Hospital

Providence Kodiak Island Medical Center

Listed in its price file as “Providence Health And Services - Washington”.

Providence Kodiak Island Medical Center in Kodiak, AK publishes cash prices for 409 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 above the Alaska median for 217 of 402 procedures and below it for 158. By typical cash price it ranks #10 of 16 Alaska hospitals, cheapest first. Select a procedure to compare it with other hospitals nearby.

1915 E Rezanof Dr, Kodiak, AK 99615 Collected Sep 23, 2026 Source price file Check a bill from this hospital (907) 486-3281

Critical access hospital (rural, 25 beds or fewer) Nonprofit hospital Emergency department CCN 021306 · CMS hospital register NPI 1013905660

Financial assistance

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

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

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

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

Scans and imaging

Procedure	Cash price	List price	Insurers pay	vs Alaska	Off list
Abdominal CT scan without and with contrast CPT 74170 HC CT ABDOMEN W & W/O CONTRAST	$3,688.62	$4,729.00	—	10% above	22%
Abdominal CT scan without and with contrast inpatient CPT 74170 HC CT ABDOMEN W & W/O CONTRAST	$3,688.62	$4,729.00	—	—	22%
Abdominal X-ray, 2 views CPT 74019 HC XR ABDOMEN 2 VIEWS	$635.70	$815.00	—	11% above	22%
Abdominal X-ray, 2 views inpatient CPT 74019 HC XR ABDOMEN 2 VIEWS	$635.70	$815.00	—	—	22%
Ankle X-ray, complete, 3 or more views CPT 73610 HC XR ANKLE COMPLETE MIN 3 VIEWS	$609.96	$782.00	—	31% above	22%
Ankle X-ray, complete, 3 or more views inpatient CPT 73610 HC XR ANKLE COMPLETE MIN 3 VIEWS	$609.96	$782.00	—	—	22%
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 HC NON-INVAS PHYSIOLOGIC STD EXTREMITY ART 2 LEVEL	$950.04	$1,218.00	—	63% above	22%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 HC NON-INVAS PHYSIOLOGIC STD EXTREMITY ART 2 LEVEL	$950.04	$1,218.00	—	—	22%
Arm CT scan without contrast (shoulder to hand, any part) CPT 73200 HC CT UPPER EXTREMITY WO CONTRAST	$2,389.92	$3,064.00	—	12% above	22%
Arm CT scan without contrast (shoulder to hand, any part) inpatient CPT 73200 HC CT UPPER EXTREMITY WO CONTRAST	$2,389.92	$3,064.00	—	—	22%
Barium swallow (esophagus X-ray with contrast) CPT 74220 HC XR ESOPHAGUS W CONTRAST	$1,114.62	$1,429.00	—	37% above	22%
Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 HC XR ESOPHAGUS W CONTRAST	$1,114.62	$1,429.00	—	—	22%
Breast ultrasound, complete, one breast CPT 76641 HC US BREAST UNI COMPLETE	$562.38	$721.00	—	at median	22%
Breast ultrasound, complete, one breast inpatient CPT 76641 HC US BREAST UNI COMPLETE	$562.38	$721.00	—	—	22%
Breast ultrasound, limited (one breast or one area) CPT 76642 HC US ED BREAST UNI LIMITED CDM	$489.06	$627.00	—	4% above	22%
Breast ultrasound, limited (one breast or one area) CPT 76642 HC US BREAST UNI LIMITED	$562.38	$721.00	—	20% above	22%
Breast ultrasound, limited (one breast or one area) inpatient CPT 76642 HC US ED BREAST UNI LIMITED CDM	$489.06	$627.00	—	—	22%
Breast ultrasound, limited (one breast or one area) inpatient CPT 76642 HC US BREAST UNI LIMITED	$562.38	$721.00	—	—	22%
CT angiography (CTA) of the abdomen and pelvis CPT 74174 HC CTA ABDOMEN PELVIS	$4,557.54	$5,843.00	—	5% below	22%
CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174 HC CTA ABDOMEN PELVIS	$4,557.54	$5,843.00	—	—	22%
CT angiography (CTA) of the head CPT 70496 HC CT ANGIOGRAPHY HEAD W CONTRAST	$3,669.12	$4,704.00	—	6% above	22%
CT angiography (CTA) of the head inpatient CPT 70496 HC CT ANGIOGRAPHY HEAD W CONTRAST	$3,669.12	$4,704.00	—	—	22%
CT angiography (CTA) of the neck CPT 70498 HC CT ANGIOGRAPHY NECK W CONTRAST	$3,663.66	$4,697.00	—	7% above	22%
CT angiography (CTA) of the neck inpatient CPT 70498 HC CT ANGIOGRAPHY NECK W CONTRAST	$3,663.66	$4,697.00	—	—	22%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 HC CT ANGIOGRAPHY CHEST	$3,485.82	$4,469.00	—	13% above	22%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 HC CT ANGIOGRAPHY CHEST	$3,485.82	$4,469.00	—	—	22%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 HC CT ABD & PELVIS WO CONTRAST	$2,020.98	$2,591.00	—	47% below	22%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 HC CT ABD & PELVIS WO CONTRAST	$2,020.98	$2,591.00	—	—	22%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 HC CT ABDOMEN & PELVIS W CONTRAST	$3,091.92	$3,964.00	—	29% below	22%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 HC CT ABDOMEN & PELVIS W CONTRAST	$3,091.92	$3,964.00	—	—	22%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 HC CT ABDOMEN & PELVIS W & W/O CONTRAST	$4,035.72	$5,174.00	—	17% below	22%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 HC CT ABDOMEN & PELVIS W & W/O CONTRAST	$4,035.72	$5,174.00	—	—	22%
CT scan of the abdomen with contrast CPT 74160 HC CT ABDOMEN W CONTRAST	$2,953.86	$3,787.00	—	15% above	22%
CT scan of the abdomen with contrast inpatient CPT 74160 HC CT ABDOMEN W CONTRAST	$2,953.86	$3,787.00	—	—	22%
CT scan of the abdomen without contrast CPT 74150 HC CT ABDOMEN WO CONTRAST	$2,553.72	$3,274.00	—	7% above	22%
CT scan of the abdomen without contrast inpatient CPT 74150 HC CT ABDOMEN WO CONTRAST	$2,553.72	$3,274.00	—	—	22%
CT scan of the face and sinuses, no contrast dye CPT 70486 HC CT MAXILLOFACIAL WO CONTRAST	$2,056.86	$2,637.00	—	10% above	22%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 HC CT MAXILLOFACIAL WO CONTRAST	$2,056.86	$2,637.00	—	—	22%
CT scan of the head or brain, no contrast dye CPT 70450 HC CT HEAD/BRAIN WO CONTRAST	$2,079.48	$2,666.00	—	4% below	22%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 HC CT HEAD/BRAIN WO CONTRAST	$2,079.48	$2,666.00	—	—	22%
CT scan of the head with contrast CPT 70460 HC CT HEAD/BRAIN W CONTRAST	$2,554.50	$3,275.00	—	7% above	22%
CT scan of the head with contrast inpatient CPT 70460 HC CT HEAD/BRAIN W CONTRAST	$2,554.50	$3,275.00	—	—	22%
CT scan of the head without and with contrast CPT 70470 HC CT HEAD/BRAIN W & W/O CONTRAST	$2,613.78	$3,351.00	—	1% below	22%
CT scan of the head without and with contrast inpatient CPT 70470 HC CT HEAD/BRAIN W & W/O CONTRAST	$2,613.78	$3,351.00	—	—	22%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 HC CT LUMBAR SPINE WO CONTRAST	$2,506.14	$3,213.00	—	18% above	22%
CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 HC CT LUMBAR SPINE WO CONTRAST	$2,506.14	$3,213.00	—	—	22%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 HC CT NECK SPINE WO CONTRAST	$2,224.56	$2,852.00	—	8% above	22%
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 HC CT NECK SPINE WO CONTRAST	$2,224.56	$2,852.00	—	—	22%
CT scan of the pelvis, with contrast dye CPT 72193 HC CT PELVIS W CONTRAST	$2,431.26	$3,117.00	—	at median	22%
CT scan of the pelvis, with contrast dye inpatient CPT 72193 HC CT PELVIS W CONTRAST	$2,431.26	$3,117.00	—	—	22%
Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 HC DUPLEX SCAN EXTRACRANIAL ART COMPL BI STUDY	$1,418.04	$1,818.00	—	—	22%
Carotid artery ultrasound (duplex), both sides of the neck inpatient both sides CPT 93880 HC DUPLEX SCAN EXTRACRANIAL ART COMPL BI STUDY	$1,418.04	$1,818.00	—	—	22%
Chest CT scan without and with contrast CPT 71270 HC CT THORAX W & W/O CONTRAST	$3,603.60	$4,620.00	—	24% above	22%
Chest CT scan without and with contrast inpatient CPT 71270 HC CT THORAX W & W/O CONTRAST	$3,603.60	$4,620.00	—	—	22%
Chest X-ray, 2 views CPT 71046 HC XR CHEST 2 VIEWS	$716.04	$918.00	—	64% above	22%
Chest X-ray, 2 views inpatient CPT 71046 HC XR CHEST 2 VIEWS	$716.04	$918.00	—	—	22%
Chest X-ray, single view CPT 71045 HC XR CHEST 1 VIEW	$648.18	$831.00	—	64% above	22%
Chest X-ray, single view CPT 71045 HC XR CHEST PORTABLE 1 VIEW	$648.18	$831.00	—	64% above	22%
Chest X-ray, single view inpatient CPT 71045 HC XR CHEST 1 VIEW	$648.18	$831.00	—	—	22%
Chest X-ray, single view inpatient CPT 71045 HC XR CHEST PORTABLE 1 VIEW	$648.18	$831.00	—	—	22%
Collarbone (clavicle) X-ray, complete CPT 73000 HC XR CLAVICLE COMPLETE	$420.42	$539.00	—	1% above	22%
Collarbone (clavicle) X-ray, complete inpatient CPT 73000 HC XR CLAVICLE COMPLETE	$420.42	$539.00	—	—	22%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 HC US RETROPERITONEAL COMPLETE	$1,304.94	$1,673.00	—	36% above	22%
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 HC US RETROPERITONEAL COMPLETE	$1,304.94	$1,673.00	—	—	22%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 HC XR DXA BONE DENSITY STUDY AXIAL	$561.60	$720.00	—	41% above	22%
DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 HC XR DXA BONE DENSITY STUDY AXIAL	$561.60	$720.00	—	—	22%
DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 HC BONE DENSITY PERIPHERAL SKELETON	$318.24	$408.00	—	21% above	22%
DEXA bone density scan of the wrist, heel or finger (peripheral) inpatient CPT 77081 HC BONE DENSITY PERIPHERAL SKELETON	$318.24	$408.00	—	—	22%
Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 HC US OB DETAILED SINGLE FETUS CDM	$471.12	$604.00	—	62% below	22%
Detailed fetal anatomy ultrasound, through the belly, one baby inpatient CPT 76811 HC US OB DETAILED SINGLE FETUS CDM	$471.12	$604.00	—	—	22%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 HC CT THORAX W/O DYE F/U LUNG SCREENING	$2,978.04	$3,818.00	—	37% above	22%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 HC CT THORAX WO CONTRAST	$2,978.04	$3,818.00	—	37% above	22%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 HC CT THORAX W/O DYE F/U LUNG SCREENING	$2,978.04	$3,818.00	—	—	22%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 HC CT THORAX WO CONTRAST	$2,978.04	$3,818.00	—	—	22%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 HC CT THORAX W CONTRAST	$3,275.22	$4,199.00	—	9% above	22%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 HC CT THORAX W CONTRAST	$3,275.22	$4,199.00	—	—	22%
Diagnostic mammogram, both breasts CPT 77066 HC MAMMO DIAG BIL W CAD	$677.82	$869.00	—	4% above	22%
Diagnostic mammogram, both breasts inpatient CPT 77066 HC MAMMO DIAG BIL W CAD	$677.82	$869.00	—	—	22%
Diagnostic mammogram, one breast CPT 77065 HC MAMMO DIAG UNI W CAD	$615.42	$789.00	—	35% above	22%
Diagnostic mammogram, one breast inpatient CPT 77065 HC MAMMO DIAG UNI W CAD	$615.42	$789.00	—	—	22%
Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 HC DUP-SCAN LXTR ART/ARTL BPGS COMPL BI STUDY	$1,769.04	$2,268.00	—	—	22%
Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 HC DUP-SCAN LXTR ART/ARTL BPGS COMPL BI STUDY	$1,769.04	$2,268.00	—	—	22%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 HC DUP-SCAN XTR VEINS COMPLETE BILATERAL STUDY	$1,640.34	$2,103.00	—	—	22%
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 HC DUP-SCAN XTR VEINS COMPLETE BILATERAL STUDY	$1,640.34	$2,103.00	—	—	22%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 HC PR 93306 ECHO TTE 2D W/COLOR & DOP	$677.82	$869.00	—	66% below	22%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 HC ECHO TTE 2D W DOPPLER COMPLETE	$3,350.10	$4,295.00	—	69% above	22%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 HC PR 93306 ECHO TTE 2D W/COLOR & DOP	$677.82	$869.00	—	—	22%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 HC ECHO TTE 2D W DOPPLER COMPLETE	$3,350.10	$4,295.00	—	—	22%
Elbow X-ray, 2 views CPT 73070 HC XR ELBOW 2 VIEWS	$517.14	$663.00	—	32% above	22%
Elbow X-ray, 2 views inpatient CPT 73070 HC XR ELBOW 2 VIEWS	$517.14	$663.00	—	—	22%
Elbow X-ray, complete, 3 or more views CPT 73080 HC XR ELBOW COMPLETE MIN 3 VIEWS	$593.58	$761.00	—	34% above	22%
Elbow X-ray, complete, 3 or more views inpatient CPT 73080 HC XR ELBOW COMPLETE MIN 3 VIEWS	$593.58	$761.00	—	—	22%
Eye socket (orbit) CT scan without contrast CPT 70480 HC CT ORBIT/EAR/FOSSA WO CONTRAST	$2,383.68	$3,056.00	—	22% above	22%
Eye socket (orbit) CT scan without contrast inpatient CPT 70480 HC CT ORBIT/EAR/FOSSA WO CONTRAST	$2,383.68	$3,056.00	—	—	22%
Facial bones X-ray, complete, 3 or more views CPT 70150 HC XR FACIAL BONES MIN 3 VIEWS	$810.42	$1,039.00	—	46% above	22%
Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 HC XR FACIAL BONES MIN 3 VIEWS	$810.42	$1,039.00	—	—	22%
Forearm X-ray (radius and ulna), 2 views CPT 73090 HC XR FOREARM 2 VIEWS	$510.90	$655.00	—	at median	22%
Forearm X-ray (radius and ulna), 2 views inpatient CPT 73090 HC XR FOREARM 2 VIEWS	$510.90	$655.00	—	—	22%
Hand X-ray, 2 views CPT 73120 HC XR HAND 1 VIEW	$657.54	$843.00	—	64% above	22%
Hand X-ray, 2 views CPT 73120 HC XR HAND 2 VIEWS	$657.54	$843.00	—	64% above	22%
Hand X-ray, 2 views inpatient CPT 73120 HC XR HAND 1 VIEW	$657.54	$843.00	—	—	22%
Hand X-ray, 2 views inpatient CPT 73120 HC XR HAND 2 VIEWS	$657.54	$843.00	—	—	22%
Heel bone (calcaneus) X-ray, 2 or more views CPT 73650 HC XR HEEL MIN 2 VIEWS	$471.12	$604.00	—	21% above	22%
Heel bone (calcaneus) X-ray, 2 or more views inpatient CPT 73650 HC XR HEEL MIN 2 VIEWS	$471.12	$604.00	—	—	22%
Knee X-ray, 3 views CPT 73562 HC XR KNEE 3 VIEWS	$573.30	$735.00	—	13% above	22%
Knee X-ray, 3 views inpatient CPT 73562 HC XR KNEE 3 VIEWS	$573.30	$735.00	—	—	22%
Knee X-ray, complete, 4 or more views CPT 73564 HC XR KNEE 4/PLUS VIEWS	$766.74	$983.00	—	18% above	22%
Knee X-ray, complete, 4 or more views inpatient CPT 73564 HC XR KNEE 4/PLUS VIEWS	$766.74	$983.00	—	—	22%
Leg CT scan without contrast (hip to foot, any part) CPT 73700 HC CT LOWER EXTREMITY WO CONTRAST	$2,389.92	$3,064.00	—	12% above	22%
Leg CT scan without contrast (hip to foot, any part) inpatient CPT 73700 HC CT LOWER EXTREMITY WO CONTRAST	$2,389.92	$3,064.00	—	—	22%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 HC US ED ABDOMEN LIMITED CDM	$643.50	$825.00	—	3% above	22%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 HC US ABDOMEN LIMITED	$740.22	$949.00	—	18% above	22%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 HC US ED ABDOMEN LIMITED CDM	$643.50	$825.00	—	—	22%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 HC US ABDOMEN LIMITED	$740.22	$949.00	—	—	22%
Limited ultrasound of an arm or leg (non-vascular) CPT 76882 HC US ED LMTD JT/FCL EVAL NONVASC XTR STRUX R-T W/IMG CDM	$507.00	$650.00	—	6% above	22%
Limited ultrasound of an arm or leg (non-vascular) CPT 76882 HC US LMTD JT/FCL EVAL NONVASC XTR STRUX R-T W/IMG CDM	$583.44	$748.00	—	22% above	22%
Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 HC US ED LMTD JT/FCL EVAL NONVASC XTR STRUX R-T W/IMG CDM	$507.00	$650.00	—	—	22%
Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 HC US LMTD JT/FCL EVAL NONVASC XTR STRUX R-T W/IMG CDM	$583.44	$748.00	—	—	22%
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 HC CT THORAX LW DOSE LNG CA SCR WO CONTRAST CDM	$221.52	$284.00	—	24% below	22%
Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 HC CT THORAX LW DOSE LNG CA SCR WO CONTRAST CDM	$221.52	$284.00	—	—	22%
Lower leg X-ray (tibia and fibula), 2 views CPT 73590 HC XR LOWER LEG 2 VIEWS	$613.86	$787.00	—	36% above	22%
Lower leg X-ray (tibia and fibula), 2 views CPT 73590 HC XR LOWER LEG LIMITED	$613.86	$787.00	—	36% above	22%
Lower leg X-ray (tibia and fibula), 2 views inpatient CPT 73590 HC XR LOWER LEG 2 VIEWS	$613.86	$787.00	—	—	22%
Lower leg X-ray (tibia and fibula), 2 views inpatient CPT 73590 HC XR LOWER LEG LIMITED	$613.86	$787.00	—	—	22%
MR angiography (MRA) of the head without contrast CPT 70544 HC MRA HEAD WO CONTRAST	$3,430.44	$4,398.00	—	21% above	22%
MR angiography (MRA) of the head without contrast inpatient CPT 70544 HC MRA HEAD WO CONTRAST	$3,430.44	$4,398.00	—	—	22%
MRI of knee or other lower-limb joint, no contrast dye CPT 73721 HC MRI LOWER EXTREMITY JOINT WO CONTRAST	$3,651.96	$4,682.00	—	13% above	22%
MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 HC MRI LOWER EXTREMITY JOINT WO CONTRAST	$3,651.96	$4,682.00	—	—	22%
MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 HC MRI LOWER EXTREMITY JOINT WO & W CONTRAST	$5,782.14	$7,413.00	—	54% above	22%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 HC MRI LOWER EXTREMITY JOINT WO & W CONTRAST	$5,782.14	$7,413.00	—	—	22%
MRI of the abdomen without contrast CPT 74181 HC MRI ABDOMEN WO CONTRAST	$4,839.12	$6,204.00	—	37% above	22%
MRI of the abdomen without contrast CPT 74181 HC MRI MRCP ABDOMEN WO CONTRAST	$5,203.38	$6,671.00	—	47% above	22%
MRI of the abdomen without contrast inpatient CPT 74181 HC MRI ABDOMEN WO CONTRAST	$4,839.12	$6,204.00	—	—	22%
MRI of the abdomen without contrast inpatient CPT 74181 HC MRI MRCP ABDOMEN WO CONTRAST	$5,203.38	$6,671.00	—	—	22%
MRI of the abdomen, without and then with contrast dye CPT 74183 HC MRI ABDOMEN WO & W CONTRAST	$6,296.16	$8,072.00	—	33% above	22%
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 HC MRI ABDOMEN WO & W CONTRAST	$6,296.16	$8,072.00	—	—	22%
MRI of the brain, no contrast dye CPT 70551 HC MRI BRAIN STEM W/O DYE	$4,273.62	$5,479.00	—	29% above	22%
MRI of the brain, no contrast dye inpatient CPT 70551 HC MRI BRAIN STEM W/O DYE	$4,273.62	$5,479.00	—	—	22%
MRI of the brain, with and without contrast dye CPT 70553 HC MRI BRAIN W/O & W/DYE	$5,938.92	$7,614.00	—	37% above	22%
MRI of the brain, with and without contrast dye inpatient CPT 70553 HC MRI BRAIN W/O & W/DYE	$5,938.92	$7,614.00	—	—	22%
MRI of the lower back, no contrast dye CPT 72148 HC MRI LUMBAR SPINE W/O DYE	$3,650.40	$4,680.00	—	6% above	22%
MRI of the lower back, no contrast dye inpatient CPT 72148 HC MRI LUMBAR SPINE W/O DYE	$3,650.40	$4,680.00	—	—	22%
MRI of the lower back, without and then with contrast dye CPT 72158 HC MRI LUMBAR SPINE W/O & W/DYE LIMITED	$5,782.14	$7,413.00	—	37% above	22%
MRI of the lower back, without and then with contrast dye CPT 72158 HC MRI LUMBAR SPINE W/O & W/DYE	$5,782.14	$7,413.00	—	37% above	22%
MRI of the lower back, without and then with contrast dye inpatient CPT 72158 HC MRI LUMBAR SPINE W/O & W/DYE LIMITED	$5,782.14	$7,413.00	—	—	22%
MRI of the lower back, without and then with contrast dye inpatient CPT 72158 HC MRI LUMBAR SPINE W/O & W/DYE	$5,782.14	$7,413.00	—	—	22%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 HC MRI THORACIC SPINE W/O DYE	$3,650.40	$4,680.00	—	17% above	22%
MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 HC MRI THORACIC SPINE W/O DYE	$3,650.40	$4,680.00	—	—	22%
MRI of the neck (cervical spine) without and with contrast CPT 72156 HC MRI CERVICAL SPINE W/O & W/DYE	$5,938.92	$7,614.00	—	43% above	22%
MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 HC MRI CERVICAL SPINE W/O & W/DYE	$5,938.92	$7,614.00	—	—	22%
MRI of the neck (cervical spine), no contrast dye CPT 72141 HC MRI CERVICAL SPINE W/O DYE	$3,750.24	$4,808.00	—	8% above	22%
MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 HC MRI CERVICAL SPINE W/O DYE	$3,750.24	$4,808.00	—	—	22%
MRI of the pelvis without and with contrast CPT 72197 HC MRI PELVIS WO & W CONTRAST	$5,389.02	$6,909.00	—	15% above	22%
MRI of the pelvis without and with contrast inpatient CPT 72197 HC MRI PELVIS WO & W CONTRAST	$5,389.02	$6,909.00	—	—	22%
MRI of the pelvis, no contrast dye CPT 72195 HC MRI PELVIS WO CONTRAST	$3,338.40	$4,280.00	—	6% above	22%
MRI of the pelvis, no contrast dye inpatient CPT 72195 HC MRI PELVIS WO CONTRAST	$3,338.40	$4,280.00	—	—	22%
MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 HC MRI UPPER EXTREMITY JOINT WO CONTRAST	$3,947.58	$5,061.00	—	24% above	22%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 HC MRI UPPER EXTREMITY JOINT WO CONTRAST	$3,947.58	$5,061.00	—	—	22%
Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 HC XR SPINE CERVICAL 4 OR 5 VIEWS	$928.20	$1,190.00	—	23% above	22%
Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 HC XR SPINE CERVICAL 4 OR 5 VIEWS	$928.20	$1,190.00	—	—	22%
Neck soft tissue CT scan with contrast CPT 70491 HC CT SOFT TISSUE NECK W CONTRAST	$2,457.78	$3,151.00	—	6% above	22%
Neck soft tissue CT scan with contrast inpatient CPT 70491 HC CT SOFT TISSUE NECK W CONTRAST	$2,457.78	$3,151.00	—	—	22%
Neck soft tissue CT scan without contrast CPT 70490 HC CT SOFT TISSUE NECK WO CONTRAST	$2,066.22	$2,649.00	—	6% above	22%
Neck soft tissue CT scan without contrast inpatient CPT 70490 HC CT SOFT TISSUE NECK WO CONTRAST	$2,066.22	$2,649.00	—	—	22%
Neck soft tissue X-ray CPT 70360 HC XR NECK SOFT TISSUE	$499.98	$641.00	—	47% above	22%
Neck soft tissue X-ray inpatient CPT 70360 HC XR NECK SOFT TISSUE	$499.98	$641.00	—	—	22%
Pelvic CT scan without contrast CPT 72192 HC CT PELVIS WO CONTRAST	$2,073.24	$2,658.00	—	6% below	22%
Pelvic CT scan without contrast inpatient CPT 72192 HC CT PELVIS WO CONTRAST	$2,073.24	$2,658.00	—	—	22%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 HC US ED EXAM PELVIC LIMITED CDM	$398.58	$511.00	—	27% below	22%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 HC US EXAM PELVIC LIMITED	$458.64	$588.00	—	16% below	22%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 HC US EXAM PELVIC FOLLICLE LIMITED	$458.64	$588.00	—	16% below	22%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 HC US ED EXAM PELVIC LIMITED CDM	$398.58	$511.00	—	—	22%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 HC US EXAM PELVIC FOLLICLE LIMITED	$458.64	$588.00	—	—	22%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 HC US EXAM PELVIC LIMITED	$458.64	$588.00	—	—	22%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 HC US PELVIC NON-OB COMPLETE	$1,046.76	$1,342.00	—	11% above	22%
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 HC US PELVIC NON-OB COMPLETE	$1,046.76	$1,342.00	—	—	22%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 HC US OB AFTER 1ST TRIMEST 1/1ST FETUS	$1,102.92	$1,414.00	—	4% above	22%
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 HC US OB AFTER 1ST TRIMEST 1/1ST FETUS	$1,102.92	$1,414.00	—	—	22%
Pregnancy ultrasound before 14 weeks, through the belly, one baby one side CPT 76801 HC US OB LT 14 WKS SINGLE FETUS CDM	$1,046.76	$1,342.00	—	35% above	22%
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient one side CPT 76801 HC US OB LT 14 WKS SINGLE FETUS CDM	$1,046.76	$1,342.00	—	—	22%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 HC PR 76815 US OB LIMITED FETUS(S)	$286.26	$367.00	—	50% below	22%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 HC US ED OB LIMITED FETUS(S) CDM	$333.06	$427.00	—	42% below	22%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 HC US OB LIMITED FETUS(S) CDM	$382.98	$491.00	—	33% below	22%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 HC PR 76815 US OB LIMITED FETUS(S)	$286.26	$367.00	—	—	22%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 HC US ED OB LIMITED FETUS(S) CDM	$333.06	$427.00	—	—	22%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 HC US OB LIMITED FETUS(S) CDM	$382.98	$491.00	—	—	22%
Rib X-ray, one side, 2 views CPT 71100 HC XR RIBS UNI 2 VIEWS	$438.36	$562.00	—	5% below	22%
Rib X-ray, one side, 2 views inpatient CPT 71100 HC XR RIBS UNI 2 VIEWS	$438.36	$562.00	—	—	22%
Rib X-ray, one side, with a chest view, 3 or more views CPT 71101 HC XR RIBS/CHEST UNI MIN 3 VIEWS	$621.66	$797.00	—	13% above	22%
Rib X-ray, one side, with a chest view, 3 or more views inpatient CPT 71101 HC XR RIBS/CHEST UNI MIN 3 VIEWS	$621.66	$797.00	—	—	22%
Screening mammogram, both breasts CPT 77067 HC MAMMO SCREEN BIL W CAD	$559.26	$717.00	—	6% above	22%
Screening mammogram, both breasts CPT 77067 HC MAMMO SCREEN UNIL/BIL W CAD	$559.26	$717.00	—	6% above	22%
Screening mammogram, both breasts inpatient CPT 77067 HC MAMMO SCREEN BIL W CAD	$559.26	$717.00	—	—	22%
Screening mammogram, both breasts inpatient CPT 77067 HC MAMMO SCREEN UNIL/BIL W CAD	$559.26	$717.00	—	—	22%
Shoulder X-ray, complete, 2 or more views CPT 73030 HC XR SHOULDER COMPLETE MIN 2 VIEWS	$735.54	$943.00	—	18% above	22%
Shoulder X-ray, complete, 2 or more views inpatient CPT 73030 HC XR SHOULDER COMPLETE MIN 2 VIEWS	$735.54	$943.00	—	—	22%
Sinus X-ray, complete, 3 or more views CPT 70220 HC XR SINUSES PARANASAL MIN 3 VIEWS	$760.50	$975.00	—	42% above	22%
Sinus X-ray, complete, 3 or more views inpatient CPT 70220 HC XR SINUSES PARANASAL MIN 3 VIEWS	$760.50	$975.00	—	—	22%
Skull X-ray, fewer than 4 views CPT 70250 HC XR SKULL 1-3 VIEWS	$622.44	$798.00	—	18% above	22%
Skull X-ray, fewer than 4 views inpatient CPT 70250 HC XR SKULL 1-3 VIEWS	$622.44	$798.00	—	—	22%
Swallow study (modified barium swallow, video X-ray) CPT 74230 HC XR RADIOLOGIC EXAM SWALLOW FUNCTION CONTRAST STUDY	$1,114.62	$1,429.00	—	16% above	22%
Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 HC XR RADIOLOGIC EXAM SWALLOW FUNCTION CONTRAST STUDY	$1,114.62	$1,429.00	—	—	22%
Thigh bone (femur) X-ray, 2 or more views CPT 73552 HC XR FEMUR MIN 2 VIEWS	$875.16	$1,122.00	—	52% above	22%
Thigh bone (femur) X-ray, 2 or more views inpatient CPT 73552 HC XR FEMUR MIN 2 VIEWS	$875.16	$1,122.00	—	—	22%
Thoracic spine (mid back) CT scan without contrast CPT 72128 HC CT CHEST SPINE WO CONTRAST	$2,809.56	$3,602.00	—	11% above	22%
Thoracic spine (mid back) CT scan without contrast inpatient CPT 72128 HC CT CHEST SPINE WO CONTRAST	$2,809.56	$3,602.00	—	—	22%
Toe X-ray, 2 or more views CPT 73660 HC XR TOE(S) MIN 2 VIEWS	$504.66	$647.00	—	14% above	22%
Toe X-ray, 2 or more views inpatient CPT 73660 HC XR TOE(S) MIN 2 VIEWS	$504.66	$647.00	—	—	22%
Transvaginal pelvic ultrasound CPT 76830 HC US TRANSVAGINAL NON-OB	$715.26	$917.00	—	24% above	22%
Transvaginal pelvic ultrasound inpatient CPT 76830 HC US TRANSVAGINAL NON-OB	$715.26	$917.00	—	—	22%
Transvaginal ultrasound during pregnancy CPT 76817 HC US OB TRANSVAGINAL CDM	$740.22	$949.00	—	4% above	22%
Transvaginal ultrasound during pregnancy inpatient CPT 76817 HC US OB TRANSVAGINAL CDM	$740.22	$949.00	—	—	22%
Ultrasound of the abdomen, complete CPT 76700 HC US EXAM ABDOMEN COMPLETE	$1,728.48	$2,216.00	—	63% above	22%
Ultrasound of the abdomen, complete inpatient CPT 76700 HC US EXAM ABDOMEN COMPLETE	$1,728.48	$2,216.00	—	—	22%
Ultrasound of the scrotum and testicles CPT 76870 HC US EXAM SCROTUM & CONTENTS	$1,180.14	$1,513.00	—	27% above	22%
Ultrasound of the scrotum and testicles inpatient CPT 76870 HC US EXAM SCROTUM & CONTENTS	$1,180.14	$1,513.00	—	—	22%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 HC US ED EXAM OF HEAD AND NECK CDM	$1,203.54	$1,543.00	—	37% above	22%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 HC US EXAM OF HEAD AND NECK	$1,383.72	$1,774.00	—	58% above	22%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 HC US ED EXAM OF HEAD AND NECK CDM	$1,203.54	$1,543.00	—	—	22%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 HC US EXAM OF HEAD AND NECK	$1,383.72	$1,774.00	—	—	22%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 HC XR RADIOLOGIC EXAM UPR GI TRC SINGLE CONTRAST STUDY CDM	$1,194.96	$1,532.00	—	19% above	22%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 HC XR RADIOLOGIC EXAM UPR GI TRC SINGLE CONTRAST STUDY CDM	$1,194.96	$1,532.00	—	—	22%
Upper arm X-ray (humerus), 2 views CPT 73060 HC XR HUMERUS 1 VIEW	$492.96	$632.00	—	9% above	22%
Upper arm X-ray (humerus), 2 views CPT 73060 HC XR HUMERUS MIN 2 VIEWS	$509.34	$653.00	—	13% above	22%
Upper arm X-ray (humerus), 2 views inpatient CPT 73060 HC XR HUMERUS 1 VIEW	$492.96	$632.00	—	—	22%
Upper arm X-ray (humerus), 2 views inpatient CPT 73060 HC XR HUMERUS MIN 2 VIEWS	$509.34	$653.00	—	—	22%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 HC DUP-SCAN XTR VEINS UNILATERAL/LIMITED STUDY	$1,371.24	$1,758.00	—	16% above	22%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 HC DUP-SCAN XTR VEINS UNILATERAL/LIMITED STUDY	$1,371.24	$1,758.00	—	—	22%
Wrist X-ray, 2 views CPT 73100 HC XR WRIST 1 VIEW	$421.20	$540.00	—	31% above	22%
Wrist X-ray, 2 views CPT 73100 HC XR WRIST 2 VIEWS	$463.32	$594.00	—	44% above	22%
Wrist X-ray, 2 views inpatient CPT 73100 HC XR WRIST 1 VIEW	$421.20	$540.00	—	—	22%
Wrist X-ray, 2 views inpatient CPT 73100 HC XR WRIST 2 VIEWS	$463.32	$594.00	—	—	22%
Wrist X-ray, complete, 3 or more views CPT 73110 HC XR WRIST COMPLETE MIN 3 VIEWS	$550.68	$706.00	—	18% above	22%
Wrist X-ray, complete, 3 or more views inpatient CPT 73110 HC XR WRIST COMPLETE MIN 3 VIEWS	$550.68	$706.00	—	—	22%
X-ray of one hip, 2 or 3 views, with the pelvis when included CPT 73502 HC XR HIPS UNI W PELVIS WHEN PERFORMED 2-3 VIEWS	$840.06	$1,077.00	—	92% above	22%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient CPT 73502 HC XR HIPS UNI W PELVIS WHEN PERFORMED 2-3 VIEWS	$840.06	$1,077.00	—	—	22%
X-ray of the abdomen, 1 view CPT 74018 HC XR ABDOMEN 1 VIEW	$577.20	$740.00	—	39% above	22%
X-ray of the abdomen, 1 view CPT 74018 HC XR ABDOMEN PORTABLE 1 VIEW	$577.20	$740.00	—	39% above	22%
X-ray of the abdomen, 1 view inpatient CPT 74018 HC XR ABDOMEN PORTABLE 1 VIEW	$577.20	$740.00	—	—	22%
X-ray of the abdomen, 1 view inpatient CPT 74018 HC XR ABDOMEN 1 VIEW	$577.20	$740.00	—	—	22%
X-ray of the ankle, 2 views CPT 73600 HC XR ANKLE 1 VIEW	$429.78	$551.00	—	21% above	22%
X-ray of the ankle, 2 views CPT 73600 HC XR ANKLE 2 VIEWS	$473.46	$607.00	—	33% above	22%
X-ray of the ankle, 2 views inpatient CPT 73600 HC XR ANKLE 1 VIEW	$429.78	$551.00	—	—	22%
X-ray of the ankle, 2 views inpatient CPT 73600 HC XR ANKLE 2 VIEWS	$473.46	$607.00	—	—	22%
X-ray of the finger(s), 2 or more views CPT 73140 HC XR FINGERS(S) MIN 2 VIEWS	$438.36	$562.00	—	19% above	22%
X-ray of the finger(s), 2 or more views inpatient CPT 73140 HC XR FINGERS(S) MIN 2 VIEWS	$438.36	$562.00	—	—	22%
X-ray of the foot, 2 views CPT 73620 HC XR FOOT 2 VIEWS	$438.36	$562.00	—	19% above	22%
X-ray of the foot, 2 views inpatient CPT 73620 HC XR FOOT 2 VIEWS	$438.36	$562.00	—	—	22%
X-ray of the foot, complete, 3 or more views CPT 73630 HC XR FOOT MIN 3 VIEWS	$609.96	$782.00	—	32% above	22%
X-ray of the foot, complete, 3 or more views inpatient CPT 73630 HC XR FOOT MIN 3 VIEWS	$609.96	$782.00	—	—	22%
X-ray of the hand, 3 or more views CPT 73130 HC XR HAND MIN 3 VIEWS	$789.36	$1,012.00	—	68% above	22%
X-ray of the hand, 3 or more views inpatient CPT 73130 HC XR HAND MIN 3 VIEWS	$789.36	$1,012.00	—	—	22%
X-ray of the knee, 1 or 2 views CPT 73560 HC XR KNEE 1-2 VIEWS	$506.22	$649.00	—	22% above	22%
X-ray of the knee, 1 or 2 views inpatient CPT 73560 HC XR KNEE 1-2 VIEWS	$506.22	$649.00	—	—	22%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 HC XR SPINE LUMBOSACRAL 2 OR 3 VIEWS	$659.88	$846.00	—	29% above	22%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 HC XR SPINE LUMBOSACRAL 2 OR 3 VIEWS	$659.88	$846.00	—	—	22%
X-ray of the lower back, 4 or more views CPT 72110 HC SPINE LUMBOSACRAL MIN 4 VIEWS	$783.12	$1,004.00	—	24% above	22%
X-ray of the lower back, 4 or more views inpatient CPT 72110 HC SPINE LUMBOSACRAL MIN 4 VIEWS	$783.12	$1,004.00	—	—	22%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 HC XR SPINE THORACIC 2 VIEWS	$659.88	$846.00	—	54% above	22%
X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 HC XR SPINE THORACIC 2 VIEWS	$659.88	$846.00	—	—	22%
X-ray of the nasal bones, 3 or more views CPT 70160 HC XR NASAL BONES MIN 3 VIEWS	$542.10	$695.00	—	23% above	22%
X-ray of the nasal bones, 3 or more views inpatient CPT 70160 HC XR NASAL BONES MIN 3 VIEWS	$542.10	$695.00	—	—	22%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 HC XR SPINE CERVICAL 2 OR 3 VIEWS	$612.30	$785.00	—	26% above	22%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 HC XR SPINE CERVICAL 2 OR 3 VIEWS	$612.30	$785.00	—	—	22%
X-ray of the pelvis, 1 or 2 views CPT 72170 HC XR PELVIS 1-2 VIEWS NO HIP VIEWS	$438.36	$562.00	—	5% above	22%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 HC XR PELVIS 1-2 VIEWS NO HIP VIEWS	$438.36	$562.00	—	—	22%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 HC XR TAILBONE MIN 2 VIEWS	$517.14	$663.00	—	34% above	22%
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 HC XR TAILBONE MIN 2 VIEWS	$517.14	$663.00	—	—	22%

