Hospital Los Angeles-Long Beach-Anaheim, CA

UCI Health - Fountain Valley

UCI Health - Fountain Valley in Fountain Valley, CA publishes cash prices for 257 common procedures listed here, from its own machine-readable price file updated Apr 1, 2026. Compared with other hospitals in the state, its outpatient cash prices are below the California median for 223 of 254 procedures and above it for 31. By typical cash price it ranks #43 of 226 California hospitals and #12 of 55 hospitals in the Los Angeles, CA area, cheapest first. Select a procedure to compare it with other hospitals nearby.

17100 Euclid Street, Fountain Valley, CA 92708 Collected Sep 28, 2026 Source price file Check a bill from this hospital (714) 966-7200

Acute care hospital For-profit hospital No emergency department CMS star rating 2 of 5 CCN 050570 · CMS hospital register

State law

This state limits hospital bills for lower-income patients

California law (Health and Safety Code §127405): if you are uninsured or have high medical costs and your family income is at or below 400% of the federal poverty level, a hospital may not expect you to pay more than it would expect from Medicare or Medi-Cal, whichever is greater. That can be less than the cash prices below; ask the hospital for its discount payment policy. A separate physician fee may still apply. Other states' laws.

Scans and imaging

Procedure	Cash price	List price	Insurers pay	vs California	Off list
Abdominal CT scan without and with contrast CPT 74170 CT ABDOMEN WO/W CM	$1,109.60	$2,774.00	—	61% below	60%
Abdominal CT scan without and with contrast inpatient CPT 74170 CT ABDOMEN WO/W CM	$1,109.60	$2,774.00	—	—	60%
Abdominal X-ray, 2 views CPT 74019 ABDOMEN 2 VIEWS	$315.20	$788.00	—	27% below	60%
Abdominal X-ray, 2 views inpatient CPT 74019 ABDOMEN 2 VIEWS	$315.20	$788.00	—	—	60%
Ankle X-ray, complete, 3 or more views CPT 73610 ANKLE 3 VIEWS MINIMUM	$439.20	$1,098.00	—	15% below	60%
Ankle X-ray, complete, 3 or more views inpatient CPT 73610 ANKLE 3 VIEWS MINIMUM	$439.20	$1,098.00	—	—	60%
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 UE/LE ART STUD LTD 1-2LV	$100.80	$252.00	—	82% below	60%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 UE/LE ART STUD LTD 1-2LV	$100.80	$252.00	—	—	60%
Arm CT scan without contrast (shoulder to hand, any part) CPT 73200 CT UPPER EXTRMTY W/O CM	$2,286.00	$5,715.00	—	at median	60%
Arm CT scan without contrast (shoulder to hand, any part) inpatient CPT 73200 CT UPPER EXTRMTY W/O CM	$2,286.00	$5,715.00	—	—	60%
Barium swallow (esophagus X-ray with contrast) CPT 74220 X-RAY ESOPHAGUS SNGL CM STDY	$548.80	$1,372.00	—	9% below	60%
Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 X-RAY ESOPHAGUS SNGL CM STDY	$548.80	$1,372.00	—	—	60%
Bone scan, whole body (nuclear medicine) CPT 78306 BONE IMAGING WHOLE BODY	$1,655.60	$4,139.00	—	22% below	60%
Bone scan, whole body (nuclear medicine) inpatient CPT 78306 BONE IMAGING WHOLE BODY	$1,655.60	$4,139.00	—	—	60%
Breast ultrasound, complete, one breast CPT 76641 US BREAST UNI COMPLETE	$433.60	$1,084.00	—	39% below	60%
Breast ultrasound, complete, one breast inpatient CPT 76641 US BREAST UNI COMPLETE	$433.60	$1,084.00	—	—	60%
CT angiography (CTA) of the abdomen and pelvis CPT 74174 CTA ABD/PEL W CONTRAST	$1,597.60	$3,994.00	—	70% below	60%
CT angiography (CTA) of the abdomen and pelvis CPT 74174 CTA ABD/PEL WO/W CM	$1,597.60	$3,994.00	—	70% below	60%
CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174 CTA ABD/PEL WO/W CM	$1,597.60	$3,994.00	—	—	60%
CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174 CTA ABD/PEL W CONTRAST	$1,597.60	$3,994.00	—	—	60%
CT angiography (CTA) of the head CPT 70496 CTA HEAD WO/W CONTRAST	$749.60	$1,874.00	—	75% below	60%
CT angiography (CTA) of the head CPT 70496 CTA HEAD W CONTRAST ONLY	$749.60	$1,874.00	—	75% below	60%
CT angiography (CTA) of the head inpatient CPT 70496 CTA HEAD WO/W CONTRAST	$749.60	$1,874.00	—	—	60%
CT angiography (CTA) of the head inpatient CPT 70496 CTA HEAD W CONTRAST ONLY	$749.60	$1,874.00	—	—	60%
CT angiography (CTA) of the neck CPT 70498 CTA NECK WO/W CONTRAST	$701.20	$1,753.00	—	76% below	60%
CT angiography (CTA) of the neck CPT 70498 CTA NECK W CONTRAST ONLY	$701.20	$1,753.00	—	76% below	60%
CT angiography (CTA) of the neck inpatient CPT 70498 CTA NECK WO/W CONTRAST	$701.20	$1,753.00	—	—	60%
CT angiography (CTA) of the neck inpatient CPT 70498 CTA NECK W CONTRAST ONLY	$701.20	$1,753.00	—	—	60%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CTA CHEST (NONCOR) W CM	$3,648.80	$9,122.00	—	6% above	60%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CTA CHEST (NONCOR) WO/W	$3,648.80	$9,122.00	—	6% above	60%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CTA CHEST (NONCOR) W CM	$3,648.80	$9,122.00	—	—	60%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CTA CHEST (NONCOR) WO/W	$3,648.80	$9,122.00	—	—	60%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT ABD & PELVIS W/O CM	$840.80	$2,102.00	—	74% below	60%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT ABD & PELVIS W/O CM	$840.80	$2,102.00	—	—	60%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ABD & PELVIS W/CM	$1,248.00	$3,120.00	—	70% below	60%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT ABD & PELVIS W/CM	$1,248.00	$3,120.00	—	—	60%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT ABD & PELVIS WO/W CM	$1,536.00	$3,840.00	—	67% below	60%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT ABD & PELVIS WO/W CM	$1,536.00	$3,840.00	—	—	60%
CT scan of the abdomen with contrast CPT 74160 CT ABDOMEN W/ CM	$1,026.80	$2,567.00	—	59% below	60%
CT scan of the abdomen with contrast inpatient CPT 74160 CT ABDOMEN W/ CM	$1,026.80	$2,567.00	—	—	60%
CT scan of the abdomen without contrast CPT 74150 CT ABDOMEN W/O CM	$989.20	$2,473.00	—	48% below	60%
CT scan of the abdomen without contrast inpatient CPT 74150 CT ABDOMEN W/O CM	$989.20	$2,473.00	—	—	60%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT SINUS W/O CONTRAST	$571.20	$1,428.00	—	74% below	60%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT MAXILLOFACIAL W/O CM	$571.20	$1,428.00	—	74% below	60%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT SINUS W/O CONTRAST	$571.20	$1,428.00	—	—	60%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT MAXILLOFACIAL W/O CM	$571.20	$1,428.00	—	—	60%
CT scan of the head or brain, no contrast dye CPT 70450 CT HEAD/BRAIN WO CONTRST	$821.60	$2,054.00	—	64% below	60%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT HEAD/BRAIN WO CONTRST	$821.60	$2,054.00	—	—	60%
CT scan of the head with contrast CPT 70460 CT HEAD/BRAIN W CONTRAST	$1,101.20	$2,753.00	—	59% below	60%
CT scan of the head with contrast inpatient CPT 70460 CT HEAD/BRAIN W CONTRAST	$1,101.20	$2,753.00	—	—	60%
CT scan of the head without and with contrast CPT 70470 CT HEAD/BRAIN WO/W CONTR	$1,337.60	$3,344.00	—	57% below	60%
CT scan of the head without and with contrast inpatient CPT 70470 CT HEAD/BRAIN WO/W CONTR	$1,337.60	$3,344.00	—	—	60%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT SPINE LUMBAR W/O CM	$828.80	$2,072.00	—	71% below	60%
CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 CT SPINE LUMBAR W/O CM	$828.80	$2,072.00	—	—	60%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT SPINE CERVICAL W/O CM	$1,532.00	$3,830.00	—	47% below	60%
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CT SPINE CERVICAL W/O CM	$1,532.00	$3,830.00	—	—	60%
CT scan of the pelvis, with contrast dye CPT 72193 CT PELVIS WITH CONTRAST	$1,088.80	$2,722.00	—	57% below	60%
CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT PELVIS WITH CONTRAST	$1,088.80	$2,722.00	—	—	60%
Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 DUPLEX CAROTID BI/COMP	$1,735.20	$4,338.00	—	—	60%
Carotid artery ultrasound (duplex), both sides of the neck inpatient both sides CPT 93880 DUPLEX CAROTID BI/COMP	$1,735.20	$4,338.00	—	—	60%
Chest CT scan without and with contrast CPT 71270 CT THORAX WO/W CONTRAST	$2,160.00	$5,400.00	—	34% below	60%
Chest CT scan without and with contrast inpatient CPT 71270 CT THORAX WO/W CONTRAST	$2,160.00	$5,400.00	—	—	60%
Chest X-ray, 2 views CPT 71046 CHEST 2 VIEWS	$321.60	$804.00	—	21% below	60%
Chest X-ray, 2 views inpatient CPT 71046 CHEST 2 VIEWS	$321.60	$804.00	—	—	60%
Chest X-ray, single view CPT 71045 CHEST 1 VIEW	$257.20	$643.00	—	29% below	60%
Chest X-ray, single view inpatient CPT 71045 CHEST 1 VIEW	$257.20	$643.00	—	—	60%
Collarbone (clavicle) X-ray, complete CPT 73000 CLAVICLE COMPLETE	$510.80	$1,277.00	—	6% above	60%
Collarbone (clavicle) X-ray, complete inpatient CPT 73000 CLAVICLE COMPLETE	$510.80	$1,277.00	—	—	60%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US RETROPERITONEAL COMP	$373.60	$934.00	—	56% below	60%
