Hospital Bismarck, ND

CHI St Alexius Health

Listed in its price file as “St. Alexius Medical Center”.

CHI St Alexius Health in Bismarck, ND publishes cash prices for 409 common procedures listed here, from its own machine-readable price file updated Sep 30, 2026. Compared with other hospitals in the state, its outpatient cash prices are below the North Dakota median for 320 of 404 procedures and above it for 65. By typical cash price it ranks #10 of 33 North Dakota hospitals, cheapest first. Select a procedure to compare it with other hospitals nearby.

900 E. Broadway Ave., Bismarck, ND 58501 Collected Nov 5, 2026 Source price file Check a bill from this hospital (701) 530-7000

Acute care hospital Nonprofit hospital Emergency department CMS star rating 4 of 5 CCN 350002 · CMS hospital register NPI 1306832654

Financial assistance

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

CHI St Alexius Health 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 North Dakota	Off list
Abdominal CT scan without and with contrast CPT 74170 HC CT ABDOMEN W WO CONTRAST	$1,521.00	$3,042.00	$179.20–$2,737.80	26% below	50%
Abdominal CT scan without and with contrast inpatient CPT 74170 HC CT ABDOMEN W WO CONTRAST	$1,521.00	$3,042.00	$2,251.08–$2,768.22	—	50%
Abdominal X-ray, 2 views CPT 74019 HC ABDOMEN COMPLETE 2V	$162.00	$324.00	$106.81–$291.60	7% below	50%
Abdominal X-ray, 2 views inpatient CPT 74019 HC ABDOMEN COMPLETE 2V	$162.00	$324.00	$239.76–$294.84	—	50%
Ankle X-ray, complete, 3 or more views CPT 73610 HC ANKLE COMPLETE	$116.50	$233.00	$88.91–$209.70	24% below	50%
Ankle X-ray, complete, 3 or more views inpatient CPT 73610 HC ANKLE COMPLETE	$116.50	$233.00	$172.42–$212.03	—	50%
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 HC ANKLE BRACHIAL INDEX	$198.00	$396.00	$135.93–$356.40	33% below	50%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 HC ANKLE BRACHIAL INDEX	$198.00	$396.00	$293.04–$360.36	—	50%
Arm CT scan without contrast (shoulder to hand, any part) CPT 73200 HC CT UPPER EXT WO CONTRAST	$890.50	$1,781.00	$106.81–$1,602.90	29% below	50%
Arm CT scan without contrast (shoulder to hand, any part) inpatient CPT 73200 HC CT UPPER EXT WO CONTRAST	$890.50	$1,781.00	$1,317.94–$1,620.71	—	50%
Barium swallow (esophagus X-ray with contrast) CPT 74220 HC ESOPHAGRAM	$310.50	$621.00	$179.20–$558.90	13% below	50%
Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 HC ESOPHAGRAM	$310.50	$621.00	$459.54–$565.11	—	50%
Bone scan, whole body (nuclear medicine) CPT 78306 HC NM BONE SCAN WHOLE BODY	$906.00	$1,812.00	$408.43–$1,630.80	15% below	50%
Bone scan, whole body (nuclear medicine) inpatient CPT 78306 HC NM BONE SCAN WHOLE BODY	$906.00	$1,812.00	$1,340.88–$1,648.92	—	50%
Breast ultrasound, complete, one breast CPT 76641 HC ULTRASOUND BREAST COMPLETE	$234.00	$468.00	$106.81–$421.20	34% below	50%
Breast ultrasound, complete, one breast inpatient CPT 76641 HC ULTRASOUND BREAST COMPLETE	$234.00	$468.00	$346.32–$425.88	—	50%
Breast ultrasound, limited (one breast or one area) CPT 76642 HC ULTRASOUND BREAST LIMITED	$177.00	$354.00	$88.91–$318.60	41% below	50%
Breast ultrasound, limited (one breast or one area) inpatient CPT 76642 HC ULTRASOUND BREAST LIMITED	$177.00	$354.00	$261.96–$322.14	—	50%
CT angiography (CTA) of the abdomen and pelvis CPT 74174 HC CT ANGIO AB PELV W WO CONTR	$1,983.50	$3,967.00	$356.43–$3,570.30	30% below	50%
CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174 HC CT ANGIO AB PELV W WO CONTR	$1,983.50	$3,967.00	$2,935.58–$3,609.97	—	50%
CT angiography (CTA) of the head CPT 70496 HC CT ANGIO HEAD W WO CONTRAST	$1,435.00	$2,870.00	$179.20–$2,583.00	28% below	50%
CT angiography (CTA) of the head inpatient CPT 70496 HC CT ANGIO HEAD W WO CONTRAST	$1,435.00	$2,870.00	$2,123.80–$2,611.70	—	50%
CT angiography (CTA) of the neck CPT 70498 HC CT ANGIO NECK W WO CONTRAST	$1,415.50	$2,831.00	$179.20–$2,547.90	29% below	50%
CT angiography (CTA) of the neck inpatient CPT 70498 HC CT ANGIO NECK W WO CONTRAST	$1,415.50	$2,831.00	$2,094.94–$2,576.21	—	50%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 HC CT ANGIO CHEST W WO CONTRST	$1,330.00	$2,660.00	$179.20–$2,394.00	36% below	50%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 HC CT ANGIO CHEST W WO CONTRST	$1,330.00	$2,660.00	$1,968.40–$2,420.60	—	50%
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 HC CTA HEART ARTERIES W CONTRA	$1,244.50	$2,489.00	$356.43–$2,240.10	34% below	50%
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score inpatient CPT 75574 HC CTA HEART ARTERIES W CONTRA	$1,244.50	$2,489.00	$1,841.86–$2,264.99	—	50%
CT of the heart without contrast dye to measure coronary calcium CPT 75571 HC CT HEART CALCIUM SCORING	$50.00	$100.00	$60.00–$189.31	88% below	50%
CT of the heart without contrast dye to measure coronary calcium inpatient CPT 75571 HC CT HEART CALCIUM SCORING	$50.00	$100.00	$74.00–$91.00	—	50%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 HC CT ABD PELVIS WO CONTRAST	$2,120.00	$4,240.00	$243.77–$3,816.00	29% above	50%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 HC CT ABD PELVIS WO CONTRAST	$2,120.00	$4,240.00	$3,137.60–$3,858.40	—	50%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 HC CT ABDOMEN PELVIS W CONTRST	$2,208.50	$4,417.00	$356.43–$3,975.30	10% below	50%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 HC CT ABDOMEN PELVIS W CONTRST	$2,208.50	$4,417.00	$3,268.58–$4,019.47	—	50%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 HC CT ABD PELVIS W WO CONTRAST	$2,650.00	$5,300.00	$356.43–$4,770.00	9% below	50%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 HC CT ABD PELVIS W WO CONTRAST	$2,650.00	$5,300.00	$3,922.00–$4,823.00	—	50%
CT scan of the abdomen with contrast CPT 74160 HC CT ABDOMEN W CONTRAST	$1,131.00	$2,262.00	$179.20–$2,035.80	31% below	50%
CT scan of the abdomen with contrast inpatient CPT 74160 HC CT ABDOMEN W CONTRAST	$1,131.00	$2,262.00	$1,673.88–$2,058.42	—	50%
CT scan of the abdomen without contrast CPT 74150 HC CT ABDOMEN WO CONTRAST	$975.00	$1,950.00	$106.81–$1,755.00	22% below	50%
CT scan of the abdomen without contrast inpatient CPT 74150 HC CT ABDOMEN WO CONTRAST	$975.00	$1,950.00	$1,443.00–$1,774.50	—	50%
CT scan of the face and sinuses, no contrast dye CPT 70486 HC CT MAXILLOFACIAL WO CONTRST	$879.00	$1,758.00	$106.81–$1,582.20	17% below	50%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 HC CT MAXILLOFACIAL WO CONTRST	$879.00	$1,758.00	$1,300.92–$1,599.78	—	50%
CT scan of the head or brain, no contrast dye CPT 70450 HC CT HEAD WO CONTRAST	$1,216.00	$2,432.00	$106.81–$2,188.80	13% above	50%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 HC CT HEAD WO CONTRAST	$1,216.00	$2,432.00	$1,799.68–$2,213.12	—	50%
CT scan of the head with contrast CPT 70460 HC CT HEAD W CONTRAST	$1,337.50	$2,675.00	$179.20–$2,407.50	5% above	50%
CT scan of the head with contrast inpatient CPT 70460 HC CT HEAD W CONTRAST	$1,337.50	$2,675.00	$1,979.50–$2,434.25	—	50%
CT scan of the head without and with contrast CPT 70470 HC CT HEAD W WO CONTRAST	$1,714.00	$3,428.00	$179.20–$3,085.20	13% above	50%
CT scan of the head without and with contrast inpatient CPT 70470 HC CT HEAD W WO CONTRAST	$1,714.00	$3,428.00	$2,536.72–$3,119.48	—	50%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 HC CT LUMBAR WO CONTRAST	$990.00	$1,980.00	$106.81–$1,782.00	24% below	50%
CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 HC CT LUMBAR WO CONTRAST	$990.00	$1,980.00	$1,465.20–$1,801.80	—	50%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 HC CT CERVICAL WO CONTRAST	$1,135.00	$2,270.00	$106.81–$2,043.00	16% below	50%
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 HC CT CERVICAL WO CONTRAST	$1,135.00	$2,270.00	$1,679.80–$2,065.70	—	50%
CT scan of the pelvis, with contrast dye CPT 72193 HC CT PELVIS W CONTRAST	$931.00	$1,862.00	$179.20–$1,675.80	42% below	50%
CT scan of the pelvis, with contrast dye inpatient CPT 72193 HC CT PELVIS W CONTRAST	$931.00	$1,862.00	$1,377.88–$1,694.42	—	50%
Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 HC CAROTID DUPLEX BILATERAL	$257.00	$514.00	$243.77–$462.60	—	50%
Carotid artery ultrasound (duplex), both sides of the neck inpatient both sides CPT 93880 HC CAROTID DUPLEX BILATERAL	$257.00	$514.00	$380.36–$467.74	—	50%
Chest CT scan without and with contrast CPT 71270 HC CT CHEST W WO CONTRAST	$1,144.00	$2,288.00	$179.20–$2,059.20	33% below	50%
Chest CT scan without and with contrast inpatient CPT 71270 HC CT CHEST W WO CONTRAST	$1,144.00	$2,288.00	$1,693.12–$2,082.08	—	50%
Chest X-ray, 2 views CPT 71046 HC CHEST 2 VIEWS PA LAT	$163.00	$326.00	$88.91–$293.40	6% below	50%
Chest X-ray, 2 views inpatient CPT 71046 HC CHEST 2 VIEWS PA LAT	$163.00	$326.00	$241.24–$296.66	—	50%
Chest X-ray, single view CPT 71045 HC CHEST 1 VIEW PA OR AP ONLY	$124.50	$249.00	$88.91–$224.10	14% below	50%
Chest X-ray, single view inpatient CPT 71045 HC CHEST 1 VIEW PA OR AP ONLY	$124.50	$249.00	$184.26–$226.59	—	50%
Collarbone (clavicle) X-ray, complete CPT 73000 HC CLAVICLE	$141.00	$282.00	$88.91–$253.80	at median	50%
Collarbone (clavicle) X-ray, complete inpatient CPT 73000 HC CLAVICLE	$141.00	$282.00	$208.68–$256.62	—	50%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 HC US RETROPERITONEAL COMPLETE	$294.50	$589.00	$106.81–$530.10	32% below	50%
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 HC US RETROPERITONEAL COMPLETE	$294.50	$589.00	$435.86–$535.99	—	50%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 HC DEXA BONE DENSITY	$157.50	$315.00	$106.81–$283.50	38% below	50%
DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 HC DEXA BONE DENSITY	$157.50	$315.00	$233.10–$286.65	—	50%
DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 HC DXA BONE DENSITY STUDY 1/>SITES APPENDICLR SKEL	$200.00	$400.00	$88.91–$360.00	73% above	50%
DEXA bone density scan of the wrist, heel or finger (peripheral) inpatient CPT 77081 HC DXA BONE DENSITY STUDY 1/>SITES APPENDICLR SKEL	$200.00	$400.00	$296.00–$364.00	—	50%
Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 HC US PREG DTL TRANSABDOMINAL	$173.00	$346.00	$207.60–$519.70	65% below	50%
Detailed fetal anatomy ultrasound, through the belly, one baby inpatient CPT 76811 HC US PREG DTL TRANSABDOMINAL	$173.00	$346.00	$256.04–$314.86	—	50%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 HC CT CHEST WO CONTRAST	$922.50	$1,845.00	$106.81–$1,660.50	24% below	50%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 HC CT CHEST WO CONTRAST	$922.50	$1,845.00	$1,365.30–$1,678.95	—	50%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 HC CT CHEST W CONTRAST	$969.00	$1,938.00	$179.20–$1,744.20	31% below	50%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 HC CT CHEST W CONTRAST	$969.00	$1,938.00	$1,434.12–$1,763.58	—	50%
Diagnostic mammogram, both breasts both sides CPT 77066 HC MAMMOGRAM DIGITAL BILATERAL	$250.00	$500.00	$232.97–$450.00	—	50%
Diagnostic mammogram, both breasts inpatient both sides CPT 77066 HC MAMMOGRAM DIGITAL BILATERAL	$250.00	$500.00	$370.00–$455.00	—	50%
Diagnostic mammogram, one breast CPT 77065 HC MAMMOGRAM DIGITAL UNILATERL	$191.50	$383.00	$182.90–$344.70	51% below	50%
Diagnostic mammogram, one breast CPT 77065 HC DX MAMMO INCL CAD UNI	$195.50	$391.00	$182.90–$351.90	50% below	50%
Diagnostic mammogram, one breast inpatient CPT 77065 HC MAMMOGRAM DIGITAL UNILATERL	$191.50	$383.00	$283.42–$348.53	—	50%
Diagnostic mammogram, one breast inpatient CPT 77065 HC DX MAMMO INCL CAD UNI	$195.50	$391.00	$289.34–$355.81	—	50%
Duplex ultrasound of the leg arteries, both legs CPT 93925 HC ART DUPLEX LOW EXT BIL	$678.50	$1,357.00	$243.77–$1,221.30	21% below	50%
Duplex ultrasound of the leg arteries, both legs inpatient CPT 93925 HC ART DUPLEX LOW EXT BIL	$678.50	$1,357.00	$1,004.18–$1,234.87	—	50%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 HC VENOUS DUPLEX BILATERAL	$451.50	$903.00	$243.77–$812.70	—	50%
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 HC VENOUS DUPLEX BILATERAL	$451.50	$903.00	$668.22–$821.73	—	50%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 HC ECHO W PW CW CF DOPPLER	$726.00	$1,452.00	$558.25–$1,306.80	6% below	50%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 HC ECHO W PW CW CF DOPPLER	$726.00	$1,452.00	$1,074.48–$1,321.32	—	50%
Elbow X-ray, 2 views CPT 73070 HC ELBOW 2 VIEWS	$142.00	$284.00	$88.91–$255.60	4% above	50%
Elbow X-ray, 2 views inpatient CPT 73070 HC ELBOW 2 VIEWS	$142.00	$284.00	$210.16–$258.44	—	50%
Elbow X-ray, complete, 3 or more views CPT 73080 HC ELBOW COMPLETE	$244.50	$489.00	$88.91–$440.10	50% above	50%
Elbow X-ray, complete, 3 or more views inpatient CPT 73080 HC ELBOW COMPLETE	$244.50	$489.00	$361.86–$444.99	—	50%
Eye socket (orbit) CT scan without contrast CPT 70480 HC CT ORBIT WO CONTRAST	$940.50	$1,881.00	$106.81–$1,692.90	32% below	50%
Eye socket (orbit) CT scan without contrast inpatient CPT 70480 HC CT ORBIT WO CONTRAST	$940.50	$1,881.00	$1,391.94–$1,711.71	—	50%
Facial bones X-ray, complete, 3 or more views CPT 70150 HC FACIAL BONES COMPLETE	$156.50	$313.00	$106.81–$281.70	20% below	50%
Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 HC FACIAL BONES COMPLETE	$156.50	$313.00	$231.62–$284.83	—	50%
