University of Vermont Medical Center Inc
University of Vermont Medical Center Inc in Burlington, VT publishes cash prices for 73 common procedures listed here, from its own machine-readable price file updated Apr 28, 2026. Click a procedure to compare it with other hospitals nearby.
111 Colchester Avenue, Burlington, VT 05401 Collected Sep 23, 2026 Source price file
Scans and imaging
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 CHG CT ABDOMEN & PELVIS W/CONTRAST MATERIAL | $1,454.00 | $1,454.00 | — |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 HC - CT ABDOMEN & PELVIS W/CONTRAST MATERIAL | $6,553.00 | $6,553.00 | — |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CHG CT ABDOMEN & PELVIS W/CONTRAST MATERIAL | $1,454.00 | $1,454.00 | — |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 HC - CT ABDOMEN & PELVIS W/CONTRAST MATERIAL | $6,553.00 | $6,553.00 | — |
| CT scan of the head or brain, no contrast dye CPT 70450 CHG CT HEAD/BRAIN W/O CONTRAST MATERIAL | $502.00 | $502.00 | — |
| CT scan of the head or brain, no contrast dye CPT 70450 HC - CT HEAD/BRAIN W/O CONTRAST MATERIAL | $3,749.00 | $3,749.00 | — |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 CHG CT HEAD/BRAIN W/O CONTRAST MATERIAL | $502.00 | $502.00 | — |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 HC - CT HEAD/BRAIN W/O CONTRAST MATERIAL | $3,749.00 | $3,749.00 | — |
| CT scan of the pelvis, with contrast dye CPT 72193 CHG CT PELVIS W/CONTRAST MATERIAL | $1,099.00 | $1,099.00 | — |
| CT scan of the pelvis, with contrast dye CPT 72193 HC - CT PELVIS W/CONTRAST MATERIAL | $4,510.00 | $4,510.00 | — |
| CT scan of the pelvis, with contrast dye inpatient CPT 72193 CHG CT PELVIS W/CONTRAST MATERIAL | $1,099.00 | $1,099.00 | — |
| CT scan of the pelvis, with contrast dye inpatient CPT 72193 HC - CT PELVIS W/CONTRAST MATERIAL | $4,510.00 | $4,510.00 | — |
| Diagnostic mammogram, both breasts both sides CPT 77066 CHG DIAGNOSTIC MAMMOGRAPHY COMPUTER-AIDED DETCJ BI | $725.00 | $725.00 | — |
| Diagnostic mammogram, both breasts both sides CPT 77066 HC - DIAGNOSTIC MAMMOGRAPHY COMPUTER-AIDED DETCJ BI | $731.00 | $731.00 | — |
| Diagnostic mammogram, both breasts inpatient both sides CPT 77066 CHG DIAGNOSTIC MAMMOGRAPHY COMPUTER-AIDED DETCJ BI | $725.00 | $725.00 | — |
| Diagnostic mammogram, both breasts inpatient both sides CPT 77066 HC - DIAGNOSTIC MAMMOGRAPHY COMPUTER-AIDED DETCJ BI | $731.00 | $731.00 | — |
| Diagnostic mammogram, one breast CPT 77065 CHG DIAGNOSTIC MAMMOGRAPHY COMPUTER-AIDED DETCJ UNI | $574.00 | $574.00 | — |
| Diagnostic mammogram, one breast CPT 77065 HC - DIAGNOSTIC MAMMOGRAPHY COMPUTER-AIDED DETCJ UNI | $574.00 | $574.00 | — |
| Diagnostic mammogram, one breast inpatient CPT 77065 HC - DIAGNOSTIC MAMMOGRAPHY COMPUTER-AIDED DETCJ UNI | $574.00 | $574.00 | — |
| Diagnostic mammogram, one breast inpatient CPT 77065 CHG DIAGNOSTIC MAMMOGRAPHY COMPUTER-AIDED DETCJ UNI | $574.00 | $574.00 | — |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 CHG MRI ANY JT LOWER EXTREM W/O CONTRAST MATRL | $963.00 | $963.00 | — |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 HC - MRI ANY JT LOWER EXTREM W/O CONTRAST MATRL | $5,028.00 | $5,028.00 | — |
| MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 CHG MRI ANY JT LOWER EXTREM W/O CONTRAST MATRL | $963.00 | $963.00 | — |
| MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 HC - MRI ANY JT LOWER EXTREM W/O CONTRAST MATRL | $5,028.00 | $5,028.00 | — |
| MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 CHG MRI ANY JT LOWER EXTREM W/O & W/CONTRAST MATRL | $1,853.00 | $1,853.00 | — |
| MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 HC - MRI ANY JT LOWER EXTREM W/O & W/CONTRAST MATRL | $7,356.00 | $7,356.00 | — |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 CHG MRI ANY JT LOWER EXTREM W/O & W/CONTRAST MATRL | $1,853.00 | $1,853.00 | — |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 HC - MRI ANY JT LOWER EXTREM W/O & W/CONTRAST MATRL | $7,356.00 | $7,356.00 | — |
| MRI of the brain, no contrast dye CPT 70551 CHG MRI BRAIN BRAIN STEM W/O CONTRAST MATERIAL | $932.00 | $932.00 | — |
| MRI of the brain, no contrast dye CPT 70551 HC - MRI QUICK BRAIN BRAIN STEM W/O CONTRAST MATERIAL | $2,640.00 | $2,640.00 | — |
| MRI of the brain, no contrast dye CPT 70551 HC - MRI BRAIN BRAIN STEM W/O CONTRAST MATERIAL | $5,279.00 | $5,279.00 | — |
| MRI of the brain, no contrast dye inpatient CPT 70551 CHG MRI BRAIN BRAIN STEM W/O CONTRAST MATERIAL | $932.00 | $932.00 | — |