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US RETROPERITONEAL COMP	$373.60	$934.00	—	—	60%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT THORAX W/O CONTRAST	$989.20	$2,473.00	—	51% below	60%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT THORAX W/O CONTRAST	$989.20	$2,473.00	—	—	60%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT THORAX WITH CONTRAST	$1,557.60	$3,894.00	—	46% below	60%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT THORAX WITH CONTRAST	$1,557.60	$3,894.00	—	—	60%
Diagnostic mammogram, one breast one side CPT 77065 DX MAMMO+CAD UNILAT	$322.40	$806.00	—	14% below	60%
Diagnostic mammogram, one breast inpatient one side CPT 77065 DX MAMMO+CAD UNILAT	$322.40	$806.00	—	—	60%
Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 LE ART IMAGING COMP BILAT	$1,726.00	$4,315.00	—	—	60%
Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 LE ART IMAGING COMP BILAT	$1,726.00	$4,315.00	—	—	60%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 UE/LE IMG VEINS COMP BILAT	$1,360.40	$3,401.00	—	—	60%
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 UE/LE IMG VEINS COMP BILAT	$1,360.40	$3,401.00	—	—	60%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 ECHO2D SPECTR/COLOR FLO	$1,291.60	$3,229.00	—	52% below	60%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 ECHO2D SPECTR/COLOR FLO	$1,291.60	$3,229.00	—	—	60%
Elbow X-ray, 2 views CPT 73070 ELBOW 2 VIEWS	$223.20	$558.00	—	44% below	60%
Elbow X-ray, 2 views inpatient CPT 73070 ELBOW 2 VIEWS	$223.20	$558.00	—	—	60%
Elbow X-ray, complete, 3 or more views CPT 73080 ELBOW 3 VIEW MINIMUM	$348.00	$870.00	—	28% below	60%
Elbow X-ray, complete, 3 or more views inpatient CPT 73080 ELBOW 3 VIEW MINIMUM	$348.00	$870.00	—	—	60%
Eye socket (orbit) CT scan without contrast CPT 70480 CT ORB/EAR/FOSSA W/O CM	$581.60	$1,454.00	—	75% below	60%
Eye socket (orbit) CT scan without contrast inpatient CPT 70480 CT ORB/EAR/FOSSA W/O CM	$581.60	$1,454.00	—	—	60%
Facial bones X-ray, complete, 3 or more views CPT 70150 FACIAL BONES 3VW MIN	$815.20	$2,038.00	—	65% above	60%
Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 FACIAL BONES 3VW MIN	$815.20	$2,038.00	—	—	60%
Forearm X-ray (radius and ulna), 2 views CPT 73090 FOREARM 2 VIEWS	$336.40	$841.00	—	21% below	60%
Forearm X-ray (radius and ulna), 2 views inpatient CPT 73090 FOREARM 2 VIEWS	$336.40	$841.00	—	—	60%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 HEPATOBILIARY SYSTEM IMG	$3,613.20	$9,033.00	—	103% above	60%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 HEPATOBILIARY SYSTEM IMG	$3,613.20	$9,033.00	—	—	60%
Hand X-ray, 2 views CPT 73120 HAND 2 VIEWS	$292.40	$731.00	—	28% below	60%
Hand X-ray, 2 views inpatient CPT 73120 HAND 2 VIEWS	$292.40	$731.00	—	—	60%
Heel bone (calcaneus) X-ray, 2 or more views CPT 73650 OS CALCIS 2 VIEWS	$222.00	$555.00	—	37% below	60%
Heel bone (calcaneus) X-ray, 2 or more views inpatient CPT 73650 OS CALCIS 2 VIEWS	$222.00	$555.00	—	—	60%
Knee X-ray, complete, 4 or more views CPT 73564 KNEE COMP 4 VW MIN	$929.60	$2,324.00	—	59% above	60%
Knee X-ray, complete, 4 or more views inpatient CPT 73564 KNEE COMP 4 VW MIN	$929.60	$2,324.00	—	—	60%
Leg CT scan without contrast (hip to foot, any part) CPT 73700 CT LOWER EXTRMTY W/O CM	$1,583.20	$3,958.00	—	26% below	60%
Leg CT scan without contrast (hip to foot, any part) inpatient CPT 73700 CT LOWER EXTRMTY W/O CM	$1,583.20	$3,958.00	—	—	60%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US ABD LTD SNGLE/QUAD/FU	$572.40	$1,431.00	—	31% below	60%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US ABD LTD SNGLE/QUAD/FU	$572.40	$1,431.00	—	—	60%
Limited ultrasound of an arm or leg (non-vascular) CPT 76882 US XTR JOINT LMTD	$672.00	$1,680.00	—	23% above	60%
Limited ultrasound of an arm or leg (non-vascular) CPT 76882 US XTR SOFT TISSUE LMTD	$672.00	$1,680.00	—	23% above	60%
Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 US XTR JOINT LMTD	$672.00	$1,680.00	—	—	60%
Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 US XTR SOFT TISSUE LMTD	$672.00	$1,680.00	—	—	60%
Lower leg X-ray (tibia and fibula), 2 views CPT 73590 TIBIA/FIBULA 2 VIEWS	$416.00	$1,040.00	—	4% below	60%
Lower leg X-ray (tibia and fibula), 2 views inpatient CPT 73590 TIBIA/FIBULA 2 VIEWS	$416.00	$1,040.00	—	—	60%
MR angiography (MRA) of the head without contrast CPT 70544 MRA HEAD W/O CONTRAST	$1,762.40	$4,406.00	—	39% below	60%
MR angiography (MRA) of the head without contrast inpatient CPT 70544 MRA HEAD W/O CONTRAST	$1,762.40	$4,406.00	—	—	60%
MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MRI LOWR EXT JNT W/O CM	$1,530.00	$3,825.00	—	50% below	60%
MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 MRI LOWR EXT JNT W/O CM	$1,530.00	$3,825.00	—	—	60%
MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 MRI LE JNT WO/W CM	$2,196.80	$5,492.00	—	52% below	60%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 MRI LE JNT WO/W CM	$2,196.80	$5,492.00	—	—	60%
MRI of the abdomen without contrast CPT 74181 MRI ABDOMEN W/O CM	$1,464.40	$3,661.00	—	48% below	60%
MRI of the abdomen without contrast inpatient CPT 74181 MRI ABDOMEN W/O CM	$1,464.40	$3,661.00	—	—	60%
MRI of the abdomen, without and then with contrast dye CPT 74183 MRI ABDOMEN WO/W CM	$2,179.60	$5,449.00	—	50% below	60%
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MRI ABDOMEN WO/W CM	$2,179.60	$5,449.00	—	—	60%
MRI of the brain, no contrast dye CPT 70551 MRI BRAIN W/O CONTRAST	$1,430.80	$3,577.00	—	51% below	60%
MRI of the brain, no contrast dye inpatient CPT 70551 MRI BRAIN W/O CONTRAST	$1,430.80	$3,577.00	—	—	60%
MRI of the brain, with and without contrast dye CPT 70553 MRI BRAIN WO/W CONTRAST	$1,920.00	$4,800.00	—	56% below	60%
MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI BRAIN WO/W CONTRAST	$1,920.00	$4,800.00	—	—	60%
MRI of the lower back, no contrast dye CPT 72148 MRI SPINE LUMBAR W/O CM	$1,532.00	$3,830.00	—	50% below	60%
MRI of the lower back, no contrast dye inpatient CPT 72148 MRI SPINE LUMBAR W/O CM	$1,532.00	$3,830.00	—	—	60%
MRI of the lower back, without and then with contrast dye CPT 72158 MRI SPINE LUMBAR WO/W CM	$1,776.00	$4,440.00	—	61% below	60%
MRI of the lower back, without and then with contrast dye inpatient CPT 72158 MRI SPINE LUMBAR WO/W CM	$1,776.00	$4,440.00	—	—	60%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI SPINE THORAC W/O CM	$1,532.00	$3,830.00	—	47% below	60%
MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 MRI SPINE THORAC W/O CM	$1,532.00	$3,830.00	—	—	60%
MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI SPINE CERV WO/W CM	$1,776.00	$4,440.00	—	60% below	60%
MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 MRI SPINE CERV WO/W CM	$1,776.00	$4,440.00	—	—	60%
MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI SPINE CERVICL W/O CM	$1,532.00	$3,830.00	—	49% below	60%
MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 MRI SPINE CERVICL W/O CM	$1,532.00	$3,830.00	—	—	60%
MRI of the pelvis without and with contrast CPT 72197 MRI PELVIS WO/W CONTRAST	$2,471.20	$6,178.00	—	40% below	60%
MRI of the pelvis without and with contrast inpatient CPT 72197 MRI PELVIS WO/W CONTRAST	$2,471.20	$6,178.00	—	—	60%
MRI of the pelvis, no contrast dye CPT 72195 MRI PELVIS W/O CONTRAST	$1,667.60	$4,169.00	—	35% below	60%
MRI of the pelvis, no contrast dye inpatient CPT 72195 MRI PELVIS W/O CONTRAST	$1,667.60	$4,169.00	—	—	60%
MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 MRI UP EXT JNT W/O CM	$1,527.20	$3,818.00	—	42% below	60%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 MRI UP EXT JNT W/O CM	$1,527.20	$3,818.00	—	—	60%
Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 SPINE CERVICAL 4 OR 5 VW	$493.20	$1,233.00	—	23% below	60%
Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 SPINE CERVICAL 4 OR 5 VW	$493.20	$1,233.00	—	—	60%
Neck soft tissue CT scan with contrast CPT 70491 CT SOFT TISS NECK W CM	$1,370.00	$3,425.00	—	50% below	60%
Neck soft tissue CT scan with contrast inpatient CPT 70491 CT SOFT TISS NECK W CM	$1,370.00	$3,425.00	—	—	60%
Neck soft tissue CT scan without contrast CPT 70490 CT SOFT TISS NECK WO CM	$804.00	$2,010.00	—	62% below	60%
Neck soft tissue CT scan without contrast inpatient CPT 70490 CT SOFT TISS NECK WO CM	$804.00	$2,010.00	—	—	60%
Neck soft tissue X-ray CPT 70360 NECK FOR SOFT TISSUES	$681.20	$1,703.00	—	110% above	60%
Neck soft tissue X-ray inpatient CPT 70360 NECK FOR SOFT TISSUES	$681.20	$1,703.00	—	—	60%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 MC PERF SPECT WM EF MULT	$2,331.20	$5,828.00	—	43% below	60%
