—	5% below	40%
Colonoscopy with polyp removal inpatient CPT 45385 Hc Colsc Flx W/Rmvl Of Tumor Polyp Lesion Snare Tq	$3,163.20	$5,272.00	—	—	40%
Colonoscopy, diagnostic CPT 45378 Hc Colonoscopy Flx Dx W/Collj Spec When Pfrmd	$2,636.40	$4,394.00	—	3% below	40%
Colonoscopy, diagnostic inpatient CPT 45378 Hc Colonoscopy Flx Dx W/Collj Spec When Pfrmd	$2,636.40	$4,394.00	—	—	40%
Colposcopy with LEEP (loop electrosurgical excision) CPT 57460 Hc Colpo Crvx W/Loop Electrode Biopsy	$5,511.00	$9,185.00	—	42% above	40%
Colposcopy with LEEP (loop electrosurgical excision) inpatient CPT 57460 Hc Colpo Crvx W/Loop Electrode Biopsy	$5,511.00	$9,185.00	—	—	40%
Colposcopy with cervical biopsy and scraping of the cervical canal CPT 57454 Hc Colposcopy Crvx With Biopsy & Ecc	$1,228.80	$2,048.00	—	35% above	40%
Colposcopy with cervical biopsy and scraping of the cervical canal inpatient CPT 57454 Hc Colposcopy Crvx With Biopsy & Ecc	$1,228.80	$2,048.00	—	—	40%
Coronary stent placement, one artery CPT 92928 Hc Bms	$10,285.20	$17,142.00	—	20% below	40%
Coronary stent placement, one artery inpatient CPT 92928 Hc Bms	$10,285.20	$17,142.00	—	—	40%
Cystoscopy with ureteral stent placement CPT 52332 Hc Cysto W/Insert Ureteral Stent	$6,241.20	$10,402.00	—	37% below	40%
Cystoscopy with ureteral stent placement inpatient CPT 52332 Hc Cysto W/Insert Ureteral Stent	$6,241.20	$10,402.00	—	—	40%
Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 Hc Cystoscopy	$4,509.00	$7,515.00	—	126% above	40%
Cystoscopy, diagnostic look inside the bladder and urethra inpatient CPT 52000 Hc Cystoscopy	$4,509.00	$7,515.00	—	—	40%
D&C (dilation and curettage), not related to pregnancy CPT 58120 Hc Dilation/Curettage Diagnostic	$7,203.00	$12,005.00	—	3% above	40%
D&C (dilation and curettage), not related to pregnancy inpatient CPT 58120 Hc Dilation/Curettage Diagnostic	$7,203.00	$12,005.00	—	—	40%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 Hc Destr Lesn Premal 1St Any Method	$375.60	$626.00	—	86% above	40%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 Hc Destr Lesn Premal 1St Any Method	$375.60	$626.00	—	—	40%
Ear tube placement (tympanostomy) under general anesthesia, one ear CPT 69436 Hc Pe Tube Insertion W/ Anes	$7,738.80	$12,898.00	—	81% above	40%
Ear tube placement (tympanostomy) under general anesthesia, one ear inpatient CPT 69436 Hc Pe Tube Insertion W/ Anes	$7,738.80	$12,898.00	—	—	40%
Ear tube placement (tympanostomy) with local anesthesia, one ear one side CPT 69433 Hc Tympanostomy/Insert Ventilating Tube Rt	$4,757.40	$7,929.00	—	259% above	40%
Ear tube placement (tympanostomy) with local anesthesia, one ear inpatient one side CPT 69433 Hc Tympanostomy/Insert Ventilating Tube Rt	$4,757.40	$7,929.00	—	—	40%
Earwax removal by irrigation (rinsing), one ear CPT 69209 Hc Removal Impacted Ear Wax Uni	$313.80	$523.00	—	103% above	40%
Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 Hc Removal Impacted Ear Wax Uni	$313.80	$523.00	—	—	40%
Earwax removal with instruments, one ear CPT 69210 Hc Removal Impacted Cerumen	$490.20	$817.00	—	217% above	40%
Earwax removal with instruments, one ear inpatient CPT 69210 Hc Removal Impacted Cerumen	$490.20	$817.00	—	—	40%
Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 Hc Bx Endometrial	$1,180.20	$1,967.00	—	207% above	40%
Endometrial biopsy (uterine lining sample) without dilating the cervix inpatient CPT 58100 Hc Bx Endometrial	$1,180.20	$1,967.00	—	—	40%
Endoscopic sinus surgery: full ethmoid sinus opening CPT 31255 Hc Removal Of Ethmoid Sinus	$6,676.20	$11,127.00	—	49% below	40%
Endoscopic sinus surgery: full ethmoid sinus opening inpatient CPT 31255 Hc Removal Of Ethmoid Sinus	$6,676.20	$11,127.00	—	—	40%
Endoscopic sinus surgery: opening the frontal sinus CPT 31276 Hc Nasal/Sinus Ndsc W/Rmvl Tiss From Frontal Sinus	$6,551.40	$10,919.00	—	71% below	40%
Endoscopic sinus surgery: opening the frontal sinus inpatient CPT 31276 Hc Nasal/Sinus Ndsc W/Rmvl Tiss From Frontal Sinus	$6,551.40	$10,919.00	—	—	40%
Endoscopic sinus surgery: opening the maxillary (cheek) sinus CPT 31256 Hc Nasal/Sinus Endoscopy Open Maxill Sinus	$4,737.60	$7,896.00	—	55% below	40%
Endoscopic sinus surgery: opening the maxillary (cheek) sinus inpatient CPT 31256 Hc Nasal/Sinus Endoscopy Open Maxill Sinus	$4,737.60	$7,896.00	—	—	40%
Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 Hc Fluoro Inj Epidurography C Or T	$4,698.00	$7,830.00	—	110% above	40%
Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 Hc Fluoro Inj Epidurography C Or T	$4,698.00	$7,830.00	—	—	40%
Eye injection into the vitreous (intravitreal injection) CPT 67028 Hc Intravitreal Inject Pharmacologic Agent	$608.40	$1,014.00	—	55% above	40%
Eye injection into the vitreous (intravitreal injection) inpatient CPT 67028 Hc Intravitreal Inject Pharmacologic Agent	$608.40	$1,014.00	—	—	40%
Facet joint injection, lower back, one level, with imaging guidance CPT 64493 Hc Inj Facet L/S 1St Lvl	$6,522.71	$10,871.19	—	199% above	40%
Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 Hc Inj Facet L/S 1St Lvl	$6,522.71	$10,871.19	—	—	40%
Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 Hc Sigmoidoscopy Flx Dx W/Collj Spec Br/Wa If Pfrmd	$2,826.00	$4,710.00	—	10% above	40%
Flexible sigmoidoscopy, diagnostic (lower colon only) inpatient CPT 45330 Hc Sigmoidoscopy Flx Dx W/Collj Spec Br/Wa If Pfrmd	$2,826.00	$4,710.00	—	—	40%
Hemorrhoid banding (rubber band ligation) CPT 46221 Hc Hemorrhoidectomy Internal Rubber Band Ligations	$2,243.40	$3,739.00	—	17% above	40%
Hemorrhoid banding (rubber band ligation) inpatient CPT 46221 Hc Hemorrhoidectomy Internal Rubber Band Ligations	$2,243.40	$3,739.00	—	—	40%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 Hc Hysterosal Cath & Injection	$584.40	$974.00	—	53% above	40%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes inpatient CPT 58340 Hc Hysterosal Cath & Injection	$584.40	$974.00	—	—	40%
Hysteroscopy with endometrial ablation CPT 58563 Hc Hysteroscopy W/Endometrial Ablation	$10,350.60	$17,251.00	—	10% below	40%
Hysteroscopy with endometrial ablation inpatient CPT 58563 Hc Hysteroscopy W/Endometrial Ablation	$10,350.60	$17,251.00	—	—	40%
Hysteroscopy with uterine lining sampling and/or polyp removal CPT 58558 Hc Hysteroscopy Bx Endometrium & Polypc W/Wo	$8,112.60	$13,521.00	—	15% below	40%
Hysteroscopy with uterine lining sampling and/or polyp removal inpatient CPT 58558 Hc Hysteroscopy Bx Endometrium & Polypc W/Wo	$8,112.60	$13,521.00	—	—	40%
IUD insertion (the device itself billed separately) CPT 58300 Hc Insert Iud	$2,031.00	$3,385.00	—	303% above	40%
IUD insertion (the device itself billed separately) inpatient CPT 58300 Hc Insert Iud	$2,031.00	$3,385.00	—	—	40%
Incision and drainage of a simple or single skin abscess CPT 10060 Hc I&D Abscess Simple/Single	$1,256.40	$2,094.00	—	224% above	40%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 Hc I&D Abscess Simple/Single	$1,256.40	$2,094.00	—	—	40%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 Hc Inj Tendon Sheath Ligament	$1,335.73	$2,226.22	—	294% above	40%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 Hc Inj Tendon Sheath Ligament	$1,335.73	$2,226.22	—	—	40%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 Hc Arthrocentesis/Aspir/A/O Inj Major Jnt	$1,591.37	$2,652.29	—	129% above	40%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 Hc Arthrocentesis/Aspir/A/O Inj Major Jnt	$1,591.37	$2,652.29	—	—	40%
Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 Hc Insert Nonbio Drug Implant	$1,418.40	$2,364.00	—	276% above	40%