| MRI of the brain, no contrast dye inpatient CPT 70551 HC - MRI QUICK BRAIN BRAIN STEM W/O CONTRAST MATERIAL | $2,640.00 | $2,640.00 | — |
| MRI of the brain, no contrast dye inpatient CPT 70551 HC - MRI BRAIN BRAIN STEM W/O CONTRAST MATERIAL | $5,279.00 | $5,279.00 | — |
| MRI of the brain, with and without contrast dye CPT 70553 CHG MRI BRAIN BRAIN STEM W/O W/CONTRAST MATERIAL | $1,519.00 | $1,519.00 | — |
| MRI of the brain, with and without contrast dye CPT 70553 HC - MRI BRAIN BRAIN STEM W/O W/CONTRAST MATERIAL | $7,767.00 | $7,767.00 | — |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 CHG MRI BRAIN BRAIN STEM W/O W/CONTRAST MATERIAL | $1,519.00 | $1,519.00 | — |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 HC - MRI BRAIN BRAIN STEM W/O W/CONTRAST MATERIAL | $7,767.00 | $7,767.00 | — |
| MRI of the lower back, no contrast dye CPT 72148 CHG MRI SPINAL CANAL LUMBAR W/O CONTRAST MATERIAL | $909.00 | $909.00 | — |
| MRI of the lower back, no contrast dye CPT 72148 HC - MRI SPINAL CANAL LUMBAR W/O CONTRAST MATERIAL | $5,367.00 | $5,367.00 | — |
| MRI of the lower back, no contrast dye inpatient CPT 72148 CHG MRI SPINAL CANAL LUMBAR W/O CONTRAST MATERIAL | $909.00 | $909.00 | — |
| MRI of the lower back, no contrast dye inpatient CPT 72148 HC - MRI SPINAL CANAL LUMBAR W/O CONTRAST MATERIAL | $5,367.00 | $5,367.00 | — |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 CHG US PREG UTERUS AFTER 1ST TRIMEST 1/1ST GESTATION | $623.00 | $623.00 | — |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 HC - US PREG UTERUS AFTER 1ST TRIMEST 1/1ST GESTATION | $1,226.00 | $1,226.00 | — |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 CHG US PREG UTERUS AFTER 1ST TRIMEST 1/1ST GESTATION | $623.00 | $623.00 | — |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 HC - US PREG UTERUS AFTER 1ST TRIMEST 1/1ST GESTATION | $1,226.00 | $1,226.00 | — |
| Screening mammogram, both breasts both sides CPT 77067 CHG SCREENING MAMMOGRAPHY BI 2-VIEW BREAST INC CAD | $588.00 | $588.00 | — |
| Screening mammogram, both breasts both sides CPT 77067 HC - SCREENING MAMMOGRAPHY BI 2-VIEW BREAST INC CAD | $777.00 | $777.00 | — |
| Screening mammogram, both breasts inpatient both sides CPT 77067 CHG SCREENING MAMMOGRAPHY BI 2-VIEW BREAST INC CAD | $588.00 | $588.00 | — |
| Screening mammogram, both breasts inpatient both sides CPT 77067 HC - SCREENING MAMMOGRAPHY BI 2-VIEW BREAST INC CAD | $777.00 | $777.00 | — |
| Sleep study in a lab (polysomnography) CPT 95810 PR POLYSOM 6/>YRS SLEEP 4/> ADDL PARAM ATTND | $2,621.00 | $2,621.00 | — |
| Sleep study in a lab (polysomnography) CPT 95810 HC - POLYSOM 6/>YRS SLEEP 4/> ADDL PARAM ATTND | $8,280.00 | $8,280.00 | — |
| Sleep study in a lab (polysomnography) inpatient CPT 95810 PR POLYSOM 6/>YRS SLEEP 4/> ADDL PARAM ATTND | $2,621.00 | $2,621.00 | — |
| Sleep study in a lab (polysomnography) inpatient CPT 95810 HC - POLYSOM 6/>YRS SLEEP 4/> ADDL PARAM ATTND | $8,280.00 | $8,280.00 | — |
| Transvaginal pelvic ultrasound CPT 76830 CHG US TRANSVAGINAL | $551.00 | $551.00 | — |
| Transvaginal pelvic ultrasound CPT 76830 HC - US TRANSVAGINAL | $1,333.00 | $1,333.00 | — |
| Transvaginal pelvic ultrasound inpatient CPT 76830 CHG US TRANSVAGINAL | $551.00 | $551.00 | — |
| Transvaginal pelvic ultrasound inpatient CPT 76830 HC - US TRANSVAGINAL | $1,333.00 | $1,333.00 | — |
| Ultrasound of the abdomen, complete CPT 76700 CHG US ABDOMINAL REAL TIME W/IMAGE DOCUMENTATION | $536.00 | $536.00 | — |
| Ultrasound of the abdomen, complete CPT 76700 HC - US ABDOMINAL REAL TIME W/IMAGE DOCUMENTATION | $1,883.00 | $1,883.00 | — |
| Ultrasound of the abdomen, complete inpatient CPT 76700 CHG US ABDOMINAL REAL TIME W/IMAGE DOCUMENTATION | $536.00 | $536.00 | — |
| Ultrasound of the abdomen, complete inpatient CPT 76700 HC - US ABDOMINAL REAL TIME W/IMAGE DOCUMENTATION | $1,883.00 | $1,883.00 | — |
| X-ray of the lower back, 4 or more views CPT 72110 CHG RADEX SPINE LUMBOSACRAL MINIMUM 4 VIEWS | $235.00 | $235.00 | — |
| X-ray of the lower back, 4 or more views CPT 72110 HC - RADEX SPINE LUMBOSACRAL MINIMUM 4 VIEWS | $1,091.00 | $1,091.00 | — |
| X-ray of the lower back, 4 or more views inpatient CPT 72110 CHG RADEX SPINE LUMBOSACRAL MINIMUM 4 VIEWS | $235.00 | $235.00 | — |
| X-ray of the lower back, 4 or more views inpatient CPT 72110 HC - RADEX SPINE LUMBOSACRAL MINIMUM 4 VIEWS | $1,091.00 | $1,091.00 | — |
Lab tests