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 MC PERF SPECT WM EF MULT	$2,331.20	$5,828.00	—	—	60%
Pelvic CT scan without contrast CPT 72192 CT PELVIS W/O CONTRAST	$927.20	$2,318.00	—	53% below	60%
Pelvic CT scan without contrast inpatient CPT 72192 CT PELVIS W/O CONTRAST	$927.20	$2,318.00	—	—	60%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US PELVIC LTD/FU	$370.40	$926.00	—	31% below	60%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US PELVIC LTD/FU	$370.40	$926.00	—	—	60%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US PELVIC COMPLETE	$543.20	$1,358.00	—	42% below	60%
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 US PELVIC COMPLETE	$543.20	$1,358.00	—	—	60%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US OB COMP>14WK SGL GEST	$655.20	$1,638.00	—	24% below	60%
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US OB COMP>14WK SGL GEST	$655.20	$1,638.00	—	—	60%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 US OB COMP<14WKS 1STGEST	$497.60	$1,244.00	—	36% below	60%
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 US OB COMP<14WKS 1STGEST	$497.60	$1,244.00	—	—	60%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US OB LTD 1OR> FETUS	$899.60	$2,249.00	—	49% above	60%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 US OB LTD 1OR> FETUS	$899.60	$2,249.00	—	—	60%
Rib X-ray, one side, 2 views one side CPT 71100 RIBS UNILAT 2VW	$592.80	$1,482.00	—	28% above	60%
Rib X-ray, one side, 2 views inpatient one side CPT 71100 RIBS UNILAT 2VW	$592.80	$1,482.00	—	—	60%
Rib X-ray, one side, with a chest view, 3 or more views CPT 71101 RIBS UNI 3V MIN W/PA CXR	$720.40	$1,801.00	—	17% above	60%
Rib X-ray, one side, with a chest view, 3 or more views inpatient CPT 71101 RIBS UNI 3V MIN W/PA CXR	$720.40	$1,801.00	—	—	60%
Shoulder X-ray, complete, 2 or more views CPT 73030 SHOULDER 2 VWS MINIMUM	$658.80	$1,647.00	—	19% above	60%
Shoulder X-ray, complete, 2 or more views inpatient CPT 73030 SHOULDER 2 VWS MINIMUM	$658.80	$1,647.00	—	—	60%
Sinus X-ray, complete, 3 or more views CPT 70220 SINUSES 3VW MIN	$202.40	$506.00	—	56% below	60%
Sinus X-ray, complete, 3 or more views inpatient CPT 70220 SINUSES 3VW MIN	$202.40	$506.00	—	—	60%
Skull X-ray, fewer than 4 views CPT 70250 SKULL < 4 VIEWS	$563.20	$1,408.00	—	39% above	60%
Skull X-ray, fewer than 4 views inpatient CPT 70250 SKULL < 4 VIEWS	$563.20	$1,408.00	—	—	60%
Swallow study (modified barium swallow, video X-ray) CPT 74230 SWAL FUNC W/CINE/VIDEO+CM STDY	$532.00	$1,330.00	—	20% below	60%
Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 SWAL FUNC W/CINE/VIDEO+CM STDY	$532.00	$1,330.00	—	—	60%
Thigh bone (femur) X-ray, 2 or more views CPT 73552 FEMUR 2 VIEWS MIN	$718.40	$1,796.00	—	76% above	60%
Thigh bone (femur) X-ray, 2 or more views inpatient CPT 73552 FEMUR 2 VIEWS MIN	$718.40	$1,796.00	—	—	60%
Thoracic spine (mid back) CT scan without contrast CPT 72128 CT SPINE THORACIC W/O CM	$833.20	$2,083.00	—	70% below	60%
Thoracic spine (mid back) CT scan without contrast inpatient CPT 72128 CT SPINE THORACIC W/O CM	$833.20	$2,083.00	—	—	60%
Toe X-ray, 2 or more views CPT 73660 TOE(S) 2 VIEWS	$465.20	$1,163.00	—	41% above	60%
Toe X-ray, 2 or more views inpatient CPT 73660 TOE(S) 2 VIEWS	$465.20	$1,163.00	—	—	60%
Transvaginal pelvic ultrasound CPT 76830 US TRANSVAGINAL NOT OB	$416.40	$1,041.00	—	42% below	60%
Transvaginal pelvic ultrasound inpatient CPT 76830 US TRANSVAGINAL NOT OB	$416.40	$1,041.00	—	—	60%
Transvaginal ultrasound during pregnancy CPT 76817 US OB TRANSVAGINAL	$966.80	$2,417.00	—	45% above	60%
Transvaginal ultrasound during pregnancy inpatient CPT 76817 US OB TRANSVAGINAL	$966.80	$2,417.00	—	—	60%
Ultrasound of the abdomen, complete CPT 76700 US ABDOMEN COMPLETE	$725.60	$1,814.00	—	34% below	60%
Ultrasound of the abdomen, complete inpatient CPT 76700 US ABDOMEN COMPLETE	$725.60	$1,814.00	—	—	60%
Ultrasound of the scrotum and testicles CPT 76870 US SCROTUM CONTENTS	$488.40	$1,221.00	—	45% below	60%
Ultrasound of the scrotum and testicles inpatient CPT 76870 US SCROTUM CONTENTS	$488.40	$1,221.00	—	—	60%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US SOFT TISSUE HEAD/NECK	$320.80	$802.00	—	61% below	60%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US SOFT TISSUE HEAD/NECK	$320.80	$802.00	—	—	60%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 UPPER GI W/SNGL CM STDY	$388.80	$972.00	—	37% below	60%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 UPPER GI W/SNGL CM STDY	$388.80	$972.00	—	—	60%
Upper arm X-ray (humerus), 2 views CPT 73060 HUMERUS 2 VIEW MINIMUM	$428.40	$1,071.00	—	at median	60%
Upper arm X-ray (humerus), 2 views inpatient CPT 73060 HUMERUS 2 VIEW MINIMUM	$428.40	$1,071.00	—	—	60%
Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 UE/LE IMG VEINS UNI/LTD	$762.80	$1,907.00	—	15% below	60%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 UE/LE IMG VEINS UNI/LTD	$762.80	$1,907.00	—	—	60%
Wrist X-ray, 2 views CPT 73100 WRIST 2 VIEWS	$241.20	$603.00	—	38% below	60%
Wrist X-ray, 2 views inpatient CPT 73100 WRIST 2 VIEWS	$241.20	$603.00	—	—	60%
Wrist X-ray, complete, 3 or more views CPT 73110 WRIST 3 VIEWS MINIMUM	$294.00	$735.00	—	42% below	60%
Wrist X-ray, complete, 3 or more views inpatient CPT 73110 WRIST 3 VIEWS MINIMUM	$294.00	$735.00	—	—	60%
X-ray of one hip, 2 or 3 views, with the pelvis when included CPT 73502 HIP UNI W/PELV 2-3 VWS	$858.80	$2,147.00	—	114% above	60%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 HIP UNILATERAL 2-3 VWS	$858.80	$2,147.00	—	114% above	60%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient CPT 73502 HIP UNI W/PELV 2-3 VWS	$858.80	$2,147.00	—	—	60%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 HIP UNILATERAL 2-3 VWS	$858.80	$2,147.00	—	—	60%
X-ray of the abdomen, 1 view CPT 74018 ABDOMEN 1 VIEW	$184.40	$461.00	—	39% below	60%
X-ray of the abdomen, 1 view inpatient CPT 74018 ABDOMEN 1 VIEW	$184.40	$461.00	—	—	60%
X-ray of the ankle, 2 views CPT 73600 ANKLE 2 VIEWS	$296.80	$742.00	—	24% below	60%
X-ray of the ankle, 2 views inpatient CPT 73600 ANKLE 2 VIEWS	$296.80	$742.00	—	—	60%
X-ray of the finger(s), 2 or more views CPT 73140 FINGER(S) 2 VIEWS	$216.00	$540.00	—	41% below	60%
X-ray of the finger(s), 2 or more views inpatient CPT 73140 FINGER(S) 2 VIEWS	$216.00	$540.00	—	—	60%
X-ray of the foot, 2 views CPT 73620 FOOT 2 VIEWS	$296.80	$742.00	—	27% below	60%
X-ray of the foot, 2 views inpatient CPT 73620 FOOT 2 VIEWS	$296.80	$742.00	—	—	60%
X-ray of the foot, complete, 3 or more views CPT 73630 FOOT 3 VIEWS MINIMUM	$306.00	$765.00	—	38% below	60%
X-ray of the foot, complete, 3 or more views inpatient CPT 73630 FOOT 3 VIEWS MINIMUM	$306.00	$765.00	—	—	60%
X-ray of the hand, 3 or more views CPT 73130 HAND 3 VIEWS MINIMUM	$307.20	$768.00	—	40% below	60%
X-ray of the hand, 3 or more views inpatient CPT 73130 HAND 3 VIEWS MINIMUM	$307.20	$768.00	—	—	60%
X-ray of the knee, 1 or 2 views CPT 73560 KNEE 1-2 VIEWS	$215.20	$538.00	—	46% below	60%
X-ray of the knee, 1 or 2 views inpatient CPT 73560 KNEE 1-2 VIEWS	$215.20	$538.00	—	—	60%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 SPINE LUMBAR 2 VIEWS	$344.40	$861.00	—	27% below	60%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 SPINE LUMBAR 2 VIEWS	$344.40	$861.00	—	—	60%
X-ray of the lower back, 4 or more views CPT 72110 SPINE LUMBAR MIN 4VWS	$472.00	$1,180.00	—	28% below	60%
X-ray of the lower back, 4 or more views inpatient CPT 72110 SPINE LUMBAR MIN 4VWS	$472.00	$1,180.00	—	—	60%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 SPINE THORACIC 2 VIEWS	$260.00	$650.00	—	44% below	60%
X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 SPINE THORACIC 2 VIEWS	$260.00	$650.00	—	—	60%
X-ray of the nasal bones, 3 or more views CPT 70160 NASAL BONES 3VW MIN	$360.80	$902.00	—	17% below	60%
X-ray of the nasal bones, 3 or more views inpatient CPT 70160 NASAL BONES 3VW MIN	$360.80	$902.00	—	—	60%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 SPINE CERVICAL 2 VIEWS	$366.40	$916.00	—	19% below	60%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 SPINE CERVICAL 2 VIEWS	$366.40	$916.00	—	—	60%
X-ray of the pelvis, 1 or 2 views CPT 72170 PELVIS 1 VIEW	$396.00	$990.00	—	3% above	60%
X-ray of the pelvis, 1 or 2 views CPT 72170 PELVIS 2 VIEWS	$396.00	$990.00	—	3% above	60%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 PELVIS 2 VIEWS	$396.00	$990.00	—	—	60%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 PELVIS 1 VIEW	$396.00	$990.00	—	—	60%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 SACRUM COCCYX 2 VWS	$677.20	$1,693.00	—	44% above	60%
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 SACRUM COCCYX 2 VWS	$677.20	$1,693.00	—	—	60%