Insertion of a drug-delivery implant, such as the arm birth control implant inpatient CPT 11981 Hc Insert Nonbio Drug Implant	$1,418.40	$2,364.00	—	—	40%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 Hc Arthrocentesis/Asp/&/Or Inj Med Joint	$1,426.20	$2,377.00	—	131% above	40%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 Hc Arthrocentesis/Asp/&/Or Inj Med Joint	$1,426.20	$2,377.00	—	—	40%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 Hc Arthrocentesis/Asp/And/Or Inj Sm Jnt	$1,283.40	$2,139.00	—	160% above	40%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 Hc Arthrocentesis/Asp/And/Or Inj Sm Jnt	$1,283.40	$2,139.00	—	—	40%
Laser treatment of clouding after cataract surgery (YAG) CPT 66821 Hc Discission-2Nd Membranous Cataract W/Las	$2,448.00	$4,080.00	—	73% above	40%
Laser treatment of clouding after cataract surgery (YAG) inpatient CPT 66821 Hc Discission-2Nd Membranous Cataract W/Las	$2,448.00	$4,080.00	—	—	40%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 Hc Lyrd Wound Rep Scalp <2.6 Cm	$1,363.20	$2,272.00	—	156% above	40%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 Hc Lyrd Wound Rep Scalp <2.6 Cm	$1,363.20	$2,272.00	—	—	40%
Left heart catheterization, diagnostic CPT 93452 Hc Lhc +/- Lv Gram No Coronaries	$7,979.40	$13,299.00	—	14% below	40%
Left heart catheterization, diagnostic inpatient CPT 93452 Hc Lhc +/- Lv Gram No Coronaries	$7,979.40	$13,299.00	—	—	40%
Lower-back epidural injection, with imaging guidance CPT 62323 Hc Flouro Inj Epidurography Lumbar	$4,768.37	$7,947.28	—	134% above	40%
Lower-back epidural injection, with imaging guidance inpatient CPT 62323 Hc Flouro Inj Epidurography Lumbar	$4,768.37	$7,947.28	—	—	40%
Lower-back epidural injection, without imaging guidance CPT 62322 Hc Inj Interlaminar Lmbr/Sac W/O Gdn	$3,717.00	$6,195.00	—	129% above	40%
Lower-back epidural injection, without imaging guidance inpatient CPT 62322 Hc Inj Interlaminar Lmbr/Sac W/O Gdn	$3,717.00	$6,195.00	—	—	40%
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 Hc Nerve Block Lumbar/Sacral Single	$7,177.20	$11,962.00	—	246% above	40%
Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 Hc Nerve Block Lumbar/Sacral Single	$7,177.20	$11,962.00	—	—	40%
Lumbar spinal fusion (posterior), one level CPT 22612 Hc Arthrodesis Posterior/Pstlat Tq 1Ntrspc Lumbar	$22,794.00	$37,990.00	—	24% below	40%
Lumbar spinal fusion (posterior), one level inpatient CPT 22612 Hc Arthrodesis Posterior/Pstlat Tq 1Ntrspc Lumbar	$22,794.00	$37,990.00	—	—	40%
Miscarriage treatment with D&C, first trimester CPT 59820 Hc Tx Missed Abort 1St Trimester	$6,690.60	$11,151.00	—	6% below	40%
Miscarriage treatment with D&C, first trimester inpatient CPT 59820 Hc Tx Missed Abort 1St Trimester	$6,690.60	$11,151.00	—	—	40%
Mohs surgery for skin cancer, first stage, head, neck, hands, feet or genitals CPT 17311 Hc Mohs 1 Stage Head/Neck/Hand/Feet/Gential	$2,673.60	$4,456.00	—	122% above	40%
Mohs surgery for skin cancer, first stage, head, neck, hands, feet or genitals inpatient CPT 17311 Hc Mohs 1 Stage Head/Neck/Hand/Feet/Gential	$2,673.60	$4,456.00	—	—	40%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 Hc Exc Ben Lesn 0-.5 Cm Tal Incl Margins	$3,763.80	$6,273.00	—	179% above	40%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 Hc Exc Ben Lesn 0-.5 Cm Tal Incl Margins	$3,763.80	$6,273.00	—	—	40%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 Hc Exc Ben Lesn 0-.5Cm Feenl Incl Margins	$3,048.60	$5,081.00	—	122% above	40%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 Hc Exc Ben Lesn 0-.5Cm Feenl Incl Margins	$3,048.60	$5,081.00	—	—	40%
Nail removal (partial or complete), one nail CPT 11730 Hc Avulsion Nail Plate Part/Complete Sing	$1,180.80	$1,968.00	—	270% above	40%
Nail removal (partial or complete), one nail inpatient CPT 11730 Hc Avulsion Nail Plate Part/Complete Sing	$1,180.80	$1,968.00	—	—	40%
Occipital nerve block (injection for headaches) CPT 64405 Hc Greater Occipital Nerve Block	$2,586.60	$4,311.00	—	229% above	40%
Occipital nerve block (injection for headaches) inpatient CPT 64405 Hc Greater Occipital Nerve Block	$2,586.60	$4,311.00	—	—	40%
Pacemaker implant (dual chamber) CPT 33208 Hc Insert/Replace Pacer Atrial&Ventrical	$8,809.20	$14,682.00	—	44% below	40%
Pacemaker implant (dual chamber) inpatient CPT 33208 Hc Insert/Replace Pacer Atrial&Ventrical	$8,809.20	$14,682.00	—	—	40%
Paracentesis with imaging guidance CPT 49083 Hc Paracentesis Incl Image Guidance	$3,591.00	$5,985.00	—	107% above	40%
Paracentesis with imaging guidance inpatient CPT 49083 Hc Paracentesis Incl Image Guidance	$3,591.00	$5,985.00	—	—	40%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 Hc Exc Nail & Nail Matrix Partial Or Compl	$2,680.20	$4,467.00	—	245% above	40%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 Hc Exc Nail & Nail Matrix Partial Or Compl	$2,680.20	$4,467.00	—	—	40%
Prostate biopsy CPT 55700 Hc Prostate Biopsy	$6,758.40	$11,264.00	—	235% above	40%
Prostate biopsy inpatient CPT 55700 Hc Prostate Biopsy	$6,758.40	$11,264.00	—	—	40%
Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 Hc Ablat Lum 1St Lvl Uni Inc Img	$1,137.60	$1,896.00	—	66% below	40%
Radiofrequency ablation of facet joint nerves, lower back, one level inpatient CPT 64635 Hc Ablat Lum 1St Lvl Uni Inc Img	$1,137.60	$1,896.00	—	—	40%
Removal of a breast lump, open surgery CPT 19120 Hc Rmvl Breast Lesion 1 Or More	$8,850.60	$14,751.00	—	99% above	40%
Removal of a breast lump, open surgery inpatient CPT 19120 Hc Rmvl Breast Lesion 1 Or More	$8,850.60	$14,751.00	—	—	40%
Removal of a foreign object under the skin, simple CPT 10120 Hc Incision & Rmvl Fb Subcut Tissue/Simple	$2,108.40	$3,514.00	—	215% above	40%
Removal of a foreign object under the skin, simple inpatient CPT 10120 Hc Incision & Rmvl Fb Subcut Tissue/Simple	$2,108.40	$3,514.00	—	—	40%
Screening colonoscopy, high risk of colorectal cancer (Medicare code) HCPCS G0105 Hc Colorectal Scrn; Hi Risk Ind	$3,232.20	$5,387.00	—	24% above	40%
Screening colonoscopy, high risk of colorectal cancer (Medicare code) inpatient HCPCS G0105 Hc Colorectal Scrn; Hi Risk Ind	$3,232.20	$5,387.00	—	—	40%
Short arm cast (elbow to hand) CPT 29075 Hc Appl Cast Short Arm	$1,083.00	$1,805.00	—	260% above	40%
Short arm cast (elbow to hand) inpatient CPT 29075 Hc Appl Cast Short Arm	$1,083.00	$1,805.00	—	—	40%
Short arm splint (forearm and hand) CPT 29125 Hc Appl Splint Short Arm (Forearm To Hand)	$978.60	$1,631.00	—	237% above	40%
Short arm splint (forearm and hand) inpatient CPT 29125 Hc Appl Splint Short Arm (Forearm To Hand)	$978.60	$1,631.00	—	—	40%
Short leg cast (below the knee) CPT 29405 Hc Appl Cast Short Leg	$1,209.00	$2,015.00	—	217% above	40%
Short leg cast (below the knee) inpatient CPT 29405 Hc Appl Cast Short Leg	$1,209.00	$2,015.00	—	—	40%
Short leg splint (calf to foot) CPT 29515 Hc Apply Lower Leg Splint	$881.40	$1,469.00	—	199% above	40%
Short leg splint (calf to foot) inpatient CPT 29515 Hc Apply Lower Leg Splint	$881.40	$1,469.00	—	—	40%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 Hc Repair Sprfcl Wd Up To 2.5Cm Simple Snag	$330.00	$550.00	—	at median	40%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 Hc Repair Sprfcl Wd Up To 2.5Cm Simple Snag	$330.00	$550.00	—	—	40%
Skin biopsy, punch, one lesion CPT 11104 Hc Punch Biopsy Skin Single Lesion	$696.60	$1,161.00	—	56% above	40%
Skin biopsy, punch, one lesion inpatient CPT 11104 Hc Punch Biopsy Skin Single Lesion	$696.60	$1,161.00	—	—	40%
Skin cancer removal (excision), body, arms or legs, up to 0.5 cm CPT 11600 Hc Exc Skin Malig <0.5 Cm Trunk Arm Leg	$3,195.60	$5,326.00	—	133% above	40%
Skin cancer removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11600 Hc Exc Skin Malig <0.5 Cm Trunk Arm Leg	$3,195.60	$5,326.00	—	—	40%
Skin tag removal, up to 15 tags CPT 11200 Hc Remvl Skin Tags/Multi Fibro Tag Up To 15	$753.00	$1,255.00	—	157% above	40%
Skin tag removal, up to 15 tags inpatient CPT 11200 Hc Remvl Skin Tags/Multi Fibro Tag Up To 15	$753.00	$1,255.00	—	—	40%