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Basic metabolic panel (blood test) CPT 80048 CHG BASIC METABOLIC PANEL CALCIUM TOTAL | $38.00 | $38.00 | — |
| Basic metabolic panel (blood test) CPT 80048 HC - BASIC METABOLIC PANEL CALCIUM TOTAL | $105.00 | $105.00 | — |
| Basic metabolic panel (blood test) inpatient CPT 80048 CHG BASIC METABOLIC PANEL CALCIUM TOTAL | $38.00 | $38.00 | — |
| Basic metabolic panel (blood test) inpatient CPT 80048 HC - BASIC METABOLIC PANEL CALCIUM TOTAL | $105.00 | $105.00 | — |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 CHG LIPID PANEL | $61.00 | $61.00 | — |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 HC - LIPID PROFILE | $103.00 | $103.00 | — |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 HC - LIPOEL LIPID PANEL | $103.00 | $103.00 | — |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 CHG LIPID PANEL | $61.00 | $61.00 | — |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 HC - LIPID PROFILE | $103.00 | $103.00 | — |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 HC - LIPOEL LIPID PANEL | $103.00 | $103.00 | — |
| Complete blood count (CBC) with differential CPT 85025 CHG BLOOD COUNT COMPLETE AUTO&AUTO DIFRNTL WBC | $35.00 | $35.00 | — |
| Complete blood count (CBC) with differential CPT 85025 HC - BLOOD COUNT COMPLETE AUTO&AUTO DIFRNTL WBC | $53.00 | $53.00 | — |
| Complete blood count (CBC) with differential CPT 85025 HC - AUTOMATED DIFFERENTIAL ADD | $53.00 | $53.00 | — |
| Complete blood count (CBC) with differential inpatient CPT 85025 CHG BLOOD COUNT COMPLETE AUTO&AUTO DIFRNTL WBC | $35.00 | $35.00 | — |
| Complete blood count (CBC) with differential inpatient CPT 85025 HC - AUTOMATED DIFFERENTIAL ADD | $53.00 | $53.00 | — |
| Complete blood count (CBC) with differential inpatient CPT 85025 HC - BLOOD COUNT COMPLETE AUTO&AUTO DIFRNTL WBC | $53.00 | $53.00 | — |
| Complete blood count (CBC), no differential CPT 85027 CHG BLOOD COUNT COMPLETE AUTOMATED | $29.00 | $29.00 | — |
| Complete blood count (CBC), no differential CPT 85027 HC - HEMAGRAM | $50.00 | $50.00 | — |
| Complete blood count (CBC), no differential inpatient CPT 85027 CHG BLOOD COUNT COMPLETE AUTOMATED | $29.00 | $29.00 | — |
| Complete blood count (CBC), no differential inpatient CPT 85027 HC - HEMAGRAM | $50.00 | $50.00 | — |
| Comprehensive metabolic panel (blood test) CPT 80053 CHG COMPREHENSIVE METABOLIC PANEL | $48.00 | $48.00 | — |
| Comprehensive metabolic panel (blood test) CPT 80053 HC - COMPREHENSIVE METABOLIC PANEL | $123.00 | $123.00 | — |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 CHG COMPREHENSIVE METABOLIC PANEL | $48.00 | $48.00 | — |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 HC - COMPREHENSIVE METABOLIC PANEL | $123.00 | $123.00 | — |
| Kidney function blood test panel CPT 80069 CHG RENAL FUNCTION PANEL | $39.00 | $39.00 | — |
| Kidney function blood test panel CPT 80069 HC - RENAL FUNCTION PANEL | $187.00 | $187.00 | — |
| Kidney function blood test panel inpatient CPT 80069 CHG RENAL FUNCTION PANEL | $39.00 | $39.00 | — |
| Kidney function blood test panel inpatient CPT 80069 HC - RENAL FUNCTION PANEL | $187.00 | $187.00 | — |
| Liver function blood test panel CPT 80076 CHG HEPATIC FUNCTION PANEL | $37.00 | $37.00 | — |
| Liver function blood test panel CPT 80076 HC - HEPATIC FUNCTION PANEL | $117.00 | $117.00 | — |
| Liver function blood test panel inpatient CPT 80076 CHG HEPATIC FUNCTION PANEL | $37.00 | $37.00 | — |
| Liver function blood test panel inpatient CPT 80076 HC - HEPATIC FUNCTION PANEL | $117.00 | $117.00 | — |
| Obstetric blood test panel CPT 80055 HC - PRENATAL PANEL | $312.00 | $312.00 | — |
| Obstetric blood test panel inpatient CPT 80055 HC - PRENATAL PANEL | $312.00 | $312.00 | — |
| PSA (prostate-specific antigen) blood test, free CPT 84154 CHG ASSAY OF PROSTATE SPECIFIC ANTIGEN FREE | $84.00 | $84.00 | — |
| PSA (prostate-specific antigen) blood test, free CPT 84154 HC - FREE PSA, PHI | $167.00 | $167.00 | — |
| PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 CHG ASSAY OF PROSTATE SPECIFIC ANTIGEN FREE | $84.00 | $84.00 | — |
| PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 HC - FREE PSA, PHI | $167.00 | $167.00 | — |
| PSA (prostate-specific antigen) blood test, total CPT 84153 CHG ASSAY OF PROSTATE SPECIFIC ANTIGEN TOTAL | $84.00 | $84.00 | — |
| PSA (prostate-specific antigen) blood test, total CPT 84153 HC - ASSAY OF PROSTATE SPECIFIC ANTIGEN TOTAL | $108.00 | $108.00 | — |