Lab tests

Procedure	Cash price	List price	Insurers pay	vs California	Off list
ACTH blood test CPT 82024 ACTH	$100.00	$250.00	—	48% above	60%
ACTH blood test inpatient CPT 82024 ACTH	$100.00	$250.00	—	—	60%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 TRANSAMINASE-SGPT (ALT)	$14.80	$37.00	—	66% below	60%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 TRANSAMINASE-SGPT (ALT)	$14.80	$37.00	—	—	60%
AST (aspartate aminotransferase) enzyme test CPT 84450 TRANSTERASE AST(SGOT)	$45.20	$113.00	—	at median	60%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 TRANSTERASE AST(SGOT)	$45.20	$113.00	—	—	60%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 ACUTE HEPATITIS PANEL	$24.42	$61.05	—	91% below	60%
Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 ACUTE HEPATITIS PANEL	$24.42	$61.05	—	—	60%
Albumin blood test CPT 82040 ALBUMIN SERUM	$15.20	$38.00	—	39% below	60%
Albumin blood test inpatient CPT 82040 ALBUMIN SERUM	$15.20	$38.00	—	—	60%
Aldosterone blood test CPT 82088 ALDOSTERONE	$11.30	$28.25	—	62% below	60%
Aldosterone blood test inpatient CPT 82088 ALDOSTERONE	$11.30	$28.25	—	—	60%
Alkaline phosphatase (ALP) blood test CPT 84075 PHOSPHATASE ALKALINE	$8.80	$22.00	—	76% below	60%
Alkaline phosphatase (ALP) blood test inpatient CPT 84075 PHOSPHATASE ALKALINE	$8.80	$22.00	—	—	60%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLRGN SPEC IGE EA/22	$1.30	$3.26	—	74% below	60%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLRGN SPEC IGE EA	$2.87	$7.18	—	43% below	60%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLRGN SPEC IGE EA/22	$1.30	$3.26	—	—	60%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLRGN SPEC IGE EA	$2.87	$7.18	—	—	60%
Alpha-fetoprotein (AFP) blood test CPT 82105 ALPHA FETO PROTEIN SERUM	$23.20	$58.00	—	70% below	60%
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 ALPHA FETO PROTEIN SERUM	$23.20	$58.00	—	—	60%
Ammonia blood test CPT 82140 AMMONIA	$19.20	$48.00	—	89% below	60%
Ammonia blood test inpatient CPT 82140 AMMONIA	$19.20	$48.00	—	—	60%
Amylase blood test CPT 82150 AMYLASE	$15.20	$38.00	—	70% below	60%
Amylase blood test CPT 82150 AMYLASE/5	$15.20	$38.00	—	70% below	60%
Amylase blood test inpatient CPT 82150 AMYLASE/5	$15.20	$38.00	—	—	60%
Amylase blood test inpatient CPT 82150 AMYLASE	$15.20	$38.00	—	—	60%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 B-TYP NATRIURETC PEPTIDE	$34.40	$86.00	—	81% below	60%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 B-TYP NATRIURETC PEPTIDE	$34.40	$86.00	—	—	60%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE BACT OTH SOURCE/16	$129.20	$323.00	—	7% above	60%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE BACT OTH SOURCE/2	$129.20	$323.00	—	7% above	60%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE BACT OTH SOURCE/14	$129.20	$323.00	—	7% above	60%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE BACT OTH SOURCE/20	$129.20	$323.00	—	7% above	60%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE BACT OTH SOURCE/13	$129.20	$323.00	—	7% above	60%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE BACT OTH SOURCE/11	$129.20	$323.00	—	7% above	60%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE BACT OTH SOURCE/18	$129.20	$323.00	—	7% above	60%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE BACT OTH SOURCE/9	$129.20	$323.00	—	7% above	60%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE BACT OTH SOURCE/25	$129.20	$323.00	—	7% above	60%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE BACT OTH SOURCE/15	$129.20	$323.00	—	7% above	60%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE BACT OTH SOURCE/6	$202.80	$507.00	—	68% above	60%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE BACT OTH SOURCE/3	$344.00	$860.00	—	185% above	60%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE BACT OTH SOURCE/18	$129.20	$323.00	—	—	60%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE BACT OTH SOURCE/13	$129.20	$323.00	—	—	60%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE BACT OTH SOURCE/11	$129.20	$323.00	—	—	60%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE BACT OTH SOURCE/9	$129.20	$323.00	—	—	60%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE BACT OTH SOURCE/2	$129.20	$323.00	—	—	60%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE BACT OTH SOURCE/14	$129.20	$323.00	—	—	60%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE BACT OTH SOURCE/15	$129.20	$323.00	—	—	60%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE BACT OTH SOURCE/25	$129.20	$323.00	—	—	60%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE BACT OTH SOURCE/20	$129.20	$323.00	—	—	60%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE BACT OTH SOURCE/16	$129.20	$323.00	—	—	60%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE BACT OTH SOURCE/6	$202.80	$507.00	—	—	60%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE BACT OTH SOURCE/3	$344.00	$860.00	—	—	60%
Basic metabolic panel (blood test) CPT 80048 BASIC METABOLIC PANEL	$44.80	$112.00	—	77% below	60%
Basic metabolic panel (blood test) inpatient CPT 80048 BASIC METABOLIC PANEL	$44.80	$112.00	—	—	60%
Bilirubin blood test, total CPT 82247 BILIRUBIN TOTAL	$4.10	$10.25	—	91% below	60%
Bilirubin blood test, total CPT 82247 BILIRUBIN TOTAL/2	$12.80	$32.00	—	72% below	60%
Bilirubin blood test, total CPT 82247 BILIRUBIN TOTAL/3	$12.80	$32.00	—	72% below	60%
Bilirubin blood test, total inpatient CPT 82247 BILIRUBIN TOTAL	$4.10	$10.25	—	—	60%
Bilirubin blood test, total inpatient CPT 82247 BILIRUBIN TOTAL/2	$12.80	$32.00	—	—	60%
Bilirubin blood test, total inpatient CPT 82247 BILIRUBIN TOTAL/3	$12.80	$32.00	—	—	60%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 SURGICAL PATH LEVEL IV/2	$20.86	$52.15	—	84% below	60%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 SURGICAL PATH LEVEL IV	$157.60	$394.00	—	21% above	60%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 SURGICAL PATH LEVEL IV/2	$20.86	$52.15	—	—	60%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 SURGICAL PATH LEVEL IV	$157.60	$394.00	—	—	60%
Blood culture for bacteria CPT 87040 CULTURE BLOOD	$188.00	$470.00	—	31% below	60%
Blood culture for bacteria inpatient CPT 87040 CULTURE BLOOD	$188.00	$470.00	—	—	60%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 VENIPUNCTURE/4	$15.60	$39.00	—	26% below	60%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 VENIPUNCTURE/2	$15.60	$39.00	—	26% below	60%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 VENIPUNCTURE/4	$15.60	$39.00	—	—	60%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 VENIPUNCTURE/2	$15.60	$39.00	—	—	60%
Blood glucose (sugar) test CPT 82947 GLUCOSE QUANTITATIVE	$45.20	$113.00	—	20% above	60%
Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE QUANTITATIVE	$45.20	$113.00	—	—	60%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 GONADTOPN CHRONC(HCG)QL	$248.00	$620.00	—	55% above	60%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 GONADTOPN CHRONC(HCG)QL	$248.00	$620.00	—	—	60%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 BLD TYPE ABO	$64.00	$160.00	—	38% below	60%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 BLD TYPE ABO	$64.00	$160.00	—	—	60%
Blood urea nitrogen (BUN) test CPT 84520 BLD UREA NITROGEN QUAN	$12.80	$32.00	—	61% below	60%
Blood urea nitrogen (BUN) test inpatient CPT 84520 BLD UREA NITROGEN QUAN	$12.80	$32.00	—	—	60%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C-REACTIVE PROTEIN	$38.80	$97.00	—	28% below	60%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 C-REACTIVE PROTEIN	$38.80	$97.00	—	—	60%
C. difficile toxin gene test (stool PCR) CPT 87493 C DIFF TOXIN AMP PROBE	$115.20	$288.00	—	25% below	60%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 C DIFF TOXIN AMP PROBE	$115.20	$288.00	—	—	60%
CA 19-9 blood test (tumor marker) CPT 86301 IA TUMOR CA 19-9 QUAN	$50.40	$126.00	—	1% above	60%
CA 19-9 blood test (tumor marker) inpatient CPT 86301 IA TUMOR CA 19-9 QUAN	$50.40	$126.00	—	—	60%
Calcium blood test, total CPT 82310 CALCIUM	$9.20	$23.00	—	85% below	60%
Calcium blood test, total inpatient CPT 82310 CALCIUM	$9.20	$23.00	—	—	60%
Carcinoembryonic antigen (CEA) test CPT 82378 CARCINO-EMBRYONIC AG/2	$9.04	$22.60	—	89% below	60%
Carcinoembryonic antigen (CEA) test CPT 82378 CARCINO-EMBRYONIC AG	$23.60	$59.00	—	72% below	60%
Carcinoembryonic antigen (CEA) test inpatient CPT 82378 CARCINO-EMBRYONIC AG/2	$9.04	$22.60	—	—	60%