Spinal tap (lumbar puncture), diagnostic CPT 62270 Hc Diag-Lumbar Spine Puncture	$2,434.20	$4,057.00	—	127% above	40%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 Hc Diag-Lumbar Spine Puncture	$2,434.20	$4,057.00	—	—	40%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 Hc Resup Npterf Wnd Body 2.6-7.5 Cm	$1,151.40	$1,919.00	—	227% above	40%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 Hc Resup Npterf Wnd Body 2.6-7.5 Cm	$1,151.40	$1,919.00	—	—	40%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 Hc Smpl Repair Supfcl Wnd Feenl 2.5Cm Less	$872.40	$1,454.00	—	175% above	40%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 Hc Smpl Repair Supfcl Wnd Feenl 2.5Cm Less	$872.40	$1,454.00	—	—	40%
Tangential (shave-style) skin biopsy, one lesion CPT 11102 Hc Tangential Biopsy Skin Single Lesion	$696.60	$1,161.00	—	131% above	40%
Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 Hc Tangential Biopsy Skin Single Lesion	$696.60	$1,161.00	—	—	40%
Thoracentesis with imaging guidance CPT 32555 Hc Thoracentesis Ndl Or Cath W Img Guide	$2,461.80	$4,103.00	—	42% above	40%
Thoracentesis with imaging guidance inpatient CPT 32555 Hc Thoracentesis Ndl Or Cath W Img Guide	$2,461.80	$4,103.00	—	—	40%
Trigger finger release surgery CPT 26055 Hc Incise Finger Tendon Sheath	$5,385.60	$8,976.00	—	64% above	40%
Trigger finger release surgery inpatient CPT 26055 Hc Incise Finger Tendon Sheath	$5,385.60	$8,976.00	—	—	40%
Trigger point injections, 1 or 2 muscles CPT 20552 Hc Injection(S) Trigger Point(S) 1 Or 2 Mus	$1,793.40	$2,989.00	—	157% above	40%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 Hc Injection(S) Trigger Point(S) 1 Or 2 Mus	$1,793.40	$2,989.00	—	—	40%
Tubal ligation, laparoscopic (tubes sealed by cautery) CPT 58670 Hc Tubal Ligation W/Delivery	$7,195.20	$11,992.00	—	13% above	40%
Tubal ligation, laparoscopic (tubes sealed by cautery) CPT 58670 Hc Tubal Ligation W/Recovery	$16,750.80	$27,918.00	—	164% above	40%
Tubal ligation, laparoscopic (tubes sealed by cautery) inpatient CPT 58670 Hc Tubal Ligation W/Delivery	$7,195.20	$11,992.00	—	—	40%
Tubal ligation, laparoscopic (tubes sealed by cautery) inpatient CPT 58670 Hc Tubal Ligation W/Recovery	$16,750.80	$27,918.00	—	—	40%
Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 Hc Mammo Us Bx W Clip Lesion	$2,140.20	$3,567.00	—	36% below	40%
Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient CPT 19083 Hc Mammo Us Bx W Clip Lesion	$2,140.20	$3,567.00	—	—	40%
Upper endoscopy (EGD) with balloon widening of the esophagus CPT 43249 Hc Esoph Egd Dilation 30 Min	$2,862.60	$4,771.00	—	18% below	40%
Upper endoscopy (EGD) with balloon widening of the esophagus inpatient CPT 43249 Hc Esoph Egd Dilation 30 Min	$2,862.60	$4,771.00	—	—	40%
Upper endoscopy (EGD) with biopsy CPT 43239 Hc Egd Biopsy Single/Muliple	$2,727.00	$4,545.00	—	3% below	40%
Upper endoscopy (EGD) with biopsy inpatient CPT 43239 Hc Egd Biopsy Single/Muliple	$2,727.00	$4,545.00	—	—	40%
Upper endoscopy (EGD) with injection into the lining CPT 43236 Hc Esophagogastroduodenoscopy Submucosal Injection	$3,435.00	$5,725.00	—	23% above	40%
Upper endoscopy (EGD) with injection into the lining inpatient CPT 43236 Hc Esophagogastroduodenoscopy Submucosal Injection	$3,435.00	$5,725.00	—	—	40%
Upper endoscopy (EGD) with widening of the esophagus over a guide wire CPT 43248 Hc Egd Insert Guide Wire Dilator Passage Esophagus	$2,820.60	$4,701.00	—	1% above	40%
Upper endoscopy (EGD) with widening of the esophagus over a guide wire inpatient CPT 43248 Hc Egd Insert Guide Wire Dilator Passage Esophagus	$2,820.60	$4,701.00	—	—	40%
Upper endoscopy (EGD), diagnostic CPT 43235 Hc Egd Upper Gastro Endoscopy Bedside	$2,484.00	$4,140.00	—	4% below	40%
Upper endoscopy (EGD), diagnostic inpatient CPT 43235 Hc Egd Upper Gastro Endoscopy Bedside	$2,484.00	$4,140.00	—	—	40%
Ureteroscopy with laser stone breaking and stent placement CPT 52356 Hc Cysto/Uretero W Lithotripsy & Indwell Stent Insrt	$13,165.20	$21,942.00	—	13% below	40%
Ureteroscopy with laser stone breaking and stent placement inpatient CPT 52356 Hc Cysto/Uretero W Lithotripsy & Indwell Stent Insrt	$13,165.20	$21,942.00	—	—	40%
Vaginal delivery, including prenatal and postpartum care CPT 59400 Hc Ob Care Antepartum Vag Dlvr & Postpartum	$4,209.60	$7,016.00	—	at median	40%
Vaginal delivery, including prenatal and postpartum care inpatient CPT 59400 Hc Ob Care Antepartum Vag Dlvr & Postpartum	$4,209.60	$7,016.00	—	—	40%
Vasectomy, one or both sides, including follow-up semen testing CPT 55250 Hc Vasectomy W Postop Semen Exam	$3,315.60	$5,526.00	—	4% below	40%
Vasectomy, one or both sides, including follow-up semen testing inpatient CPT 55250 Hc Vasectomy W Postop Semen Exam	$3,315.60	$5,526.00	—	—	40%
Vein ablation, radiofrequency, first vein CPT 36475 Hc Endovenous Rf 1St Vein	$6,949.20	$11,582.00	—	6% above	40%
Vein ablation, radiofrequency, first vein inpatient CPT 36475 Hc Endovenous Rf 1St Vein	$6,949.20	$11,582.00	—	—	40%
Wart removal, up to 14 warts CPT 17110 Hc Exc Flat Wart Mollu Milia Up To 14	$586.20	$977.00	—	87% above	40%
Wart removal, up to 14 warts inpatient CPT 17110 Hc Exc Flat Wart Mollu Milia Up To 14	$586.20	$977.00	—	—	40%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 Hc Debridement - Skin & Subq Tissues	$1,834.23	$3,057.05	—	135% above	40%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 Hc Debridement - Skin & Subq Tissues	$1,834.23	$3,057.05	—	—	40%

Doctor visits and therapy

Procedure	Cash price	List price	Insurers pay	vs Ohio	Off list
Blood transfusion (giving blood or blood components) CPT 36430 Hc Blood Administration	$2,461.80	$4,103.00	—	122% above	40%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Hc Blood Administration	$2,461.80	$4,103.00	—	—	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Hc Inexsufflator Treatment	$295.80	$493.00	—	69% above	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Hc Hhn /Mdi Treatment	$295.80	$493.00	—	69% above	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Hc Ipv Treatment	$295.80	$493.00	—	69% above	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Hc Manual Bagging Up To 1 Hr	$325.20	$542.00	—	85% above	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Hc Pep Treatment	$325.20	$542.00	—	85% above	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Hc Hhn /Mdi Treatment	$295.80	$493.00	—	—	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Hc Inexsufflator Treatment	$295.80	$493.00	—	—	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Hc Ipv Treatment	$295.80	$493.00	—	—	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Hc Pep Treatment	$325.20	$542.00	—	—	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Hc Manual Bagging Up To 1 Hr	$325.20	$542.00	—	—	40%
Chemotherapy IV infusion, first hour CPT 96413 Hc Chemo Infusion 16Min - 1 Hr Initial	$1,852.20	$3,087.00	—	142% above	40%
Chemotherapy IV infusion, first hour inpatient CPT 96413 Hc Chemo Infusion 16Min - 1 Hr Initial	$1,852.20	$3,087.00	—	—	40%
Comprehensive eye exam by an eye doctor, new patient CPT 92004 Hc Oph Svcs Medical Xm&Eval Compre New Pt 1/> Vst	$238.80	$398.00	—	7% below	40%
Comprehensive eye exam by an eye doctor, new patient inpatient CPT 92004 Hc Oph Svcs Medical Xm&Eval Compre New Pt 1/> Vst	$238.80	$398.00	—	—	40%
Comprehensive eye exam, returning patient CPT 92014 Hc Oph Svcs Medical Xm&Eval Compre Est Pt 1/>Vst	$231.00	$385.00	—	at median	40%
Comprehensive eye exam, returning patient inpatient CPT 92014 Hc Oph Svcs Medical Xm&Eval Compre Est Pt 1/>Vst	$231.00	$385.00	—	—	40%
Comprehensive hearing test: tone and speech audiometry, both ears CPT 92557 Hc Comprehensive Audiologic Evaluation	$465.00	$775.00	—	77% above	40%
Comprehensive hearing test: tone and speech audiometry, both ears inpatient CPT 92557 Hc Comprehensive Audiologic Evaluation	$465.00	$775.00	—	—	40%