| PSA (prostate-specific antigen) blood test, total CPT 84153 HC - PROSTATE SPECIFIC AG, PHI | $108.00 | $108.00 | — |
| PSA (prostate-specific antigen) blood test, total CPT 84153 HC - DIAGNOSTIC PROSTATIC SPEC AG | $108.00 | $108.00 | — |
| PSA (prostate-specific antigen) blood test, total CPT 84153 HC - PROSTATIC SPEC AG SCREEN | $108.00 | $108.00 | — |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 CHG ASSAY OF PROSTATE SPECIFIC ANTIGEN TOTAL | $84.00 | $84.00 | — |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 HC - PROSTATIC SPEC AG SCREEN | $108.00 | $108.00 | — |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 HC - PROSTATE SPECIFIC AG, PHI | $108.00 | $108.00 | — |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 HC - ASSAY OF PROSTATE SPECIFIC ANTIGEN TOTAL | $108.00 | $108.00 | — |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 HC - DIAGNOSTIC PROSTATIC SPEC AG | $108.00 | $108.00 | — |
| Partial thromboplastin time (PTT) clotting test CPT 85730 CHG THROMBOPLASTIN TIME PARTIAL PLASMA/WHOLE BLOOD | $27.00 | $27.00 | — |
| Partial thromboplastin time (PTT) clotting test CPT 85730 HC - THROMBOPLASTIN TIME PARTIAL PLASMA/WHOLE BLOOD | $42.00 | $42.00 | — |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 CHG THROMBOPLASTIN TIME PARTIAL PLASMA/WHOLE BLOOD | $27.00 | $27.00 | — |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 HC - THROMBOPLASTIN TIME PARTIAL PLASMA/WHOLE BLOOD | $42.00 | $42.00 | — |
| Prothrombin time (PT/INR) clotting test CPT 85610 CHG PROTHROMBIN TIME | $20.00 | $20.00 | — |
| Prothrombin time (PT/INR) clotting test CPT 85610 HC - PROTHROMBIN TIME | $40.00 | $40.00 | — |
| Prothrombin time (PT/INR) clotting test CPT 85610 HC - PROTIME, LUPUS CASCADE REFLEX | $40.00 | $40.00 | — |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 CHG PROTHROMBIN TIME | $20.00 | $20.00 | — |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 HC - PROTIME, LUPUS CASCADE REFLEX | $40.00 | $40.00 | — |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 HC - PROTHROMBIN TIME | $40.00 | $40.00 | — |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 CHG ASSAY OF THYROID STIMULATING HORMONE TSH | $76.00 | $76.00 | — |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 HC - ASSAY OF THYROID STIMULATING HORMONE TSH | $130.00 | $130.00 | — |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 CHG ASSAY OF THYROID STIMULATING HORMONE TSH | $76.00 | $76.00 | — |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 HC - ASSAY OF THYROID STIMULATING HORMONE TSH | $130.00 | $130.00 | — |
| Urinalysis with microscope exam, automated CPT 81001 CHG URNLS DIP STICK/TABLET REAGENT AUTO MICROSCOPY | $14.00 | $14.00 | — |
| Urinalysis with microscope exam, automated CPT 81001 HC - URINALYSIS, CHEMICAL AND SEDIMENT, AUTOMATED | $47.00 | $47.00 | — |
| Urinalysis with microscope exam, automated inpatient CPT 81001 CHG URNLS DIP STICK/TABLET REAGENT AUTO MICROSCOPY | $14.00 | $14.00 | — |
| Urinalysis with microscope exam, automated inpatient CPT 81001 HC - URINALYSIS, CHEMICAL AND SEDIMENT, AUTOMATED | $47.00 | $47.00 | — |
| Urinalysis with microscope exam, manual CPT 81000 CHG URINLS DIP STICK/TABLET REAGNT NON-AUTO MICRSCPY | $18.00 | $18.00 | — |
| Urinalysis with microscope exam, manual inpatient CPT 81000 CHG URINLS DIP STICK/TABLET REAGNT NON-AUTO MICRSCPY | $18.00 | $18.00 | — |
| Urinalysis without microscope exam, automated CPT 81003 CHG URNLS DIP STICK/TABLET RGNT AUTO W/O MICROSCOPY | $10.00 | $10.00 | — |
| Urinalysis without microscope exam, automated CPT 81003 HC - URNLS DIP STICK/TABLET RGNT AUTO W/O MICROSCOPY | $38.00 | $38.00 | — |
| Urinalysis without microscope exam, automated inpatient CPT 81003 CHG URNLS DIP STICK/TABLET RGNT AUTO W/O MICROSCOPY | $10.00 | $10.00 | — |
| Urinalysis without microscope exam, automated inpatient CPT 81003 HC - URNLS DIP STICK/TABLET RGNT AUTO W/O MICROSCOPY | $38.00 | $38.00 | — |
| Urinalysis without microscope exam, manual CPT 81002 CHG URNLS DIP STICK/TABLET RGNT NON-AUTO W/O MICRSCP | $16.00 | $16.00 | — |
| Urinalysis without microscope exam, manual inpatient CPT 81002 CHG URNLS DIP STICK/TABLET RGNT NON-AUTO W/O MICRSCP | $16.00 | $16.00 | — |
Surgery and procedures
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Cataract surgery with lens implant CPT 66984 PR XCAPSL CTRC RMVL INSJ IO LENS PROSTH W/O ECP | $2,242.00 | $2,242.00 | — |
| Cataract surgery with lens implant inpatient CPT 66984 PR XCAPSL CTRC RMVL INSJ IO LENS PROSTH W/O ECP | $2,242.00 | $2,242.00 | — |
