Hospital

Blue Hill Memorial Hospital

Blue Hill Memorial Hospital in Blue Hill, ME publishes cash prices for 373 common procedures listed here, from its own machine-readable price file updated Mar 30, 2026. Compared with other hospitals in the state, its outpatient cash prices are below the Maine median for 345 of 372 procedures and above it for 18. By typical cash price it ranks #8 of 28 Maine hospitals, cheapest first. Select a procedure to compare it with other hospitals nearby.

57 Water St. Blue Hill, ME 04614 Collected Sep 23, 2026 Source price file Check a bill from this hospital (207) 374-2836

Critical access hospital (rural, 25 beds or fewer) Nonprofit hospital Emergency department CCN 201300 · CMS hospital register NPI 1023057809

Financial assistance

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

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

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

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

Scans and imaging

Procedure	Cash price	List price	Insurers pay	vs Maine	Off list
Abdominal CT scan without and with contrast CPT 74170 ABDOMEN W/ AND W/O CONTRAST	$668.96	$1,808.00	$813.60–$1,808.00	52% below	63%
Abdominal CT scan without and with contrast inpatient CPT 74170 ABDOMEN W/ AND W/O CONTRAST	$668.96	$1,808.00	$1,175.20–$1,808.00	—	63%
Abdominal X-ray, 2 views CPT 74019 ABDOMEN 2 VIEWS	$180.56	$488.00	$219.60–$488.00	26% below	63%
Abdominal X-ray, 2 views inpatient CPT 74019 ABDOMEN 2 VIEWS	$180.56	$488.00	$317.20–$488.00	—	63%
Ankle X-ray, complete, 3 or more views one side CPT 73610 ANKLE MIN 3 VIEWS LT	$157.62	$426.00	$191.70–$426.00	26% below	63%
Ankle X-ray, complete, 3 or more views one side CPT 73610 ANKLE MIN 3 VIEWS RT	$157.62	$426.00	$191.70–$426.00	26% below	63%
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 ANKLE MIN 3 VIEWS RT	$157.62	$426.00	$276.90–$426.00	—	63%
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 ANKLE MIN 3 VIEWS LT	$157.62	$426.00	$276.90–$426.00	—	63%
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 UPR/L XTREMITY ART 2 LEVELS F	$85.84	$232.00	$104.40–$232.00	41% below	63%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 UPR/L XTREMITY ART 2 LEVELS F	$85.84	$232.00	$150.80–$232.00	—	63%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 EXTREMITY UPPER LT	$472.86	$1,278.00	$575.10–$1,278.00	58% below	63%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 EXTREMITY UPPER RT	$472.86	$1,278.00	$575.10–$1,278.00	58% below	63%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 EXTREMITY UPPER RT	$472.86	$1,278.00	$830.70–$1,278.00	—	63%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 EXTREMITY UPPER LT	$472.86	$1,278.00	$830.70–$1,278.00	—	63%
Barium swallow (esophagus X-ray with contrast) CPT 74220 ESOPHAGUS	$303.77	$821.00	$369.45–$821.00	14% below	63%
Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 ESOPHAGUS	$303.77	$821.00	$533.65–$821.00	—	63%
Bone scan, whole body (nuclear medicine) CPT 78306 BONE SCAN	$664.89	$1,797.00	$808.65–$1,797.00	44% below	63%
Bone scan, whole body (nuclear medicine) inpatient CPT 78306 BONE SCAN	$664.89	$1,797.00	$1,168.05–$1,797.00	—	63%
Breast ultrasound, complete, one breast one side CPT 76641 BREAST SONOGRAM COMPLETE RT	$181.67	$491.00	$220.95–$491.00	10% below	63%
Breast ultrasound, complete, one breast one side CPT 76641 BREAST SONOGRAM COMPLETE LT	$181.67	$491.00	$220.95–$491.00	10% below	63%
Breast ultrasound, complete, one breast inpatient one side CPT 76641 BREAST SONOGRAM COMPLETE RT	$181.67	$491.00	$319.15–$491.00	—	63%
Breast ultrasound, complete, one breast inpatient one side CPT 76641 BREAST SONOGRAM COMPLETE LT	$181.67	$491.00	$319.15–$491.00	—	63%
Breast ultrasound, limited (one breast or one area) one side CPT 76642 BREAST SONOGRAM LIMITED LT	$150.22	$406.00	$182.70–$406.00	36% below	63%
Breast ultrasound, limited (one breast or one area) one side CPT 76642 BREAST SONOGRAM LIMITED RT	$150.22	$406.00	$182.70–$406.00	36% below	63%
Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 BREAST SONOGRAM LIMITED LT	$150.22	$406.00	$263.90–$406.00	—	63%
Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 BREAST SONOGRAM LIMITED RT	$150.22	$406.00	$263.90–$406.00	—	63%
CT angiography (CTA) of the abdomen and pelvis CPT 74174 CTA ANGIO ABD&PELV W/O&W/DYE	$1,250.97	$3,381.00	$1,521.45–$3,381.00	18% below	63%
CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174 CTA ANGIO ABD&PELV W/O&W/DYE	$1,250.97	$3,381.00	$2,197.65–$3,381.00	—	63%
CT angiography (CTA) of the head CPT 70496 CTA HEAD W & WO CONTRAST	$824.73	$2,229.00	$1,003.05–$2,229.00	47% below	63%
CT angiography (CTA) of the head inpatient CPT 70496 CTA HEAD W & WO CONTRAST	$824.73	$2,229.00	$1,448.85–$2,229.00	—	63%
CT angiography (CTA) of the neck CPT 70498 CTA NECK W & WO CONTRAST	$1,026.75	$2,775.00	$1,248.75–$2,775.00	35% below	63%
CT angiography (CTA) of the neck inpatient CPT 70498 CTA NECK W & WO CONTRAST	$1,026.75	$2,775.00	$1,803.75–$2,775.00	—	63%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CTA CHEST W & WO CONTRAST	$1,366.04	$3,692.00	$1,661.40–$3,692.00	26% below	63%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CTA CHEST W & WO CONTRAST	$1,366.04	$3,692.00	$2,399.80–$3,692.00	—	63%
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 CT ANGIO HRT W/3D IMAGE	$693.01	$1,873.00	$842.85–$1,873.00	32% above	63%
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score inpatient CPT 75574 CT ANGIO HRT W/3D IMAGE	$693.01	$1,873.00	$1,217.45–$1,873.00	—	63%
CT of the heart without contrast dye to measure coronary calcium CPT 75571 CT HRT W/O DYE W/CA TEST	$142.82	$386.00	$173.70–$386.00	9% above	63%
CT of the heart without contrast dye to measure coronary calcium inpatient CPT 75571 CT HRT W/O DYE W/CA TEST	$142.82	$386.00	$250.90–$386.00	—	63%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT ABD & PELVIS W/O CONTRAST	$1,336.07	$3,611.00	$1,624.95–$3,611.00	4% below	63%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT ABD & PELVIS W/O CONTRAST	$1,336.07	$3,611.00	$2,347.15–$3,611.00	—	63%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ABD/PEL WITH CONTRAST	$1,676.10	$4,530.00	$2,038.50–$4,530.00	16% below	63%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT ABD/PEL WITH CONTRAST	$1,676.10	$4,530.00	$2,944.50–$4,530.00	—	63%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT ABD/PELV 1+ SECTION/REGNS	$1,893.29	$5,117.00	$2,302.65–$5,117.00	14% below	63%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT ABD/PELV 1+ SECTION/REGNS	$1,893.29	$5,117.00	$3,326.05–$5,117.00	—	63%
CT scan of the abdomen with contrast CPT 74160 ABDOMEN WITH CONTRAST	$592.74	$1,602.00	$720.90–$1,602.00	47% below	63%
CT scan of the abdomen with contrast inpatient CPT 74160 ABDOMEN WITH CONTRAST	$592.74	$1,602.00	$1,041.30–$1,602.00	—	63%
CT scan of the abdomen without contrast CPT 74150 ABDOMEN W/O CONTRAST	$479.52	$1,296.00	$583.20–$1,296.00	43% below	63%
CT scan of the abdomen without contrast inpatient CPT 74150 ABDOMEN W/O CONTRAST	$479.52	$1,296.00	$842.40–$1,296.00	—	63%
CT scan of the face and sinuses, no contrast dye CPT 70486 MAXIOFACIAL W/O CONTRAST	$501.35	$1,355.00	$609.75–$1,355.00	43% below	63%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 MAXIOFACIAL W/O CONTRAST	$501.35	$1,355.00	$880.75–$1,355.00	—	63%
CT scan of the head or brain, no contrast dye CPT 70450 BRAIN	$634.18	$1,714.00	$771.30–$1,714.00	35% below	63%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 BRAIN	$634.18	$1,714.00	$1,114.10–$1,714.00	—	63%
CT scan of the head with contrast CPT 70460 BRAIN W/CONTRAST	$657.49	$1,777.00	$799.65–$1,777.00	38% below	63%
CT scan of the head with contrast inpatient CPT 70460 BRAIN W/CONTRAST	$657.49	$1,777.00	$1,155.05–$1,777.00	—	63%
CT scan of the head without and with contrast CPT 70470 BRAIN WITH & W/O CONTRAST	$785.51	$2,123.00	$955.35–$2,123.00	46% below	63%
CT scan of the head without and with contrast inpatient CPT 70470 BRAIN WITH & W/O CONTRAST	$785.51	$2,123.00	$1,379.95–$2,123.00	—	63%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 SPINE LUMBAR	$515.78	$1,394.00	$627.30–$1,394.00	47% below	63%
CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 SPINE LUMBAR	$515.78	$1,394.00	$906.10–$1,394.00	—	63%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 SPINE CERVICAL	$552.78	$1,494.00	$672.30–$1,494.00	44% below	63%
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 SPINE CERVICAL	$552.78	$1,494.00	$971.10–$1,494.00	—	63%
CT scan of the pelvis, with contrast dye CPT 72193 PELVIS W/CONTRAST	$661.56	$1,788.00	$804.60–$1,788.00	34% below	63%
CT scan of the pelvis, with contrast dye inpatient CPT 72193 PELVIS W/CONTRAST	$661.56	$1,788.00	$1,162.20–$1,788.00	—	63%
Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 CAROTID ARTERY SONOGRAM BILAT	$404.78	$1,094.00	$492.30–$1,094.00	—	63%
Carotid artery ultrasound (duplex), both sides of the neck inpatient both sides CPT 93880 CAROTID ARTERY SONOGRAM BILAT	$404.78	$1,094.00	$711.10–$1,094.00	—	63%
Chest CT scan without and with contrast CPT 71270 CHEST W/ AND W/O CONTRAST	$1,226.55	$3,315.00	$1,491.75–$3,315.00	28% below	63%
Chest CT scan without and with contrast inpatient CPT 71270 CHEST W/ AND W/O CONTRAST	$1,226.55	$3,315.00	$2,154.75–$3,315.00	—	63%
Chest X-ray, 2 views CPT 71046 CHEST 2 VIEWS	$172.79	$467.00	$210.15–$467.00	18% below	63%
Chest X-ray, 2 views inpatient CPT 71046 CHEST 2 VIEWS	$172.79	$467.00	$303.55–$467.00	—	63%
Chest X-ray, single view CPT 71045 CHEST SINGLE VIEW	$150.22	$406.00	$182.70–$406.00	25% below	63%
Chest X-ray, single view inpatient CPT 71045 CHEST SINGLE VIEW	$150.22	$406.00	$263.90–$406.00	—	63%
Collarbone (clavicle) X-ray, complete one side CPT 73000 CLAVICLE XRAY	$150.22	$406.00	$182.70–$406.00	32% below	63%
Collarbone (clavicle) X-ray, complete one side CPT 73000 CLAVICLE XRAY LT	$150.22	$406.00	$182.70–$406.00	32% below	63%
Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 CLAVICLE XRAY LT	$150.22	$406.00	$263.90–$406.00	—	63%
Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 CLAVICLE XRAY	$150.22	$406.00	$263.90–$406.00	—	63%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 ABD RETROPERITINEAL FULL	$284.90	$770.00	$346.50–$770.00	37% below	63%
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 ABD RETROPERITINEAL FULL	$284.90	$770.00	$500.50–$770.00	—	63%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 DXA BONE DENSITOMETRY AXIAL	$181.67	$491.00	$220.95–$491.00	28% below	63%
DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 DXA BONE DENSITOMETRY AXIAL	$181.67	$491.00	$319.15–$491.00	—	63%
DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 BONE DENSITOMETRY PIXIE	$99.53	$269.00	$121.05–$269.00	38% below	63%
DEXA bone density scan of the wrist, heel or finger (peripheral) inpatient CPT 77081 BONE DENSITOMETRY PIXIE	$99.53	$269.00	$174.85–$269.00	—	63%
Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 OB PREG COMPLETE	$305.62	$826.00	$371.70–$826.00	26% below	63%
Detailed fetal anatomy ultrasound, through the belly, one baby inpatient CPT 76811 OB PREG COMPLETE	$305.62	$826.00	$536.90–$826.00	—	63%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CHEST W/O CONTRAST	$661.93	$1,789.00	$805.05–$1,789.00	30% below	63%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CHEST W/O CONTRAST	$661.93	$1,789.00	$1,162.85–$1,789.00	—	63%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CHEST W/CONTRAST	$1,000.85	$2,705.00	$1,217.25–$2,705.00	22% below	63%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CHEST W/CONTRAST	$1,000.85	$2,705.00	$1,758.25–$2,705.00	—	63%
Diagnostic mammogram, both breasts CPT 77066 DX MAMMO INCL CAD BIL	$196.47	$531.00	$238.95–$531.00	at median	63%
Diagnostic mammogram, both breasts inpatient CPT 77066 DX MAMMO INCL CAD BIL	$196.47	$531.00	$345.15–$531.00	—	63%
Diagnostic mammogram, one breast one side CPT 77065 DX MAMMO INCL CAD UNI-LT	$115.81	$313.00	$140.85–$313.00	26% below	63%
Diagnostic mammogram, one breast one side CPT 77065 DX MAMMO INCL CAD UNI-RT	$115.81	$313.00	$140.85–$313.00	26% below	63%
Diagnostic mammogram, one breast inpatient one side CPT 77065 DX MAMMO INCL CAD UNI-LT	$115.81	$313.00	$203.45–$313.00	—	63%
Diagnostic mammogram, one breast inpatient one side CPT 77065 DX MAMMO INCL CAD UNI-RT	$115.81	$313.00	$203.45–$313.00	—	63%
Duplex ultrasound of the leg arteries, both legs CPT 93925 EXT ART LOWER COMPLETE	$404.78	$1,094.00	$492.30–$1,094.00	9% above	63%
Duplex ultrasound of the leg arteries, both legs inpatient CPT 93925 EXT ART LOWER COMPLETE	$404.78	$1,094.00	$711.10–$1,094.00	—	63%
Duplex ultrasound of the leg veins, both legs CPT 93970 EXT VEINS COMPLETE	$404.78	$1,094.00	$492.30–$1,094.00	21% below	63%
Duplex ultrasound of the leg veins, both legs inpatient CPT 93970 EXT VEINS COMPLETE	$404.78	$1,094.00	$711.10–$1,094.00	—	63%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 ECHO 2D WITH SPECT & COL DOPP	$910.94	$2,462.00	$1,107.90–$2,462.00	16% below	63%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 ECHO 2D WITH SPECT & COL DOPP	$910.94	$2,462.00	$1,600.30–$2,462.00	—	63%
Elbow X-ray, 2 views one side CPT 73070 ELBOW RT 2 VIEWS	$99.53	$269.00	$121.05–$269.00	54% below	63%
Elbow X-ray, 2 views one side CPT 73070 ELBOW LT 2 VIEWS	$99.53	$269.00	$121.05–$269.00	54% below	63%
Elbow X-ray, 2 views inpatient one side CPT 73070 ELBOW LT 2 VIEWS	$99.53	$269.00	$174.85–$269.00	—	63%
Elbow X-ray, 2 views inpatient one side CPT 73070 ELBOW RT 2 VIEWS	$99.53	$269.00	$174.85–$269.00	—	63%
Elbow X-ray, complete, 3 or more views one side CPT 73080 ELBOW MIN 3 VIEWS LT	$149.85	$405.00	$182.25–$405.00	32% below	63%
Elbow X-ray, complete, 3 or more views one side CPT 73080 ELBOW MIN 3 VIEWS RT	$149.85	$405.00	$182.25–$405.00	32% below	63%
Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 ELBOW MIN 3 VIEWS RT	$149.85	$405.00	$263.25–$405.00	—	63%
Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 ELBOW MIN 3 VIEWS LT	$149.85	$405.00	$263.25–$405.00	—	63%
Eye socket (orbit) CT scan without contrast CPT 70480 ORBIT EAR SELLA	$514.30	$1,390.00	$625.50–$1,390.00	48% below	63%
Eye socket (orbit) CT scan without contrast inpatient CPT 70480 ORBIT EAR SELLA	$514.30	$1,390.00	$903.50–$1,390.00	—	63%
Facial bones X-ray, complete, 3 or more views CPT 70150 FACIAL/ORBIT MIN 3 VIEWS	$155.40	$420.00	$189.00–$420.00	32% below	63%
Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 FACIAL/ORBIT MIN 3 VIEWS	$155.40	$420.00	$273.00–$420.00	—	63%
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 FOREARM LT 2 VIEWS	$150.22	$406.00	$182.70–$406.00	29% below	63%
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 FOREARM RT 2 VIEWS	$150.22	$406.00	$182.70–$406.00	29% below	63%
Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 FOREARM LT 2 VIEWS	$150.22	$406.00	$263.90–$406.00	—	63%
Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 FOREARM RT 2 VIEWS	$150.22	$406.00	$263.90–$406.00	—	63%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 HEPATOBILIARY SCAN	$681.17	$1,841.00	$828.45–$1,841.00	32% below	63%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 HEPATOBILIARY SCAN	$681.17	$1,841.00	$1,196.65–$1,841.00	—	63%
Hand X-ray, 2 views one side CPT 73120 HAND 2 VIEWS LT	$169.09	$457.00	$205.65–$457.00	20% below	63%
Hand X-ray, 2 views one side CPT 73120 HAND 2 VIEWS RT	$169.09	$457.00	$205.65–$457.00	20% below	63%
Hand X-ray, 2 views inpatient one side CPT 73120 HAND 2 VIEWS RT	$169.09	$457.00	$297.05–$457.00	—	63%
Hand X-ray, 2 views inpatient one side CPT 73120 HAND 2 VIEWS LT	$169.09	$457.00	$297.05–$457.00	—	63%
Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 HEEL MIN 2 VIEWS LT	$109.15	$295.00	$132.75–$295.00	48% below	63%
Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 HEEL MIN 2 VIEWS RT	$109.15	$295.00	$132.75–$295.00	48% below	63%
Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 HEEL MIN 2 VIEWS RT	$109.15	$295.00	$191.75–$295.00	—	63%
Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 HEEL MIN 2 VIEWS LT	$109.15	$295.00	$191.75–$295.00	—	63%
Knee X-ray, 3 views one side CPT 73562 KNEE MIN 3 VIEWS RT	$150.22	$406.00	$182.70–$406.00	34% below	63%
Knee X-ray, 3 views one side CPT 73562 KNEE MIN 3 VIEWS LT	$150.22	$406.00	$182.70–$406.00	34% below	63%
Knee X-ray, 3 views inpatient one side CPT 73562 KNEE MIN 3 VIEWS LT	$150.22	$406.00	$263.90–$406.00	—	63%
Knee X-ray, 3 views inpatient one side CPT 73562 KNEE MIN 3 VIEWS RT	$150.22	$406.00	$263.90–$406.00	—	63%
Knee X-ray, complete, 4 or more views one side CPT 73564 KNEE MIN 4 VIEWS RT	$181.67	$491.00	$220.95–$491.00	28% below	63%
Knee X-ray, complete, 4 or more views one side CPT 73564 KNEE MIN 4 VIEWS LT	$181.67	$491.00	$220.95–$491.00	28% below	63%
Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 KNEE MIN 4 VIEWS LT	$181.67	$491.00	$319.15–$491.00	—	63%
Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 KNEE MIN 4 VIEWS RT	$181.67	$491.00	$319.15–$491.00	—	63%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 EXTREMITY LOWER LT	$492.47	$1,331.00	$598.95–$1,331.00	53% below	63%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 EXTREMITY LOWER RT	$492.47	$1,331.00	$598.95–$1,331.00	53% below	63%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 EXTREMITY LOWER RT	$492.47	$1,331.00	$865.15–$1,331.00	—	63%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 EXTREMITY LOWER LT	$492.47	$1,331.00	$865.15–$1,331.00	—	63%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 HC POCUS GALLBLADDER	$247.53	$669.00	$301.05–$669.00	2% above	63%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 HC POCUS ABDOMEN	$247.53	$669.00	$301.05–$669.00	2% above	63%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 HC POCUS ABDOMEN	$247.53	$669.00	$434.85–$669.00	—	63%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 HC POCUS GALLBLADDER	$247.53	$669.00	$434.85–$669.00	—	63%
Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 HC POCUS MSK/SOFT TISSUE RT	$181.67	$491.00	$220.95–$491.00	9% above	63%
Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 US EXT NON-VASC LIMITED LT	$181.67	$491.00	$220.95–$491.00	9% above	63%
Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 US EXT NON-VASC LIMITED RT	$181.67	$491.00	$220.95–$491.00	9% above	63%
Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 HC POCUS MSK/SOFT TISSUE LT	$181.67	$491.00	$220.95–$491.00	9% above	63%
Limited ultrasound of an arm or leg (non-vascular) inpatient one side CPT 76882 HC POCUS MSK/SOFT TISSUE RT	$181.67	$491.00	$319.15–$491.00	—	63%
Limited ultrasound of an arm or leg (non-vascular) inpatient one side CPT 76882 US EXT NON-VASC LIMITED LT	$181.67	$491.00	$319.15–$491.00	—	63%
Limited ultrasound of an arm or leg (non-vascular) inpatient one side CPT 76882 US EXT NON-VASC LIMITED RT	$181.67	$491.00	$319.15–$491.00	—	63%
Limited ultrasound of an arm or leg (non-vascular) inpatient one side CPT 76882 HC POCUS MSK/SOFT TISSUE LT	$181.67	$491.00	$319.15–$491.00	—	63%
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 LDCT FOR LUNG CA SCREEN	$181.67	$491.00	$220.95–$491.00	20% below	63%
Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 LDCT FOR LUNG CA SCREEN	$181.67	$491.00	$319.15–$491.00	—	63%
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 LEG RT 2 VIEWS	$150.22	$406.00	$182.70–$406.00	30% below	63%
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 LEG LT 2 VIEWS	$150.22	$406.00	$182.70–$406.00	30% below	63%
Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 LEG RT 2 VIEWS	$150.22	$406.00	$263.90–$406.00	—	63%
Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 LEG LT 2 VIEWS	$150.22	$406.00	$263.90–$406.00	—	63%
MR angiography (MRA) of the head without contrast CPT 70544 MRA HEAD W/O CONTRAST	$715.21	$1,933.00	$869.85–$1,933.00	59% below	63%
MR angiography (MRA) of the head without contrast inpatient CPT 70544 MRA HEAD W/O CONTRAST	$715.21	$1,933.00	$1,256.45–$1,933.00	—	63%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI HIP W/O CONTRAST RT	$715.21	$1,933.00	$869.85–$1,933.00	52% below	63%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI KNEE W/O CONTRAST RT	$715.21	$1,933.00	$869.85–$1,933.00	52% below	63%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI KNEE W/O CONTR LIMITED LT	$715.21	$1,933.00	$869.85–$1,933.00	52% below	63%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI ANKLE W/O CONTRAST LT	$715.21	$1,933.00	$869.85–$1,933.00	52% below	63%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI ANKLE W/O CONTRAST RT	$715.21	$1,933.00	$869.85–$1,933.00	52% below	63%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI KNEE W/O CONTR LIMITED RT	$715.21	$1,933.00	$869.85–$1,933.00	52% below	63%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI KNEE W/O CONTRAST LT	$715.21	$1,933.00	$869.85–$1,933.00	52% below	63%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI HIP W/O CONTRAST LT	$715.21	$1,933.00	$869.85–$1,933.00	52% below	63%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI KNEE W/O CONTRAST LT	$715.21	$1,933.00	$1,256.45–$1,933.00	—	63%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI ANKLE W/O CONTRAST LT	$715.21	$1,933.00	$1,256.45–$1,933.00	—	63%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI KNEE W/O CONTRAST RT	$715.21	$1,933.00	$1,256.45–$1,933.00	—	63%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI KNEE W/O CONTR LIMITED RT	$715.21	$1,933.00	$1,256.45–$1,933.00	—	63%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI KNEE W/O CONTR LIMITED LT	$715.21	$1,933.00	$1,256.45–$1,933.00	—	63%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI HIP W/O CONTRAST RT	$715.21	$1,933.00	$1,256.45–$1,933.00	—	63%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI HIP W/O CONTRAST LT	$715.21	$1,933.00	$1,256.45–$1,933.00	—	63%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI ANKLE W/O CONTRAST RT	$715.21	$1,933.00	$1,256.45–$1,933.00	—	63%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI KNEE W & W/O CONTRAST LT	$1,212.49	$3,277.00	$1,474.65–$3,277.00	53% below	63%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI ANKLE W&W/O CONTRAST LT	$1,212.49	$3,277.00	$1,474.65–$3,277.00	53% below	63%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI ANKLE W&W/O CONTRAST RT	$1,212.49	$3,277.00	$1,474.65–$3,277.00	53% below	63%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI KNEE W & W/O CONTRAST RT	$1,212.49	$3,277.00	$1,474.65–$3,277.00	53% below	63%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI HIP W & W/O CONTRAST LT	$1,212.49	$3,277.00	$1,474.65–$3,277.00	53% below	63%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI HIP W & W/O CONTRAST RT	$1,212.49	$3,277.00	$1,474.65–$3,277.00	53% below	63%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI ANKLE W&W/O CONTRAST LT	$1,212.49	$3,277.00	$2,130.05–$3,277.00	—	63%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI KNEE W & W/O CONTRAST RT	$1,212.49	$3,277.00	$2,130.05–$3,277.00	—	63%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI KNEE W & W/O CONTRAST LT	$1,212.49	$3,277.00	$2,130.05–$3,277.00	—	63%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI HIP W & W/O CONTRAST RT	$1,212.49	$3,277.00	$2,130.05–$3,277.00	—	63%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI HIP W & W/O CONTRAST LT	$1,212.49	$3,277.00	$2,130.05–$3,277.00	—	63%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI ANKLE W&W/O CONTRAST RT	$1,212.49	$3,277.00	$2,130.05–$3,277.00	—	63%