Lab tests

Procedure	Cash price	List price	Insurers pay	vs Alaska	Off list
ACTH blood test CPT 82024 HC ADRENOCORTICOTROPIC HORMONE ACTH CDM	$425.88	$546.00	—	102% above	22%
ACTH blood test inpatient CPT 82024 HC ADRENOCORTICOTROPIC HORMONE ACTH CDM	$425.88	$546.00	—	—	22%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 HC TRANSFERASE ALANINE AMINO ALT SGPT LAB	$6.24	$8.00	—	89% below	22%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 HC SGPT (ALT)	$144.30	$185.00	—	147% above	22%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 HC TRANSFERASE ALANINE AMINO ALT SGPT LAB	$6.24	$8.00	—	—	22%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 HC SGPT (ALT)	$144.30	$185.00	—	—	22%
AST (aspartate aminotransferase) enzyme test CPT 84450 HC TRANSFERASE ASPARTATE AMINO AST SGOT LAB	$6.24	$8.00	—	88% below	22%
AST (aspartate aminotransferase) enzyme test CPT 84450 HC SGOT (AST)	$85.02	$109.00	—	60% above	22%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 HC TRANSFERASE ASPARTATE AMINO AST SGOT LAB	$6.24	$8.00	—	—	22%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 HC SGOT (AST)	$85.02	$109.00	—	—	22%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 HC HEPATITIS ACUTE PANEL	$151.32	$194.00	—	56% below	22%
Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 HC HEPATITIS ACUTE PANEL	$151.32	$194.00	—	—	22%
Albumin blood test CPT 82040 HC ALBUMIN SERUM PLASMA/WHOLE BLOOD LAB	$5.46	$7.00	—	88% below	22%
Albumin blood test CPT 82040 HC ALBUMIN SERUM PLASMA/WHOLE BLOOD CDM	$28.08	$36.00	—	37% below	22%
Albumin blood test CPT 82040 HC ASSAY OF SERUM ALBUMIN	$79.56	$102.00	—	78% above	22%
Albumin blood test inpatient CPT 82040 HC ALBUMIN SERUM PLASMA/WHOLE BLOOD LAB	$5.46	$7.00	—	—	22%
Albumin blood test inpatient CPT 82040 HC ALBUMIN SERUM PLASMA/WHOLE BLOOD CDM	$28.08	$36.00	—	—	22%
Albumin blood test inpatient CPT 82040 HC ASSAY OF SERUM ALBUMIN	$79.56	$102.00	—	—	22%
Aldosterone blood test CPT 82088 HC ASSAY OF ALDOSTERONE PLASMA LAB	$38.22	$49.00	—	72% below	22%
Aldosterone blood test CPT 82088 HC ALDOSTERONE BLD	$115.44	$148.00	—	14% below	22%
Aldosterone blood test inpatient CPT 82088 HC ASSAY OF ALDOSTERONE PLASMA LAB	$38.22	$49.00	—	—	22%
Aldosterone blood test inpatient CPT 82088 HC ALDOSTERONE BLD	$115.44	$148.00	—	—	22%
Alkaline phosphatase (ALP) blood test CPT 84075 HC ASSAY OF PHOSPHATASE ALKALINE LAB	$14.04	$18.00	—	64% below	22%
Alkaline phosphatase (ALP) blood test CPT 84075 HC ALKALINE PHOS	$127.92	$164.00	—	226% above	22%
Alkaline phosphatase (ALP) blood test inpatient CPT 84075 HC ASSAY OF PHOSPHATASE ALKALINE LAB	$14.04	$18.00	—	—	22%
Alkaline phosphatase (ALP) blood test inpatient CPT 84075 HC ALKALINE PHOS	$127.92	$164.00	—	—	22%
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE CRUDE ALLERGEN EXTRACT EACH CDM	$7.80	$10.00	—	41% below	22%
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE CRUDE ALLERGEN EXTRACT EACH LAB	$7.80	$10.00	—	41% below	22%
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE CRUDE ALLERGEN EXTRACT X 1LAB	$7.80	$10.00	—	41% below	22%
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE CRUDE ALLERGEN EXTRACT X 33LAB	$7.80	$10.00	—	41% below	22%
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN STACHYBOTRYS CHARTARUM IGE CRUDE ALLERGEN EXTRACT EACH LAB	$11.70	$15.00	—	12% below	22%
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPECIFIC IGE	$22.62	$29.00	—	70% above	22%
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLG SPEC IGE CRUDE XTRC EA (RL)	$34.32	$44.00	—	158% above	22%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE CRUDE ALLERGEN EXTRACT EACH CDM	$7.80	$10.00	—	—	22%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE CRUDE ALLERGEN EXTRACT EACH LAB	$7.80	$10.00	—	—	22%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE CRUDE ALLERGEN EXTRACT X 33LAB	$7.80	$10.00	—	—	22%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE CRUDE ALLERGEN EXTRACT X 1LAB	$7.80	$10.00	—	—	22%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN STACHYBOTRYS CHARTARUM IGE CRUDE ALLERGEN EXTRACT EACH LAB	$11.70	$15.00	—	—	22%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPECIFIC IGE	$22.62	$29.00	—	—	22%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLG SPEC IGE CRUDE XTRC EA (RL)	$34.32	$44.00	—	—	22%
Alpha-fetoprotein (AFP) blood test CPT 82105 HC ALPHA-FETOPROTEIN SERUM	$26.52	$34.00	—	62% below	22%
Alpha-fetoprotein (AFP) blood test CPT 82105 HC ALPHA-FETOPROTEIN SERUM CDM	$46.02	$59.00	—	34% below	22%
Alpha-fetoprotein (AFP) blood test CPT 82105 HC ALPHA-FETOPROTEIN SERUM LAB	$61.62	$79.00	—	11% below	22%
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 HC ALPHA-FETOPROTEIN SERUM	$26.52	$34.00	—	—	22%
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 HC ALPHA-FETOPROTEIN SERUM CDM	$46.02	$59.00	—	—	22%
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 HC ALPHA-FETOPROTEIN SERUM LAB	$61.62	$79.00	—	—	22%
Ammonia blood test CPT 82140 HC ASSAY OF AMMONIA LAB	$14.04	$18.00	—	91% below	22%
Ammonia blood test inpatient CPT 82140 HC ASSAY OF AMMONIA LAB	$14.04	$18.00	—	—	22%
Amylase blood test CPT 82150 HC ASSAY OF AMYLASE ISOENZYME PANCREATIC	$23.40	$30.00	—	60% below	22%
Amylase blood test CPT 82150 HC ASSAY OF AMYLASE	$35.10	$45.00	—	39% below	22%
Amylase blood test CPT 82150 HC ASSAY OF AMYLASE LAB	$168.48	$216.00	—	191% above	22%
Amylase blood test CPT 82150 HC AMYLASE	$168.48	$216.00	—	191% above	22%
Amylase blood test inpatient CPT 82150 HC ASSAY OF AMYLASE ISOENZYME PANCREATIC	$23.40	$30.00	—	—	22%
Amylase blood test inpatient CPT 82150 HC ASSAY OF AMYLASE	$35.10	$45.00	—	—	22%
Amylase blood test inpatient CPT 82150 HC ASSAY OF AMYLASE LAB	$168.48	$216.00	—	—	22%
Amylase blood test inpatient CPT 82150 HC AMYLASE	$168.48	$216.00	—	—	22%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 HC CCP ANTIBODY	$36.66	$47.00	—	61% below	22%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 HC CYCLIC CITRULLINATED PEPTIDE ANTIBODY LAB	$39.78	$51.00	—	57% below	22%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 HC CCP ANTIBODY	$36.66	$47.00	—	—	22%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 HC CYCLIC CITRULLINATED PEPTIDE ANTIBODY LAB	$39.78	$51.00	—	—	22%
Antinuclear antibody (ANA) blood test, screen CPT 86038 HC ANTINUCLEAR ANTIBODIES ANA LAB	$12.48	$16.00	—	84% below	22%
Antinuclear antibody (ANA) blood test, screen CPT 86038 HC ANTINUCLEAR ANTIBODIES ANA	$18.72	$24.00	—	75% below	22%
Antinuclear antibody (ANA) blood test, screen CPT 86038 HC ANTINUCLEAR ANTIBODIES	$312.78	$401.00	—	310% above	22%
Antinuclear antibody (ANA) blood test, screen CPT 86038 HC ANTINUCLEAR ANTIBODIES - ANA	$312.78	$401.00	—	310% above	22%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 HC ANTINUCLEAR ANTIBODIES ANA LAB	$12.48	$16.00	—	—	22%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 HC ANTINUCLEAR ANTIBODIES ANA	$18.72	$24.00	—	—	22%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 HC ANTINUCLEAR ANTIBODIES - ANA	$312.78	$401.00	—	—	22%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 HC ANTINUCLEAR ANTIBODIES	$312.78	$401.00	—	—	22%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 HC NATRIURETIC PEPTIDE	$296.40	$380.00	—	1% above	22%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 HC NATRIURETIC PEPTIDE LAB	$296.40	$380.00	—	1% above	22%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 HC NATRIURETIC PEPTIDE LAB	$296.40	$380.00	—	—	22%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 HC NATRIURETIC PEPTIDE	$296.40	$380.00	—	—	22%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HC CUL BACT XCPT URINE BLOOD/STOOL AEROBIC ISOL LAB	$38.22	$49.00	—	74% below	22%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HC CUL BACT XCPT URINE BLOOD/STOOL AEROBIC ISOL CDM	$69.42	$89.00	—	52% below	22%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HC CULTURE BACTERIA OTHER	$301.08	$386.00	—	108% above	22%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 HC CUL BACT XCPT URINE BLOOD/STOOL AEROBIC ISOL LAB	$38.22	$49.00	—	—	22%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 HC CUL BACT XCPT URINE BLOOD/STOOL AEROBIC ISOL CDM	$69.42	$89.00	—	—	22%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 HC CULTURE BACTERIA OTHER	$301.08	$386.00	—	—	22%
Basic metabolic panel (blood test) CPT 80048 HC BASIC METABOLIC PANEL	$381.42	$489.00	—	187% above	22%
Basic metabolic panel (blood test) inpatient CPT 80048 HC BASIC METABOLIC PANEL	$381.42	$489.00	—	—	22%
Bilirubin blood test, total CPT 82247 HC BILIRUBIN TOTAL LAB	$6.24	$8.00	—	89% below	22%
Bilirubin blood test, total CPT 82247 HC BILIRUBIN TOTAL	$140.40	$180.00	—	150% above	22%
Bilirubin blood test, total inpatient CPT 82247 HC BILIRUBIN TOTAL LAB	$6.24	$8.00	—	—	22%
Bilirubin blood test, total inpatient CPT 82247 HC BILIRUBIN TOTAL	$140.40	$180.00	—	—	22%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 HC LEVEL IV SURG PATHOLOGY GROSS&MICROSCOPIC EXAM LAB	$304.20	$390.00	—	5% above	22%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 HC LEVEL IV SURG PATHOLOGY GROSS&MICROSCOPIC EXAM LAB	$304.20	$390.00	—	—	22%
Blood culture for bacteria CPT 87040 HC BLOOD CULTURE FOR BACTERIA	$234.78	$301.00	—	12% above	22%
Blood culture for bacteria inpatient CPT 87040 HC BLOOD CULTURE FOR BACTERIA	$234.78	$301.00	—	—	22%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 HC ROUTINE VENIPUNCTURE - REFERRAL DRAW FEE	$31.20	$40.00	—	18% below	22%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 HC ROUTINE VENIPUNCTURE - REFERRAL PROCESSING	$31.20	$40.00	—	18% below	22%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 HC ROUTINE VENIPUNCTURE - COLLECTION VENOUS BLD CDM	$78.00	$100.00	—	105% above	22%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 HC BLOOD DRAW VENIPUNCTURE CDM	$78.78	$101.00	—	107% above	22%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 HC ED ROUTINE VENIPUNCTURE OR LEGAL DRAW CDM	$78.78	$101.00	—	107% above	22%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 HC ROUTINE VENIPUNCTURE - REFERRAL DRAW FEE	$31.20	$40.00	—	—	22%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 HC ROUTINE VENIPUNCTURE - REFERRAL PROCESSING	$31.20	$40.00	—	—	22%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 HC ROUTINE VENIPUNCTURE - COLLECTION VENOUS BLD CDM	$78.00	$100.00	—	—	22%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 HC BLOOD DRAW VENIPUNCTURE CDM	$78.78	$101.00	—	—	22%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 HC ED ROUTINE VENIPUNCTURE OR LEGAL DRAW CDM	$78.78	$101.00	—	—	22%
Blood glucose (sugar) test CPT 82947 HC GLUCOSE QUANTITATIVE BLOOD XCPT REAGENT STRIP LAB	$14.82	$19.00	—	65% below	22%
Blood glucose (sugar) test CPT 82947 HC GLUCOSE QUANTITATIVE BLOOD (EXCEPT REAGENT STRIP)	$84.24	$108.00	—	97% above	22%
Blood glucose (sugar) test inpatient CPT 82947 HC GLUCOSE QUANTITATIVE BLOOD XCPT REAGENT STRIP LAB	$14.82	$19.00	—	—	22%
Blood glucose (sugar) test inpatient CPT 82947 HC GLUCOSE QUANTITATIVE BLOOD (EXCEPT REAGENT STRIP)	$84.24	$108.00	—	—	22%
Blood lead test CPT 83655 HC ASSAY OF LEAD LAB	$12.48	$16.00	—	84% below	22%
Blood lead test CPT 83655 HC ASSAY OF LEAD CDM	$17.94	$23.00	—	77% below	22%
Blood lead test CPT 83655 HC HVY MET UR - LEAD	$18.72	$24.00	—	76% below	22%
Blood lead test CPT 83655 HC LEAD BLOOD	$177.84	$228.00	—	130% above	22%
Blood lead test inpatient CPT 83655 HC ASSAY OF LEAD LAB	$12.48	$16.00	—	—	22%
Blood lead test inpatient CPT 83655 HC ASSAY OF LEAD CDM	$17.94	$23.00	—	—	22%
Blood lead test inpatient CPT 83655 HC HVY MET UR - LEAD	$18.72	$24.00	—	—	22%
Blood lead test inpatient CPT 83655 HC LEAD BLOOD	$177.84	$228.00	—	—	22%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 HC GONADOTROPIN CHORIONIC QUALITATIVE CDM	$190.32	$244.00	—	88% above	22%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 HC GONADOTROPIN CHORIONIC QUALITATIVE CDM	$190.32	$244.00	—	—	22%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 HC BLOOD TYPING SEROLOGIC ABO CDM	$22.62	$29.00	—	60% below	22%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 HC BLOOD TYPING SEROLOGIC ABO LAB	$69.42	$89.00	—	23% above	22%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 HC BLOOD TYPING SEROLOGIC ABO CDM	$22.62	$29.00	—	—	22%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 HC BLOOD TYPING SEROLOGIC ABO LAB	$69.42	$89.00	—	—	22%
Blood urea nitrogen (BUN) test CPT 84520 HC UREA NITROGEN BODY FLUID	$11.70	$15.00	—	76% below	22%
Blood urea nitrogen (BUN) test CPT 84520 HC BUN	$88.92	$114.00	—	84% above	22%
Blood urea nitrogen (BUN) test CPT 84520 HC ASSAY OF UREA NITROGEN QUANTITATIVE LAB	$88.92	$114.00	—	84% above	22%
Blood urea nitrogen (BUN) test inpatient CPT 84520 HC UREA NITROGEN BODY FLUID	$11.70	$15.00	—	—	22%
Blood urea nitrogen (BUN) test inpatient CPT 84520 HC ASSAY OF UREA NITROGEN QUANTITATIVE LAB	$88.92	$114.00	—	—	22%
Blood urea nitrogen (BUN) test inpatient CPT 84520 HC BUN	$88.92	$114.00	—	—	22%
C-peptide blood test CPT 84681 HC ASSAY OF C PEPTIDE LAB	$18.72	$24.00	—	89% below	22%
C-peptide blood test CPT 84681 HC ASSAY OF C-PEPTIDE CDM	$19.50	$25.00	—	88% below	22%
C-peptide blood test inpatient CPT 84681 HC ASSAY OF C PEPTIDE LAB	$18.72	$24.00	—	—	22%
C-peptide blood test inpatient CPT 84681 HC ASSAY OF C-PEPTIDE CDM	$19.50	$25.00	—	—	22%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 HC C-REACTIVE PROTEIN LAB	$12.48	$16.00	—	80% below	22%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 HC C-REACTIVE PROTEIN	$181.74	$233.00	—	187% above	22%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 HC C-REACTIVE PROTEIN LAB	$12.48	$16.00	—	—	22%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 HC C-REACTIVE PROTEIN	$181.74	$233.00	—	—	22%
C. difficile toxin gene test (stool PCR) CPT 87493 HC CLOSTRIDIUM DIFFICILE TOXINS AMPLIFIED PROBE	$485.94	$623.00	—	108% above	22%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 HC CLOSTRIDIUM DIFFICILE TOXINS AMPLIFIED PROBE	$485.94	$623.00	—	—	22%
CA 19-9 blood test (tumor marker) CPT 86301 HC IMMUNOASSAY TUMOR CA 19-9	$372.84	$478.00	—	62% above	22%
CA 19-9 blood test (tumor marker) inpatient CPT 86301 HC IMMUNOASSAY TUMOR CA 19-9	$372.84	$478.00	—	—	22%
CA-125 blood test (ovarian cancer marker) CPT 86304 HC IMMUNOASSAY TUMOR ANTIGEN QUANTITATIVE CA 125 CDM	$453.18	$581.00	—	159% above	22%
CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 HC IMMUNOASSAY TUMOR ANTIGEN QUANTITATIVE CA 125 CDM	$453.18	$581.00	—	—	22%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 HC IADNA SARS-COV-2 COVID-19 AMPLIFIED PROBE TQ LAB	$136.50	$175.00	—	32% above	22%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 HC IADNA SARS-COV-2 COVID-19 AMPLIFIED PROBE TQ CDM	$136.50	$175.00	—	32% above	22%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 HC IADNA SARS-COV-2 COVID-19 AMPLIFIED PROBE TQ CDM	$136.50	$175.00	—	—	22%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 HC IADNA SARS-COV-2 COVID-19 AMPLIFIED PROBE TQ LAB	$136.50	$175.00	—	—	22%
Calcium blood test, total CPT 82310 HC CALCIUM TOTAL LAB	$140.40	$180.00	—	100% above	22%
Calcium blood test, total CPT 82310 HC CALCIUM SERUM	$140.40	$180.00	—	100% above	22%
Calcium blood test, total inpatient CPT 82310 HC CALCIUM TOTAL LAB	$140.40	$180.00	—	—	22%
Calcium blood test, total inpatient CPT 82310 HC CALCIUM SERUM	$140.40	$180.00	—	—	22%
Carcinoembryonic antigen (CEA) test CPT 82378 HC CARCINOEMBRYONIC ANTIGEN CEA CDM	$205.92	$264.00	—	10% above	22%
Carcinoembryonic antigen (CEA) test inpatient CPT 82378 HC CARCINOEMBRYONIC ANTIGEN CEA CDM	$205.92	$264.00	—	—	22%
Chickenpox (varicella) immunity blood test CPT 86787 HC VARICELLA-ZOSTER ANTIBODY - IGG	$19.50	$25.00	—	76% below	22%
Chickenpox (varicella) immunity blood test CPT 86787 HC ANTIBODY VARICELLA-ZOSTER CDM	$382.98	$491.00	—	364% above	22%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 HC VARICELLA-ZOSTER ANTIBODY - IGG	$19.50	$25.00	—	—	22%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 HC ANTIBODY VARICELLA-ZOSTER CDM	$382.98	$491.00	—	—	22%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 HC CHLAMYDIA TRACHOMATIS AMPLIFIED DNA	$42.12	$54.00	—	72% below	22%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 HC IADNA CHLAMYDIA TRACHOMATIS AMPLIFIED PROBE TQ LAB	$98.28	$126.00	—	35% below	22%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 HC IADNA CHLAMYDIA TRACHOMATIS AMPLIFIED PROBE TQ	$400.14	$513.00	—	164% above	22%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 HC CHLAMYDIA TRACHOMATIS PCR	$400.14	$513.00	—	164% above	22%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 HC CHLAMYDIA TRACHOMATIS AMPLIFIED DNA	$42.12	$54.00	—	—	22%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 HC IADNA CHLAMYDIA TRACHOMATIS AMPLIFIED PROBE TQ LAB	$98.28	$126.00	—	—	22%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 HC CHLAMYDIA TRACHOMATIS PCR	$400.14	$513.00	—	—	22%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 HC IADNA CHLAMYDIA TRACHOMATIS AMPLIFIED PROBE TQ	$400.14	$513.00	—	—	22%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 HC LIPID PANEL LAB	$12.48	$16.00	—	87% below	22%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 HC LIPID PANEL	$142.74	$183.00	—	45% above	22%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 HC LIPID PANEL LAB	$12.48	$16.00	—	—	22%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 HC LIPID PANEL	$142.74	$183.00	—	—	22%
Complete blood count (CBC) with differential CPT 85025 HC BLOOD COUNT COMPLETE AUTO&AUTO DIFRNTL WBC LAB	$14.04	$18.00	—	87% below	22%
Complete blood count (CBC) with differential CPT 85025 HC BLOOD COUNT COMPLETE AUTO&AUTO DIFRNTL WBC	$214.50	$275.00	—	98% above	22%
Complete blood count (CBC) with differential CPT 85025 HC CBC WITH DIFF AUTO	$214.50	$275.00	—	98% above	22%
Complete blood count (CBC) with differential inpatient CPT 85025 HC BLOOD COUNT COMPLETE AUTO&AUTO DIFRNTL WBC LAB	$14.04	$18.00	—	—	22%
Complete blood count (CBC) with differential inpatient CPT 85025 HC BLOOD COUNT COMPLETE AUTO&AUTO DIFRNTL WBC	$214.50	$275.00	—	—	22%
Complete blood count (CBC) with differential inpatient CPT 85025 HC CBC WITH DIFF AUTO	$214.50	$275.00	—	—	22%
Complete blood count (CBC), no differential CPT 85027 HC BLOOD COUNT COMPLETE AUTOMATED LAB	$31.98	$41.00	—	61% below	22%
Complete blood count (CBC), no differential CPT 85027 HC BLOOD COUNT COMPLETE AUTOMATED	$167.70	$215.00	—	105% above	22%
Complete blood count (CBC), no differential inpatient CPT 85027 HC BLOOD COUNT COMPLETE AUTOMATED LAB	$31.98	$41.00	—	—	22%
Complete blood count (CBC), no differential inpatient CPT 85027 HC BLOOD COUNT COMPLETE AUTOMATED	$167.70	$215.00	—	—	22%
Comprehensive metabolic panel (blood test) CPT 80053 HC COMPREHEN METABOLIC PANEL	$390.78	$501.00	—	130% above	22%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 HC COMPREHEN METABOLIC PANEL	$390.78	$501.00	—	—	22%
Cortisol blood test, total CPT 82533 HC CORTISOL TOTAL LAB	$24.18	$31.00	—	74% below	22%
Cortisol blood test, total CPT 82533 HC CORTISOL TOTAL CDM	$42.12	$54.00	—	56% below	22%
Cortisol blood test, total CPT 82533 HC CORTISOL	$212.16	$272.00	—	124% above	22%
Cortisol blood test, total CPT 82533 HC CORTISOL TOTAL	$212.16	$272.00	—	124% above	22%
Cortisol blood test, total inpatient CPT 82533 HC CORTISOL TOTAL LAB	$24.18	$31.00	—	—	22%
Cortisol blood test, total inpatient CPT 82533 HC CORTISOL TOTAL CDM	$42.12	$54.00	—	—	22%
Cortisol blood test, total inpatient CPT 82533 HC CORTISOL	$212.16	$272.00	—	—	22%
Cortisol blood test, total inpatient CPT 82533 HC CORTISOL TOTAL	$212.16	$272.00	—	—	22%
Creatine kinase (CK) blood test, total CPT 82550 HC CREATINE KINASE TOTAL CDM	$13.26	$17.00	—	87% below	22%
Creatine kinase (CK) blood test, total CPT 82550 HC CK TOTAL	$95.94	$123.00	—	6% below	22%
Creatine kinase (CK) blood test, total CPT 82550 HC CREATINE KINASE TOTAL LAB	$95.94	$123.00	—	6% below	22%
Creatine kinase (CK) blood test, total inpatient CPT 82550 HC CREATINE KINASE TOTAL CDM	$13.26	$17.00	—	—	22%
Creatine kinase (CK) blood test, total inpatient CPT 82550 HC CREATINE KINASE TOTAL LAB	$95.94	$123.00	—	—	22%
Creatine kinase (CK) blood test, total inpatient CPT 82550 HC CK TOTAL	$95.94	$123.00	—	—	22%