| Cesarean delivery, including prenatal and postpartum care CPT 59510 PR OB ANTEPARTUM CARE CESAREAN DLVR & POSTPARTUM | $10,623.00 | $10,623.00 | — |
| Cesarean delivery, including prenatal and postpartum care inpatient CPT 59510 PR OB ANTEPARTUM CARE CESAREAN DLVR & POSTPARTUM | $10,623.00 | $10,623.00 | — |
| Colonoscopy with endoscopic ultrasound CPT 45391 PR COLSC FLX W/NDSC US XM RCTM ET AL LMTD&ADJ STRUX | $1,036.00 | $1,036.00 | — |
| Colonoscopy with endoscopic ultrasound CPT 45391 HC - COLSC FLX W/NDSC US XM RCTM ET AL LMTD&ADJ STRUX | $4,309.00 | $4,309.00 | — |
| Colonoscopy with endoscopic ultrasound inpatient CPT 45391 PR COLSC FLX W/NDSC US XM RCTM ET AL LMTD&ADJ STRUX | $1,036.00 | $1,036.00 | — |
| Colonoscopy with endoscopic ultrasound inpatient CPT 45391 HC - COLSC FLX W/NDSC US XM RCTM ET AL LMTD&ADJ STRUX | $4,309.00 | $4,309.00 | — |
| Colonoscopy with polyp removal CPT 45385 PR COLSC FLX W/RMVL OF TUMOR POLYP LESION SNARE TQ | $1,881.00 | $1,881.00 | — |
| Colonoscopy with polyp removal CPT 45385 HC - COLSC FLX W/RMVL OF TUMOR POLYP LESION SNARE TQ | $5,184.00 | $5,184.00 | — |
| Colonoscopy with polyp removal inpatient CPT 45385 PR COLSC FLX W/RMVL OF TUMOR POLYP LESION SNARE TQ | $1,881.00 | $1,881.00 | — |
| Colonoscopy with polyp removal inpatient CPT 45385 HC - COLSC FLX W/RMVL OF TUMOR POLYP LESION SNARE TQ | $5,184.00 | $5,184.00 | — |
| Colonoscopy with tissue sample CPT 45380 PR COLONOSCOPY W/BIOPSY SINGLE/MULTIPLE | $1,802.00 | $1,802.00 | — |
| Colonoscopy with tissue sample CPT 45380 HC - COLONOSCOPY W/BIOPSY SINGLE/MULTIPLE | $4,918.00 | $4,918.00 | — |
| Colonoscopy with tissue sample inpatient CPT 45380 PR COLONOSCOPY W/BIOPSY SINGLE/MULTIPLE | $1,802.00 | $1,802.00 | — |
| Colonoscopy with tissue sample inpatient CPT 45380 HC - COLONOSCOPY W/BIOPSY SINGLE/MULTIPLE | $4,918.00 | $4,918.00 | — |
| Colonoscopy, diagnostic CPT 45378 PR COLONOSCOPY FLX DX W/COLLJ SPEC WHEN PFRMD | $1,409.00 | $1,409.00 | — |
| Colonoscopy, diagnostic CPT 45378 HC - COLONOSCOPY FLX DX W/COLLJ SPEC WHEN PFRMD SCREENING LOW RISK | $4,293.00 | $4,293.00 | — |
| Colonoscopy, diagnostic CPT 45378 HC - COLONOSCOPY FLX DX W/COLLJ SPEC WHEN PFRMD | $4,293.00 | $4,293.00 | — |
| Colonoscopy, diagnostic CPT 45378 HC - COLONOSCOPY FLX DX W/COLLJ SPEC WHEN PFRMD SCREENING HIGH RISK | $4,293.00 | $4,293.00 | — |
| Colonoscopy, diagnostic inpatient CPT 45378 PR COLONOSCOPY FLX DX W/COLLJ SPEC WHEN PFRMD | $1,409.00 | $1,409.00 | — |
| Colonoscopy, diagnostic inpatient CPT 45378 HC - COLONOSCOPY FLX DX W/COLLJ SPEC WHEN PFRMD | $4,293.00 | $4,293.00 | — |
| Colonoscopy, diagnostic inpatient CPT 45378 HC - COLONOSCOPY FLX DX W/COLLJ SPEC WHEN PFRMD SCREENING HIGH RISK | $4,293.00 | $4,293.00 | — |
| Colonoscopy, diagnostic inpatient CPT 45378 HC - COLONOSCOPY FLX DX W/COLLJ SPEC WHEN PFRMD SCREENING LOW RISK | $4,293.00 | $4,293.00 | — |
| Gallbladder removal, laparoscopic CPT 47562 PR LAPAROSCOPY SURG CHOLECYSTECTOMY | $2,636.00 | $2,636.00 | — |
| Gallbladder removal, laparoscopic inpatient CPT 47562 PR LAPAROSCOPY SURG CHOLECYSTECTOMY | $2,636.00 | $2,636.00 | — |
| Inguinal (groin) hernia repair, age 5 or older CPT 49505 PR RPR 1ST INGUN HRNA AGE 5 YRS/> REDUCIBLE | $2,099.00 | $2,099.00 | — |
| Inguinal (groin) hernia repair, age 5 or older inpatient CPT 49505 PR RPR 1ST INGUN HRNA AGE 5 YRS/> REDUCIBLE | $2,099.00 | $2,099.00 | — |
| Knee arthroscopy with meniscus trim CPT 29881 PR ARTHRS KNE SURG W/MENISCECTOMY MED/LAT W/SHVG | $2,235.00 | $2,235.00 | — |
| Knee arthroscopy with meniscus trim inpatient CPT 29881 PR ARTHRS KNE SURG W/MENISCECTOMY MED/LAT W/SHVG | $2,235.00 | $2,235.00 | — |
| Laser treatment of clouding after cataract surgery (YAG) CPT 66821 HC - POST-CATARACT LASER SURGERY | $1,347.00 | $1,347.00 | — |
| Laser treatment of clouding after cataract surgery (YAG) CPT 66821 PR POST-CATARACT LASER SURGERY | $1,391.00 | $1,391.00 | — |
| Laser treatment of clouding after cataract surgery (YAG) inpatient CPT 66821 HC - POST-CATARACT LASER SURGERY | $1,347.00 | $1,347.00 | — |
| Laser treatment of clouding after cataract surgery (YAG) inpatient CPT 66821 PR POST-CATARACT LASER SURGERY | $1,391.00 | $1,391.00 | — |
| Left heart catheterization, diagnostic CPT 93452 PR L HRT CATH W/NJX L VENTRICULOGRAPHY IMG S&I | $3,676.00 | $3,676.00 | — |
| Left heart catheterization, diagnostic CPT 93452 HC - L HRT CATH W/NJX L VENTRICULOGRAPHY IMG S&I | $9,102.00 | $9,102.00 | — |