Carcinoembryonic antigen (CEA) test inpatient CPT 82378 CARCINO-EMBRYONIC AG	$23.60	$59.00	—	—	60%
Chickenpox (varicella) immunity blood test CPT 86787 VARICELLA ZOSTER AB/4	$6.30	$15.75	—	81% below	60%
Chickenpox (varicella) immunity blood test CPT 86787 VARICELLA ZOSTER AB	$6.30	$15.75	—	81% below	60%
Chickenpox (varicella) immunity blood test CPT 86787 VARICELLA ZOSTER AB/2	$8.13	$20.33	—	76% below	60%
Chickenpox (varicella) immunity blood test CPT 86787 VARICELLA ZOSTER AB/5	$8.13	$20.33	—	76% below	60%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 VARICELLA ZOSTER AB/4	$6.30	$15.75	—	—	60%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 VARICELLA ZOSTER AB	$6.30	$15.75	—	—	60%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 VARICELLA ZOSTER AB/2	$8.13	$20.33	—	—	60%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 VARICELLA ZOSTER AB/5	$8.13	$20.33	—	—	60%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA AMP PROBE	$237.07	$592.67	—	334% above	60%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMYDIA AMP PROBE	$237.07	$592.67	—	—	60%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PANEL	$18.40	$46.00	—	82% below	60%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PANEL	$18.40	$46.00	—	—	60%
Complete blood count (CBC) with differential CPT 85025 CBC WITH AUTO DIFF	$32.00	$80.00	—	71% below	60%
Complete blood count (CBC) with differential inpatient CPT 85025 CBC WITH AUTO DIFF	$32.00	$80.00	—	—	60%
Complete blood count (CBC), no differential CPT 85027 CBC AUTO W/O DIFF	$26.80	$67.00	—	70% below	60%
Complete blood count (CBC), no differential inpatient CPT 85027 CBC AUTO W/O DIFF	$26.80	$67.00	—	—	60%
Comprehensive metabolic panel (blood test) CPT 80053 COMP METABOLIC PANEL	$50.00	$125.00	—	80% below	60%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 COMP METABOLIC PANEL	$50.00	$125.00	—	—	60%
Cortisol blood test, total CPT 82533 CORTISOL TOTAL/3	$19.20	$48.00	—	80% below	60%
Cortisol blood test, total CPT 82533 CORTISOL TOTAL	$19.20	$48.00	—	80% below	60%
Cortisol blood test, total CPT 82533 CORTISOL TOTAL/2	$19.20	$48.00	—	80% below	60%
Cortisol blood test, total inpatient CPT 82533 CORTISOL TOTAL/2	$19.20	$48.00	—	—	60%
Cortisol blood test, total inpatient CPT 82533 CORTISOL TOTAL	$19.20	$48.00	—	—	60%
Cortisol blood test, total inpatient CPT 82533 CORTISOL TOTAL/3	$19.20	$48.00	—	—	60%
Creatine kinase (CK) blood test, total CPT 82550 CREATINE KINASE TOTAL	$19.60	$49.00	—	78% below	60%
Creatine kinase (CK) blood test, total inpatient CPT 82550 CREATINE KINASE TOTAL	$19.60	$49.00	—	—	60%
Creatinine blood test CPT 82565 CREATININE BLOOD/2	$9.20	$23.00	—	80% below	60%
Creatinine blood test inpatient CPT 82565 CREATININE BLOOD/2	$9.20	$23.00	—	—	60%
Cytomegalovirus (CMV) antibody test CPT 86644 CYTOMEGALOVIRUS AB/2	$5.64	$14.10	—	80% below	60%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 CYTOMEGALOVIRUS AB/2	$5.64	$14.10	—	—	60%
D-dimer blood test (blood clot marker) CPT 85379 FDP D-DIMER QNT	$77.20	$193.00	—	46% below	60%
D-dimer blood test (blood clot marker) inpatient CPT 85379 FDP D-DIMER QNT	$77.20	$193.00	—	—	60%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG TEST PRSMV CHEM ANLYZR/4	$14.00	$35.00	—	77% below	60%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG TEST PRSMV CHEM ANLYZR/6	$24.00	$60.00	—	61% below	60%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG TEST PRSMV CHEM ANLYZR/18	$28.55	$71.37	—	54% below	60%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG TEST PRSMV CHEM ANLYZR/38	$40.58	$101.46	—	35% below	60%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG TEST PRSMV CHEM ANLYZR	$60.40	$151.00	—	3% below	60%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG TEST PRSMV CHEM ANLYZR/9	$65.60	$164.00	—	6% above	60%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG TEST PRSMV CHEM ANLYZR/8	$65.60	$164.00	—	6% above	60%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG TEST PRSMV CHEM ANLYZR/11	$65.60	$164.00	—	6% above	60%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG TEST PRSMV CHEM ANLYZR/10	$65.60	$164.00	—	6% above	60%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG TEST PRSMV CHEM ANLYZR/4	$14.00	$35.00	—	—	60%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG TEST PRSMV CHEM ANLYZR/6	$24.00	$60.00	—	—	60%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG TEST PRSMV CHEM ANLYZR/18	$28.55	$71.37	—	—	60%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG TEST PRSMV CHEM ANLYZR/38	$40.58	$101.46	—	—	60%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG TEST PRSMV CHEM ANLYZR	$60.40	$151.00	—	—	60%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG TEST PRSMV CHEM ANLYZR/9	$65.60	$164.00	—	—	60%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG TEST PRSMV CHEM ANLYZR/11	$65.60	$164.00	—	—	60%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG TEST PRSMV CHEM ANLYZR/8	$65.60	$164.00	—	—	60%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG TEST PRSMV CHEM ANLYZR/10	$65.60	$164.00	—	—	60%
Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 ELECTROLYTE PANEL	$60.80	$152.00	—	28% below	60%
Electrolyte panel (sodium, potassium, chloride, CO2) inpatient CPT 80051 ELECTROLYTE PANEL	$60.80	$152.00	—	—	60%
Fecal calprotectin (stool inflammation test) CPT 83993 CALPROTECTIN FECAL	$40.00	$100.00	—	45% below	60%
Fecal calprotectin (stool inflammation test) inpatient CPT 83993 CALPROTECTIN FECAL	$40.00	$100.00	—	—	60%
Ferritin blood test (iron stores) CPT 82728 FERRITIN	$20.80	$52.00	—	81% below	60%
Ferritin blood test (iron stores) inpatient CPT 82728 FERRITIN	$20.80	$52.00	—	—	60%
Fibrinogen blood test CPT 85384 FIBRINOGEN ACTIVITY	$39.20	$98.00	—	71% below	60%
Fibrinogen blood test inpatient CPT 85384 FIBRINOGEN ACTIVITY	$39.20	$98.00	—	—	60%
Folate (folic acid) blood test CPT 82746 FOLIC ACID	$19.60	$49.00	—	82% below	60%
Folate (folic acid) blood test inpatient CPT 82746 FOLIC ACID	$19.60	$49.00	—	—	60%
Free T3 thyroid hormone test CPT 84481 T3 FREE	$14.40	$36.00	—	82% below	60%
Free T3 thyroid hormone test inpatient CPT 84481 T3 FREE	$14.40	$36.00	—	—	60%
Free T4 (free thyroxine) thyroid blood test CPT 84439 THYROXINE FREE	$17.20	$43.00	—	75% below	60%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 THYROXINE FREE	$17.20	$43.00	—	—	60%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GLUCOSE POST DOSE	$194.40	$486.00	—	274% above	60%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 GLUCOSE POST DOSE	$194.40	$486.00	—	—	60%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 GC DNA AMP PROBE	$237.07	$592.67	—	297% above	60%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 GC DNA AMP PROBE	$237.07	$592.67	—	—	60%
H. pylori stool antigen test CPT 87338 H. PYLORI STOOL IA	$12.00	$30.00	—	85% below	60%
H. pylori stool antigen test inpatient CPT 87338 H. PYLORI STOOL IA	$12.00	$30.00	—	—	60%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV-1 QUANT/5	$29.97	$74.93	—	70% below	60%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV-1 QUANT	$45.60	$114.00	—	55% below	60%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HIV-1 QUANT/5	$29.97	$74.93	—	—	60%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HIV-1 QUANT	$45.60	$114.00	—	—	60%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV I AG HIV I HIV II AB	$12.62	$31.55	—	86% below	60%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HIV I AG HIV I HIV II AB	$12.62	$31.55	—	—	60%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HEMOGLOBIN GLYCATED	$16.80	$42.00	—	74% below	60%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HEMOGLOBIN GLYCATED	$16.80	$42.00	—	—	60%
Hemoglobin blood test CPT 85018 BLOOD HEMOGLBN	$56.00	$140.00	—	39% above	60%
Hemoglobin blood test inpatient CPT 85018 BLOOD HEMOGLBN	$56.00	$140.00	—	—	60%
Hepatitis C viral load (HCV RNA) test CPT 87522 HEP C QUANT/2	$20.00	$50.00	—	77% below	60%
Hepatitis C viral load (HCV RNA) test CPT 87522 HEP C QUANT	$74.94	$187.34	—	15% below	60%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HEP C QUANT/2	$20.00	$50.00	—	—	60%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HEP C QUANT	$74.94	$187.34	—	—	60%
Herpes blood test, HSV-1 antibody CPT 86695 HERPES AB SMPLX TYPE 1/3	$13.50	$33.75	—	30% below	60%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 HERPES AB SMPLX TYPE 1/3	$13.50	$33.75	—	—	60%
Herpes blood test, HSV-2 antibody CPT 86696 HERPES AB SMPLX TYPE 2/7	$5.99	$14.97	—	75% below	60%