Creatinine blood test CPT 82565 HC ASSAY CREATININE	$88.92	$114.00	—	48% above	22%
Creatinine blood test inpatient CPT 82565 HC ASSAY CREATININE	$88.92	$114.00	—	—	22%
Cytomegalovirus (CMV) antibody test CPT 86644 HC ANTIBODY CYTOMEGALOVIRUS CMV LAB	$15.60	$20.00	—	74% below	22%
Cytomegalovirus (CMV) antibody test CPT 86644 HC ANTIBODY CYTOMEGALOVIRUS CMV CDM	$30.42	$39.00	—	49% below	22%
Cytomegalovirus (CMV) antibody test CPT 86644 HC CMV ANTIBODY	$241.80	$310.00	—	309% above	22%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 HC ANTIBODY CYTOMEGALOVIRUS CMV LAB	$15.60	$20.00	—	—	22%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 HC ANTIBODY CYTOMEGALOVIRUS CMV CDM	$30.42	$39.00	—	—	22%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 HC CMV ANTIBODY	$241.80	$310.00	—	—	22%
D-dimer blood test (blood clot marker) CPT 85379 HC DDIMER QUANT	$226.20	$290.00	—	11% above	22%
D-dimer blood test (blood clot marker) inpatient CPT 85379 HC DDIMER QUANT	$226.20	$290.00	—	—	22%
DHEA sulfate (DHEA-S) blood test CPT 82627 HC DEHYDROEPIANDROSTERONE-SULFATE LAB	$141.18	$181.00	—	3% below	22%
DHEA sulfate (DHEA-S) blood test CPT 82627 HC DEHYDROEPIANDROSTERONE-SULFATE CDM	$367.38	$471.00	—	151% above	22%
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 HC DEHYDROEPIANDROSTERONE-SULFATE LAB	$141.18	$181.00	—	—	22%
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 HC DEHYDROEPIANDROSTERONE-SULFATE CDM	$367.38	$471.00	—	—	22%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC DRUGS OF ABUSE URINE	$11.70	$15.00	—	93% below	22%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC DRUG TST PRSMV INSTRMNT CHEMAN LAB	$17.16	$22.00	—	90% below	22%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC DRUG TST PRSMV INSTRMNT CHEM ANALYZERS PR DATE	$54.60	$70.00	—	69% below	22%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC DRUG TST PRSMV INSTRMNT CHEM ANALYZERS PR DATE LAB	$60.06	$77.00	—	66% below	22%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC DRUG TEST PRSMV CHEM ANLYZR PER DOS	$87.36	$112.00	—	51% below	22%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC DRUG TEST PRSMV CHEM ANLYZR ALCOHOL PER DOS	$102.96	$132.00	—	42% below	22%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC DRUG TST PRSMV INSTRMNT CHEM ANALYZERS PR DATE CDM	$123.24	$158.00	—	30% below	22%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC DRUG TEST PRSMV CHEM ANLYZR MECONIUM PER DOS	$262.86	$337.00	—	49% above	22%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC DRUG TEST PRSMV CHEM ANLYZR CORDSTAT PER DOS	$306.54	$393.00	—	74% above	22%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC DRUGS OF ABUSE URINE	$11.70	$15.00	—	—	22%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC DRUG TST PRSMV INSTRMNT CHEMAN LAB	$17.16	$22.00	—	—	22%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC DRUG TST PRSMV INSTRMNT CHEM ANALYZERS PR DATE	$54.60	$70.00	—	—	22%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC DRUG TST PRSMV INSTRMNT CHEM ANALYZERS PR DATE LAB	$60.06	$77.00	—	—	22%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC DRUG TEST PRSMV CHEM ANLYZR PER DOS	$87.36	$112.00	—	—	22%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC DRUG TEST PRSMV CHEM ANLYZR ALCOHOL PER DOS	$102.96	$132.00	—	—	22%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC DRUG TST PRSMV INSTRMNT CHEM ANALYZERS PR DATE CDM	$123.24	$158.00	—	—	22%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC DRUG TEST PRSMV CHEM ANLYZR MECONIUM PER DOS	$262.86	$337.00	—	—	22%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC DRUG TEST PRSMV CHEM ANLYZR CORDSTAT PER DOS	$306.54	$393.00	—	—	22%
Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 HC ELECTROLYTE PANEL	$208.26	$267.00	—	113% above	22%
Electrolyte panel (sodium, potassium, chloride, CO2) inpatient CPT 80051 HC ELECTROLYTE PANEL	$208.26	$267.00	—	—	22%
Epstein-Barr virus (EBV) antibody test CPT 86665 HC ANTIBODY EPSTEIN-BARR EB VIRUS VIRAL CAPSID VCA LAB	$27.30	$35.00	—	64% below	22%
Epstein-Barr virus (EBV) antibody test CPT 86665 HC EPSTEIN-BARR ANTIBODY - VIRAL CAPSID	$42.90	$55.00	—	43% below	22%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 HC ANTIBODY EPSTEIN-BARR EB VIRUS VIRAL CAPSID VCA LAB	$27.30	$35.00	—	—	22%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 HC EPSTEIN-BARR ANTIBODY - VIRAL CAPSID	$42.90	$55.00	—	—	22%
Estradiol blood test CPT 82670 HC ESTRADIOL	$25.74	$33.00	—	85% below	22%
Estradiol blood test CPT 82670 HC ASSAY OF TOTAL ESTRADIOL LAB	$70.20	$90.00	—	59% below	22%
Estradiol blood test CPT 82670 HC ASSAY OF ESTRADIOL LAB	$230.88	$296.00	—	34% above	22%
Estradiol blood test inpatient CPT 82670 HC ESTRADIOL	$25.74	$33.00	—	—	22%
Estradiol blood test inpatient CPT 82670 HC ASSAY OF TOTAL ESTRADIOL LAB	$70.20	$90.00	—	—	22%
Estradiol blood test inpatient CPT 82670 HC ASSAY OF ESTRADIOL LAB	$230.88	$296.00	—	—	22%
FSH (follicle-stimulating hormone) test CPT 83001 HC GONADOTROPIN FOLLICLE STIMULATING HORMONE CDM	$263.64	$338.00	—	36% above	22%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 HC GONADOTROPIN FOLLICLE STIMULATING HORMONE CDM	$263.64	$338.00	—	—	22%
Fecal calprotectin (stool inflammation test) CPT 83993 HC ASSAY OF CALPROTECTIN FECAL CDM	$418.86	$537.00	—	9% below	22%
Fecal calprotectin (stool inflammation test) inpatient CPT 83993 HC ASSAY OF CALPROTECTIN FECAL CDM	$418.86	$537.00	—	—	22%
Ferritin blood test (iron stores) CPT 82728 HC ASSAY OF FERRITIN LAB	$32.76	$42.00	—	72% below	22%
Ferritin blood test (iron stores) CPT 82728 HC ASSAY OF FERRITIN CDM	$346.32	$444.00	—	195% above	22%
Ferritin blood test (iron stores) inpatient CPT 82728 HC ASSAY OF FERRITIN LAB	$32.76	$42.00	—	—	22%
Ferritin blood test (iron stores) inpatient CPT 82728 HC ASSAY OF FERRITIN CDM	$346.32	$444.00	—	—	22%
Fibrinogen blood test CPT 85384 HC FIBRINOGEN	$141.18	$181.00	—	2% below	22%
Fibrinogen blood test inpatient CPT 85384 HC FIBRINOGEN	$141.18	$181.00	—	—	22%
Folate (folic acid) blood test CPT 82746 HC ASSAY OF FOLIC ACID SERUM CDM	$144.30	$185.00	—	4% above	22%
Folate (folic acid) blood test inpatient CPT 82746 HC ASSAY OF FOLIC ACID SERUM CDM	$144.30	$185.00	—	—	22%
Free T3 thyroid hormone test CPT 84481 HC ASSAY OF TRIIODOTHYRONINE T3 FREE CDM	$423.54	$543.00	—	167% above	22%
Free T3 thyroid hormone test inpatient CPT 84481 HC ASSAY OF TRIIODOTHYRONINE T3 FREE CDM	$423.54	$543.00	—	—	22%
Free T4 (free thyroxine) thyroid blood test CPT 84439 HC ASSAY OF FREE THYROXINE LAB	$14.04	$18.00	—	90% below	22%
Free T4 (free thyroxine) thyroid blood test CPT 84439 HC ASSAY OF FREE THYROXINE CDM	$152.10	$195.00	—	11% above	22%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 HC ASSAY OF FREE THYROXINE LAB	$14.04	$18.00	—	—	22%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 HC ASSAY OF FREE THYROXINE CDM	$152.10	$195.00	—	—	22%
Free testosterone test CPT 84402 HC ASSAY OF TESTOSTERONE FREE LAB	$24.18	$31.00	—	81% below	22%
Free testosterone test CPT 84402 HC ASSAY OF TESTOSTERONE FREE	$24.18	$31.00	—	81% below	22%
Free testosterone test CPT 84402 HC TESTOSTERONE FREE	$27.30	$35.00	—	78% below	22%
Free testosterone test inpatient CPT 84402 HC ASSAY OF TESTOSTERONE FREE LAB	$24.18	$31.00	—	—	22%
Free testosterone test inpatient CPT 84402 HC ASSAY OF TESTOSTERONE FREE	$24.18	$31.00	—	—	22%
Free testosterone test inpatient CPT 84402 HC TESTOSTERONE FREE	$27.30	$35.00	—	—	22%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 HC GAMMA GT TOTAL	$140.40	$180.00	—	99% above	22%
Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 HC GAMMA GT TOTAL	$140.40	$180.00	—	—	22%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 HC GLUCOSE POST GLUCOSE DOSE LAB	$14.82	$19.00	—	77% below	22%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 HC GLUCOSE POST GLUCOSE DOSE	$153.66	$197.00	—	141% above	22%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 HC GLUCOSE POST GLUCOSE DOSE LAB	$14.82	$19.00	—	—	22%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 HC GLUCOSE POST GLUCOSE DOSE	$153.66	$197.00	—	—	22%
Glucose tolerance test, 3 samples CPT 82951 HC GLUCOSE TOLERANCE TEST GTT 3 SPECIMENS LAB	$15.60	$20.00	—	86% below	22%
Glucose tolerance test, 3 samples CPT 82951 HC GLUCOSE TOLERANCE TEST (GTT) 3 SPECIMENS	$234.78	$301.00	—	114% above	22%
Glucose tolerance test, 3 samples inpatient CPT 82951 HC GLUCOSE TOLERANCE TEST GTT 3 SPECIMENS LAB	$15.60	$20.00	—	—	22%
Glucose tolerance test, 3 samples inpatient CPT 82951 HC GLUCOSE TOLERANCE TEST (GTT) 3 SPECIMENS	$234.78	$301.00	—	—	22%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 HC IADNA NEISSERIA GONORRHOEAE AMPLIFIED PROBE TQ CDM	$49.92	$64.00	—	57% below	22%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 HC IADNA NEISSERIA GONORRHOEAE AMPLIFIED PROBE TQ LAB	$98.28	$126.00	—	15% below	22%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 HC IADNA NEISSERIA GONORRHOEAE AMPLIFIED PROBE TQ	$378.30	$485.00	—	228% above	22%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 HC IADNA NEISSERIA GONORRHOEAE AMPLIFIED PROBE TQ CDM	$49.92	$64.00	—	—	22%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 HC IADNA NEISSERIA GONORRHOEAE AMPLIFIED PROBE TQ LAB	$98.28	$126.00	—	—	22%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 HC IADNA NEISSERIA GONORRHOEAE AMPLIFIED PROBE TQ	$378.30	$485.00	—	—	22%
H. pylori antibody blood test CPT 86677 HC ANTIBODY HELICOBACTER PYLORI CDM	$23.40	$30.00	—	75% below	22%
H. pylori antibody blood test CPT 86677 HC ANTIBODY HELICOBACTER PYLORI LAB	$32.76	$42.00	—	65% below	22%
H. pylori antibody blood test CPT 86677 HC HELICOBACTER PYLORI	$88.92	$114.00	—	6% below	22%
H. pylori antibody blood test inpatient CPT 86677 HC ANTIBODY HELICOBACTER PYLORI CDM	$23.40	$30.00	—	—	22%
H. pylori antibody blood test inpatient CPT 86677 HC ANTIBODY HELICOBACTER PYLORI LAB	$32.76	$42.00	—	—	22%
H. pylori antibody blood test inpatient CPT 86677 HC HELICOBACTER PYLORI	$88.92	$114.00	—	—	22%
H. pylori stool antigen test CPT 87338 HC IAAD IA HPYLORI STOOL CDM	$103.74	$133.00	—	44% below	22%
H. pylori stool antigen test inpatient CPT 87338 HC IAAD IA HPYLORI STOOL CDM	$103.74	$133.00	—	—	22%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HC IADNA HIV-1 QUANT & REVERSE TRANSCRIPTION LAB	$113.10	$145.00	—	69% below	22%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HC HIV ULTRA SENSITIVE PCR	$113.10	$145.00	—	69% below	22%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HC IADNA HIV-1 QUANT & REVERSE TRANSCRIPTION LAB	$113.10	$145.00	—	—	22%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HC HIV ULTRA SENSITIVE PCR	$113.10	$145.00	—	—	22%
HIV-1 and HIV-2 antibody test CPT 86703 HC HIV-1/HIV-2 SINGLE ASSAY	$244.14	$313.00	—	at median	22%
HIV-1 and HIV-2 antibody test inpatient CPT 86703 HC HIV-1/HIV-2 SINGLE ASSAY	$244.14	$313.00	—	—	22%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HC HIV-1 AG W/HIV-1 & HIV-2 AB	$75.66	$97.00	—	34% below	22%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HC IAAD IA HIV-1 AG W/HIV-1 & HIV-2 ANTBDY SINGLE	$213.72	$274.00	—	88% above	22%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HC HIV-1 AG W/HIV-1 & HIV-2 AB	$75.66	$97.00	—	—	22%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HC IAAD IA HIV-1 AG W/HIV-1 & HIV-2 ANTBDY SINGLE	$213.72	$274.00	—	—	22%
HPV test for high-risk types, one combined (pooled) result CPT 87624 HC IADNA HUMAN PAPILLOMAVIRUS HIGH-RISK TYPES	$48.36	$62.00	—	53% below	22%
HPV test for high-risk types, one combined (pooled) result CPT 87624 HC IADNA HUMAN PAPILLOMAVIRUS HIGH-RISK TYPES LAB	$85.80	$110.00	—	17% below	22%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HC IADNA HUMAN PAPILLOMAVIRUS HIGH-RISK TYPES	$48.36	$62.00	—	—	22%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HC IADNA HUMAN PAPILLOMAVIRUS HIGH-RISK TYPES LAB	$85.80	$110.00	—	—	22%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HC HEMOGLOBIN GLYCOSYLATED A1C CDM	$152.88	$196.00	—	25% above	22%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HC HEMOGLOBIN GLYCOSYLATED A1C CDM	$152.88	$196.00	—	—	22%
Hemoglobin blood test CPT 85018 HC BLOOD COUNT HEMOGLOBIN	$59.28	$76.00	—	27% above	22%
Hemoglobin blood test CPT 85018 HC HEMOGLOBIN (HGB)	$59.28	$76.00	—	27% above	22%
Hemoglobin blood test CPT 85018 HC BLOOD COUNT HEMOGLOBIN LAB	$59.28	$76.00	—	27% above	22%
Hemoglobin blood test inpatient CPT 85018 HC BLOOD COUNT HEMOGLOBIN	$59.28	$76.00	—	—	22%
Hemoglobin blood test inpatient CPT 85018 HC BLOOD COUNT HEMOGLOBIN LAB	$59.28	$76.00	—	—	22%
Hemoglobin blood test inpatient CPT 85018 HC HEMOGLOBIN (HGB)	$59.28	$76.00	—	—	22%
Hepatitis B core antibody test (total) CPT 86704 HC HEPATITIS B CORE ANTIBODY HBCAB TOTAL LAB	$17.16	$22.00	—	77% below	22%
Hepatitis B core antibody test (total) CPT 86704 HC HEPATITIS B CORE ANTIBODY HBCAB TOTAL CDM	$139.62	$179.00	—	91% above	22%
Hepatitis B core antibody test (total) inpatient CPT 86704 HC HEPATITIS B CORE ANTIBODY HBCAB TOTAL LAB	$17.16	$22.00	—	—	22%
Hepatitis B core antibody test (total) inpatient CPT 86704 HC HEPATITIS B CORE ANTIBODY HBCAB TOTAL CDM	$139.62	$179.00	—	—	22%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HC HEPATITIS B SURF ANTIBODY HBSAB LAB	$27.30	$35.00	—	70% below	22%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HC HEPATITIS B SURF ANTIBODY HBSAB CDM	$39.78	$51.00	—	56% below	22%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HC HEPATITIS B SURF ANTIBODY HBSAB LAB	$27.30	$35.00	—	—	22%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HC HEPATITIS B SURF ANTIBODY HBSAB CDM	$39.78	$51.00	—	—	22%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HC IAAD IA HEPATITIS B SURFACE ANTIGEN LAB	$54.60	$70.00	—	23% below	22%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HC IAAD IA HEPATITIS B SURFACE ANTIGEN CDM	$54.60	$70.00	—	23% below	22%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HC IAAD IA HEPATITIS B SURFACE ANTIGEN LAB	$54.60	$70.00	—	—	22%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HC IAAD IA HEPATITIS B SURFACE ANTIGEN CDM	$54.60	$70.00	—	—	22%
Hepatitis C antibody blood test (screening) CPT 86803 HC HEPATITIS C ANTIBODY LAB	$19.50	$25.00	—	80% below	22%
Hepatitis C antibody blood test (screening) CPT 86803 HC HEPATITIS C ANTIBODY CDM	$52.26	$67.00	—	45% below	22%
Hepatitis C antibody blood test (screening) CPT 86803 HC HEPATITIS C ANTIBODY	$52.26	$67.00	—	45% below	22%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 HC HEPATITIS C ANTIBODY LAB	$19.50	$25.00	—	—	22%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 HC HEPATITIS C ANTIBODY CDM	$52.26	$67.00	—	—	22%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 HC HEPATITIS C ANTIBODY	$52.26	$67.00	—	—	22%
Hepatitis C viral load (HCV RNA) test CPT 87522 HC IADNA HEPATITIS C QUANT & REVERSE TRANSCRIPTION CDM	$118.56	$152.00	—	63% below	22%
Hepatitis C viral load (HCV RNA) test CPT 87522 HC IADNA HEPATITIS C QUANT & REVERSE TRANSCRIPTION LAB	$155.22	$199.00	—	52% below	22%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HC IADNA HEPATITIS C QUANT & REVERSE TRANSCRIPTION CDM	$118.56	$152.00	—	—	22%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HC IADNA HEPATITIS C QUANT & REVERSE TRANSCRIPTION LAB	$155.22	$199.00	—	—	22%
Herpes blood test, HSV-1 antibody CPT 86695 HC ANTIBODY HERPES SMPLX TYPE 1 LAB	$27.30	$35.00	—	51% below	22%
Herpes blood test, HSV-1 antibody CPT 86695 HC ANTIBODY HERPES SMPLX TYPE 1 CDM	$30.42	$39.00	—	46% below	22%
Herpes blood test, HSV-1 antibody CPT 86695 HC HERPES SIMPLEX TEST - TYPE 1 IGG	$287.04	$368.00	—	413% above	22%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 HC ANTIBODY HERPES SMPLX TYPE 1 LAB	$27.30	$35.00	—	—	22%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 HC ANTIBODY HERPES SMPLX TYPE 1 CDM	$30.42	$39.00	—	—	22%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 HC HERPES SIMPLEX TEST - TYPE 1 IGG	$287.04	$368.00	—	—	22%
Herpes blood test, HSV-2 antibody CPT 86696 HC ANTIBODY HERPES SMPLX TYPE 2 LAB	$27.30	$35.00	—	66% below	22%
Herpes blood test, HSV-2 antibody CPT 86696 HC HERPES SIMPLEX TYPE 2	$30.42	$39.00	—	63% below	22%
Herpes blood test, HSV-2 antibody CPT 86696 HC ANTIBODY HERPES SMPLX TYPE 2 CDM	$287.04	$368.00	—	254% above	22%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HC ANTIBODY HERPES SMPLX TYPE 2 LAB	$27.30	$35.00	—	—	22%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HC HERPES SIMPLEX TYPE 2	$30.42	$39.00	—	—	22%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HC ANTIBODY HERPES SMPLX TYPE 2 CDM	$287.04	$368.00	—	—	22%
High-sensitivity CRP (hs-CRP) test CPT 86141 HC C-REACTIVE PROTEIN HIGH SENSITIVITY CDM	$181.74	$233.00	—	11% above	22%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 HC C-REACTIVE PROTEIN HIGH SENSITIVITY CDM	$181.74	$233.00	—	—	22%
Homocysteine blood test CPT 83090 HC ASSAY OF HOMOCYSTEINE LAB	$58.50	$75.00	—	72% below	22%
Homocysteine blood test inpatient CPT 83090 HC ASSAY OF HOMOCYSTEINE LAB	$58.50	$75.00	—	—	22%
Insulin blood test CPT 83525 HC ASSAY OF INSULIN TOTAL LAB	$35.88	$46.00	—	16% below	22%
Insulin blood test CPT 83525 HC ASSAY OF INSULIN TOTAL CDM	$170.82	$219.00	—	298% above	22%
Insulin blood test inpatient CPT 83525 HC ASSAY OF INSULIN TOTAL LAB	$35.88	$46.00	—	—	22%
Insulin blood test inpatient CPT 83525 HC ASSAY OF INSULIN TOTAL CDM	$170.82	$219.00	—	—	22%
Iron blood test (serum iron) CPT 83540 HC IRON	$148.98	$191.00	—	89% above	22%
Iron blood test (serum iron) inpatient CPT 83540 HC IRON	$148.98	$191.00	—	—	22%
Kidney function blood test panel CPT 80069 HC RENAL FUNCTION PANEL CDM	$381.42	$489.00	—	153% above	22%
Kidney function blood test panel inpatient CPT 80069 HC RENAL FUNCTION PANEL CDM	$381.42	$489.00	—	—	22%
LH (luteinizing hormone) test CPT 83002 HC GONADOTROPIN LUTEINIZING HORMONE CDM	$308.88	$396.00	—	51% above	22%
LH (luteinizing hormone) test inpatient CPT 83002 HC GONADOTROPIN LUTEINIZING HORMONE CDM	$308.88	$396.00	—	—	22%
Lactate (lactic acid) blood test CPT 83605 HC ASSAY OF LACTATE LAB	$200.46	$257.00	—	26% above	22%
Lactate (lactic acid) blood test CPT 83605 HC ASSAY OF LACTATE	$205.92	$264.00	—	29% above	22%
Lactate (lactic acid) blood test inpatient CPT 83605 HC ASSAY OF LACTATE LAB	$200.46	$257.00	—	—	22%
Lactate (lactic acid) blood test inpatient CPT 83605 HC ASSAY OF LACTATE	$205.92	$264.00	—	—	22%
Lactate dehydrogenase (LDH) blood test CPT 83615 HC LDH SERUM	$88.92	$114.00	—	16% above	22%
Lactate dehydrogenase (LDH) blood test CPT 83615 HC LDH BODY FLUID	$88.92	$114.00	—	16% above	22%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 HC LDH BODY FLUID	$88.92	$114.00	—	—	22%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 HC LDH SERUM	$88.92	$114.00	—	—	22%
Lipase blood test (pancreas enzyme) CPT 83690 HC ASSAY OF LIPASE LAB	$172.38	$221.00	—	43% above	22%
Lipase blood test (pancreas enzyme) CPT 83690 HC ASSAY OF LIPASE CDM	$172.38	$221.00	—	43% above	22%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 HC ASSAY OF LIPASE LAB	$172.38	$221.00	—	—	22%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 HC ASSAY OF LIPASE CDM	$172.38	$221.00	—	—	22%
Liver function blood test panel CPT 80076 HC HEPATIC FUNCTION PANEL LAB	$14.04	$18.00	—	86% below	22%
Liver function blood test panel CPT 80076 HC HEPATIC FUNCTION PANEL CDM	$289.38	$371.00	—	187% above	22%
Liver function blood test panel inpatient CPT 80076 HC HEPATIC FUNCTION PANEL LAB	$14.04	$18.00	—	—	22%
Liver function blood test panel inpatient CPT 80076 HC HEPATIC FUNCTION PANEL CDM	$289.38	$371.00	—	—	22%
Lyme disease antibody test CPT 86618 HC ANTIBODY BORRELIA BURGDORFERI LYME DISEASE LAB	$34.32	$44.00	—	71% below	22%
Lyme disease antibody test CPT 86618 HC LYME DISEASE ANTIBODY - CSF	$112.32	$144.00	—	4% below	22%
Lyme disease antibody test inpatient CPT 86618 HC ANTIBODY BORRELIA BURGDORFERI LYME DISEASE LAB	$34.32	$44.00	—	—	22%
Lyme disease antibody test inpatient CPT 86618 HC LYME DISEASE ANTIBODY - CSF	$112.32	$144.00	—	—	22%
Magnesium blood test CPT 83735 HC ASSAY OF MAGNESIUM CDM	$168.48	$216.00	—	127% above	22%
Magnesium blood test CPT 83735 HC ASSAY OF MAGNESIUM LAB	$178.62	$229.00	—	141% above	22%