| Left heart catheterization, diagnostic inpatient CPT 93452 PR L HRT CATH W/NJX L VENTRICULOGRAPHY IMG S&I | $3,676.00 | $3,676.00 | — |
| Left heart catheterization, diagnostic inpatient CPT 93452 HC - L HRT CATH W/NJX L VENTRICULOGRAPHY IMG S&I | $9,102.00 | $9,102.00 | — |
| Lower-back epidural injection, with imaging guidance CPT 62323 PR NJX DX/THER SBST INTRLMNR LMBR/SAC W/IMG GDN | $1,082.00 | $1,082.00 | — |
| Lower-back epidural injection, with imaging guidance CPT 62323 HC - NJX DX/THER SBST INTRLMNR LMBR/SAC W/IMG GDN | $3,057.00 | $3,057.00 | — |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 PR NJX DX/THER SBST INTRLMNR LMBR/SAC W/IMG GDN | $1,082.00 | $1,082.00 | — |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 HC - NJX DX/THER SBST INTRLMNR LMBR/SAC W/IMG GDN | $3,057.00 | $3,057.00 | — |
| Lower-back epidural injection, without imaging guidance CPT 62322 PR NJX DX/THER SBST INTRLMNR LMBR/SAC W/O IMG GDN | $589.00 | $589.00 | — |
| Lower-back epidural injection, without imaging guidance CPT 62322 HC - NJX DX/THER SBST INTRLMNR LMBR/SAC W/O IMG GDN | $2,926.00 | $2,926.00 | — |
| Lower-back epidural injection, without imaging guidance inpatient CPT 62322 PR NJX DX/THER SBST INTRLMNR LMBR/SAC W/O IMG GDN | $589.00 | $589.00 | — |
| Lower-back epidural injection, without imaging guidance inpatient CPT 62322 HC - NJX DX/THER SBST INTRLMNR LMBR/SAC W/O IMG GDN | $2,926.00 | $2,926.00 | — |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 PR NJX AA&/STRD TFRML EPI LUMBAR/SACRAL 1 LEVEL | $1,031.00 | $1,031.00 | — |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 HC - NJX AA&/STRD TFRML EPI LUMBAR/SACRAL 1 LEVEL | $3,005.00 | $3,005.00 | — |
| Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 PR NJX AA&/STRD TFRML EPI LUMBAR/SACRAL 1 LEVEL | $1,031.00 | $1,031.00 | — |
| Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 HC - NJX AA&/STRD TFRML EPI LUMBAR/SACRAL 1 LEVEL | $3,005.00 | $3,005.00 | — |
| Prostate biopsy CPT 55700 PR PROSTATE NEEDLE BIOPSY ANY APPROACH | $999.00 | $999.00 | — |
| Prostate biopsy CPT 55700 HC - PROSTATE NEEDLE BIOPSY ANY APPROACH | $3,023.00 | $3,023.00 | — |
| Prostate biopsy inpatient CPT 55700 PR PROSTATE NEEDLE BIOPSY ANY APPROACH | $999.00 | $999.00 | — |
| Prostate biopsy inpatient CPT 55700 HC - PROSTATE NEEDLE BIOPSY ANY APPROACH | $3,023.00 | $3,023.00 | — |
| Prostate removal (prostatectomy), laparoscopic CPT 55866 PR LAPS SURG PRST8ECT RPBIC RAD W/NRV SPARING ROBOT | $4,838.00 | $4,838.00 | — |
| Prostate removal (prostatectomy), laparoscopic inpatient CPT 55866 PR LAPS SURG PRST8ECT RPBIC RAD W/NRV SPARING ROBOT | $4,838.00 | $4,838.00 | — |
| Removal of a breast lump, open surgery CPT 19120 PR EXC CYST/ABERRANT BREAST TISSUE OPEN 1/> LESION | $2,121.00 | $2,121.00 | — |
| Removal of a breast lump, open surgery CPT 19120 HC - EXC CYST/ABERRANT BREAST TISSUE OPEN 1/> LESION | $3,971.00 | $3,971.00 | — |
| Removal of a breast lump, open surgery inpatient CPT 19120 PR EXC CYST/ABERRANT BREAST TISSUE OPEN 1/> LESION | $2,121.00 | $2,121.00 | — |
| Removal of a breast lump, open surgery inpatient CPT 19120 HC - EXC CYST/ABERRANT BREAST TISSUE OPEN 1/> LESION | $3,971.00 | $3,971.00 | — |
| Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) CPT 29826 PR SURGICAL ARTHROSCOPY SHO W/CORACOACRM LIGM RLS | $682.00 | $682.00 | — |
| Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) inpatient CPT 29826 PR SURGICAL ARTHROSCOPY SHO W/CORACOACRM LIGM RLS | $682.00 | $682.00 | — |
| Tonsil and adenoid removal, child under 12 CPT 42820 PR TONSILLECTOMY & ADENOIDECTOMY <AGE 12 | $1,209.00 | $1,209.00 | — |
| Tonsil and adenoid removal, child under 12 inpatient CPT 42820 PR TONSILLECTOMY & ADENOIDECTOMY <AGE 12 | $1,209.00 | $1,209.00 | — |
| Total hip replacement CPT 27130 PR ARTHRP ACETBLR/PROX FEM PROSTC AGRFT/ALGRFT | $5,184.00 | $5,184.00 | — |
| Total hip replacement inpatient CPT 27130 PR ARTHRP ACETBLR/PROX FEM PROSTC AGRFT/ALGRFT | $5,184.00 | $5,184.00 | — |
| Total knee replacement CPT 27447 PR ARTHRP KNE CONDYLE&PLATU MEDIAL&LAT COMPARTMENTS | $5,177.00 | $5,177.00 | — |
| Total knee replacement inpatient CPT 27447 PR ARTHRP KNE CONDYLE&PLATU MEDIAL&LAT COMPARTMENTS | $5,177.00 | $5,177.00 | — |
| Upper endoscopy (EGD) with biopsy CPT 43239 PR EGD TRANSORAL BIOPSY SINGLE/MULTIPLE | $1,570.00 | $1,570.00 | — |
| Upper endoscopy (EGD) with biopsy CPT 43239 HC - EGD TRANSORAL BIOPSY SINGLE/MULTIPLE | $4,190.00 | $4,190.00 | — |