Critical care, first 30 to 74 minutes CPT 99291 Hc Eu-Critical Care First Hour	$5,215.20	$8,692.00	—	78% above	40%
Critical care, first 30 to 74 minutes inpatient CPT 99291 Hc Eu-Critical Care First Hour	$5,215.20	$8,692.00	—	—	40%
EEG (brain wave test), awake and drowsy, routine CPT 95816 Hc Eeg Routine - Awake/Drowsy	$1,532.40	$2,554.00	—	60% above	40%
EEG (brain wave test), awake and drowsy, routine inpatient CPT 95816 Hc Eeg Routine - Awake/Drowsy	$1,532.40	$2,554.00	—	—	40%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 Hc Electrocardiogram	$273.00	$455.00	—	47% above	40%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 Hc Electrocardiogram	$273.00	$455.00	—	—	40%
Electroconvulsive therapy (ECT), one session CPT 90870 Hc Ect-Electroconvulsive Therapy	$1,509.00	$2,515.00	—	12% above	40%
Electroconvulsive therapy (ECT), one session inpatient CPT 90870 Hc Ect-Electroconvulsive Therapy	$1,509.00	$2,515.00	—	—	40%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 Hc Eu-Level 1 Visit	$285.00	$475.00	—	9% below	40%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 Hc Eu-Level 1 Visit	$285.00	$475.00	—	—	40%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 Hc Eu-Level 2 Visit	$610.20	$1,017.00	—	20% above	40%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 Hc Eu-Level 2 Visit	$610.20	$1,017.00	—	—	40%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 Hc Eu-Level 3 Visit	$1,218.00	$2,030.00	—	44% above	40%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 Hc Eu-Level 3 Visit	$1,218.00	$2,030.00	—	—	40%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 Hc Eu-Level 4 Visit	$1,917.60	$3,196.00	—	44% above	40%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 Hc Eu-Level 4 Visit	$1,917.60	$3,196.00	—	—	40%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 Hc Eu-Level 5 Visit	$2,820.60	$4,701.00	—	62% above	40%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 Hc Eu-Critical Care < 30 Minutes	$3,945.60	$6,576.00	—	127% above	40%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 Hc Eu-Level 5 Visit	$2,820.60	$4,701.00	—	—	40%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 Hc Eu-Critical Care < 30 Minutes	$3,945.60	$6,576.00	—	—	40%
Exercise stress test, tracing only, the hospital charge CPT 93017 Hc Cardiovascular Stress Test	$885.60	$1,476.00	—	1% below	40%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 Hc Cardiovascular Stress Test	$885.60	$1,476.00	—	—	40%
Eye exam, returning patient, intermediate CPT 92012 Hc Oph Svcs Medical Xm&Eval Intermediate Est Pt	$204.00	$340.00	—	33% below	40%
Eye exam, returning patient, intermediate inpatient CPT 92012 Hc Oph Svcs Medical Xm&Eval Intermediate Est Pt	$204.00	$340.00	—	—	40%
Family therapy with the patient, 50 minutes CPT 90847 Hc Family Psychotherapy W/ Patient 50 Mins	$199.20	$332.00	—	33% below	40%
Family therapy with the patient, 50 minutes inpatient CPT 90847 Hc Family Psychotherapy W/ Patient 50 Mins	$199.20	$332.00	—	—	40%
Family therapy without the patient, 50 minutes CPT 90846 Hc Medical Psychotherapy W/O Patient 50 Mins	$199.20	$332.00	—	36% below	40%
Family therapy without the patient, 50 minutes inpatient CPT 90846 Hc Medical Psychotherapy W/O Patient 50 Mins	$199.20	$332.00	—	—	40%
Group psychotherapy session CPT 90853 Hc Group Medical Psychother	$121.20	$202.00	—	29% below	40%
Group psychotherapy session CPT 90853 Hc Group Medical Psychotherapy	$121.20	$202.00	—	29% below	40%
Group psychotherapy session CPT 90853 Hc Iop Alcohol/Drug Serv 3 Hrs	$288.00	$480.00	—	68% above	40%
Group psychotherapy session CPT 90853 Hc Iop Alcohol/Drug Servs 3 Hrs	$288.00	$480.00	—	68% above	40%
Group psychotherapy session inpatient CPT 90853 Hc Group Medical Psychother	$121.20	$202.00	—	—	40%
Group psychotherapy session inpatient CPT 90853 Hc Group Medical Psychotherapy	$121.20	$202.00	—	—	40%
Group psychotherapy session inpatient CPT 90853 Hc Iop Alcohol/Drug Servs 3 Hrs	$288.00	$480.00	—	—	40%
Group psychotherapy session inpatient CPT 90853 Hc Iop Alcohol/Drug Serv 3 Hrs	$288.00	$480.00	—	—	40%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 Hc Ed Iv Hydration Infusion 1St Hr	$348.00	$580.00	—	17% below	40%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 Hc Iv Hydration Infusion 1St Hr	$385.80	$643.00	—	8% below	40%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 Hc Ed Iv Hydration Infusion 1St Hr	$348.00	$580.00	—	—	40%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 Hc Iv Hydration Infusion 1St Hr	$385.80	$643.00	—	—	40%
IV infusion of a medicine, first hour CPT 96365 Hc Ed Iv Infusion 16 Min-1 Hr	$729.60	$1,216.00	—	69% above	40%
IV infusion of a medicine, first hour CPT 96365 Hc Iv Infusion- 16 Min-1 Hr	$810.60	$1,351.00	—	87% above	40%
IV infusion of a medicine, first hour inpatient CPT 96365 Hc Ed Iv Infusion 16 Min-1 Hr	$729.60	$1,216.00	—	—	40%
IV infusion of a medicine, first hour inpatient CPT 96365 Hc Iv Infusion- 16 Min-1 Hr	$810.60	$1,351.00	—	—	40%
IV push of a medicine, first drug CPT 96374 Hc Ed Inject Medicine Iv Push Initial	$309.00	$515.00	—	20% above	40%
IV push of a medicine, first drug CPT 96374 Hc Inject Medicine Iv Push Initial	$343.20	$572.00	—	34% above	40%
IV push of a medicine, first drug inpatient CPT 96374 Hc Ed Inject Medicine Iv Push Initial	$309.00	$515.00	—	—	40%
IV push of a medicine, first drug inpatient CPT 96374 Hc Inject Medicine Iv Push Initial	$343.20	$572.00	—	—	40%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 Hc Botox Inject Fee - Derm	$81.60	$136.00	—	42% below	40%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 Hc Ed Inject Medicine Im/Subcut/Antibiotc	$115.20	$192.00	—	19% below	40%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 Hc Inject Medicine Im/Subcut/Antibiotc	$127.80	$213.00	—	10% below	40%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 Hc Botox Inject Fee - Derm	$81.60	$136.00	—	—	40%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 Hc Ed Inject Medicine Im/Subcut/Antibiotc	$115.20	$192.00	—	—	40%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 Hc Inject Medicine Im/Subcut/Antibiotc	$127.80	$213.00	—	—	40%
Mental health diagnostic evaluation (intake), without medical services CPT 90791 Hc Psychiatric Diagnostic Evaluation	$219.00	$365.00	—	30% below	40%
Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 Hc Psychiatric Diagnostic Evaluation	$219.00	$365.00	—	—	40%
Nerve conduction study, 7 or 8 nerve studies CPT 95910 Hc Nerve Conduction Studies(7-8)	$462.60	$771.00	—	66% below	40%
Nerve conduction study, 7 or 8 nerve studies CPT 95910 Hc Iom Nerve Conduction Studies 7-8	$915.00	$1,525.00	—	34% below	40%
Nerve conduction study, 7 or 8 nerve studies inpatient CPT 95910 Hc Nerve Conduction Studies(7-8)	$462.60	$771.00	—	—	40%
Nerve conduction study, 7 or 8 nerve studies inpatient CPT 95910 Hc Iom Nerve Conduction Studies 7-8	$915.00	$1,525.00	—	—	40%
Neuromuscular re-education, 15 minutes CPT 97112 Hc Tr Neuromuscular Reeducation Bal 15 Min	$78.60	$131.00	—	28% below	40%
Neuromuscular re-education, 15 minutes CPT 97112 Hc Pt Neuromuscular Reeducation-Balance 15M	$78.60	$131.00	—	28% below	40%
Neuromuscular re-education, 15 minutes CPT 97112 Hc Ot Neuomuscular Re-Edu Bal(15 Min)	$100.80	$168.00	—	8% below	40%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 Hc Pt Neuromuscular Reeducation-Balance 15M	$78.60	$131.00	—	—	40%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 Hc Tr Neuromuscular Reeducation Bal 15 Min	$78.60	$131.00	—	—	40%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 Hc Ot Neuomuscular Re-Edu Bal(15 Min)	$100.80	$168.00	—	—	40%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 Hc Nutritn Tx Initl Ass&Interv Ind/Ea 15 Mn	$202.80	$338.00	—	213% above	40%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 Hc Nutritn Tx Initl Ass&Interv Ind/Ea 15 Mn	$202.80	$338.00	—	—	40%