Magnesium blood test inpatient CPT 83735 HC ASSAY OF MAGNESIUM CDM	$168.48	$216.00	—	—	22%
Magnesium blood test inpatient CPT 83735 HC ASSAY OF MAGNESIUM LAB	$178.62	$229.00	—	—	22%
Measles (rubeola) antibody test CPT 86765 HC RUBEOLA ANTIBODY - IGG	$14.04	$18.00	—	75% below	22%
Measles (rubeola) antibody test CPT 86765 HC ANTIBODY RUBEOLA LAB	$17.94	$23.00	—	69% below	22%
Measles (rubeola) antibody test inpatient CPT 86765 HC RUBEOLA ANTIBODY - IGG	$14.04	$18.00	—	—	22%
Measles (rubeola) antibody test inpatient CPT 86765 HC ANTIBODY RUBEOLA LAB	$17.94	$23.00	—	—	22%
Mono test (heterophile antibody, Monospot) CPT 86308 HC HETEROPHILE ANTIBODIES SCREEN LAB	$21.84	$28.00	—	72% below	22%
Mono test (heterophile antibody, Monospot) CPT 86308 HC HETEROPHILE ANTIBODIES	$159.90	$205.00	—	108% above	22%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 HC HETEROPHILE ANTIBODIES SCREEN LAB	$21.84	$28.00	—	—	22%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 HC HETEROPHILE ANTIBODIES	$159.90	$205.00	—	—	22%
Mumps immunity blood test CPT 86735 HC ANTIBODY MUMPS CDM	$14.82	$19.00	—	82% below	22%
Mumps immunity blood test CPT 86735 HC ANTIBODY MUMPS LAB	$14.82	$19.00	—	82% below	22%
Mumps immunity blood test inpatient CPT 86735 HC ANTIBODY MUMPS LAB	$14.82	$19.00	—	—	22%
Mumps immunity blood test inpatient CPT 86735 HC ANTIBODY MUMPS CDM	$14.82	$19.00	—	—	22%
PSA (prostate-specific antigen) blood test, free CPT 84154 HC PSA FREE	$17.94	$23.00	—	77% below	22%
PSA (prostate-specific antigen) blood test, free CPT 84154 HC ASSAY OF PROSTATE SPECIFIC ANTIGEN FREE LAB	$167.70	$215.00	—	111% above	22%
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 HC PSA FREE	$17.94	$23.00	—	—	22%
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 HC ASSAY OF PROSTATE SPECIFIC ANTIGEN FREE LAB	$167.70	$215.00	—	—	22%
PSA (prostate-specific antigen) blood test, total CPT 84153 HC ASSAY OF PROSTATE SPECIFIC ANTIGEN TOTAL LAB	$185.64	$238.00	—	12% above	22%
PSA (prostate-specific antigen) blood test, total CPT 84153 HC ASSAY OF PROSTATE SPECIFIC ANTIGEN TOTAL CDM	$191.10	$245.00	—	15% above	22%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 HC ASSAY OF PROSTATE SPECIFIC ANTIGEN TOTAL LAB	$185.64	$238.00	—	—	22%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 HC ASSAY OF PROSTATE SPECIFIC ANTIGEN TOTAL CDM	$191.10	$245.00	—	—	22%
Pap test (liquid-based, automated screening with review) CPT 88175 HC CYTP C/V AUTO THIN LYR PREPJ SCR MNL RESCR PHYS LAB	$61.62	$79.00	—	38% below	22%
Pap test (liquid-based, automated screening with review) CPT 88175 HC CYTP C/V AUTO THIN LYR PREPJ SCR MNL RESCR PHYS	$128.70	$165.00	—	30% above	22%
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 HC CYTP C/V AUTO THIN LYR PREPJ SCR MNL RESCR PHYS LAB	$61.62	$79.00	—	—	22%
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 HC CYTP C/V AUTO THIN LYR PREPJ SCR MNL RESCR PHYS	$128.70	$165.00	—	—	22%
Parathyroid hormone (PTH) blood test CPT 83970 HC PARATHORMONE (PARATHYROID HORMONE)	$666.12	$854.00	—	101% above	22%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 HC PARATHORMONE (PARATHYROID HORMONE)	$666.12	$854.00	—	—	22%
Partial thromboplastin time (PTT) clotting test CPT 85730 HC THROMBOPLASTIN TIME PARTIAL PLASMA/WHOLE BLOOD LAB	$24.96	$32.00	—	74% below	22%
Partial thromboplastin time (PTT) clotting test CPT 85730 HC THROMBOPLASTIN TIME PARTIAL	$188.76	$242.00	—	98% above	22%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 HC THROMBOPLASTIN TIME PARTIAL PLASMA/WHOLE BLOOD LAB	$24.96	$32.00	—	—	22%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 HC THROMBOPLASTIN TIME PARTIAL	$188.76	$242.00	—	—	22%
Phosphorus (phosphate) blood test CPT 84100 HC ASSAY PHOSPHORUS	$79.56	$102.00	—	20% above	22%
Phosphorus (phosphate) blood test inpatient CPT 84100 HC ASSAY PHOSPHORUS	$79.56	$102.00	—	—	22%
Potassium blood test CPT 84132 HC POTASSIUM	$88.92	$114.00	—	45% above	22%
Potassium blood test CPT 84132 HC POTASSIUM SERUM PLASMA/WHOLE BLOOD CDM	$248.04	$318.00	—	303% above	22%
Potassium blood test inpatient CPT 84132 HC POTASSIUM	$88.92	$114.00	—	—	22%
Potassium blood test inpatient CPT 84132 HC POTASSIUM SERUM PLASMA/WHOLE BLOOD CDM	$248.04	$318.00	—	—	22%
Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) CPT 81420 HC FETAL CHROMOSOMAL ANEUPLOIDY GENOMIC SEQ ANALYS	$682.50	$875.00	—	45% below	22%
Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) CPT 81420 HC FETAL CHROMOSOMAL ANEUPLOIDY GENOMIC SEQ ANALYS LAB	$686.40	$880.00	—	44% below	22%
Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) inpatient CPT 81420 HC FETAL CHROMOSOMAL ANEUPLOIDY GENOMIC SEQ ANALYS	$682.50	$875.00	—	—	22%
Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) inpatient CPT 81420 HC FETAL CHROMOSOMAL ANEUPLOIDY GENOMIC SEQ ANALYS LAB	$686.40	$880.00	—	—	22%
Progesterone blood test CPT 84144 HC ASSAY OF PROGESTERONE CDM	$274.56	$352.00	—	23% above	22%
Progesterone blood test inpatient CPT 84144 HC ASSAY OF PROGESTERONE CDM	$274.56	$352.00	—	—	22%
Prolactin blood test CPT 84146 HC ASSAY OF PROLACTIN CDM	$237.90	$305.00	—	22% above	22%
Prolactin blood test inpatient CPT 84146 HC ASSAY OF PROLACTIN CDM	$237.90	$305.00	—	—	22%
Prothrombin time (PT/INR) clotting test CPT 85610 HC PROTHROMBIN TIME LAB	$24.96	$32.00	—	37% below	22%
Prothrombin time (PT/INR) clotting test CPT 85610 HC PROTHROMBIN TIME	$170.82	$219.00	—	329% above	22%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 HC PROTHROMBIN TIME LAB	$24.96	$32.00	—	—	22%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 HC PROTHROMBIN TIME	$170.82	$219.00	—	—	22%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 HC IAADIADOO STREPTOCOCCUS GROUP A LAB	$131.82	$169.00	—	50% above	22%
Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 HC IAADIADOO STREPTOCOCCUS GROUP A LAB	$131.82	$169.00	—	—	22%
Renin blood test CPT 84244 HC RENIN	$21.84	$28.00	—	73% below	22%
Renin blood test CPT 84244 HC ASSAY OF RENIN CDM	$365.82	$469.00	—	347% above	22%
Renin blood test inpatient CPT 84244 HC RENIN	$21.84	$28.00	—	—	22%
Renin blood test inpatient CPT 84244 HC ASSAY OF RENIN CDM	$365.82	$469.00	—	—	22%
Rh blood typing CPT 86901 HC BLOOD TYPING SEROLOGIC RH (D) LAB	$8.58	$11.00	—	83% below	22%
Rh blood typing CPT 86901 HC BLOOD TYPING SEROLOGIC RH (D) CDM	$22.62	$29.00	—	54% below	22%
Rh blood typing inpatient CPT 86901 HC BLOOD TYPING SEROLOGIC RH (D) LAB	$8.58	$11.00	—	—	22%
Rh blood typing inpatient CPT 86901 HC BLOOD TYPING SEROLOGIC RH (D) CDM	$22.62	$29.00	—	—	22%
Rheumatoid factor (RF) test CPT 86431 HC RHEUMATOID FACTOR QUANTITATIVE LAB	$17.94	$23.00	—	73% below	22%
Rheumatoid factor (RF) test CPT 86431 HC RHEUMATOID FACTOR QUANT	$159.12	$204.00	—	135% above	22%
Rheumatoid factor (RF) test inpatient CPT 86431 HC RHEUMATOID FACTOR QUANTITATIVE LAB	$17.94	$23.00	—	—	22%
Rheumatoid factor (RF) test inpatient CPT 86431 HC RHEUMATOID FACTOR QUANT	$159.12	$204.00	—	—	22%
Rubella antibody test (immunity check) CPT 86762 HC ANTIBODY RUBELLA LAB	$15.60	$20.00	—	75% below	22%
Rubella antibody test (immunity check) CPT 86762 HC ANTIBODY RUBELLA CDM	$30.42	$39.00	—	52% below	22%
Rubella antibody test (immunity check) CPT 86762 HC RUBELLA ANTIBODY	$224.64	$288.00	—	257% above	22%
Rubella antibody test (immunity check) inpatient CPT 86762 HC ANTIBODY RUBELLA LAB	$15.60	$20.00	—	—	22%
Rubella antibody test (immunity check) inpatient CPT 86762 HC ANTIBODY RUBELLA CDM	$30.42	$39.00	—	—	22%
Rubella antibody test (immunity check) inpatient CPT 86762 HC RUBELLA ANTIBODY	$224.64	$288.00	—	—	22%
Semen analysis: volume, sperm count, motility and morphology CPT 89320 HC SEMEN ANALYSIS VOLUME COUNT MOTILITY DIFFERENT LAB	$94.38	$121.00	—	11% below	22%
Semen analysis: volume, sperm count, motility and morphology inpatient CPT 89320 HC SEMEN ANALYSIS VOLUME COUNT MOTILITY DIFFERENT LAB	$94.38	$121.00	—	—	22%
Sodium blood test CPT 84295 HC SODIUM	$50.70	$65.00	—	3% below	22%
Sodium blood test inpatient CPT 84295 HC SODIUM	$50.70	$65.00	—	—	22%
Stool ova and parasites exam CPT 87177 HC OVA AND PARASITES SMEARS	$258.18	$331.00	—	146% above	22%
Stool ova and parasites exam inpatient CPT 87177 HC OVA AND PARASITES SMEARS	$258.18	$331.00	—	—	22%
Stool test for hidden blood (guaiac FOBT) CPT 82270 HC BLOOD OCCULT PEROXIDASE ACTV QUAL FECES 1 DETER CDM	$84.24	$108.00	—	38% above	22%
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 HC BLOOD OCCULT PEROXIDASE ACTV QUAL FECES 1 DETER CDM	$84.24	$108.00	—	—	22%
Stool test for hidden blood by immunoassay (FIT) CPT 82274 HC BLOOD OCCULT FECAL HGB DETER IA QUAL FECES 1-3 CDM	$21.84	$28.00	—	61% below	22%
Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 HC BLOOD OCCULT FECAL HGB DETER IA QUAL FECES 1-3 CDM	$21.84	$28.00	—	—	22%
Syphilis antibody test (Treponema pallidum) CPT 86780 HC TREPONEMA PALLIDUM - AB	$17.16	$22.00	—	61% below	22%
Syphilis antibody test (Treponema pallidum) CPT 86780 HC ANTIBODY TREPONEMA PALLIDUM CDM	$129.48	$166.00	—	197% above	22%
Syphilis antibody test (Treponema pallidum) CPT 86780 HC ANTIBODY TREPONEMA PALLIDUM LAB	$129.48	$166.00	—	197% above	22%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 HC TREPONEMA PALLIDUM - AB	$17.16	$22.00	—	—	22%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 HC ANTIBODY TREPONEMA PALLIDUM CDM	$129.48	$166.00	—	—	22%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 HC ANTIBODY TREPONEMA PALLIDUM LAB	$129.48	$166.00	—	—	22%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 HC SYPHILIS TEST NON-TREPONEMAL ANTIBODY QUAL CDM	$90.48	$116.00	—	47% above	22%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 HC SYPHILIS TEST NON-TREPONEMAL ANTIBODY QUAL CDM	$90.48	$116.00	—	—	22%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 HC TB CELL MEDIATED ANTIGN RESPNSE GAMMA INTERFERON LAB	$91.26	$117.00	—	10% below	22%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 HC TB CELL MEDIATED ANTIGN RESPNSE GAMMA INTERFERON CDM	$191.10	$245.00	—	88% above	22%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 HC TB CELL MEDIATED ANTIGN RESPNSE GAMMA INTERFERON LAB	$91.26	$117.00	—	—	22%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 HC TB CELL MEDIATED ANTIGN RESPNSE GAMMA INTERFERON CDM	$191.10	$245.00	—	—	22%
Testosterone blood test, total (not free testosterone) CPT 84403 HC ASSAY OF TESTOSTERONE TOTAL LAB	$22.62	$29.00	—	75% below	22%
Testosterone blood test, total (not free testosterone) CPT 84403 HC ASSAY OF TESTOSTERONE TOTAL CDM	$42.12	$54.00	—	53% below	22%
Testosterone blood test, total (not free testosterone) CPT 84403 HC TESTOSTERONE TOTAL	$281.58	$361.00	—	211% above	22%
Testosterone blood test, total (not free testosterone) CPT 84403 HC TESTOSTERONE	$281.58	$361.00	—	211% above	22%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 HC ASSAY OF TESTOSTERONE TOTAL LAB	$22.62	$29.00	—	—	22%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 HC ASSAY OF TESTOSTERONE TOTAL CDM	$42.12	$54.00	—	—	22%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 HC TESTOSTERONE TOTAL	$281.58	$361.00	—	—	22%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 HC TESTOSTERONE	$281.58	$361.00	—	—	22%
Thyroid peroxidase (TPO) antibody test CPT 86376 HC MICROSOMAL ANTIBODIES EACH LAB	$17.16	$22.00	—	83% below	22%
Thyroid peroxidase (TPO) antibody test CPT 86376 HC MICROSOMAL ANTIBODY	$134.94	$173.00	—	35% above	22%
Thyroid peroxidase (TPO) antibody test CPT 86376 HC MICROSOMAL ANTIBODIES EACH CDM	$250.38	$321.00	—	150% above	22%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 HC MICROSOMAL ANTIBODIES EACH LAB	$17.16	$22.00	—	—	22%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 HC MICROSOMAL ANTIBODY	$134.94	$173.00	—	—	22%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 HC MICROSOMAL ANTIBODIES EACH CDM	$250.38	$321.00	—	—	22%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 HC ASSAY OF THYROID STIMULATING HORMONE TSH LAB	$16.38	$21.00	—	89% below	22%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 HC TSH REFLEX TO FT4	$83.46	$107.00	—	46% below	22%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 HC THYROID STIMULATING HORMONE (TSH)	$173.16	$222.00	—	13% above	22%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 HC ASSAY OF THYROID STIMULATING HORMONE TSH LAB	$16.38	$21.00	—	—	22%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 HC TSH REFLEX TO FT4	$83.46	$107.00	—	—	22%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 HC THYROID STIMULATING HORMONE (TSH)	$173.16	$222.00	—	—	22%
Total IgE blood test CPT 82785 HC ASSAY OF GAMMAGLOBULIN IGE CDM	$14.82	$19.00	—	80% below	22%
Total IgE blood test CPT 82785 HC ASSAY OF GAMMAGLOBULIN IGE LAB	$15.60	$20.00	—	79% below	22%
Total IgE blood test CPT 82785 HC ASSAY OF GAMMAGLOBULIN IGE	$16.38	$21.00	—	78% below	22%
Total IgE blood test inpatient CPT 82785 HC ASSAY OF GAMMAGLOBULIN IGE CDM	$14.82	$19.00	—	—	22%
Total IgE blood test inpatient CPT 82785 HC ASSAY OF GAMMAGLOBULIN IGE LAB	$15.60	$20.00	—	—	22%
Total IgE blood test inpatient CPT 82785 HC ASSAY OF GAMMAGLOBULIN IGE	$16.38	$21.00	—	—	22%
Total cholesterol blood test CPT 82465 HC CHOLESTEROL	$80.34	$103.00	—	20% above	22%
Total cholesterol blood test inpatient CPT 82465 HC CHOLESTEROL	$80.34	$103.00	—	—	22%
Total thyroxine (T4) blood test CPT 84436 HC ASSAY OF THYROXINE TOTAL LAB	$12.48	$16.00	—	85% below	22%
Total thyroxine (T4) blood test CPT 84436 HC THYROXINE T4	$174.72	$224.00	—	106% above	22%
Total thyroxine (T4) blood test inpatient CPT 84436 HC ASSAY OF THYROXINE TOTAL LAB	$12.48	$16.00	—	—	22%
Total thyroxine (T4) blood test inpatient CPT 84436 HC THYROXINE T4	$174.72	$224.00	—	—	22%
Total triiodothyronine (T3) blood test CPT 84480 HC ASSAY OF TRIIODOTHYRONINE T3 TOTAL TT3	$206.70	$265.00	—	18% above	22%
Total triiodothyronine (T3) blood test inpatient CPT 84480 HC ASSAY OF TRIIODOTHYRONINE T3 TOTAL TT3	$206.70	$265.00	—	—	22%
Transferrin blood test CPT 84466 HC ASSAY TRANSFERRIN	$115.44	$148.00	—	5% below	22%
Transferrin blood test inpatient CPT 84466 HC ASSAY TRANSFERRIN	$115.44	$148.00	—	—	22%
Trichomonas test (NAAT) CPT 87661 HC IADNA TRICHOMONAS VAGINALIS AMPLIFIED PROBE TECH CDM	$49.92	$64.00	—	49% below	22%
Trichomonas test (NAAT) CPT 87661 HC IADNA TRICHOMONAS VAGINALIS AMPLIFIED PROBE TECH LAB	$98.28	$126.00	—	1% above	22%
Trichomonas test (NAAT) inpatient CPT 87661 HC IADNA TRICHOMONAS VAGINALIS AMPLIFIED PROBE TECH CDM	$49.92	$64.00	—	—	22%
Trichomonas test (NAAT) inpatient CPT 87661 HC IADNA TRICHOMONAS VAGINALIS AMPLIFIED PROBE TECH LAB	$98.28	$126.00	—	—	22%
Triglycerides blood test CPT 84478 HC ASSAY OF TRIGLYCERIDES LAB	$130.26	$167.00	—	137% above	22%
Triglycerides blood test CPT 84478 HC TRIGLYCERIDES	$130.26	$167.00	—	137% above	22%
Triglycerides blood test inpatient CPT 84478 HC ASSAY OF TRIGLYCERIDES LAB	$130.26	$167.00	—	—	22%
Triglycerides blood test inpatient CPT 84478 HC TRIGLYCERIDES	$130.26	$167.00	—	—	22%
Troponin test, quantitative CPT 84484 HC ASSAY OF TROPONIN QUANTITATIVE LAB	$205.92	$264.00	—	1% below	22%
Troponin test, quantitative CPT 84484 HC TROPONIN QUANTITATIVE	$205.92	$264.00	—	1% below	22%
Troponin test, quantitative inpatient CPT 84484 HC ASSAY OF TROPONIN QUANTITATIVE LAB	$205.92	$264.00	—	—	22%
Troponin test, quantitative inpatient CPT 84484 HC TROPONIN QUANTITATIVE	$205.92	$264.00	—	—	22%
Uric acid blood test CPT 84550 HC ASSAY OF BLOOD/URIC ACID LAB	$16.38	$21.00	—	73% below	22%
Uric acid blood test CPT 84550 HC ASSAY OF BLOOD/URIC ACID CDM	$127.92	$164.00	—	114% above	22%
Uric acid blood test inpatient CPT 84550 HC ASSAY OF BLOOD/URIC ACID LAB	$16.38	$21.00	—	—	22%
Uric acid blood test inpatient CPT 84550 HC ASSAY OF BLOOD/URIC ACID CDM	$127.92	$164.00	—	—	22%
Urinalysis with microscope exam, automated CPT 81001 HC URNLS DIP STICK/TABLET REAGENT AUTO MICROSCOPY LAB	$156.78	$201.00	—	42% above	22%
Urinalysis with microscope exam, automated CPT 81001 HC URNLS DIP STICK/TABLET REAGENT AUTO MICROSCOPY CDM	$180.18	$231.00	—	63% above	22%
Urinalysis with microscope exam, automated inpatient CPT 81001 HC URNLS DIP STICK/TABLET REAGENT AUTO MICROSCOPY LAB	$156.78	$201.00	—	—	22%
Urinalysis with microscope exam, automated inpatient CPT 81001 HC URNLS DIP STICK/TABLET REAGENT AUTO MICROSCOPY CDM	$180.18	$231.00	—	—	22%
Urinalysis without microscope exam, automated CPT 81003 HC URNLS DIP STICK/TABLET RGNT AUTO W/O MICROSCOPY LAB	$14.82	$19.00	—	70% below	22%
Urinalysis without microscope exam, automated CPT 81003 HC URINALYSIS AUTO W/O SCOPE	$114.66	$147.00	—	132% above	22%
Urinalysis without microscope exam, automated inpatient CPT 81003 HC URNLS DIP STICK/TABLET RGNT AUTO W/O MICROSCOPY LAB	$14.82	$19.00	—	—	22%
Urinalysis without microscope exam, automated inpatient CPT 81003 HC URINALYSIS AUTO W/O SCOPE	$114.66	$147.00	—	—	22%
Urine culture for bacteria, with colony count CPT 87086 HC CULTURE BACTERIAL QUANTTATIVE COLONY COUNT URINE LAB	$35.88	$46.00	—	66% below	22%
Urine culture for bacteria, with colony count CPT 87086 HC CULTURE BACTERIAL QUANTTATIVE COLONY COUNT URINE CDM	$67.86	$87.00	—	35% below	22%
Urine culture for bacteria, with colony count CPT 87086 HC URINE CULTURE/COLONY COUNT	$303.42	$389.00	—	189% above	22%
Urine culture for bacteria, with colony count inpatient CPT 87086 HC CULTURE BACTERIAL QUANTTATIVE COLONY COUNT URINE LAB	$35.88	$46.00	—	—	22%
Urine culture for bacteria, with colony count inpatient CPT 87086 HC CULTURE BACTERIAL QUANTTATIVE COLONY COUNT URINE CDM	$67.86	$87.00	—	—	22%
Urine culture for bacteria, with colony count inpatient CPT 87086 HC URINE CULTURE/COLONY COUNT	$303.42	$389.00	—	—	22%
Urine microalbumin (albumin) test CPT 82043 HC URINE ALBUMIN QUANTITATIVE LAB	$78.78	$101.00	—	12% below	22%
Urine microalbumin (albumin) test CPT 82043 HC MICROALBUMIN QUANTITATIVE	$78.78	$101.00	—	12% below	22%
Urine microalbumin (albumin) test inpatient CPT 82043 HC URINE ALBUMIN QUANTITATIVE LAB	$78.78	$101.00	—	—	22%
Urine microalbumin (albumin) test inpatient CPT 82043 HC MICROALBUMIN QUANTITATIVE	$78.78	$101.00	—	—	22%
Urine pregnancy test, read by color change CPT 81025 HC URINE PREGNANCY TEST	$127.92	$164.00	—	43% above	22%
Urine pregnancy test, read by color change inpatient CPT 81025 HC URINE PREGNANCY TEST	$127.92	$164.00	—	—	22%
Vitamin B12 (cobalamin) blood test CPT 82607 HC CYANOCOBALAMIN VITAMIN B-12 LAB	$14.82	$19.00	—	87% below	22%
Vitamin B12 (cobalamin) blood test CPT 82607 HC VITAMIN-B12	$228.54	$293.00	—	96% above	22%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 HC CYANOCOBALAMIN VITAMIN B-12 LAB	$14.82	$19.00	—	—	22%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 HC VITAMIN-B12	$228.54	$293.00	—	—	22%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 HC 25 HYDROXY INCLUDES FRACTIONS IF PERFORMED CDM	$46.02	$59.00	—	69% below	22%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 HC 25 HYDROXY INCLUDES FRACTIONS IF PERFORMED LAB	$70.20	$90.00	—	52% below	22%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 HC 25 HYDROXY INCLUDES FRACTIONS IF PERFORMED CDM	$46.02	$59.00	—	—	22%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 HC 25 HYDROXY INCLUDES FRACTIONS IF PERFORMED LAB	$70.20	$90.00	—	—	22%
Vitamin D, 1,25-dihydroxy blood test CPT 82652 HC 1 25 DIHYDROXY INCLUDES FRACTIONS IF PERFORMED CDM	$109.20	$140.00	—	62% below	22%
Vitamin D, 1,25-dihydroxy blood test inpatient CPT 82652 HC 1 25 DIHYDROXY INCLUDES FRACTIONS IF PERFORMED CDM	$109.20	$140.00	—	—	22%
Zinc blood test CPT 84630 HC ASSAY OF ZINC LAB	$31.98	$41.00	—	46% below	22%
Zinc blood test CPT 84630 HC ASSAY OF ZINC CDM	$226.20	$290.00	—	285% above	22%
Zinc blood test inpatient CPT 84630 HC ASSAY OF ZINC LAB	$31.98	$41.00	—	—	22%
Zinc blood test inpatient CPT 84630 HC ASSAY OF ZINC CDM	$226.20	$290.00	—	—	22%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HC GONADOTROPIN CHORIONIC QUANTITATIVE	$26.52	$34.00	—	80% below	22%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HC GONADOTROPIN CHORIONIC QUANTITATIVE LAB	$308.88	$396.00	—	132% above	22%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HC GONADOTROPIN CHORIONIC QUANTITATIVE	$26.52	$34.00	—	—	22%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HC GONADOTROPIN CHORIONIC QUANTITATIVE LAB	$308.88	$396.00	—	—	22%