MRI of the abdomen without contrast CPT 74181 ABDOMEN	$715.21	$1,933.00	$869.85–$1,933.00	59% below	63%
MRI of the abdomen without contrast inpatient CPT 74181 ABDOMEN	$715.21	$1,933.00	$1,256.45–$1,933.00	—	63%
MRI of the abdomen, without and then with contrast dye CPT 74183 ABDOMEN W/WO CONTRAST	$909.09	$2,457.00	$1,105.65–$2,457.00	58% below	63%
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 ABDOMEN W/WO CONTRAST	$909.09	$2,457.00	$1,597.05–$2,457.00	—	63%
MRI of the brain, no contrast dye CPT 70551 HEAD	$715.21	$1,933.00	$869.85–$1,933.00	50% below	63%
MRI of the brain, no contrast dye inpatient CPT 70551 HEAD	$715.21	$1,933.00	$1,256.45–$1,933.00	—	63%
MRI of the brain, with and without contrast dye CPT 70553 HEAD W/WO CONTRAST	$908.72	$2,456.00	$1,105.20–$2,456.00	59% below	63%
MRI of the brain, with and without contrast dye inpatient CPT 70553 HEAD W/WO CONTRAST	$908.72	$2,456.00	$1,596.40–$2,456.00	—	63%
MRI of the lower back, no contrast dye CPT 72148 LUMBAR SPINE	$684.13	$1,849.00	$832.05–$1,849.00	52% below	63%
MRI of the lower back, no contrast dye inpatient CPT 72148 LUMBAR SPINE	$684.13	$1,849.00	$1,201.85–$1,849.00	—	63%
MRI of the lower back, without and then with contrast dye CPT 72158 LUMBAR SPINE W/WO CONT	$909.09	$2,457.00	$1,105.65–$2,457.00	61% below	63%
MRI of the lower back, without and then with contrast dye inpatient CPT 72158 LUMBAR SPINE W/WO CONT	$909.09	$2,457.00	$1,597.05–$2,457.00	—	63%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 THORACIC SPINE	$715.21	$1,933.00	$869.85–$1,933.00	50% below	63%
MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 THORACIC SPINE	$715.21	$1,933.00	$1,256.45–$1,933.00	—	63%
MRI of the neck (cervical spine) without and with contrast CPT 72156 CERVICAL SPINE W/WO CONT	$909.09	$2,457.00	$1,105.65–$2,457.00	56% below	63%
MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 CERVICAL SPINE W/WO CONT	$909.09	$2,457.00	$1,597.05–$2,457.00	—	63%
MRI of the neck (cervical spine), no contrast dye CPT 72141 CERVICAL SPINE	$692.64	$1,872.00	$842.40–$1,872.00	51% below	63%
MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 CERVICAL SPINE	$692.64	$1,872.00	$1,216.80–$1,872.00	—	63%
MRI of the pelvis without and with contrast CPT 72197 PELVIS W/WO CONTRAST	$1,086.69	$2,937.00	$1,321.65–$2,937.00	53% below	63%
MRI of the pelvis without and with contrast inpatient CPT 72197 PELVIS W/WO CONTRAST	$1,086.69	$2,937.00	$1,909.05–$2,937.00	—	63%
MRI of the pelvis, no contrast dye CPT 72195 PELVIS	$715.21	$1,933.00	$869.85–$1,933.00	54% below	63%
MRI of the pelvis, no contrast dye inpatient CPT 72195 PELVIS	$715.21	$1,933.00	$1,256.45–$1,933.00	—	63%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI WRIST W/O CONTRAST LT	$715.21	$1,933.00	$869.85–$1,933.00	52% below	63%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI WRIST W/O CONTRAST RT	$715.21	$1,933.00	$869.85–$1,933.00	52% below	63%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI SHOULDER W/O CONTRAST RT	$715.21	$1,933.00	$869.85–$1,933.00	52% below	63%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI SHOULDER W/O CONTRAST LT	$715.21	$1,933.00	$869.85–$1,933.00	52% below	63%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI ELBOW W/O CONTRAST RT	$715.21	$1,933.00	$869.85–$1,933.00	52% below	63%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI ELBOW W/O CONTRAST LT	$715.21	$1,933.00	$869.85–$1,933.00	52% below	63%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI ELBOW W/O CONTRAST RT	$715.21	$1,933.00	$1,256.45–$1,933.00	—	63%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI ELBOW W/O CONTRAST LT	$715.21	$1,933.00	$1,256.45–$1,933.00	—	63%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI SHOULDER W/O CONTRAST LT	$715.21	$1,933.00	$1,256.45–$1,933.00	—	63%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI SHOULDER W/O CONTRAST RT	$715.21	$1,933.00	$1,256.45–$1,933.00	—	63%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI WRIST W/O CONTRAST LT	$715.21	$1,933.00	$1,256.45–$1,933.00	—	63%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI WRIST W/O CONTRAST RT	$715.21	$1,933.00	$1,256.45–$1,933.00	—	63%
Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 X-RAY EXAM NECK SPINE 4/5VWS	$181.67	$491.00	$220.95–$491.00	38% below	63%
Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 X-RAY EXAM NECK SPINE 4/5VWS	$181.67	$491.00	$319.15–$491.00	—	63%
Neck soft tissue CT scan with contrast CPT 70491 NECK W/CONTRAST	$637.88	$1,724.00	$775.80–$1,724.00	50% below	63%
Neck soft tissue CT scan with contrast inpatient CPT 70491 NECK W/CONTRAST	$637.88	$1,724.00	$1,120.60–$1,724.00	—	63%
Neck soft tissue CT scan without contrast CPT 70490 NECK	$450.66	$1,218.00	$548.10–$1,218.00	55% below	63%
Neck soft tissue CT scan without contrast inpatient CPT 70490 NECK	$450.66	$1,218.00	$791.70–$1,218.00	—	63%
Neck soft tissue X-ray CPT 70360 NASOPHARYNX/NECK SOFT TISSUE	$147.63	$399.00	$179.55–$399.00	30% below	63%
Neck soft tissue X-ray inpatient CPT 70360 NASOPHARYNX/NECK SOFT TISSUE	$147.63	$399.00	$259.35–$399.00	—	63%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 TREADMILL STRESS TEST (MIBI)	$1,889.96	$5,108.00	$2,298.60–$5,108.00	8% below	63%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 LEXISCAN NUCLEAR STRESS TEST	$1,889.96	$5,108.00	$2,298.60–$5,108.00	8% below	63%
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 TREADMILL STRESS TEST (MIBI)	$1,889.96	$5,108.00	$3,320.20–$5,108.00	—	63%
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 LEXISCAN NUCLEAR STRESS TEST	$1,889.96	$5,108.00	$3,320.20–$5,108.00	—	63%
Pelvic CT scan without contrast CPT 72192 PELVIS	$505.42	$1,366.00	$614.70–$1,366.00	47% below	63%
Pelvic CT scan without contrast CPT 72192 LIMITED PELVIS POST REDUCTI	$505.42	$1,366.00	$614.70–$1,366.00	47% below	63%
Pelvic CT scan without contrast inpatient CPT 72192 PELVIS	$505.42	$1,366.00	$887.90–$1,366.00	—	63%
Pelvic CT scan without contrast inpatient CPT 72192 LIMITED PELVIS POST REDUCTI	$505.42	$1,366.00	$887.90–$1,366.00	—	63%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 HC POCUS POST VOID RESID BLADR	$153.55	$415.00	$186.75–$415.00	12% below	63%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 HC POCUS POST VOID RESID BLADR	$153.55	$415.00	$269.75–$415.00	—	63%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 PELVIC SONOGRAM	$253.82	$686.00	$308.70–$686.00	36% below	63%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 U/S PELVIC NON OB LIM F	$253.82	$686.00	$308.70–$686.00	36% below	63%
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 PELVIC SONOGRAM	$253.82	$686.00	$445.90–$686.00	—	63%
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 U/S PELVIC NON OB LIM F	$253.82	$686.00	$445.90–$686.00	—	63%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 OB US >/= 14 WKS SNGL FETUS F	$269.73	$729.00	$328.05–$729.00	39% below	63%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 OBSTETRICAL ULTRASOUND	$269.73	$729.00	$328.05–$729.00	39% below	63%
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 OB US >/= 14 WKS SNGL FETUS F	$269.73	$729.00	$473.85–$729.00	—	63%
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 OBSTETRICAL ULTRASOUND	$269.73	$729.00	$473.85–$729.00	—	63%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 PREG<14WKS TRANSABDOMINAL	$191.29	$517.00	$232.65–$517.00	38% below	63%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 U/S OB FIRST TRIMESTER F	$191.29	$517.00	$232.65–$517.00	38% below	63%
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 PREG<14WKS TRANSABDOMINAL	$191.29	$517.00	$336.05–$517.00	—	63%
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 U/S OB FIRST TRIMESTER F	$191.29	$517.00	$336.05–$517.00	—	63%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 HC POCUS PREGNANT TRANSABDOM	$165.02	$446.00	$200.70–$446.00	14% below	63%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 HC POCUS PREGNANT TRANSABDOM	$165.02	$446.00	$289.90–$446.00	—	63%
Rib X-ray, one side, 2 views one side CPT 71100 RIBS 2 VIEWS LT	$150.22	$406.00	$182.70–$406.00	35% below	63%
Rib X-ray, one side, 2 views one side CPT 71100 RIBS 2 VIEWS RT	$150.22	$406.00	$182.70–$406.00	35% below	63%
Rib X-ray, one side, 2 views inpatient one side CPT 71100 RIBS 2 VIEWS RT	$150.22	$406.00	$263.90–$406.00	—	63%
Rib X-ray, one side, 2 views inpatient one side CPT 71100 RIBS 2 VIEWS LT	$150.22	$406.00	$263.90–$406.00	—	63%
Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 RIBS W/CHEST MIN 3 V RT	$181.67	$491.00	$220.95–$491.00	45% below	63%
Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 RIBS W/CHEST MIN 3 V LT	$181.67	$491.00	$220.95–$491.00	45% below	63%
Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 RIBS W/CHEST MIN 3 V LT	$181.67	$491.00	$319.15–$491.00	—	63%
Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 RIBS W/CHEST MIN 3 V RT	$181.67	$491.00	$319.15–$491.00	—	63%
Screening mammogram, both breasts CPT 77067 SCR MAMMO INCL CAD BIL	$176.86	$478.00	$215.10–$478.00	5% above	63%
Screening mammogram, both breasts inpatient CPT 77067 SCR MAMMO INCL CAD BIL	$176.86	$478.00	$310.70–$478.00	—	63%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 SHOULDER XRAY MIN 2 VIEWS RT	$155.03	$419.00	$188.55–$419.00	32% below	63%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 SHOULDER XRAY MIN 2 VIEWS LT	$155.03	$419.00	$188.55–$419.00	32% below	63%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 SHOULDER XRAY MIN 2 VIEWS RT	$155.03	$419.00	$272.35–$419.00	—	63%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 SHOULDER XRAY MIN 2 VIEWS LT	$155.03	$419.00	$272.35–$419.00	—	63%
Sinus X-ray, complete, 3 or more views CPT 70220 SINUSES MIN 3 VIEWS	$135.05	$365.00	$164.25–$365.00	41% below	63%
Sinus X-ray, complete, 3 or more views inpatient CPT 70220 SINUSES MIN 3 VIEWS	$135.05	$365.00	$237.25–$365.00	—	63%
Skull X-ray, fewer than 4 views CPT 70250 SKULL < 4 VIEWS	$116.55	$315.00	$141.75–$315.00	46% below	63%
Skull X-ray, fewer than 4 views inpatient CPT 70250 SKULL < 4 VIEWS	$116.55	$315.00	$204.75–$315.00	—	63%
Swallow study (modified barium swallow, video X-ray) CPT 74230 ESOPHAGUS WITH VIDEO	$268.25	$725.00	$326.25–$725.00	39% below	63%
Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 ESOPHAGUS WITH VIDEO	$268.25	$725.00	$471.25–$725.00	—	63%
Thigh bone (femur) X-ray, 2 or more views CPT 73552 X-RAY EXAM OF FEMUR 2/>	$150.22	$406.00	$182.70–$406.00	29% below	63%
Thigh bone (femur) X-ray, 2 or more views inpatient CPT 73552 X-RAY EXAM OF FEMUR 2/>	$150.22	$406.00	$263.90–$406.00	—	63%
Thoracic spine (mid back) CT scan without contrast CPT 72128 SPINE THORACIC	$505.05	$1,365.00	$614.25–$1,365.00	52% below	63%
Thoracic spine (mid back) CT scan without contrast inpatient CPT 72128 SPINE THORACIC	$505.05	$1,365.00	$887.25–$1,365.00	—	63%
Toe X-ray, 2 or more views one side CPT 73660 TOE 2/4 VIEWS RT	$133.20	$360.00	$162.00–$360.00	26% below	63%
Toe X-ray, 2 or more views one side CPT 73660 TOE 2/4 VIEWS LT	$133.20	$360.00	$162.00–$360.00	26% below	63%
Toe X-ray, 2 or more views inpatient one side CPT 73660 TOE 2/4 VIEWS RT	$133.20	$360.00	$234.00–$360.00	—	63%
Toe X-ray, 2 or more views inpatient one side CPT 73660 TOE 2/4 VIEWS LT	$133.20	$360.00	$234.00–$360.00	—	63%
Transvaginal pelvic ultrasound CPT 76830 HC POCUS NON-PREGNANT TRANSVAG	$210.53	$569.00	$256.05–$569.00	44% below	63%
Transvaginal pelvic ultrasound inpatient CPT 76830 HC POCUS NON-PREGNANT TRANSVAG	$210.53	$569.00	$369.85–$569.00	—	63%
Transvaginal ultrasound during pregnancy CPT 76817 HC POCUS PREGNANT TRANSVAGINAL	$181.67	$491.00	$220.95–$491.00	41% below	63%
Transvaginal ultrasound during pregnancy inpatient CPT 76817 HC POCUS PREGNANT TRANSVAGINAL	$181.67	$491.00	$319.15–$491.00	—	63%
Ultrasound of the abdomen, complete CPT 76700 ABDOMINAL SONOGRAM	$297.11	$803.00	$361.35–$803.00	37% below	63%
Ultrasound of the abdomen, complete inpatient CPT 76700 ABDOMINAL SONOGRAM	$297.11	$803.00	$521.95–$803.00	—	63%
Ultrasound of the scrotum and testicles CPT 76870 TESTICULAR SONOGRAM	$250.12	$676.00	$304.20–$676.00	46% below	63%
Ultrasound of the scrotum and testicles inpatient CPT 76870 TESTICULAR SONOGRAM	$250.12	$676.00	$439.40–$676.00	—	63%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 NECK/HEAD SONOGRAM	$220.52	$596.00	$268.20–$596.00	45% below	63%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 NECK/HEAD SONOGRAM	$220.52	$596.00	$387.40–$596.00	—	63%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 GI SERIES W/O KUB	$303.77	$821.00	$369.45–$821.00	31% below	63%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 GI SERIES W/O KUB	$303.77	$821.00	$533.65–$821.00	—	63%
Upper arm X-ray (humerus), 2 views one side CPT 73060 HUMERUS MIN 2 VIEWS LT	$150.22	$406.00	$182.70–$406.00	28% below	63%
Upper arm X-ray (humerus), 2 views one side CPT 73060 HUMERUS MIN 2 VIEWS RT	$150.22	$406.00	$182.70–$406.00	28% below	63%
Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 HUMERUS MIN 2 VIEWS RT	$150.22	$406.00	$263.90–$406.00	—	63%
Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 HUMERUS MIN 2 VIEWS LT	$150.22	$406.00	$263.90–$406.00	—	63%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 HC POCUS FOCUSED DVT STUDY LT	$273.80	$740.00	$333.00–$740.00	45% below	63%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 EXT VEINS UNILAT LT	$273.80	$740.00	$333.00–$740.00	45% below	63%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 EXT VEINS UNILAT RT	$273.80	$740.00	$333.00–$740.00	45% below	63%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 HC POCUS FOCUSED DVT STUDY RT	$273.80	$740.00	$333.00–$740.00	45% below	63%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 HC POCUS FOCUSED DVT STUDY RT	$273.80	$740.00	$481.00–$740.00	—	63%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 EXT VEINS UNILAT RT	$273.80	$740.00	$481.00–$740.00	—	63%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 HC POCUS FOCUSED DVT STUDY LT	$273.80	$740.00	$481.00–$740.00	—	63%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 EXT VEINS UNILAT LT	$273.80	$740.00	$481.00–$740.00	—	63%
Wrist X-ray, 2 views one side CPT 73100 WRIST LT 2 VIEWS	$146.15	$395.00	$177.75–$395.00	36% below	63%
Wrist X-ray, 2 views one side CPT 73100 WRIST RT 2 VIEWS	$146.15	$395.00	$177.75–$395.00	36% below	63%
Wrist X-ray, 2 views inpatient one side CPT 73100 WRIST RT 2 VIEWS	$146.15	$395.00	$256.75–$395.00	—	63%
Wrist X-ray, 2 views inpatient one side CPT 73100 WRIST LT 2 VIEWS	$146.15	$395.00	$256.75–$395.00	—	63%
Wrist X-ray, complete, 3 or more views one side CPT 73110 WRIST MIN 3 VIEWS RT	$150.22	$406.00	$182.70–$406.00	32% below	63%
Wrist X-ray, complete, 3 or more views one side CPT 73110 WRIST MIN 3 VIEWS LT	$150.22	$406.00	$182.70–$406.00	32% below	63%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 WRIST MIN 3 VIEWS LT	$150.22	$406.00	$263.90–$406.00	—	63%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 WRIST MIN 3 VIEWS RT	$150.22	$406.00	$263.90–$406.00	—	63%
X-ray of one hip, 2 or 3 views, with the pelvis when included CPT 73502 X-RAY EXAM HIP UNI 2-3 VIEWS	$150.22	$406.00	$182.70–$406.00	26% below	63%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient CPT 73502 X-RAY EXAM HIP UNI 2-3 VIEWS	$150.22	$406.00	$263.90–$406.00	—	63%
X-ray of the abdomen, 1 view CPT 74018 ABDOMEN SINGLE VIEW	$149.85	$405.00	$182.25–$405.00	29% below	63%
X-ray of the abdomen, 1 view inpatient CPT 74018 ABDOMEN SINGLE VIEW	$149.85	$405.00	$263.25–$405.00	—	63%
X-ray of the ankle, 2 views one side CPT 73600 ANKLE RT 2 VIEWS	$150.22	$406.00	$182.70–$406.00	28% below	63%
X-ray of the ankle, 2 views one side CPT 73600 ANKLE LT 2 VIEWS	$150.22	$406.00	$182.70–$406.00	28% below	63%
X-ray of the ankle, 2 views inpatient one side CPT 73600 ANKLE LT 2 VIEWS	$150.22	$406.00	$263.90–$406.00	—	63%
X-ray of the ankle, 2 views inpatient one side CPT 73600 ANKLE RT 2 VIEWS	$150.22	$406.00	$263.90–$406.00	—	63%
X-ray of the finger(s), 2 or more views one side CPT 73140 FINGER MIN 2 VIEWS RT	$139.49	$377.00	$169.65–$377.00	29% below	63%
X-ray of the finger(s), 2 or more views one side CPT 73140 FINGER MIN 2 VIEWS LT	$139.49	$377.00	$169.65–$377.00	29% below	63%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 FINGER MIN 2 VIEWS LT	$139.49	$377.00	$245.05–$377.00	—	63%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 FINGER MIN 2 VIEWS RT	$139.49	$377.00	$245.05–$377.00	—	63%
X-ray of the foot, 2 views one side CPT 73620 FOOT RT 2 VIEWS	$150.22	$406.00	$182.70–$406.00	26% below	63%
X-ray of the foot, 2 views one side CPT 73620 FOOT LT 2 VIEWS	$150.22	$406.00	$182.70–$406.00	26% below	63%
X-ray of the foot, 2 views inpatient one side CPT 73620 FOOT RT 2 VIEWS	$150.22	$406.00	$263.90–$406.00	—	63%
X-ray of the foot, 2 views inpatient one side CPT 73620 FOOT LT 2 VIEWS	$150.22	$406.00	$263.90–$406.00	—	63%
X-ray of the foot, complete, 3 or more views one side CPT 73630 FOOT MIN 3 VIEWS RT	$157.62	$426.00	$191.70–$426.00	26% below	63%
X-ray of the foot, complete, 3 or more views one side CPT 73630 FOOT MIN 3 VIEWS LT	$157.62	$426.00	$191.70–$426.00	26% below	63%
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 FOOT MIN 3 VIEWS LT	$157.62	$426.00	$276.90–$426.00	—	63%
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 FOOT MIN 3 VIEWS RT	$157.62	$426.00	$276.90–$426.00	—	63%
X-ray of the hand, 3 or more views one side CPT 73130 HAND MIN 3 VIEWS LT	$177.60	$480.00	$216.00–$480.00	19% below	63%
X-ray of the hand, 3 or more views one side CPT 73130 HAND MIN 3 VIEWS RT	$177.60	$480.00	$216.00–$480.00	19% below	63%
X-ray of the hand, 3 or more views inpatient one side CPT 73130 HAND MIN 3 VIEWS RT	$177.60	$480.00	$312.00–$480.00	—	63%
X-ray of the hand, 3 or more views inpatient one side CPT 73130 HAND MIN 3 VIEWS LT	$177.60	$480.00	$312.00–$480.00	—	63%
X-ray of the knee, 1 or 2 views one side CPT 73560 KNEE 1-2 VIEWS RT	$145.41	$393.00	$176.85–$393.00	34% below	63%
X-ray of the knee, 1 or 2 views one side CPT 73560 KNEE 1-2 VIEWS LT	$145.41	$393.00	$176.85–$393.00	34% below	63%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 KNEE 1-2 VIEWS RT	$145.41	$393.00	$255.45–$393.00	—	63%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 KNEE 1-2 VIEWS LT	$145.41	$393.00	$255.45–$393.00	—	63%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 LUMBAR SPINE 2 VIEWS	$181.67	$491.00	$220.95–$491.00	26% below	63%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 LUMBAR SPINE 2 VIEWS	$181.67	$491.00	$319.15–$491.00	—	63%
X-ray of the lower back, 4 or more views CPT 72110 LUMBAR SPINE MIN 4 VIEWS	$209.42	$566.00	$254.70–$566.00	35% below	63%
X-ray of the lower back, 4 or more views inpatient CPT 72110 LUMBAR SPINE MIN 4 VIEWS	$209.42	$566.00	$367.90–$566.00	—	63%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 THORACIC SPINE 2 VIEWS	$181.67	$491.00	$220.95–$491.00	20% below	63%
X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 THORACIC SPINE 2 VIEWS	$181.67	$491.00	$319.15–$491.00	—	63%
X-ray of the nasal bones, 3 or more views CPT 70160 NASAL BONE MIN 3 VIEWS	$150.22	$406.00	$182.70–$406.00	34% below	63%
X-ray of the nasal bones, 3 or more views inpatient CPT 70160 NASAL BONE MIN 3 VIEWS	$150.22	$406.00	$263.90–$406.00	—	63%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 X-RAY EXAM NECK SPINE 3/<VWS<	$150.22	$406.00	$182.70–$406.00	29% below	63%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 X-RAY EXAM NECK SPINE 3/<VWS<	$150.22	$406.00	$263.90–$406.00	—	63%
X-ray of the pelvis, 1 or 2 views CPT 72170 PELVIS 1 OR 2 VIEWS	$106.56	$288.00	$129.60–$288.00	50% below	63%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 PELVIS 1 OR 2 VIEWS	$106.56	$288.00	$187.20–$288.00	—	63%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 SACRUM / CCOCYX	$150.22	$406.00	$182.70–$406.00	34% below	63%
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 SACRUM / CCOCYX	$150.22	$406.00	$263.90–$406.00	—	63%