Forearm X-ray (radius and ulna), 2 views CPT 73090 HC FOREARM	$155.50	$311.00	$88.91–$279.90	6% above	50%
Forearm X-ray (radius and ulna), 2 views inpatient CPT 73090 HC FOREARM	$155.50	$311.00	$230.14–$283.01	—	50%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 HC HEPATOBILRY IMG W GALL BLAD	$888.50	$1,777.00	$408.43–$1,599.30	25% below	50%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 HC HEPATOBILRY IMG W GALL BLAD	$888.50	$1,777.00	$1,314.98–$1,617.07	—	50%
Hand X-ray, 2 views CPT 73120 HC HAND 2 VIEW	$132.00	$264.00	$106.81–$237.60	6% below	50%
Hand X-ray, 2 views inpatient CPT 73120 HC HAND 2 VIEW	$132.00	$264.00	$195.36–$240.24	—	50%
Heel bone (calcaneus) X-ray, 2 or more views CPT 73650 HC CALCANEUS	$160.50	$321.00	$88.91–$288.90	11% above	50%
Heel bone (calcaneus) X-ray, 2 or more views inpatient CPT 73650 HC CALCANEUS	$160.50	$321.00	$237.54–$292.11	—	50%
Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 HC SLEEP STUDY UNATTENDED	$308.50	$617.00	$220.60–$555.30	12% below	50%
Home sleep apnea test, unattended, recording breathing and oxygen inpatient CPT 95806 HC SLEEP STUDY UNATTENDED	$308.50	$617.00	$456.58–$561.47	—	50%
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 HC POLYSOMNOGRPHY=>6 YR CPAP	$2,109.00	$4,218.00	$877.34–$3,796.20	13% below	50%
In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 HC POLYSOMNOGRPHY=>6 YR CPAP	$2,109.00	$4,218.00	$3,121.32–$3,838.38	—	50%
Knee X-ray, 3 views both sides CPT 73562 HC KNEE 3 VIEW -BILATERAL	$370.00	$740.00	$88.91–$666.00	—	50%
Knee X-ray, 3 views CPT 73562 HC KNEE 3 VIEW	$245.00	$490.00	$88.91–$441.00	33% above	50%
Knee X-ray, 3 views inpatient both sides CPT 73562 HC KNEE 3 VIEW -BILATERAL	$370.00	$740.00	$547.60–$673.40	—	50%
Knee X-ray, 3 views inpatient CPT 73562 HC KNEE 3 VIEW	$245.00	$490.00	$362.60–$445.90	—	50%
Knee X-ray, complete, 4 or more views CPT 73564 HC KNEE 4 OR> VIEWS	$276.00	$552.00	$106.81–$496.80	42% above	50%
Knee X-ray, complete, 4 or more views inpatient CPT 73564 HC KNEE 4 OR> VIEWS	$276.00	$552.00	$408.48–$502.32	—	50%
Leg CT scan without contrast (hip to foot, any part) CPT 73700 HC CT LOWER EXT WO CONTRAST	$995.50	$1,991.00	$106.81–$1,791.90	18% below	50%
Leg CT scan without contrast (hip to foot, any part) inpatient CPT 73700 HC CT LOWER EXT WO CONTRAST	$995.50	$1,991.00	$1,473.34–$1,811.81	—	50%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 HC US ABDOMEN LIMITED	$329.00	$658.00	$106.81–$592.20	15% below	50%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 HC US ABDOMEN LIMITED	$329.00	$658.00	$486.92–$598.78	—	50%
Limited ultrasound of an arm or leg (non-vascular) CPT 76882 HC US LMTD JT/FCL EVL NVASC XTR	$254.50	$509.00	$106.81–$458.10	5% above	50%
Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 HC US LMTD JT/FCL EVL NVASC XTR	$254.50	$509.00	$376.66–$463.19	—	50%
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 HC LUNG CT SCREEN INITIAL	$351.00	$702.00	$106.81–$631.80	53% below	50%
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 HC LUNG CT SCREEN ANNUAL FU	$351.00	$702.00	$106.81–$631.80	53% below	50%
Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 HC LUNG CT SCREEN ANNUAL FU	$351.00	$702.00	$519.48–$638.82	—	50%
Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 HC LUNG CT SCREEN INITIAL	$351.00	$702.00	$519.48–$638.82	—	50%
Lower leg X-ray (tibia and fibula), 2 views CPT 73590 HC TIBIA FIBULA	$155.50	$311.00	$88.91–$279.90	1% below	50%
Lower leg X-ray (tibia and fibula), 2 views inpatient CPT 73590 HC TIBIA FIBULA	$155.50	$311.00	$230.14–$283.01	—	50%
MR angiography (MRA) of the head without contrast CPT 70544 HC MRA HEAD WO CONTRAST	$1,394.50	$2,789.00	$243.77–$2,510.10	37% below	50%
MR angiography (MRA) of the head without contrast inpatient CPT 70544 HC MRA HEAD WO CONTRAST	$1,394.50	$2,789.00	$2,063.86–$2,537.99	—	50%
MRI of both breasts, without and then with contrast dye both sides CPT 77049 HC MRI BREAST WITHOUT&WITH CONTRAST W/CAD BILATERAL	$1,172.50	$2,345.00	$497.25–$2,110.50	—	50%
MRI of both breasts, without and then with contrast dye both sides CPT 77049 HC MRI BREAT W/OUT & W/CONTRAST W/CAD BILATERAL	$2,000.00	$4,000.00	$497.25–$3,600.00	—	50%
MRI of both breasts, without and then with contrast dye inpatient both sides CPT 77049 HC MRI BREAST WITHOUT&WITH CONTRAST W/CAD BILATERAL	$1,172.50	$2,345.00	$1,735.30–$2,133.95	—	50%
MRI of both breasts, without and then with contrast dye inpatient both sides CPT 77049 HC MRI BREAT W/OUT & W/CONTRAST W/CAD BILATERAL	$2,000.00	$4,000.00	$2,960.00–$3,640.00	—	50%
MRI of knee or other lower-limb joint, no contrast dye CPT 73721 HC MR JOINT LOWER EXT WO CONT	$1,609.50	$3,219.00	$243.77–$2,897.10	17% below	50%
MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 HC MR JOINT LOWER EXT WO CONT	$1,609.50	$3,219.00	$2,382.06–$2,929.29	—	50%
MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 HC MR JNT LOWER EXT W WO CONT	$2,688.00	$5,376.00	$356.43–$4,838.40	14% below	50%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 HC MR JNT LOWER EXT W WO CONT	$2,688.00	$5,376.00	$3,978.24–$4,892.16	—	50%
MRI of the abdomen without contrast CPT 74181 HC MR ABDOMEN WO CONTRAST	$1,359.00	$2,718.00	$243.77–$2,446.20	30% below	50%
MRI of the abdomen without contrast inpatient CPT 74181 HC MR ABDOMEN WO CONTRAST	$1,359.00	$2,718.00	$2,011.32–$2,473.38	—	50%
MRI of the abdomen, without and then with contrast dye CPT 74183 HC MR ABDOMEN W WO CONTRAST	$2,427.00	$4,854.00	$356.43–$4,368.60	25% below	50%
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 HC MR ABDOMEN W WO CONTRAST	$2,427.00	$4,854.00	$3,591.96–$4,417.14	—	50%
MRI of the brain, no contrast dye CPT 70551 HC MR BRAIN WO CONTRAST	$1,189.00	$2,378.00	$243.77–$2,140.20	32% below	50%
MRI of the brain, no contrast dye inpatient CPT 70551 HC MR BRAIN WO CONTRAST	$1,189.00	$2,378.00	$1,759.72–$2,163.98	—	50%
MRI of the brain, with and without contrast dye CPT 70553 HC MR BRAIN W WO CONTRAST	$2,331.00	$4,662.00	$356.43–$4,195.80	23% below	50%
MRI of the brain, with and without contrast dye inpatient CPT 70553 HC MR BRAIN W WO CONTRAST	$2,331.00	$4,662.00	$3,449.88–$4,242.42	—	50%
MRI of the lower back, no contrast dye CPT 72148 HC MR LUMBAR WO CONTRAST	$1,452.00	$2,904.00	$243.77–$2,613.60	25% below	50%
MRI of the lower back, no contrast dye inpatient CPT 72148 HC MR LUMBAR WO CONTRAST	$1,452.00	$2,904.00	$2,148.96–$2,642.64	—	50%
MRI of the lower back, without and then with contrast dye CPT 72158 HC MR LUMBAR W WO CONTRAST	$2,846.00	$5,692.00	$356.43–$5,122.80	8% below	50%
MRI of the lower back, without and then with contrast dye inpatient CPT 72158 HC MR LUMBAR W WO CONTRAST	$2,846.00	$5,692.00	$4,212.08–$5,179.72	—	50%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 HC MR THORACIC WO CONTRAST	$1,238.50	$2,477.00	$243.77–$2,229.30	40% below	50%
MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 HC MR THORACIC WO CONTRAST	$1,238.50	$2,477.00	$1,832.98–$2,254.07	—	50%
MRI of the neck (cervical spine) without and with contrast CPT 72156 HC MR CERVICAL W WO CONTRAST	$2,645.50	$5,291.00	$356.43–$4,761.90	14% below	50%
MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 HC MR CERVICAL W WO CONTRAST	$2,645.50	$5,291.00	$3,915.34–$4,814.81	—	50%
MRI of the neck (cervical spine), no contrast dye CPT 72141 HC MR CERVICAL WO CONTRAST	$1,349.00	$2,698.00	$243.77–$2,428.20	30% below	50%
MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 HC MR CERVICAL WO CONTRAST	$1,349.00	$2,698.00	$1,996.52–$2,455.18	—	50%
MRI of the pelvis without and with contrast CPT 72197 HC MR PELVIS W WO CONTRAST	$2,055.00	$4,110.00	$356.43–$3,699.00	33% below	50%
MRI of the pelvis without and with contrast inpatient CPT 72197 HC MR PELVIS W WO CONTRAST	$2,055.00	$4,110.00	$3,041.40–$3,740.10	—	50%
MRI of the pelvis, no contrast dye CPT 72195 HC MR PELVIS WO CONTRAST	$925.00	$1,850.00	$243.77–$1,665.00	58% below	50%
MRI of the pelvis, no contrast dye inpatient CPT 72195 HC MR PELVIS WO CONTRAST	$925.00	$1,850.00	$1,369.00–$1,683.50	—	50%
MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 HC MR JOINT UP EXT WO CONTRAST	$1,377.50	$2,755.00	$243.77–$2,479.50	29% below	50%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 HC MR JOINT UP EXT WO CONTRAST	$1,377.50	$2,755.00	$2,038.70–$2,507.05	—	50%
Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 HC CERVICAL SPINE 4 OR 5 VIEWS	$141.50	$283.00	$106.81–$254.70	37% below	50%
Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 HC CERVICAL SPINE 4 OR 5 VIEWS	$141.50	$283.00	$209.42–$257.53	—	50%
Neck soft tissue CT scan with contrast CPT 70491 HC CT NECK W CONTRAST	$1,085.00	$2,170.00	$179.20–$1,953.00	24% below	50%
Neck soft tissue CT scan with contrast inpatient CPT 70491 HC CT NECK W CONTRAST	$1,085.00	$2,170.00	$1,605.80–$1,974.70	—	50%
Neck soft tissue CT scan without contrast CPT 70490 HC CT NECK WO CONT	$868.00	$1,736.00	$106.81–$1,562.40	30% below	50%
Neck soft tissue CT scan without contrast inpatient CPT 70490 HC CT NECK WO CONT	$868.00	$1,736.00	$1,284.64–$1,579.76	—	50%
Neck soft tissue X-ray CPT 70360 HC NECK SOFT TISSUE	$144.00	$288.00	$88.91–$259.20	2% below	50%
Neck soft tissue X-ray inpatient CPT 70360 HC NECK SOFT TISSUE	$144.00	$288.00	$213.12–$262.08	—	50%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 HC MYOCARDIAL SPCT STDY MUL	$2,060.00	$4,120.00	$1,322.69–$3,708.00	6% below	50%
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 HC MYOCARDIAL SPCT STDY MUL	$2,060.00	$4,120.00	$3,048.80–$3,749.20	—	50%
PET/CT scan from the base of the skull to mid-thigh CPT 78815 HC NM PET CT SK TO M THGH SUB	$2,849.00	$5,698.00	$1,460.92–$5,128.20	28% below	50%
PET/CT scan from the base of the skull to mid-thigh CPT 78815 HC NM PET CT SK TO M THGH INT	$2,849.00	$5,698.00	$1,460.92–$5,128.20	28% below	50%
PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 HC NM PET CT SK TO M THGH SUB	$2,849.00	$5,698.00	$4,216.52–$5,185.18	—	50%
PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 HC NM PET CT SK TO M THGH INT	$2,849.00	$5,698.00	$4,216.52–$5,185.18	—	50%
Pelvic CT scan without contrast CPT 72192 HC CT PELVIS WO CONTRAST	$846.00	$1,692.00	$106.81–$1,522.80	31% below	50%
Pelvic CT scan without contrast inpatient CPT 72192 HC CT PELVIS WO CONTRAST	$846.00	$1,692.00	$1,252.08–$1,539.72	—	50%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 HC US PELVIS GYN LIMITED	$229.00	$458.00	$106.81–$412.20	31% below	50%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 HC US PELVIS GYN LIMITED	$229.00	$458.00	$338.92–$416.78	—	50%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 HC US PELVIS GYN	$332.00	$664.00	$106.81–$597.60	27% below	50%
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 HC US PELVIS GYN	$332.00	$664.00	$491.36–$604.24	—	50%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 HC US PREGNANCY >14 WKS	$436.00	$872.00	$106.81–$784.80	14% below	50%
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 HC US PREGNANCY >14 WKS	$436.00	$872.00	$645.28–$793.52	—	50%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 HC US PREG < 14 WKS TRANSABD	$271.00	$542.00	$106.81–$487.80	33% below	50%
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 HC US PREG < 14 WKS TRANSABD	$271.00	$542.00	$401.08–$493.22	—	50%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 HC ULTRASOUND LIMITED	$258.00	$516.00	$106.81–$464.40	20% below	50%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 HC ULTRASOUND LIMITED	$258.00	$516.00	$381.84–$469.56	—	50%
Rib X-ray, one side, 2 views one side CPT 71100 HC RIBS UNILATERAL	$113.50	$227.00	$88.91–$204.30	34% below	50%
Rib X-ray, one side, 2 views inpatient one side CPT 71100 HC RIBS UNILATERAL	$113.50	$227.00	$167.98–$206.57	—	50%
Rib X-ray, one side, with a chest view, 3 or more views CPT 71101 HC RIBS UNI PA CHEST	$157.50	$315.00	$106.81–$283.50	16% below	50%
Rib X-ray, one side, with a chest view, 3 or more views inpatient CPT 71101 HC RIBS UNI PA CHEST	$157.50	$315.00	$233.10–$286.65	—	50%
Screening mammogram, both breasts CPT 77067 HC MAMMOGRAM DIGITAL SCREEN	$206.50	$413.00	$192.64–$371.70	43% below	50%
Screening mammogram, both breasts inpatient CPT 77067 HC MAMMOGRAM DIGITAL SCREEN	$206.50	$413.00	$305.62–$375.83	—	50%
Shoulder X-ray, complete, 2 or more views CPT 73030 HC SHOULDER COMPLETE	$340.50	$681.00	$88.91–$612.90	92% above	50%
Shoulder X-ray, complete, 2 or more views inpatient CPT 73030 HC SHOULDER COMPLETE	$340.50	$681.00	$503.94–$619.71	—	50%
Sinus X-ray, complete, 3 or more views CPT 70220 HC SINUSES COMPLETE	$162.00	$324.00	$88.91–$291.60	9% below	50%
Sinus X-ray, complete, 3 or more views inpatient CPT 70220 HC SINUSES COMPLETE	$162.00	$324.00	$239.76–$294.84	—	50%
Skull X-ray, fewer than 4 views CPT 70250 HC SKULL PARTIAL <4	$122.00	$244.00	$106.81–$228.63	27% below	50%
Skull X-ray, fewer than 4 views inpatient CPT 70250 HC SKULL PARTIAL <4	$122.00	$244.00	$180.56–$222.04	—	50%
Sleep study in a lab (polysomnography) CPT 95810 HC POLYSOMNOGRAPHY=> 6 YR	$2,109.00	$4,218.00	$877.34–$3,796.20	13% below	50%
Sleep study in a lab (polysomnography) inpatient CPT 95810 HC POLYSOMNOGRAPHY=> 6 YR	$2,109.00	$4,218.00	$3,121.32–$3,838.38	—	50%