| Upper endoscopy (EGD) with biopsy inpatient CPT 43239 PR EGD TRANSORAL BIOPSY SINGLE/MULTIPLE | $1,570.00 | $1,570.00 | — |
| Upper endoscopy (EGD) with biopsy inpatient CPT 43239 HC - EGD TRANSORAL BIOPSY SINGLE/MULTIPLE | $4,190.00 | $4,190.00 | — |
| Upper endoscopy (EGD), diagnostic CPT 43235 PR ESOPHAGOGASTRODUODENOSCOPY TRANSORAL DIAGNOSTIC | $1,199.00 | $1,199.00 | — |
| Upper endoscopy (EGD), diagnostic CPT 43235 HC - ESOPHAGOGASTRODUODENOSCOPY TRANSORAL DIAGNOSTIC | $4,202.00 | $4,202.00 | — |
| Upper endoscopy (EGD), diagnostic inpatient CPT 43235 PR ESOPHAGOGASTRODUODENOSCOPY TRANSORAL DIAGNOSTIC | $1,199.00 | $1,199.00 | — |
| Upper endoscopy (EGD), diagnostic inpatient CPT 43235 HC - ESOPHAGOGASTRODUODENOSCOPY TRANSORAL DIAGNOSTIC | $4,202.00 | $4,202.00 | — |
| Vaginal birth after cesarean (VBAC), including prenatal and postpartum care CPT 59610 PR ROUTINE OB CARE VAG DLVRY & POSTPARTUM CARE VB | $10,007.00 | $10,007.00 | — |
| Vaginal birth after cesarean (VBAC), including prenatal and postpartum care inpatient CPT 59610 PR ROUTINE OB CARE VAG DLVRY & POSTPARTUM CARE VB | $10,007.00 | $10,007.00 | — |
| Vaginal delivery, including prenatal and postpartum care CPT 59400 PR OB CARE ANTEPARTUM VAG DLVR & POSTPARTUM | $9,623.00 | $9,623.00 | — |
| Vaginal delivery, including prenatal and postpartum care inpatient CPT 59400 PR OB CARE ANTEPARTUM VAG DLVR & POSTPARTUM | $9,623.00 | $9,623.00 | — |
Doctor visits and therapy
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Electrocardiogram (ECG/EKG) with interpretation CPT 93000 PR ECG ROUTINE ECG W/LEAST 12 LDS W/I&R | $105.00 | $105.00 | — |
| Electrocardiogram (ECG/EKG) with interpretation inpatient CPT 93000 PR ECG ROUTINE ECG W/LEAST 12 LDS W/I&R | $105.00 | $105.00 | — |
| Family therapy with the patient, 50 minutes CPT 90847 PR FAMILY PSYCHOTHERAPY W/PATIENT PRESENT 50 MINS | $278.00 | $278.00 | — |
| Family therapy with the patient, 50 minutes CPT 90847 HC - FAMILY PSYCHOTHERAPY W/PATIENT PRESENT 50 MINS NON-MD | $278.00 | $278.00 | — |
| Family therapy with the patient, 50 minutes inpatient CPT 90847 PR FAMILY PSYCHOTHERAPY W/PATIENT PRESENT 50 MINS | $278.00 | $278.00 | — |
| Family therapy with the patient, 50 minutes inpatient CPT 90847 HC - FAMILY PSYCHOTHERAPY W/PATIENT PRESENT 50 MINS NON-MD | $278.00 | $278.00 | — |
| Family therapy without the patient, 50 minutes CPT 90846 PR FAMILY PSYCHOTHERAPY W/O PATIENT PRESENT 50 MINS | $265.00 | $265.00 | — |
| Family therapy without the patient, 50 minutes CPT 90846 HC - FAMILY PSYCHOTHERAPY W/O PATIENT PRESENT 50 MINS NON-MD | $265.00 | $265.00 | — |
| Family therapy without the patient, 50 minutes inpatient CPT 90846 PR FAMILY PSYCHOTHERAPY W/O PATIENT PRESENT 50 MINS | $265.00 | $265.00 | — |
| Family therapy without the patient, 50 minutes inpatient CPT 90846 HC - FAMILY PSYCHOTHERAPY W/O PATIENT PRESENT 50 MINS NON-MD | $265.00 | $265.00 | — |
| Group psychotherapy session CPT 90853 HC - GROUP PSYCHOTHERAPY | $75.00 | $75.00 | — |
| Group psychotherapy session CPT 90853 PR GROUP PSYCHOTHERAPY | $75.00 | $75.00 | — |
| Group psychotherapy session CPT 90853 HC - IOP GROUP PSYCHOTHERAPY | $75.00 | $75.00 | — |
| Group psychotherapy session CPT 90853 HC - PHP GROUP PSYCHOTHERAPY | $75.00 | $75.00 | — |
| Group psychotherapy session inpatient CPT 90853 PR GROUP PSYCHOTHERAPY | $75.00 | $75.00 | — |
| Group psychotherapy session inpatient CPT 90853 HC - PHP GROUP PSYCHOTHERAPY | $75.00 | $75.00 | — |
| Group psychotherapy session inpatient CPT 90853 HC - IOP GROUP PSYCHOTHERAPY | $75.00 | $75.00 | — |
| Group psychotherapy session inpatient CPT 90853 HC - GROUP PSYCHOTHERAPY | $75.00 | $75.00 | — |
| New patient office visit, about 30 minutes CPT 99203 HC - OFFICE/OUTPATIENT NEW LOW MDM 30 MINUTES | $251.00 | $251.00 | — |
| New patient office visit, about 30 minutes CPT 99203 PR OFFICE/OUTPATIENT NEW LOW MDM 30 MINUTES | $333.00 | $333.00 | — |
| New patient office visit, about 30 minutes inpatient CPT 99203 HC - OFFICE/OUTPATIENT NEW LOW MDM 30 MINUTES | $251.00 | $251.00 | — |
| New patient office visit, about 30 minutes inpatient CPT 99203 PR OFFICE/OUTPATIENT NEW LOW MDM 30 MINUTES | $333.00 | $333.00 | — |
| New patient office visit, about 45 minutes CPT 99204 HC - OFFICE/OUTPATIENT NEW MODERATE MDM 45 MINUTES | $363.00 | $363.00 | — |
| New patient office visit, about 45 minutes CPT 99204 PR OFFICE/OUTPATIENT NEW MODERATE MDM 45 MINUTES | $496.00 | $496.00 | — |