Occupational therapy evaluation, low complexity CPT 97165 Hc Ot Eval Low Complex 30 Min	$151.80	$253.00	—	42% below	40%
Occupational therapy evaluation, low complexity inpatient CPT 97165 Hc Ot Eval Low Complex 30 Min	$151.80	$253.00	—	—	40%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 Hc Pt Eval High Comp 45Min	$184.80	$308.00	—	39% below	40%
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 Hc Pt Eval High Comp 45Min	$184.80	$308.00	—	—	40%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 Hc Pt Eval Low Comp 20Min	$151.80	$253.00	—	42% below	40%
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 Hc Pt Eval Low Comp 20Min	$151.80	$253.00	—	—	40%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 Hc Pt Eval Mod Comp 30Min	$168.00	$280.00	—	40% below	40%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 Hc Pt Eval Mod Comp 30Min	$168.00	$280.00	—	—	40%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 Hc St Manual Therapy/Mobilization/Lymph 15M	$76.80	$128.00	—	31% below	40%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 Hc Pt Manual Therapy/Mobilztn/Lymph 15 Min	$76.80	$128.00	—	31% below	40%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 Hc Ot Manual Therapy/Mobilization/Lymph 15M	$76.80	$128.00	—	31% below	40%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 Hc St Manual Therapy/Mobilization/Lymph 15M	$76.80	$128.00	—	—	40%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 Hc Ot Manual Therapy/Mobilization/Lymph 15M	$76.80	$128.00	—	—	40%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 Hc Pt Manual Therapy/Mobilztn/Lymph 15 Min	$76.80	$128.00	—	—	40%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 Hc Pt Therapeutic Exeise 15Mins	$78.60	$131.00	—	34% below	40%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 Hc Ot Therapeutic Exeise (15 Min)	$78.60	$131.00	—	34% below	40%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 Hc St Therapeutic Exercise (15 Min)	$78.60	$131.00	—	34% below	40%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 Hc St Therapeutic Exercise (15 Min)	$78.60	$131.00	—	—	40%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 Hc Ot Therapeutic Exeise (15 Min)	$78.60	$131.00	—	—	40%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 Hc Pt Therapeutic Exeise 15Mins	$78.60	$131.00	—	—	40%
Preventive checkup, new patient aged 18–39 CPT 99385 Hc Preventive Med New 18 - 39 Year	$156.60	$261.00	—	31% above	40%
Preventive checkup, new patient aged 18–39 inpatient CPT 99385 Hc Preventive Med New 18 - 39 Year	$156.60	$261.00	—	—	40%
Preventive checkup, new patient aged 40–64 CPT 99386 Hc Prev Med 40-64 Years - New	$157.20	$262.00	—	8% above	40%
Preventive checkup, new patient aged 40–64 inpatient CPT 99386 Hc Prev Med 40-64 Years - New	$157.20	$262.00	—	—	40%
Preventive checkup, new patient aged 65 or older CPT 99387 Hc Preventive Med New 65+ Year	$156.60	$261.00	—	at median	40%
Preventive checkup, new patient aged 65 or older inpatient CPT 99387 Hc Preventive Med New 65+ Year	$156.60	$261.00	—	—	40%
Preventive checkup, returning patient aged 18–39 CPT 99395 Hc Preventive Med Estab 18 - 39 Year	$126.00	$210.00	—	1% above	40%
Preventive checkup, returning patient aged 18–39 inpatient CPT 99395 Hc Preventive Med Estab 18 - 39 Year	$126.00	$210.00	—	—	40%
Preventive checkup, returning patient aged 40–64 CPT 99396 Hc Preventive Med Estab 40 - 64 Year	$125.40	$209.00	—	at median	40%
Preventive checkup, returning patient aged 40–64 inpatient CPT 99396 Hc Preventive Med Estab 40 - 64 Year	$125.40	$209.00	—	—	40%
Preventive checkup, returning patient aged 65 or older CPT 99397 Hc Preventive Med Estab 65+ Year	$125.40	$209.00	—	3% below	40%
Preventive checkup, returning patient aged 65 or older inpatient CPT 99397 Hc Preventive Med Estab 65+ Year	$125.40	$209.00	—	—	40%
Psychiatric evaluation with medical services CPT 90792 Hc Psychiatric Diagnostic Eval W Medical Servs	$204.60	$341.00	—	42% below	40%
Psychiatric evaluation with medical services inpatient CPT 90792 Hc Psychiatric Diagnostic Eval W Medical Servs	$204.60	$341.00	—	—	40%
Psychological testing evaluation by a psychologist or physician, first hour CPT 96130 Hc Psycl Tst Eval Phys/Qhp 1St Hr	$439.80	$733.00	—	4% above	40%
Psychological testing evaluation by a psychologist or physician, first hour inpatient CPT 96130 Hc Psycl Tst Eval Phys/Qhp 1St Hr	$439.80	$733.00	—	—	40%
Psychotherapy for crisis, first 60 minutes CPT 90839 Hc Psychotherapy Crisis Initial 60 Min	$378.00	$630.00	—	21% above	40%
Psychotherapy for crisis, first 60 minutes inpatient CPT 90839 Hc Psychotherapy Crisis Initial 60 Min	$378.00	$630.00	—	—	40%
Psychotherapy session, 30 minutes CPT 90832 Hc Psychotherapy 30 Min W Patient	$153.60	$256.00	—	19% below	40%
Psychotherapy session, 30 minutes inpatient CPT 90832 Hc Psychotherapy 30 Min W Patient	$153.60	$256.00	—	—	40%
Psychotherapy session, 45 minutes CPT 90834 Hc Psychotherapy 45 Min W Patient	$219.00	$365.00	—	18% below	40%
Psychotherapy session, 45 minutes inpatient CPT 90834 Hc Psychotherapy 45 Min W Patient	$219.00	$365.00	—	—	40%
Psychotherapy session, 60 minutes CPT 90837 Hc Psychotherapy 60 Min With Patient	$219.00	$365.00	—	30% below	40%
Psychotherapy session, 60 minutes inpatient CPT 90837 Hc Psychotherapy 60 Min With Patient	$219.00	$365.00	—	—	40%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 Hc Smoke Tobacco Counseling 3-10 Minutes	$43.80	$73.00	—	at median	40%
Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 Hc Smoke Tobacco Counseling 3-10 Minutes	$43.80	$73.00	—	—	40%
Speech and language evaluation CPT 92523 Hc Eval Speech Sound Prd W/Lng Comp & Expr	$294.00	$490.00	—	14% below	40%
Speech and language evaluation inpatient CPT 92523 Hc Eval Speech Sound Prd W/Lng Comp & Expr	$294.00	$490.00	—	—	40%
Speech therapy session, individual CPT 92507 Hc Treatment Speech Dysfunction/Individual	$249.60	$416.00	—	14% above	40%
Speech therapy session, individual inpatient CPT 92507 Hc Treatment Speech Dysfunction/Individual	$249.60	$416.00	—	—	40%
Spirometry (breathing test) CPT 94010 Hc Spirometry	$418.20	$697.00	—	35% above	40%
Spirometry (breathing test) CPT 94010 Hc Pft Bedside	$418.20	$697.00	—	35% above	40%
Spirometry (breathing test) inpatient CPT 94010 Hc Pft Bedside	$418.20	$697.00	—	—	40%
Spirometry (breathing test) inpatient CPT 94010 Hc Spirometry	$418.20	$697.00	—	—	40%
Spirometry before and after a bronchodilator CPT 94060 Hc Spirometry W Bd	$557.40	$929.00	—	3% below	40%
Spirometry before and after a bronchodilator inpatient CPT 94060 Hc Spirometry W Bd	$557.40	$929.00	—	—	40%
TMS (transcranial magnetic stimulation), first session with mapping CPT 90867 Hc Tcranial Magn Stim Tx Plan	$448.80	$748.00	—	at median	40%
TMS (transcranial magnetic stimulation), first session with mapping inpatient CPT 90867 Hc Tcranial Magn Stim Tx Plan	$448.80	$748.00	—	—	40%
Therapeutic activities (functional training), 15 minutes CPT 97530 Hc Pt Therapeutic Activities (15Mins)	$83.40	$139.00	—	32% below	40%
Therapeutic activities (functional training), 15 minutes CPT 97530 Hc Ot Therapeutic Activities (15 Min)	$83.40	$139.00	—	32% below	40%
Therapeutic activities (functional training), 15 minutes CPT 97530 Hc Tr Therapeutic Activities 15 Mins	$83.40	$139.00	—	32% below	40%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 Hc Ot Therapeutic Activities (15 Min)	$83.40	$139.00	—	—	40%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 Hc Pt Therapeutic Activities (15Mins)	$83.40	$139.00	—	—	40%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 Hc Tr Therapeutic Activities 15 Mins	$83.40	$139.00	—	—	40%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 Hc Therapeutic Blood Draw-	$586.80	$978.00	—	148% above	40%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 Hc Therapeutic Blood Draw-	$586.80	$978.00	—	—	40%