Stress echocardiogram, complete, including the stress test and supervision CPT 93351 HC STRESS ECHO W EKG MNTR	$685.50	$1,371.00	$558.25–$1,233.90	26% below	50%
Stress echocardiogram, complete, including the stress test and supervision inpatient CPT 93351 HC STRESS ECHO W EKG MNTR	$685.50	$1,371.00	$1,014.54–$1,247.61	—	50%
Swallow study (modified barium swallow, video X-ray) CPT 74230 HC SWALLOWING STUDY FOR SPEECH	$258.00	$516.00	$179.20–$464.40	49% below	50%
Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 HC SWALLOWING STUDY FOR SPEECH	$258.00	$516.00	$381.84–$469.56	—	50%
Thigh bone (femur) X-ray, 2 or more views CPT 73552 HC X-RAY EXAM OF FEMUR 2/>	$108.50	$217.00	$88.91–$195.30	34% below	50%
Thigh bone (femur) X-ray, 2 or more views inpatient CPT 73552 HC X-RAY EXAM OF FEMUR 2/>	$108.50	$217.00	$160.58–$197.47	—	50%
Thoracic spine (mid back) CT scan without contrast CPT 72128 HC CT THORACIC WO CONTRAST	$993.00	$1,986.00	$106.81–$1,787.40	23% below	50%
Thoracic spine (mid back) CT scan without contrast inpatient CPT 72128 HC CT THORACIC WO CONTRAST	$993.00	$1,986.00	$1,469.64–$1,807.26	—	50%
Toe X-ray, 2 or more views both sides CPT 73660 HC TOE RT GREAT TOE T5-BILATERAL	$93.00	$186.00	$88.91–$189.31	—	50%
Toe X-ray, 2 or more views one side CPT 73660 HC TOE LT GREAT TOE TA	$97.00	$194.00	$88.91–$189.31	24% below	50%
Toe X-ray, 2 or more views inpatient both sides CPT 73660 HC TOE RT GREAT TOE T5-BILATERAL	$93.00	$186.00	$137.64–$169.26	—	50%
Toe X-ray, 2 or more views inpatient one side CPT 73660 HC TOE LT GREAT TOE TA	$97.00	$194.00	$143.56–$176.54	—	50%
Transvaginal pelvic ultrasound CPT 76830 HC US TRANSVAGINAL	$305.00	$610.00	$106.81–$549.00	37% below	50%
Transvaginal pelvic ultrasound inpatient CPT 76830 HC US TRANSVAGINAL	$305.00	$610.00	$451.40–$555.10	—	50%
Transvaginal ultrasound during pregnancy CPT 76817 HC US PREG UTERUS TRANSVAGINAL	$137.00	$274.00	$106.81–$246.60	59% below	50%
Transvaginal ultrasound during pregnancy inpatient CPT 76817 HC US PREG UTERUS TRANSVAGINAL	$137.00	$274.00	$202.76–$249.34	—	50%
Ultrasound of the abdomen, complete CPT 76700 HC US ABDOMEN	$467.00	$934.00	$106.81–$840.60	9% below	50%
Ultrasound of the abdomen, complete inpatient CPT 76700 HC US ABDOMEN	$467.00	$934.00	$691.16–$849.94	—	50%
Ultrasound of the scrotum and testicles CPT 76870 HC US SCROTUM TESTICLE	$317.50	$635.00	$106.81–$571.50	23% below	50%
Ultrasound of the scrotum and testicles inpatient CPT 76870 HC US SCROTUM TESTICLE	$317.50	$635.00	$469.90–$577.85	—	50%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 HC US THYROID PARATHYROID NECK	$318.50	$637.00	$106.81–$573.30	34% below	50%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 HC US THYROID PARATHYROID NECK	$318.50	$637.00	$471.38–$579.67	—	50%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 HC UGI	$272.00	$544.00	$179.20–$489.60	48% below	50%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 HC UGI WO AIR W KUB	$294.00	$588.00	$179.20–$529.20	44% below	50%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 HC UGI	$272.00	$544.00	$402.56–$495.04	—	50%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 HC UGI WO AIR W KUB	$294.00	$588.00	$435.12–$535.08	—	50%
Upper arm X-ray (humerus), 2 views CPT 73060 HC HUMERUS	$111.00	$222.00	$88.91–$199.80	22% below	50%
Upper arm X-ray (humerus), 2 views inpatient CPT 73060 HC HUMERUS	$111.00	$222.00	$164.28–$202.02	—	50%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 HC VENOUS DUPLEX UNILATERAL	$480.50	$961.00	$106.81–$864.90	8% below	50%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 HC VENOUS DUPLEX UNILATERAL	$480.50	$961.00	$711.14–$874.51	—	50%
Wrist X-ray, 2 views CPT 73100 HC WRIST 2 VIEW	$154.00	$308.00	$88.91–$277.20	1% below	50%
Wrist X-ray, 2 views inpatient CPT 73100 HC WRIST 2 VIEW	$154.00	$308.00	$227.92–$280.28	—	50%
Wrist X-ray, complete, 3 or more views CPT 73110 HC WRIST COMPLETE	$244.50	$489.00	$88.91–$440.10	41% above	50%
Wrist X-ray, complete, 3 or more views inpatient CPT 73110 HC WRIST COMPLETE	$244.50	$489.00	$361.86–$444.99	—	50%
X-ray of one hip, 2 or 3 views, with the pelvis when included CPT 73502 HC XR HIP W PELVIS UNI 2-3 VIEWS	$66.50	$133.00	$79.80–$189.31	67% below	50%
X-ray of one hip, 2 or 3 views, with the pelvis when included CPT 73502 HC X-RAY EXAM HIP UNI 2-3 VIEWS	$110.50	$221.00	$88.91–$198.90	46% below	50%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient CPT 73502 HC XR HIP W PELVIS UNI 2-3 VIEWS	$66.50	$133.00	$98.42–$121.03	—	50%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient CPT 73502 HC X-RAY EXAM HIP UNI 2-3 VIEWS	$110.50	$221.00	$163.54–$201.11	—	50%
X-ray of the abdomen, 1 view CPT 74018 HC ABDOMEN 1 VIEW	$112.50	$225.00	$88.91–$202.50	20% below	50%
X-ray of the abdomen, 1 view inpatient CPT 74018 HC ABDOMEN 1 VIEW	$112.50	$225.00	$166.50–$204.75	—	50%
X-ray of the ankle, 2 views CPT 73600 HC ANKLE 2 VIEWS	$94.50	$189.00	$88.91–$189.31	35% below	50%
X-ray of the ankle, 2 views inpatient CPT 73600 HC ANKLE 2 VIEWS	$94.50	$189.00	$139.86–$171.99	—	50%
X-ray of the finger(s), 2 or more views both sides CPT 73140 HC FINGER RT THUMB F5-BILATERAL	$144.50	$289.00	$88.91–$260.10	—	50%
X-ray of the finger(s), 2 or more views one side CPT 73140 HC FINGER LT THUMB FA	$155.50	$311.00	$88.91–$279.90	at median	50%
X-ray of the finger(s), 2 or more views inpatient both sides CPT 73140 HC FINGER RT THUMB F5-BILATERAL	$144.50	$289.00	$213.86–$262.99	—	50%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 HC FINGER LT THUMB FA	$155.50	$311.00	$230.14–$283.01	—	50%
X-ray of the foot, 2 views CPT 73620 HC FOOT 2 VIEW	$90.50	$181.00	$88.91–$189.31	35% below	50%
X-ray of the foot, 2 views one side CPT 73620 HC XR FOOT 2 VIEWS UNILATERAL	$53.50	$107.00	$64.20–$189.31	62% below	50%
X-ray of the foot, 2 views inpatient CPT 73620 HC FOOT 2 VIEW	$90.50	$181.00	$133.94–$164.71	—	50%
X-ray of the foot, 2 views inpatient one side CPT 73620 HC XR FOOT 2 VIEWS UNILATERAL	$53.50	$107.00	$79.18–$97.37	—	50%
X-ray of the foot, complete, 3 or more views CPT 73630 HC FOOT COMPLETE	$114.50	$229.00	$88.91–$206.10	22% below	50%
X-ray of the foot, complete, 3 or more views inpatient CPT 73630 HC FOOT COMPLETE	$114.50	$229.00	$169.46–$208.39	—	50%
X-ray of the hand, 3 or more views CPT 73130 HC HAND COMPLETE	$244.50	$489.00	$88.91–$440.10	49% above	50%
X-ray of the hand, 3 or more views inpatient CPT 73130 HC HAND COMPLETE	$244.50	$489.00	$361.86–$444.99	—	50%
X-ray of the knee, 1 or 2 views CPT 73560 HC KNEE 2 VIEW AP LAT	$196.00	$392.00	$88.91–$352.80	22% above	50%
X-ray of the knee, 1 or 2 views inpatient CPT 73560 HC KNEE 2 VIEW AP LAT	$196.00	$392.00	$290.08–$356.72	—	50%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 HC LUMBAR SPINE 2 OR 3V	$157.50	$315.00	$106.81–$283.50	18% below	50%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 HC LUMBAR SPINE 2 OR 3V	$157.50	$315.00	$233.10–$286.65	—	50%
X-ray of the lower back, 4 or more views CPT 72110 HC LUMBR SPINE W OBLIQUES 4OR>	$181.00	$362.00	$106.81–$325.80	24% below	50%
X-ray of the lower back, 4 or more views inpatient CPT 72110 HC LUMBR SPINE W OBLIQUES 4OR>	$181.00	$362.00	$267.88–$329.42	—	50%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 HC THORACIC SPINE 2 VIEW	$149.00	$298.00	$106.81–$268.20	2% below	50%
X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 HC THORACIC SPINE 2 VIEW	$149.00	$298.00	$220.52–$271.18	—	50%
X-ray of the nasal bones, 3 or more views CPT 70160 HC NASAL BONES =>3 VIEWS	$118.50	$237.00	$88.91–$213.30	22% below	50%
X-ray of the nasal bones, 3 or more views inpatient CPT 70160 HC NASAL BONES =>3 VIEWS	$118.50	$237.00	$175.38–$215.67	—	50%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 HC CERVICAL SPINE =<3 VIEWS	$111.50	$223.00	$88.91–$200.70	32% below	50%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 HC CERVICAL SPINE =<3 VIEWS	$111.50	$223.00	$165.02–$202.93	—	50%
X-ray of the pelvis, 1 or 2 views CPT 72170 HC PELVIS	$154.50	$309.00	$106.81–$278.10	at median	50%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 HC PELVIS	$154.50	$309.00	$228.66–$281.19	—	50%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 HC RHC XRAY SACRUM & COCCYX	$55.00	$110.00	$66.00–$189.31	64% below	50%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 HC SACRUM AND COCCYX	$104.50	$209.00	$88.91–$189.31	32% below	50%
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 HC RHC XRAY SACRUM & COCCYX	$55.00	$110.00	$81.40–$100.10	—	50%
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 HC SACRUM AND COCCYX	$104.50	$209.00	$154.66–$190.19	—	50%

Lab tests

Procedure	Cash price	List price	Insurers pay	vs North Dakota	Off list
ACTH blood test CPT 82024 HC ACTH	$154.50	$309.00	$38.62–$278.10	7% above	50%
ACTH blood test inpatient CPT 82024 HC ACTH	$154.50	$309.00	$228.66–$281.19	—	50%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 HC ALT SGPT	$37.50	$75.00	$5.30–$67.50	8% below	50%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 HC ALT SGPT	$37.50	$75.00	$55.50–$68.25	—	50%
AST (aspartate aminotransferase) enzyme test CPT 84450 HC AST SGOT	$33.50	$67.00	$5.18–$60.30	19% below	50%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 HC AST SGOT	$33.50	$67.00	$49.58–$60.97	—	50%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 HC ACUTE HEPATITIS PANEL	$182.00	$364.00	$47.63–$327.60	20% below	50%
Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 HC ACUTE HEPATITIS PANEL	$182.00	$364.00	$269.36–$331.24	—	50%
Albumin blood test CPT 82040 HC ALBUMIN	$32.00	$64.00	$4.95–$57.60	9% below	50%
Albumin blood test CPT 82040 HC IGGI ALB	$34.00	$68.00	$4.95–$61.20	3% below	50%
Albumin blood test inpatient CPT 82040 HC ALBUMIN	$32.00	$64.00	$47.36–$58.24	—	50%
Albumin blood test inpatient CPT 82040 HC IGGI ALB	$34.00	$68.00	$50.32–$61.88	—	50%
Aldosterone blood test CPT 82088 HC ALDOSTERONE	$153.50	$307.00	$40.75–$276.30	25% above	50%
Aldosterone blood test inpatient CPT 82088 HC ALDOSTERONE	$153.50	$307.00	$227.18–$279.37	—	50%
Alkaline phosphatase (ALP) blood test CPT 84075 HC ALKALINE PHOSPHATASE	$31.00	$62.00	$5.18–$55.80	7% below	50%
Alkaline phosphatase (ALP) blood test inpatient CPT 84075 HC ALKALINE PHOSPHATASE	$31.00	$62.00	$45.88–$56.42	—	50%
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPECIFIC IGE QUAN/SEMIQUAN EA ALLERGEN	$29.00	$58.00	$5.22–$52.20	8% above	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPECIFIC IGE QUAN/SEMIQUAN EA ALLERGEN	$29.00	$58.00	$42.92–$52.78	—	50%
Alpha-fetoprotein (AFP) blood test CPT 82105 HC ALPHA FETOPROTN TUMR MARKR	$87.50	$175.00	$16.77–$157.50	9% below	50%
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 HC ALPHA FETOPROTN TUMR MARKR	$87.50	$175.00	$129.50–$159.25	—	50%
Ammonia blood test CPT 82140 HC AMMONIA	$80.00	$160.00	$14.57–$144.00	61% above	50%
Ammonia blood test inpatient CPT 82140 HC AMMONIA	$80.00	$160.00	$118.40–$145.60	—	50%
Amylase blood test CPT 82150 HC AMYLASE	$51.50	$103.00	$6.48–$92.70	13% above	50%
Amylase blood test inpatient CPT 82150 HC AMYLASE	$51.50	$103.00	$76.22–$93.73	—	50%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 HC CYCLIC CITRUL PEPTIDE ANTB	$67.50	$135.00	$12.95–$121.50	18% below	50%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 HC CYCLIC CITRUL PEPTIDE ANTB	$67.50	$135.00	$99.90–$122.85	—	50%
Antinuclear antibody (ANA) blood test, screen CPT 86038 HC ANA	$63.00	$126.00	$12.09–$113.40	1% below	50%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 HC ANA	$63.00	$126.00	$93.24–$114.66	—	50%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 HC NATRIURETIC PEPTIDE	$48.50	$97.00	$39.26–$97.00	79% below	50%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 HC BNP	$138.50	$277.00	$39.26–$249.30	40% below	50%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 HC NATRIURETIC PEPTIDE	$48.50	$97.00	$71.78–$88.27	—	50%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 HC BNP	$138.50	$277.00	$204.98–$252.07	—	50%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HC RESPIRATORY CULTURE	$73.50	$147.00	$8.62–$132.30	13% above	50%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 HC RESPIRATORY CULTURE	$73.50	$147.00	$108.78–$133.77	—	50%
Basic metabolic panel (blood test) CPT 80048 HC BASIC METABOLIC PANEL	$50.50	$101.00	$8.46–$90.90	32% below	50%
Basic metabolic panel (blood test) inpatient CPT 80048 HC BASIC METABOLIC PANEL	$50.50	$101.00	$74.74–$91.91	—	50%
Bilirubin blood test, total CPT 82247 HC BILIRUBIN TOTAL	$33.50	$67.00	$5.02–$60.30	5% below	50%
Bilirubin blood test, total CPT 82247 HC BODY FLUID TOTAL BILIRUBIN	$34.00	$68.00	$5.02–$61.20	3% below	50%
Bilirubin blood test, total inpatient CPT 82247 HC BILIRUBIN TOTAL	$33.50	$67.00	$49.58–$60.97	—	50%
Bilirubin blood test, total inpatient CPT 82247 HC BODY FLUID TOTAL BILIRUBIN	$34.00	$68.00	$50.32–$61.88	—	50%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 HC LEVEL 4 GROSS EXAM	$131.00	$262.00	$53.24–$235.80	6% above	50%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 HC LEVEL 4 GROSS EXAM	$131.00	$262.00	$193.88–$238.42	—	50%