Lab tests

Procedure	Cash price	List price	Insurers pay	vs Maine	Off list
ACTH blood test CPT 82024 ACTH/LAB	$120.62	$326.00	$146.70–$326.00	25% below	63%
ACTH blood test inpatient CPT 82024 ACTH/LAB	$120.62	$326.00	$211.90–$326.00	—	63%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 ALANINE AMINOTRANSFERASE-Q	$25.16	$68.00	$30.60–$68.00	25% below	63%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 SGPT (ALT)	$26.27	$71.00	$31.95–$71.00	22% below	63%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 ALANINE AMINO (ALT) (SGPT)	$26.27	$71.00	$31.95–$71.00	22% below	63%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 ALANINE AMINO ALT (SGPT)	$26.27	$71.00	$31.95–$71.00	22% below	63%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 ALANINE AMINOTRANSFERASE-Q	$25.16	$68.00	$44.20–$68.00	—	63%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 ALANINE AMINO (ALT) (SGPT)	$26.27	$71.00	$46.15–$71.00	—	63%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 SGPT (ALT)	$26.27	$71.00	$46.15–$71.00	—	63%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 ALANINE AMINO ALT (SGPT)	$26.27	$71.00	$46.15–$71.00	—	63%
AST (aspartate aminotransferase) enzyme test CPT 84450 ASPARTATE AMINOTRANSFERASE-Q	$21.46	$58.00	$26.10–$58.00	30% below	63%
AST (aspartate aminotransferase) enzyme test CPT 84450 TRANSFERASE AST (SGOT)	$22.57	$61.00	$27.45–$61.00	27% below	63%
AST (aspartate aminotransferase) enzyme test CPT 84450 SGOT (AST)	$22.57	$61.00	$27.45–$61.00	27% below	63%
AST (aspartate aminotransferase) enzyme test CPT 84450 TRANSFERASE (AST) (SGOT)	$22.57	$61.00	$27.45–$61.00	27% below	63%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 ASPARTATE AMINOTRANSFERASE-Q	$21.46	$58.00	$37.70–$58.00	—	63%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 TRANSFERASE (AST) (SGOT)	$22.57	$61.00	$39.65–$61.00	—	63%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 TRANSFERASE AST (SGOT)	$22.57	$61.00	$39.65–$61.00	—	63%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 SGOT (AST)	$22.57	$61.00	$39.65–$61.00	—	63%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 ACUTE HEPATITIS PANEL	$111.37	$301.00	$135.45–$301.00	31% below	63%
Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 ACUTE HEPATITIS PANEL	$111.37	$301.00	$195.65–$301.00	—	63%
Albumin blood test CPT 82040 ALBUMIN LEVEL-Q	$22.94	$62.00	$27.90–$62.00	at median	63%
Albumin blood test CPT 82040 ALBUMIN SERUM	$24.05	$65.00	$29.25–$65.00	5% above	63%
Albumin blood test CPT 82040 ALBUMIN W/PROFILE	$24.05	$65.00	$29.25–$65.00	5% above	63%
Albumin blood test inpatient CPT 82040 ALBUMIN LEVEL-Q	$22.94	$62.00	$40.30–$62.00	—	63%
Albumin blood test inpatient CPT 82040 ALBUMIN W/PROFILE	$24.05	$65.00	$42.25–$65.00	—	63%
Albumin blood test inpatient CPT 82040 ALBUMIN SERUM	$24.05	$65.00	$42.25–$65.00	—	63%
Aldosterone blood test CPT 82088 ALDOSTERONE URINE	$69.56	$188.00	$84.60–$188.00	55% below	63%
Aldosterone blood test CPT 82088 ALDOSTERONE/LAB	$69.56	$188.00	$84.60–$188.00	55% below	63%
Aldosterone blood test inpatient CPT 82088 ALDOSTERONE URINE	$69.56	$188.00	$122.20–$188.00	—	63%
Aldosterone blood test inpatient CPT 82088 ALDOSTERONE/LAB	$69.56	$188.00	$122.20–$188.00	—	63%
Alkaline phosphatase (ALP) blood test CPT 84075 ALKALINE PHOSPHATASE-Q	$18.13	$49.00	$22.05–$49.00	34% below	63%
Alkaline phosphatase (ALP) blood test CPT 84075 BONE SPECIFIC ALKALINE PHOS	$18.87	$51.00	$22.95–$51.00	31% below	63%
Alkaline phosphatase (ALP) blood test CPT 84075 ALKALINE PHOSPHATASE	$18.87	$51.00	$22.95–$51.00	31% below	63%
Alkaline phosphatase (ALP) blood test CPT 84075 ALK PHOS ISOTOTAL	$18.87	$51.00	$22.95–$51.00	31% below	63%
Alkaline phosphatase (ALP) blood test inpatient CPT 84075 ALKALINE PHOSPHATASE-Q	$18.13	$49.00	$31.85–$49.00	—	63%
Alkaline phosphatase (ALP) blood test inpatient CPT 84075 ALKALINE PHOSPHATASE	$18.87	$51.00	$33.15–$51.00	—	63%
Alkaline phosphatase (ALP) blood test inpatient CPT 84075 ALK PHOS ISOTOTAL	$18.87	$51.00	$33.15–$51.00	—	63%
Alkaline phosphatase (ALP) blood test inpatient CPT 84075 BONE SPECIFIC ALKALINE PHOS	$18.87	$51.00	$33.15–$51.00	—	63%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLG SPEC IGE CRUDE XTRC EA	$16.65	$45.00	$20.25–$45.00	27% below	63%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGENSEACH/LAB	$16.65	$45.00	$20.25–$45.00	27% below	63%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST ALLERGENS/LAB	$16.65	$45.00	$20.25–$45.00	27% below	63%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGENSEACH/LAB	$16.65	$45.00	$29.25–$45.00	—	63%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLG SPEC IGE CRUDE XTRC EA	$16.65	$45.00	$29.25–$45.00	—	63%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST ALLERGENS/LAB	$16.65	$45.00	$29.25–$45.00	—	63%
Alpha-fetoprotein (AFP) blood test CPT 82105 AFP PROFILE 4	$44.03	$119.00	$53.55–$119.00	33% below	63%
Alpha-fetoprotein (AFP) blood test CPT 82105 AFPTUMOR MARKER/LAB	$44.03	$119.00	$53.55–$119.00	33% below	63%
Alpha-fetoprotein (AFP) blood test CPT 82105 ALPHA-FETOPROTEIN	$44.03	$119.00	$53.55–$119.00	33% below	63%
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 AFP PROFILE 4	$44.03	$119.00	$77.35–$119.00	—	63%
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 ALPHA-FETOPROTEIN	$44.03	$119.00	$77.35–$119.00	—	63%
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 AFPTUMOR MARKER/LAB	$44.03	$119.00	$77.35–$119.00	—	63%
Ammonia blood test CPT 82140 STONE ANALYSIS AMMONIA	$48.47	$131.00	$58.95–$131.00	47% below	63%
Ammonia blood test CPT 82140 AMMONIA	$48.47	$131.00	$58.95–$131.00	47% below	63%
Ammonia blood test inpatient CPT 82140 AMMONIA	$48.47	$131.00	$85.15–$131.00	—	63%
Ammonia blood test inpatient CPT 82140 STONE ANALYSIS AMMONIA	$48.47	$131.00	$85.15–$131.00	—	63%
Amylase blood test CPT 82150 AMYLASE BODY FLUID-Q	$35.89	$97.00	$43.65–$97.00	14% below	63%
Amylase blood test CPT 82150 BODY FLUID AMYLASE	$35.89	$97.00	$43.65–$97.00	14% below	63%
Amylase blood test CPT 82150 AMYLASE	$35.89	$97.00	$43.65–$97.00	14% below	63%
Amylase blood test CPT 82150 AMYLASE URINE	$35.89	$97.00	$43.65–$97.00	14% below	63%
Amylase blood test CPT 82150 AMYLASE LEVEL RANDOM URINE-Q	$35.89	$97.00	$43.65–$97.00	14% below	63%
Amylase blood test CPT 82150 AMYLASE ISOENZYMES	$35.89	$97.00	$43.65–$97.00	14% below	63%
Amylase blood test CPT 82150 AMYLASE LEVEL-Q	$35.89	$97.00	$43.65–$97.00	14% below	63%
Amylase blood test inpatient CPT 82150 AMYLASE ISOENZYMES	$35.89	$97.00	$63.05–$97.00	—	63%
Amylase blood test inpatient CPT 82150 AMYLASE URINE	$35.89	$97.00	$63.05–$97.00	—	63%
Amylase blood test inpatient CPT 82150 AMYLASE	$35.89	$97.00	$63.05–$97.00	—	63%
Amylase blood test inpatient CPT 82150 BODY FLUID AMYLASE	$35.89	$97.00	$63.05–$97.00	—	63%
Amylase blood test inpatient CPT 82150 AMYLASE LEVEL-Q	$35.89	$97.00	$63.05–$97.00	—	63%
Amylase blood test inpatient CPT 82150 AMYLASE BODY FLUID-Q	$35.89	$97.00	$63.05–$97.00	—	63%
Amylase blood test inpatient CPT 82150 AMYLASE LEVEL RANDOM URINE-Q	$35.89	$97.00	$63.05–$97.00	—	63%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CYCLIC CITRULINATED PEPTIDE	$64.38	$174.00	$78.30–$174.00	10% below	63%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 CYCLIC CITRULINATED PEPTIDE	$64.38	$174.00	$113.10–$174.00	—	63%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANTINUCLEAR AB W/PROFILE	$45.88	$124.00	$55.80–$124.00	17% below	63%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA	$45.88	$124.00	$55.80–$124.00	17% below	63%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA (FBR)	$45.88	$124.00	$55.80–$124.00	17% below	63%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA (FBR)	$45.88	$124.00	$80.60–$124.00	—	63%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANTINUCLEAR AB W/PROFILE	$45.88	$124.00	$80.60–$124.00	—	63%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA	$45.88	$124.00	$80.60–$124.00	—	63%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 B-TYPE NATRIURETIC PEPTIDE	$75.48	$204.00	$91.80–$204.00	52% below	63%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 B-TYPE NATRIURETIC PEPTIDE	$75.48	$204.00	$132.60–$204.00	—	63%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 ROUTINE CULTURE	$54.02	$146.00	$65.70–$146.00	at median	63%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 GENITAL CULTURE	$54.02	$146.00	$65.70–$146.00	at median	63%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 GENITAL CULTURE	$54.02	$146.00	$94.90–$146.00	—	63%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 ROUTINE CULTURE	$54.02	$146.00	$94.90–$146.00	—	63%
Basic metabolic panel (blood test) CPT 80048 BASIC METABOLIC PANEL-Q	$67.34	$182.00	$81.90–$182.00	14% below	63%
Basic metabolic panel (blood test) CPT 80048 BASIC METABOLIC PANEL	$70.67	$191.00	$85.95–$191.00	10% below	63%
Basic metabolic panel (blood test) inpatient CPT 80048 BASIC METABOLIC PANEL-Q	$67.34	$182.00	$118.30–$182.00	—	63%
Basic metabolic panel (blood test) inpatient CPT 80048 BASIC METABOLIC PANEL	$70.67	$191.00	$124.15–$191.00	—	63%
Bilirubin blood test, total CPT 82247 BILIRUBIN TOTAL-Q	$22.94	$62.00	$27.90–$62.00	26% below	63%
Bilirubin blood test, total CPT 82247 BILIRUBIN-TOTAL	$24.05	$65.00	$29.25–$65.00	22% below	63%
Bilirubin blood test, total CPT 82247 BILIRUBIN TOTAL	$24.05	$65.00	$29.25–$65.00	22% below	63%
Bilirubin blood test, total inpatient CPT 82247 BILIRUBIN TOTAL-Q	$22.94	$62.00	$40.30–$62.00	—	63%
Bilirubin blood test, total inpatient CPT 82247 BILIRUBIN TOTAL	$24.05	$65.00	$42.25–$65.00	—	63%
Bilirubin blood test, total inpatient CPT 82247 BILIRUBIN-TOTAL	$24.05	$65.00	$42.25–$65.00	—	63%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 MICRO SURG IV	$113.59	$307.00	$138.15–$307.00	18% below	63%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 MICRO SURG IV	$113.59	$307.00	$199.55–$307.00	—	63%
Blood culture for bacteria CPT 87040 BLOOD CULTURE	$79.55	$215.00	$96.75–$215.00	6% below	63%
Blood culture for bacteria inpatient CPT 87040 BLOOD CULTURE	$79.55	$215.00	$139.75–$215.00	—	63%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 BLOOD DRAW FEE	$8.88	$24.00	$10.80–$24.00	37% below	63%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 HC VENIPUNCTURE	$8.88	$24.00	$10.80–$24.00	37% below	63%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 HC VENIPUNCTURE	$8.88	$24.00	$15.60–$24.00	—	63%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 BLOOD DRAW FEE	$8.88	$24.00	$15.60–$24.00	—	63%
Blood glucose (sugar) test CPT 82947 GLUCOSE LEVEL-Q	$20.35	$55.00	$24.75–$55.00	12% below	63%
Blood glucose (sugar) test CPT 82947 ISTAT GLUCOSE ER	$21.46	$58.00	$26.10–$58.00	7% below	63%
Blood glucose (sugar) test CPT 82947 ASSAY GLUCOSE BLOOD QUANT	$21.46	$58.00	$26.10–$58.00	7% below	63%
Blood glucose (sugar) test CPT 82947 GLUCOSE SERUM	$21.46	$58.00	$26.10–$58.00	7% below	63%
Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE LEVEL-Q	$20.35	$55.00	$35.75–$55.00	—	63%
Blood glucose (sugar) test inpatient CPT 82947 ISTAT GLUCOSE ER	$21.46	$58.00	$37.70–$58.00	—	63%
Blood glucose (sugar) test inpatient CPT 82947 ASSAY GLUCOSE BLOOD QUANT	$21.46	$58.00	$37.70–$58.00	—	63%
Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE SERUM	$21.46	$58.00	$37.70–$58.00	—	63%
Blood lead test CPT 83655 LEAD WHOLE BLOOD	$33.30	$90.00	$40.50–$90.00	26% below	63%
Blood lead test CPT 83655 LEADINDUSTRIAL EXP	$33.30	$90.00	$40.50–$90.00	26% below	63%
Blood lead test CPT 83655 LEAD URINE	$33.30	$90.00	$40.50–$90.00	26% below	63%
Blood lead test CPT 83655 LEAD BLOOD/LAB	$33.30	$90.00	$40.50–$90.00	26% below	63%
Blood lead test inpatient CPT 83655 LEADINDUSTRIAL EXP	$33.30	$90.00	$58.50–$90.00	—	63%
Blood lead test inpatient CPT 83655 LEAD WHOLE BLOOD	$33.30	$90.00	$58.50–$90.00	—	63%
Blood lead test inpatient CPT 83655 LEAD BLOOD/LAB	$33.30	$90.00	$58.50–$90.00	—	63%
Blood lead test inpatient CPT 83655 LEAD URINE	$33.30	$90.00	$58.50–$90.00	—	63%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 BETA HCG QUALITATIVE-Q	$32.93	$89.00	$40.05–$89.00	24% below	63%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 PREG TEST-QUALITATIVE	$34.41	$93.00	$41.85–$93.00	20% below	63%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 BETA HCG QUALITATIVE-Q	$32.93	$89.00	$57.85–$89.00	—	63%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 PREG TEST-QUALITATIVE	$34.41	$93.00	$60.45–$93.00	—	63%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 ABO GROUP	$67.34	$182.00	$81.90–$182.00	36% above	63%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 ABO GROUP	$67.34	$182.00	$118.30–$182.00	—	63%
Blood urea nitrogen (BUN) test CPT 84520 UREA NITROGEN (BUN)-Q	$11.47	$31.00	$13.95–$31.00	54% below	63%
Blood urea nitrogen (BUN) test CPT 84520 ISTAT UREA NITROGEN ER	$12.21	$33.00	$14.85–$33.00	52% below	63%
Blood urea nitrogen (BUN) test CPT 84520 BLOOD UREA NITROGEN BUN	$12.21	$33.00	$14.85–$33.00	52% below	63%
Blood urea nitrogen (BUN) test CPT 84520 ASSAY OF UREA NITROGEN	$12.21	$33.00	$14.85–$33.00	52% below	63%
Blood urea nitrogen (BUN) test CPT 84520 BODY FLUID UREA	$12.21	$33.00	$14.85–$33.00	52% below	63%
Blood urea nitrogen (BUN) test inpatient CPT 84520 UREA NITROGEN (BUN)-Q	$11.47	$31.00	$20.15–$31.00	—	63%
Blood urea nitrogen (BUN) test inpatient CPT 84520 ISTAT UREA NITROGEN ER	$12.21	$33.00	$21.45–$33.00	—	63%
Blood urea nitrogen (BUN) test inpatient CPT 84520 BLOOD UREA NITROGEN BUN	$12.21	$33.00	$21.45–$33.00	—	63%
Blood urea nitrogen (BUN) test inpatient CPT 84520 ASSAY OF UREA NITROGEN	$12.21	$33.00	$21.45–$33.00	—	63%
Blood urea nitrogen (BUN) test inpatient CPT 84520 BODY FLUID UREA	$12.21	$33.00	$21.45–$33.00	—	63%
C-peptide blood test CPT 84681 C PEPTIDE/LAB	$56.24	$152.00	$68.40–$152.00	20% below	63%
C-peptide blood test CPT 84681 C-PEPTIDE REACTIVITY	$56.24	$152.00	$68.40–$152.00	20% below	63%
C-peptide blood test inpatient CPT 84681 C-PEPTIDE REACTIVITY	$56.24	$152.00	$98.80–$152.00	—	63%
C-peptide blood test inpatient CPT 84681 C PEPTIDE/LAB	$56.24	$152.00	$98.80–$152.00	—	63%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C-REACTIVE PROTEIN MG/L-Q	$28.49	$77.00	$34.65–$77.00	23% below	63%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C-REACTIVE PROTEIN	$29.97	$81.00	$36.45–$81.00	19% below	63%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C-REACTIVE PROTEIN PANEL FEE	$29.97	$81.00	$36.45–$81.00	19% below	63%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C REACTIVE INFECT INFLAMMATION	$29.97	$81.00	$36.45–$81.00	19% below	63%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 C-REACTIVE PROTEIN MG/L-Q	$28.49	$77.00	$50.05–$77.00	—	63%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 C-REACTIVE PROTEIN PANEL FEE	$29.97	$81.00	$52.65–$81.00	—	63%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 C-REACTIVE PROTEIN	$29.97	$81.00	$52.65–$81.00	—	63%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 C REACTIVE INFECT INFLAMMATION	$29.97	$81.00	$52.65–$81.00	—	63%
C. difficile toxin gene test (stool PCR) CPT 87493 DNA AMPLIF PROBE	$65.49	$177.00	$79.65–$177.00	36% below	63%
C. difficile toxin gene test (stool PCR) CPT 87493 CLOSTRIDIUM DIFFICILE TESTING	$65.49	$177.00	$79.65–$177.00	36% below	63%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 DNA AMPLIF PROBE	$65.49	$177.00	$115.05–$177.00	—	63%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 CLOSTRIDIUM DIFFICILE TESTING	$65.49	$177.00	$115.05–$177.00	—	63%
CA 19-9 blood test (tumor marker) CPT 86301 CA 19-9	$48.10	$130.00	$58.50–$130.00	26% below	63%
CA 19-9 blood test (tumor marker) inpatient CPT 86301 CA 19-9	$48.10	$130.00	$84.50–$130.00	—	63%
CA-125 blood test (ovarian cancer marker) CPT 86304 CA 125	$55.13	$149.00	$67.05–$149.00	36% below	63%
CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 CA 125	$55.13	$149.00	$96.85–$149.00	—	63%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 HC COVID CEPHEID	$41.07	$111.00	$49.95–$111.00	53% below	63%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 COVID AMPLIFIED PROBE	$49.95	$135.00	$60.75–$135.00	43% below	63%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 COVID CEPHEID	$49.95	$135.00	$60.75–$135.00	43% below	63%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 HC COVID CEPHEID	$41.07	$111.00	$72.15–$111.00	—	63%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 COVID CEPHEID	$49.95	$135.00	$87.75–$135.00	—	63%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 COVID AMPLIFIED PROBE	$49.95	$135.00	$87.75–$135.00	—	63%
Calcium blood test, total CPT 82310 CALCIUM LEVEL TOTAL-Q	$22.94	$62.00	$27.90–$62.00	19% below	63%
Calcium blood test, total CPT 82310 CALCIUM SERUM	$24.05	$65.00	$29.25–$65.00	15% below	63%
Calcium blood test, total inpatient CPT 82310 CALCIUM LEVEL TOTAL-Q	$22.94	$62.00	$40.30–$62.00	—	63%
Calcium blood test, total inpatient CPT 82310 CALCIUM SERUM	$24.05	$65.00	$42.25–$65.00	—	63%
Carcinoembryonic antigen (CEA) test CPT 82378 CEA	$69.93	$189.00	$85.05–$189.00	21% below	63%
Carcinoembryonic antigen (CEA) test inpatient CPT 82378 CEA	$69.93	$189.00	$122.85–$189.00	—	63%
Chickenpox (varicella) immunity blood test CPT 86787 VARICELLA-ZOSTER ANTIBODY	$42.18	$114.00	$51.30–$114.00	13% below	63%
Chickenpox (varicella) immunity blood test CPT 86787 VARICELLA-ZOSTER ABY	$42.18	$114.00	$51.30–$114.00	13% below	63%
Chickenpox (varicella) immunity blood test CPT 86787 VARICELLA ZOSTER	$42.18	$114.00	$51.30–$114.00	13% below	63%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 VARICELLA-ZOSTER ANTIBODY	$42.18	$114.00	$74.10–$114.00	—	63%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 VARICELLA ZOSTER	$42.18	$114.00	$74.10–$114.00	—	63%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 VARICELLA-ZOSTER ABY	$42.18	$114.00	$74.10–$114.00	—	63%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA-DIRECT SCR	$44.03	$119.00	$53.55–$119.00	39% below	63%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 HC CHLAMYDIA TRACHOMTS NAP AMP	$58.46	$158.00	$71.10–$158.00	19% below	63%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMYDIA-DIRECT SCR	$44.03	$119.00	$77.35–$119.00	—	63%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 HC CHLAMYDIA TRACHOMTS NAP AMP	$58.46	$158.00	$102.70–$158.00	—	63%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PROFILE	$49.95	$135.00	$60.75–$135.00	33% below	63%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PROFILE	$49.95	$135.00	$87.75–$135.00	—	63%
Complete blood count (CBC) with differential CPT 85025 CBC WITH DIFF-Q	$42.92	$116.00	$52.20–$116.00	9% below	63%
Complete blood count (CBC) with differential CPT 85025 CBC	$45.14	$122.00	$54.90–$122.00	4% below	63%
Complete blood count (CBC) with differential inpatient CPT 85025 CBC WITH DIFF-Q	$42.92	$116.00	$75.40–$116.00	—	63%
Complete blood count (CBC) with differential inpatient CPT 85025 CBC	$45.14	$122.00	$79.30–$122.00	—	63%
Complete blood count (CBC), no differential CPT 85027 CBC WITHOUT DIFFERENTIAL-Q	$24.79	$67.00	$30.15–$67.00	20% below	63%
Complete blood count (CBC), no differential CPT 85027 CBC MINUS	$25.90	$70.00	$31.50–$70.00	16% below	63%
Complete blood count (CBC), no differential inpatient CPT 85027 CBC WITHOUT DIFFERENTIAL-Q	$24.79	$67.00	$43.55–$67.00	—	63%
Complete blood count (CBC), no differential inpatient CPT 85027 CBC MINUS	$25.90	$70.00	$45.50–$70.00	—	63%
Comprehensive metabolic panel (blood test) CPT 80053 COMPREHENSIVE METABOLIC	$105.08	$284.00	$127.80–$284.00	at median	63%
Comprehensive metabolic panel (blood test) CPT 80053 COMPREHENSIVE METABOLIC PANL-Q	$105.08	$284.00	$127.80–$284.00	at median	63%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 COMPREHENSIVE METABOLIC	$105.08	$284.00	$184.60–$284.00	—	63%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 COMPREHENSIVE METABOLIC PANL-Q	$105.08	$284.00	$184.60–$284.00	—	63%
Cortisol blood test, total CPT 82533 ACTH STIMULATION	$52.91	$143.00	$64.35–$143.00	25% below	63%
Cortisol blood test, total CPT 82533 CORTISOL PLASMA	$52.91	$143.00	$64.35–$143.00	25% below	63%
Cortisol blood test, total CPT 82533 CORTISOL PEDS COSYNTROPIN TEST	$52.91	$143.00	$64.35–$143.00	25% below	63%
Cortisol blood test, total CPT 82533 CORTISOL/LAB	$52.91	$143.00	$64.35–$143.00	25% below	63%
Cortisol blood test, total CPT 82533 TOTAL CORTISOL	$52.91	$143.00	$64.35–$143.00	25% below	63%
Cortisol blood test, total inpatient CPT 82533 ACTH STIMULATION	$52.91	$143.00	$92.95–$143.00	—	63%
Cortisol blood test, total inpatient CPT 82533 TOTAL CORTISOL	$52.91	$143.00	$92.95–$143.00	—	63%
Cortisol blood test, total inpatient CPT 82533 CORTISOL/LAB	$52.91	$143.00	$92.95–$143.00	—	63%
Cortisol blood test, total inpatient CPT 82533 CORTISOL PEDS COSYNTROPIN TEST	$52.91	$143.00	$92.95–$143.00	—	63%
Cortisol blood test, total inpatient CPT 82533 CORTISOL PLASMA	$52.91	$143.00	$92.95–$143.00	—	63%