Treadmill or drug stress test with ECG, supervision and report CPT 93015 Hc Cardiac Stress Tst Complete	$885.60	$1,476.00	—	13% above	40%
Treadmill or drug stress test with ECG, supervision and report inpatient CPT 93015 Hc Cardiac Stress Tst Complete	$885.60	$1,476.00	—	—	40%
Visual field test, extended CPT 92083 Hc Visual Fields Exam - Extended	$219.60	$366.00	—	43% above	40%
Visual field test, extended inpatient CPT 92083 Hc Visual Fields Exam - Extended	$219.60	$366.00	—	—	40%

Vaccines

Procedure	Cash price	List price	Insurers pay	vs Ohio	Off list
Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older CPT 90653 NDC Description Not Available	$112.18	$186.96	—	48% above	40%
Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older CPT 90653 Hc Iiv Adjuvanted Vaccine For Intramuscular Use	$112.18	$186.96	—	48% above	40%
Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older inpatient CPT 90653 NDC Description Not Available	$112.18	$186.96	—	—	40%
Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older inpatient CPT 90653 Hc Iiv Adjuvanted Vaccine For Intramuscular Use	$112.18	$186.96	—	—	40%
COVID-19 vaccine (Moderna), age 12 and older CPT 91322 NDC Description Not Available	$207.41	$345.68	—	at median	40%
COVID-19 vaccine (Moderna), age 12 and older CPT 91322 Hc Sarscov2 50Mcg/0.5Ml Im	$223.31	$372.19	—	8% above	40%
COVID-19 vaccine (Moderna), age 12 and older inpatient CPT 91322 NDC Description Not Available	$207.41	$345.68	—	—	40%
COVID-19 vaccine (Moderna), age 12 and older inpatient CPT 91322 Hc Sarscov2 50Mcg/0.5Ml Im	$223.31	$372.19	—	—	40%
COVID-19 vaccine (Pfizer-BioNTech), age 12 and older CPT 91320 Hc Sarscov2 Vacc 30Mcg/0.3Ml Tris-Sucrose Im Use	$266.48	$444.14	—	20% below	40%
COVID-19 vaccine (Pfizer-BioNTech), age 12 and older CPT 91320 Comirnaty: 10 SYRINGE, PLASTIC in 1 CARTON (0069-2392-10) / .432 mL in 1 SYRINGE, PLASTIC (0069-2392-01)	$266.48	$444.14	—	20% below	40%
COVID-19 vaccine (Pfizer-BioNTech), age 12 and older CPT 91320 NDC Description Not Available	$266.48	$444.14	—	20% below	40%
COVID-19 vaccine (Pfizer-BioNTech), age 12 and older inpatient CPT 91320 Hc Sarscov2 Vacc 30Mcg/0.3Ml Tris-Sucrose Im Use	$266.48	$444.14	—	—	40%
COVID-19 vaccine (Pfizer-BioNTech), age 12 and older inpatient CPT 91320 Comirnaty: 10 SYRINGE, PLASTIC in 1 CARTON (0069-2392-10) / .432 mL in 1 SYRINGE, PLASTIC (0069-2392-01)	$266.48	$444.14	—	—	40%
COVID-19 vaccine (Pfizer-BioNTech), age 12 and older inpatient CPT 91320 NDC Description Not Available	$266.48	$444.14	—	—	40%
Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 NDC Description Not Available	$65.27	$108.78	—	82% below	40%
Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 Hc Varicella Virus Vac Live Vial Inj-Clinic	$354.30	$590.50	—	5% below	40%
Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 Varivax: 10 Vial, Single-Dose In 1 Carton (0006-4827-00) / .5 Ml In 1 Vial, Single-Dose (0006-4827-01)	$364.93	$608.22	—	2% below	40%
Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 NDC Description Not Available	$65.27	$108.78	—	—	40%
Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 Hc Varicella Virus Vac Live Vial Inj-Clinic	$354.30	$590.50	—	—	40%
Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 Varivax: 10 Vial, Single-Dose In 1 Carton (0006-4827-00) / .5 Ml In 1 Vial, Single-Dose (0006-4827-01)	$364.93	$608.22	—	—	40%
DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) CPT 90696 Hc Dtap-Ipv Im Age 4-6 Year	$115.11	$191.85	—	11% below	40%
DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) inpatient CPT 90696 Hc Dtap-Ipv Im Age 4-6 Year	$115.11	$191.85	—	—	40%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 Hc Dipht Tetanus Acellular Pe Vac Im	$67.74	$112.90	—	4% above	40%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 NDC Description Not Available	$69.77	$116.29	—	8% above	40%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 inpatient CPT 90700 Hc Dipht Tetanus Acellular Pe Vac Im	$67.74	$112.90	—	—	40%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 inpatient CPT 90700 NDC Description Not Available	$69.77	$116.29	—	—	40%
DTaP, hepatitis B and polio combination vaccine (Pediarix) CPT 90723 NDC Description Not Available	$190.72	$317.86	—	2% below	40%
DTaP, hepatitis B and polio combination vaccine (Pediarix) CPT 90723 Hc Dtap/Hepb/Ipv Vaccine Im	$214.04	$356.74	—	10% above	40%
DTaP, hepatitis B and polio combination vaccine (Pediarix) inpatient CPT 90723 NDC Description Not Available	$190.72	$317.86	—	—	40%
DTaP, hepatitis B and polio combination vaccine (Pediarix) inpatient CPT 90723 Hc Dtap/Hepb/Ipv Vaccine Im	$214.04	$356.74	—	—	40%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 Hc Influ Vacc (Iiv3) P Free 0.5 Ml Dose Im	$41.44	$69.06	—	9% below	40%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 NDC Description Not Available	$41.44	$69.06	—	9% below	40%
Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 Hc Influ Vacc (Iiv3) P Free 0.5 Ml Dose Im	$41.44	$69.06	—	—	40%
Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 NDC Description Not Available	$41.44	$69.06	—	—	40%
HPV vaccine, 9-valent (Gardasil 9) CPT 90651 Hc Hpv Virus Vaccine 9 Val Im	$614.45	$1,024.08	—	18% above	40%
HPV vaccine, 9-valent (Gardasil 9) CPT 90651 NDC Description Not Available	$614.45	$1,024.08	—	18% above	40%
HPV vaccine, 9-valent (Gardasil 9) CPT 90651 Gardasil 9: 10 Syringe, Glass In 1 Carton (0006-4121-02) / .5 Ml In 1 Syringe, Glass (0006-4121-01)	$621.22	$1,035.37	—	20% above	40%
HPV vaccine, 9-valent (Gardasil 9) inpatient CPT 90651 Hc Hpv Virus Vaccine 9 Val Im	$614.45	$1,024.08	—	—	40%
HPV vaccine, 9-valent (Gardasil 9) inpatient CPT 90651 NDC Description Not Available	$614.45	$1,024.08	—	—	40%
HPV vaccine, 9-valent (Gardasil 9) inpatient CPT 90651 Gardasil 9: 10 Syringe, Glass In 1 Carton (0006-4121-02) / .5 Ml In 1 Syringe, Glass (0006-4121-01)	$621.22	$1,035.37	—	—	40%
Hepatitis A and B combination vaccine, adult (Twinrix) CPT 90636 Hc Hep B Vaccine/Hep A Vaccine 1Ml	$164.45	$274.08	—	46% below	40%
Hepatitis A and B combination vaccine, adult (Twinrix) CPT 90636 NDC Description Not Available	$192.16	$320.26	—	37% below	40%
Hepatitis A and B combination vaccine, adult (Twinrix) inpatient CPT 90636 Hc Hep B Vaccine/Hep A Vaccine 1Ml	$164.45	$274.08	—	—	40%
Hepatitis A and B combination vaccine, adult (Twinrix) inpatient CPT 90636 NDC Description Not Available	$192.16	$320.26	—	—	40%
Hepatitis A vaccine, adult dose CPT 90632 Hc Hepatitis A Vaccine 50 U/Ml Vial	$161.33	$268.88	—	17% below	40%
Hepatitis A vaccine, adult dose CPT 90632 NDC Description Not Available	$164.16	$273.60	—	15% below	40%
Hepatitis A vaccine, adult dose inpatient CPT 90632 Hc Hepatitis A Vaccine 50 U/Ml Vial	$161.33	$268.88	—	—	40%
Hepatitis A vaccine, adult dose inpatient CPT 90632 NDC Description Not Available	$164.16	$273.60	—	—	40%
Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 Hc Hepatitis A Vaccine Ped/Adolescent Im	$72.45	$120.75	—	19% below	40%
Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 NDC Description Not Available	$74.62	$124.37	—	17% below	40%
Hepatitis A vaccine, child and teen dose (2-dose schedule) inpatient CPT 90633 Hc Hepatitis A Vaccine Ped/Adolescent Im	$72.45	$120.75	—	—	40%
Hepatitis A vaccine, child and teen dose (2-dose schedule) inpatient CPT 90633 NDC Description Not Available	$74.62	$124.37	—	—	40%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 Hc Hepatitis B Vaccine Adult Im	$137.66	$229.43	—	12% below	40%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 NDC Description Not Available	$159.76	$266.26	—	3% above	40%