Herpes blood test, HSV-2 antibody CPT 86696 HERPES AB SMPLX TYPE 2	$13.50	$33.75	—	43% below	60%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HERPES AB SMPLX TYPE 2/7	$5.99	$14.97	—	—	60%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HERPES AB SMPLX TYPE 2	$13.50	$33.75	—	—	60%
Iron blood test (serum iron) CPT 83540 IRON ASSAY	$16.00	$40.00	—	72% below	60%
Iron blood test (serum iron) inpatient CPT 83540 IRON ASSAY	$16.00	$40.00	—	—	60%
Iron-binding capacity (TIBC) test CPT 83550 IRON BINDING CAPCTY	$14.80	$37.00	—	80% below	60%
Iron-binding capacity (TIBC) test inpatient CPT 83550 IRON BINDING CAPCTY	$14.80	$37.00	—	—	60%
Kidney function blood test panel CPT 80069 RENAL FUNCTION PANEL	$68.00	$170.00	—	52% below	60%
Kidney function blood test panel inpatient CPT 80069 RENAL FUNCTION PANEL	$68.00	$170.00	—	—	60%
Lactate (lactic acid) blood test CPT 83605 LACTATE(LACTIC ACID)	$19.60	$49.00	—	85% below	60%
Lactate (lactic acid) blood test inpatient CPT 83605 LACTATE(LACTIC ACID)	$19.60	$49.00	—	—	60%
Lactate dehydrogenase (LDH) blood test CPT 83615 LDH-LACTIC DEHYDROGENASE/2	$4.10	$10.25	—	89% below	60%
Lactate dehydrogenase (LDH) blood test CPT 83615 LDH-LACTIC DEHYDROGENASE/3	$16.40	$41.00	—	55% below	60%
Lactate dehydrogenase (LDH) blood test CPT 83615 LDH-LACTIC DEHYDROGENASE	$16.40	$41.00	—	55% below	60%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 LDH-LACTIC DEHYDROGENASE/2	$4.10	$10.25	—	—	60%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 LDH-LACTIC DEHYDROGENASE	$16.40	$41.00	—	—	60%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 LDH-LACTIC DEHYDROGENASE/3	$16.40	$41.00	—	—	60%
Lipase blood test (pancreas enzyme) CPT 83690 LIPASE/2	$4.50	$11.25	—	95% below	60%
Lipase blood test (pancreas enzyme) CPT 83690 LIPASE	$19.60	$49.00	—	80% below	60%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 LIPASE/2	$4.50	$11.25	—	—	60%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 LIPASE	$19.60	$49.00	—	—	60%
Liver function blood test panel CPT 80076 HEPATIC FUNCTION PANEL	$26.80	$67.00	—	82% below	60%
Liver function blood test panel inpatient CPT 80076 HEPATIC FUNCTION PANEL	$26.80	$67.00	—	—	60%
Magnesium blood test CPT 83735 MAGNESIUM	$21.20	$53.00	—	67% below	60%
Magnesium blood test inpatient CPT 83735 MAGNESIUM	$21.20	$53.00	—	—	60%
Measles (rubeola) antibody test CPT 86765 RUBEOLA AB/4	$9.10	$22.75	—	71% below	60%
Measles (rubeola) antibody test CPT 86765 RUBEOLA AB/3	$11.40	$28.50	—	64% below	60%
Measles (rubeola) antibody test inpatient CPT 86765 RUBEOLA AB/4	$9.10	$22.75	—	—	60%
Measles (rubeola) antibody test inpatient CPT 86765 RUBEOLA AB/3	$11.40	$28.50	—	—	60%
Mono test (heterophile antibody, Monospot) CPT 86308 HETEROPHILE AB SCREEN	$184.40	$461.00	—	79% above	60%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 HETEROPHILE AB SCREEN	$184.40	$461.00	—	—	60%
Mumps immunity blood test CPT 86735 MUMPS AB/5	$9.04	$22.60	—	44% below	60%
Mumps immunity blood test CPT 86735 MUMPS AB/4	$9.84	$24.60	—	39% below	60%
Mumps immunity blood test inpatient CPT 86735 MUMPS AB/5	$9.04	$22.60	—	—	60%
Mumps immunity blood test inpatient CPT 86735 MUMPS AB/4	$9.84	$24.60	—	—	60%
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA TOTAL	$21.20	$53.00	—	65% below	60%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA TOTAL	$21.20	$53.00	—	—	60%
Parathyroid hormone (PTH) blood test CPT 83970 PARATHORMONE (PTH)/2	$35.60	$89.00	—	68% below	60%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 PARATHORMONE (PTH)/2	$35.60	$89.00	—	—	60%
Partial thromboplastin time (PTT) clotting test CPT 85730 PTT	$5.94	$14.85	—	90% below	60%
Partial thromboplastin time (PTT) clotting test CPT 85730 PTT/2	$37.60	$94.00	—	40% below	60%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PTT	$5.94	$14.85	—	—	60%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PTT/2	$37.60	$94.00	—	—	60%
Phosphorus (phosphate) blood test CPT 84100 PHOSPHORUS	$10.40	$26.00	—	86% below	60%
Phosphorus (phosphate) blood test inpatient CPT 84100 PHOSPHORUS	$10.40	$26.00	—	—	60%
Potassium blood test CPT 84132 POTASSIUM	$23.20	$58.00	—	68% below	60%
Potassium blood test inpatient CPT 84132 POTASSIUM	$23.20	$58.00	—	—	60%
Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME	$29.20	$73.00	—	47% below	60%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTHROMBIN TIME	$29.20	$73.00	—	—	60%
Rh blood typing CPT 86901 BLD TYPE RH (D)	$38.00	$95.00	—	32% below	60%
Rh blood typing inpatient CPT 86901 BLD TYPE RH (D)	$38.00	$95.00	—	—	60%
Rubella antibody test (immunity check) CPT 86762 RUBELLA AB/4	$5.42	$13.55	—	89% below	60%
Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA AB/4	$5.42	$13.55	—	—	60%
Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 SED RATE AUTO	$19.60	$49.00	—	65% below	60%
Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 SED RATE AUTO	$19.60	$49.00	—	—	60%
Sodium blood test CPT 84295 SODIUM	$14.80	$37.00	—	77% below	60%
Sodium blood test inpatient CPT 84295 SODIUM	$14.80	$37.00	—	—	60%
Stool ova and parasites exam CPT 87177 OVA & PARASITES SMEARS	$14.90	$37.25	—	29% below	60%
Stool ova and parasites exam inpatient CPT 87177 OVA & PARASITES SMEARS	$14.90	$37.25	—	—	60%
Syphilis antibody test (Treponema pallidum) CPT 86780 TREPONEMA PALLIDUM AB/3	$7.24	$18.10	—	55% below	60%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 TREPONEMA PALLIDUM AB/3	$7.24	$18.10	—	—	60%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 SYPHILIS NONTREP QUAL	$76.00	$190.00	—	466% above	60%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 SYPHILIS NONTREP QUAL	$76.00	$190.00	—	—	60%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 TB TEST CELL AG RESPONSE	$16.00	$40.00	—	81% below	60%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 TB TEST CELL AG RESPONSE	$16.00	$40.00	—	—	60%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH	$23.60	$59.00	—	74% below	60%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH	$23.60	$59.00	—	—	60%
Total cholesterol blood test CPT 82465 CHOLESTEROL TOTAL	$11.60	$29.00	—	72% below	60%
Total cholesterol blood test inpatient CPT 82465 CHOLESTEROL TOTAL	$11.60	$29.00	—	—	60%
Total thyroxine (T4) blood test CPT 84436 THYROXINE TOTAL	$11.60	$29.00	—	70% below	60%
Total thyroxine (T4) blood test inpatient CPT 84436 THYROXINE TOTAL	$11.60	$29.00	—	—	60%
Transferrin blood test CPT 84466 TRANSFERRIN	$17.60	$44.00	—	67% below	60%
Transferrin blood test inpatient CPT 84466 TRANSFERRIN	$17.60	$44.00	—	—	60%
Triglycerides blood test CPT 84478 TRIGLYCERIDES	$12.00	$30.00	—	71% below	60%
Triglycerides blood test inpatient CPT 84478 TRIGLYCERIDES	$12.00	$30.00	—	—	60%
Troponin test, quantitative CPT 84484 TROPONIN QUAN/2	$79.20	$198.00	—	56% below	60%
Troponin test, quantitative inpatient CPT 84484 TROPONIN QUAN/2	$79.20	$198.00	—	—	60%
Uric acid blood test CPT 84550 URIC ACID BLOOD	$9.20	$23.00	—	86% below	60%
Uric acid blood test inpatient CPT 84550 URIC ACID BLOOD	$9.20	$23.00	—	—	60%
Urinalysis with microscope exam, automated CPT 81001 UA AUTO W/MICRO	$68.80	$172.00	—	17% below	60%
Urinalysis with microscope exam, automated inpatient CPT 81001 UA AUTO W/MICRO	$68.80	$172.00	—	—	60%
Urinalysis without microscope exam, manual CPT 81002 UA NON-AUTO W/O MICRO	$15.20	$38.00	—	56% below	60%
Urinalysis without microscope exam, manual CPT 81002 UA NON-AUTO W/O MICRO/4	$15.20	$38.00	—	56% below	60%
Urinalysis without microscope exam, manual inpatient CPT 81002 UA NON-AUTO W/O MICRO/4	$15.20	$38.00	—	—	60%
Urinalysis without microscope exam, manual inpatient CPT 81002 UA NON-AUTO W/O MICRO	$15.20	$38.00	—	—	60%
Urine pregnancy test, read by color change CPT 81025 URINE PREG TEST QUAL	$30.40	$76.00	—	65% below	60%
Urine pregnancy test, read by color change inpatient CPT 81025 URINE PREG TEST QUAL	$30.40	$76.00	—	—	60%
Vitamin B12 (cobalamin) blood test CPT 82607 CYANOCOBLMN(VIT B12)	$19.60	$49.00	—	79% below	60%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 CYANOCOBLMN(VIT B12)	$19.60	$49.00	—	—	60%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D/25 HYDROXY	$24.80	$62.00	—	61% below	60%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 VITAMIN D/25 HYDROXY	$24.80	$62.00	—	—	60%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 GONADTOPN CHORNC(HCG)QNT	$19.60	$49.00	—	89% below	60%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 GONADTOPN CHORNC(HCG)QNT	$19.60	$49.00	—	—	60%