Creatine kinase (CK) blood test, total CPT 82550 CPK	$39.22	$106.00	$47.70–$106.00	14% below	63%
Creatine kinase (CK) blood test, total CPT 82550 CREATINE KINASE TOTAL-Q	$39.22	$106.00	$47.70–$106.00	14% below	63%
Creatine kinase (CK) blood test, total CPT 82550 CPK WITH PROFILE	$39.22	$106.00	$47.70–$106.00	14% below	63%
Creatine kinase (CK) blood test, total inpatient CPT 82550 CREATINE KINASE TOTAL-Q	$39.22	$106.00	$68.90–$106.00	—	63%
Creatine kinase (CK) blood test, total inpatient CPT 82550 CPK	$39.22	$106.00	$68.90–$106.00	—	63%
Creatine kinase (CK) blood test, total inpatient CPT 82550 CPK WITH PROFILE	$39.22	$106.00	$68.90–$106.00	—	63%
Creatinine blood test CPT 82565 CREATININE SERUM-Q	$17.39	$47.00	$21.15–$47.00	40% below	63%
Creatinine blood test CPT 82565 ISTAT CREATININE ER	$18.13	$49.00	$22.05–$49.00	37% below	63%
Creatinine blood test CPT 82565 CREATININE SERUM	$18.13	$49.00	$22.05–$49.00	37% below	63%
Creatinine blood test inpatient CPT 82565 CREATININE SERUM-Q	$17.39	$47.00	$30.55–$47.00	—	63%
Creatinine blood test inpatient CPT 82565 CREATININE SERUM	$18.13	$49.00	$31.85–$49.00	—	63%
Creatinine blood test inpatient CPT 82565 ISTAT CREATININE ER	$18.13	$49.00	$31.85–$49.00	—	63%
Cytomegalovirus (CMV) antibody test CPT 86644 CMV ABY. IGG + IGM	$38.11	$103.00	$46.35–$103.00	40% below	63%
Cytomegalovirus (CMV) antibody test CPT 86644 CMV ANTIBODY IGG	$38.11	$103.00	$46.35–$103.00	40% below	63%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 CMV ANTIBODY IGG	$38.11	$103.00	$66.95–$103.00	—	63%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 CMV ABY. IGG + IGM	$38.11	$103.00	$66.95–$103.00	—	63%
D-dimer blood test (blood clot marker) CPT 85379 D DIMER	$57.72	$156.00	$70.20–$156.00	20% below	63%
D-dimer blood test (blood clot marker) inpatient CPT 85379 D DIMER	$57.72	$156.00	$101.40–$156.00	—	63%
DHEA sulfate (DHEA-S) blood test CPT 82627 DHEA SULFATE/LAB	$59.20	$160.00	$72.00–$160.00	35% below	63%
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 DHEA SULFATE/LAB	$59.20	$160.00	$104.00–$160.00	—	63%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG PANEL 9 SERUM W REFLEX	$95.09	$257.00	$115.65–$257.00	2% below	63%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG SCREEN SINGLE	$95.09	$257.00	$115.65–$257.00	2% below	63%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG TEST PRSMV CHEM ANLYZR	$95.09	$257.00	$115.65–$257.00	2% below	63%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG SCREEN RAPID	$95.09	$257.00	$115.65–$257.00	2% below	63%
Drug screen by lab instrument (any number of drug classes) CPT 80307 ETHANOL LEVEL URINE-Q	$101.01	$273.00	$122.85–$273.00	4% above	63%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG TEST PRSMV CHEM ANLYZR	$95.09	$257.00	$167.05–$257.00	—	63%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG PANEL 9 SERUM W REFLEX	$95.09	$257.00	$167.05–$257.00	—	63%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG SCREEN RAPID	$95.09	$257.00	$167.05–$257.00	—	63%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG SCREEN SINGLE	$95.09	$257.00	$167.05–$257.00	—	63%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 ETHANOL LEVEL URINE-Q	$101.01	$273.00	$177.45–$273.00	—	63%
Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 ELECTROLYES-Q	$34.78	$94.00	$42.30–$94.00	31% below	63%
Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 ELECTROLYTES PANEL	$36.63	$99.00	$44.55–$99.00	27% below	63%
Electrolyte panel (sodium, potassium, chloride, CO2) inpatient CPT 80051 ELECTROLYES-Q	$34.78	$94.00	$61.10–$94.00	—	63%
Electrolyte panel (sodium, potassium, chloride, CO2) inpatient CPT 80051 ELECTROLYTES PANEL	$36.63	$99.00	$64.35–$99.00	—	63%
Epstein-Barr virus (EBV) antibody test CPT 86665 EBV AB V.CAPSID AG	$45.14	$122.00	$54.90–$122.00	26% below	63%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 EBV AB V.CAPSID AG	$45.14	$122.00	$79.30–$122.00	—	63%
Estradiol blood test CPT 82670 ESTRADIOL/LAB	$103.23	$279.00	$125.55–$279.00	1% above	63%
Estradiol blood test CPT 82670 ESTRADIOL	$103.23	$279.00	$125.55–$279.00	1% above	63%
Estradiol blood test inpatient CPT 82670 ESTRADIOL	$103.23	$279.00	$181.35–$279.00	—	63%
Estradiol blood test inpatient CPT 82670 ESTRADIOL/LAB	$103.23	$279.00	$181.35–$279.00	—	63%
FSH (follicle-stimulating hormone) test CPT 83001 FSH	$62.53	$169.00	$76.05–$169.00	21% below	63%
FSH (follicle-stimulating hormone) test CPT 83001 FSH/LAB	$62.53	$169.00	$76.05–$169.00	21% below	63%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 FSH/LAB	$62.53	$169.00	$109.85–$169.00	—	63%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 FSH	$62.53	$169.00	$109.85–$169.00	—	63%
Fecal calprotectin (stool inflammation test) CPT 83993 CALPROTECTIN	$103.23	$279.00	$125.55–$279.00	33% below	63%
Fecal calprotectin (stool inflammation test) inpatient CPT 83993 CALPROTECTIN	$103.23	$279.00	$181.35–$279.00	—	63%
Ferritin blood test (iron stores) CPT 82728 FERRITIN	$51.06	$138.00	$62.10–$138.00	32% below	63%
Ferritin blood test (iron stores) CPT 82728 ASSAY OF FERRITIN	$51.06	$138.00	$62.10–$138.00	32% below	63%
Ferritin blood test (iron stores) inpatient CPT 82728 ASSAY OF FERRITIN	$51.06	$138.00	$89.70–$138.00	—	63%
Ferritin blood test (iron stores) inpatient CPT 82728 FERRITIN	$51.06	$138.00	$89.70–$138.00	—	63%
Fibrinogen blood test CPT 85384 FIBRINOGEN	$37.37	$101.00	$45.45–$101.00	38% below	63%
Fibrinogen blood test inpatient CPT 85384 FIBRINOGEN	$37.37	$101.00	$65.65–$101.00	—	63%
Folate (folic acid) blood test CPT 82746 FOLATE SERUM	$51.06	$138.00	$62.10–$138.00	32% below	63%
Folate (folic acid) blood test inpatient CPT 82746 FOLATE SERUM	$51.06	$138.00	$89.70–$138.00	—	63%
Free T3 thyroid hormone test CPT 84481 T3 FREE	$66.60	$180.00	$81.00–$180.00	23% below	63%
Free T3 thyroid hormone test inpatient CPT 84481 T3 FREE	$66.60	$180.00	$117.00–$180.00	—	63%
Free T4 (free thyroxine) thyroid blood test CPT 84439 FREE T4	$57.72	$156.00	$70.20–$156.00	4% below	63%
Free T4 (free thyroxine) thyroid blood test CPT 84439 T4 FREE DIRECT DIALYSIS	$57.72	$156.00	$70.20–$156.00	4% below	63%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 T4 FREE DIRECT DIALYSIS	$57.72	$156.00	$101.40–$156.00	—	63%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 FREE T4	$57.72	$156.00	$101.40–$156.00	—	63%
Free testosterone test CPT 84402 TESTOSTERONE FREE	$68.45	$185.00	$83.25–$185.00	33% below	63%
Free testosterone test CPT 84402 FREE TESTOSTERONE	$68.45	$185.00	$83.25–$185.00	33% below	63%
Free testosterone test inpatient CPT 84402 FREE TESTOSTERONE	$68.45	$185.00	$120.25–$185.00	—	63%
Free testosterone test inpatient CPT 84402 TESTOSTERONE FREE	$68.45	$185.00	$120.25–$185.00	—	63%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 GAMMA GLUTAMYL TRANSFERASE-Q	$35.52	$96.00	$43.20–$96.00	20% below	63%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 GAMMA GT	$35.52	$96.00	$43.20–$96.00	20% below	63%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 ASSAY OF (GGT)	$35.52	$96.00	$43.20–$96.00	20% below	63%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 ASSAY OF GGT	$35.52	$96.00	$43.20–$96.00	20% below	63%
Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 ASSAY OF (GGT)	$35.52	$96.00	$62.40–$96.00	—	63%
Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 GAMMA GT	$35.52	$96.00	$62.40–$96.00	—	63%
Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 GAMMA GLUTAMYL TRANSFERASE-Q	$35.52	$96.00	$62.40–$96.00	—	63%
Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 ASSAY OF GGT	$35.52	$96.00	$62.40–$96.00	—	63%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GEST/GLUC/TOL-1HR	$29.60	$80.00	$36.00–$80.00	20% below	63%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 1 HOUR GTT	$29.60	$80.00	$36.00–$80.00	20% below	63%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 GEST/GLUC/TOL-1HR	$29.60	$80.00	$52.00–$80.00	—	63%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 1 HOUR GTT	$29.60	$80.00	$52.00–$80.00	—	63%
Glucose tolerance test, 3 samples CPT 82951 LACTOSE TOLERANCE TEST-Q	$51.43	$139.00	$62.55–$139.00	20% below	63%
Glucose tolerance test, 3 samples CPT 82951 LACTOSE TOLERANCE	$54.02	$146.00	$65.70–$146.00	16% below	63%
Glucose tolerance test, 3 samples CPT 82951 GTT 3 SPEC INC GLU	$54.02	$146.00	$65.70–$146.00	16% below	63%
Glucose tolerance test, 3 samples CPT 82951 GLUCOSE TOLER HYPO	$54.02	$146.00	$65.70–$146.00	16% below	63%
Glucose tolerance test, 3 samples CPT 82951 GLUCOSE TOLER GEST	$54.02	$146.00	$65.70–$146.00	16% below	63%
Glucose tolerance test, 3 samples inpatient CPT 82951 LACTOSE TOLERANCE TEST-Q	$51.43	$139.00	$90.35–$139.00	—	63%
Glucose tolerance test, 3 samples inpatient CPT 82951 GTT 3 SPEC INC GLU	$54.02	$146.00	$94.90–$146.00	—	63%
Glucose tolerance test, 3 samples inpatient CPT 82951 LACTOSE TOLERANCE	$54.02	$146.00	$94.90–$146.00	—	63%
Glucose tolerance test, 3 samples inpatient CPT 82951 GLUCOSE TOLER GEST	$54.02	$146.00	$94.90–$146.00	—	63%
Glucose tolerance test, 3 samples inpatient CPT 82951 GLUCOSE TOLER HYPO	$54.02	$146.00	$94.90–$146.00	—	63%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 GC-DIRECT SCREEN	$45.51	$123.00	$55.35–$123.00	31% below	63%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 HC NEISSERIA GONORRHEA NAP AMP	$60.68	$164.00	$73.80–$164.00	8% below	63%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 GC-DIRECT SCREEN	$45.51	$123.00	$79.95–$123.00	—	63%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 HC NEISSERIA GONORRHEA NAP AMP	$60.68	$164.00	$106.60–$164.00	—	63%
H. pylori antibody blood test CPT 86677 HELICOBACTER PYLORI ANTIBODY	$57.35	$155.00	$69.75–$155.00	25% below	63%
H. pylori antibody blood test CPT 86677 H PYLORI AB	$57.35	$155.00	$69.75–$155.00	25% below	63%
H. pylori antibody blood test inpatient CPT 86677 HELICOBACTER PYLORI ANTIBODY	$57.35	$155.00	$100.75–$155.00	—	63%
H. pylori antibody blood test inpatient CPT 86677 H PYLORI AB	$57.35	$155.00	$100.75–$155.00	—	63%
H. pylori stool antigen test CPT 87338 HPYLORI, STOOL, EIA	$98.42	$266.00	$119.70–$266.00	15% below	63%
H. pylori stool antigen test inpatient CPT 87338 HPYLORI, STOOL, EIA	$98.42	$266.00	$172.90–$266.00	—	63%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV1 REV TRANSCRIP QUANIF PCR	$169.46	$458.00	$206.10–$458.00	26% below	63%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV1 REV TRANSCRIP QUANIF BDNA	$169.46	$458.00	$206.10–$458.00	26% below	63%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HIV1 REV TRANSCRIP QUANIF BDNA	$169.46	$458.00	$297.70–$458.00	—	63%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HIV1 REV TRANSCRIP QUANIF PCR	$169.46	$458.00	$297.70–$458.00	—	63%
HIV-1 and HIV-2 antibody test CPT 86703 HIV1/2 ANTIBODY	$33.67	$91.00	$40.95–$91.00	26% below	63%
HIV-1 and HIV-2 antibody test inpatient CPT 86703 HIV1/2 ANTIBODY	$33.67	$91.00	$59.15–$91.00	—	63%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV COMBO ANTIGEN/ANTIBODY REF	$24.79	$67.00	$30.15–$67.00	48% below	63%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV-1 AG W/HIV-1 & HIV-2 AB	$24.79	$67.00	$30.15–$67.00	48% below	63%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HIV-1 AG W/HIV-1 & HIV-2 AB	$24.79	$67.00	$43.55–$67.00	—	63%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HIV COMBO ANTIGEN/ANTIBODY REF	$24.79	$67.00	$43.55–$67.00	—	63%
HPV test for high-risk types, one combined (pooled) result CPT 87624 HPV DNA ASSAY	$53.28	$144.00	$64.80–$144.00	26% below	63%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HPV DNA ASSAY	$53.28	$144.00	$93.60–$144.00	—	63%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HEMOGLOBIN A1C LEVEL POS	$42.18	$114.00	$51.30–$114.00	20% below	63%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 GLYCOSYLATED HGB	$42.18	$114.00	$51.30–$114.00	20% below	63%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HEMAGLOBIN A1C - POS	$42.18	$114.00	$51.30–$114.00	20% below	63%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HEMOGLOBIN A1C LEVEL POS	$42.18	$114.00	$74.10–$114.00	—	63%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 GLYCOSYLATED HGB	$42.18	$114.00	$74.10–$114.00	—	63%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HEMAGLOBIN A1C - POS	$42.18	$114.00	$74.10–$114.00	—	63%
Hemoglobin blood test CPT 85018 HEMOGLOBIN-Q	$8.88	$24.00	$10.80–$24.00	42% below	63%
Hemoglobin blood test inpatient CPT 85018 HEMOGLOBIN-Q	$8.88	$24.00	$15.60–$24.00	—	63%
Hepatitis B core antibody test (total) CPT 86704 HEPATITIS B CORE AB	$49.58	$134.00	$60.30–$134.00	18% below	63%
Hepatitis B core antibody test (total) inpatient CPT 86704 HEPATITIS B CORE AB	$49.58	$134.00	$87.10–$134.00	—	63%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEPATITIS B SURFACE AB	$38.48	$104.00	$46.80–$104.00	24% below	63%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HEPATITIS B SURFACE AB	$38.48	$104.00	$67.60–$104.00	—	63%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HEPATITIS B AG	$36.63	$99.00	$44.55–$99.00	25% below	63%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HEPATITIS B AG	$36.63	$99.00	$64.35–$99.00	—	63%
Hepatitis C antibody blood test (screening) CPT 86803 HEPATITIS C AB	$52.54	$142.00	$63.90–$142.00	29% below	63%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 HEPATITIS C AB	$52.54	$142.00	$92.30–$142.00	—	63%
Hepatitis C viral load (HCV RNA) test CPT 87522 HEP C RNA QUANT	$134.31	$363.00	$163.35–$363.00	22% below	63%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HEP C RNA QUANT	$134.31	$363.00	$235.95–$363.00	—	63%
Herpes blood test, HSV-1 antibody CPT 86695 HERPES SIMPLEX TYPE 1	$38.11	$103.00	$46.35–$103.00	28% below	63%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 HERPES SIMPLEX TYPE 1	$38.11	$103.00	$66.95–$103.00	—	63%
Herpes blood test, HSV-2 antibody CPT 86696 HERPES SIMPLEX TYPE 2	$51.06	$138.00	$62.10–$138.00	28% below	63%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HERPES SIMPLEX TYPE 2	$51.06	$138.00	$89.70–$138.00	—	63%
High-sensitivity CRP (hs-CRP) test CPT 86141 CRP HIGH SENSITIVITY Q	$41.07	$111.00	$49.95–$111.00	21% below	63%
High-sensitivity CRP (hs-CRP) test CPT 86141 CRP HIGH SENSITIVITY	$41.07	$111.00	$49.95–$111.00	21% below	63%
High-sensitivity CRP (hs-CRP) test CPT 86141 CRP-HIGH SENSITIVITY-Q	$41.07	$111.00	$49.95–$111.00	21% below	63%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 CRP HIGH SENSITIVITY Q	$41.07	$111.00	$72.15–$111.00	—	63%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 CRP-HIGH SENSITIVITY-Q	$41.07	$111.00	$72.15–$111.00	—	63%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 CRP HIGH SENSITIVITY	$41.07	$111.00	$72.15–$111.00	—	63%
Homocysteine blood test CPT 83090 HOMOCYSTINE	$56.98	$154.00	$69.30–$154.00	22% below	63%
Homocysteine blood test inpatient CPT 83090 HOMOCYSTINE	$56.98	$154.00	$100.10–$154.00	—	63%
Insulin blood test CPT 83525 INSULIN/LAB	$51.43	$139.00	$62.55–$139.00	21% below	63%
Insulin blood test inpatient CPT 83525 INSULIN/LAB	$51.43	$139.00	$90.35–$139.00	—	63%
Iron blood test (serum iron) CPT 83540 IRON	$28.86	$78.00	$35.10–$78.00	23% below	63%
Iron blood test (serum iron) CPT 83540 IRON TOTAL SERUM	$28.86	$78.00	$35.10–$78.00	23% below	63%
Iron blood test (serum iron) inpatient CPT 83540 IRON	$28.86	$78.00	$50.70–$78.00	—	63%
Iron blood test (serum iron) inpatient CPT 83540 IRON TOTAL SERUM	$28.86	$78.00	$50.70–$78.00	—	63%
Iron-binding capacity (TIBC) test CPT 83550 TIBC	$33.30	$90.00	$40.50–$90.00	17% below	63%
Iron-binding capacity (TIBC) test inpatient CPT 83550 TIBC	$33.30	$90.00	$58.50–$90.00	—	63%
Kidney function blood test panel CPT 80069 RENAL FUNCTION PANEL	$37.74	$102.00	$45.90–$102.00	44% below	63%
Kidney function blood test panel CPT 80069 RENAL FUNCTION PANEL-Q	$37.74	$102.00	$45.90–$102.00	44% below	63%
Kidney function blood test panel inpatient CPT 80069 RENAL FUNCTION PANEL-Q	$37.74	$102.00	$66.30–$102.00	—	63%
Kidney function blood test panel inpatient CPT 80069 RENAL FUNCTION PANEL	$37.74	$102.00	$66.30–$102.00	—	63%
LH (luteinizing hormone) test CPT 83002 LH/LAB	$78.81	$213.00	$95.85–$213.00	7% below	63%
LH (luteinizing hormone) test CPT 83002 LUTEINIZING HORMONE	$78.81	$213.00	$95.85–$213.00	7% below	63%
LH (luteinizing hormone) test inpatient CPT 83002 LH/LAB	$78.81	$213.00	$138.45–$213.00	—	63%
LH (luteinizing hormone) test inpatient CPT 83002 LUTEINIZING HORMONE	$78.81	$213.00	$138.45–$213.00	—	63%
Lactate (lactic acid) blood test CPT 83605 CSF LACTIC ACID	$48.47	$131.00	$58.95–$131.00	17% below	63%
Lactate (lactic acid) blood test CPT 83605 LACTIC ACID	$48.47	$131.00	$58.95–$131.00	17% below	63%
Lactate (lactic acid) blood test CPT 83605 ISTAT LACTATE	$48.47	$131.00	$58.95–$131.00	17% below	63%
Lactate (lactic acid) blood test inpatient CPT 83605 CSF LACTIC ACID	$48.47	$131.00	$85.15–$131.00	—	63%
Lactate (lactic acid) blood test inpatient CPT 83605 LACTIC ACID	$48.47	$131.00	$85.15–$131.00	—	63%
Lactate (lactic acid) blood test inpatient CPT 83605 ISTAT LACTATE	$48.47	$131.00	$85.15–$131.00	—	63%
Lactate dehydrogenase (LDH) blood test CPT 83615 LACTATE DEHYDROGENASE (LDH)-Q	$16.28	$44.00	$19.80–$44.00	55% below	63%
Lactate dehydrogenase (LDH) blood test CPT 83615 TOTAL LD (ARUP)	$17.02	$46.00	$20.70–$46.00	53% below	63%
Lactate dehydrogenase (LDH) blood test CPT 83615 CSF LDH	$17.02	$46.00	$20.70–$46.00	53% below	63%
Lactate dehydrogenase (LDH) blood test CPT 83615 LDH BODY FLUID-Q	$17.02	$46.00	$20.70–$46.00	53% below	63%
Lactate dehydrogenase (LDH) blood test CPT 83615 LDH	$17.02	$46.00	$20.70–$46.00	53% below	63%
Lactate dehydrogenase (LDH) blood test CPT 83615 BODY FLUID LDH	$17.02	$46.00	$20.70–$46.00	53% below	63%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 LACTATE DEHYDROGENASE (LDH)-Q	$16.28	$44.00	$28.60–$44.00	—	63%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 CSF LDH	$17.02	$46.00	$29.90–$46.00	—	63%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 LDH BODY FLUID-Q	$17.02	$46.00	$29.90–$46.00	—	63%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 LDH	$17.02	$46.00	$29.90–$46.00	—	63%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 BODY FLUID LDH	$17.02	$46.00	$29.90–$46.00	—	63%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 TOTAL LD (ARUP)	$17.02	$46.00	$29.90–$46.00	—	63%
Lipase blood test (pancreas enzyme) CPT 83690 LIPASE LEVEL-Q	$34.41	$93.00	$41.85–$93.00	25% below	63%
Lipase blood test (pancreas enzyme) CPT 83690 LIPASE	$34.41	$93.00	$41.85–$93.00	25% below	63%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 LIPASE	$34.41	$93.00	$60.45–$93.00	—	63%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 LIPASE LEVEL-Q	$34.41	$93.00	$60.45–$93.00	—	63%
Liver function blood test panel CPT 80076 HEPATIC FUNCTION PANEL-Q	$51.43	$139.00	$62.55–$139.00	38% below	63%
Liver function blood test panel CPT 80076 HEPATIC FUNCTION PANEL	$54.02	$146.00	$65.70–$146.00	35% below	63%
Liver function blood test panel inpatient CPT 80076 HEPATIC FUNCTION PANEL-Q	$51.43	$139.00	$90.35–$139.00	—	63%
Liver function blood test panel inpatient CPT 80076 HEPATIC FUNCTION PANEL	$54.02	$146.00	$94.90–$146.00	—	63%
Lyme disease antibody test CPT 86618 LYME ANTIBODY SCREEN	$59.94	$162.00	$72.90–$162.00	23% below	63%
Lyme disease antibody test CPT 86618 LYME DISEASE CSF/LAB	$59.94	$162.00	$72.90–$162.00	23% below	63%
Lyme disease antibody test inpatient CPT 86618 LYME ANTIBODY SCREEN	$59.94	$162.00	$105.30–$162.00	—	63%
Lyme disease antibody test inpatient CPT 86618 LYME DISEASE CSF/LAB	$59.94	$162.00	$105.30–$162.00	—	63%
Magnesium blood test CPT 83735 MAGNESIUM LEVEL-Q	$35.89	$97.00	$43.65–$97.00	10% below	63%
Magnesium blood test CPT 83735 STONE ANALYSIS MAGNESIUM	$37.74	$102.00	$45.90–$102.00	6% below	63%
Magnesium blood test CPT 83735 MAGNESIUM URINE TIMED-Q	$37.74	$102.00	$45.90–$102.00	6% below	63%
Magnesium blood test CPT 83735 URINE MAGNESIUM	$37.74	$102.00	$45.90–$102.00	6% below	63%
Magnesium blood test CPT 83735 MAGNESIUM, RBC/LAB	$37.74	$102.00	$45.90–$102.00	6% below	63%
Magnesium blood test CPT 83735 MAGNESIUM	$37.74	$102.00	$45.90–$102.00	6% below	63%
Magnesium blood test CPT 83735 MAGNESIUM URINE RANDOM COLCT-Q	$37.74	$102.00	$45.90–$102.00	6% below	63%
Magnesium blood test inpatient CPT 83735 MAGNESIUM LEVEL-Q	$35.89	$97.00	$63.05–$97.00	—	63%
Magnesium blood test inpatient CPT 83735 MAGNESIUM, RBC/LAB	$37.74	$102.00	$66.30–$102.00	—	63%
Magnesium blood test inpatient CPT 83735 MAGNESIUM URINE RANDOM COLCT-Q	$37.74	$102.00	$66.30–$102.00	—	63%
Magnesium blood test inpatient CPT 83735 URINE MAGNESIUM	$37.74	$102.00	$66.30–$102.00	—	63%
Magnesium blood test inpatient CPT 83735 MAGNESIUM	$37.74	$102.00	$66.30–$102.00	—	63%
Magnesium blood test inpatient CPT 83735 MAGNESIUM URINE TIMED-Q	$37.74	$102.00	$66.30–$102.00	—	63%