Surgery and procedures

Procedure	Cash price	List price	Insurers pay	vs Alaska	Off list
Appendectomy, open surgery CPT 44950 HC PR 44950 APPENDECTOMY	$7,108.92	$9,114.00	—	—	22%
Appendectomy, open surgery inpatient CPT 44950 HC PR 44950 APPENDECTOMY	$7,108.92	$9,114.00	—	—	22%
Arthroscopic ACL reconstruction or repair of the knee CPT 29888 HC PR 29888 KNEE ARTHRO/SURG	$11,301.42	$14,489.00	—	at median	22%
Arthroscopic ACL reconstruction or repair of the knee inpatient CPT 29888 HC PR 29888 KNEE ARTHRO/SURG	$11,301.42	$14,489.00	—	—	22%
Arthroscopic rotator cuff repair of the shoulder CPT 29827 HC PR 29827 SHLDR ARTHROSCOP,SURG,W/ROTAT CUFF REPR	$9,459.84	$12,128.00	—	at median	22%
Arthroscopic rotator cuff repair of the shoulder CPT 29827 HC PR 29827 ARTHROSCOP ROTATOR CUFF REPR	$9,459.84	$12,128.00	—	at median	22%
Arthroscopic rotator cuff repair of the shoulder inpatient CPT 29827 HC PR 29827 SHLDR ARTHROSCOP,SURG,W/ROTAT CUFF REPR	$9,459.84	$12,128.00	—	—	22%
Arthroscopic rotator cuff repair of the shoulder inpatient CPT 29827 HC PR 29827 ARTHROSCOP ROTATOR CUFF REPR	$9,459.84	$12,128.00	—	—	22%
Balloon dilation of the maxillary sinus opening, one side CPT 31295 HC ED SINUS ENDO W/BALLOON DILATION CDM	$13,874.64	$17,788.00	—	4% above	22%
Balloon dilation of the maxillary sinus opening, one side inpatient CPT 31295 HC ED SINUS ENDO W/BALLOON DILATION CDM	$13,874.64	$17,788.00	—	—	22%
Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 HC ED CLOSED TREATMENT OF ANKLE FRACTURE W/O MANIP CDM	$230.88	$296.00	—	71% below	22%
Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 HC PR ED 27786 CLOSED TREATMENT OF ANKLE FRACTURE W/O MANIP CDM	$2,271.36	$2,912.00	—	184% above	22%
Broken ankle (outer ankle bone) treatment without surgery or setting inpatient CPT 27786 HC ED CLOSED TREATMENT OF ANKLE FRACTURE W/O MANIP CDM	$230.88	$296.00	—	—	22%
Broken ankle (outer ankle bone) treatment without surgery or setting inpatient CPT 27786 HC PR ED 27786 CLOSED TREATMENT OF ANKLE FRACTURE W/O MANIP CDM	$2,271.36	$2,912.00	—	—	22%
Broken foot (metatarsal) treatment without surgery or setting CPT 28470 HC ED TREAT METATARSAL FRACTURE W/O MANIPULATION CDM	$230.88	$296.00	—	59% below	22%
Broken foot (metatarsal) treatment without surgery or setting CPT 28470 HC PR ED 28470 TREAT METATARSAL FRACTURE W/O MANIPULATION CDM	$1,633.32	$2,094.00	—	189% above	22%
Broken foot (metatarsal) treatment without surgery or setting inpatient CPT 28470 HC ED TREAT METATARSAL FRACTURE W/O MANIPULATION CDM	$230.88	$296.00	—	—	22%
Broken foot (metatarsal) treatment without surgery or setting inpatient CPT 28470 HC PR ED 28470 TREAT METATARSAL FRACTURE W/O MANIPULATION CDM	$1,633.32	$2,094.00	—	—	22%
Bunion correction with a bone cut near the head of the first metatarsal CPT 28296 HC ED CORRECTION OF BUNION CDM	$5,804.76	$7,442.00	—	at median	22%
Bunion correction with a bone cut near the head of the first metatarsal inpatient CPT 28296 HC ED CORRECTION OF BUNION CDM	$5,804.76	$7,442.00	—	—	22%
Cardioversion, elective (restoring heart rhythm) CPT 92960 HC PR 92960 CARDIOVERSION ELECTIVE ARRHYTHMIA EXTERNAL CDM	$1,976.52	$2,534.00	—	37% above	22%
Cardioversion, elective (restoring heart rhythm) CPT 92960 HC PR ED 92960 CARDIOVERSION ELECTIVE EXTERNAL CDM	$1,976.52	$2,534.00	—	37% above	22%
Cardioversion, elective (restoring heart rhythm) CPT 92960 HC CARDIOVERSION ELECTIVE ARRHYTHMIA EXTERNAL	$2,530.32	$3,244.00	—	76% above	22%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 HC PR 92960 CARDIOVERSION ELECTIVE ARRHYTHMIA EXTERNAL CDM	$1,976.52	$2,534.00	—	—	22%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 HC PR ED 92960 CARDIOVERSION ELECTIVE EXTERNAL CDM	$1,976.52	$2,534.00	—	—	22%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 HC CARDIOVERSION ELECTIVE ARRHYTHMIA EXTERNAL	$2,530.32	$3,244.00	—	—	22%
Carpal tunnel release, open surgery CPT 64721 HC ED NEUROPLASTY MEDIAN NERVE AT CARP TUNNEL CDM	$3,505.32	$4,494.00	—	at median	22%
Carpal tunnel release, open surgery CPT 64721 HC PR 64721 CARPAL TUNNEL SURGERY	$4,017.78	$5,151.00	—	15% above	22%
Carpal tunnel release, open surgery CPT 64721 HC PR 64721 CARPAL TUNNEL SURGERY, SEPARATE PROC	$4,017.78	$5,151.00	—	15% above	22%
Carpal tunnel release, open surgery inpatient CPT 64721 HC ED NEUROPLASTY MEDIAN NERVE AT CARP TUNNEL CDM	$3,505.32	$4,494.00	—	—	22%
Carpal tunnel release, open surgery inpatient CPT 64721 HC PR 64721 CARPAL TUNNEL SURGERY, SEPARATE PROC	$4,017.78	$5,151.00	—	—	22%
Carpal tunnel release, open surgery inpatient CPT 64721 HC PR 64721 CARPAL TUNNEL SURGERY	$4,017.78	$5,151.00	—	—	22%
Cervical biopsy CPT 57500 HC PR 57500 BIOPSY OF CERVIX	$843.18	$1,081.00	—	8% below	22%
Cervical biopsy CPT 57500 HC ED BIOPSY OF CERVIX CDM	$1,372.02	$1,759.00	—	50% above	22%
Cervical biopsy inpatient CPT 57500 HC PR 57500 BIOPSY OF CERVIX	$843.18	$1,081.00	—	—	22%
Cervical biopsy inpatient CPT 57500 HC ED BIOPSY OF CERVIX CDM	$1,372.02	$1,759.00	—	—	22%
Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 HC CIRCUMCISION W/REGIONL BLOCK CDM	$971.10	$1,245.00	—	82% above	22%
Circumcision with a clamp or device and a numbing nerve block, usually newborns inpatient CPT 54150 HC CIRCUMCISION W/REGIONL BLOCK CDM	$971.10	$1,245.00	—	—	22%
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 HC ED TREAT DISTAL RADIAL FRACTURE RADIUS/ULNA W/O MANIP CDM	$274.56	$352.00	—	45% below	22%
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 HC PR ED 25600 TREAT DISTAL RADIAL FRACTURE RADIUS/UNA W/O MANIP CDM	$2,394.60	$3,070.00	—	384% above	22%
Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 HC ED TREAT DISTAL RADIAL FRACTURE RADIUS/ULNA W/O MANIP CDM	$274.56	$352.00	—	—	22%
Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 HC PR ED 25600 TREAT DISTAL RADIAL FRACTURE RADIUS/UNA W/O MANIP CDM	$2,394.60	$3,070.00	—	—	22%
Colonoscopy with polyp removal CPT 45385 HC PR 45385 COLSC FLX W/RMVL OF TUMOR POLYP LESION SNARE TQ CDM	$4,266.60	$5,470.00	—	77% above	22%
Colonoscopy with polyp removal inpatient CPT 45385 HC PR 45385 COLSC FLX W/RMVL OF TUMOR POLYP LESION SNARE TQ CDM	$4,266.60	$5,470.00	—	—	22%
Colonoscopy with tissue sample CPT 45380 HC PR 45380 COLONOSCOPY FLEXIBLE W/BIOPSY SINGLE/MULTIPLE CDM	$3,343.86	$4,287.00	—	86% above	22%
Colonoscopy with tissue sample inpatient CPT 45380 HC PR 45380 COLONOSCOPY FLEXIBLE W/BIOPSY SINGLE/MULTIPLE CDM	$3,343.86	$4,287.00	—	—	22%
Colonoscopy, diagnostic CPT 45378 HC ED COLONOSCOPY FLX DX W/COLLJ SPEC WHEN PFRMD CDM	$2,143.44	$2,748.00	—	32% above	22%
Colonoscopy, diagnostic CPT 45378 HC PR 45378 DX COLONOSCOPY FLEXIBLE W/COLLTN SPEC WHEN PFRMD CDM	$2,917.98	$3,741.00	—	80% above	22%
Colonoscopy, diagnostic inpatient CPT 45378 HC ED COLONOSCOPY FLX DX W/COLLJ SPEC WHEN PFRMD CDM	$2,143.44	$2,748.00	—	—	22%
Colonoscopy, diagnostic inpatient CPT 45378 HC PR 45378 DX COLONOSCOPY FLEXIBLE W/COLLTN SPEC WHEN PFRMD CDM	$2,917.98	$3,741.00	—	—	22%
Colposcopy with LEEP (loop electrosurgical excision) CPT 57460 HC PR 57460 BX OF CERVIX W/SCOPE LEEP	$2,083.38	$2,671.00	—	at median	22%
Colposcopy with LEEP (loop electrosurgical excision) inpatient CPT 57460 HC PR 57460 BX OF CERVIX W/SCOPE LEEP	$2,083.38	$2,671.00	—	—	22%
Colposcopy with cervical biopsy and scraping of the cervical canal CPT 57454 HC PR 57454 BX/CURETT OF CERVIX W/SCOPE	$1,037.40	$1,330.00	—	36% above	22%
Colposcopy with cervical biopsy and scraping of the cervical canal inpatient CPT 57454 HC PR 57454 BX/CURETT OF CERVIX W/SCOPE	$1,037.40	$1,330.00	—	—	22%
Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 HC ED CYSTOURETHROSCOPY CDM	$432.90	$555.00	—	66% below	22%
Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 HC PR 52000 CYSTOURETHROSCOPY	$1,752.66	$2,247.00	—	37% above	22%
Cystoscopy, diagnostic look inside the bladder and urethra inpatient CPT 52000 HC ED CYSTOURETHROSCOPY CDM	$432.90	$555.00	—	—	22%
Cystoscopy, diagnostic look inside the bladder and urethra inpatient CPT 52000 HC PR 52000 CYSTOURETHROSCOPY	$1,752.66	$2,247.00	—	—	22%
D&C (dilation and curettage), not related to pregnancy CPT 58120 HC PR 58120 DILATION AND CURETTAGE	$2,193.36	$2,812.00	—	at median	22%
D&C (dilation and curettage), not related to pregnancy CPT 58120 HC ED DILATION AND CURETTAGE CDM	$5,513.82	$7,069.00	—	151% above	22%
D&C (dilation and curettage), not related to pregnancy inpatient CPT 58120 HC PR 58120 DILATION AND CURETTAGE	$2,193.36	$2,812.00	—	—	22%
D&C (dilation and curettage), not related to pregnancy inpatient CPT 58120 HC ED DILATION AND CURETTAGE CDM	$5,513.82	$7,069.00	—	—	22%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 HC ED DESTRUCT PREMALG LESION FIRST LESION CDM	$351.78	$451.00	—	73% above	22%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 HC PR 17000 DESTRUCT PREMALG LESION FIRST LESION	$393.90	$505.00	—	94% above	22%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 HC ED DESTRUCT PREMALG LESION FIRST LESION CDM	$351.78	$451.00	—	—	22%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 HC PR 17000 DESTRUCT PREMALG LESION FIRST LESION	$393.90	$505.00	—	—	22%
Earwax removal by irrigation (rinsing), one ear CPT 69209 HC ED REMOVE IMPACTED EAR WAX UNI CDM	$230.88	$296.00	—	153% above	22%
Earwax removal by irrigation (rinsing), one ear one side CPT 69209 HC PR ED 69209 REMOVAL IMPACTED CERUMEN IRRIGATION/LVG UNILAT CDM	$145.08	$186.00	—	59% above	22%
Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 HC ED REMOVE IMPACTED EAR WAX UNI CDM	$230.88	$296.00	—	—	22%
Earwax removal by irrigation (rinsing), one ear inpatient one side CPT 69209 HC PR ED 69209 REMOVAL IMPACTED CERUMEN IRRIGATION/LVG UNILAT CDM	$145.08	$186.00	—	—	22%
Earwax removal with instruments, one ear one side CPT 69210 HC ED REMOVAL IMPACTED CERUMEN INSTRUMENTATION UNILAT CDM	$230.88	$296.00	—	15% above	22%
Earwax removal with instruments, one ear one side CPT 69210 HC PR ED 69210 REMOVAL IMPACTED CERUMEN INSTRUMENTATION UNILAT CDM	$370.50	$475.00	—	85% above	22%
Earwax removal with instruments, one ear inpatient one side CPT 69210 HC ED REMOVAL IMPACTED CERUMEN INSTRUMENTATION UNILAT CDM	$230.88	$296.00	—	—	22%
Earwax removal with instruments, one ear inpatient one side CPT 69210 HC PR ED 69210 REMOVAL IMPACTED CERUMEN INSTRUMENTATION UNILAT CDM	$370.50	$475.00	—	—	22%
Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 HC ED ENDOMETRIAL BX W/WO ENDOCERVIX BX W/O DILAT SPX CDM	$347.10	$445.00	—	at median	22%
Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 HC PR 58100 ENDOMETRIAL BX W/WO ENDOCERVIX BX W/O DILAT SPX CDM	$588.12	$754.00	—	69% above	22%
Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 HC PR 58100 BIOPSY OF UTERUS LINING	$690.30	$885.00	—	99% above	22%
Endometrial biopsy (uterine lining sample) without dilating the cervix inpatient CPT 58100 HC ED ENDOMETRIAL BX W/WO ENDOCERVIX BX W/O DILAT SPX CDM	$347.10	$445.00	—	—	22%
Endometrial biopsy (uterine lining sample) without dilating the cervix inpatient CPT 58100 HC PR 58100 ENDOMETRIAL BX W/WO ENDOCERVIX BX W/O DILAT SPX CDM	$588.12	$754.00	—	—	22%
Endometrial biopsy (uterine lining sample) without dilating the cervix inpatient CPT 58100 HC PR 58100 BIOPSY OF UTERUS LINING	$690.30	$885.00	—	—	22%
Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 HC ED INJ INTERLAMINR CRV-THOR W IMG CDM	$1,256.58	$1,611.00	—	23% below	22%
Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 HC ED INJ INTERLAMINR CRV-THOR W IMG CDM	$1,256.58	$1,611.00	—	—	22%
Eye injection into the vitreous (intravitreal injection) CPT 67028 HC ED INTRAVITREAL NJX PHARMACOLOGIC AGT SPX CDM	$648.96	$832.00	—	6% below	22%
Eye injection into the vitreous (intravitreal injection) inpatient CPT 67028 HC ED INTRAVITREAL NJX PHARMACOLOGIC AGT SPX CDM	$648.96	$832.00	—	—	22%
Facet joint injection, lower back, one level, with imaging guidance CPT 64493 HC PR 64493 NJX DX/THER AGT PVRT FACET JT LMBR/SAC 1 LEVEL	$1,896.96	$2,432.00	—	16% below	22%
Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 HC PR 64493 NJX DX/THER AGT PVRT FACET JT LMBR/SAC 1 LEVEL	$1,896.96	$2,432.00	—	—	22%
First repair of a front abdominal hernia (such as umbilical) 3 to 10 cm CPT 49593 HC PR 49593 RPR AA HERNIA 1ST 3-10 CM REDUCIBLE CDM	$5,807.10	$7,445.00	—	11% below	22%
First repair of a front abdominal hernia (such as umbilical) 3 to 10 cm inpatient CPT 49593 HC PR 49593 RPR AA HERNIA 1ST 3-10 CM REDUCIBLE CDM	$5,807.10	$7,445.00	—	—	22%
First repair of a small front abdominal hernia (e.g. umbilical), under 3 cm CPT 49591 HC PR 49591 RPR AA HERNIA 1ST/LESS THAN 3 CM REDUCIBLE CDM	$3,150.42	$4,039.00	—	40% below	22%
First repair of a small front abdominal hernia (e.g. umbilical), under 3 cm inpatient CPT 49591 HC PR 49591 RPR AA HERNIA 1ST/LESS THAN 3 CM REDUCIBLE CDM	$3,150.42	$4,039.00	—	—	22%
Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 HC ED SIGMOID DX FLX W WO SPEC COLL CDM	$2,143.44	$2,748.00	—	32% above	22%
Flexible sigmoidoscopy, diagnostic (lower colon only) inpatient CPT 45330 HC ED SIGMOID DX FLX W WO SPEC COLL CDM	$2,143.44	$2,748.00	—	—	22%
Gallbladder removal, laparoscopic CPT 47562 HC PR 47562 LAPAROSCOPIC CHOLECYSTECTOMY	$11,117.34	$14,253.00	—	29% above	22%
Gallbladder removal, laparoscopic inpatient CPT 47562 HC PR 47562 LAPAROSCOPIC CHOLECYSTECTOMY	$11,117.34	$14,253.00	—	—	22%
Gallbladder removal, laparoscopic, with X-ray of the bile ducts during surgery CPT 47563 HC PR 47563 LAPAROSCOPY CHOLECYSTECTOMY/GRAPH	$11,852.88	$15,196.00	—	1% above	22%
Gallbladder removal, laparoscopic, with X-ray of the bile ducts during surgery CPT 47563 HC ED LAPARO CHOLECYSTECTOMY/GRAPH CDM	$13,440.96	$17,232.00	—	14% above	22%
Gallbladder removal, laparoscopic, with X-ray of the bile ducts during surgery inpatient CPT 47563 HC PR 47563 LAPAROSCOPY CHOLECYSTECTOMY/GRAPH	$11,852.88	$15,196.00	—	—	22%
Gallbladder removal, laparoscopic, with X-ray of the bile ducts during surgery inpatient CPT 47563 HC ED LAPARO CHOLECYSTECTOMY/GRAPH CDM	$13,440.96	$17,232.00	—	—	22%
Gallbladder removal, open surgery through a larger incision CPT 47600 HC PR 47600 CHOLECYSTECTOMY	$11,117.34	$14,253.00	—	—	22%
Gallbladder removal, open surgery through a larger incision inpatient CPT 47600 HC PR 47600 CHOLECYSTECTOMY	$11,117.34	$14,253.00	—	—	22%
Hemorrhoid banding (rubber band ligation) CPT 46221 HC PR ED 46221 LIGATION OF HEMORRHOID(S) CDM	$1,591.98	$2,041.00	—	2% below	22%
Hemorrhoid banding (rubber band ligation) CPT 46221 HC PR 46221 LIGATION OF HEMORRHOID(S)	$1,591.98	$2,041.00	—	2% below	22%
Hemorrhoid banding (rubber band ligation) CPT 46221 HC ED HEMORRHOIDECTOMY INTERNAL RUBBER BAND LIGATIONS CDM	$1,620.84	$2,078.00	—	at median	22%
Hemorrhoid banding (rubber band ligation) inpatient CPT 46221 HC PR ED 46221 LIGATION OF HEMORRHOID(S) CDM	$1,591.98	$2,041.00	—	—	22%
Hemorrhoid banding (rubber band ligation) inpatient CPT 46221 HC PR 46221 LIGATION OF HEMORRHOID(S)	$1,591.98	$2,041.00	—	—	22%
Hemorrhoid banding (rubber band ligation) inpatient CPT 46221 HC ED HEMORRHOIDECTOMY INTERNAL RUBBER BAND LIGATIONS CDM	$1,620.84	$2,078.00	—	—	22%
Hemorrhoidectomy (internal and external), one area CPT 46255 HC PR 46255 REMOVE INTERNAL/EXTERNAL HEMORROID SINGLE GROUP	$3,485.04	$4,468.00	—	30% below	22%
Hemorrhoidectomy (internal and external), one area CPT 46255 HC ED HEMORRHOIDECTOMY NTRNL & XTRNL 1 COLUMN/GROUP CDM	$5,010.72	$6,424.00	—	at median	22%
Hemorrhoidectomy (internal and external), one area inpatient CPT 46255 HC PR 46255 REMOVE INTERNAL/EXTERNAL HEMORROID SINGLE GROUP	$3,485.04	$4,468.00	—	—	22%
Hemorrhoidectomy (internal and external), one area inpatient CPT 46255 HC ED HEMORRHOIDECTOMY NTRNL & XTRNL 1 COLUMN/GROUP CDM	$5,010.72	$6,424.00	—	—	22%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 HC CATHETER FOR HYSTEROGRAPHY	$1,409.46	$1,807.00	—	41% above	22%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes inpatient CPT 58340 HC CATHETER FOR HYSTEROGRAPHY	$1,409.46	$1,807.00	—	—	22%
Hysteroscopy with endometrial ablation CPT 58563 HC PR 58563 HYSTEROSCOPY ABLATION	$9,441.90	$12,105.00	—	at median	22%
Hysteroscopy with endometrial ablation inpatient CPT 58563 HC PR 58563 HYSTEROSCOPY ABLATION	$9,441.90	$12,105.00	—	—	22%
Hysteroscopy with uterine lining sampling and/or polyp removal CPT 58558 HC PR 58558 HYSTEROSCOPY BIOPSY	$4,533.36	$5,812.00	—	38% below	22%
Hysteroscopy with uterine lining sampling and/or polyp removal inpatient CPT 58558 HC PR 58558 HYSTEROSCOPY BIOPSY	$4,533.36	$5,812.00	—	—	22%
IUD insertion (the device itself billed separately) CPT 58300 HC ED INSERTION INTRAUTERINE DEVICE IUD CDM	$347.10	$445.00	—	9% below	22%
IUD insertion (the device itself billed separately) CPT 58300 HC PR 58300 INSERTION INTRAUTERINE DEVICE IUD CDM	$469.56	$602.00	—	23% above	22%
IUD insertion (the device itself billed separately) CPT 58300 HC PR 58300 INSERT INTRAUTERINE DEVICE	$587.34	$753.00	—	54% above	22%
IUD insertion (the device itself billed separately) inpatient CPT 58300 HC ED INSERTION INTRAUTERINE DEVICE IUD CDM	$347.10	$445.00	—	—	22%
IUD insertion (the device itself billed separately) inpatient CPT 58300 HC PR 58300 INSERTION INTRAUTERINE DEVICE IUD CDM	$469.56	$602.00	—	—	22%
IUD insertion (the device itself billed separately) inpatient CPT 58300 HC PR 58300 INSERT INTRAUTERINE DEVICE	$587.34	$753.00	—	—	22%
Incision and drainage of a simple or single skin abscess CPT 10060 HC INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE	$274.56	$352.00	—	30% below	22%
Incision and drainage of a simple or single skin abscess CPT 10060 HC ED DRAINAGE OF SKIN ABSCESS SIMPLE OR SINGLE CDM	$274.56	$352.00	—	30% below	22%
Incision and drainage of a simple or single skin abscess CPT 10060 HC PR ED 10060 DRAINAGE OF SKIN ABSCESS SIMPLE OR SINGLE CDM	$569.40	$730.00	—	45% above	22%
Incision and drainage of a simple or single skin abscess CPT 10060 HC PR 10060 INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE CDM	$1,007.76	$1,292.00	—	156% above	22%
Incision and drainage of a simple or single skin abscess CPT 10060 HC PR 10060 DRAINAGE OF SKIN ABSCESS SIMPLE OR SINGLE	$1,007.76	$1,292.00	—	156% above	22%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 HC ED DRAINAGE OF SKIN ABSCESS SIMPLE OR SINGLE CDM	$274.56	$352.00	—	—	22%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 HC INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE	$274.56	$352.00	—	—	22%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 HC PR ED 10060 DRAINAGE OF SKIN ABSCESS SIMPLE OR SINGLE CDM	$569.40	$730.00	—	—	22%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 HC PR 10060 INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE CDM	$1,007.76	$1,292.00	—	—	22%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 HC PR 10060 DRAINAGE OF SKIN ABSCESS SIMPLE OR SINGLE	$1,007.76	$1,292.00	—	—	22%
Inguinal (groin) hernia repair, age 5 or older CPT 49505 HC PR 49505 REPAIR INGUINAL HERNIA INITIAL BLOCK >5 YR REDUCIBLE	$6,191.64	$7,938.00	—	10% below	22%
Inguinal (groin) hernia repair, age 5 or older CPT 49505 HC ED RPR 1ST INGUN HRNA AGE 5 YRS OR MORE REDUCIBLE CDM	$6,906.90	$8,855.00	—	at median	22%
Inguinal (groin) hernia repair, age 5 or older inpatient CPT 49505 HC PR 49505 REPAIR INGUINAL HERNIA INITIAL BLOCK >5 YR REDUCIBLE	$6,191.64	$7,938.00	—	—	22%
Inguinal (groin) hernia repair, age 5 or older inpatient CPT 49505 HC ED RPR 1ST INGUN HRNA AGE 5 YRS OR MORE REDUCIBLE CDM	$6,906.90	$8,855.00	—	—	22%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 HC PR 20550 INJ TENDON SHEATH/LIGAMENT	$363.48	$466.00	—	6% above	22%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 HC PR ED 20550 INJ TENDON SHEATH/LIGAMENT CDM	$363.48	$466.00	—	6% above	22%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 HC ED INJ TENDON SHEATH/LIGAMENT CDM	$433.68	$556.00	—	26% above	22%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 HC PR ED 20550 INJ TENDON SHEATH/LIGAMENT CDM	$363.48	$466.00	—	—	22%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 HC PR 20550 INJ TENDON SHEATH/LIGAMENT	$363.48	$466.00	—	—	22%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 HC ED INJ TENDON SHEATH/LIGAMENT CDM	$433.68	$556.00	—	—	22%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 HC PR 20610 DRAIN/INJECT JOINT/BURSA MAJOR JOINT W/O ULTRASOUND GUIDANCE	$423.54	$543.00	—	1% above	22%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 HC PR ED 20610 DRAIN/INJECT JOINT/BURSA MAJOR CDM	$640.38	$821.00	—	53% above	22%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 HC PR ED 20610 DRAIN/INJECT JOINT/BURSA MAJOR JOINT W/O US GUIDANCE CDM	$640.38	$821.00	—	53% above	22%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 HC PR 20610 ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/O US CDM	$640.38	$821.00	—	53% above	22%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 HC ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/O US	$780.78	$1,001.00	—	87% above	22%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 HC ED ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/O US CDM	$780.78	$1,001.00	—	87% above	22%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 HC PR 20610 DRAIN/INJECT JOINT/BURSA MAJOR JOINT W/O ULTRASOUND GUIDANCE	$423.54	$543.00	—	—	22%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 HC PR 20610 ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/O US CDM	$640.38	$821.00	—	—	22%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 HC PR ED 20610 DRAIN/INJECT JOINT/BURSA MAJOR CDM	$640.38	$821.00	—	—	22%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 HC PR ED 20610 DRAIN/INJECT JOINT/BURSA MAJOR JOINT W/O US GUIDANCE CDM	$640.38	$821.00	—	—	22%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 HC ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/O US	$780.78	$1,001.00	—	—	22%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 HC ED ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/O US CDM	$780.78	$1,001.00	—	—	22%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 HC PR ED 20605 DRAIN/INJECT JOINT/BURSA INTERM W/O ULTRASOUND GUIDANCE CDM	$508.56	$652.00	—	40% above	22%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 HC DRAIN/INJECT JOINT/BURSA INTERM W/O ULTRASOUND GUIDANCE	$780.78	$1,001.00	—	114% above	22%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 HC ED ARTHROCENTESIS ASPIR&/INJ INTERM JT/BURS W/O US CDM	$780.78	$1,001.00	—	114% above	22%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 HC PR ED 20605 DRAIN/INJECT JOINT/BURSA INTERM W/O ULTRASOUND GUIDANCE CDM	$508.56	$652.00	—	—	22%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 HC DRAIN/INJECT JOINT/BURSA INTERM W/O ULTRASOUND GUIDANCE	$780.78	$1,001.00	—	—	22%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 HC ED ARTHROCENTESIS ASPIR&/INJ INTERM JT/BURS W/O US CDM	$780.78	$1,001.00	—	—	22%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 HC PR ED 20600 DRAIN/INJECT JOINT/BURSA SMALL W/O ULTRASOUND GUIDANCE CDM	$481.26	$617.00	—	37% above	22%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 HC DRAIN/INJECT JOINT/BURSA SMALL W/O ULTRASOUND GUIDANCE	$780.78	$1,001.00	—	123% above	22%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 HC ED ARTHROCENTESIS ASPIR&/INJ SMALL JT/BURSA W/O US CDM	$780.78	$1,001.00	—	123% above	22%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 HC PR ED 20600 DRAIN/INJECT JOINT/BURSA SMALL W/O ULTRASOUND GUIDANCE CDM	$481.26	$617.00	—	—	22%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 HC DRAIN/INJECT JOINT/BURSA SMALL W/O ULTRASOUND GUIDANCE	$780.78	$1,001.00	—	—	22%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 HC ED ARTHROCENTESIS ASPIR&/INJ SMALL JT/BURSA W/O US CDM	$780.78	$1,001.00	—	—	22%
Knee arthroscopy with meniscus repair (one side of the knee) CPT 29882 HC PR 29882 KNEE ARTHROSCOPY/SURGERY MENISCUS	$7,543.38	$9,671.00	—	at median	22%
Knee arthroscopy with meniscus repair (one side of the knee) inpatient CPT 29882 HC PR 29882 KNEE ARTHROSCOPY/SURGERY MENISCUS	$7,543.38	$9,671.00	—	—	22%
Knee arthroscopy with meniscus trim CPT 29881 HC PR 29881 KNEE ARTHROSCOPY/SURGERY MENISECTOMY	$6,913.92	$8,864.00	—	at median	22%
Knee arthroscopy with meniscus trim inpatient CPT 29881 HC PR 29881 KNEE ARTHROSCOPY/SURGERY MENISECTOMY	$6,913.92	$8,864.00	—	—	22%
Knee arthroscopy with removal of both torn meniscus parts CPT 29880 HC PR 29880 ARTHRSCP M/L MENISECTOMY	$8,110.44	$10,398.00	—	at median	22%
Knee arthroscopy with removal of both torn meniscus parts inpatient CPT 29880 HC PR 29880 ARTHRSCP M/L MENISECTOMY	$8,110.44	$10,398.00	—	—	22%
Laparoscopic appendectomy (appendix removal through small cuts) CPT 44970 HC PR 44970 LAPAROSCOPY APPENDECTOMY	$6,136.26	$7,867.00	—	at median	22%
Laparoscopic appendectomy (appendix removal through small cuts) inpatient CPT 44970 HC PR 44970 LAPAROSCOPY APPENDECTOMY	$6,136.26	$7,867.00	—	—	22%
Laparoscopic inguinal (groin) hernia repair, first repair on that side CPT 49650 HC PR 49650 LAPAROSCOPY INGUINAL HERNIA REPAIR, INITIAL	$4,160.52	$5,334.00	—	68% below	22%