Blood culture for bacteria CPT 87040 HC CULTURE BLOOD	$85.00	$170.00	$10.32–$153.00	at median	50%
Blood culture for bacteria inpatient CPT 87040 HC CULTURE BLOOD	$85.00	$170.00	$125.80–$154.70	—	50%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 HC VENIPUNCTURE COLLECTION	$15.00	$30.00	$9.34–$27.00	12% below	50%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 HC KIT DRAW	$16.00	$32.00	$9.34–$28.80	6% below	50%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 HC VENIPUNCTURE COLLECTION	$15.00	$30.00	$22.20–$27.30	—	50%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 HC KIT DRAW	$16.00	$32.00	$23.68–$29.12	—	50%
Blood glucose (sugar) test CPT 82947 HC GLUCOSE	$27.00	$54.00	$3.93–$48.60	8% below	50%
Blood glucose (sugar) test inpatient CPT 82947 HC GLUCOSE	$27.00	$54.00	$39.96–$49.14	—	50%
Blood lead test CPT 83655 HC LEAD	$46.00	$92.00	$12.11–$82.80	at median	50%
Blood lead test inpatient CPT 83655 HC LEAD	$46.00	$92.00	$68.08–$83.72	—	50%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 HC HCG QUAL	$50.00	$100.00	$7.52–$90.00	22% below	50%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 HC HCG QUAL	$50.00	$100.00	$74.00–$91.00	—	50%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 HC ABO TYPE	$79.00	$158.00	$4.49–$142.73	102% above	50%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 HC ABO TYPE	$79.00	$158.00	$116.92–$143.78	—	50%
Blood urea nitrogen (BUN) test CPT 84520 HC BUN	$27.50	$55.00	$3.95–$49.50	26% below	50%
Blood urea nitrogen (BUN) test inpatient CPT 84520 HC BUN	$27.50	$55.00	$40.70–$50.05	—	50%
C-peptide blood test CPT 84681 HC C PEPTIDE	$87.50	$175.00	$20.81–$157.50	20% below	50%
C-peptide blood test inpatient CPT 84681 HC C PEPTIDE	$87.50	$175.00	$129.50–$159.25	—	50%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 HC CRP	$61.50	$123.00	$5.18–$110.70	71% above	50%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 HC CRP	$61.50	$123.00	$91.02–$111.93	—	50%
C. difficile toxin gene test (stool PCR) CPT 87493 HC C. DIFF TOXIN BY PCR	$183.00	$366.00	$37.27–$329.40	5% below	50%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 HC C. DIFF TOXIN BY PCR	$183.00	$366.00	$270.84–$333.06	—	50%
CA 19-9 blood test (tumor marker) CPT 86301 HC CA 19 09	$82.50	$165.00	$20.81–$148.50	25% below	50%
CA 19-9 blood test (tumor marker) inpatient CPT 86301 HC CA 19 09	$82.50	$165.00	$122.10–$150.15	—	50%
CA-125 blood test (ovarian cancer marker) CPT 86304 HC CA 125	$109.00	$218.00	$20.81–$196.20	14% below	50%
CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 HC CA 125	$109.00	$218.00	$161.32–$198.38	—	50%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 HC CHG IADNA SARS-COV-2 COVID-19 AMPLIFIED PROBE TQ	$100.00	$200.00	$51.31–$180.00	20% below	50%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 HC CHG IADNA SARS-COV-2 COVID-19 AMPLIFIED PROBE TQ	$100.00	$200.00	$148.00–$182.00	—	50%
Calcium blood test, total CPT 82310 HC CALCIUM	$21.00	$42.00	$5.16–$37.80	34% below	50%
Calcium blood test, total inpatient CPT 82310 HC CALCIUM	$21.00	$42.00	$31.08–$38.22	—	50%
Carcinoembryonic antigen (CEA) test CPT 82378 HC CEA	$98.50	$197.00	$18.96–$177.30	20% below	50%
Carcinoembryonic antigen (CEA) test inpatient CPT 82378 HC CEA	$98.50	$197.00	$145.78–$179.27	—	50%
Chickenpox (varicella) immunity blood test CPT 86787 HC VARICELLA ZOSTER	$68.00	$136.00	$12.88–$122.40	15% above	50%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 HC VARICELLA ZOSTER	$68.00	$136.00	$100.64–$123.76	—	50%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 HC CHLAMYD TRACHOMATS AMP PROB	$183.00	$366.00	$35.09–$329.40	19% above	50%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 HC CHLAMYD TRACHOMATS AMP PROB	$183.00	$366.00	$270.84–$333.06	—	50%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 HC LIPID PANEL	$50.00	$100.00	$13.39–$90.00	32% below	50%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 HC LIPID PANEL	$50.00	$100.00	$74.00–$91.00	—	50%
Complete blood count (CBC) with differential CPT 85025 HC CBC W AUTO DIFF	$53.50	$107.00	$7.77–$96.30	8% below	50%
Complete blood count (CBC) with differential inpatient CPT 85025 HC CBC W AUTO DIFF	$53.50	$107.00	$79.18–$97.37	—	50%
Complete blood count (CBC), no differential CPT 85027 HC ABC (AUTOMATED BLD COUNT)	$44.50	$89.00	$6.47–$80.10	3% below	50%
Complete blood count (CBC), no differential inpatient CPT 85027 HC ABC (AUTOMATED BLD COUNT)	$44.50	$89.00	$65.86–$80.99	—	50%
Comprehensive metabolic panel (blood test) CPT 80053 HC COMPREHENSIVE PANEL	$70.50	$141.00	$10.56–$126.90	25% below	50%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 HC COMPREHENSIVE PANEL	$70.50	$141.00	$104.34–$128.31	—	50%
Cortisol blood test, total CPT 82533 HC CORTISOL	$85.50	$171.00	$16.30–$153.90	57% above	50%
Cortisol blood test, total inpatient CPT 82533 HC CORTISOL	$85.50	$171.00	$126.54–$155.61	—	50%
Creatine kinase (CK) blood test, total CPT 82550 HC CPK	$41.50	$83.00	$6.51–$74.70	12% below	50%
Creatine kinase (CK) blood test, total inpatient CPT 82550 HC CPK	$41.50	$83.00	$61.42–$75.53	—	50%
Creatinine blood test CPT 82565 HC CREATININE	$30.50	$61.00	$5.12–$54.90	23% below	50%
Creatinine blood test inpatient CPT 82565 HC CREATININE	$30.50	$61.00	$45.14–$55.51	—	50%
Cytomegalovirus (CMV) antibody test CPT 86644 HC CMV IGG ANTIBODY	$62.50	$125.00	$14.39–$112.50	20% above	50%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 HC CMV IGG ANTIBODY	$62.50	$125.00	$92.50–$113.75	—	50%
D-dimer blood test (blood clot marker) CPT 85379 HC D DIMER QUANTITATIVE	$73.50	$147.00	$10.18–$132.30	at median	50%
D-dimer blood test (blood clot marker) inpatient CPT 85379 HC D DIMER QUANTITATIVE	$73.50	$147.00	$108.78–$133.77	—	50%
DHEA sulfate (DHEA-S) blood test CPT 82627 HC DHEA S	$89.50	$179.00	$22.23–$161.10	17% below	50%
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 HC DHEA S	$89.50	$179.00	$132.46–$162.89	—	50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC PAIN MANAGEMENT DRUG PANEL URINE	$185.00	$370.00	$62.14–$333.00	28% above	50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC DRUG SCREEN SINGLE	$319.00	$638.00	$62.14–$574.20	121% above	50%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC PAIN MANAGEMENT DRUG PANEL URINE	$185.00	$370.00	$273.80–$336.70	—	50%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC DRUG SCREEN SINGLE	$319.00	$638.00	$472.12–$580.58	—	50%
Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 HC ELECTROLYTES	$50.00	$100.00	$7.01–$90.00	10% below	50%
Electrolyte panel (sodium, potassium, chloride, CO2) inpatient CPT 80051 HC ELECTROLYTES	$50.00	$100.00	$74.00–$91.00	—	50%
Epstein-Barr virus (EBV) antibody test CPT 86665 HC EBV VCA IGG	$83.00	$166.00	$18.14–$149.40	2% below	50%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 HC EBV VCA IGG	$83.00	$166.00	$122.84–$151.06	—	50%
Estradiol blood test CPT 82670 HC ESTRADIOL	$112.50	$225.00	$27.94–$202.50	13% below	50%
Estradiol blood test inpatient CPT 82670 HC ESTRADIOL	$112.50	$225.00	$166.50–$204.75	—	50%
FSH (follicle-stimulating hormone) test CPT 83001 HC FSH	$97.00	$194.00	$18.58–$174.60	9% below	50%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 HC FSH	$97.00	$194.00	$143.56–$176.54	—	50%
Fecal calprotectin (stool inflammation test) CPT 83993 HC CALPROTECTIN FECAL	$133.50	$267.00	$19.63–$240.30	15% below	50%
Fecal calprotectin (stool inflammation test) inpatient CPT 83993 HC CALPROTECTIN FECAL	$133.50	$267.00	$197.58–$242.97	—	50%
Ferritin blood test (iron stores) CPT 82728 HC FERRITIN	$78.50	$157.00	$13.63–$141.30	16% below	50%
Ferritin blood test (iron stores) inpatient CPT 82728 HC FERRITIN	$78.50	$157.00	$116.18–$142.87	—	50%
Fibrinogen blood test CPT 85384 HC FIBRINOGEN	$59.00	$118.00	$9.72–$106.20	7% above	50%
Fibrinogen blood test inpatient CPT 85384 HC FIBRINOGEN	$59.00	$118.00	$87.32–$107.38	—	50%
Folate (folic acid) blood test CPT 82746 HC FOLIC ACID	$81.00	$162.00	$14.70–$145.80	14% below	50%
Folate (folic acid) blood test inpatient CPT 82746 HC FOLIC ACID	$81.00	$162.00	$119.88–$147.42	—	50%
Free T3 thyroid hormone test CPT 84481 HC T3 FREE	$101.00	$202.00	$16.94–$181.80	at median	50%
Free T3 thyroid hormone test CPT 84481 HC FREE T3	$105.00	$210.00	$16.94–$189.00	4% above	50%
Free T3 thyroid hormone test inpatient CPT 84481 HC T3 FREE	$101.00	$202.00	$149.48–$183.82	—	50%
Free T3 thyroid hormone test inpatient CPT 84481 HC FREE T3	$105.00	$210.00	$155.40–$191.10	—	50%
Free T4 (free thyroxine) thyroid blood test CPT 84439 HC T4 FREE	$106.00	$212.00	$9.02–$190.80	69% above	50%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 HC T4 FREE	$106.00	$212.00	$156.88–$192.92	—	50%
Free testosterone test CPT 84402 HC TESTOSTERONE FREE	$81.50	$163.00	$25.47–$146.70	6% above	50%
Free testosterone test inpatient CPT 84402 HC TESTOSTERONE FREE	$81.50	$163.00	$120.62–$148.33	—	50%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 HC GGTP	$36.50	$73.00	$7.20–$65.70	18% below	50%
Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 HC GGTP	$36.50	$73.00	$54.02–$66.43	—	50%
General health panel: metabolic panel, blood count and TSH in one order CPT 80050 HC GENERAL HEALTH PANEL	$161.50	$323.00	$58.71–$290.70	32% below	50%
General health panel: metabolic panel, blood count and TSH in one order inpatient CPT 80050 HC GENERAL HEALTH PANEL	$161.50	$323.00	$239.02–$293.93	—	50%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 HC POST GLUCOSE DOSE	$33.50	$67.00	$4.75–$60.30	5% below	50%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 HC POST GLUCOSE DOSE	$33.50	$67.00	$49.58–$60.97	—	50%
Glucose tolerance test, 3 samples CPT 82951 HC GLUCOSE TOLERANCE TEST	$74.50	$149.00	$12.87–$134.10	18% below	50%
Glucose tolerance test, 3 samples inpatient CPT 82951 HC GLUCOSE TOLERANCE TEST	$74.50	$149.00	$110.26–$135.59	—	50%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 HC N GON AMP (ARUP)	$183.00	$366.00	$35.09–$329.40	19% above	50%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 HC N GON AMP (ARUP)	$183.00	$366.00	$270.84–$333.06	—	50%
H. pylori antibody blood test CPT 86677 HC H PLY IGG	$51.50	$103.00	$16.85–$92.70	39% below	50%
H. pylori antibody blood test inpatient CPT 86677 HC H PLY IGG	$51.50	$103.00	$76.22–$93.73	—	50%
H. pylori stool antigen test CPT 87338 HC HELICOBCTR PY STOOL ANTIGEN	$96.00	$192.00	$14.38–$172.80	4% below	50%
H. pylori stool antigen test inpatient CPT 87338 HC HELICOBCTR PY STOOL ANTIGEN	$96.00	$192.00	$142.08–$174.72	—	50%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HC HIV 1 RNA PCR LOG	$441.00	$882.00	$85.10–$793.80	84% above	50%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HC HIV 1 RNA PCR LOG	$441.00	$882.00	$652.68–$802.62	—	50%
HIV-1 and HIV-2 antibody test CPT 86703 HC HIV	$73.00	$146.00	$13.71–$131.40	6% below	50%
HIV-1 and HIV-2 antibody test inpatient CPT 86703 HC HIV	$73.00	$146.00	$108.04–$132.86	—	50%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HC HIV TO PHL	$125.50	$251.00	$24.08–$225.90	7% above	50%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HC HIV TO PHL	$125.50	$251.00	$185.74–$228.41	—	50%
HPV test for high-risk types, one combined (pooled) result CPT 87624 HC HPV HIGH RISK TYPES	$97.50	$195.00	$35.09–$175.50	at median	50%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HC HPV HIGH RISK TYPES	$97.50	$195.00	$144.30–$177.45	—	50%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HC GLYCOSYLATED HEMOGLOBIN	$50.50	$101.00	$9.71–$90.90	28% below	50%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HC GLYCOSYLATED HEMOGLOBIN	$50.50	$101.00	$74.74–$91.91	—	50%
Hemoglobin blood test CPT 85018 HC PFT CO-OX THB	$19.00	$38.00	$2.37–$34.20	18% below	50%
Hemoglobin blood test CPT 85018 HC HEMOGLOBIN	$19.00	$38.00	$2.37–$34.20	18% below	50%
Hemoglobin blood test inpatient CPT 85018 HC HEMOGLOBIN	$19.00	$38.00	$28.12–$34.58	—	50%
Hemoglobin blood test inpatient CPT 85018 HC PFT CO-OX THB	$19.00	$38.00	$28.12–$34.58	—	50%
Hepatitis B core antibody test (total) CPT 86704 HC HEPATITIS B CORE AB TOTAL	$62.50	$125.00	$12.05–$112.50	6% below	50%
Hepatitis B core antibody test (total) inpatient CPT 86704 HC HEPATITIS B CORE AB TOTAL	$62.50	$125.00	$92.50–$113.75	—	50%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HC HEPATITIS B SURFACE AG	$54.00	$108.00	$10.33–$97.20	at median	50%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HC HEPATITIS B SURFACE AG	$54.00	$108.00	$79.92–$98.28	—	50%
Hepatitis C antibody blood test (screening) CPT 86803 HC HEPATITIS C AB	$74.50	$149.00	$14.27–$134.10	at median	50%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 HC HEPATITIS C AB	$74.50	$149.00	$110.26–$135.59	—	50%
Hepatitis C viral load (HCV RNA) test CPT 87522 HC HEPATITIS C QUANT	$259.00	$518.00	$42.84–$466.20	97% above	50%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HC HEPATITIS C QUANT	$259.00	$518.00	$383.32–$471.38	—	50%
Herpes blood test, HSV-1 antibody CPT 86695 HC HERPES SIMPLEX TYPE I	$39.50	$79.00	$13.19–$71.10	30% below	50%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 HC HERPES SIMPLEX TYPE I	$39.50	$79.00	$58.46–$71.89	—	50%
Herpes blood test, HSV-2 antibody CPT 86696 HC HSV 2 AB IGG IMMUNOBLOT	$57.50	$115.00	$19.35–$103.50	15% below	50%