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 Hc Hepatitis B Vaccine Adult Im	$137.66	$229.43	—	—	40%
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 NDC Description Not Available	$159.76	$266.26	—	—	40%
Hepatitis B vaccine, adult, 2-dose schedule (Heplisav-B) CPT 90739 Hc Hepb Vaccine Adult 2 Dose Schedule For Im Use	$224.33	$373.89	—	3% above	40%
Hepatitis B vaccine, adult, 2-dose schedule (Heplisav-B) CPT 90739 NDC Description Not Available	$224.33	$373.89	—	3% above	40%
Hepatitis B vaccine, adult, 2-dose schedule (Heplisav-B) CPT 90739 Recombivax Hb: 10 Syringe In 1 Carton (0006-4093-02) / .5 Ml In 1 Syringe (0006-4093-01)	$224.33	$373.89	—	3% above	40%
Hepatitis B vaccine, adult, 2-dose schedule (Heplisav-B) inpatient CPT 90739 Hc Hepb Vaccine Adult 2 Dose Schedule For Im Use	$224.33	$373.89	—	—	40%
Hepatitis B vaccine, adult, 2-dose schedule (Heplisav-B) inpatient CPT 90739 Recombivax Hb: 10 Syringe In 1 Carton (0006-4093-02) / .5 Ml In 1 Syringe (0006-4093-01)	$224.33	$373.89	—	—	40%
Hepatitis B vaccine, adult, 2-dose schedule (Heplisav-B) inpatient CPT 90739 NDC Description Not Available	$224.33	$373.89	—	—	40%
Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 Recombivax Hb: 10 Vial, Single-Dose In 1 Carton (0006-4981-00) / .5 Ml In 1 Vial, Single-Dose (0006-4981-01)	$10.13	$16.88	—	83% below	40%
Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 NDC Description Not Available	$12.11	$20.18	—	80% below	40%
Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 Hc Hepatitis B Vaccine Ped/Adolescent Im	$53.82	$89.70	—	10% below	40%
Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 Recombivax Hb: 10 Vial, Single-Dose In 1 Carton (0006-4981-00) / .5 Ml In 1 Vial, Single-Dose (0006-4981-01)	$10.13	$16.88	—	—	40%
Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 NDC Description Not Available	$12.11	$20.18	—	—	40%
Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 Hc Hepatitis B Vaccine Ped/Adolescent Im	$53.82	$89.70	—	—	40%
Hib vaccine (Haemophilus influenzae type b), 3-dose schedule (PedvaxHIB) CPT 90647 NDC Description Not Available	$59.73	$99.55	—	15% below	40%
Hib vaccine (Haemophilus influenzae type b), 3-dose schedule (PedvaxHIB) CPT 90647 Hc Hib Vaccine Hbp-Omp Im	$59.73	$99.55	—	15% below	40%
Hib vaccine (Haemophilus influenzae type b), 3-dose schedule (PedvaxHIB) inpatient CPT 90647 Hc Hib Vaccine Hbp-Omp Im	$59.73	$99.55	—	—	40%
Hib vaccine (Haemophilus influenzae type b), 3-dose schedule (PedvaxHIB) inpatient CPT 90647 NDC Description Not Available	$59.73	$99.55	—	—	40%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) CPT 90648 Hc Hib 4 Dose	$37.74	$62.90	—	24% above	40%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) inpatient CPT 90648 Hc Hib 4 Dose	$37.74	$62.90	—	—	40%
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 NDC Description Not Available	$41.75	$69.58	—	60% below	40%
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 Hc Flu Vacc Prsv Free Hd	$41.75	$69.58	—	60% below	40%
High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 NDC Description Not Available	$41.75	$69.58	—	—	40%
High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 Hc Flu Vacc Prsv Free Hd	$41.75	$69.58	—	—	40%
MMR vaccine (measles, mumps and rubella), live CPT 90707 M-M-R Ii: 10 Vial, Single-Dose In 1 Carton (0006-4681-00) / .5 Ml In 1 Vial, Single-Dose (0006-4681-01)	$93.38	$155.63	—	55% below	40%
MMR vaccine (measles, mumps and rubella), live CPT 90707 Hc Mmr Vaccine	$180.72	$301.20	—	13% below	40%
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 M-M-R Ii: 10 Vial, Single-Dose In 1 Carton (0006-4681-00) / .5 Ml In 1 Vial, Single-Dose (0006-4681-01)	$93.38	$155.63	—	—	40%
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 Hc Mmr Vaccine	$180.72	$301.20	—	—	40%
MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) CPT 90710 NDC Description Not Available	$107.51	$179.18	—	79% below	40%
MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) CPT 90710 Hc Combined Vaccine Mmr+Varicella Sub-Q	$550.98	$918.30	—	8% above	40%
MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) inpatient CPT 90710 NDC Description Not Available	$107.51	$179.18	—	—	40%
MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) inpatient CPT 90710 Hc Combined Vaccine Mmr+Varicella Sub-Q	$550.98	$918.30	—	—	40%
Meningococcal ACWY (MenACWY) vaccine CPT 90734 Hc Meningococcal Vaccine Im	$304.44	$507.40	—	4% below	40%
Meningococcal ACWY (MenACWY) vaccine CPT 90734 NDC Description Not Available	$320.96	$534.93	—	1% above	40%
Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 Hc Meningococcal Vaccine Im	$304.44	$507.40	—	—	40%
Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 NDC Description Not Available	$320.96	$534.93	—	—	40%
Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 Hc Meningococcal Vaccine Serogroup B	$446.54	$744.23	—	19% below	40%
Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 NDC Description Not Available	$464.87	$774.79	—	16% below	40%
Meningococcal B vaccine (Bexsero), 2-dose schedule inpatient CPT 90620 Hc Meningococcal Vaccine Serogroup B	$446.54	$744.23	—	—	40%
Meningococcal B vaccine (Bexsero), 2-dose schedule inpatient CPT 90620 NDC Description Not Available	$464.87	$774.79	—	—	40%
Mpox and smallpox vaccine (Jynneos), 2-dose schedule CPT 90611 Hc Smallpox&Monkeypox Vacc 0.5Ml Dos For Subq Use	$540.62	$901.04	—	6% above	40%
Mpox and smallpox vaccine (Jynneos), 2-dose schedule CPT 90611 NDC Description Not Available	$540.62	$901.04	—	6% above	40%
Mpox and smallpox vaccine (Jynneos), 2-dose schedule inpatient CPT 90611 NDC Description Not Available	$540.62	$901.04	—	—	40%
Mpox and smallpox vaccine (Jynneos), 2-dose schedule inpatient CPT 90611 Hc Smallpox&Monkeypox Vacc 0.5Ml Dos For Subq Use	$540.62	$901.04	—	—	40%
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) CPT 90670 Hc Pneumococcal Conj Vaccine 13 Valent Im	$438.75	$731.25	—	at median	40%
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) CPT 90670 Prevnar 20: 10 Syringe In 1 Carton (0005-2000-10) / .5 Ml In 1 Syringe (0005-2000-01)	$494.34	$823.90	—	13% above	40%
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) inpatient CPT 90670 Hc Pneumococcal Conj Vaccine 13 Valent Im	$438.75	$731.25	—	—	40%
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) inpatient CPT 90670 Prevnar 20: 10 Syringe In 1 Carton (0005-2000-10) / .5 Ml In 1 Syringe (0005-2000-01)	$494.34	$823.90	—	—	40%
Pneumonia vaccine, 15-valent conjugate (Vaxneuvance) CPT 90671 Hc Pcv15 Vaccine For Intramuscular Use	$457.45	$762.41	—	91% above	40%
Pneumonia vaccine, 15-valent conjugate (Vaxneuvance) inpatient CPT 90671 Hc Pcv15 Vaccine For Intramuscular Use	$457.45	$762.41	—	—	40%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 Hc Pneumococcal V20 Vaccine For Im Use	$522.24	$870.40	—	21% below	40%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 NDC Description Not Available	$522.24	$870.40	—	21% below	40%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 Prevnar 20: 1 Syringe In 1 Carton (0005-2000-02) / .5 Ml In 1 Syringe (0005-2000-01)	$538.65	$897.75	—	19% below	40%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 Prevnar 20: 10 Syringe In 1 Carton (0005-2000-10) / .5 Ml In 1 Syringe (0005-2000-01)	$543.37	$905.61	—	18% below	40%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 Hc Pneumococcal V20 Vaccine For Im Use	$522.24	$870.40	—	—	40%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 NDC Description Not Available	$522.24	$870.40	—	—	40%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 Prevnar 20: 1 Syringe In 1 Carton (0005-2000-02) / .5 Ml In 1 Syringe (0005-2000-01)	$538.65	$897.75	—	—	40%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 Prevnar 20: 10 Syringe In 1 Carton (0005-2000-10) / .5 Ml In 1 Syringe (0005-2000-01)	$543.37	$905.61	—	—	40%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 NDC Description Not Available	$137.50	$229.16	—	50% below	40%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 Pneumovax 23: 10 Syringe, Glass In 1 Carton (0006-4837-03) / .5 Ml In 1 Syringe, Glass (0006-4837-01)	$139.67	$232.78	—	49% below	40%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 Hc Pneumococcal Vaccine	$234.44	$390.73	—	15% below	40%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 NDC Description Not Available	$137.50	$229.16	—	—	40%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 Pneumovax 23: 10 Syringe, Glass In 1 Carton (0006-4837-03) / .5 Ml In 1 Syringe, Glass (0006-4837-01)	$139.67	$232.78	—	—	40%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 Hc Pneumococcal Vaccine	$234.44	$390.73	—	—	40%