Magnesium blood test inpatient CPT 83735 STONE ANALYSIS MAGNESIUM	$37.74	$102.00	$66.30–$102.00	—	63%
Measles (rubeola) antibody test CPT 86765 RUBEOLA	$31.82	$86.00	$38.70–$86.00	10% below	63%
Measles (rubeola) antibody test CPT 86765 RUBEOLA ANTIBODY	$31.82	$86.00	$38.70–$86.00	10% below	63%
Measles (rubeola) antibody test inpatient CPT 86765 RUBEOLA ANTIBODY	$31.82	$86.00	$55.90–$86.00	—	63%
Measles (rubeola) antibody test inpatient CPT 86765 RUBEOLA	$31.82	$86.00	$55.90–$86.00	—	63%
Mono test (heterophile antibody, Monospot) CPT 86308 MONOTEST	$25.90	$70.00	$31.50–$70.00	28% below	63%
Mono test (heterophile antibody, Monospot) CPT 86308 HETEROPHILE AB SCRN	$25.90	$70.00	$31.50–$70.00	28% below	63%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 MONOTEST	$25.90	$70.00	$45.50–$70.00	—	63%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 HETEROPHILE AB SCRN	$25.90	$70.00	$45.50–$70.00	—	63%
Mumps immunity blood test CPT 86735 MUMPS IGM	$40.33	$109.00	$49.05–$109.00	9% above	63%
Mumps immunity blood test CPT 86735 MUMPS TITER	$40.33	$109.00	$49.05–$109.00	9% above	63%
Mumps immunity blood test inpatient CPT 86735 MUMPS TITER	$40.33	$109.00	$70.85–$109.00	—	63%
Mumps immunity blood test inpatient CPT 86735 MUMPS IGM	$40.33	$109.00	$70.85–$109.00	—	63%
Obstetric blood test panel CPT 80055 PRENATAL SCREEN	$180.19	$487.00	$219.15–$487.00	27% above	63%
Obstetric blood test panel inpatient CPT 80055 PRENATAL SCREEN	$180.19	$487.00	$316.55–$487.00	—	63%
PSA (prostate-specific antigen) blood test, free CPT 84154 FREE PSA	$60.31	$163.00	$73.35–$163.00	35% below	63%
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 FREE PSA	$60.31	$163.00	$105.95–$163.00	—	63%
PSA (prostate-specific antigen) blood test, total CPT 84153 PROSTATIC SPEC ANTIGEN	$54.39	$147.00	$66.15–$147.00	24% below	63%
PSA (prostate-specific antigen) blood test, total CPT 84153 HC PSA TOTAL(PART OF PSA FREE)	$54.39	$147.00	$66.15–$147.00	24% below	63%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PROSTATIC SPEC ANTIGEN	$54.39	$147.00	$95.55–$147.00	—	63%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 HC PSA TOTAL(PART OF PSA FREE)	$54.39	$147.00	$95.55–$147.00	—	63%
Pap test (liquid-based, automated screening with review) CPT 88175 THIN PREP TEST IMAGINE	$29.23	$79.00	$35.55–$79.00	54% below	63%
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 THIN PREP TEST IMAGINE	$29.23	$79.00	$51.35–$79.00	—	63%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 SUREPATH PAP SMEAR	$40.70	$110.00	$49.50–$110.00	42% below	63%
Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 SUREPATH PAP SMEAR	$40.70	$110.00	$71.50–$110.00	—	63%
Parathyroid hormone (PTH) blood test CPT 83970 PARATHYROID HOR PTH	$92.50	$250.00	$112.50–$250.00	6% below	63%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 PARATHYROID HOR PTH	$92.50	$250.00	$162.50–$250.00	—	63%
Partial thromboplastin time (PTT) clotting test CPT 85730 THROMBOPLASTIN TIME PARTIAL	$31.08	$84.00	$37.80–$84.00	29% below	63%
Partial thromboplastin time (PTT) clotting test CPT 85730 ACTIVATED PTT	$31.08	$84.00	$37.80–$84.00	29% below	63%
Partial thromboplastin time (PTT) clotting test CPT 85730 PTT SUBSTITUTION EA	$31.08	$84.00	$37.80–$84.00	29% below	63%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PTT SUBSTITUTION EA	$31.08	$84.00	$54.60–$84.00	—	63%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 THROMBOPLASTIN TIME PARTIAL	$31.08	$84.00	$54.60–$84.00	—	63%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 ACTIVATED PTT	$31.08	$84.00	$54.60–$84.00	—	63%
Phosphorus (phosphate) blood test CPT 84100 PHOSPHORUS LEVEL-Q	$14.43	$39.00	$17.55–$39.00	48% below	63%
Phosphorus (phosphate) blood test CPT 84100 PHOSPHORUS SERUM	$15.17	$41.00	$18.45–$41.00	45% below	63%
Phosphorus (phosphate) blood test inpatient CPT 84100 PHOSPHORUS LEVEL-Q	$14.43	$39.00	$25.35–$39.00	—	63%
Phosphorus (phosphate) blood test inpatient CPT 84100 PHOSPHORUS SERUM	$15.17	$41.00	$26.65–$41.00	—	63%
Potassium blood test CPT 84132 POTASSIUM LEVEL-Q	$14.06	$38.00	$17.10–$38.00	42% below	63%
Potassium blood test CPT 84132 POTASSIUM SERUM	$14.80	$40.00	$18.00–$40.00	39% below	63%
Potassium blood test CPT 84132 ISTAT POTASSIUM ER	$14.80	$40.00	$18.00–$40.00	39% below	63%
Potassium blood test inpatient CPT 84132 POTASSIUM LEVEL-Q	$14.06	$38.00	$24.70–$38.00	—	63%
Potassium blood test inpatient CPT 84132 ISTAT POTASSIUM ER	$14.80	$40.00	$26.00–$40.00	—	63%
Potassium blood test inpatient CPT 84132 POTASSIUM SERUM	$14.80	$40.00	$26.00–$40.00	—	63%
Progesterone blood test CPT 84144 PROGESTERONE LEVEL	$68.08	$184.00	$82.80–$184.00	23% below	63%
Progesterone blood test inpatient CPT 84144 PROGESTERONE LEVEL	$68.08	$184.00	$119.60–$184.00	—	63%
Prolactin blood test CPT 84146 PROLACTIN DILUTION STUDY	$64.75	$175.00	$78.75–$175.00	14% below	63%
Prolactin blood test CPT 84146 PROLACTIN	$64.75	$175.00	$78.75–$175.00	14% below	63%
Prolactin blood test inpatient CPT 84146 PROLACTIN DILUTION STUDY	$64.75	$175.00	$113.75–$175.00	—	63%
Prolactin blood test inpatient CPT 84146 PROLACTIN	$64.75	$175.00	$113.75–$175.00	—	63%
Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME	$17.39	$47.00	$21.15–$47.00	41% below	63%
Prothrombin time (PT/INR) clotting test CPT 85610 INR FINGERSTICK	$17.39	$47.00	$21.15–$47.00	41% below	63%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 INR FINGERSTICK	$17.39	$47.00	$30.55–$47.00	—	63%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTHROMBIN TIME	$17.39	$47.00	$30.55–$47.00	—	63%
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 POC URINE DRUG SCREEN	$14.06	$38.00	$17.10–$38.00	46% below	63%
Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 POC URINE DRUG SCREEN	$14.06	$38.00	$24.70–$38.00	—	63%
Renin blood test CPT 84244 RENIN 1/LAB	$58.46	$158.00	$71.10–$158.00	21% below	63%
Renin blood test inpatient CPT 84244 RENIN 1/LAB	$58.46	$158.00	$102.70–$158.00	—	63%
Rh blood typing CPT 86901 RH	$32.56	$88.00	$39.60–$88.00	11% below	63%
Rh blood typing inpatient CPT 86901 RH	$32.56	$88.00	$57.20–$88.00	—	63%
Rheumatoid factor (RF) test CPT 86431 RHEUMATOID FACTOR QUANT	$26.64	$72.00	$32.40–$72.00	21% below	63%
Rheumatoid factor (RF) test CPT 86431 RHEUMATOID FACTOR	$26.64	$72.00	$32.40–$72.00	21% below	63%
Rheumatoid factor (RF) test inpatient CPT 86431 RHEUMATOID FACTOR	$26.64	$72.00	$46.80–$72.00	—	63%
Rheumatoid factor (RF) test inpatient CPT 86431 RHEUMATOID FACTOR QUANT	$26.64	$72.00	$46.80–$72.00	—	63%
Rubella antibody test (immunity check) CPT 86762 RUBELLA	$36.26	$98.00	$44.10–$98.00	28% below	63%
Rubella antibody test (immunity check) CPT 86762 RUBELLA AB, IGG	$36.26	$98.00	$44.10–$98.00	28% below	63%
Rubella antibody test (immunity check) CPT 86762 RUBELLA, IGM ABY	$36.26	$98.00	$44.10–$98.00	28% below	63%
Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA, IGM ABY	$36.26	$98.00	$63.70–$98.00	—	63%
Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA	$36.26	$98.00	$63.70–$98.00	—	63%
Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA AB, IGG	$36.26	$98.00	$63.70–$98.00	—	63%
Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 SEDIMENTATION RATE	$22.94	$62.00	$27.90–$62.00	23% below	63%
Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 SEDIMENTATION RATE (ESR)-Q	$22.94	$62.00	$27.90–$62.00	23% below	63%
Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 SEDIMENTATION RATE	$22.94	$62.00	$40.30–$62.00	—	63%
Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 SEDIMENTATION RATE (ESR)-Q	$22.94	$62.00	$40.30–$62.00	—	63%
Sodium blood test CPT 84295 SODIUM LEVEL-Q	$13.32	$36.00	$16.20–$36.00	44% below	63%
Sodium blood test CPT 84295 ISTAT SODIUM/LAB ER	$14.06	$38.00	$17.10–$38.00	41% below	63%
Sodium blood test CPT 84295 SODIUM SERUM	$14.06	$38.00	$17.10–$38.00	41% below	63%
Sodium blood test inpatient CPT 84295 SODIUM LEVEL-Q	$13.32	$36.00	$23.40–$36.00	—	63%
Sodium blood test inpatient CPT 84295 SODIUM SERUM	$14.06	$38.00	$24.70–$38.00	—	63%
Sodium blood test inpatient CPT 84295 ISTAT SODIUM/LAB ER	$14.06	$38.00	$24.70–$38.00	—	63%
Stool ova and parasites exam CPT 87177 O & P COMP	$23.31	$63.00	$28.35–$63.00	37% below	63%
Stool ova and parasites exam inpatient CPT 87177 O & P COMP	$23.31	$63.00	$40.95–$63.00	—	63%
Stool test for hidden blood (guaiac FOBT) CPT 82270 OCCULT BLOOD LAB	$12.58	$34.00	$15.30–$34.00	39% below	63%
Stool test for hidden blood (guaiac FOBT) CPT 82270 OCCULT BLOOD GUIACBS, IGG/IGM	$12.58	$34.00	$15.30–$34.00	39% below	63%
Stool test for hidden blood (guaiac FOBT) CPT 82270 LAB OCCULT BLOOD	$12.58	$34.00	$15.30–$34.00	39% below	63%
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 OCCULT BLOOD GUIACBS, IGG/IGM	$12.58	$34.00	$22.10–$34.00	—	63%
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 OCCULT BLOOD LAB	$12.58	$34.00	$22.10–$34.00	—	63%
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 LAB OCCULT BLOOD	$12.58	$34.00	$22.10–$34.00	—	63%
Stool test for hidden blood by immunoassay (FIT) CPT 82274 ASSAY TEST FOR BLOOD FECAL FIT	$27.38	$74.00	$33.30–$74.00	33% below	63%
Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 ASSAY TEST FOR BLOOD FECAL FIT	$27.38	$74.00	$48.10–$74.00	—	63%
Syphilis antibody test (Treponema pallidum) CPT 86780 RPR-FTA-ABS/LAB	$38.48	$104.00	$46.80–$104.00	28% below	63%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 RPR-FTA-ABS/LAB	$38.48	$104.00	$67.60–$104.00	—	63%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 VDRL/LAB	$27.38	$74.00	$33.30–$74.00	12% below	63%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 RPR SERUM	$27.38	$74.00	$33.30–$74.00	12% below	63%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 VDRL/LAB	$27.38	$74.00	$48.10–$74.00	—	63%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 RPR SERUM	$27.38	$74.00	$48.10–$74.00	—	63%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 TB TEST CELL IMMUN MEASURE	$76.96	$208.00	$93.60–$208.00	34% below	63%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 TB TEST CELL IMMUN MEASURE	$76.96	$208.00	$135.20–$208.00	—	63%
Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE/TOTAL	$82.51	$223.00	$100.35–$223.00	10% below	63%
Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE/	$82.51	$223.00	$100.35–$223.00	10% below	63%
Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE TOTAL	$82.51	$223.00	$100.35–$223.00	10% below	63%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE/TOTAL	$82.51	$223.00	$144.95–$223.00	—	63%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE/	$82.51	$223.00	$144.95–$223.00	—	63%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE TOTAL	$82.51	$223.00	$144.95–$223.00	—	63%
Thyroid peroxidase (TPO) antibody test CPT 86376 MICROSOMAL ANTIBODIES	$64.01	$173.00	$77.85–$173.00	25% below	63%
Thyroid peroxidase (TPO) antibody test CPT 86376 THYROID AUTOANTIBODY	$64.01	$173.00	$77.85–$173.00	25% below	63%
Thyroid peroxidase (TPO) antibody test CPT 86376 MICROSOMAL ANTIBODY EACH	$64.01	$173.00	$77.85–$173.00	25% below	63%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 MICROSOMAL ANTIBODIES	$64.01	$173.00	$112.45–$173.00	—	63%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 MICROSOMAL ANTIBODY EACH	$64.01	$173.00	$112.45–$173.00	—	63%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 THYROID AUTOANTIBODY	$64.01	$173.00	$112.45–$173.00	—	63%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH	$59.20	$160.00	$72.00–$160.00	24% below	63%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH	$59.20	$160.00	$104.00–$160.00	—	63%
Total IgE blood test CPT 82785 IMMUNOGLOBULIN E	$63.64	$172.00	$77.40–$172.00	at median	63%
Total IgE blood test inpatient CPT 82785 IMMUNOGLOBULIN E	$63.64	$172.00	$111.80–$172.00	—	63%
Total cholesterol blood test CPT 82465 CHOLESTEROL TOTAL-Q	$24.42	$66.00	$29.70–$66.00	at median	63%
Total cholesterol blood test CPT 82465 ASSAY BLD/SERUM CHOLESTEROL	$25.53	$69.00	$31.05–$69.00	5% above	63%
Total cholesterol blood test inpatient CPT 82465 CHOLESTEROL TOTAL-Q	$24.42	$66.00	$42.90–$66.00	—	63%
Total cholesterol blood test inpatient CPT 82465 ASSAY BLD/SERUM CHOLESTEROL	$25.53	$69.00	$44.85–$69.00	—	63%
Total thyroxine (T4) blood test CPT 84436 T4 THYROXINE	$37.00	$100.00	$45.00–$100.00	24% below	63%
Total thyroxine (T4) blood test inpatient CPT 84436 T4 THYROXINE	$37.00	$100.00	$65.00–$100.00	—	63%
Total triiodothyronine (T3) blood test CPT 84480 T3 TOTAL	$49.95	$135.00	$60.75–$135.00	41% below	63%
Total triiodothyronine (T3) blood test inpatient CPT 84480 T3 TOTAL	$49.95	$135.00	$87.75–$135.00	—	63%
Transferrin blood test CPT 84466 TRANSFERRIN/LAB	$26.64	$72.00	$32.40–$72.00	54% below	63%
Transferrin blood test CPT 84466 TRANSFERRIN	$26.64	$72.00	$32.40–$72.00	54% below	63%
Transferrin blood test inpatient CPT 84466 TRANSFERRIN	$26.64	$72.00	$46.80–$72.00	—	63%
Transferrin blood test inpatient CPT 84466 TRANSFERRIN/LAB	$26.64	$72.00	$46.80–$72.00	—	63%
Trichomonas test (NAAT) CPT 87661 TRICHOMONAS VAGINALIS AMPLIF	$68.45	$185.00	$83.25–$185.00	24% below	63%
Trichomonas test (NAAT) inpatient CPT 87661 TRICHOMONAS VAGINALIS AMPLIF	$68.45	$185.00	$120.25–$185.00	—	63%
Triglycerides blood test CPT 84478 ASSAY OF TRIGYCERIDES	$33.30	$90.00	$40.50–$90.00	25% below	63%
Triglycerides blood test CPT 84478 ASSAY OF TRIGLYCERIDES	$33.30	$90.00	$40.50–$90.00	25% below	63%
Triglycerides blood test CPT 84478 BODY FLUID TRIGLYCERIDE	$33.30	$90.00	$40.50–$90.00	25% below	63%
Triglycerides blood test CPT 84478 TRIGLYCERIDES	$33.30	$90.00	$40.50–$90.00	25% below	63%
Triglycerides blood test inpatient CPT 84478 ASSAY OF TRIGYCERIDES	$33.30	$90.00	$58.50–$90.00	—	63%
Triglycerides blood test inpatient CPT 84478 TRIGLYCERIDES	$33.30	$90.00	$58.50–$90.00	—	63%
Triglycerides blood test inpatient CPT 84478 ASSAY OF TRIGLYCERIDES	$33.30	$90.00	$58.50–$90.00	—	63%
Triglycerides blood test inpatient CPT 84478 BODY FLUID TRIGLYCERIDE	$33.30	$90.00	$58.50–$90.00	—	63%
Troponin test, quantitative CPT 84484 TROPONIN T HS (RANDOM)-Q	$83.25	$225.00	$101.25–$225.00	4% above	63%
Troponin test, quantitative CPT 84484 TROPONIN	$83.25	$225.00	$101.25–$225.00	4% above	63%
Troponin test, quantitative CPT 84484 ISTAT TROPONIN	$83.25	$225.00	$101.25–$225.00	4% above	63%
Troponin test, quantitative inpatient CPT 84484 TROPONIN	$83.25	$225.00	$146.25–$225.00	—	63%
Troponin test, quantitative inpatient CPT 84484 ISTAT TROPONIN	$83.25	$225.00	$146.25–$225.00	—	63%
Troponin test, quantitative inpatient CPT 84484 TROPONIN T HS (RANDOM)-Q	$83.25	$225.00	$146.25–$225.00	—	63%
Uric acid blood test CPT 84550 URIC ACID-Q	$22.57	$61.00	$27.45–$61.00	27% below	63%
Uric acid blood test CPT 84550 URIC ACID SERUM	$23.68	$64.00	$28.80–$64.00	24% below	63%
Uric acid blood test inpatient CPT 84550 URIC ACID-Q	$22.57	$61.00	$39.65–$61.00	—	63%
Uric acid blood test inpatient CPT 84550 URIC ACID SERUM	$23.68	$64.00	$41.60–$64.00	—	63%
Urinalysis with microscope exam, automated CPT 81001 URINE SCREEN/SED	$17.39	$47.00	$21.15–$47.00	49% below	63%
Urinalysis with microscope exam, automated CPT 81001 URINALYSIS REFLEX TO CULTURE-Q	$17.39	$47.00	$21.15–$47.00	49% below	63%
Urinalysis with microscope exam, automated inpatient CPT 81001 URINALYSIS REFLEX TO CULTURE-Q	$17.39	$47.00	$30.55–$47.00	—	63%
Urinalysis with microscope exam, automated inpatient CPT 81001 URINE SCREEN/SED	$17.39	$47.00	$30.55–$47.00	—	63%
Urinalysis without microscope exam, automated CPT 81003 URINE SCREEN	$13.69	$37.00	$16.65–$37.00	37% below	63%
Urinalysis without microscope exam, automated CPT 81003 PH URINE-Q	$13.69	$37.00	$16.65–$37.00	37% below	63%
Urinalysis without microscope exam, automated CPT 81003 SPECIFIC GRAVITY URINE	$13.69	$37.00	$16.65–$37.00	37% below	63%
Urinalysis without microscope exam, automated CPT 81003 PH URINE	$13.69	$37.00	$16.65–$37.00	37% below	63%
Urinalysis without microscope exam, automated CPT 81003 SPECIFIC GRAVITY URINE-Q	$13.69	$37.00	$16.65–$37.00	37% below	63%
Urinalysis without microscope exam, automated CPT 81003 URINALYSIS MACROSCOPIC-Q	$13.69	$37.00	$16.65–$37.00	37% below	63%
Urinalysis without microscope exam, automated CPT 81003 URINALYSIS W/MICROSCOPIC-Q	$13.69	$37.00	$16.65–$37.00	37% below	63%
Urinalysis without microscope exam, automated inpatient CPT 81003 PH URINE	$13.69	$37.00	$24.05–$37.00	—	63%
Urinalysis without microscope exam, automated inpatient CPT 81003 URINALYSIS W/MICROSCOPIC-Q	$13.69	$37.00	$24.05–$37.00	—	63%
Urinalysis without microscope exam, automated inpatient CPT 81003 URINE SCREEN	$13.69	$37.00	$24.05–$37.00	—	63%
Urinalysis without microscope exam, automated inpatient CPT 81003 URINALYSIS MACROSCOPIC-Q	$13.69	$37.00	$24.05–$37.00	—	63%
Urinalysis without microscope exam, automated inpatient CPT 81003 PH URINE-Q	$13.69	$37.00	$24.05–$37.00	—	63%
Urinalysis without microscope exam, automated inpatient CPT 81003 SPECIFIC GRAVITY URINE-Q	$13.69	$37.00	$24.05–$37.00	—	63%
Urinalysis without microscope exam, automated inpatient CPT 81003 SPECIFIC GRAVITY URINE	$13.69	$37.00	$24.05–$37.00	—	63%
Urine culture for bacteria, with colony count CPT 87086 URINE CULTURE	$36.26	$98.00	$44.10–$98.00	44% below	63%
Urine culture for bacteria, with colony count inpatient CPT 87086 URINE CULTURE	$36.26	$98.00	$63.70–$98.00	—	63%
Urine microalbumin (albumin) test CPT 82043 MICROALBUMIN URINE RNDM CLCT-Q	$48.84	$132.00	$59.40–$132.00	4% below	63%
Urine microalbumin (albumin) test CPT 82043 MICROALBUMIN URINE TIMED-Q	$48.84	$132.00	$59.40–$132.00	4% below	63%
Urine microalbumin (albumin) test CPT 82043 MICROALBUMIN URINE	$48.84	$132.00	$59.40–$132.00	4% below	63%
Urine microalbumin (albumin) test inpatient CPT 82043 MICROALBUMIN URINE TIMED-Q	$48.84	$132.00	$85.80–$132.00	—	63%
Urine microalbumin (albumin) test inpatient CPT 82043 MICROALBUMIN URINE	$48.84	$132.00	$85.80–$132.00	—	63%
Urine microalbumin (albumin) test inpatient CPT 82043 MICROALBUMIN URINE RNDM CLCT-Q	$48.84	$132.00	$85.80–$132.00	—	63%
Urine pregnancy test, read by color change CPT 81025 BETA HCG QUALITATIVE URINE-Q	$21.83	$59.00	$26.55–$59.00	22% below	63%
Urine pregnancy test, read by color change CPT 81025 URINE PREGNANCY TEST	$22.94	$62.00	$27.90–$62.00	18% below	63%
Urine pregnancy test, read by color change inpatient CPT 81025 BETA HCG QUALITATIVE URINE-Q	$21.83	$59.00	$38.35–$59.00	—	63%
Urine pregnancy test, read by color change inpatient CPT 81025 URINE PREGNANCY TEST	$22.94	$62.00	$40.30–$62.00	—	63%
Vitamin B12 (cobalamin) blood test CPT 82607 VITAMIN B12 LEVEL REFLEX	$65.86	$178.00	$80.10–$178.00	23% below	63%
Vitamin B12 (cobalamin) blood test CPT 82607 VITAMIN B12	$69.19	$187.00	$84.15–$187.00	19% below	63%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 VITAMIN B12 LEVEL REFLEX	$65.86	$178.00	$115.70–$178.00	—	63%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 VITAMIN B12	$69.19	$187.00	$121.55–$187.00	—	63%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D 25-HYDROXY/LAB	$66.60	$180.00	$81.00–$180.00	42% below	63%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 25-HYDROXY VIT	$66.60	$180.00	$81.00–$180.00	42% below	63%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D2 AND D3 BY LCMS	$66.60	$180.00	$81.00–$180.00	42% below	63%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 VITAMIN D 25-HYDROXY/LAB	$66.60	$180.00	$117.00–$180.00	—	63%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 VITAMIN D2 AND D3 BY LCMS	$66.60	$180.00	$117.00–$180.00	—	63%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 25-HYDROXY VIT	$66.60	$180.00	$117.00–$180.00	—	63%
Vitamin D, 1,25-dihydroxy blood test CPT 82652 VITAMIN D 1 25-DIHYDROXY/LAB	$98.79	$267.00	$120.15–$267.00	25% below	63%
Vitamin D, 1,25-dihydroxy blood test inpatient CPT 82652 VITAMIN D 1 25-DIHYDROXY/LAB	$98.79	$267.00	$173.55–$267.00	—	63%
Zinc blood test CPT 84630 ZINC/LAB	$35.89	$97.00	$43.65–$97.00	15% below	63%
Zinc blood test CPT 84630 ASSAY OF ZINC	$35.89	$97.00	$43.65–$97.00	15% below	63%
Zinc blood test inpatient CPT 84630 ASSAY OF ZINC	$35.89	$97.00	$63.05–$97.00	—	63%
Zinc blood test inpatient CPT 84630 ZINC/LAB	$35.89	$97.00	$63.05–$97.00	—	63%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 PREG TEST-QUANTITATION	$56.61	$153.00	$68.85–$153.00	31% below	63%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 BETA HCG QUANTITATIVE SERUM-Q	$56.61	$153.00	$68.85–$153.00	31% below	63%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 BHCG	$56.61	$153.00	$68.85–$153.00	31% below	63%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 BETA HCG QUANTITATIVE SERUM-Q	$56.61	$153.00	$99.45–$153.00	—	63%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 PREG TEST-QUANTITATION	$56.61	$153.00	$99.45–$153.00	—	63%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 BHCG	$56.61	$153.00	$99.45–$153.00	—	63%