Surgery and procedures

Procedure	Cash price	List price	Insurers pay	vs California	Off list
Cardiac catheterization with coronary angiogram CPT 93458 CATH L HRT ARTERY/VENTR	$2,768.80	$6,922.00	—	79% below	60%
Cardiac catheterization with coronary angiogram inpatient CPT 93458 CATH L HRT ARTERY/VENTR	$2,768.80	$6,922.00	—	—	60%
Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION ELEC	$795.20	$1,988.00	—	58% below	60%
Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION ELEC/SCHED	$795.20	$1,988.00	—	58% below	60%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 CARDIOVERSION ELEC	$795.20	$1,988.00	—	—	60%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 CARDIOVERSION ELEC/SCHED	$795.20	$1,988.00	—	—	60%

Doctor visits and therapy

Procedure	Cash price	List price	Insurers pay	vs California	Off list
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 MDI TREATMENT	$170.00	$425.00	—	47% below	60%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 SPUTUM INDUCTION	$170.00	$425.00	—	47% below	60%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 AEROSOL TREATMENT	$170.00	$425.00	—	47% below	60%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HAND HELD NEB TREATMENT	$170.00	$425.00	—	47% below	60%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 SPUTUM INDUCTION	$170.00	$425.00	—	—	60%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 AEROSOL TREATMENT	$170.00	$425.00	—	—	60%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HAND HELD NEB TREATMENT	$170.00	$425.00	—	—	60%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 MDI TREATMENT	$170.00	$425.00	—	—	60%
Critical care, first 30 to 74 minutes CPT 99291 CRIT CARE E&M 30-74 MIN	$2,381.60	$5,954.00	—	57% below	60%
Critical care, first 30 to 74 minutes inpatient CPT 99291 CRIT CARE E&M 30-74 MIN	$2,381.60	$5,954.00	—	—	60%
EEG (brain wave test), awake and drowsy, routine CPT 95816 EEG AWAKE/DROWSY	$957.20	$2,393.00	—	7% below	60%
EEG (brain wave test), awake and drowsy, routine inpatient CPT 95816 EEG AWAKE/DROWSY	$957.20	$2,393.00	—	—	60%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG TRACE ONLY	$108.00	$270.00	—	68% below	60%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG TRACE ONLY	$108.00	$270.00	—	—	60%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 ER VISIT LVL I	$227.20	$568.00	—	46% below	60%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 OB ER VISIT LVL I	$227.20	$568.00	—	46% below	60%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 ER VISIT LVL I	$227.20	$568.00	—	—	60%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 OB ER VISIT LVL I	$227.20	$568.00	—	—	60%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 ER VISIT LVL II	$446.00	$1,115.00	—	49% below	60%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 OB ER VISIT LVL II	$446.00	$1,115.00	—	49% below	60%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 ER VISIT LVL II	$446.00	$1,115.00	—	—	60%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 OB ER VISIT LVL II	$446.00	$1,115.00	—	—	60%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 OB ER VISIT LVL III	$669.20	$1,673.00	—	55% below	60%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 ER VISIT LVL III	$669.20	$1,673.00	—	55% below	60%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 OB ER VISIT LVL III	$669.20	$1,673.00	—	—	60%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 ER VISIT LVL III	$669.20	$1,673.00	—	—	60%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 OB ER VISIT LVL IV	$1,260.40	$3,151.00	—	54% below	60%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 ER VISIT LVL IV	$1,260.40	$3,151.00	—	54% below	60%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 OB ER VISIT LVL IV	$1,260.40	$3,151.00	—	—	60%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 ER VISIT LVL IV	$1,260.40	$3,151.00	—	—	60%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 OB ER VISIT LVL V	$1,831.20	$4,578.00	—	48% below	60%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 ER VISIT LVL V	$1,831.20	$4,578.00	—	48% below	60%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 ER VISIT LVL V	$1,831.20	$4,578.00	—	—	60%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 OB ER VISIT LVL V	$1,831.20	$4,578.00	—	—	60%
Exercise stress test, tracing only, the hospital charge CPT 93017 CARDIO STRESS TRACE ONLY	$636.40	$1,591.00	—	55% below	60%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 CARDIO STRESS TRACE ONLY	$636.40	$1,591.00	—	—	60%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV INF HYD INIT 31-60MIN	$295.60	$739.00	—	41% below	60%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV INF HYD INIT 31-60MIN	$295.60	$739.00	—	—	60%
IV infusion of a medicine, first hour CPT 96365 IV INF TX INIT <=1 HR	$268.80	$672.00	—	54% below	60%
IV infusion of a medicine, first hour inpatient CPT 96365 IV INF TX INIT <=1 HR	$268.80	$672.00	—	—	60%
IV push of a medicine, first drug CPT 96374 INJ TX/PRPH/DX IVP INT	$190.40	$476.00	—	46% below	60%
IV push of a medicine, first drug inpatient CPT 96374 INJ TX/PRPH/DX IVP INT	$190.40	$476.00	—	—	60%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJ TX/PROPH/DX SQ/IM	$80.00	$200.00	—	55% below	60%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INJ TX/PROPH/DX SQ/IM	$80.00	$200.00	—	—	60%
Neuromuscular re-education, 15 minutes CPT 97112 PT NEUROMUSC RE-ED EA15	$93.20	$233.00	—	27% below	60%
Neuromuscular re-education, 15 minutes CPT 97112 PT NEUROMUSC RE-ED EA15#	$93.20	$233.00	—	27% below	60%
Neuromuscular re-education, 15 minutes CPT 97112 OT NEUROMUSC RE-EDUC EA15	$93.20	$233.00	—	27% below	60%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 OT NEUROMUSC RE-EDUC EA15	$93.20	$233.00	—	—	60%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 PT NEUROMUSC RE-ED EA15#	$93.20	$233.00	—	—	60%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 PT NEUROMUSC RE-ED EA15	$93.20	$233.00	—	—	60%
New patient office visit, about 30 minutes CPT 99203 E&M-NEW PATIENT-LVL III	$72.00	$180.00	—	66% below	60%
New patient office visit, about 30 minutes inpatient CPT 99203 E&M-NEW PATIENT-LVL III	$72.00	$180.00	—	—	60%
New patient office visit, about 45 minutes CPT 99204 E&M-NEW PATIENT-LVL IV	$72.00	$180.00	—	71% below	60%
New patient office visit, about 45 minutes inpatient CPT 99204 E&M-NEW PATIENT-LVL IV	$72.00	$180.00	—	—	60%
New patient office visit, about 60 minutes CPT 99205 E&M-NEW PATIENT-LVL V	$72.00	$180.00	—	79% below	60%
New patient office visit, about 60 minutes inpatient CPT 99205 E&M-NEW PATIENT-LVL V	$72.00	$180.00	—	—	60%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 E&M-NEW PATIENT-LVL II	$72.00	$180.00	—	48% below	60%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 E&M-NEW PATIENT-LVL II	$72.00	$180.00	—	—	60%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 MED NUTRTN TH INIT 15MIN	$88.80	$222.00	—	11% below	60%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 MED NUTRTN TH INIT 15MIN	$88.80	$222.00	—	—	60%
Occupational therapy evaluation, low complexity CPT 97165 OT EVAL LOW COMP	$146.80	$367.00	—	44% below	60%
Occupational therapy evaluation, low complexity inpatient CPT 97165 OT EVAL LOW COMP	$146.80	$367.00	—	—	60%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PT EVAL HIGH COMP	$293.60	$734.00	—	25% below	60%
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 PT EVAL HIGH COMP	$293.60	$734.00	—	—	60%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PT EVAL LOW COMP	$146.80	$367.00	—	38% below	60%
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 PT EVAL LOW COMP	$146.80	$367.00	—	—	60%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PT EVAL MOD COMP	$220.00	$550.00	—	38% below	60%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 PT EVAL MOD COMP	$220.00	$550.00	—	—	60%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 PT THER EX EA 15	$102.40	$256.00	—	21% below	60%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 OT THERAPTC EXER EA 15	$102.40	$256.00	—	21% below	60%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 PT THER EX EA 15	$102.40	$256.00	—	—	60%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 OT THERAPTC EXER EA 15	$102.40	$256.00	—	—	60%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 SMKE/TOBAC CNSL 3-10MIN	$19.20	$48.00	—	74% below	60%
Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 SMKE/TOBAC CNSL 3-10MIN	$19.20	$48.00	—	—	60%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 E&M-EST. PATIENT-LVL V	$72.00	$180.00	—	71% below	60%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 E&M-EST. PATIENT-LVL V	$72.00	$180.00	—	—	60%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 E&M-EST. PATIENT-LVL III	$72.00	$180.00	—	50% below	60%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 E&M-EST. PATIENT-LVL III	$72.00	$180.00	—	—	60%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 E&M-EST. PATIENT-LVL IV	$72.00	$180.00	—	64% below	60%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 E&M-EST. PATIENT-LVL IV	$72.00	$180.00	—	—	60%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 E&M-EST. PATIENT-LVL II	$72.00	$180.00	—	37% below	60%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 E&M-EST. PATIENT-LVL II	$72.00	$180.00	—	—	60%
Speech and language evaluation CPT 92523 SP EVAL LNG COM W/EXP COMPLEX	$227.60	$569.00	—	50% below	60%
Speech and language evaluation CPT 92523 SP EVAL LNG COM W/EXP INTERM	$227.60	$569.00	—	50% below	60%
Speech and language evaluation inpatient CPT 92523 SP EVAL LNG COM W/EXP COMPLEX	$227.60	$569.00	—	—	60%
Speech and language evaluation inpatient CPT 92523 SP EVAL LNG COM W/EXP INTERM	$227.60	$569.00	—	—	60%
Speech therapy session, individual CPT 92507 SPEECH/LANG TX BASIC	$131.60	$329.00	—	53% below	60%
Speech therapy session, individual CPT 92507 SPEECH/LANG TX INTER	$131.60	$329.00	—	53% below	60%
Speech therapy session, individual CPT 92507 SPEECH/LANG TX CMPLX	$131.60	$329.00	—	53% below	60%
Speech therapy session, individual inpatient CPT 92507 SPEECH/LANG TX BASIC	$131.60	$329.00	—	—	60%
Speech therapy session, individual inpatient CPT 92507 SPEECH/LANG TX CMPLX	$131.60	$329.00	—	—	60%
Speech therapy session, individual inpatient CPT 92507 SPEECH/LANG TX INTER	$131.60	$329.00	—	—	60%
Spirometry (breathing test) CPT 94010 SPIROMETRY	$194.40	$486.00	—	49% below	60%
Spirometry (breathing test) inpatient CPT 94010 SPIROMETRY	$194.40	$486.00	—	—	60%
Spirometry before and after a bronchodilator CPT 94060 BRONCHOSPASM EVAL PRE/PS	$232.40	$581.00	—	71% below	60%
Spirometry before and after a bronchodilator inpatient CPT 94060 BRONCHOSPASM EVAL PRE/PS	$232.40	$581.00	—	—	60%
Therapeutic activities (functional training), 15 minutes CPT 97530 OT THERAPTC ACT EA 15	$42.80	$107.00	—	69% below	60%
Therapeutic activities (functional training), 15 minutes CPT 97530 PT THERAPEUTC ACT EA 15	$42.80	$107.00	—	69% below	60%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 PT THERAPEUTC ACT EA 15	$42.80	$107.00	—	—	60%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 OT THERAPTC ACT EA 15	$42.80	$107.00	—	—	60%