Herpes blood test, HSV-2 antibody CPT 86696 HC HERPES SIMPLEX TYPE II	$58.00	$116.00	$19.35–$104.40	14% below	50%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HC HSV 2 AB IGG IMMUNOBLOT	$57.50	$115.00	$85.10–$104.65	—	50%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HC HERPES SIMPLEX TYPE II	$58.00	$116.00	$85.84–$105.56	—	50%
High-sensitivity CRP (hs-CRP) test CPT 86141 HC C REACTIVE PROTEIN HS	$72.50	$145.00	$12.95–$130.50	7% below	50%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 HC C REACTIVE PROTEIN HS	$72.50	$145.00	$107.30–$131.95	—	50%
Homocysteine blood test CPT 83090 HC HOMOCYSTEINE	$124.00	$248.00	$17.92–$223.20	28% above	50%
Homocysteine blood test inpatient CPT 83090 HC HOMOCYSTEINE	$124.00	$248.00	$183.52–$225.68	—	50%
Insulin blood test CPT 83525 HC INSULIN	$53.50	$107.00	$11.43–$96.30	8% below	50%
Insulin blood test inpatient CPT 83525 HC INSULIN	$53.50	$107.00	$79.18–$97.37	—	50%
Iron blood test (serum iron) CPT 83540 HC IRON	$35.50	$71.00	$6.47–$63.90	8% below	50%
Iron blood test (serum iron) inpatient CPT 83540 HC IRON	$35.50	$71.00	$52.54–$64.61	—	50%
Iron-binding capacity (TIBC) test CPT 83550 HC IRON BINDING CAPACITY	$46.00	$92.00	$8.74–$82.80	14% below	50%
Iron-binding capacity (TIBC) test inpatient CPT 83550 HC IRON BINDING CAPACITY	$46.00	$92.00	$68.08–$83.72	—	50%
Kidney function blood test panel CPT 80069 HC RENAL FUNCTION PANEL	$67.00	$134.00	$8.68–$120.60	at median	50%
Kidney function blood test panel inpatient CPT 80069 HC RENAL FUNCTION PANEL	$67.00	$134.00	$99.16–$121.94	—	50%
LH (luteinizing hormone) test CPT 83002 HC LUTEINIZING HORMONE	$97.00	$194.00	$18.52–$174.60	10% below	50%
LH (luteinizing hormone) test inpatient CPT 83002 HC LUTEINIZING HORMONE	$97.00	$194.00	$143.56–$176.54	—	50%
Lactate (lactic acid) blood test CPT 83605 HC LACTIC ACID	$68.00	$136.00	$11.57–$122.40	12% below	50%
Lactate (lactic acid) blood test inpatient CPT 83605 HC LACTIC ACID	$68.00	$136.00	$100.64–$123.76	—	50%
Lactate dehydrogenase (LDH) blood test CPT 83615 HC LDH	$40.50	$81.00	$6.04–$72.90	7% below	50%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 HC LDH	$40.50	$81.00	$59.94–$73.71	—	50%
Lipase blood test (pancreas enzyme) CPT 83690 HC LIPASE	$59.00	$118.00	$6.89–$106.20	10% above	50%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 HC LIPASE	$59.00	$118.00	$87.32–$107.38	—	50%
Liver function blood test panel CPT 80076 HC HEPATIC PROFILE	$46.00	$92.00	$8.17–$82.80	35% below	50%
Liver function blood test panel inpatient CPT 80076 HC HEPATIC PROFILE	$46.00	$92.00	$68.08–$83.72	—	50%
Lyme disease antibody test CPT 86618 HC LYME MODIFIED 2-TIER TESTING 2ND TIER IGM	$13.50	$27.00	$16.20–$27.00	79% below	50%
Lyme disease antibody test CPT 86618 HC LYME AB	$68.00	$136.00	$17.03–$122.40	4% above	50%
Lyme disease antibody test inpatient CPT 86618 HC LYME MODIFIED 2-TIER TESTING 2ND TIER IGM	$13.50	$27.00	$19.98–$24.57	—	50%
Lyme disease antibody test inpatient CPT 86618 HC LYME AB	$68.00	$136.00	$100.64–$123.76	—	50%
Magnesium blood test CPT 83735 HC MAGNESIUM	$52.50	$105.00	$6.70–$94.50	65% above	50%
Magnesium blood test CPT 83735 HC URINE MAGNESIUM	$55.50	$111.00	$6.70–$99.90	75% above	50%
Magnesium blood test inpatient CPT 83735 HC MAGNESIUM	$52.50	$105.00	$77.70–$95.55	—	50%
Magnesium blood test inpatient CPT 83735 HC URINE MAGNESIUM	$55.50	$111.00	$82.14–$101.01	—	50%
Measles (rubeola) antibody test CPT 86765 HC RUBEOLA IGG IGM	$54.00	$108.00	$12.88–$97.20	5% below	50%
Measles (rubeola) antibody test inpatient CPT 86765 HC RUBEOLA IGG IGM	$54.00	$108.00	$79.92–$98.28	—	50%
Mono test (heterophile antibody, Monospot) CPT 86308 HC MONONUCLEOSIS	$37.50	$75.00	$5.18–$67.50	15% below	50%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 HC MONONUCLEOSIS	$37.50	$75.00	$55.50–$68.25	—	50%
Mumps immunity blood test CPT 86735 HC MUMPS ANTIBODY	$49.50	$99.00	$13.05–$89.10	21% above	50%
Mumps immunity blood test inpatient CPT 86735 HC MUMPS ANTIBODY	$49.50	$99.00	$73.26–$90.09	—	50%
Obstetric blood test panel CPT 80055 HC OBSTETRIC PANEL	$254.50	$509.00	$47.81–$458.10	9% below	50%
Obstetric blood test panel inpatient CPT 80055 HC OBSTETRIC PANEL	$254.50	$509.00	$376.66–$463.19	—	50%
PSA (prostate-specific antigen) blood test, free CPT 84154 HC PSA FREE	$69.50	$139.00	$18.39–$125.10	7% above	50%
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 HC PSA FREE	$69.50	$139.00	$102.86–$126.49	—	50%
PSA (prostate-specific antigen) blood test, total CPT 84153 HC PSA	$96.50	$193.00	$18.39–$173.70	at median	50%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 HC PSA	$96.50	$193.00	$142.82–$175.63	—	50%
Pap test (liquid-based, automated screening with review) CPT 88175 HC PAP SCRN AUTO W MAN RESCRN	$82.00	$164.00	$26.61–$147.60	29% below	50%
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 HC PAP SCRN AUTO W MAN RESCRN	$82.00	$164.00	$121.36–$149.24	—	50%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 HC THIN PREP PAP	$80.50	$161.00	$20.26–$144.90	22% below	50%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 HC THIN PREP PAP SCREEN	$81.50	$163.00	$20.26–$146.70	21% below	50%
Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 HC THIN PREP PAP	$80.50	$161.00	$119.14–$146.51	—	50%
Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 HC THIN PREP PAP SCREEN	$81.50	$163.00	$120.62–$148.33	—	50%
Parathyroid hormone (PTH) blood test CPT 83970 HC PTH INTACT	$215.00	$430.00	$41.28–$387.00	3% above	50%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 HC PTH INTACT	$215.00	$430.00	$318.20–$391.30	—	50%
Partial thromboplastin time (PTT) clotting test CPT 85730 HC THROMBOPLASTIN TIME PARTIAL	$33.00	$66.00	$6.01–$59.40	at median	50%
Partial thromboplastin time (PTT) clotting test CPT 85730 HC PTT	$40.00	$80.00	$6.01–$72.00	21% above	50%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 HC THROMBOPLASTIN TIME PARTIAL	$33.00	$66.00	$48.84–$60.06	—	50%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 HC PTT	$40.00	$80.00	$59.20–$72.80	—	50%
Phosphorus (phosphate) blood test CPT 84100 HC PHOSPHORUS	$33.50	$67.00	$4.74–$60.30	at median	50%
Phosphorus (phosphate) blood test inpatient CPT 84100 HC PHOSPHORUS	$33.50	$67.00	$49.58–$60.97	—	50%
Potassium blood test CPT 84132 HC POCT POTASSIUM	$17.50	$35.00	$4.76–$31.50	57% below	50%
Potassium blood test CPT 84132 HC RC/NICU POTASSIUM	$33.00	$66.00	$4.76–$59.40	19% below	50%
Potassium blood test CPT 84132 HC POTASSIUM	$33.00	$66.00	$4.76–$59.40	19% below	50%
Potassium blood test inpatient CPT 84132 HC POCT POTASSIUM	$17.50	$35.00	$25.90–$31.85	—	50%
Potassium blood test inpatient CPT 84132 HC RC/NICU POTASSIUM	$33.00	$66.00	$48.84–$60.06	—	50%
Potassium blood test inpatient CPT 84132 HC POTASSIUM	$33.00	$66.00	$48.84–$60.06	—	50%
Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) CPT 81420 HC NON-INVASIVE PRENATAL ANEUPLOIDY SCREEN	$252.00	$504.00	$302.40–$1,138.58	80% below	50%
Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) inpatient CPT 81420 HC NON-INVASIVE PRENATAL ANEUPLOIDY SCREEN	$252.00	$504.00	$372.96–$458.64	—	50%
Progesterone blood test CPT 84144 HC PROGESTERONE	$88.00	$176.00	$20.86–$158.40	27% below	50%
Progesterone blood test inpatient CPT 84144 HC PROGESTERONE	$88.00	$176.00	$130.24–$160.16	—	50%
Prolactin blood test CPT 84146 HC PROLACTIN	$101.00	$202.00	$19.38–$181.80	at median	50%
Prolactin blood test inpatient CPT 84146 HC PROLACTIN	$101.00	$202.00	$149.48–$183.82	—	50%
Prothrombin time (PT/INR) clotting test CPT 85610 HC PT	$30.50	$61.00	$4.29–$54.90	18% above	50%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 HC PT	$30.50	$61.00	$45.14–$55.51	—	50%
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 HC DRUG TEST PRSMV QUAL DIR OPTICAL OBS PER DAY	$67.00	$134.00	$12.60–$120.60	22% below	50%
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 HC PCUMX DRUG SCRN LIST B	$202.00	$404.00	$12.60–$363.60	134% above	50%
Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 HC DRUG TEST PRSMV QUAL DIR OPTICAL OBS PER DAY	$67.00	$134.00	$99.16–$121.94	—	50%
Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 HC PCUMX DRUG SCRN LIST B	$202.00	$404.00	$298.96–$367.64	—	50%
Rapid flu test (influenza antigen) CPT 87804 HC RHC RAPID INFLUENZA 59	$19.50	$39.00	$16.55–$39.00	77% below	50%
Rapid flu test (influenza antigen) CPT 87804 HC INFLUENZA AB	$92.50	$185.00	$16.55–$166.50	10% above	50%
Rapid flu test (influenza antigen) inpatient CPT 87804 HC RHC RAPID INFLUENZA 59	$19.50	$39.00	$28.86–$35.49	—	50%
Rapid flu test (influenza antigen) inpatient CPT 87804 HC INFLUENZA AB	$92.50	$185.00	$136.90–$168.35	—	50%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 HC STREP SCREEN	$78.00	$156.00	$16.53–$140.40	1% below	50%
Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 HC STREP SCREEN	$78.00	$156.00	$115.44–$141.96	—	50%
Renin blood test CPT 84244 HC RENIN	$83.50	$167.00	$21.99–$150.30	11% above	50%
Renin blood test inpatient CPT 84244 HC RENIN	$83.50	$167.00	$123.58–$151.97	—	50%
Rh blood typing CPT 86901 HC REF PRO RH TYPE	$34.00	$68.00	$4.49–$61.20	11% below	50%
Rh blood typing CPT 86901 HC BLOOD TYPING SEROLOGIC RH(D)	$35.50	$71.00	$4.49–$63.90	7% below	50%
Rh blood typing inpatient CPT 86901 HC REF PRO RH TYPE	$34.00	$68.00	$50.32–$61.88	—	50%
Rh blood typing inpatient CPT 86901 HC BLOOD TYPING SEROLOGIC RH(D)	$35.50	$71.00	$52.54–$64.61	—	50%
Rheumatoid factor (RF) test CPT 86431 HC RA QUANT	$40.00	$80.00	$5.67–$72.00	9% above	50%
Rheumatoid factor (RF) test CPT 86431 HC RHEUMATOID FACTOR	$41.50	$83.00	$5.67–$74.70	13% above	50%
Rheumatoid factor (RF) test inpatient CPT 86431 HC RA QUANT	$40.00	$80.00	$59.20–$72.80	—	50%
Rheumatoid factor (RF) test inpatient CPT 86431 HC RHEUMATOID FACTOR	$41.50	$83.00	$61.42–$75.53	—	50%
Rubella antibody test (immunity check) CPT 86762 HC RUBELLA SCREEN	$52.50	$105.00	$14.39–$94.50	21% below	50%
Rubella antibody test (immunity check) CPT 86762 HC RUBELLA	$55.50	$111.00	$14.39–$99.90	17% below	50%
Rubella antibody test (immunity check) inpatient CPT 86762 HC RUBELLA SCREEN	$52.50	$105.00	$77.70–$95.55	—	50%
Rubella antibody test (immunity check) inpatient CPT 86762 HC RUBELLA	$55.50	$111.00	$82.14–$101.01	—	50%
Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 HC SED RATE AUTOMATED	$23.00	$46.00	$2.70–$41.40	25% below	50%
Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 HC SED RATE AUTOMATED	$23.00	$46.00	$34.04–$41.86	—	50%
Semen analysis: volume, sperm count, motility and morphology CPT 89320 HC SEMEN ANALYSIS	$34.50	$69.00	$12.31–$62.10	66% below	50%
Semen analysis: volume, sperm count, motility and morphology inpatient CPT 89320 HC SEMEN ANALYSIS	$34.50	$69.00	$51.06–$62.79	—	50%
Sodium blood test CPT 84295 HC SODIUM	$33.00	$66.00	$4.81–$59.40	15% below	50%
Sodium blood test inpatient CPT 84295 HC SODIUM	$33.00	$66.00	$48.84–$60.06	—	50%
Stool ova and parasites exam CPT 87177 HC OVA PARASITES	$47.50	$95.00	$8.90–$85.50	3% below	50%
Stool ova and parasites exam inpatient CPT 87177 HC OVA PARASITES	$47.50	$95.00	$70.30–$86.45	—	50%
Stool test for hidden blood (guaiac FOBT) CPT 82270 HC RHC HEMOCCULT	$23.00	$46.00	$4.38–$41.40	19% below	50%
Stool test for hidden blood (guaiac FOBT) CPT 82270 HC HEMOCCULT	$24.50	$49.00	$4.38–$44.10	13% below	50%
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 HC RHC HEMOCCULT	$23.00	$46.00	$34.04–$41.86	—	50%
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 HC HEMOCCULT	$24.50	$49.00	$36.26–$44.59	—	50%
Stool test for hidden blood by immunoassay (FIT) CPT 82274 HC BLOOD OCCULT FECAL HGB DETER IA QUAL FECES 1-3	$84.00	$168.00	$15.92–$151.20	at median	50%
Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 HC BLOOD OCCULT FECAL HGB DETER IA QUAL FECES 1-3	$84.00	$168.00	$124.32–$152.88	—	50%
Syphilis antibody test (Treponema pallidum) CPT 86780 HC FTA-ABS	$54.00	$108.00	$13.24–$97.20	26% above	50%
Syphilis antibody test (Treponema pallidum) CPT 86780 HC ANTIBODY TREPONEMA PALLIDUM	$69.00	$138.00	$13.24–$124.20	62% above	50%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 HC FTA-ABS	$54.00	$108.00	$79.92–$98.28	—	50%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 HC ANTIBODY TREPONEMA PALLIDUM	$69.00	$138.00	$102.12–$125.58	—	50%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 HC RPR QUAL	$35.00	$70.00	$4.27–$63.00	20% above	50%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 HC RPR QUAL	$35.00	$70.00	$51.80–$63.70	—	50%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 HC QUANTIFERON TB GOLD	$170.50	$341.00	$61.98–$306.90	55% above	50%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 HC QUANTIFERON TB GOLD	$170.50	$341.00	$252.34–$310.31	—	50%
Testosterone blood test, total (not free testosterone) CPT 84403 HC TESTOSTERONE TOTAL	$75.50	$151.00	$25.81–$135.90	at median	50%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 HC TESTOSTERONE TOTAL	$75.50	$151.00	$111.74–$137.41	—	50%
Thyroid peroxidase (TPO) antibody test CPT 86376 HC MICROSOMAL ANTIBODY	$76.00	$152.00	$14.55–$136.80	19% above	50%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 HC MICROSOMAL ANTIBODY	$76.00	$152.00	$112.48–$138.32	—	50%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 HC TSH	$88.00	$176.00	$16.80–$158.40	15% below	50%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 HC TSH	$88.00	$176.00	$130.24–$160.16	—	50%