Surgery and procedures

Procedure	Cash price	List price	Insurers pay	vs Maine	Off list
Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION F	$410.33	$1,109.00	$499.05–$1,109.00	16% below	63%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 CARDIOVERSION F	$410.33	$1,109.00	$720.85–$1,109.00	—	63%
Cervical biopsy CPT 57500 BIOPSY OF CERVIX F	$126.54	$342.00	$153.90–$342.00	65% below	63%
Cervical biopsy inpatient CPT 57500 BIOPSY OF CERVIX F	$126.54	$342.00	$222.30–$342.00	—	63%
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 CLS TREAT DSTL RADIAL FX F	$229.77	$621.00	$279.45–$621.00	22% below	63%
Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 CLS TREAT DSTL RADIAL FX F	$229.77	$621.00	$403.65–$621.00	—	63%
Colposcopy with cervical biopsy and scraping of the cervical canal CPT 57454 COLPOSCOPY W/BIOPSY F	$122.10	$330.00	$148.50–$330.00	42% below	63%
Colposcopy with cervical biopsy and scraping of the cervical canal inpatient CPT 57454 COLPOSCOPY W/BIOPSY F	$122.10	$330.00	$214.50–$330.00	—	63%
Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 CYSTOSCOPY F	$200.54	$542.00	$243.90–$542.00	64% below	63%
Cystoscopy, diagnostic look inside the bladder and urethra inpatient CPT 52000 CYSTOSCOPY F	$200.54	$542.00	$352.30–$542.00	—	63%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 DESTRUCT PREMALG LESION F	$72.89	$197.00	$88.65–$197.00	21% below	63%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 DESTRUCT PREMALG LESION F	$72.89	$197.00	$128.05–$197.00	—	63%
Earwax removal by irrigation (rinsing), one ear CPT 69209 REMOVE IMPACTED EAR WAX UNI F	$37.00	$100.00	$45.00–$100.00	26% below	63%
Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 REMOVE IMPACTED EAR WAX UNI F	$37.00	$100.00	$65.00–$100.00	—	63%
Earwax removal with instruments, one ear CPT 69210 REMOVE IMPACT EAR WAX UNI F	$40.70	$110.00	$49.50–$110.00	30% below	63%
Earwax removal with instruments, one ear CPT 69210 REM IMP CER BOTH EAR F	$40.70	$110.00	$49.50–$110.00	30% below	63%
Earwax removal with instruments, one ear inpatient CPT 69210 REM IMP CER BOTH EAR F	$40.70	$110.00	$71.50–$110.00	—	63%
Earwax removal with instruments, one ear inpatient CPT 69210 REMOVE IMPACT EAR WAX UNI F	$40.70	$110.00	$71.50–$110.00	—	63%
Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 ENDOMETRIAL BX SUCTION TYPE	$97.68	$264.00	$118.80–$264.00	51% below	63%
Endometrial biopsy (uterine lining sample) without dilating the cervix inpatient CPT 58100 ENDOMETRIAL BX SUCTION TYPE	$97.68	$264.00	$171.60–$264.00	—	63%
IUD insertion (the device itself billed separately) CPT 58300 IUD INSERTION F	$50.69	$137.00	$61.65–$137.00	70% below	63%
IUD insertion (the device itself billed separately) CPT 58300 INSERTION OF IUD	$50.69	$137.00	$61.65–$137.00	70% below	63%
IUD insertion (the device itself billed separately) inpatient CPT 58300 IUD INSERTION F	$50.69	$137.00	$89.05–$137.00	—	63%
IUD insertion (the device itself billed separately) inpatient CPT 58300 INSERTION OF IUD	$50.69	$137.00	$89.05–$137.00	—	63%
Incision and drainage of a simple or single skin abscess CPT 10060 I&D ABSC SIM/SN F	$115.81	$313.00	$140.85–$313.00	28% below	63%
Incision and drainage of a simple or single skin abscess CPT 10060 I&D ABSCESS SIMPLE/SNGL F	$115.81	$313.00	$140.85–$313.00	28% below	63%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 I&D ABSC SIM/SN F	$115.81	$313.00	$203.45–$313.00	—	63%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 I&D ABSCESS SIMPLE/SNGL F	$115.81	$313.00	$203.45–$313.00	—	63%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 HC INJ TENDON SHEATH/LIGAMENT	$67.34	$182.00	$81.90–$182.00	64% below	63%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 INJ TENDON SHEATH/LIGAMENT F	$67.34	$182.00	$81.90–$182.00	64% below	63%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 INJ TENDON SHEATH/LIGAMENT F	$67.34	$182.00	$118.30–$182.00	—	63%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 HC INJ TENDON SHEATH/LIGAMENT	$67.34	$182.00	$118.30–$182.00	—	63%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 HC DRAIN/INJ MJR JNT/BURSA LT	$66.60	$180.00	$81.00–$180.00	75% below	63%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 HC DRAIN/INJ MJR JNT/BURSA RT	$66.60	$180.00	$81.00–$180.00	75% below	63%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient one side CPT 20610 HC DRAIN/INJ MJR JNT/BURSA LT	$66.60	$180.00	$117.00–$180.00	—	63%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient one side CPT 20610 HC DRAIN/INJ MJR JNT/BURSA RT	$66.60	$180.00	$117.00–$180.00	—	63%
Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 HC INSERT DRUG IMPLANT DEVICE	$115.07	$311.00	$139.95–$311.00	at median	63%
Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 INSERT DRUG IMPLANT DEVICE F	$115.07	$311.00	$139.95–$311.00	at median	63%
Insertion of a drug-delivery implant, such as the arm birth control implant inpatient CPT 11981 HC INSERT DRUG IMPLANT DEVICE	$115.07	$311.00	$202.15–$311.00	—	63%
Insertion of a drug-delivery implant, such as the arm birth control implant inpatient CPT 11981 INSERT DRUG IMPLANT DEVICE F	$115.07	$311.00	$202.15–$311.00	—	63%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 DRAIN INJ JOINT BURSA INTRM F	$53.65	$145.00	$65.25–$145.00	70% below	63%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ARTHRO INTERM WR/ELBOW F	$53.65	$145.00	$65.25–$145.00	70% below	63%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 HC DRAIN/INJ INTM JOINT/BURSA	$53.65	$145.00	$65.25–$145.00	70% below	63%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 ARTHRO INTERM WR/ELBOW F	$53.65	$145.00	$94.25–$145.00	—	63%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 HC DRAIN/INJ INTM JOINT/BURSA	$53.65	$145.00	$94.25–$145.00	—	63%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 DRAIN INJ JOINT BURSA INTRM F	$53.65	$145.00	$94.25–$145.00	—	63%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 DRAIN INJ JOINT BURSA SM F	$48.47	$131.00	$58.95–$131.00	76% below	63%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 HC DRAIN/INJ SML JOINT/BURSA	$48.47	$131.00	$58.95–$131.00	76% below	63%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 DRAIN INJ JOINT BURSA SM F	$48.47	$131.00	$85.15–$131.00	—	63%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 HC DRAIN/INJ SML JOINT/BURSA	$48.47	$131.00	$85.15–$131.00	—	63%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 EXC TAL B9+MARG <.5 CM F	$61.79	$167.00	$75.15–$167.00	64% below	63%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 EXC TAL B9+MARG <.5 CM F	$61.79	$167.00	$108.55–$167.00	—	63%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 EXC FEENL B9+MARG <.5 CM F	$94.35	$255.00	$114.75–$255.00	65% below	63%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 EXC FEENL B9+MARG <.5 CM F	$94.35	$255.00	$165.75–$255.00	—	63%
Nail removal (partial or complete), one nail CPT 11730 AVUL NAIL PLATE F	$62.16	$168.00	$75.60–$168.00	52% below	63%
Nail removal (partial or complete), one nail inpatient CPT 11730 AVUL NAIL PLATE F	$62.16	$168.00	$109.20–$168.00	—	63%
Occipital nerve block (injection for headaches) CPT 64405 N BLOCK INJ OCCIPITAL F	$105.08	$284.00	$127.80–$284.00	65% below	63%
Occipital nerve block (injection for headaches) inpatient CPT 64405 N BLOCK INJ OCCIPITAL F	$105.08	$284.00	$184.60–$284.00	—	63%
Paracentesis with imaging guidance CPT 49083 US PARACENTESIS	$765.90	$2,070.00	$931.50–$2,070.00	6% below	63%
Paracentesis with imaging guidance inpatient CPT 49083 US PARACENTESIS	$765.90	$2,070.00	$1,345.50–$2,070.00	—	63%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 REMOVAL OF NAIL BED F	$212.01	$573.00	$257.85–$573.00	35% below	63%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 REMOVAL OF NAIL BED F	$212.01	$573.00	$372.45–$573.00	—	63%
Prostate biopsy CPT 55700 PROSTATE BX F	$204.24	$552.00	$248.40–$552.00	53% below	63%
Removal of a foreign object under the skin, simple CPT 10120 HC INC&RMVL FB SUBQ TISS SMPL	$99.90	$270.00	$121.50–$270.00	56% below	63%
Removal of a foreign object under the skin, simple CPT 10120 I&REM FB SIM F	$105.08	$284.00	$127.80–$284.00	54% below	63%
Removal of a foreign object under the skin, simple CPT 10120 FB REMOVAL SIMPLE F	$105.08	$284.00	$127.80–$284.00	54% below	63%
Removal of a foreign object under the skin, simple inpatient CPT 10120 HC INC&RMVL FB SUBQ TISS SMPL	$99.90	$270.00	$175.50–$270.00	—	63%
Removal of a foreign object under the skin, simple inpatient CPT 10120 FB REMOVAL SIMPLE F	$105.08	$284.00	$184.60–$284.00	—	63%
Removal of a foreign object under the skin, simple inpatient CPT 10120 I&REM FB SIM F	$105.08	$284.00	$184.60–$284.00	—	63%
Short arm cast (elbow to hand) CPT 29075 HC OT SHORT ARM CAST UNITS	$69.56	$188.00	$84.60–$188.00	60% below	63%
Short arm cast (elbow to hand) inpatient CPT 29075 HC OT SHORT ARM CAST UNITS	$69.56	$188.00	$122.20–$188.00	—	63%
Short arm splint (forearm and hand) CPT 29125 HC PT APPL SPL SHORT STATIC FH	$93.61	$253.00	$113.85–$253.00	19% below	63%
Short arm splint (forearm and hand) CPT 29125 HC PTA APPL SPL SHRT STATIC FH	$93.61	$253.00	$113.85–$253.00	19% below	63%
Short arm splint (forearm and hand) CPT 29125 APPLY SHORT ARM SPLINT F	$93.61	$253.00	$113.85–$253.00	19% below	63%
Short arm splint (forearm and hand) CPT 29125 SPLINT-SHORT ARM STA	$93.61	$253.00	$113.85–$253.00	19% below	63%
Short arm splint (forearm and hand) CPT 29125 APPLICATION SPLINT SHORT ARM F	$93.61	$253.00	$113.85–$253.00	19% below	63%
Short arm splint (forearm and hand) inpatient CPT 29125 APPLICATION SPLINT SHORT ARM F	$93.61	$253.00	$164.45–$253.00	—	63%
Short arm splint (forearm and hand) inpatient CPT 29125 SPLINT-SHORT ARM STA	$93.61	$253.00	$164.45–$253.00	—	63%
Short arm splint (forearm and hand) inpatient CPT 29125 HC PT APPL SPL SHORT STATIC FH	$93.61	$253.00	$164.45–$253.00	—	63%
Short arm splint (forearm and hand) inpatient CPT 29125 HC PTA APPL SPL SHRT STATIC FH	$93.61	$253.00	$164.45–$253.00	—	63%
Short arm splint (forearm and hand) inpatient CPT 29125 APPLY SHORT ARM SPLINT F	$93.61	$253.00	$164.45–$253.00	—	63%
Short leg cast (below the knee) CPT 29405 HC PTA SHRT LEG CAST APP UNITS	$76.22	$206.00	$92.70–$206.00	53% below	63%
Short leg cast (below the knee) inpatient CPT 29405 HC PTA SHRT LEG CAST APP UNITS	$76.22	$206.00	$133.90–$206.00	—	63%
Short leg splint (calf to foot) CPT 29515 APPLICATION SPLINT SHORT LEG F	$93.61	$253.00	$113.85–$253.00	26% below	63%
Short leg splint (calf to foot) CPT 29515 APP OF SHORT LEG SPLINT F	$93.61	$253.00	$113.85–$253.00	26% below	63%
Short leg splint (calf to foot) CPT 29515 HC PTA APPL SPL SHORT LEG	$93.61	$253.00	$113.85–$253.00	26% below	63%
Short leg splint (calf to foot) CPT 29515 HC PT APPL SPL SHORT LEG	$93.61	$253.00	$113.85–$253.00	26% below	63%
Short leg splint (calf to foot) inpatient CPT 29515 APP OF SHORT LEG SPLINT F	$93.61	$253.00	$164.45–$253.00	—	63%
Short leg splint (calf to foot) inpatient CPT 29515 HC PT APPL SPL SHORT LEG	$93.61	$253.00	$164.45–$253.00	—	63%
Short leg splint (calf to foot) inpatient CPT 29515 APPLICATION SPLINT SHORT LEG F	$93.61	$253.00	$164.45–$253.00	—	63%
Short leg splint (calf to foot) inpatient CPT 29515 HC PTA APPL SPL SHORT LEG	$93.61	$253.00	$164.45–$253.00	—	63%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 LAC MINOR 2.5CM/LESS F	$137.27	$371.00	$166.95–$371.00	8% below	63%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 SIM RPR SNAGT <2.5 CM F	$137.27	$371.00	$166.95–$371.00	8% below	63%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 SIM RPR SNAGT <2.5 CM F	$137.27	$371.00	$241.15–$371.00	—	63%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 LAC MINOR 2.5CM/LESS F	$137.27	$371.00	$241.15–$371.00	—	63%
Skin biopsy, punch, one lesion CPT 11104 PUNCH BX SKIN SINGLE LESION F	$76.22	$206.00	$92.70–$206.00	70% below	63%
Skin biopsy, punch, one lesion inpatient CPT 11104 PUNCH BX SKIN SINGLE LESION F	$76.22	$206.00	$133.90–$206.00	—	63%
Skin tag removal, up to 15 tags CPT 11200 REM SKIN TAGS 1-15 F	$72.15	$195.00	$87.75–$195.00	45% below	63%
Skin tag removal, up to 15 tags inpatient CPT 11200 REM SKIN TAGS 1-15 F	$72.15	$195.00	$126.75–$195.00	—	63%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 LAC MINOR 2.6-7.5 CM F	$162.43	$439.00	$197.55–$439.00	13% below	63%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 SIM RPR SNAGT 2.6-7.5 CM F	$162.43	$439.00	$197.55–$439.00	13% below	63%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 SIM RPR SNAGT 2.6-7.5 CM F	$162.43	$439.00	$285.35–$439.00	—	63%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 LAC MINOR 2.6-7.5 CM F	$162.43	$439.00	$285.35–$439.00	—	63%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 LAC MINOR FACE/EAR 2.5CM OR< F	$166.50	$450.00	$202.50–$450.00	1% above	63%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 LAC MINOR FACE/EAR 2.5CM OR< F	$166.50	$450.00	$292.50–$450.00	—	63%
Tangential (shave-style) skin biopsy, one lesion CPT 11102 HC TANGNTL BX SKN SING LES SUR	$58.46	$158.00	$71.10–$158.00	70% below	63%
Tangential (shave-style) skin biopsy, one lesion CPT 11102 TANGNTL BX SKIN SINGLE LES F	$58.46	$158.00	$71.10–$158.00	70% below	63%
Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 HC TANGNTL BX SKN SING LES SUR	$58.46	$158.00	$102.70–$158.00	—	63%
Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 TANGNTL BX SKIN SINGLE LES F	$58.46	$158.00	$102.70–$158.00	—	63%
Thoracentesis with imaging guidance CPT 32555 ASPIRATE PLEURA W/ IMAGING	$646.76	$1,748.00	$786.60–$1,748.00	4% below	63%
Thoracentesis with imaging guidance inpatient CPT 32555 ASPIRATE PLEURA W/ IMAGING	$646.76	$1,748.00	$1,136.20–$1,748.00	—	63%
Trigger point injections, 1 or 2 muscles CPT 20552 INJ TRIGGER POINT 1/2 MUSCL F	$50.69	$137.00	$61.65–$137.00	74% below	63%
Trigger point injections, 1 or 2 muscles CPT 20552 INJ TRIG 1-2 MUSCLE F	$50.69	$137.00	$61.65–$137.00	74% below	63%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 INJ TRIGGER POINT 1/2 MUSCL F	$50.69	$137.00	$89.05–$137.00	—	63%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 INJ TRIG 1-2 MUSCLE F	$50.69	$137.00	$89.05–$137.00	—	63%
Vasectomy, one or both sides, including follow-up semen testing CPT 55250 VASECTOMY F	$211.64	$572.00	$257.40–$572.00	58% below	63%
Vasectomy, one or both sides, including follow-up semen testing inpatient CPT 55250 VASECTOMY F	$211.64	$572.00	$371.80–$572.00	—	63%
Wart removal, up to 14 warts CPT 17110 DESTRUCT B9 LESION 1-14 F	$101.38	$274.00	$123.30–$274.00	40% below	63%
Wart removal, up to 14 warts inpatient CPT 17110 DESTRUCT B9 LESION 1-14 F	$101.38	$274.00	$178.10–$274.00	—	63%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 HC DEB SUBQ TISS 20SQ CM/< WND	$52.91	$143.00	$64.35–$143.00	72% below	63%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEB SUBQ TISSUE 20 SQ CM/< F	$52.91	$143.00	$64.35–$143.00	72% below	63%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DEB SUBQ TISSUE 20 SQ CM/< F	$52.91	$143.00	$92.95–$143.00	—	63%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 HC DEB SUBQ TISS 20SQ CM/< WND	$52.91	$143.00	$92.95–$143.00	—	63%