Vaccines

Procedure	Cash price	List price	Insurers pay	vs California	Off list
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 DTAP VACC <7YR IJ	$21.60	$54.00	—	70% below	60%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 inpatient CPT 90700 DTAP VACC <7YR IJ	$21.60	$54.00	—	—	60%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 FLU VAC > 3 YRS IM PF IJ	$9.20	$23.00	—	79% below	60%
Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 FLU VAC > 3 YRS IM PF IJ	$9.20	$23.00	—	—	60%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 HEP B VAC ADULT IJ	$30.80	$77.00	—	75% below	60%
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 HEP B VAC ADULT IJ	$30.80	$77.00	—	—	60%
Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 HEP B VAC PED/ADOL3DS IJ	$13.20	$33.00	—	77% below	60%
Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 HEP B VAC PED/ADOL3DS IJ	$13.20	$33.00	—	—	60%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) CPT 90648 HAEMOPH B PRP-T VAC IJ	$30.00	$75.00	—	28% below	60%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) inpatient CPT 90648 HAEMOPH B PRP-T VAC IJ	$30.00	$75.00	—	—	60%
MMR vaccine (measles, mumps and rubella), live CPT 90707 MEASLES/MUMPS/RUB VACCIJ	$60.00	$150.00	—	57% below	60%
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 MEASLES/MUMPS/RUB VACCIJ	$60.00	$150.00	—	—	60%
Meningococcal ACWY (MenACWY) vaccine CPT 90734 MENINGOCOCCAL VAC IM IJ	$180.00	$450.00	—	31% below	60%
Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 MENINGOCOCCAL VAC IM IJ	$180.00	$450.00	—	—	60%
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) CPT 90670 PNEUMOCOC 13 VAL VACC IJ	$145.60	$364.00	—	53% below	60%
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) inpatient CPT 90670 PNEUMOCOC 13 VAL VACC IJ	$145.60	$364.00	—	—	60%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 PNEUMOCOCCAL 20-VALENT VACCINE	$298.40	$746.00	—	43% below	60%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 PNEUMOCOCCAL 20-VALENT VACCINE	$298.40	$746.00	—	—	60%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PNEUMOCOC23 VAL VACC IJ	$71.20	$178.00	—	56% below	60%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 PNEUMOCOC23 VAL VACC IJ	$71.20	$178.00	—	—	60%
Polio vaccine, inactivated (IPV) CPT 90713 POLIOVIRUS VAC IM/SQ IJ	$30.80	$77.00	—	66% below	60%
Polio vaccine, inactivated (IPV) inpatient CPT 90713 POLIOVIRUS VAC IM/SQ IJ	$30.80	$77.00	—	—	60%
RSV antibody shot for infants and toddlers, larger dose (1 mL, 100 mg) CPT 90381 NIRSEVIMAB-ALIP RSV MAB 1ML IJ	$546.48	$1,366.20	—	42% below	60%
RSV antibody shot for infants and toddlers, larger dose (1 mL, 100 mg) inpatient CPT 90381 NIRSEVIMAB-ALIP RSV MAB 1ML IJ	$546.48	$1,366.20	—	—	60%
RSV antibody shot for infants, seasonal dose (0.5 mL) CPT 90380 NIRSEVIMAB-ALIP RSV MAB .5MLIJ	$573.80	$1,434.51	—	41% below	60%
RSV antibody shot for infants, seasonal dose (0.5 mL) inpatient CPT 90380 NIRSEVIMAB-ALIP RSV MAB .5MLIJ	$573.80	$1,434.51	—	—	60%
Rabies vaccine, one dose CPT 90675 RABIES VACCINE IM IJ	$317.20	$793.00	—	55% below	60%
Rabies vaccine, one dose inpatient CPT 90675 RABIES VACCINE IM IJ	$317.20	$793.00	—	—	60%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 TDAP > 7YR VAC IJ	$34.80	$87.00	—	70% below	60%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 TDAP > 7YR VAC IJ	$34.80	$87.00	—	—	60%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMM ADMIN SNGL/COMBO VAC	$30.00	$75.00	—	71% below	60%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMM ADMIN SNGL/COMBO VAC	$30.00	$75.00	—	—	60%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMM ADM EA ADDL VACCINE	$13.60	$34.00	—	83% below	60%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 IMM ADM EA ADDL VACCINE	$13.60	$34.00	—	—	60%

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://ucihealth.org/pricetransparency/952226406_uci-health-fountain-valley_standardcharges.json