Polio vaccine, inactivated (IPV) CPT 90713 NDC Description Not Available	$34.58	$57.63	—	46% below	40%
Polio vaccine, inactivated (IPV) CPT 90713 Hc Ipv (Poliovirus Vaccine) Subcut Use	$99.51	$165.85	—	56% above	40%
Polio vaccine, inactivated (IPV) inpatient CPT 90713 NDC Description Not Available	$34.58	$57.63	—	—	40%
Polio vaccine, inactivated (IPV) inpatient CPT 90713 Hc Ipv (Poliovirus Vaccine) Subcut Use	$99.51	$165.85	—	—	40%
RSV antibody shot for infants and toddlers, larger dose (1 mL, 100 mg) CPT 90381 Hc Rsv Monoclonal Antb Seasonal Dose 1 Ml Im Use	$1,040.71	$1,734.52	—	at median	40%
RSV antibody shot for infants and toddlers, larger dose (1 mL, 100 mg) inpatient CPT 90381 Hc Rsv Monoclonal Antb Seasonal Dose 1 Ml Im Use	$1,040.71	$1,734.52	—	—	40%
RSV antibody shot for infants, seasonal dose (0.5 mL) CPT 90380 NDC Description Not Available	$972.90	$1,621.50	—	28% below	40%
RSV antibody shot for infants, seasonal dose (0.5 mL) CPT 90380 Hc Rsv Monoclonal Antb Seasonal Dose 0.5 Ml Im Use	$1,040.71	$1,734.52	—	23% below	40%
RSV antibody shot for infants, seasonal dose (0.5 mL) inpatient CPT 90380 NDC Description Not Available	$972.90	$1,621.50	—	—	40%
RSV antibody shot for infants, seasonal dose (0.5 mL) inpatient CPT 90380 Hc Rsv Monoclonal Antb Seasonal Dose 0.5 Ml Im Use	$1,040.71	$1,734.52	—	—	40%
RSV vaccine (Abrysvo), one dose for older adults or during pregnancy CPT 90678 Hc Rsv Vaccine Pref Subunit Bivalent For Im Use	$590.68	$984.47	—	18% below	40%
RSV vaccine (Abrysvo), one dose for older adults or during pregnancy CPT 90678 NDC Description Not Available	$595.65	$992.75	—	17% below	40%
RSV vaccine (Abrysvo), one dose for older adults or during pregnancy CPT 90678 Abrysvo: 10 Vial In 1 Carton (0069-2465-10) / .5 Ml In 1 Vial (0069-2465-19)	$620.47	$1,034.12	—	14% below	40%
RSV vaccine (Abrysvo), one dose for older adults or during pregnancy CPT 90678 Abrysvo: 5 Tray In 1 Carton (0069-0344-05) / 1 Kit In 1 Tray (0069-0344-21) * .5 Ml In 1 Vial, Glass (0069-0207-01) * .69 Ml In 1 Syringe, Glass (0069-0250-01)	$620.47	$1,034.12	—	14% below	40%
RSV vaccine (Abrysvo), one dose for older adults or during pregnancy inpatient CPT 90678 Hc Rsv Vaccine Pref Subunit Bivalent For Im Use	$590.68	$984.47	—	—	40%
RSV vaccine (Abrysvo), one dose for older adults or during pregnancy inpatient CPT 90678 NDC Description Not Available	$595.65	$992.75	—	—	40%
RSV vaccine (Abrysvo), one dose for older adults or during pregnancy inpatient CPT 90678 Abrysvo: 5 Tray In 1 Carton (0069-0344-05) / 1 Kit In 1 Tray (0069-0344-21) * .5 Ml In 1 Vial, Glass (0069-0207-01) * .69 Ml In 1 Syringe, Glass (0069-0250-01)	$620.47	$1,034.12	—	—	40%
RSV vaccine (Abrysvo), one dose for older adults or during pregnancy inpatient CPT 90678 Abrysvo: 10 Vial In 1 Carton (0069-2465-10) / .5 Ml In 1 Vial (0069-2465-19)	$620.47	$1,034.12	—	—	40%
Rabies vaccine, one dose CPT 90675 Lupron Depot: 1 Kit In 1 Carton (0074-3683-03) * 1.5 Ml In 1 Syringe (0074-9930-01) * 1 Swab In 1 Packet (0074-0009-01) * 1.5 Ml In 1 Syringe * 1 Swab In 1 Packet	$828.80	$1,381.33	—	13% below	40%
Rabies vaccine, one dose CPT 90675 NDC Description Not Available	$841.83	$1,403.05	—	12% below	40%
Rabies vaccine, one dose CPT 90675 Hc Rabies Vaccine Im	$895.67	$1,492.78	—	6% below	40%
Rabies vaccine, one dose inpatient CPT 90675 Lupron Depot: 1 Kit In 1 Carton (0074-3683-03) * 1.5 Ml In 1 Syringe (0074-9930-01) * 1 Swab In 1 Packet (0074-0009-01) * 1.5 Ml In 1 Syringe * 1 Swab In 1 Packet	$828.80	$1,381.33	—	—	40%
Rabies vaccine, one dose inpatient CPT 90675 NDC Description Not Available	$841.83	$1,403.05	—	—	40%
Rabies vaccine, one dose inpatient CPT 90675 Hc Rabies Vaccine Im	$895.67	$1,492.78	—	—	40%
Rotavirus vaccine, oral, 2-dose schedule (Rotarix) CPT 90681 Hc Rv1 Vaccine 2 Dose Schedule Live For Oral Use	$276.31	$460.51	—	6% above	40%
Rotavirus vaccine, oral, 2-dose schedule (Rotarix) CPT 90681 Hc Rotavirus Monovalent Vaccine 2 Dose Oral	$276.31	$460.51	—	6% above	40%
Rotavirus vaccine, oral, 2-dose schedule (Rotarix) inpatient CPT 90681 Hc Rv1 Vaccine 2 Dose Schedule Live For Oral Use	$276.31	$460.51	—	—	40%
Rotavirus vaccine, oral, 2-dose schedule (Rotarix) inpatient CPT 90681 Hc Rotavirus Monovalent Vaccine 2 Dose Oral	$276.31	$460.51	—	—	40%
Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) CPT 90680 Hc Rotavirus Vaccine Pentav 2 Ml Susp Po	$209.88	$349.80	—	55% above	40%
Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) inpatient CPT 90680 Hc Rotavirus Vaccine Pentav 2 Ml Susp Po	$209.88	$349.80	—	—	40%
Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 Hc Hzv Zoster Vacc Recombinant Adjuvanted Im Njx	$396.26	$660.44	—	21% below	40%
Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 NDC Description Not Available	$434.41	$724.02	—	14% below	40%
Shingles vaccine (Shingrix), recombinant, one dose inpatient CPT 90750 Hc Hzv Zoster Vacc Recombinant Adjuvanted Im Njx	$396.26	$660.44	—	—	40%
Shingles vaccine (Shingrix), recombinant, one dose inpatient CPT 90750 NDC Description Not Available	$434.41	$724.02	—	—	40%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 Hc Td Vaccine No Hbsrv >/= 7 Yo Im	$71.32	$118.86	—	21% below	40%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 NDC Description Not Available	$77.18	$128.63	—	14% below	40%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 Hc Td Vaccine No Hbsrv >/= 7 Yo Im	$71.32	$118.86	—	—	40%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 NDC Description Not Available	$77.18	$128.63	—	—	40%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 Hc Tdap Vaccine >7 Yo Im	$88.62	$147.70	—	20% below	40%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 NDC Description Not Available	$93.42	$155.70	—	15% below	40%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 Hc Tdap Vaccine >7 Yo Im	$88.62	$147.70	—	—	40%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 NDC Description Not Available	$93.42	$155.70	—	—	40%
Typhoid vaccine, injectable (Vi polysaccharide) CPT 90691 Hc Typhoid Vaccine Im	$279.52	$465.87	—	2% below	40%
Typhoid vaccine, injectable (Vi polysaccharide) inpatient CPT 90691 Hc Typhoid Vaccine Im	$279.52	$465.87	—	—	40%
Typhoid vaccine, oral capsules (Vivotif) CPT 90690 Hc Typhoid Vaccine Oral	$53.42	$89.04	—	8% above	40%
Typhoid vaccine, oral capsules (Vivotif) inpatient CPT 90690 Hc Typhoid Vaccine Oral	$53.42	$89.04	—	—	40%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Hc Immunization Injection Single	$60.00	$100.00	—	47% above	40%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Hc Immunization Injection Single	$60.00	$100.00	—	—	40%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Hc Admin Immunization Additional Vaccine	$35.40	$59.00	—	2% above	40%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 Hc Admin Immunization Additional Vaccine	$35.40	$59.00	—	—	40%

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.uchealth.com/content/dam/uchealth/json-files/311588499_West-Chester-Hospital_StandardCharges.json