Doctor visits and therapy

Procedure	Cash price	List price	Insurers pay	vs Maine	Off list
Blood transfusion (giving blood or blood components) CPT 36430 HC TRANSFUSION BLD/BLD CPNT(S)	$382.21	$1,033.00	$464.85–$1,033.00	22% below	63%
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD TRANSFUSION	$382.21	$1,033.00	$464.85–$1,033.00	22% below	63%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD TRANSFUSION	$382.21	$1,033.00	$671.45–$1,033.00	—	63%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 HC TRANSFUSION BLD/BLD CPNT(S)	$382.21	$1,033.00	$671.45–$1,033.00	—	63%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 INHALATION TREATMENT	$247.90	$670.00	$301.50–$670.00	35% above	63%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 INHALATION TREATMENT	$247.90	$670.00	$435.50–$670.00	—	63%
Critical care, first 30 to 74 minutes CPT 99291 CRITICAL CARE FIRST HOUR F	$692.64	$1,872.00	$842.40–$1,872.00	32% below	63%
Critical care, first 30 to 74 minutes CPT 99291 CRITICAL CARE 30-74 MIN F	$692.64	$1,872.00	$842.40–$1,872.00	32% below	63%
Critical care, first 30 to 74 minutes inpatient CPT 99291 CRITICAL CARE FIRST HOUR F	$692.64	$1,872.00	$1,216.80–$1,872.00	—	63%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG CARDIOLOGY F	$101.38	$274.00	$123.30–$274.00	10% below	63%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG CARDIO INTERP & REPORT F	$101.38	$274.00	$123.30–$274.00	10% below	63%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG F	$101.38	$274.00	$123.30–$274.00	10% below	63%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge one side CPT 93005 HC ECG RT 12 LEAD TRACING ONLY	$101.38	$274.00	$123.30–$274.00	10% below	63%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG F	$101.38	$274.00	$178.10–$274.00	—	63%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG CARDIOLOGY F	$101.38	$274.00	$178.10–$274.00	—	63%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG CARDIO INTERP & REPORT F	$101.38	$274.00	$178.10–$274.00	—	63%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient one side CPT 93005 HC ECG RT 12 LEAD TRACING ONLY	$101.38	$274.00	$178.10–$274.00	—	63%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 SUTURE REMOVAL F	$79.92	$216.00	$97.20–$216.00	23% below	63%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 EMERG ROOM/LEVEL 1	$79.92	$216.00	$97.20–$216.00	23% below	63%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 SUTURE REMOVAL F	$79.92	$216.00	$140.40–$216.00	—	63%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 EMERG ROOM/LEVEL 1	$79.92	$216.00	$140.40–$216.00	—	63%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 EMERG ROOM/LEVEL 2	$154.66	$418.00	$188.10–$418.00	26% below	63%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 EMERG ROOM/LEVEL 2	$154.66	$418.00	$271.70–$418.00	—	63%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 EMERG ROOM/LEVEL 3	$277.13	$749.00	$337.05–$749.00	17% below	63%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 EMERG ROOM/LEVEL 3	$277.13	$749.00	$486.85–$749.00	—	63%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 EMERG ROOM/LEVEL 4	$452.14	$1,222.00	$549.90–$1,222.00	26% below	63%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 EMERG ROOM/LEVEL 4	$452.14	$1,222.00	$794.30–$1,222.00	—	63%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 EMERG ROOM/LEVEL 5	$750.73	$2,029.00	$913.05–$2,029.00	24% below	63%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 EMERG ROOM/LEVEL 5	$750.73	$2,029.00	$1,318.85–$2,029.00	—	63%
Exercise stress test, tracing only, the hospital charge CPT 93017 HC CV STRSS TST TRACING ONLY	$421.80	$1,140.00	$513.00–$1,140.00	27% below	63%
Exercise stress test, tracing only, the hospital charge CPT 93017 TREADMILL STRESS TEST CARDIO F	$421.80	$1,140.00	$513.00–$1,140.00	27% below	63%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 HC CV STRSS TST TRACING ONLY	$421.80	$1,140.00	$741.00–$1,140.00	—	63%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 TREADMILL STRESS TEST CARDIO F	$421.80	$1,140.00	$741.00–$1,140.00	—	63%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV HYDRATION 31-60 MIN	$127.65	$345.00	$155.25–$345.00	39% below	63%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV INFUS HYDRATION 1ST HR	$127.65	$345.00	$155.25–$345.00	39% below	63%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV INFUS HYDRATION 1ST HR	$127.65	$345.00	$224.25–$345.00	—	63%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV HYDRATION 31-60 MIN	$127.65	$345.00	$224.25–$345.00	—	63%
IV infusion of a medicine, first hour CPT 96365 INFUSION THERAPY 1ST HR	$354.46	$958.00	$431.10–$958.00	9% above	63%
IV infusion of a medicine, first hour CPT 96365 IV INFUSION THERAPY 60 MIN	$354.46	$958.00	$431.10–$958.00	9% above	63%
IV infusion of a medicine, first hour CPT 96365 IV THERAPY INITIAL	$354.46	$958.00	$431.10–$958.00	9% above	63%
IV infusion of a medicine, first hour inpatient CPT 96365 IV THERAPY INITIAL	$354.46	$958.00	$622.70–$958.00	—	63%
IV infusion of a medicine, first hour inpatient CPT 96365 IV INFUSION THERAPY 60 MIN	$354.46	$958.00	$622.70–$958.00	—	63%
IV infusion of a medicine, first hour inpatient CPT 96365 INFUSION THERAPY 1ST HR	$354.46	$958.00	$622.70–$958.00	—	63%
IV push of a medicine, first drug CPT 96374 HC THER/PROPH/DIAG INJ IV PUSH	$128.39	$347.00	$156.15–$347.00	35% below	63%
IV push of a medicine, first drug CPT 96374 ED THER INJ IV INITIAL DRUG	$354.46	$958.00	$431.10–$958.00	80% above	63%
IV push of a medicine, first drug CPT 96374 INJ IV INITIAL DRUG NON CHEMO	$354.46	$958.00	$431.10–$958.00	80% above	63%
IV push of a medicine, first drug inpatient CPT 96374 HC THER/PROPH/DIAG INJ IV PUSH	$128.39	$347.00	$225.55–$347.00	—	63%
IV push of a medicine, first drug inpatient CPT 96374 ED THER INJ IV INITIAL DRUG	$354.46	$958.00	$622.70–$958.00	—	63%
IV push of a medicine, first drug inpatient CPT 96374 INJ IV INITIAL DRUG NON CHEMO	$354.46	$958.00	$622.70–$958.00	—	63%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 HC THER/PROPH/DIAG INJ SC/IM	$116.55	$315.00	$141.75–$315.00	69% above	63%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 THER/PROPH/DIAG INJ SC/IM	$116.55	$315.00	$141.75–$315.00	69% above	63%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 HC THER/PROPH/DIAG INJ SC/IM	$116.55	$315.00	$204.75–$315.00	—	63%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 THER/PROPH/DIAG INJ SC/IM	$116.55	$315.00	$204.75–$315.00	—	63%
Mental health diagnostic evaluation (intake), without medical services CPT 90791 HC PSYCHIATRIC DX EVAL	$55.13	$149.00	$67.05–$149.00	74% below	63%
Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 HC PSYCHIATRIC DX EVAL	$55.13	$149.00	$96.85–$149.00	—	63%
Nerve conduction study, 7 or 8 nerve studies CPT 95910 NRV CNDJ TEST 7-8 STUDIES F	$201.28	$544.00	$244.80–$544.00	7% below	63%
Nerve conduction study, 7 or 8 nerve studies inpatient CPT 95910 NRV CNDJ TEST 7-8 STUDIES F	$201.28	$544.00	$353.60–$544.00	—	63%
Neuromuscular re-education, 15 minutes CPT 97112 OTA NEURO RE-EDUCATION	$56.98	$154.00	$69.30–$154.00	42% below	63%
Neuromuscular re-education, 15 minutes CPT 97112 NEURO RE-EDUCATION PER 15 MIN	$56.98	$154.00	$69.30–$154.00	42% below	63%
Neuromuscular re-education, 15 minutes CPT 97112 HC SP NEUROMUSCLR RE-ED 15MINS	$56.98	$154.00	$69.30–$154.00	42% below	63%
Neuromuscular re-education, 15 minutes CPT 97112 NEURO RE-EDUCATION	$56.98	$154.00	$69.30–$154.00	42% below	63%
Neuromuscular re-education, 15 minutes CPT 97112 PTA NEURO REEDUCATN PER 15 MIN	$56.98	$154.00	$69.30–$154.00	42% below	63%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 OTA NEURO RE-EDUCATION	$56.98	$154.00	$100.10–$154.00	—	63%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 NEURO RE-EDUCATION	$56.98	$154.00	$100.10–$154.00	—	63%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 NEURO RE-EDUCATION PER 15 MIN	$56.98	$154.00	$100.10–$154.00	—	63%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 PTA NEURO REEDUCATN PER 15 MIN	$56.98	$154.00	$100.10–$154.00	—	63%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 HC SP NEUROMUSCLR RE-ED 15MINS	$56.98	$154.00	$100.10–$154.00	—	63%
New patient office visit, about 30 minutes CPT 99203 HC OFF CONSLT NEW PT 40MIN SUR	$36.63	$99.00	$44.55–$99.00	75% below	63%
New patient office visit, about 30 minutes CPT 99203 OFFICE VISIT NEW L3 F	$69.19	$187.00	$84.15–$187.00	52% below	63%
New patient office visit, about 30 minutes CPT 99203 NEW OFFICE VISIT LV 3 F	$69.19	$187.00	$84.15–$187.00	52% below	63%
New patient office visit, about 30 minutes CPT 99203 HC NEW PT OV LV3 GEN SUR	$69.19	$187.00	$84.15–$187.00	52% below	63%
New patient office visit, about 30 minutes CPT 99203 HC OUTPT CLINIC VST NEW LVL 3	$69.19	$187.00	$84.15–$187.00	52% below	63%
New patient office visit, about 30 minutes CPT 99203 HC OP CLINIC VISIT NEW LVL 3	$69.19	$187.00	$84.15–$187.00	52% below	63%
New patient office visit, about 30 minutes CPT 99203 EVAL/MGT INITIAL L3 O/P	$69.19	$187.00	$84.15–$187.00	52% below	63%
New patient office visit, about 30 minutes CPT 99203 NEW PT OV LEV 3 FAC	$69.19	$187.00	$84.15–$187.00	52% below	63%
New patient office visit, about 30 minutes CPT 99203 OFFICE/OP VISIT NEW L3 F	$69.19	$187.00	$84.15–$187.00	52% below	63%
New patient office visit, about 30 minutes CPT 99203 NEW PT OV L3 F	$69.19	$187.00	$84.15–$187.00	52% below	63%
New patient office visit, about 30 minutes CPT 99203 NEW PT OV LEV 3 F	$69.19	$187.00	$84.15–$187.00	52% below	63%
New patient office visit, about 45 minutes CPT 99204 HC OFF CONSLT NEW PT 60MIN SUR	$58.83	$159.00	$71.55–$159.00	72% below	63%
New patient office visit, about 45 minutes CPT 99204 EVAL/MGT INITIAL L4 O/P	$94.35	$255.00	$114.75–$255.00	55% below	63%
New patient office visit, about 45 minutes CPT 99204 NEW PT OV LEV 4 F	$94.35	$255.00	$114.75–$255.00	55% below	63%
New patient office visit, about 45 minutes CPT 99204 HC OUTPT CLINIC VST NEW LVL 4	$94.35	$255.00	$114.75–$255.00	55% below	63%
New patient office visit, about 45 minutes CPT 99204 HC OP CLINIC VISIT NEW LVL 4	$94.35	$255.00	$114.75–$255.00	55% below	63%
New patient office visit, about 45 minutes CPT 99204 NEW PT OV LEV 4 FAC	$94.35	$255.00	$114.75–$255.00	55% below	63%
New patient office visit, about 45 minutes CPT 99204 NEW PT OV L4 F	$94.35	$255.00	$114.75–$255.00	55% below	63%
New patient office visit, about 45 minutes CPT 99204 OFFICE VISIT NEW L4 F	$94.35	$255.00	$114.75–$255.00	55% below	63%
New patient office visit, about 45 minutes CPT 99204 NEW OFFICE VISIT LV 4 F	$94.35	$255.00	$114.75–$255.00	55% below	63%
New patient office visit, about 45 minutes CPT 99204 HC NEW PT OV LV4 GEN SUR	$94.35	$255.00	$114.75–$255.00	55% below	63%
New patient office visit, about 45 minutes CPT 99204 OFFICE/OP VISIT NEW L4 F	$94.35	$255.00	$114.75–$255.00	55% below	63%
New patient office visit, about 60 minutes CPT 99205 HC OFF CONSLT NEW PT 80MIN SUR	$72.15	$195.00	$87.75–$195.00	78% below	63%
New patient office visit, about 60 minutes CPT 99205 NEW PT OV LEV 5 F	$166.13	$449.00	$202.05–$449.00	50% below	63%
New patient office visit, about 60 minutes CPT 99205 HC OUTPT CLINIC VST NEW LVL 5	$166.13	$449.00	$202.05–$449.00	50% below	63%
New patient office visit, about 60 minutes CPT 99205 HC OP CLINIC VISIT NEW LVL 5	$166.13	$449.00	$202.05–$449.00	50% below	63%
New patient office visit, about 60 minutes CPT 99205 FAA NEW PT OV LEV 5 F	$166.13	$449.00	$202.05–$449.00	50% below	63%
New patient office visit, about 60 minutes CPT 99205 NEW PT OV LEV 5 FAC	$166.13	$449.00	$202.05–$449.00	50% below	63%
New patient office visit, about 60 minutes CPT 99205 EVAL/MGT INITIAL L5 O/P	$166.13	$449.00	$202.05–$449.00	50% below	63%
New patient office visit, about 60 minutes CPT 99205 OFFICE/OP VISIT NEW L5 F	$166.13	$449.00	$202.05–$449.00	50% below	63%
New patient office visit, about 60 minutes CPT 99205 NEW PT OV L5 F	$166.13	$449.00	$202.05–$449.00	50% below	63%
New patient office visit, about 60 minutes CPT 99205 OFFICE VISIT NEW L5 F	$166.13	$449.00	$202.05–$449.00	50% below	63%
New patient office visit, about 60 minutes CPT 99205 NEW OFFICE VISIT LV 5 F	$166.13	$449.00	$202.05–$449.00	50% below	63%
New patient office visit, about 60 minutes CPT 99205 HC NEW PT OV LV5 GEN SUR	$166.13	$449.00	$202.05–$449.00	50% below	63%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 HC NEW PT OV LV2 GEN SUR	$58.83	$159.00	$71.55–$159.00	33% below	63%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 NEW OFFICE VISIT LV 2 F	$58.83	$159.00	$71.55–$159.00	33% below	63%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 OFFICE VISIT NEW L2 F	$58.83	$159.00	$71.55–$159.00	33% below	63%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 NEW PT OV L2 F	$58.83	$159.00	$71.55–$159.00	33% below	63%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 OFFICE/OP VISIT NEW L2 F	$58.83	$159.00	$71.55–$159.00	33% below	63%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 NEW PT OV LEV 2 FAC	$58.83	$159.00	$71.55–$159.00	33% below	63%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 EVAL/MGT INITIAL L2 O/P	$58.83	$159.00	$71.55–$159.00	33% below	63%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 NEW PT OV LEV 2 F	$58.83	$159.00	$71.55–$159.00	33% below	63%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 HC OUTPT CLINIC VST NEW LVL 2	$58.83	$159.00	$71.55–$159.00	33% below	63%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 HC OP CLINIC VISIT NEW LVL 2	$58.83	$159.00	$71.55–$159.00	33% below	63%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 TELE NUTRITION CONSULT 15MIN	$33.67	$91.00	$40.95–$91.00	26% below	63%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 NUTRITION CONSULT 15MIN	$33.67	$91.00	$40.95–$91.00	26% below	63%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 TELE NUTRITION CONSULT 15MIN	$33.67	$91.00	$59.15–$91.00	—	63%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 NUTRITION CONSULT 15MIN	$33.67	$91.00	$59.15–$91.00	—	63%
Occupational therapy evaluation, low complexity CPT 97165 OT EVAL LOW COMPLEX 30 MIN	$165.02	$446.00	$200.70–$446.00	26% below	63%
Occupational therapy evaluation, low complexity inpatient CPT 97165 OT EVAL LOW COMPLEX 30 MIN	$165.02	$446.00	$289.90–$446.00	—	63%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PT EVAL HIGH COMPLEX 45 MIN	$181.67	$491.00	$220.95–$491.00	35% below	63%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PT RE-EVAL EST PLAN CARE	$181.67	$491.00	$220.95–$491.00	35% below	63%
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 PT RE-EVAL EST PLAN CARE	$181.67	$491.00	$319.15–$491.00	—	63%
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 PT EVAL HIGH COMPLEX 45 MIN	$181.67	$491.00	$319.15–$491.00	—	63%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PT EVAL LOW COMPLEX 20 MIN	$165.02	$446.00	$200.70–$446.00	26% below	63%
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 PT EVAL LOW COMPLEX 20 MIN	$165.02	$446.00	$289.90–$446.00	—	63%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PT EVAL MOD COMPLEX 30 MIN	$173.16	$468.00	$210.60–$468.00	36% below	63%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 PT EVAL MOD COMPLEX 30 MIN	$173.16	$468.00	$304.20–$468.00	—	63%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 PTA MANUAL THERAPY PER 15 MIN	$52.91	$143.00	$64.35–$143.00	46% below	63%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MANUAL THERAPY PER 15 MIN	$52.91	$143.00	$64.35–$143.00	46% below	63%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 OTA MANUAL THERAPY PER 15 MIN	$52.91	$143.00	$64.35–$143.00	46% below	63%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 PTA MANUAL THERAPY PER 15 MIN	$52.91	$143.00	$92.95–$143.00	—	63%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 MANUAL THERAPY PER 15 MIN	$52.91	$143.00	$92.95–$143.00	—	63%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 OTA MANUAL THERAPY PER 15 MIN	$52.91	$143.00	$92.95–$143.00	—	63%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HC SP THERAPEUTIC EXER 15 MINS	$48.84	$132.00	$59.40–$132.00	28% below	63%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERAPEUTIC PROCEDURE	$49.58	$134.00	$60.30–$134.00	27% below	63%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 OTA THERAPEUTIC PROCEDURE	$49.58	$134.00	$60.30–$134.00	27% below	63%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 PTA THERAPTC PRO EXER PR 15MIN	$49.58	$134.00	$60.30–$134.00	27% below	63%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERAPEUTIC PRO EXER PER 15MIN	$49.58	$134.00	$60.30–$134.00	27% below	63%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 HC SP THERAPEUTIC EXER 15 MINS	$48.84	$132.00	$85.80–$132.00	—	63%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 OTA THERAPEUTIC PROCEDURE	$49.58	$134.00	$87.10–$134.00	—	63%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THERAPEUTIC PROCEDURE	$49.58	$134.00	$87.10–$134.00	—	63%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THERAPEUTIC PRO EXER PER 15MIN	$49.58	$134.00	$87.10–$134.00	—	63%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 PTA THERAPTC PRO EXER PR 15MIN	$49.58	$134.00	$87.10–$134.00	—	63%
Preventive checkup, new patient aged 18–39 CPT 99385 NEW PT WELLNESS 18-39 YRS F	$27.75	$75.00	$33.75–$75.00	81% below	63%
Preventive checkup, new patient aged 18–39 CPT 99385 PREVT CARE 18-39 YR NEW PT F	$27.75	$75.00	$33.75–$75.00	81% below	63%
Preventive checkup, new patient aged 40–64 CPT 99386 PREVT CARE 40-64 YR NEW PT F	$33.67	$91.00	$40.95–$91.00	81% below	63%
Preventive checkup, new patient aged 40–64 CPT 99386 NEW PT WELLNESS 40-64 YRS F	$33.67	$91.00	$40.95–$91.00	81% below	63%
Preventive checkup, new patient aged 65 or older CPT 99387 NEW PT WELLNESS 65+ YRS F	$36.63	$99.00	$44.55–$99.00	70% below	63%
Preventive checkup, new patient aged 65 or older CPT 99387 HC NEW PT WELLNESS 65+ YRS	$36.63	$99.00	$44.55–$99.00	70% below	63%
Preventive checkup, new patient aged 65 or older CPT 99387 PREVT CARE 65 & OVER NEW PT F	$36.63	$99.00	$44.55–$99.00	70% below	63%
Preventive checkup, returning patient aged 18–39 CPT 99395 PREVT CARE 18-39 YR EST PT F	$25.90	$70.00	$31.50–$70.00	78% below	63%
Preventive checkup, returning patient aged 18–39 CPT 99395 PREVENTATIVE 18-39 YEARS EST	$25.90	$70.00	$31.50–$70.00	78% below	63%
Preventive checkup, returning patient aged 40–64 CPT 99396 PREVT CARE 40-64 YR EST PT F	$28.12	$76.00	$34.20–$76.00	75% below	63%
Preventive checkup, returning patient aged 40–64 CPT 99396 PREVENTATIVE 40-64 YEARS EST	$28.12	$76.00	$34.20–$76.00	75% below	63%
Preventive checkup, returning patient aged 65 or older CPT 99397 PREVENTIVE CARE 65+ EST	$29.60	$80.00	$36.00–$80.00	81% below	63%
Preventive checkup, returning patient aged 65 or older CPT 99397 PREVT CARE 65 & OVER EST PT F	$29.60	$80.00	$36.00–$80.00	81% below	63%
Psychotherapy session, 30 minutes CPT 90832 HC PSYCHOTHERAPY W/PAT 30 MIN	$45.88	$124.00	$55.80–$124.00	66% below	63%
Psychotherapy session, 30 minutes CPT 90832 PSYTX PT&/FAMILY 30 MINUTES F	$57.35	$155.00	$69.75–$155.00	57% below	63%
Psychotherapy session, 30 minutes inpatient CPT 90832 HC PSYCHOTHERAPY W/PAT 30 MIN	$45.88	$124.00	$80.60–$124.00	—	63%
Psychotherapy session, 30 minutes inpatient CPT 90832 PSYTX PT&/FAMILY 30 MINUTES F	$57.35	$155.00	$100.75–$155.00	—	63%
Psychotherapy session, 45 minutes CPT 90834 HC PSYCHOTHERAPY W/PAT 45 MIN	$61.05	$165.00	$74.25–$165.00	65% below	63%
Psychotherapy session, 45 minutes CPT 90834 PSYTX PT&/FAMILY 45 MINUTES F	$76.22	$206.00	$92.70–$206.00	56% below	63%
Psychotherapy session, 45 minutes inpatient CPT 90834 HC PSYCHOTHERAPY W/PAT 45 MIN	$61.05	$165.00	$107.25–$165.00	—	63%
Psychotherapy session, 45 minutes inpatient CPT 90834 PSYTX PT&/FAMILY 45 MINUTES F	$76.22	$206.00	$133.90–$206.00	—	63%
Psychotherapy session, 60 minutes CPT 90837 HC PSYCHOTHERAPY W/PAT 60 MIN	$74.00	$200.00	$90.00–$200.00	56% below	63%
Psychotherapy session, 60 minutes CPT 90837 PSYTX PT&/FAMILY 60 MINUTES F	$92.50	$250.00	$112.50–$250.00	45% below	63%
Psychotherapy session, 60 minutes inpatient CPT 90837 HC PSYCHOTHERAPY W/PAT 60 MIN	$74.00	$200.00	$130.00–$200.00	—	63%
Psychotherapy session, 60 minutes inpatient CPT 90837 PSYTX PT&/FAMILY 60 MINUTES F	$92.50	$250.00	$162.50–$250.00	—	63%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 HC BEHAV CHNG SMOKING 3-10 MIN	$18.13	$49.00	$22.05–$49.00	27% below	63%
Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 HC BEHAV CHNG SMOKING 3-10 MIN	$18.13	$49.00	$31.85–$49.00	—	63%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 HC CONSULT OP INI 40MIN SUR	$58.83	$159.00	$71.55–$159.00	60% below	63%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 HC CONSULT OP INI 55MIN SUR	$72.15	$195.00	$87.75–$195.00	50% below	63%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 EVAL/MGT F/U L5 O/P	$126.91	$343.00	$154.35–$343.00	13% below	63%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 EST PT OV LEV 5 F	$126.91	$343.00	$154.35–$343.00	13% below	63%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 HC OP CLINIC VISIT EST LVL 5	$126.91	$343.00	$154.35–$343.00	13% below	63%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 EST PT OV LEV 5 FAC	$126.91	$343.00	$154.35–$343.00	13% below	63%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 OFFICE CONSULT NEW PT L5 F	$126.91	$343.00	$154.35–$343.00	13% below	63%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 EST PT OV LEV 5 OBSTETRICS F	$126.91	$343.00	$154.35–$343.00	13% below	63%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 FAA EST PT OV LEV 2 F	$126.91	$343.00	$154.35–$343.00	13% below	63%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 OB VISIT 5 F	$126.91	$343.00	$154.35–$343.00	13% below	63%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 OFFICE/OP VISIT EST L5 F	$126.91	$343.00	$154.35–$343.00	13% below	63%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 EST PT OV L5 F	$126.91	$343.00	$154.35–$343.00	13% below	63%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 OFFICE VISIT EST L5 FF	$126.91	$343.00	$154.35–$343.00	13% below	63%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 EST OFFICE VISIT LV5 F	$126.91	$343.00	$154.35–$343.00	13% below	63%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 HC EST PT OV LV5 GEN SUR	$126.91	$343.00	$154.35–$343.00	13% below	63%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 HC OUTPT CLINIC VST EST LVL 5	$126.91	$343.00	$154.35–$343.00	13% below	63%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 HC CONSULT OP INI 20MIN SUR	$26.27	$71.00	$31.95–$71.00	64% below	63%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 EST PT OV LEV 3 F	$63.64	$172.00	$77.40–$172.00	13% below	63%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 HC OP CLINIC VISIT EST LVL 3	$63.64	$172.00	$77.40–$172.00	13% below	63%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 HC OUTPT CLINIC VST EST LVL 3	$63.64	$172.00	$77.40–$172.00	13% below	63%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 HC EST PT OV LV3 GEN SUR	$63.64	$172.00	$77.40–$172.00	13% below	63%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 EST OFFICE VISIT LV3 F	$63.64	$172.00	$77.40–$172.00	13% below	63%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 OFFICE VISIT EST L3 F	$63.64	$172.00	$77.40–$172.00	13% below	63%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 EST PT OV L3 F	$63.64	$172.00	$77.40–$172.00	13% below	63%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 OFFICE/OP VISIT EST L3 F	$63.64	$172.00	$77.40–$172.00	13% below	63%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 EST PT OV LEV 3 OBSTETRICS F	$63.64	$172.00	$77.40–$172.00	13% below	63%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 EST PT OV LEV 3 FAC	$63.64	$172.00	$77.40–$172.00	13% below	63%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 OB VISIT 3 F	$63.64	$172.00	$77.40–$172.00	13% below	63%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 EVAL/MGT F/U L3 O/P	$63.64	$172.00	$77.40–$172.00	13% below	63%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 HC CONSULT OP INI 30MIN SUR	$36.63	$99.00	$44.55–$99.00	65% below	63%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 OFFICE CONSULT NEW PT L4 F	$83.62	$226.00	$101.70–$226.00	21% below	63%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 HC OP CLINIC VISIT EST LVL 4	$83.62	$226.00	$101.70–$226.00	21% below	63%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 HC OUTPT CLINIC VST EST LVL 4	$83.62	$226.00	$101.70–$226.00	21% below	63%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 EST PT OV LEV 4 F	$83.62	$226.00	$101.70–$226.00	21% below	63%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 EVAL/MGT F/U L4 O/P	$83.62	$226.00	$101.70–$226.00	21% below	63%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 OB VISIT 4 F	$83.62	$226.00	$101.70–$226.00	21% below	63%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 EST PT OV LEV 4 FAC	$83.62	$226.00	$101.70–$226.00	21% below	63%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 EST PT OV LEV 4 OBSTETRICS F	$83.62	$226.00	$101.70–$226.00	21% below	63%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 OFFICE/OP VISIT EST L4 F	$83.62	$226.00	$101.70–$226.00	21% below	63%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 EST PT OV L4 F	$83.62	$226.00	$101.70–$226.00	21% below	63%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 OFFICE VISIT EST L4 F	$83.62	$226.00	$101.70–$226.00	21% below	63%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 EST OFFICE VISIT LV4 F	$83.62	$226.00	$101.70–$226.00	21% below	63%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 HC EST PT OV LV4 GEN SUR	$83.62	$226.00	$101.70–$226.00	21% below	63%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 HC EST PT OV LV2 GEN SUR	$49.21	$133.00	$59.85–$133.00	13% below	63%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 EST PT OV LEV 2 F	$49.21	$133.00	$59.85–$133.00	13% below	63%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 HC OUTPT CLINIC VST EST LVL 2	$49.21	$133.00	$59.85–$133.00	13% below	63%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 HC OP CLINIC VISIT EST LVL 2	$49.21	$133.00	$59.85–$133.00	13% below	63%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 EST PT OV LEV 2 OBSTETRICS F	$49.21	$133.00	$59.85–$133.00	13% below	63%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 OFFICE/OP VISIT EST L2 F	$49.21	$133.00	$59.85–$133.00	13% below	63%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 EST PT OV LEV 2 FAC	$49.21	$133.00	$59.85–$133.00	13% below	63%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 EST PT OV L2 F	$49.21	$133.00	$59.85–$133.00	13% below	63%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 OFFICE VISIT EST L2 F	$49.21	$133.00	$59.85–$133.00	13% below	63%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 EST OFFICE VISIT LV2 F	$49.21	$133.00	$59.85–$133.00	13% below	63%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 EVAL/MGT F/U L2 O/P	$49.21	$133.00	$59.85–$133.00	13% below	63%
Specialist consultation, low complexity or 30+ minutes CPT 99243 CONSULT INIT O/P 30 MIN F	$36.63	$99.00	$44.55–$99.00	19% below	63%
Specialist consultation, low complexity or 30+ minutes CPT 99243 HC OFFICE CONSULT 30 MIN	$36.63	$99.00	$44.55–$99.00	19% below	63%
Specialist consultation, low complexity or 30+ minutes CPT 99243 HC OFFICE CONSULT EST 30 MIN	$36.63	$99.00	$44.55–$99.00	19% below	63%
Specialist consultation, low complexity or 30+ minutes CPT 99243 OFFICE CONSULT 30 MIN F	$36.63	$99.00	$44.55–$99.00	19% below	63%
Specialist consultation, low complexity or 30+ minutes CPT 99243 CONSULT OP INI L3 F	$36.63	$99.00	$44.55–$99.00	19% below	63%
Specialist consultation, low complexity or 30+ minutes CPT 99243 OFFICE CONSULT NEW PT 30 MIN F	$36.63	$99.00	$44.55–$99.00	19% below	63%
Specialist consultation, moderate complexity or 40+ minutes CPT 99244 OFFICE CONSULT 40 MIN F	$58.83	$159.00	$71.55–$159.00	8% below	63%
Specialist consultation, moderate complexity or 40+ minutes CPT 99244 HC OFFICE CONSULT EST 40 MIN	$58.83	$159.00	$71.55–$159.00	8% below	63%
Specialist consultation, moderate complexity or 40+ minutes CPT 99244 HC OFFICE CONSULT 40 MIN	$58.83	$159.00	$71.55–$159.00	8% below	63%
Specialist consultation, moderate complexity or 40+ minutes CPT 99244 CONSULT INIT O/P 40 MIN F	$58.83	$159.00	$71.55–$159.00	8% below	63%
Specialist consultation, moderate complexity or 40+ minutes CPT 99244 CONSULT OP INI L4 F	$58.83	$159.00	$71.55–$159.00	8% below	63%
Speech and language evaluation CPT 92523 SPEECH SOUND LANG COMP TELE	$221.63	$599.00	$269.55–$599.00	31% below	63%
Speech and language evaluation CPT 92523 SPEECH SOUND LANG COMPREHEN	$221.63	$599.00	$269.55–$599.00	31% below	63%
Speech and language evaluation inpatient CPT 92523 SPEECH SOUND LANG COMPREHEN	$221.63	$599.00	$389.35–$599.00	—	63%
Speech and language evaluation inpatient CPT 92523 SPEECH SOUND LANG COMP TELE	$221.63	$599.00	$389.35–$599.00	—	63%
Speech therapy session, individual CPT 92507 SPEECH THER TX	$120.99	$327.00	$147.15–$327.00	26% below	63%
Speech therapy session, individual inpatient CPT 92507 SPEECH THER TX	$120.99	$327.00	$212.55–$327.00	—	63%
Spirometry (breathing test) CPT 94010 HC SPIROMETRY	$130.61	$353.00	$158.85–$353.00	7% below	63%
Spirometry (breathing test) CPT 94010 SPIROMETRY	$130.61	$353.00	$158.85–$353.00	7% below	63%
Spirometry (breathing test) inpatient CPT 94010 HC SPIROMETRY	$130.61	$353.00	$229.45–$353.00	—	63%
Spirometry (breathing test) inpatient CPT 94010 SPIROMETRY	$130.61	$353.00	$229.45–$353.00	—	63%
Spirometry before and after a bronchodilator CPT 94060 HC SPIROMETRY B&A	$288.97	$781.00	$351.45–$781.00	10% below	63%
Spirometry before and after a bronchodilator CPT 94060 BRONCHODILATOR ADMIN PRE/POST	$288.97	$781.00	$351.45–$781.00	10% below	63%
Spirometry before and after a bronchodilator inpatient CPT 94060 BRONCHODILATOR ADMIN PRE/POST	$288.97	$781.00	$507.65–$781.00	—	63%
Spirometry before and after a bronchodilator inpatient CPT 94060 HC SPIROMETRY B&A	$288.97	$781.00	$507.65–$781.00	—	63%
Therapeutic activities (functional training), 15 minutes CPT 97530 OTA THERAPEUTC ACTIV PR 15 MIN	$65.12	$176.00	$79.20–$176.00	43% below	63%
Therapeutic activities (functional training), 15 minutes CPT 97530 THERAPEUTIC ACTIV PER 15 MIN	$65.12	$176.00	$79.20–$176.00	43% below	63%
Therapeutic activities (functional training), 15 minutes CPT 97530 THERAPEUTIC ACTIVITIES 15 MIN	$65.12	$176.00	$79.20–$176.00	43% below	63%
Therapeutic activities (functional training), 15 minutes CPT 97530 PTA THERAPEUTC ACTIVITS 15 MIN	$65.12	$176.00	$79.20–$176.00	43% below	63%
Therapeutic activities (functional training), 15 minutes CPT 97530 HC SP THERAPEUTIC ACT 15MIN CA	$65.12	$176.00	$79.20–$176.00	43% below	63%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 PTA THERAPEUTC ACTIVITS 15 MIN	$65.12	$176.00	$114.40–$176.00	—	63%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 THERAPEUTIC ACTIV PER 15 MIN	$65.12	$176.00	$114.40–$176.00	—	63%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 HC SP THERAPEUTIC ACT 15MIN CA	$65.12	$176.00	$114.40–$176.00	—	63%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 OTA THERAPEUTC ACTIV PR 15 MIN	$65.12	$176.00	$114.40–$176.00	—	63%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 THERAPEUTIC ACTIVITIES 15 MIN	$65.12	$176.00	$114.40–$176.00	—	63%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 THER PHLEBOTOMY	$113.22	$306.00	$137.70–$306.00	27% below	63%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 HC THERAPEUTIC PHLEBOTOMY	$113.22	$306.00	$137.70–$306.00	27% below	63%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 THER PHLEBOTOMY	$113.22	$306.00	$198.90–$306.00	—	63%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 HC THERAPEUTIC PHLEBOTOMY	$113.22	$306.00	$198.90–$306.00	—	63%