Total IgE blood test CPT 82785 HC IGE	$66.50	$133.00	$16.46–$119.70	22% below	50%
Total IgE blood test inpatient CPT 82785 HC IGE	$66.50	$133.00	$98.42–$121.03	—	50%
Total cholesterol blood test CPT 82465 HC CHOLESTEROL	$26.50	$53.00	$4.35–$47.70	21% below	50%
Total cholesterol blood test inpatient CPT 82465 HC CHOLESTEROL	$26.50	$53.00	$39.22–$48.23	—	50%
Total thyroxine (T4) blood test CPT 84436 HC T4	$37.00	$74.00	$6.87–$66.60	17% below	50%
Total thyroxine (T4) blood test inpatient CPT 84436 HC T4	$37.00	$74.00	$54.76–$67.34	—	50%
Total triiodothyronine (T3) blood test CPT 84480 HC T3 TOTAL	$73.50	$147.00	$14.18–$132.30	19% below	50%
Total triiodothyronine (T3) blood test inpatient CPT 84480 HC T3 TOTAL	$73.50	$147.00	$108.78–$133.77	—	50%
Transferrin blood test CPT 84466 HC TRANSFERRIN	$46.00	$92.00	$12.76–$82.80	39% below	50%
Transferrin blood test inpatient CPT 84466 HC TRANSFERRIN	$46.00	$92.00	$68.08–$83.72	—	50%
Trichomonas test (NAAT) CPT 87661 HC IADNA TRICHOMONAS VAGINALIS AMPLIFIED PROBE TECH	$100.50	$201.00	$35.09–$180.90	at median	50%
Trichomonas test (NAAT) inpatient CPT 87661 HC IADNA TRICHOMONAS VAGINALIS AMPLIFIED PROBE TECH	$100.50	$201.00	$148.74–$182.91	—	50%
Triglycerides blood test CPT 84478 HC TRIGLYCERIDE	$39.00	$78.00	$5.74–$70.20	9% below	50%
Triglycerides blood test inpatient CPT 84478 HC TRIGLYCERIDE	$39.00	$78.00	$57.72–$70.98	—	50%
Troponin test, quantitative CPT 84484 HC TROPONIN -I HIGH SENSITIVITY	$47.00	$94.00	$12.47–$84.60	41% below	50%
Troponin test, quantitative CPT 84484 HC TROPONIN	$94.00	$188.00	$12.47–$169.20	18% above	50%
Troponin test, quantitative inpatient CPT 84484 HC TROPONIN -I HIGH SENSITIVITY	$47.00	$94.00	$69.56–$85.54	—	50%
Troponin test, quantitative inpatient CPT 84484 HC TROPONIN	$94.00	$188.00	$139.12–$171.08	—	50%
Uric acid blood test CPT 84550 HC URIC ACID	$30.00	$60.00	$4.52–$54.00	25% below	50%
Uric acid blood test inpatient CPT 84550 HC URIC ACID	$30.00	$60.00	$44.40–$54.60	—	50%
Urinalysis with microscope exam, automated CPT 81001 HC URINALYSIS AUTOMATD W MICRO	$27.50	$55.00	$3.17–$49.50	23% below	50%
Urinalysis with microscope exam, automated inpatient CPT 81001 HC URINALYSIS AUTOMATD W MICRO	$27.50	$55.00	$40.70–$50.05	—	50%
Urinalysis without microscope exam, automated CPT 81003 HC RHC UA WO MICRO AUTO	$15.50	$31.00	$2.25–$27.90	13% below	50%
Urinalysis without microscope exam, automated CPT 81003 HC SP MAN DOT UA	$19.00	$38.00	$2.25–$34.20	7% above	50%
Urinalysis without microscope exam, automated inpatient CPT 81003 HC RHC UA WO MICRO AUTO	$15.50	$31.00	$22.94–$28.21	—	50%
Urinalysis without microscope exam, automated inpatient CPT 81003 HC SP MAN DOT UA	$19.00	$38.00	$28.12–$34.58	—	50%
Urinalysis without microscope exam, manual CPT 81002 HC POC URINE SCREEN	$8.50	$17.00	$3.48–$15.30	60% below	50%
Urinalysis without microscope exam, manual inpatient CPT 81002 HC POC URINE SCREEN	$8.50	$17.00	$12.58–$15.47	—	50%
Urine culture for bacteria, with colony count CPT 87086 HC CULTURE URINE	$43.50	$87.00	$8.07–$78.30	28% below	50%
Urine culture for bacteria, with colony count inpatient CPT 87086 HC CULTURE URINE	$43.50	$87.00	$64.38–$79.17	—	50%
Urine microalbumin (albumin) test CPT 82043 HC ALBUMIN URINE MICROALBUMIN QUANTIATIVE	$39.50	$79.00	$5.78–$71.10	2% below	50%
Urine microalbumin (albumin) test inpatient CPT 82043 HC ALBUMIN URINE MICROALBUMIN QUANTIATIVE	$39.50	$79.00	$58.46–$71.89	—	50%
Urine pregnancy test, read by color change CPT 81025 HC POCT URINE PREGNANCY	$19.00	$38.00	$8.61–$34.20	66% below	50%
Urine pregnancy test, read by color change CPT 81025 HC HCG URINE	$40.50	$81.00	$8.61–$72.90	27% below	50%
Urine pregnancy test, read by color change inpatient CPT 81025 HC POCT URINE PREGNANCY	$19.00	$38.00	$28.12–$34.58	—	50%
Urine pregnancy test, read by color change inpatient CPT 81025 HC HCG URINE	$40.50	$81.00	$59.94–$73.71	—	50%
Vitamin B12 (cobalamin) blood test CPT 82607 HC VITAMIN B12	$78.50	$157.00	$15.08–$141.30	19% below	50%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 HC VITAMIN B12	$78.50	$157.00	$116.18–$142.87	—	50%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 HC 25-HYDROXY VIT D2 & D3	$153.50	$307.00	$29.60–$276.30	8% below	50%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 HC 25-HYDROXY VIT D2 & D3	$153.50	$307.00	$227.18–$279.37	—	50%
Vitamin D, 1,25-dihydroxy blood test CPT 82652 HC VITAMIN D 1 25	$154.00	$308.00	$38.50–$277.20	19% above	50%
Vitamin D, 1,25-dihydroxy blood test inpatient CPT 82652 HC VITAMIN D 1 25	$154.00	$308.00	$227.92–$280.28	—	50%
Zinc blood test CPT 84630 HC ZINC	$68.00	$136.00	$11.39–$122.40	45% above	50%
Zinc blood test inpatient CPT 84630 HC ZINC	$68.00	$136.00	$100.64–$123.76	—	50%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HC HCG QUANT	$78.50	$157.00	$15.05–$141.30	1% below	50%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HC AFP HCG	$79.00	$158.00	$15.05–$142.20	1% below	50%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HC HCG QUANT	$78.50	$157.00	$116.18–$142.87	—	50%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HC AFP HCG	$79.00	$158.00	$116.92–$143.78	—	50%

Surgery and procedures

Procedure	Cash price	List price	Insurers pay	vs North Dakota	Off list
Botox injections for chronic migraine CPT 64615 HC SP NEU CHEMODENERVATION MIGRAI	$165.00	$330.00	$198.00–$544.35	57% below	50%
Botox injections for chronic migraine inpatient CPT 64615 HC SP NEU CHEMODENERVATION MIGRAI	$165.00	$330.00	$244.20–$300.30	—	50%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion CPT 19081 HC BX BREAST 1ST LESN STRTCTC	$1,813.00	$3,626.00	$1,687.37–$3,263.40	24% below	50%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion inpatient CPT 19081 HC BX BREAST 1ST LESN STRTCTC	$1,813.00	$3,626.00	$2,683.24–$3,299.66	—	50%
Broken foot (metatarsal) treatment without surgery or setting CPT 28470 HC CLO TX METATRSL FX WO MANIP	$218.50	$437.00	$252.01–$437.45	45% below	50%
Broken foot (metatarsal) treatment without surgery or setting inpatient CPT 28470 HC CLO TX METATRSL FX WO MANIP	$218.50	$437.00	$323.38–$397.67	—	50%
Cardiac catheterization with coronary angiogram one side CPT 93458 HC LEFT HEART CATH	$8,949.00	$17,898.00	$3,312.15–$16,108.20	8% below	50%
Cardiac catheterization with coronary angiogram inpatient one side CPT 93458 HC LEFT HEART CATH	$8,949.00	$17,898.00	$13,244.52–$16,287.18	—	50%
Cardioversion, elective (restoring heart rhythm) CPT 92960 HC CARDIOVERSION ELECTRIC EXT	$880.00	$1,760.00	$675.26–$1,584.00	13% below	50%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 HC CARDIOVERSION ELECTRIC EXT	$880.00	$1,760.00	$1,302.40–$1,601.60	—	50%
Catheter ablation for atrial fibrillation CPT 93656 HC ABL AF W EP STDY TRANSEPT	$17,014.00	$34,028.00	$20,416.80–$46,353.32	27% below	50%
Catheter ablation for atrial fibrillation inpatient CPT 93656 HC ABL AF W EP STDY TRANSEPT	$17,014.00	$34,028.00	$25,180.72–$30,965.48	—	50%
Cervical biopsy CPT 57500 HC BX/EXC CERVIX LOCAL	$615.00	$1,230.00	$738.00–$1,633.40	31% below	50%
Cervical biopsy inpatient CPT 57500 HC BX/EXC CERVIX LOCAL	$615.00	$1,230.00	$910.20–$1,119.30	—	50%
Circumcision by surgical excision, older than 28 days (children and adults) CPT 54161 HC CIRCUMCISION 28 DAYS OR OLDER	$1,972.00	$3,944.00	$2,135.66–$3,707.13	31% below	50%
Circumcision by surgical excision, older than 28 days (children and adults) inpatient CPT 54161 HC CIRCUMCISION 28 DAYS OR OLDER	$1,972.00	$3,944.00	$2,918.56–$3,589.04	—	50%
Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 HC CIRCUMCISION W CLAMP OTH DEV W BLOCK	$1,375.00	$2,750.00	$1,650.00–$3,707.13	at median	50%
Circumcision with a clamp or device and a numbing nerve block, usually newborns inpatient CPT 54150 HC CIRCUMCISION W CLAMP OTH DEV W BLOCK	$1,375.00	$2,750.00	$2,035.00–$2,502.50	—	50%
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 HC CLS DST RAD FX WWO UL SYLD	$256.50	$513.00	$252.01–$461.70	42% below	50%
Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 HC CLS DST RAD FX WWO UL SYLD	$256.50	$513.00	$379.62–$466.83	—	50%
Coronary stent placement, one artery CPT 92928 HC PLCMT CORONARY STENT SINGLE	$5,897.50	$11,795.00	$7,077.00–$20,472.66	55% below	50%
Coronary stent placement, one artery CPT 92928 HC COR STENT SINGLE	$15,158.00	$30,316.00	$11,794.23–$27,284.40	15% above	50%
Coronary stent placement, one artery inpatient CPT 92928 HC PLCMT CORONARY STENT SINGLE	$5,897.50	$11,795.00	$8,728.30–$10,733.45	—	50%
Coronary stent placement, one artery inpatient CPT 92928 HC COR STENT SINGLE	$15,158.00	$30,316.00	$22,433.84–$27,587.56	—	50%
Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 HC CYSTOURETHROSCOPY	$513.00	$1,026.00	$615.60–$1,236.59	41% below	50%
Cystoscopy, diagnostic look inside the bladder and urethra inpatient CPT 52000 HC CYSTOURETHROSCOPY	$513.00	$1,026.00	$759.24–$933.66	—	50%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 HC DESTRUCTION/LN ONE LESION	$111.00	$222.00	$133.20–$355.81	44% below	50%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 HC DESTRUCTION/LN ONE LESION	$111.00	$222.00	$164.28–$202.02	—	50%
Earwax removal by irrigation (rinsing), one ear both sides CPT 69209 HC REM IMP EAR WAX IRR/LAV BI	$58.50	$117.00	$60.27–$105.30	—	50%
Earwax removal by irrigation (rinsing), one ear CPT 69209 HC REM IMP EAR WAX IRR/LAV UNI	$59.00	$118.00	$60.27–$106.20	3% below	50%
Earwax removal by irrigation (rinsing), one ear inpatient both sides CPT 69209 HC REM IMP EAR WAX IRR/LAV BI	$58.50	$117.00	$86.58–$106.47	—	50%
Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 HC REM IMP EAR WAX IRR/LAV UNI	$59.00	$118.00	$87.32–$107.38	—	50%
Earwax removal with instruments, one ear both sides CPT 69210 HC REM IMP EAR WAX INST BI	$62.00	$124.00	$60.27–$111.60	—	50%
Earwax removal with instruments, one ear both sides CPT 69210 HC SP NP CERUMEN IMPACTION REM BI	$62.00	$124.00	$60.27–$111.60	—	50%
Earwax removal with instruments, one ear inpatient both sides CPT 69210 HC SP NP CERUMEN IMPACTION REM BI	$62.00	$124.00	$91.76–$112.84	—	50%
Earwax removal with instruments, one ear inpatient both sides CPT 69210 HC REM IMP EAR WAX INST BI	$62.00	$124.00	$91.76–$112.84	—	50%
Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 HC ENDOMET BX WO CERVICAL DILA	$204.50	$409.00	$206.55–$368.10	29% below	50%
Endometrial biopsy (uterine lining sample) without dilating the cervix inpatient CPT 58100 HC ENDOMET BX WO CERVICAL DILA	$204.50	$409.00	$302.66–$372.19	—	50%
Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 HC NJX INTRLMNR CRV THRC W IMG GDN	$756.50	$1,513.00	$721.17–$1,361.70	30% below	50%
Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 HC NJX INTRLMNR CRV THRC W IMG GDN	$756.50	$1,513.00	$1,119.62–$1,376.83	—	50%
Facet joint injection, lower back, one level, with imaging guidance CPT 64493 HC FACET LUMBOSACRAL SINGLE	$621.50	$1,243.00	$745.80–$1,568.54	54% below	50%
Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 HC FACET LUMBOSACRAL SINGLE	$621.50	$1,243.00	$919.82–$1,131.13	—	50%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 HC INJECT HYSTERO	$324.50	$649.00	$389.40–$584.10	3% above	50%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes inpatient CPT 58340 HC INJECT HYSTERO	$324.50	$649.00	$480.26–$590.59	—	50%
Incision and drainage of a simple or single skin abscess CPT 10060 HC DRAIN SKIN ABSCESS SMPL SNGL	$194.00	$388.00	$204.98–$355.81	36% below	50%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 HC DRAIN SKIN ABSCESS SMPL SNGL	$194.00	$388.00	$287.12–$353.08	—	50%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 HC INJ TENDON/LIG/TR PT/GANGLI	$177.50	$355.00	$213.00–$544.35	43% below	50%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 HC INJ TENDON/LIG/TR PT/GANGLI	$177.50	$355.00	$262.70–$323.05	—	50%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 HC DRAIN INJ JOINT BURSA MAJOR	$263.50	$527.00	$313.60–$544.35	13% below	50%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 HC ASPIR/INJ MAJOR JNT/BUR RT HHP	$239.50	$479.00	$287.40–$544.35	21% below	50%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 HC DRAIN INJ JOINT BURSA MAJOR	$263.50	$527.00	$389.98–$479.57	—	50%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient one side CPT 20610 HC ASPIR/INJ MAJOR JNT/BUR RT HHP	$239.50	$479.00	$354.46–$435.89	—	50%
Joint injection or drainage, medium joint (wrist, elbow, ankle) both sides CPT 20605 HC ASPIRATE INJ INTERMED JOINT- BILATERAL	$527.00	$1,054.00	$313.60–$948.60	—	50%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 HC ASPIRATE INJ INTERMED JOINT	$305.50	$611.00	$313.60–$549.90	11% below	50%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient both sides CPT 20605 HC ASPIRATE INJ INTERMED JOINT- BILATERAL	$527.00	$1,054.00	$779.96–$959.14	—	50%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 HC ASPIRATE INJ INTERMED JOINT	$305.50	$611.00	$452.14–$556.01	—	50%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 HC DRAIN INJ ASP JNT BURSA SM	$263.50	$527.00	$313.60–$544.35	8% below	50%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 HC DRAIN INJ ASP JNT BURSA SM	$263.50	$527.00	$389.98–$479.57	—	50%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 HC LCW INTER H/T/E <2.5CM	$338.50	$677.00	$406.20–$720.91	35% below	50%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 HC LCW INTER H/T/E <2.5CM	$338.50	$677.00	$500.98–$616.07	—	50%