| New patient office visit, about 45 minutes inpatient CPT 99204 HC - OFFICE/OUTPATIENT NEW MODERATE MDM 45 MINUTES | $363.00 | $363.00 | — |
| New patient office visit, about 45 minutes inpatient CPT 99204 PR OFFICE/OUTPATIENT NEW MODERATE MDM 45 MINUTES | $496.00 | $496.00 | — |
| New patient office visit, about 60 minutes CPT 99205 HC - OFFICE/OUTPATIENT NEW HIGH MDM 60 MINUTES | $474.00 | $474.00 | — |
| New patient office visit, about 60 minutes CPT 99205 PR OFFICE/OUTPATIENT NEW HIGH MDM 60 MINUTES | $654.00 | $654.00 | — |
| New patient office visit, about 60 minutes inpatient CPT 99205 HC - OFFICE/OUTPATIENT NEW HIGH MDM 60 MINUTES | $474.00 | $474.00 | — |
| New patient office visit, about 60 minutes inpatient CPT 99205 PR OFFICE/OUTPATIENT NEW HIGH MDM 60 MINUTES | $654.00 | $654.00 | — |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 PR THERAPEUTIC PX 1/> AREAS EACH 15 MIN EXERCISES | $120.00 | $120.00 | — |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HC - OT THERAPEUTIC PX 1/> AREAS EACH 15 MIN EXERCISES | $121.00 | $121.00 | — |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HC - PT THERAPEUTIC PX 1/> AREAS EACH 15 MIN EXERCISES | $121.00 | $121.00 | — |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 PR THERAPEUTIC PX 1/> AREAS EACH 15 MIN EXERCISES | $120.00 | $120.00 | — |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 HC - OT THERAPEUTIC PX 1/> AREAS EACH 15 MIN EXERCISES | $121.00 | $121.00 | — |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 HC - PT THERAPEUTIC PX 1/> AREAS EACH 15 MIN EXERCISES | $121.00 | $121.00 | — |
| Preventive checkup, new patient aged 18–39 CPT 99385 PR INITIAL PREVENTIVE MEDICINE NEW PT AGE 18-39YRS | $387.00 | $387.00 | — |
| Preventive checkup, new patient aged 18–39 inpatient CPT 99385 PR INITIAL PREVENTIVE MEDICINE NEW PT AGE 18-39YRS | $387.00 | $387.00 | — |
| Preventive checkup, new patient aged 40–64 CPT 99386 PR INITIAL PREVENTIVE MEDICINE NEW PATIENT 40-64YRS | $446.00 | $446.00 | — |
| Preventive checkup, new patient aged 40–64 inpatient CPT 99386 PR INITIAL PREVENTIVE MEDICINE NEW PATIENT 40-64YRS | $446.00 | $446.00 | — |
| Psychotherapy session, 30 minutes CPT 90832 PR PSYCHOTHERAPY W/PATIENT 30 MINUTES | $213.00 | $213.00 | — |
| Psychotherapy session, 30 minutes CPT 90832 HC - PSYCHOTHERAPY W/PATIENT 30 MINUTES NON-MD | $213.00 | $213.00 | — |
| Psychotherapy session, 30 minutes inpatient CPT 90832 HC - PSYCHOTHERAPY W/PATIENT 30 MINUTES NON-MD | $213.00 | $213.00 | — |
| Psychotherapy session, 30 minutes inpatient CPT 90832 PR PSYCHOTHERAPY W/PATIENT 30 MINUTES | $213.00 | $213.00 | — |
| Psychotherapy session, 45 minutes CPT 90834 PR PSYCHOTHERAPY W/PATIENT 45 MINUTES | $281.00 | $281.00 | — |
| Psychotherapy session, 45 minutes CPT 90834 HC - PSYCHOTHERAPY W/PATIENT 45 MINUTES NON-MD | $281.00 | $281.00 | — |
| Psychotherapy session, 45 minutes inpatient CPT 90834 PR PSYCHOTHERAPY W/PATIENT 45 MINUTES | $281.00 | $281.00 | — |
| Psychotherapy session, 45 minutes inpatient CPT 90834 HC - PSYCHOTHERAPY W/PATIENT 45 MINUTES NON-MD | $281.00 | $281.00 | — |
| Psychotherapy session, 60 minutes CPT 90837 PR PSYCHOTHERAPY W/PATIENT 60 MINUTES | $414.00 | $414.00 | — |
| Psychotherapy session, 60 minutes CPT 90837 HC - PSYCHOTHERAPY W/PATIENT 60 MINUTES | $414.00 | $414.00 | — |
| Psychotherapy session, 60 minutes CPT 90837 HC - PSYCHOTHERAPY W/PATIENT 60 MINUTES NON-MD | $414.00 | $414.00 | — |
| Psychotherapy session, 60 minutes inpatient CPT 90837 HC - PSYCHOTHERAPY W/PATIENT 60 MINUTES NON-MD | $414.00 | $414.00 | — |
| Psychotherapy session, 60 minutes inpatient CPT 90837 PR PSYCHOTHERAPY W/PATIENT 60 MINUTES | $414.00 | $414.00 | — |
| Psychotherapy session, 60 minutes inpatient CPT 90837 HC - PSYCHOTHERAPY W/PATIENT 60 MINUTES | $414.00 | $414.00 | — |
| Specialist consultation, low complexity or 30+ minutes CPT 99243 PR OFFICE/OP CONSLTJ NEW/EST PT LOW MDM 30 MINUTES | $340.00 | $340.00 | — |
| Specialist consultation, low complexity or 30+ minutes inpatient CPT 99243 PR OFFICE/OP CONSLTJ NEW/EST PT LOW MDM 30 MINUTES | $340.00 | $340.00 | — |
| Specialist consultation, moderate complexity or 40+ minutes CPT 99244 PR OFFICE/OP CONSLTJ NEW/EST PT MOD MDM 40 MINUTES | $486.00 | $486.00 | — |
| Specialist consultation, moderate complexity or 40+ minutes inpatient CPT 99244 PR OFFICE/OP CONSLTJ NEW/EST PT MOD MDM 40 MINUTES | $486.00 | $486.00 | — |
Source file: https://www.uvmhealth.org/sites/default/files/030219309_university-of-vermont-medical-center-inc_standardcharges.csv