Vaccines

Procedure	Cash price	List price	Insurers pay	vs Maine	Off list
COVID-19 vaccine (Moderna), age 12 and older CPT 91322 SPIKEVAX PF (CVX 312) 0.5 ML	$99.16	$268.00	$120.60–$268.00	38% below	63%
COVID-19 vaccine (Moderna), age 12 and older inpatient CPT 91322 SPIKEVAX PF (CVX 312) 0.5 ML	$99.16	$268.00	$174.20–$268.00	—	63%
Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 VARICELLA VAC	$111.80	$302.15	$135.97–$302.15	28% below	63%
Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 VARICELLA VAC	$111.80	$302.15	$196.40–$302.15	—	63%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 DTAP VAC <7	$23.62	$63.84	$28.73–$63.84	at median	63%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 DAPTACEL (DTAP) 0.5ML INJ	$23.62	$63.84	$28.73–$63.84	at median	63%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 INFANRIX(DTAP)PF25-10-58/0.5ML	$23.62	$63.84	$28.73–$63.84	at median	63%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 inpatient CPT 90700 DTAP VAC <7	$23.62	$63.84	$41.50–$63.84	—	63%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 inpatient CPT 90700 INFANRIX(DTAP)PF25-10-58/0.5ML	$23.62	$63.84	$41.50–$63.84	—	63%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 inpatient CPT 90700 DAPTACEL (DTAP) 0.5ML INJ	$23.62	$63.84	$41.50–$63.84	—	63%
DTaP, polio and Hib combination vaccine (Pentacel) CPT 90698 PENTACEL VAC	$73.81	$199.49	$89.77–$199.49	9% above	63%
DTaP, polio and Hib combination vaccine (Pentacel) inpatient CPT 90698 PENTACEL VAC	$73.81	$199.49	$129.67–$199.49	—	63%
Flu shot, recombinant, egg-free (Flublok) CPT 90673 FLUBLOK TRIV PF VACCINE 0.5ML	$51.21	$138.41	$62.28–$138.41	21% below	63%
Flu shot, recombinant, egg-free (Flublok) CPT 90673 FLUBLOK	$51.21	$138.41	$62.28–$138.41	21% below	63%
Flu shot, recombinant, egg-free (Flublok) inpatient CPT 90673 FLUBLOK TRIV PF VACCINE 0.5ML	$51.21	$138.41	$89.97–$138.41	—	63%
Flu shot, recombinant, egg-free (Flublok) inpatient CPT 90673 FLUBLOK	$51.21	$138.41	$89.97–$138.41	—	63%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 INFLUENZA VAC PF 0.5ML TIV PF	$13.80	$37.29	$16.78–$37.29	37% below	63%
Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 INFLUENZA VAC PF 0.5ML TIV PF	$13.80	$37.29	$24.24–$37.29	—	63%
Hepatitis A vaccine, adult dose CPT 90632 HAVRIX HEPATITIS-A VAC(ADULT)	$55.22	$149.24	$67.16–$149.24	44% below	63%
Hepatitis A vaccine, adult dose CPT 90632 HEPATITIS A VAC ADULT	$55.22	$149.24	$67.16–$149.24	44% below	63%
Hepatitis A vaccine, adult dose inpatient CPT 90632 HAVRIX HEPATITIS-A VAC(ADULT)	$55.22	$149.24	$97.01–$149.24	—	63%
Hepatitis A vaccine, adult dose inpatient CPT 90632 HEPATITIS A VAC ADULT	$55.22	$149.24	$97.01–$149.24	—	63%
Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 HAVRIX HEPATITIS-A VAC(PEDS)	$25.30	$68.37	$30.77–$68.37	31% below	63%
Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 HEPATITIS A VAC 2-17	$25.30	$68.37	$30.77–$68.37	31% below	63%
Hepatitis A vaccine, child and teen dose (2-dose schedule) inpatient CPT 90633 HAVRIX HEPATITIS-A VAC(PEDS)	$25.30	$68.37	$44.44–$68.37	—	63%
Hepatitis A vaccine, child and teen dose (2-dose schedule) inpatient CPT 90633 HEPATITIS A VAC 2-17	$25.30	$68.37	$44.44–$68.37	—	63%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 ENGERIX-B INJ (ADULT)	$46.22	$124.92	$56.21–$124.92	27% below	63%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 HEPATITIS B VAC >17	$46.22	$124.92	$56.21–$124.92	27% below	63%
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 HEPATITIS B VAC >17	$46.22	$124.92	$81.20–$124.92	—	63%
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 ENGERIX-B INJ (ADULT)	$46.22	$124.92	$81.20–$124.92	—	63%
Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 ENGERIX-B INJ (PED/ADOLESCENT)	$18.61	$50.30	$22.64–$50.30	47% below	63%
Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 HEPATITIS B VAC 0-17	$18.61	$50.30	$22.64–$50.30	47% below	63%
Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 HEPATITIS B VAC 0-17	$18.61	$50.30	$32.70–$50.30	—	63%
Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 ENGERIX-B INJ (PED/ADOLESCENT)	$18.61	$50.30	$32.70–$50.30	—	63%
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 INFLUENZA VAC PF HIGHDS 65YRS+	$51.21	$138.41	$62.28–$138.41	29% below	63%
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 INFLUENZA VAC-PF HIGHDOSE	$51.22	$138.42	$62.29–$138.42	29% below	63%
High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 INFLUENZA VAC PF HIGHDS 65YRS+	$51.21	$138.41	$89.97–$138.41	—	63%
High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 INFLUENZA VAC-PF HIGHDOSE	$51.22	$138.42	$89.97–$138.42	—	63%
MMR vaccine (measles, mumps and rubella), live CPT 90707 MMR VAC	$62.58	$169.13	$76.11–$169.13	52% below	63%
MMR vaccine (measles, mumps and rubella), live CPT 90707 MEASLES/MUMPS/RUBELLA VACCINE	$62.58	$169.13	$76.11–$169.13	52% below	63%
MMR vaccine (measles, mumps and rubella), live CPT 90707 MMR	$62.58	$169.13	$76.11–$169.13	52% below	63%
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 MMR	$62.58	$169.13	$109.93–$169.13	—	63%
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 MEASLES/MUMPS/RUBELLA VACCINE	$62.58	$169.13	$109.93–$169.13	—	63%
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 MMR VAC	$62.58	$169.13	$109.93–$169.13	—	63%
Meningococcal ACWY (MenACWY) vaccine CPT 90734 MENVEO(GROUPS A, C, YANDW-135)	$103.32	$279.23	$125.65–$279.23	at median	63%
Meningococcal ACWY (MenACWY) vaccine CPT 90734 MENACTRA	$103.32	$279.23	$125.65–$279.23	at median	63%
Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 MENACTRA	$103.32	$279.23	$181.50–$279.23	—	63%
Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 MENVEO(GROUPS A, C, YANDW-135)	$103.32	$279.23	$181.50–$279.23	—	63%
Meningococcal ACWY vaccine (MenQuadfi) CPT 90619 MENINGOCOCCAL ACWY TT CONJ VAC	$120.26	$325.02	$146.26–$325.02	at median	63%
Meningococcal ACWY vaccine (MenQuadfi) inpatient CPT 90619 MENINGOCOCCAL ACWY TT CONJ VAC	$120.26	$325.02	$211.26–$325.02	—	63%
Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 MENB-4C VACC 2 DOSE IM BEXSERO	$147.25	$397.98	$179.09–$397.98	23% below	63%
Meningococcal B vaccine (Bexsero), 2-dose schedule inpatient CPT 90620 MENB-4C VACC 2 DOSE IM BEXSERO	$147.25	$397.98	$258.69–$397.98	—	63%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 PNEUMOCOCCAL 20VALNT CONJ0.5ML	$177.07	$478.58	$215.36–$478.58	54% below	63%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 PNEUMOCOCCAL 20VALNT CONJ0.5ML	$177.07	$478.58	$311.08–$478.58	—	63%
Pneumonia vaccine, 21-valent conjugate (Capvaxive) CPT 90684 PNEUMOCOCCAL 21-(CVX 327)	$200.70	$542.43	$244.09–$542.43	at median	63%
Pneumonia vaccine, 21-valent conjugate (Capvaxive) inpatient CPT 90684 PNEUMOCOCCAL 21-(CVX 327)	$200.70	$542.43	$352.58–$542.43	—	63%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PNEUMOCOCCAL VAC	$81.88	$221.29	$99.58–$221.29	15% below	63%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PNEUMOCOCCAL VACCINE 0.5ML INJ	$81.88	$221.29	$99.58–$221.29	15% below	63%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 PNEUMOCOCCAL VAC	$81.88	$221.29	$143.84–$221.29	—	63%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 PNEUMOCOCCAL VACCINE 0.5ML INJ	$81.88	$221.29	$143.84–$221.29	—	63%
Polio vaccine, inactivated (IPV) CPT 90713 POLIO IPV VAC	$27.01	$72.99	$32.85–$72.99	37% below	63%
Polio vaccine, inactivated (IPV) inpatient CPT 90713 POLIO IPV VAC	$27.01	$72.99	$47.44–$72.99	—	63%
RSV vaccine (Abrysvo), one dose for older adults or during pregnancy CPT 90678 HC RSV VACCINE, PREF A-PREF B	$206.29	$557.55	$250.90–$557.55	11% above	63%
RSV vaccine (Abrysvo), one dose for older adults or during pregnancy inpatient CPT 90678 HC RSV VACCINE, PREF A-PREF B	$206.29	$557.55	$362.41–$557.55	—	63%
Rabies vaccine, one dose CPT 90675 RABIES VACCINE	$265.06	$716.39	$322.38–$716.39	64% below	63%
Rabies vaccine, one dose CPT 90675 RABIES VACCINE (RABAVERT)	$265.06	$716.39	$322.38–$716.39	64% below	63%
Rabies vaccine, one dose inpatient CPT 90675 RABIES VACCINE (RABAVERT)	$265.06	$716.39	$465.65–$716.39	—	63%
Rabies vaccine, one dose inpatient CPT 90675 RABIES VACCINE	$265.06	$716.39	$465.65–$716.39	—	63%
Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) CPT 90680 ROTAVIRUS VAC	$65.08	$175.89	$79.15–$175.89	9% below	63%
Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) inpatient CPT 90680 ROTAVIRUS VAC	$65.08	$175.89	$114.33–$175.89	—	63%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TD VACCINE NO PRSRV >/= 7 IM	$19.57	$52.89	$23.80–$52.89	52% below	63%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 DIPT/TETANUS TOX 0.5ML INJ	$19.57	$52.89	$23.80–$52.89	52% below	63%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TETANUS-DIPH TOXOID 0.5ML INJ	$28.19	$76.19	$34.29–$76.19	31% below	63%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 DIPT/TETANUS TOX 0.5ML INJ	$19.57	$52.89	$34.38–$52.89	—	63%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 TD VACCINE NO PRSRV >/= 7 IM	$19.57	$52.89	$34.38–$52.89	—	63%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 TETANUS-DIPH TOXOID 0.5ML INJ	$28.19	$76.19	$49.52–$76.19	—	63%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 TDAP VACCINE	$30.65	$82.83	$37.27–$82.83	31% below	63%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 TDAP VAC >7	$30.65	$82.83	$37.27–$82.83	31% below	63%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 BOOSTRIX (TDAP) 0.5MLINJ	$30.65	$82.83	$37.27–$82.83	31% below	63%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 TDAP VACCINE	$30.65	$82.83	$53.84–$82.83	—	63%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 TDAP VAC >7	$30.65	$82.83	$53.84–$82.83	—	63%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 BOOSTRIX (TDAP) 0.5MLINJ	$30.65	$82.83	$53.84–$82.83	—	63%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMM ADMIN SINGLE VACCINE STATE	$7.98	$21.58	$9.71–$21.58	55% below	63%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMM ADMIN SINGLE VACCINE	$25.90	$70.00	$31.50–$70.00	47% above	63%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMM ADMIN SINGLE VACCINE STATE	$7.98	$21.58	$14.03–$21.58	—	63%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMM ADMIN SINGLE VACCINE	$25.90	$70.00	$45.50–$70.00	—	63%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMM ADMIN EACH ADD	$14.80	$40.00	$18.00–$40.00	16% below	63%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 IMM ADMIN EACH ADD	$14.80	$40.00	$26.00–$40.00	—	63%

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://northernlighthealth.org/NLH/media/Price-Transparency/010227195_Blue-Hill-Hospital_standardcharges.csv