Left heart catheterization, diagnostic one side CPT 93452 HC LEFT HEART CATH NO ANGIO	$5,379.00	$10,758.00	$3,312.15–$9,682.20	39% below	50%
Left heart catheterization, diagnostic inpatient one side CPT 93452 HC LEFT HEART CATH NO ANGIO	$5,379.00	$10,758.00	$7,960.92–$9,789.78	—	50%
Lower-back epidural injection, with imaging guidance CPT 62323 HC INJ ANE DRG LUM SAC W IMG GDN	$402.50	$805.00	$483.00–$1,251.83	64% below	50%
Lower-back epidural injection, with imaging guidance inpatient CPT 62323 HC INJ ANE DRG LUM SAC W IMG GDN	$402.50	$805.00	$595.70–$732.55	—	50%
Lower-back epidural injection, without imaging guidance CPT 62322 HC INJ ANE DRG LUM SAC W O IMG GDN	$620.00	$1,240.00	$744.00–$1,568.54	41% below	50%
Lower-back epidural injection, without imaging guidance CPT 62322 HC NJX INTERLAMINAR LMBR SAC WO IMG GDN	$652.50	$1,305.00	$783.00–$1,568.54	38% below	50%
Lower-back epidural injection, without imaging guidance inpatient CPT 62322 HC INJ ANE DRG LUM SAC W O IMG GDN	$620.00	$1,240.00	$917.60–$1,128.40	—	50%
Lower-back epidural injection, without imaging guidance inpatient CPT 62322 HC NJX INTERLAMINAR LMBR SAC WO IMG GDN	$652.50	$1,305.00	$965.70–$1,187.55	—	50%
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 HC INJ TRNSFRM LUM SNGL W IMAG	$581.00	$1,162.00	$697.20–$1,568.54	54% below	50%
Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 HC INJ TRNSFRM LUM SNGL W IMAG	$581.00	$1,162.00	$859.88–$1,057.42	—	50%
Nail removal (partial or complete), one nail CPT 11730 HC AVULSION NAIL PL SMPL SNGL	$168.50	$337.00	$202.20–$355.81	40% below	50%
Nail removal (partial or complete), one nail inpatient CPT 11730 HC AVULSION NAIL PL SMPL SNGL	$168.50	$337.00	$249.38–$306.67	—	50%
Occipital nerve block (injection for headaches) CPT 64405 HC SP PAIN OCCIPITAL NRV BLK BIL	$287.50	$575.00	$313.60–$544.35	20% below	50%
Occipital nerve block (injection for headaches) CPT 64405 HC OCCIPITAL BLOCK STERIOD	$316.50	$633.00	$313.60–$569.70	12% below	50%
Occipital nerve block (injection for headaches) inpatient CPT 64405 HC SP PAIN OCCIPITAL NRV BLK BIL	$287.50	$575.00	$425.50–$523.25	—	50%
Occipital nerve block (injection for headaches) inpatient CPT 64405 HC OCCIPITAL BLOCK STERIOD	$316.50	$633.00	$468.42–$576.03	—	50%
Pacemaker implant (dual chamber) CPT 33208 HC PACER DUAL INSERTION	$11,834.50	$23,669.00	$10,678.38–$21,302.10	34% below	50%
Pacemaker implant (dual chamber) inpatient CPT 33208 HC PACER DUAL INSERTION	$11,834.50	$23,669.00	$17,515.06–$21,538.79	—	50%
Paracentesis with imaging guidance CPT 49083 HC ABD PARACENTESIS W IMAGING	$669.50	$1,339.00	$803.40–$1,608.46	30% below	50%
Paracentesis with imaging guidance inpatient CPT 49083 HC ABD PARACENTESIS W IMAGING	$669.50	$1,339.00	$990.86–$1,218.49	—	50%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 HC PERMANENT REMOVAL NAILBED	$304.00	$608.00	$364.80–$720.91	46% below	50%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 HC PERMANENT REMOVAL NAILBED	$304.00	$608.00	$449.92–$553.28	—	50%
Prostate biopsy CPT 55700 HC BIOPSY PROSTATE	$1,374.00	$2,748.00	$1,648.80–$2,473.20	50% below	50%
Prostate biopsy inpatient CPT 55700 HC BIOPSY PROSTATE	$1,374.00	$2,748.00	$2,033.52–$2,500.68	—	50%
Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 HC DESTROY LUMB/SAC FACET JNT	$983.50	$1,967.00	$1,180.20–$3,463.00	62% below	50%
Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 HC SP PAIN FACET DESTRUCTION LS B	$1,311.00	$2,622.00	$1,573.20–$3,463.00	50% below	50%
Radiofrequency ablation of facet joint nerves, lower back, one level inpatient CPT 64635 HC DESTROY LUMB/SAC FACET JNT	$983.50	$1,967.00	$1,455.58–$1,789.97	—	50%
Radiofrequency ablation of facet joint nerves, lower back, one level inpatient CPT 64635 HC SP PAIN FACET DESTRUCTION LS B	$1,311.00	$2,622.00	$1,940.28–$2,386.02	—	50%
Removal of a foreign object under the skin, simple CPT 10120 HC RFB SUBQ TISSUE SIMPLE	$280.50	$561.00	$336.60–$720.91	34% below	50%
Removal of a foreign object under the skin, simple inpatient CPT 10120 HC RFB SUBQ TISSUE SIMPLE	$280.50	$561.00	$415.14–$510.51	—	50%
Shock-wave lithotripsy to break up kidney stones (from outside the body) CPT 50590 HC LITHOTRIPSY	$5,783.00	$11,566.00	$3,601.33–$10,409.40	14% below	50%
Shock-wave lithotripsy to break up kidney stones (from outside the body) inpatient CPT 50590 HC LITHOTRIPSY	$5,783.00	$11,566.00	$8,558.84–$10,525.06	—	50%
Short arm splint (forearm and hand) CPT 29125 HC SPLINTING OF FOREARM	$144.50	$289.00	$135.93–$260.10	25% below	50%
Short arm splint (forearm and hand) inpatient CPT 29125 HC SPLINTING OF FOREARM	$144.50	$289.00	$213.86–$262.99	—	50%
Short leg cast (below the knee) CPT 29405 HC APPL SHORT LEG CAST	$159.00	$318.00	$190.80–$496.02	55% below	50%
Short leg cast (below the knee) inpatient CPT 29405 HC APPL SHORT LEG CAST	$159.00	$318.00	$235.32–$289.38	—	50%
Short leg splint (calf to foot) CPT 29515 HC SPLINTING OF LOWER LEG	$154.50	$309.00	$166.02–$288.18	30% below	50%
Short leg splint (calf to foot) inpatient CPT 29515 HC SPLINTING OF LOWER LEG	$154.50	$309.00	$228.66–$281.19	—	50%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 HC RSW SIMPLE H/N/T/E <2.5CM	$146.00	$292.00	$175.20–$355.81	53% below	50%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 HC RSW SIMPLE H/N/T/E <2.5CM	$146.00	$292.00	$216.08–$265.72	—	50%
Skin biopsy, punch, one lesion CPT 11104 HC PUNCH BIOPSY SKIN SINGLE LESION	$255.50	$511.00	$306.60–$720.91	25% below	50%
Skin biopsy, punch, one lesion inpatient CPT 11104 HC PUNCH BIOPSY SKIN SINGLE LESION	$255.50	$511.00	$378.14–$465.01	—	50%
Skin tag removal, up to 15 tags CPT 11200 HC REMOVE SKIN TAGS <=15 LESIONS	$105.00	$210.00	$126.00–$355.81	54% below	50%
Skin tag removal, up to 15 tags inpatient CPT 11200 HC REMOVE SKIN TAGS <=15 LESIONS	$105.00	$210.00	$155.40–$191.10	—	50%
Spinal tap (lumbar puncture), diagnostic CPT 62270 HC SPINAL PUNCTURE LUMBAR DX	$556.00	$1,112.00	$667.20–$1,251.83	36% below	50%
Spinal tap (lumbar puncture), diagnostic CPT 62270 HC LUMBAR PUNCTURE DIAGNOSTIC	$1,043.50	$2,087.00	$721.17–$1,878.30	21% above	50%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 HC SPINAL PUNCTURE LUMBAR DX	$556.00	$1,112.00	$822.88–$1,011.92	—	50%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 HC LUMBAR PUNCTURE DIAGNOSTIC	$1,043.50	$2,087.00	$1,544.38–$1,899.17	—	50%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 HC RSW SIMPL H/N/T/E 2.6-7.5CM	$256.00	$512.00	$204.98–$460.80	14% below	50%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 HC RSW SIMPL H/N/T/E 2.6-7.5CM	$256.00	$512.00	$378.88–$465.92	—	50%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 HC RSW SIMPLE FACE <2.5CM	$139.50	$279.00	$167.40–$355.81	52% below	50%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 HC RSW SIMPLE FACE <2.5CM	$139.50	$279.00	$206.46–$253.89	—	50%
Tangential (shave-style) skin biopsy, one lesion CPT 11102 HC TANGENTIAL BIOPSY SKIN SINGLE LESION	$183.00	$366.00	$219.60–$720.91	32% below	50%
Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 HC TANGENTIAL BIOPSY SKIN SINGLE LESION	$183.00	$366.00	$270.84–$333.06	—	50%
Thoracentesis with imaging guidance CPT 32555 HC THORACENTESIS W IMAGE GUIDE	$856.00	$1,712.00	$640.89–$1,540.80	8% above	50%
Thoracentesis with imaging guidance inpatient CPT 32555 HC THORACENTESIS W IMAGE GUIDE	$856.00	$1,712.00	$1,266.88–$1,557.92	—	50%
Trigger point injections, 1 or 2 muscles CPT 20552 HC INJ TRIGGER PTS 1 OR 2 MUSC	$274.00	$548.00	$313.60–$544.35	25% below	50%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 HC INJ TRIGGER PTS 1 OR 2 MUSC	$274.00	$548.00	$405.52–$498.68	—	50%
Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 HC BX BREAST 1ST LESION US IMG	$1,665.00	$3,330.00	$1,687.37–$2,997.00	22% below	50%
Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient CPT 19083 HC BX BREAST 1ST LESION US IMG	$1,665.00	$3,330.00	$2,464.20–$3,030.30	—	50%
Upper endoscopy (EGD) with balloon widening of the esophagus CPT 43249 HC ESOPH EDG DILATION < 30MM	$956.00	$1,912.00	$1,147.20–$3,403.02	67% below	50%
Upper endoscopy (EGD) with balloon widening of the esophagus inpatient CPT 43249 HC ESOPH EDG DILATION < 30MM	$956.00	$1,912.00	$1,414.88–$1,739.92	—	50%
Upper endoscopy (EGD) with biopsy CPT 43239 HC EGD BIOPSY SINGLE MULTIPLE	$602.00	$1,204.00	$722.40–$1,608.46	61% below	50%
Upper endoscopy (EGD) with biopsy inpatient CPT 43239 HC EGD BIOPSY SINGLE MULTIPLE	$602.00	$1,204.00	$890.96–$1,095.64	—	50%
Upper endoscopy (EGD) with injection into the lining CPT 43236 HC UPPER GI SCOPE W SUBMUC INJ	$669.50	$1,339.00	$803.40–$1,608.46	60% below	50%
Upper endoscopy (EGD) with injection into the lining inpatient CPT 43236 HC UPPER GI SCOPE W SUBMUC INJ	$669.50	$1,339.00	$990.86–$1,218.49	—	50%
Ureteroscopy with laser stone breaking and stent placement CPT 52356 HC CYSTO/URETERO W/ LITHOTRIPSY & INDWELL STENT INSRT	$3,469.50	$6,939.00	$4,163.40–$9,508.69	33% below	50%
Ureteroscopy with laser stone breaking and stent placement inpatient CPT 52356 HC CYSTO/URETERO W/ LITHOTRIPSY & INDWELL STENT INSRT	$3,469.50	$6,939.00	$5,134.86–$6,314.49	—	50%
Vein ablation, radiofrequency, first vein CPT 36475 HC ENDOVENOUS ABLATION RF 1ST	$2,954.00	$5,908.00	$3,225.87–$5,599.53	44% below	50%
Vein ablation, radiofrequency, first vein inpatient CPT 36475 HC ENDOVENOUS ABLATION RF 1ST	$2,954.00	$5,908.00	$4,371.92–$5,376.28	—	50%
Wart removal, up to 14 warts CPT 17110 HC DESTRUCT LESION 1-14	$152.50	$305.00	$183.00–$355.81	39% below	50%
Wart removal, up to 14 warts inpatient CPT 17110 HC DESTRUCT LESION 1-14	$152.50	$305.00	$225.70–$277.55	—	50%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 HC DEBRIDE SKIN SUBCUTANEOUS	$251.00	$502.00	$301.20–$720.91	41% below	50%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 HC DEBRIDE SKIN SUBCUTANEOUS	$251.00	$502.00	$371.48–$456.82	—	50%

Doctor visits and therapy

Procedure	Cash price	List price	Insurers pay	vs North Dakota	Off list
Blood transfusion (giving blood or blood components) CPT 36430 HC BLOOD TRANSFUSION 1 UNIT	$478.00	$956.00	$450.73–$860.40	33% below	50%
Blood transfusion (giving blood or blood components) CPT 36430 HC TRANSFUSION BLOOD/BLOOD COMPONENTS	$486.00	$972.00	$450.73–$874.80	32% below	50%
Blood transfusion (giving blood or blood components) CPT 36430 HC BLOOD TRANSFUSION 1 UNIT ER	$550.00	$1,100.00	$450.73–$990.00	22% below	50%
Blood transfusion (giving blood or blood components) CPT 36430 HC BLOOD TRANSFUSION 2 UNIT ER	$765.00	$1,530.00	$450.73–$1,377.00	8% above	50%
Blood transfusion (giving blood or blood components) CPT 36430 HC BLOOD TRANSFUSION 2 UNIT	$765.00	$1,530.00	$450.73–$1,377.00	8% above	50%
Blood transfusion (giving blood or blood components) CPT 36430 HC BLOOD TRANSFUSION 3 OR > UNITS	$1,027.50	$2,055.00	$450.73–$1,849.50	45% above	50%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 HC BLOOD TRANSFUSION 1 UNIT	$478.00	$956.00	$707.44–$869.96	—	50%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 HC TRANSFUSION BLOOD/BLOOD COMPONENTS	$486.00	$972.00	$719.28–$884.52	—	50%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 HC BLOOD TRANSFUSION 1 UNIT ER	$550.00	$1,100.00	$814.00–$1,001.00	—	50%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 HC BLOOD TRANSFUSION 2 UNIT	$765.00	$1,530.00	$1,132.20–$1,392.30	—	50%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 HC BLOOD TRANSFUSION 2 UNIT ER	$765.00	$1,530.00	$1,132.20–$1,392.30	—	50%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 HC BLOOD TRANSFUSION 3 OR > UNITS	$1,027.50	$2,055.00	$1,520.70–$1,870.05	—	50%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HC AIRWAY INHALATION TREATMENT	$142.50	$285.00	$171.00–$388.34	36% above	50%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HC MDI IN-LINE TREATMENT	$145.50	$291.00	$174.60–$388.34	39% above	50%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HC AIRWAY INHALATION TREATMENT	$142.50	$285.00	$210.90–$259.35	—	50%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HC MDI IN-LINE TREATMENT	$145.50	$291.00	$215.34–$264.81	—	50%
Chemotherapy IV infusion, first hour CPT 96413 HC CHEMO INFUSN INIT UP TO 1HR	$246.00	$492.00	$295.20–$585.77	64% below	50%
Chemotherapy IV infusion, first hour inpatient CPT 96413 HC CHEMO INFUSN INIT UP TO 1HR	$246.00	$492.00	$364.08–$447.72	—	50%
Critical care, first 30 to 74 minutes CPT 99291 HC ER CRITICAL CARE CEN	$1,937.00	$3,874.00	$843.92–$3,486.60	at median	50%
Critical care, first 30 to 74 minutes inpatient CPT 99291 HC ER CRITICAL CARE CEN	$1,937.00	$3,874.00	$2,866.76–$3,525.34	—	50%
EEG (brain wave test), awake and drowsy, routine CPT 95816 HC EEG AWAKE AND DROWSY	$609.00	$1,218.00	$220.60–$1,096.20	5% below	50%