Laparoscopic inguinal (groin) hernia repair, first repair on that side inpatient CPT 49650 HC PR 49650 LAPAROSCOPY INGUINAL HERNIA REPAIR, INITIAL	$4,160.52	$5,334.00	—	—	22%
Laparoscopic inguinal (groin) hernia repair, recurrent hernia CPT 49651 HC PR 49651 LAPAROSCOPY INGUINAL HERNIA REPAIR, RECURRENT	$4,470.18	$5,731.00	—	—	22%
Laparoscopic inguinal (groin) hernia repair, recurrent hernia inpatient CPT 49651 HC PR 49651 LAPAROSCOPY INGUINAL HERNIA REPAIR, RECURRENT	$4,470.18	$5,731.00	—	—	22%
Laparoscopic removal of fallopian tubes and/or ovaries CPT 58661 HC PR 58661 LAPAROSCOPY REMOVE ADNEXA	$5,050.50	$6,475.00	—	—	22%
Laparoscopic removal of fallopian tubes and/or ovaries inpatient CPT 58661 HC PR 58661 LAPAROSCOPY REMOVE ADNEXA	$5,050.50	$6,475.00	—	—	22%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 HC ED INTMD WND REPAIR S/TR/EXT UP TO 2.5CM CDM	$516.36	$662.00	—	30% below	22%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 HC PR ED 12031 INTMD WND REPAIR S/TR/EXT UP TO 2.5CM CDM	$1,265.94	$1,623.00	—	72% above	22%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 HC ED INTMD WND REPAIR S/TR/EXT UP TO 2.5CM CDM	$516.36	$662.00	—	—	22%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 HC PR ED 12031 INTMD WND REPAIR S/TR/EXT UP TO 2.5CM CDM	$1,265.94	$1,623.00	—	—	22%
Lower-back epidural injection, with imaging guidance CPT 62323 HC ED INJ EPI LUMB/SACRAL W IMAGING CDM	$1,256.58	$1,611.00	—	50% below	22%
Lower-back epidural injection, with imaging guidance CPT 62323 HC PR 62323 INJ W/NDL OR CATH PLCMNT EPIDRL L/S W/IMG	$1,893.84	$2,428.00	—	25% below	22%
Lower-back epidural injection, with imaging guidance inpatient CPT 62323 HC ED INJ EPI LUMB/SACRAL W IMAGING CDM	$1,256.58	$1,611.00	—	—	22%
Lower-back epidural injection, with imaging guidance inpatient CPT 62323 HC PR 62323 INJ W/NDL OR CATH PLCMNT EPIDRL L/S W/IMG	$1,893.84	$2,428.00	—	—	22%
Lower-back epidural injection, without imaging guidance CPT 62322 HC PR 62322 INJ INTERLAMINAR LMBR/SAC W/O IMG	$780.00	$1,000.00	—	55% below	22%
Lower-back epidural injection, without imaging guidance CPT 62322 HC ED INJ EPI LUMB/SACRAL WO IMAGING CDM	$1,661.40	$2,130.00	—	5% below	22%
Lower-back epidural injection, without imaging guidance inpatient CPT 62322 HC PR 62322 INJ INTERLAMINAR LMBR/SAC W/O IMG	$780.00	$1,000.00	—	—	22%
Lower-back epidural injection, without imaging guidance inpatient CPT 62322 HC ED INJ EPI LUMB/SACRAL WO IMAGING CDM	$1,661.40	$2,130.00	—	—	22%
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 HC PR 64483 NJX ANES&/STRD W/IMG TFRML EDRL LMBR/SAC 1 LVL	$2,262.00	$2,900.00	—	27% below	22%
Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 HC PR 64483 NJX ANES&/STRD W/IMG TFRML EDRL LMBR/SAC 1 LVL	$2,262.00	$2,900.00	—	—	22%
Miscarriage treatment with D&C, first trimester CPT 59820 HC ED SPONTANEOUS ABORTION FAC CDM	$5,513.82	$7,069.00	—	at median	22%
Miscarriage treatment with D&C, first trimester inpatient CPT 59820 HC ED SPONTANEOUS ABORTION FAC CDM	$5,513.82	$7,069.00	—	—	22%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 HC PR11400 EXC B9 LESION MRGN XCP SK TG T/A/L 0.5 CM/OR LESS	$674.70	$865.00	—	8% below	22%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 HC PR ED 11400 EXC B9 LESION MRGN XCP SK TG T/A/L 0.5 CM/OR LESS CDM	$829.14	$1,063.00	—	13% above	22%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 HC ED EXC B9 LESION MRGN XCP SK TG T/A/L 0.5 CM OR LESS CDM	$1,265.16	$1,622.00	—	73% above	22%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 HC PR11400 EXC B9 LESION MRGN XCP SK TG T/A/L 0.5 CM/OR LESS	$674.70	$865.00	—	—	22%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 HC PR ED 11400 EXC B9 LESION MRGN XCP SK TG T/A/L 0.5 CM/OR LESS CDM	$829.14	$1,063.00	—	—	22%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 HC ED EXC B9 LESION MRGN XCP SK TG T/A/L 0.5 CM OR LESS CDM	$1,265.16	$1,622.00	—	—	22%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 HC ED EXC B9 LESION MRGN XCP SK TG F/E/E/N/L/M 0.5CM OR LESS CDM	$1,265.16	$1,622.00	—	57% above	22%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 HC ED EXC B9 LESION MRGN XCP SK TG F/E/E/N/L/M 0.5CM OR LESS CDM	$1,265.16	$1,622.00	—	—	22%
Nail removal (partial or complete), one nail CPT 11730 HC ED REMOVAL OF NAIL PLATE CDM	$230.88	$296.00	—	35% below	22%
Nail removal (partial or complete), one nail CPT 11730 HC PR ED 11730 REMOVAL OF NAIL PLATE CDM	$428.22	$549.00	—	21% above	22%
Nail removal (partial or complete), one nail inpatient CPT 11730 HC ED REMOVAL OF NAIL PLATE CDM	$230.88	$296.00	—	—	22%
Nail removal (partial or complete), one nail inpatient CPT 11730 HC PR ED 11730 REMOVAL OF NAIL PLATE CDM	$428.22	$549.00	—	—	22%
Occipital nerve block (injection for headaches) CPT 64405 HC ED NERVE BLOCK INJ OCCIPITAL CDM	$559.26	$717.00	—	32% below	22%
Occipital nerve block (injection for headaches) CPT 64405 HC PR 64405 NERVE BLOCK INJ OCCIPITAL	$931.32	$1,194.00	—	14% above	22%
Occipital nerve block (injection for headaches) inpatient CPT 64405 HC ED NERVE BLOCK INJ OCCIPITAL CDM	$559.26	$717.00	—	—	22%
Occipital nerve block (injection for headaches) inpatient CPT 64405 HC PR 64405 NERVE BLOCK INJ OCCIPITAL	$931.32	$1,194.00	—	—	22%
Paracentesis with imaging guidance CPT 49083 HC PR ED 49083 ABD PARACENT W/IMAG GUIDANCE CDM	$1,651.26	$2,117.00	—	28% above	22%
Paracentesis with imaging guidance CPT 49083 HC ABDOM PARACENTESIS DX/THER W/IMAGING GUIDANCE CDM	$2,772.90	$3,555.00	—	115% above	22%
Paracentesis with imaging guidance CPT 49083 HC ED ABD PARACENTESIS W/IMAG GUIDANCE CDM	$2,772.90	$3,555.00	—	115% above	22%
Paracentesis with imaging guidance inpatient CPT 49083 HC PR ED 49083 ABD PARACENT W/IMAG GUIDANCE CDM	$1,651.26	$2,117.00	—	—	22%
Paracentesis with imaging guidance inpatient CPT 49083 HC ABDOM PARACENTESIS DX/THER W/IMAGING GUIDANCE CDM	$2,772.90	$3,555.00	—	—	22%
Paracentesis with imaging guidance inpatient CPT 49083 HC ED ABD PARACENTESIS W/IMAG GUIDANCE CDM	$2,772.90	$3,555.00	—	—	22%
Partial knee replacement (one compartment) CPT 27446 HC PR 27446 PLASTY KNEE MED OR LAT COMPARTMT (27446) CDM	$9,843.60	$12,620.00	—	25% below	22%
Partial knee replacement (one compartment) inpatient CPT 27446 HC PR 27446 PLASTY KNEE MED OR LAT COMPARTMT (27446) CDM	$9,843.60	$12,620.00	—	—	22%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 HC ED REMOVAL OF NAIL BED CDM	$559.26	$717.00	—	35% below	22%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 HC PR ED 11750 REMOVAL OF NAIL BED CDM	$861.90	$1,105.00	—	at median	22%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 HC ED REMOVAL OF NAIL BED CDM	$559.26	$717.00	—	—	22%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 HC PR ED 11750 REMOVAL OF NAIL BED CDM	$861.90	$1,105.00	—	—	22%
Prostate biopsy CPT 55700 HC PR 55700 PROSTATE NEEDLE BIOPSY ANY APPROACH CDM	$1,255.80	$1,610.00	—	52% below	22%
Prostate biopsy CPT 55700 HC PR 55700 BIOPSY OF PROSTATE	$1,750.32	$2,244.00	—	33% below	22%
Prostate biopsy inpatient CPT 55700 HC PR 55700 PROSTATE NEEDLE BIOPSY ANY APPROACH CDM	$1,255.80	$1,610.00	—	—	22%
Prostate biopsy inpatient CPT 55700 HC PR 55700 BIOPSY OF PROSTATE	$1,750.32	$2,244.00	—	—	22%
Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 HC PR 64635 DSTR NROLYTC AGNT PARVERTEB FCT SNGL LMBR/SACRAL	$3,395.34	$4,353.00	—	at median	22%
Radiofrequency ablation of facet joint nerves, lower back, one level inpatient CPT 64635 HC PR 64635 DSTR NROLYTC AGNT PARVERTEB FCT SNGL LMBR/SACRAL	$3,395.34	$4,353.00	—	—	22%
Removal of a breast lump, open surgery CPT 19120 HC PR 19120 REMOVAL OF BREAST LESION 1 OR MORE LESIONS	$5,701.80	$7,310.00	—	at median	22%
Removal of a breast lump, open surgery inpatient CPT 19120 HC PR 19120 REMOVAL OF BREAST LESION 1 OR MORE LESIONS	$5,701.80	$7,310.00	—	—	22%
Removal of a foreign object under the skin, simple CPT 10120 HC ED REMOVE FOREIGN BODY SIMPLE CDM	$516.36	$662.00	—	13% below	22%
Removal of a foreign object under the skin, simple CPT 10120 HC PR ED 10120 REMOVE FOREIGN BODY SIMPLE CDM	$802.62	$1,029.00	—	36% above	22%
Removal of a foreign object under the skin, simple inpatient CPT 10120 HC ED REMOVE FOREIGN BODY SIMPLE CDM	$516.36	$662.00	—	—	22%
Removal of a foreign object under the skin, simple inpatient CPT 10120 HC PR ED 10120 REMOVE FOREIGN BODY SIMPLE CDM	$802.62	$1,029.00	—	—	22%
Screening colonoscopy for a person at average risk (Medicare code) HCPCS G0121 HC PR G0121 COLORECTAL SCRN NOT HI RISK IND CDM	$1,708.20	$2,190.00	—	6% above	22%
Screening colonoscopy for a person at average risk (Medicare code) HCPCS G0121 HC PR G0121 COLORECTAL SCRN NOT HI RISK IND	$2,620.02	$3,359.00	—	62% above	22%
Screening colonoscopy for a person at average risk (Medicare code) inpatient HCPCS G0121 HC PR G0121 COLORECTAL SCRN NOT HI RISK IND CDM	$1,708.20	$2,190.00	—	—	22%
Screening colonoscopy for a person at average risk (Medicare code) inpatient HCPCS G0121 HC PR G0121 COLORECTAL SCRN NOT HI RISK IND	$2,620.02	$3,359.00	—	—	22%
Screening colonoscopy, high risk of colorectal cancer (Medicare code) HCPCS G0105 HC PR G0105 COLORECTAL SCRN HI RISK IND CDM	$1,772.94	$2,273.00	—	at median	22%
Screening colonoscopy, high risk of colorectal cancer (Medicare code) HCPCS G0105 HC PR G0105 COLORECTAL SCRN HI RISK IND	$2,917.98	$3,741.00	—	65% above	22%
Screening colonoscopy, high risk of colorectal cancer (Medicare code) inpatient HCPCS G0105 HC PR G0105 COLORECTAL SCRN HI RISK IND CDM	$1,772.94	$2,273.00	—	—	22%
Screening colonoscopy, high risk of colorectal cancer (Medicare code) inpatient HCPCS G0105 HC PR G0105 COLORECTAL SCRN HI RISK IND	$2,917.98	$3,741.00	—	—	22%
Septoplasty to straighten the nasal septum CPT 30520 HC ED REPAIR OF NASAL SEPTUM CDM	$5,548.14	$7,113.00	—	at median	22%
Septoplasty to straighten the nasal septum inpatient CPT 30520 HC ED REPAIR OF NASAL SEPTUM CDM	$5,548.14	$7,113.00	—	—	22%
Short arm cast (elbow to hand) CPT 29075 HC ED SHORT ARM CAST APPLICATION CDM	$433.68	$556.00	—	at median	22%
Short arm cast (elbow to hand) CPT 29075 HC PR ED 29075 APPLICATION CAST ELBOW FINGER SHORT ARM CDM	$829.14	$1,063.00	—	92% above	22%
Short arm cast (elbow to hand) inpatient CPT 29075 HC ED SHORT ARM CAST APPLICATION CDM	$433.68	$556.00	—	—	22%
Short arm cast (elbow to hand) inpatient CPT 29075 HC PR ED 29075 APPLICATION CAST ELBOW FINGER SHORT ARM CDM	$829.14	$1,063.00	—	—	22%
Short arm splint (forearm and hand) CPT 29125 HC ED SHORT ARM SPLINT APPLICATION CDM	$274.56	$352.00	—	3% above	22%
Short arm splint (forearm and hand) CPT 29125 HC PR ED 29125 SHORT ARM SPLINT APPLICATION CDM	$627.12	$804.00	—	136% above	22%
Short arm splint (forearm and hand) inpatient CPT 29125 HC ED SHORT ARM SPLINT APPLICATION CDM	$274.56	$352.00	—	—	22%
Short arm splint (forearm and hand) inpatient CPT 29125 HC PR ED 29125 SHORT ARM SPLINT APPLICATION CDM	$627.12	$804.00	—	—	22%
Short leg cast (below the knee) CPT 29405 HC ED SHORT LEG CAST APPLICATION CDM	$433.68	$556.00	—	at median	22%
Short leg cast (below the knee) CPT 29405 HC PR ED 29405 SHORT LEG CAST APPLICATION CDM	$569.40	$730.00	—	32% above	22%
Short leg cast (below the knee) inpatient CPT 29405 HC ED SHORT LEG CAST APPLICATION CDM	$433.68	$556.00	—	—	22%
Short leg cast (below the knee) inpatient CPT 29405 HC PR ED 29405 SHORT LEG CAST APPLICATION CDM	$569.40	$730.00	—	—	22%
Short leg splint (calf to foot) CPT 29515 HC ED SHORT LEG SPLINT APPLICATION CDM	$274.56	$352.00	—	at median	22%
Short leg splint (calf to foot) CPT 29515 HC PR ED 29515 SHORT LEG SPLINT APPLICATION CDM	$501.54	$643.00	—	83% above	22%
Short leg splint (calf to foot) inpatient CPT 29515 HC ED SHORT LEG SPLINT APPLICATION CDM	$274.56	$352.00	—	—	22%
Short leg splint (calf to foot) inpatient CPT 29515 HC PR ED 29515 SHORT LEG SPLINT APPLICATION CDM	$501.54	$643.00	—	—	22%
Shoulder arthroscopy with removal of the end of the collarbone (distal clavicle) CPT 29824 HC PR 29824 SHOULDER ARTHROSCOPY/SURGERY	$5,850.78	$7,501.00	—	at median	22%
Shoulder arthroscopy with removal of the end of the collarbone (distal clavicle) inpatient CPT 29824 HC PR 29824 SHOULDER ARTHROSCOPY/SURGERY	$5,850.78	$7,501.00	—	—	22%
Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) CPT 29826 HC PR 29826 SHOULDER ARTHROSCOPY/SURGERY SUBACRMIAL DCMP	$5,486.52	$7,034.00	—	at median	22%
Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) inpatient CPT 29826 HC PR 29826 SHOULDER ARTHROSCOPY/SURGERY SUBACRMIAL DCMP	$5,486.52	$7,034.00	—	—	22%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 HC ED REPAIR SUPERFIC WOUND(S)LT/2.5CM SLP NK AX EXGEN TRNK EXTR HND FT CDM	$429.78	$551.00	—	at median	22%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 HC PR ED 12001 SIMPLE REPAIR SCALP/NECK/AX/GENIT/TRUNK 2.5CM/OR LESS CDM	$948.48	$1,216.00	—	121% above	22%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 HC ED REPAIR SUPERFIC WOUND(S)LT/2.5CM SLP NK AX EXGEN TRNK EXTR HND FT CDM	$429.78	$551.00	—	—	22%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 HC PR ED 12001 SIMPLE REPAIR SCALP/NECK/AX/GENIT/TRUNK 2.5CM/OR LESS CDM	$948.48	$1,216.00	—	—	22%
Skin biopsy, punch, one lesion CPT 11104 HC PR 11104 PUNCH BIOPSY SKIN SINGLE LESION	$587.34	$753.00	—	31% above	22%
Skin biopsy, punch, one lesion CPT 11104 HC ED PUNCH BIOPSY SKIN SINGLE LESION CDM	$727.74	$933.00	—	63% above	22%
Skin biopsy, punch, one lesion CPT 11104 HC PUNCH BIOPSY SKIN SINGLE LESION	$742.56	$952.00	—	66% above	22%
Skin biopsy, punch, one lesion inpatient CPT 11104 HC PR 11104 PUNCH BIOPSY SKIN SINGLE LESION	$587.34	$753.00	—	—	22%
Skin biopsy, punch, one lesion inpatient CPT 11104 HC ED PUNCH BIOPSY SKIN SINGLE LESION CDM	$727.74	$933.00	—	—	22%
Skin biopsy, punch, one lesion inpatient CPT 11104 HC PUNCH BIOPSY SKIN SINGLE LESION	$742.56	$952.00	—	—	22%
Skin cancer removal (excision), body, arms or legs, up to 0.5 cm CPT 11600 HC PR 11600 EXCISION MAL LESION TRUNK/ARM/LEG 0.5 CM/OR LESS	$894.66	$1,147.00	—	36% above	22%
Skin cancer removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11600 HC PR 11600 EXCISION MAL LESION TRUNK/ARM/LEG 0.5 CM/OR LESS	$894.66	$1,147.00	—	—	22%
Skin tag removal, up to 15 tags CPT 11200 HC ED REMOVAL OF SKIN TAGS CDM	$351.78	$451.00	—	10% below	22%
Skin tag removal, up to 15 tags CPT 11200 HC PR 11200 REMOVAL OF SKIN TAGS	$391.56	$502.00	—	at median	22%
Skin tag removal, up to 15 tags inpatient CPT 11200 HC ED REMOVAL OF SKIN TAGS CDM	$351.78	$451.00	—	—	22%
Skin tag removal, up to 15 tags inpatient CPT 11200 HC PR 11200 REMOVAL OF SKIN TAGS	$391.56	$502.00	—	—	22%
Spinal tap (lumbar puncture), diagnostic CPT 62270 HC DIAGNOSTIC LUMBAR SPINAL PUNCTURE	$666.12	$854.00	—	25% below	22%
Spinal tap (lumbar puncture), diagnostic CPT 62270 HC ED SPINAL PUNCTURE LUMBAR DIAGNOSTIC CDM	$666.12	$854.00	—	25% below	22%
Spinal tap (lumbar puncture), diagnostic CPT 62270 HC PR 62270 SPINAL FLUID TAP DIAGNOSTIC	$1,512.42	$1,939.00	—	69% above	22%
Spinal tap (lumbar puncture), diagnostic CPT 62270 HC PR ED 62270 SPINAL FLUID TAP DIAGNOSTIC CDM	$2,451.54	$3,143.00	—	174% above	22%
Spinal tap (lumbar puncture), diagnostic CPT 62270 HC PR 62270 ANES/SPINAL PUNC	$2,451.54	$3,143.00	—	174% above	22%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 HC DIAGNOSTIC LUMBAR SPINAL PUNCTURE	$666.12	$854.00	—	—	22%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 HC ED SPINAL PUNCTURE LUMBAR DIAGNOSTIC CDM	$666.12	$854.00	—	—	22%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 HC PR 62270 SPINAL FLUID TAP DIAGNOSTIC	$1,512.42	$1,939.00	—	—	22%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 HC PR ED 62270 SPINAL FLUID TAP DIAGNOSTIC CDM	$2,451.54	$3,143.00	—	—	22%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 HC PR 62270 ANES/SPINAL PUNC	$2,451.54	$3,143.00	—	—	22%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 HC ED REPAIR SUPERFICIAL WND(S) 2.6-7.5CM SLP NK AX EXGEN TRNK E CDM	$472.68	$606.00	—	29% below	22%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 HC PR ED 12002 REPAIR SUPERFIC WOUND(S) 2.6 TO 7.5CM SLP NK AX EXGEN T CDM	$1,187.94	$1,523.00	—	79% above	22%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 HC ED REPAIR SUPERFICIAL WND(S) 2.6-7.5CM SLP NK AX EXGEN TRNK E CDM	$472.68	$606.00	—	—	22%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 HC PR ED 12002 REPAIR SUPERFIC WOUND(S) 2.6 TO 7.5CM SLP NK AX EXGEN T CDM	$1,187.94	$1,523.00	—	—	22%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 HC PR ED 12011 SIMPLE REPAIR F/E/E/N/L/M 2.5CM/OR LESS CDM	$1,187.94	$1,523.00	—	154% above	22%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair one side CPT 12011 HC ED REPAIR SUPERFICIAL WOUND(S) LT/2.5 FACE ERS EYLD NSE LPS MUC CDM	$429.78	$551.00	—	8% below	22%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 HC PR ED 12011 SIMPLE REPAIR F/E/E/N/L/M 2.5CM/OR LESS CDM	$1,187.94	$1,523.00	—	—	22%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient one side CPT 12011 HC ED REPAIR SUPERFICIAL WOUND(S) LT/2.5 FACE ERS EYLD NSE LPS MUC CDM	$429.78	$551.00	—	—	22%
TURP (transurethral resection of the prostate) CPT 52601 HC PR 52601 TRURL ELECTROSURG RESCJ PROSTATE BLEED COMPLETE CDM	$6,800.04	$8,718.00	—	37% below	22%
TURP (transurethral resection of the prostate) CPT 52601 HC PR 52601 PROSTATECTOMY (TURP)	$8,080.02	$10,359.00	—	25% below	22%
TURP (transurethral resection of the prostate) inpatient CPT 52601 HC PR 52601 TRURL ELECTROSURG RESCJ PROSTATE BLEED COMPLETE CDM	$6,800.04	$8,718.00	—	—	22%
TURP (transurethral resection of the prostate) inpatient CPT 52601 HC PR 52601 PROSTATECTOMY (TURP)	$8,080.02	$10,359.00	—	—	22%
Tangential (shave-style) skin biopsy, one lesion CPT 11102 HC ED TANGENTIAL BIOPSY SKIN SINGLE LESION CDM	$351.78	$451.00	—	3% below	22%
Tangential (shave-style) skin biopsy, one lesion CPT 11102 HC PR 11102 TANGENTIAL BIOPSY SKIN SINGLE LESION	$473.46	$607.00	—	31% above	22%
Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 HC ED TANGENTIAL BIOPSY SKIN SINGLE LESION CDM	$351.78	$451.00	—	—	22%
Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 HC PR 11102 TANGENTIAL BIOPSY SKIN SINGLE LESION	$473.46	$607.00	—	—	22%
Thoracentesis with imaging guidance CPT 32555 HC PR 32555 THORANCENTESIS NEEDLE/CATH PLEURA W IMAGING	$3,070.86	$3,937.00	—	39% above	22%
Thoracentesis with imaging guidance CPT 32555 HC PR ED 32555 THORACENTESIS/ASPIR W IMG GD CDM	$3,070.86	$3,937.00	—	39% above	22%
Thoracentesis with imaging guidance CPT 32555 HC THORACENTESIS NEEDLE/CATH PLEURA W/IMAGING	$3,116.88	$3,996.00	—	41% above	22%
Thoracentesis with imaging guidance CPT 32555 HC ED THORACENTESIS NEEDLE/CATH PLEURA W/IMAGING CDM	$3,116.88	$3,996.00	—	41% above	22%
Thoracentesis with imaging guidance inpatient CPT 32555 HC PR ED 32555 THORACENTESIS/ASPIR W IMG GD CDM	$3,070.86	$3,937.00	—	—	22%
Thoracentesis with imaging guidance inpatient CPT 32555 HC PR 32555 THORANCENTESIS NEEDLE/CATH PLEURA W IMAGING	$3,070.86	$3,937.00	—	—	22%
Thoracentesis with imaging guidance inpatient CPT 32555 HC ED THORACENTESIS NEEDLE/CATH PLEURA W/IMAGING CDM	$3,116.88	$3,996.00	—	—	22%
Thoracentesis with imaging guidance inpatient CPT 32555 HC THORACENTESIS NEEDLE/CATH PLEURA W/IMAGING	$3,116.88	$3,996.00	—	—	22%
Trigger finger release surgery CPT 26055 HC PR 26055 INCISE FINGER TENDON SHEATH	$4,254.12	$5,454.00	—	8% below	22%
Trigger finger release surgery inpatient CPT 26055 HC PR 26055 INCISE FINGER TENDON SHEATH	$4,254.12	$5,454.00	—	—	22%
Trigger point injections, 1 or 2 muscles CPT 20552 HC ED INJ TRIGGER POINT 1/2 MUSCL CDM	$433.68	$556.00	—	23% above	22%
Trigger point injections, 1 or 2 muscles CPT 20552 HC PR 20552 INJ TRIGGER POINT 1/2 MUSCL	$466.44	$598.00	—	32% above	22%
Trigger point injections, 1 or 2 muscles CPT 20552 HC PR ED 20552 INJ TRIGGER POINT 1/2 MUSCL CDM	$466.44	$598.00	—	32% above	22%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 HC ED INJ TRIGGER POINT 1/2 MUSCL CDM	$433.68	$556.00	—	—	22%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 HC PR ED 20552 INJ TRIGGER POINT 1/2 MUSCL CDM	$466.44	$598.00	—	—	22%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 HC PR 20552 INJ TRIGGER POINT 1/2 MUSCL	$466.44	$598.00	—	—	22%
Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 HC BX BREAST 1ST LESION US IMAG	$3,086.46	$3,957.00	—	at median	22%
Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient CPT 19083 HC BX BREAST 1ST LESION US IMAG	$3,086.46	$3,957.00	—	—	22%
Upper endoscopy (EGD) with balloon widening of the esophagus CPT 43249 HC PR 43249 EGD BALLOON DILATION ESOPHAGUS/LESS THAN 30MM	$1,534.26	$1,967.00	—	55% below	22%
Upper endoscopy (EGD) with balloon widening of the esophagus CPT 43249 HC ED UGI W DILATION ESOPHAGUS BAL CDM	$4,491.24	$5,758.00	—	32% above	22%
Upper endoscopy (EGD) with balloon widening of the esophagus inpatient CPT 43249 HC PR 43249 EGD BALLOON DILATION ESOPHAGUS/LESS THAN 30MM	$1,534.26	$1,967.00	—	—	22%
Upper endoscopy (EGD) with balloon widening of the esophagus inpatient CPT 43249 HC ED UGI W DILATION ESOPHAGUS BAL CDM	$4,491.24	$5,758.00	—	—	22%
Upper endoscopy (EGD) with biopsy CPT 43239 HC ED EGD TRANSORAL BIOPSY SINGLE/MULTIPLE CDM	$2,341.56	$3,002.00	—	54% above	22%
Upper endoscopy (EGD) with biopsy CPT 43239 HC PR 43239 EGD BIOPSY SINGLE/MULTIPLE	$3,115.32	$3,994.00	—	105% above	22%
Upper endoscopy (EGD) with biopsy inpatient CPT 43239 HC ED EGD TRANSORAL BIOPSY SINGLE/MULTIPLE CDM	$2,341.56	$3,002.00	—	—	22%
Upper endoscopy (EGD) with biopsy inpatient CPT 43239 HC PR 43239 EGD BIOPSY SINGLE/MULTIPLE	$3,115.32	$3,994.00	—	—	22%
Upper endoscopy (EGD) with polyp removal by snare CPT 43251 HC PR 43251 EGD REMOVE LESION SNARE	$4,027.92	$5,164.00	—	55% above	22%
Upper endoscopy (EGD) with polyp removal by snare inpatient CPT 43251 HC PR 43251 EGD REMOVE LESION SNARE	$4,027.92	$5,164.00	—	—	22%
Upper endoscopy (EGD), diagnostic CPT 43235 HC ED ESOPHAGOGASTRODUODENOSCOPY TRANSORAL DIAGNOSTIC CDM	$2,129.40	$2,730.00	—	56% above	22%
Upper endoscopy (EGD), diagnostic CPT 43235 HC PR 43235 EGD DIAGNOSTIC BRUSH WASH	$2,577.90	$3,305.00	—	89% above	22%
Upper endoscopy (EGD), diagnostic inpatient CPT 43235 HC ED ESOPHAGOGASTRODUODENOSCOPY TRANSORAL DIAGNOSTIC CDM	$2,129.40	$2,730.00	—	—	22%
Upper endoscopy (EGD), diagnostic inpatient CPT 43235 HC PR 43235 EGD DIAGNOSTIC BRUSH WASH	$2,577.90	$3,305.00	—	—	22%
Vasectomy, one or both sides, including follow-up semen testing both sides CPT 55250 HC PR 55250 VASECTOMY UNI/BI SPX W/POSTOP SEMEN EXAMS CDM	$2,985.84	$3,828.00	—	—	22%
Vasectomy, one or both sides, including follow-up semen testing CPT 55250 HC PR 55250 REMOVAL OF SPERM DUCT(S)	$2,985.84	$3,828.00	—	27% above	22%
Vasectomy, one or both sides, including follow-up semen testing inpatient both sides CPT 55250 HC PR 55250 VASECTOMY UNI/BI SPX W/POSTOP SEMEN EXAMS CDM	$2,985.84	$3,828.00	—	—	22%
Vasectomy, one or both sides, including follow-up semen testing inpatient CPT 55250 HC PR 55250 REMOVAL OF SPERM DUCT(S)	$2,985.84	$3,828.00	—	—	22%
Wart removal, up to 14 warts CPT 17110 HC ED DESTRUCTION BENIGN LESIONS UP TO 14 CDM	$351.78	$451.00	—	61% above	22%
Wart removal, up to 14 warts CPT 17110 HC PR 17110 DESTRUCT B9 LESION 1-14	$400.92	$514.00	—	84% above	22%
Wart removal, up to 14 warts inpatient CPT 17110 HC ED DESTRUCTION BENIGN LESIONS UP TO 14 CDM	$351.78	$451.00	—	—	22%
Wart removal, up to 14 warts inpatient CPT 17110 HC PR 17110 DESTRUCT B9 LESION 1-14	$400.92	$514.00	—	—	22%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 HC ED DEB SUBQ TISSUE 20 SQ CM OR LESS - DEBRIDE SKIN CDM	$461.76	$592.00	—	8% below	22%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 HC PR 11042 DEBRIDEMENT SUBCUTANEOUS TISSUE 20 SQ CM OR LESS CDM	$567.06	$727.00	—	13% above	22%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 HC PR 11042 DEB SUBQ TISSUE FIRST 20 SQ OR LESS	$890.76	$1,142.00	—	78% above	22%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 HC PR ED 11042 DEB SUBQ TISSUE FIRST 20 SQ CM OR LESS CDM	$931.32	$1,194.00	—	86% above	22%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 HC ED DEB SUBQ TISSUE 20 SQ CM OR LESS - DEBRIDE SKIN CDM	$461.76	$592.00	—	—	22%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 HC PR 11042 DEBRIDEMENT SUBCUTANEOUS TISSUE 20 SQ CM OR LESS CDM	$567.06	$727.00	—	—	22%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 HC PR 11042 DEB SUBQ TISSUE FIRST 20 SQ OR LESS	$890.76	$1,142.00	—	—	22%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 HC PR ED 11042 DEB SUBQ TISSUE FIRST 20 SQ CM OR LESS CDM	$931.32	$1,194.00	—	—	22%
Wrist fracture surgery (plate and screws), distal radius CPT 25607 HC PR 25607 TREAT FX RAD EXTRA-ARTICUL	$5,291.52	$6,784.00	—	59% below	22%
Wrist fracture surgery (plate and screws), distal radius CPT 25607 HC ED TREAT FX RAD EXTRA-ARTICUL CDM	$12,898.86	$16,537.00	—	at median	22%
Wrist fracture surgery (plate and screws), distal radius inpatient CPT 25607 HC PR 25607 TREAT FX RAD EXTRA-ARTICUL	$5,291.52	$6,784.00	—	—	22%
Wrist fracture surgery (plate and screws), distal radius inpatient CPT 25607 HC ED TREAT FX RAD EXTRA-ARTICUL CDM	$12,898.86	$16,537.00	—	—	22%

Doctor visits and therapy

Procedure	Cash price	List price	Insurers pay	vs Alaska	Off list
Blood transfusion (giving blood or blood components) CPT 36430 HC PR ED 36430 BLOOD TRANSFUSION SERVICE CDM	$582.66	$747.00	—	51% below	22%
Blood transfusion (giving blood or blood components) CPT 36430 HC BLOOD TRANSFUSION EA UNIT CDM	$875.16	$1,122.00	—	26% below	22%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 HC PR ED 36430 BLOOD TRANSFUSION SERVICE CDM	$582.66	$747.00	—	—	22%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 HC BLOOD TRANSFUSION EA UNIT CDM	$875.16	$1,122.00	—	—	22%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HC ED INHALATION TREATMENT CDM	$356.46	$457.00	—	16% below	22%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HC INHALATION TREATMENT DAILY	$356.46	$457.00	—	16% below	22%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HC ED INHALATION TREATMENT CDM	$356.46	$457.00	—	—	22%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HC INHALATION TREATMENT DAILY	$356.46	$457.00	—	—	22%
Chemotherapy IV infusion, first hour CPT 96413 HC CHEMO IV INFUSION INITIAL HR CDM	$1,027.26	$1,317.00	—	13% above	22%
Chemotherapy IV infusion, first hour CPT 96413 HC TYSABRI INFUSION FIRST HR	$1,027.26	$1,317.00	—	13% above	22%
Chemotherapy IV infusion, first hour inpatient CPT 96413 HC TYSABRI INFUSION FIRST HR	$1,027.26	$1,317.00	—	—	22%
Chemotherapy IV infusion, first hour inpatient CPT 96413 HC CHEMO IV INFUSION INITIAL HR CDM	$1,027.26	$1,317.00	—	—	22%
Critical care, first 30 to 74 minutes CPT 99291 HC PR ED 99291 CRITICAL CARE FIRST HOUR CDM	$2,012.40	$2,580.00	—	42% below	22%
Critical care, first 30 to 74 minutes CPT 99291 HC ED CRITICAL CARE FIRST HOUR CDM	$8,957.52	$11,484.00	—	159% above	22%
Critical care, first 30 to 74 minutes inpatient CPT 99291 HC PR ED 99291 CRITICAL CARE FIRST HOUR CDM	$2,012.40	$2,580.00	—	—	22%
Critical care, first 30 to 74 minutes inpatient CPT 99291 HC ED CRITICAL CARE FIRST HOUR CDM	$8,957.52	$11,484.00	—	—	22%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 HC PR ED 93005 ECG 12 LEAD TRACING ONLY CDM	$63.96	$82.00	—	82% below	22%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 HC ECG 12 LEAD TRACING ONLY	$840.84	$1,078.00	—	138% above	22%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 HC PR ED 93005 ECG 12 LEAD TRACING ONLY CDM	$63.96	$82.00	—	—	22%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 HC ECG 12 LEAD TRACING ONLY	$840.84	$1,078.00	—	—	22%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 HC ED FAC E&M VISIT LEVEL 1 CDM	$663.78	$851.00	—	79% above	22%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 HC ED FAC E&M VISIT LEVEL 1 CDM	$663.78	$851.00	—	—	22%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 HC PR ED 99282 VISIT STRAIGHTFORWARD MDM CDM	$444.60	$570.00	—	16% below	22%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 HC ED FAC E&M VISIT LEVEL 2 CDM	$925.08	$1,186.00	—	75% above	22%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 HC PR ED 99282 VISIT STRAIGHTFORWARD MDM CDM	$444.60	$570.00	—	—	22%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 HC ED FAC E&M VISIT LEVEL 2 CDM	$925.08	$1,186.00	—	—	22%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 HC PR ED 99283 VISIT LOW MDM CDM	$663.00	$850.00	—	17% below	22%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 HC ED FAC E&M VISIT LEVEL 3 CDM	$1,737.06	$2,227.00	—	118% above	22%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 HC PR ED 99283 VISIT LOW MDM CDM	$663.00	$850.00	—	—	22%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 HC ED FAC E&M VISIT LEVEL 3 CDM	$1,737.06	$2,227.00	—	—	22%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 HC PR ED 99284 VISIT MODERATE MDM CDM	$1,180.14	$1,513.00	—	13% below	22%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 HC ED FAC E&M VISIT LEVEL 4 CDM	$3,245.58	$4,161.00	—	141% above	22%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 HC PR ED 99284 VISIT MODERATE MDM CDM	$1,180.14	$1,513.00	—	—	22%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 HC ED FAC E&M VISIT LEVEL 4 CDM	$3,245.58	$4,161.00	—	—	22%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 HC ED FAC E&M VISIT LEVEL 5 CDM	$5,453.76	$6,992.00	—	137% above	22%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 HC ED FAC E&M VISIT LEVEL 5 CDM	$5,453.76	$6,992.00	—	—	22%
Exercise stress test, tracing only, the hospital charge CPT 93017 HC PR 93017 CARDIO STRESS TEST TRACING ONLY	$358.02	$459.00	—	69% below	22%
Exercise stress test, tracing only, the hospital charge CPT 93017 HC CV STRS TST XERS&/OR RX CONT ECG TRCG ONLY	$2,119.26	$2,717.00	—	82% above	22%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 HC PR 93017 CARDIO STRESS TEST TRACING ONLY	$358.02	$459.00	—	—	22%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 HC CV STRS TST XERS&/OR RX CONT ECG TRCG ONLY	$2,119.26	$2,717.00	—	—	22%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 HC IV HYDRATION INITIAL HR CDM	$888.42	$1,139.00	—	39% above	22%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 HC ED IV HYDRATION INITIAL HR CDM	$888.42	$1,139.00	—	39% above	22%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 HC IV HYDRATION INITIAL HR CDM	$888.42	$1,139.00	—	—	22%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 HC ED IV HYDRATION INITIAL HR CDM	$888.42	$1,139.00	—	—	22%
IV infusion of a medicine, first hour CPT 96365 HC ED IV INFUSION THERAPY/PROPHYLAXIS /DX 1ST TO 1 HR CDM	$968.76	$1,242.00	—	68% above	22%
IV infusion of a medicine, first hour CPT 96365 HC IV INFUSION INITIAL HR CDM	$968.76	$1,242.00	—	68% above	22%
IV infusion of a medicine, first hour inpatient CPT 96365 HC IV INFUSION INITIAL HR CDM	$968.76	$1,242.00	—	—	22%
IV infusion of a medicine, first hour inpatient CPT 96365 HC ED IV INFUSION THERAPY/PROPHYLAXIS /DX 1ST TO 1 HR CDM	$968.76	$1,242.00	—	—	22%
IV push of a medicine, first drug CPT 96374 HC ED IV INJECTION THERAPEUTIC PROPH/DX PUSH SINGLE/1ST SBST/DRUG CDM	$685.62	$879.00	—	96% above	22%
IV push of a medicine, first drug CPT 96374 HC INJ IV PUSH INITIAL DRUG CDM	$685.62	$879.00	—	96% above	22%
IV push of a medicine, first drug inpatient CPT 96374 HC ED IV INJECTION THERAPEUTIC PROPH/DX PUSH SINGLE/1ST SBST/DRUG CDM	$685.62	$879.00	—	—	22%
IV push of a medicine, first drug inpatient CPT 96374 HC INJ IV PUSH INITIAL DRUG CDM	$685.62	$879.00	—	—	22%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 HC PR 96372 THER/PROPH/DIAG INJ SC/IM	$115.44	$148.00	—	12% below	22%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 HC INJ SQ OR IM CDM	$275.34	$353.00	—	111% above	22%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 HC ED THERAPEUTIC PROPHYLACTIC/DX INJECTION SUBQ/IM CDM	$275.34	$353.00	—	111% above	22%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 HC PR 96372 THER/PROPH/DIAG INJ SC/IM	$115.44	$148.00	—	—	22%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 HC ED THERAPEUTIC PROPHYLACTIC/DX INJECTION SUBQ/IM CDM	$275.34	$353.00	—	—	22%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 HC INJ SQ OR IM CDM	$275.34	$353.00	—	—	22%
Neuromuscular re-education, 15 minutes CPT 97112 HC CRISIS TELEH 97112 NEUROMUSCUL REEDUCAT EA 15 MIN CDM	$199.68	$256.00	—	17% above	22%
Neuromuscular re-education, 15 minutes CPT 97112 HC NEUROMUSC REEDUCA THER PX 1 OR MORE AREAS EACH 15 MIN	$199.68	$256.00	—	17% above	22%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 HC CRISIS TELEH 97112 NEUROMUSCUL REEDUCAT EA 15 MIN CDM	$199.68	$256.00	—	—	22%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 HC NEUROMUSC REEDUCA THER PX 1 OR MORE AREAS EACH 15 MIN	$199.68	$256.00	—	—	22%
New patient office visit, about 30 minutes CPT 99203 HC PR 99203 NEW PT VISIT - LEVEL 3	$745.68	$956.00	—	130% above	22%
New patient office visit, about 30 minutes CPT 99203 HC L&D TRIAGE NEW PATIENT LVL 3 CDM	$1,408.68	$1,806.00	—	335% above	22%
New patient office visit, about 30 minutes inpatient CPT 99203 HC PR 99203 NEW PT VISIT - LEVEL 3	$745.68	$956.00	—	—	22%
New patient office visit, about 30 minutes inpatient CPT 99203 HC L&D TRIAGE NEW PATIENT LVL 3 CDM	$1,408.68	$1,806.00	—	—	22%
New patient office visit, about 45 minutes CPT 99204 HC PR 99204 NEW PT VISIT - LEVEL 4	$1,010.10	$1,295.00	—	56% above	22%
New patient office visit, about 45 minutes CPT 99204 HC L&D TRIAGE NEW PATIENT LVL 4 CDM	$2,633.28	$3,376.00	—	307% above	22%
New patient office visit, about 45 minutes inpatient CPT 99204 HC PR 99204 NEW PT VISIT - LEVEL 4	$1,010.10	$1,295.00	—	—	22%
New patient office visit, about 45 minutes inpatient CPT 99204 HC L&D TRIAGE NEW PATIENT LVL 4 CDM	$2,633.28	$3,376.00	—	—	22%
New patient office visit, about 60 minutes CPT 99205 HC PR 99205 NEW PT VISIT - LEVEL 5	$1,081.86	$1,387.00	—	47% above	22%
New patient office visit, about 60 minutes CPT 99205 HC L&D TRIAGE NEW PATIENT LVL 5 CDM	$4,422.60	$5,670.00	—	503% above	22%
New patient office visit, about 60 minutes inpatient CPT 99205 HC PR 99205 NEW PT VISIT - LEVEL 5	$1,081.86	$1,387.00	—	—	22%
New patient office visit, about 60 minutes inpatient CPT 99205 HC L&D TRIAGE NEW PATIENT LVL 5 CDM	$4,422.60	$5,670.00	—	—	22%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 HC PR 99202 NEW PT VISIT - LEVEL 2	$538.98	$691.00	—	128% above	22%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 HC L&D TRIAGE NEW PATIENT LVL 2 CDM	$751.14	$963.00	—	218% above	22%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 HC L&D TRIAGE NEW PATIENT LVL 1 CDM	$751.14	$963.00	—	218% above	22%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 HC PR 99202 NEW PT VISIT - LEVEL 2	$538.98	$691.00	—	—	22%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 HC L&D TRIAGE NEW PATIENT LVL 1 CDM	$751.14	$963.00	—	—	22%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 HC L&D TRIAGE NEW PATIENT LVL 2 CDM	$751.14	$963.00	—	—	22%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 HC MEDICAL NUTRITION INDIV INITIAL THERAPY EA 15 MIN CDM	$77.22	$99.00	—	at median	22%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 HC CRISIS TELEH 97802 MEDICAL NUTRITION INDIV INIT THERAPY EA 15 MIN CDM	$77.22	$99.00	—	at median	22%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 HC MEDICAL NUTRITION INDIV INITIAL THERAPY EA 15 MIN CDM	$77.22	$99.00	—	—	22%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 HC CRISIS TELEH 97802 MEDICAL NUTRITION INDIV INIT THERAPY EA 15 MIN CDM	$77.22	$99.00	—	—	22%
Occupational therapy evaluation, low complexity CPT 97165 HC CRISIS TELEH 97165 OT EVALUATION LOW COMPLEX CDM	$494.52	$634.00	—	20% above	22%
Occupational therapy evaluation, low complexity CPT 97165 HC OT EVALUATION LOW COMPLEX	$494.52	$634.00	—	20% above	22%
Occupational therapy evaluation, low complexity inpatient CPT 97165 HC CRISIS TELEH 97165 OT EVALUATION LOW COMPLEX CDM	$494.52	$634.00	—	—	22%
Occupational therapy evaluation, low complexity inpatient CPT 97165 HC OT EVALUATION LOW COMPLEX	$494.52	$634.00	—	—	22%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 HC CRISIS TELEH 97163 PT EVALUATION HIGH COMPLEX CDM	$598.26	$767.00	—	13% above	22%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 HC PT EVALUATION HIGH COMPLEX	$598.26	$767.00	—	13% above	22%
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 HC PT EVALUATION HIGH COMPLEX	$598.26	$767.00	—	—	22%
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 HC CRISIS TELEH 97163 PT EVALUATION HIGH COMPLEX CDM	$598.26	$767.00	—	—	22%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 HC PT EVALUATION LOW COMPLEX CDM	$494.52	$634.00	—	19% above	22%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 HC CRISIS TELEH 97161 PT EVALUATION LOW COMPLEX CDM	$494.52	$634.00	—	19% above	22%
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 HC PT EVALUATION LOW COMPLEX CDM	$494.52	$634.00	—	—	22%
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 HC CRISIS TELEH 97161 PT EVALUATION LOW COMPLEX CDM	$494.52	$634.00	—	—	22%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 HC PT EVALUATION MOD COMPLEX CDM	$543.66	$697.00	—	14% above	22%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 HC CRISIS TELEH 97162 PT EVALUATION MOD COMPLEX CDM	$543.66	$697.00	—	14% above	22%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 HC CRISIS TELEH 97162 PT EVALUATION MOD COMPLEX CDM	$543.66	$697.00	—	—	22%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 HC PT EVALUATION MOD COMPLEX CDM	$543.66	$697.00	—	—	22%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 HC MANUAL THERAPY TQS 1 OR MORE REGIONS EACH 15 MINUTES	$199.68	$256.00	—	13% above	22%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 HC MANUAL THERAPY TQS 1 OR MORE REGIONS EACH 15 MINUTES	$199.68	$256.00	—	—	22%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HC THER EXERCISES PX 1 OR MORE AREAS EACH 15 MIN	$199.68	$256.00	—	18% above	22%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HC CRISIS TELEH 97110 THERAPEUTIC EXERCISES EA 15 MIN CDM	$199.68	$256.00	—	18% above	22%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 HC CRISIS TELEH 97110 THERAPEUTIC EXERCISES EA 15 MIN CDM	$199.68	$256.00	—	—	22%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 HC THER EXERCISES PX 1 OR MORE AREAS EACH 15 MIN	$199.68	$256.00	—	—	22%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 HC PR 99406 BEHAV CHNG SMOKING 3-10 MIN	$114.66	$147.00	—	88% above	22%
Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 HC PR 99406 BEHAV CHNG SMOKING 3-10 MIN	$114.66	$147.00	—	—	22%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 HC PR 99215 ESTAB PT VISIT - LEVEL 5	$781.56	$1,002.00	—	48% above	22%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 HC PR 99215 LEVEL 5 EST POSTPARTUM EVAL	$1,334.58	$1,711.00	—	153% above	22%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 HC L&D TRIAGE ESTAB PATIENT LVL 5 CDM	$4,422.60	$5,670.00	—	738% above	22%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 HC PR 99215 ESTAB PT VISIT - LEVEL 5	$781.56	$1,002.00	—	—	22%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 HC PR 99215 LEVEL 5 EST POSTPARTUM EVAL	$1,334.58	$1,711.00	—	—	22%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 HC L&D TRIAGE ESTAB PATIENT LVL 5 CDM	$4,422.60	$5,670.00	—	—	22%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 HC PR 99213 ESTAB PT VISIT - LEVEL 3	$609.96	$782.00	—	186% above	22%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 HC L&D TRIAGE ESTAB PATIENT LVL 3 CDM	$1,408.68	$1,806.00	—	562% above	22%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 HC PR 99213 ESTAB PT VISIT - LEVEL 3	$609.96	$782.00	—	—	22%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 HC L&D TRIAGE ESTAB PATIENT LVL 3 CDM	$1,408.68	$1,806.00	—	—	22%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 HC PR 99214 ESTAB PT VISIT - LEVEL 4	$903.24	$1,158.00	—	214% above	22%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 HC PR 99214 CNM LEVEL 4 EST POSTPARTUM EVAL	$903.24	$1,158.00	—	214% above	22%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 HC L&D TRIAGE ESTAB PATIENT LVL 4 CDM	$2,633.28	$3,376.00	—	814% above	22%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 HC PR 99214 ESTAB PT VISIT - LEVEL 4	$903.24	$1,158.00	—	—	22%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 HC PR 99214 CNM LEVEL 4 EST POSTPARTUM EVAL	$903.24	$1,158.00	—	—	22%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 HC L&D TRIAGE ESTAB PATIENT LVL 4 CDM	$2,633.28	$3,376.00	—	—	22%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 HC PR 99212 ESTAB PT VISIT - LEVEL 2	$363.48	$466.00	—	149% above	22%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 HC L&D TRIAGE ESTAB PATIENT LVL 2 CDM	$751.14	$963.00	—	414% above	22%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 HC PR 99212 ESTAB PT VISIT - LEVEL 2	$363.48	$466.00	—	—	22%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 HC L&D TRIAGE ESTAB PATIENT LVL 2 CDM	$751.14	$963.00	—	—	22%
Speech and language evaluation CPT 92523 HC CRISIS TELEH 92523 SPEECH SOUND LANG COMPREHEN CDM	$586.56	$752.00	—	10% below	22%
Speech and language evaluation CPT 92523 HC EVAL SPEECH SOUND PRODUCT LANGUAGE COMPREHENSION CDM	$586.56	$752.00	—	10% below	22%
Speech and language evaluation inpatient CPT 92523 HC EVAL SPEECH SOUND PRODUCT LANGUAGE COMPREHENSION CDM	$586.56	$752.00	—	—	22%
Speech and language evaluation inpatient CPT 92523 HC CRISIS TELEH 92523 SPEECH SOUND LANG COMPREHEN CDM	$586.56	$752.00	—	—	22%
Speech therapy session, individual CPT 92507 HC CRISIS TELEH 92507 SPEECH/HEARING THERAPY - INDIV CDM	$518.70	$665.00	—	13% above	22%
Speech therapy session, individual CPT 92507 HC TX SPEECH/LANG/VOICE COMMJ/AUDITORY PROCESS - INDIVIDUAL	$518.70	$665.00	—	13% above	22%
Speech therapy session, individual inpatient CPT 92507 HC TX SPEECH/LANG/VOICE COMMJ/AUDITORY PROCESS - INDIVIDUAL	$518.70	$665.00	—	—	22%
Speech therapy session, individual inpatient CPT 92507 HC CRISIS TELEH 92507 SPEECH/HEARING THERAPY - INDIV CDM	$518.70	$665.00	—	—	22%
Spirometry (breathing test) CPT 94010 HC SPMTRY W/VC EXPIRATORY FLO W/WO MXML VOL VNTJ	$741.00	$950.00	—	74% above	22%
Spirometry (breathing test) inpatient CPT 94010 HC SPMTRY W/VC EXPIRATORY FLO W/WO MXML VOL VNTJ	$741.00	$950.00	—	—	22%
Spirometry before and after a bronchodilator CPT 94060 HC PR 94060 SPIROMETRY PRE POST BRONCHODILATOR	$94.38	$121.00	—	88% below	22%
Spirometry before and after a bronchodilator CPT 94060 HC SPIROMETRY PRE POST BRONCHODILATOR CDM	$1,472.64	$1,888.00	—	90% above	22%
Spirometry before and after a bronchodilator inpatient CPT 94060 HC PR 94060 SPIROMETRY PRE POST BRONCHODILATOR	$94.38	$121.00	—	—	22%
Spirometry before and after a bronchodilator inpatient CPT 94060 HC SPIROMETRY PRE POST BRONCHODILATOR CDM	$1,472.64	$1,888.00	—	—	22%
Therapeutic activities (functional training), 15 minutes CPT 97530 HC THERAPEUT ACTVITY DIRECT PT CONTACT EACH 15 MIN	$199.68	$256.00	—	21% above	22%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 HC THERAPEUT ACTVITY DIRECT PT CONTACT EACH 15 MIN	$199.68	$256.00	—	—	22%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 HC ED PHLEBOTOMY THERAPEUTIC SEPARATE PROCEDURE CDM	$226.20	$290.00	—	19% below	22%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 HC THERAPUTIC PHLEBOTOMY	$414.18	$531.00	—	48% above	22%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 HC ED PHLEBOTOMY THERAPEUTIC SEPARATE PROCEDURE CDM	$226.20	$290.00	—	—	22%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 HC THERAPUTIC PHLEBOTOMY	$414.18	$531.00	—	—	22%

Vaccines

Procedure	Cash price	List price	Insurers pay	vs Alaska	Off list
Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older CPT 90653 INFLUENZA VAC TYPE A&B SURFACE ANT ADJ SUSP PREF SYR 0.5 ML	$409.03	$524.40	—	at median	22%
Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older inpatient CPT 90653 INFLUENZA VAC TYPE A&B SURFACE ANT ADJ SUSP PREF SYR 0.5 ML	$409.03	$524.40	—	—	22%
COVID-19 vaccine (Moderna), age 12 and older CPT 91322 HC PR RX COVID-19 VACCINE SINGLE DOSE (MODERNA) PF IM 50 MCG/0.5 ML	$330.72	$424.00	—	30% above	22%
COVID-19 vaccine (Moderna), age 12 and older inpatient CPT 91322 HC PR RX COVID-19 VACCINE SINGLE DOSE (MODERNA) PF IM 50 MCG/0.5 ML	$330.72	$424.00	—	—	22%
COVID-19 vaccine (Pfizer-BioNTech), age 12 and older CPT 91320 COVID-19 MRNA VAC TRIS-PFIZER IM SUSP PREF SYR 30 MCG/0.3ML	$188.49	$241.66	—	8% below	22%
COVID-19 vaccine (Pfizer-BioNTech), age 12 and older CPT 91320 HC PR RX COVID-19 VACCINE SINGLE DOSE (PFIZER) PF TRIS-SUC IM 30 MCG/0.3 ML	$297.18	$381.00	—	45% above	22%
COVID-19 vaccine (Pfizer-BioNTech), age 12 and older inpatient CPT 91320 COVID-19 MRNA VAC TRIS-PFIZER IM SUSP PREF SYR 30 MCG/0.3ML	$188.49	$241.66	—	—	22%
COVID-19 vaccine (Pfizer-BioNTech), age 12 and older inpatient CPT 91320 HC PR RX COVID-19 VACCINE SINGLE DOSE (PFIZER) PF TRIS-SUC IM 30 MCG/0.3 ML	$297.18	$381.00	—	—	22%
Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 VARICELLA VIRUS VAC LIVE FOR INJ 1350 PFU/0.5ML	$765.62	$981.56	—	208% above	22%
Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 HC PR RX VARICELLA VACCINE LIVE SQ 0.5 ML	$1,089.66	$1,397.00	—	338% above	22%
Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 VARICELLA VIRUS VAC LIVE FOR INJ 1350 PFU/0.5ML	$765.62	$981.56	—	—	22%
Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 HC PR RX VARICELLA VACCINE LIVE SQ 0.5 ML	$1,089.66	$1,397.00	—	—	22%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 DIPH, ACELLULAR PERT & TET TOX INJ 25 LF-58 MCG-10 LF/0.5ML	$137.24	$175.95	—	58% above	22%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 HC PR RX DIPHTH TETANUS TOX ACELL PERTUSSIS VACC/YOUNGER THAN 7 YRS/IM	$217.62	$279.00	—	151% above	22%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 inpatient CPT 90700 DIPH, ACELLULAR PERT & TET TOX INJ 25 LF-58 MCG-10 LF/0.5ML	$137.24	$175.95	—	—	22%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 inpatient CPT 90700 HC PR RX DIPHTH TETANUS TOX ACELL PERTUSSIS VACC/YOUNGER THAN 7 YRS/IM	$217.62	$279.00	—	—	22%
DTaP, hepatitis B and polio combination vaccine (Pediarix) CPT 90723 HC PR RX DTAP-HEPB-IPV VACCINE IM 0.5 ML	$286.26	$367.00	—	48% above	22%
DTaP, hepatitis B and polio combination vaccine (Pediarix) CPT 90723 DIPH-TET TOX-ACELL PERT-HEP B-POLIO IPV VAC SUSP PREF SYR	$369.60	$473.84	—	91% above	22%
DTaP, hepatitis B and polio combination vaccine (Pediarix) inpatient CPT 90723 HC PR RX DTAP-HEPB-IPV VACCINE IM 0.5 ML	$286.26	$367.00	—	—	22%
DTaP, hepatitis B and polio combination vaccine (Pediarix) inpatient CPT 90723 DIPH-TET TOX-ACELL PERT-HEP B-POLIO IPV VAC SUSP PREF SYR	$369.60	$473.84	—	—	22%
HPV vaccine, 9-valent (Gardasil 9) CPT 90651 HUMAN PAPILLOMAVIRUS (HPV) 9-VALENT RECOMB VAC SUSP PREF SYR	$1,285.39	$1,647.93	—	165% above	22%
HPV vaccine, 9-valent (Gardasil 9) CPT 90651 HC PR RX 9VHPV VACCINE 2/3 DOSE IM 0.5 ML	$1,726.14	$2,213.00	—	256% above	22%
HPV vaccine, 9-valent (Gardasil 9) inpatient CPT 90651 HUMAN PAPILLOMAVIRUS (HPV) 9-VALENT RECOMB VAC SUSP PREF SYR	$1,285.39	$1,647.93	—	—	22%
HPV vaccine, 9-valent (Gardasil 9) inpatient CPT 90651 HC PR RX 9VHPV VACCINE 2/3 DOSE IM 0.5 ML	$1,726.14	$2,213.00	—	—	22%
Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 HC PR RX HEPATITIS A VACCINE PEDIATRIC 2 DOSE IM 0.5 ML	$286.26	$367.00	—	126% above	22%
Hepatitis A vaccine, child and teen dose (2-dose schedule) inpatient CPT 90633 HC PR RX HEPATITIS A VACCINE PEDIATRIC 2 DOSE IM 0.5 ML	$286.26	$367.00	—	—	22%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 HEPATITIS B VACCINE (RECOMBINANT) SUSP 20 MCG/ML,HEPATITIS B VACCINE (RECOMBINANT) SUSP PREF SYR 20 MCG/ML	$284.26	$364.44	—	147% above	22%
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 HEPATITIS B VACCINE (RECOMBINANT) SUSP 20 MCG/ML,HEPATITIS B VACCINE (RECOMBINANT) SUSP PREF SYR 20 MCG/ML	$284.26	$364.44	—	—	22%
Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 HEPATITIS B VACCINE (RECOMBINANT) SUSP PREF SYR 10 MCG/0.5ML,HEPATITIS B VACCINE (RECOMBINANT) 10 MCG/0.5ML,HEPATITIS B VACCINE (RECOMBINANT) SUSP 10 MCG/0.5ML	$122.17	$156.63	—	25% above	22%
Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 HEPATITIS B VACCINE (RECOMBINANT) SUSP PREF SYR 10 MCG/0.5ML,HEPATITIS B VACCINE (RECOMBINANT) 10 MCG/0.5ML,HEPATITIS B VACCINE (RECOMBINANT) SUSP 10 MCG/0.5ML	$122.17	$156.63	—	—	22%
Hib vaccine (Haemophilus influenzae type b), 3-dose schedule (PedvaxHIB) CPT 90647 HAEMOPHILUS B POLYSACCHARIDE CONJ VAC IM SUSP 7.5 MCG/0.5 ML	$160.95	$206.34	—	at median	22%
Hib vaccine (Haemophilus influenzae type b), 3-dose schedule (PedvaxHIB) CPT 90647 HC PR RX HIB PRP-OMP VACCINE 3 DOSE IM 0.5 ML	$223.08	$286.00	—	39% above	22%
Hib vaccine (Haemophilus influenzae type b), 3-dose schedule (PedvaxHIB) inpatient CPT 90647 HAEMOPHILUS B POLYSACCHARIDE CONJ VAC IM SUSP 7.5 MCG/0.5 ML	$160.95	$206.34	—	—	22%
Hib vaccine (Haemophilus influenzae type b), 3-dose schedule (PedvaxHIB) inpatient CPT 90647 HC PR RX HIB PRP-OMP VACCINE 3 DOSE IM 0.5 ML	$223.08	$286.00	—	—	22%
MMR vaccine (measles, mumps and rubella), live CPT 90707 MEASLES-MUMPS-RUBELLA VIRUS VACCINES FOR INJ SOLN	$501.02	$642.33	—	154% above	22%
MMR vaccine (measles, mumps and rubella), live CPT 90707 HC PR RX MEASLES MUMPS RUBELLA VACCINE LIVE SQ 1 EA	$668.46	$857.00	—	239% above	22%
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 MEASLES-MUMPS-RUBELLA VIRUS VACCINES FOR INJ SOLN	$501.02	$642.33	—	—	22%
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 HC PR RX MEASLES MUMPS RUBELLA VACCINE LIVE SQ 1 EA	$668.46	$857.00	—	—	22%
Meningococcal ACWY (MenACWY) vaccine CPT 90734 HC PR RX MENACWYD/MENACWY-CRM CONJ VACCINE GRPS ACYW IM 0.5 ML	$894.66	$1,147.00	—	276% above	22%
Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 HC PR RX MENACWYD/MENACWY-CRM CONJ VACCINE GRPS ACYW IM 0.5 ML	$894.66	$1,147.00	—	—	22%
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) CPT 90670 PNEUMOCOCCAL 13-VALENT CONJUGATE VACCINE INJ	$667.77	$856.12	—	22% above	22%
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) CPT 90670 HC PR RX PNEUMOCOCCAL VACCINE 13 VALENT IM 0.5 ML	$1,416.48	$1,816.00	—	159% above	22%
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) inpatient CPT 90670 PNEUMOCOCCAL 13-VALENT CONJUGATE VACCINE INJ	$667.77	$856.12	—	—	22%
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) inpatient CPT 90670 HC PR RX PNEUMOCOCCAL VACCINE 13 VALENT IM 0.5 ML	$1,416.48	$1,816.00	—	—	22%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 PNEUMOCOCCAL 20-VALENT CONJUGATE VACCINE SUS PREF SYR 0.5 ML	$1,204.06	$1,543.67	—	88% above	22%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 PNEUMOCOCCAL 20-VALENT CONJUGATE VACCINE SUS PREF SYR 0.5 ML	$1,204.06	$1,543.67	—	—	22%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PNEUMOCOCCAL VACCINE POLYVALENT SOLN PREF SYR 25 MCG/0.5ML	$565.20	$724.62	—	53% above	22%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 PNEUMOCOCCAL VACCINE POLYVALENT SOLN PREF SYR 25 MCG/0.5ML	$565.20	$724.62	—	—	22%
Polio vaccine, inactivated (IPV) CPT 90713 HC PR RX POLIOVIRUS VACCINE INACTIVATED SQ/IM 0.5 ML	$190.32	$244.00	—	39% above	22%
Polio vaccine, inactivated (IPV) CPT 90713 POLIOVIRUS VACCINE, IPV INJ SUSP	$239.38	$306.90	—	75% above	22%
Polio vaccine, inactivated (IPV) inpatient CPT 90713 HC PR RX POLIOVIRUS VACCINE INACTIVATED SQ/IM 0.5 ML	$190.32	$244.00	—	—	22%
Polio vaccine, inactivated (IPV) inpatient CPT 90713 POLIOVIRUS VACCINE, IPV INJ SUSP	$239.38	$306.90	—	—	22%
Rabies vaccine, one dose CPT 90675 RABIES VACCINE, PCEC FOR INJ	$1,595.23	$2,045.17	—	168% above	22%
Rabies vaccine, one dose CPT 90675 RABIES VIRUS VACCINE, HDC FOR INJ SUSP	$1,974.52	$2,531.43	—	231% above	22%
Rabies vaccine, one dose inpatient CPT 90675 RABIES VACCINE, PCEC FOR INJ	$1,595.23	$2,045.17	—	—	22%
Rabies vaccine, one dose inpatient CPT 90675 RABIES VIRUS VACCINE, HDC FOR INJ SUSP	$1,974.52	$2,531.43	—	—	22%
Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) CPT 90680 ROTAVIRUS VACCINE, LIVE ORAL PENTAVALENT SOLN	$506.52	$649.39	—	177% above	22%
Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) CPT 90680 HC PR RX ROTOVIRUS VACCINE (RV5) 3 DOSE ORAL 2 ML	$670.80	$860.00	—	267% above	22%
Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) inpatient CPT 90680 ROTAVIRUS VACCINE, LIVE ORAL PENTAVALENT SOLN	$506.52	$649.39	—	—	22%
Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) inpatient CPT 90680 HC PR RX ROTOVIRUS VACCINE (RV5) 3 DOSE ORAL 2 ML	$670.80	$860.00	—	—	22%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TETANUS-DIPHTHERIA TOXOIDS (TD) INJ 2-2 LF/0.5ML	$139.44	$178.77	—	at median	22%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 TETANUS-DIPHTHERIA TOXOIDS (TD) INJ 2-2 LF/0.5ML	$139.44	$178.77	—	—	22%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 TET-DIPH-ACELL PERTUSS AD PREF SYR 5-2.5-18.5 LF-MCG/0.5ML	$258.41	$331.29	—	66% above	22%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 HC PR RX TDAP VACCINE 7 YRS OR OLDER IM 0.5 ML	$654.42	$839.00	—	321% above	22%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 TET-DIPH-ACELL PERTUSS AD PREF SYR 5-2.5-18.5 LF-MCG/0.5ML	$258.41	$331.29	—	—	22%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 HC PR RX TDAP VACCINE 7 YRS OR OLDER IM 0.5 ML	$654.42	$839.00	—	—	22%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 HC ADMIN PNEUMOCOCCAL VACCINE CDM	$17.94	$23.00	—	79% below	22%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 HC ADMIN INFLUENZA VIRUS VAC CDM	$19.50	$25.00	—	77% below	22%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 HC IMMUNIZATION ADMIN CDM	$19.50	$25.00	—	77% below	22%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 HC ADMIN HEPATITIS B VACCINE CDM	$19.50	$25.00	—	77% below	22%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 HC PR ADMIN VACCINE INITIAL VFC CDM	$96.72	$124.00	—	16% above	22%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 HC PR ADMIN VACCINE INITIAL CDM	$96.72	$124.00	—	16% above	22%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 HC ADMIN PNEUMOCOCCAL VACCINE CDM	$17.94	$23.00	—	—	22%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 HC IMMUNIZATION ADMIN CDM	$19.50	$25.00	—	—	22%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 HC ADMIN HEPATITIS B VACCINE CDM	$19.50	$25.00	—	—	22%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 HC ADMIN INFLUENZA VIRUS VAC CDM	$19.50	$25.00	—	—	22%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 HC PR ADMIN VACCINE INITIAL CDM	$96.72	$124.00	—	—	22%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 HC PR ADMIN VACCINE INITIAL VFC CDM	$96.72	$124.00	—	—	22%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 HC IMMUNIZATION ADMIN EACH ADD CDM	$17.94	$23.00	—	65% below	22%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 HC PR ADMIN VACCINE EA ADDL VFC CDM	$96.72	$124.00	—	91% above	22%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 HC PR 90472 ADMIN VACCINE EA ADDL CDM	$96.72	$124.00	—	91% above	22%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 HC IMMUNIZATION ADMIN EACH ADD CDM	$17.94	$23.00	—	—	22%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 HC PR 90472 ADMIN VACCINE EA ADDL CDM	$96.72	$124.00	—	—	22%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 HC PR ADMIN VACCINE EA ADDL VFC CDM	$96.72	$124.00	—	—	22%

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://pricetransparency.providence.org/alaska/live/911784793_providence-kodiak-island-medical-center_standardcharges.json