EEG (brain wave test), awake and drowsy, routine inpatient CPT 95816 HC EEG AWAKE AND DROWSY	$609.00	$1,218.00	$901.32–$1,108.38	—	50%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 HC EKG ROUTINE	$108.00	$216.00	$60.27–$194.40	4% below	50%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 HC EKG ROUTINE	$108.00	$216.00	$159.84–$196.56	—	50%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 HC ER LEVEL 1 CEN	$144.00	$288.00	$86.15–$2,758.00	19% below	50%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 HC ER LEVEL 1 CEN	$144.00	$288.00	$213.12–$262.08	—	50%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 HC ER LEVEL 2 CEN	$254.50	$509.00	$156.87–$2,758.00	15% below	50%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 HC ER LEVEL 2 CEN	$254.50	$509.00	$376.66–$463.19	—	50%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 HC ER LEVEL 3 CEN	$409.00	$818.00	$278.89–$2,758.00	17% below	50%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 HC ER LEVEL 3 CEN	$409.00	$818.00	$605.32–$744.38	—	50%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 HC ER LEVEL 4 CEN	$730.00	$1,460.00	$426.30–$2,758.00	10% below	50%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 HC ER LEVEL 4 CEN	$730.00	$1,460.00	$1,080.40–$1,328.60	—	50%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 HC ER LEVEL 5 CEN	$1,105.50	$2,211.00	$608.43–$2,758.00	11% below	50%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 HC ER LEVEL 5 CEN	$1,105.50	$2,211.00	$1,636.14–$2,012.01	—	50%
Exercise stress test, tracing only, the hospital charge CPT 93017 HC CARDIOVASCULAR STRESS TEST	$297.00	$594.00	$220.60–$534.60	7% below	50%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 HC CARDIOVASCULAR STRESS TEST	$297.00	$594.00	$439.56–$540.54	—	50%
Group psychotherapy session CPT 90853 HC PHP SOCIALIZATION GROUP	$45.00	$90.00	$54.00–$379.00	90% below	50%
Group psychotherapy session CPT 90853 HC PHP INDIVIDUAL THERAPY	$52.00	$104.00	$62.40–$379.00	89% below	50%
Group psychotherapy session CPT 90853 HC PHP FAMILY THERAPY W PATIENT	$52.50	$105.00	$63.00–$379.00	89% below	50%
Group psychotherapy session CPT 90853 HC GROUP THERAPY MEDICAID 15 MIN	$73.50	$147.00	$88.20–$180.17	84% below	50%
Group psychotherapy session CPT 90853 HC PHP GROUP THERAPY	$82.50	$165.00	$99.00–$379.00	82% below	50%
Group psychotherapy session CPT 90853 HC PHP ACTIVITY THERAPY	$160.50	$321.00	$103.79–$379.00	65% below	50%
Group psychotherapy session CPT 90853 HC THERAPIST GRP PSYCHOTHERAPY	$237.50	$475.00	$103.79–$427.50	48% below	50%
Group psychotherapy session CPT 90853 HC PHP LEVEL I	$484.00	$968.00	$103.79–$871.20	6% above	50%
Group psychotherapy session inpatient CPT 90853 HC PHP SOCIALIZATION GROUP	$45.00	$90.00	$66.60–$81.90	—	50%
Group psychotherapy session inpatient CPT 90853 HC PHP INDIVIDUAL THERAPY	$52.00	$104.00	$76.96–$94.64	—	50%
Group psychotherapy session inpatient CPT 90853 HC PHP FAMILY THERAPY W PATIENT	$52.50	$105.00	$77.70–$95.55	—	50%
Group psychotherapy session inpatient CPT 90853 HC GROUP THERAPY MEDICAID 15 MIN	$73.50	$147.00	$108.78–$133.77	—	50%
Group psychotherapy session inpatient CPT 90853 HC PHP GROUP THERAPY	$82.50	$165.00	$122.10–$150.15	—	50%
Group psychotherapy session inpatient CPT 90853 HC PHP ACTIVITY THERAPY	$160.50	$321.00	$237.54–$292.11	—	50%
Group psychotherapy session inpatient CPT 90853 HC THERAPIST GRP PSYCHOTHERAPY	$237.50	$475.00	$351.50–$432.25	—	50%
Group psychotherapy session inpatient CPT 90853 HC PHP LEVEL I	$484.00	$968.00	$716.32–$880.88	—	50%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 HC HYDRA INF INIT 31 MIN -1 HR	$263.50	$527.00	$217.31–$474.30	21% below	50%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 HC HYDRA INF INIT 31MIN-1HR ER	$263.50	$527.00	$217.31–$2,758.00	21% below	50%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 HC HYDRA INF INIT 31MIN-1HR ER	$263.50	$527.00	$389.98–$479.57	—	50%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 HC HYDRA INF INIT 31 MIN -1 HR	$263.50	$527.00	$389.98–$479.57	—	50%
IV infusion of a medicine, first hour CPT 96365 HC THERP INFSN INIT UP TO 1 HR	$286.00	$572.00	$217.31–$514.80	26% below	50%
IV infusion of a medicine, first hour CPT 96365 HC THERAPY INF INITIAL 1ST HR	$286.00	$572.00	$217.31–$2,758.00	26% below	50%
IV infusion of a medicine, first hour inpatient CPT 96365 HC THERP INFSN INIT UP TO 1 HR	$286.00	$572.00	$423.28–$520.52	—	50%
IV infusion of a medicine, first hour inpatient CPT 96365 HC THERAPY INF INITIAL 1ST HR	$286.00	$572.00	$423.28–$520.52	—	50%
IV push of a medicine, first drug CPT 96374 HC IV PUSH INITIAL SINGLE DRUG	$257.00	$514.00	$217.31–$2,758.00	14% below	50%
IV push of a medicine, first drug CPT 96374 HC IV PUSH INIT SNGL DRUG THER	$257.00	$514.00	$217.31–$462.60	14% below	50%
IV push of a medicine, first drug inpatient CPT 96374 HC IV PUSH INIT SNGL DRUG THER	$257.00	$514.00	$380.36–$467.74	—	50%
IV push of a medicine, first drug inpatient CPT 96374 HC IV PUSH INITIAL SINGLE DRUG	$257.00	$514.00	$380.36–$467.74	—	50%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 HC INJ SUBQ IM THRP PROPHYL DX	$82.50	$165.00	$73.56–$148.50	2% below	50%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 HC INJECTION SUBQ IM THERP ER	$82.50	$165.00	$73.56–$2,758.00	2% below	50%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 HC INJECTION SUBQ IM THERP ER	$82.50	$165.00	$122.10–$150.15	—	50%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 HC INJ SUBQ IM THRP PROPHYL DX	$82.50	$165.00	$122.10–$150.15	—	50%
Nerve conduction study, 7 or 8 nerve studies CPT 95910 HC NRV CNDJ TEST 7-8 STUDIES	$191.00	$382.00	$229.20–$661.76	at median	50%
Nerve conduction study, 7 or 8 nerve studies inpatient CPT 95910 HC NRV CNDJ TEST 7-8 STUDIES	$191.00	$382.00	$282.68–$347.62	—	50%
Neuromuscular re-education, 15 minutes CPT 97112 HC PT NEUROMUSCULAR RE-EDU 15M	$78.00	$156.00	$76.72–$281.00	31% below	50%
Neuromuscular re-education, 15 minutes CPT 97112 HC OT NEUROMUSCULAR RE-EDU 15M	$78.00	$156.00	$76.72–$281.00	31% below	50%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 HC OT NEUROMUSCULAR RE-EDU 15M	$78.00	$156.00	$115.44–$141.96	—	50%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 HC PT NEUROMUSCULAR RE-EDU 15M	$78.00	$156.00	$115.44–$141.96	—	50%
New patient office visit, about 30 minutes CPT 99203 HC OFFICE OUTPATIENT NEW 30-44 MINS	$126.00	$252.00	$151.20–$226.80	44% below	50%
New patient office visit, about 30 minutes inpatient CPT 99203 HC OFFICE OUTPATIENT NEW 30-44 MINS	$126.00	$252.00	$186.48–$229.32	—	50%
New patient office visit, about 45 minutes CPT 99204 HC OFFICE OUTPATIENT NEW 45-59 MINS	$195.50	$391.00	$234.60–$351.90	39% below	50%
New patient office visit, about 45 minutes inpatient CPT 99204 HC OFFICE OUTPATIENT NEW 45-59 MINS	$195.50	$391.00	$289.34–$355.81	—	50%
New patient office visit, about 60 minutes CPT 99205 HC OFFICE OUTPATIENT NEW 60-74 MINS	$244.50	$489.00	$293.40–$440.10	37% below	50%
New patient office visit, about 60 minutes inpatient CPT 99205 HC OFFICE OUTPATIENT NEW 60-74 MINS	$244.50	$489.00	$361.86–$444.99	—	50%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 HC OFFICE OUTPATIENT NEW 15-29 MINS	$35.50	$71.00	$42.60–$63.90	77% below	50%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 HC OFFICE O/P NEW SF 15-29 MIN	$74.50	$149.00	$89.40–$134.10	53% below	50%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 HC OFFICE OUTPATIENT NEW 15-29 MINS	$35.50	$71.00	$52.54–$64.61	—	50%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 HC OFFICE O/P NEW SF 15-29 MIN	$74.50	$149.00	$110.26–$135.59	—	50%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 HC MEDICAL NUTRITION INDIV EACH 15 MIN STAT	$170.50	$341.00	$36.54–$306.90	70% above	50%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 HC MEDICAL NUTRITION INDIV EACH 15 MIN STAT	$170.50	$341.00	$252.34–$310.31	—	50%
Occupational therapy evaluation, low complexity CPT 97165 HC OT EVAL LOW COMPLEXITY	$164.50	$329.00	$197.40–$296.10	37% below	50%
Occupational therapy evaluation, low complexity inpatient CPT 97165 HC OT EVAL LOW COMPLEXITY	$164.50	$329.00	$243.46–$299.39	—	50%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 HC PT EVAL HIGH COMPLEXITY	$156.00	$312.00	$187.20–$281.00	50% below	50%
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 HC PT EVAL HIGH COMPLEXITY	$156.00	$312.00	$230.88–$283.92	—	50%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 HC PT EVAL LOW COMPLEXITY	$156.00	$312.00	$187.20–$281.00	42% below	50%
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 HC PT EVAL LOW COMPLEXITY	$156.00	$312.00	$230.88–$283.92	—	50%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 HC PT EVAL MODERATE COMPLEX	$156.00	$312.00	$187.20–$281.00	46% below	50%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 HC PT EVAL MODERATE COMPLEX	$156.00	$312.00	$230.88–$283.92	—	50%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 HC PT MANUAL THERAPY EA 15MIN	$79.50	$159.00	$61.45–$281.00	26% below	50%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 HC OT MANUAL THERAPY EA 15MIN	$79.50	$159.00	$61.45–$281.00	26% below	50%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 HC PT MANUAL THERAPY EA 15MIN	$79.50	$159.00	$117.66–$144.69	—	50%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 HC OT MANUAL THERAPY EA 15MIN	$79.50	$159.00	$117.66–$144.69	—	50%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HC PT THERAPEUTIC EXERCISE 15M	$75.50	$151.00	$66.81–$281.00	31% below	50%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HC OT THERAPEUTIC EXERCISE 15M	$75.50	$151.00	$66.81–$281.00	31% below	50%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 HC OT THERAPEUTIC EXERCISE 15M	$75.50	$151.00	$111.74–$137.41	—	50%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 HC PT THERAPEUTIC EXERCISE 15M	$75.50	$151.00	$111.74–$137.41	—	50%
Psychiatric evaluation with medical services CPT 90792 HC SP PSY INTERVIEW (MD)	$95.50	$191.00	$114.60–$314.77	66% below	50%
Psychiatric evaluation with medical services inpatient CPT 90792 HC SP PSY INTERVIEW (MD)	$95.50	$191.00	$141.34–$173.81	—	50%
Psychological testing evaluation by a psychologist or physician, first hour CPT 96130 HC PSYCHOLOGICAL TST EVAL SVC PHYS/QHP FIRST HOUR	$213.50	$427.00	$220.60–$384.30	30% below	50%
Psychological testing evaluation by a psychologist or physician, first hour inpatient CPT 96130 HC PSYCHOLOGICAL TST EVAL SVC PHYS/QHP FIRST HOUR	$213.50	$427.00	$315.98–$388.57	—	50%
Psychotherapy session, 30 minutes CPT 90832 HC PSYCHOTHERAPY W PATIENT 30 MINUTES	$129.50	$259.00	$155.40–$314.77	31% below	50%
Psychotherapy session, 30 minutes inpatient CPT 90832 HC PSYCHOTHERAPY W PATIENT 30 MINUTES	$129.50	$259.00	$191.66–$235.69	—	50%
Psychotherapy session, 45 minutes CPT 90834 HC PSYCHOTHERAPY W PATIENT 45 MINUTES	$129.50	$259.00	$155.40–$314.77	50% below	50%
Psychotherapy session, 45 minutes inpatient CPT 90834 HC PSYCHOTHERAPY W PATIENT 45 MINUTES	$129.50	$259.00	$191.66–$235.69	—	50%
Psychotherapy session, 60 minutes CPT 90837 HC SP NEUPSY 60 MIN PSYCHOTHERAPY	$95.50	$191.00	$114.60–$314.77	61% below	50%
Psychotherapy session, 60 minutes inpatient CPT 90837 HC SP NEUPSY 60 MIN PSYCHOTHERAPY	$95.50	$191.00	$141.34–$173.81	—	50%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 HC SMOKE CESS INTERMED 3-10 MIN	$27.00	$54.00	$32.40–$66.44	25% below	50%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 HC SMOKE CESS SYMP IND 3-10MIN	$27.50	$55.00	$33.00–$66.44	24% below	50%
Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 HC SMOKE CESS INTERMED 3-10 MIN	$27.00	$54.00	$39.96–$49.14	—	50%
Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 HC SMOKE CESS SYMP IND 3-10MIN	$27.50	$55.00	$40.70–$50.05	—	50%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 HC OFFICE VISIT EST 40-54 MINS	$173.50	$347.00	$208.20–$312.30	50% below	50%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 HC OFFICE VISIT EST 40-54 MINS	$173.50	$347.00	$256.78–$315.77	—	50%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 HC OFFICE VISIT EST 20-29 MINS	$122.50	$245.00	$147.00–$220.50	34% below	50%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 HC OFFICE VISIT EST 20-29 MINS	$122.50	$245.00	$181.30–$222.95	—	50%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 HC OFFICE VISIT EST 30-39 MINS	$139.50	$279.00	$167.40–$251.10	44% below	50%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 HC OFFICE VISIT EST 30-39 MINS	$139.50	$279.00	$206.46–$253.89	—	50%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 HC OFFICE VISIT EST 10-19 MINS	$105.00	$210.00	$126.00–$189.00	21% above	50%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 HC IR TUNNEL REM W/O DISECTION	$173.50	$347.00	$208.20–$312.30	99% above	50%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 HC OFFICE VISIT EST 10-19 MINS	$105.00	$210.00	$155.40–$191.10	—	50%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 HC IR TUNNEL REM W/O DISECTION	$173.50	$347.00	$256.78–$315.77	—	50%
Speech and language evaluation CPT 92523 HC ST EVAL SOUND LANG COMPREH	$351.00	$702.00	$281.00–$631.80	39% below	50%
Speech and language evaluation inpatient CPT 92523 HC ST EVAL SOUND LANG COMPREH	$351.00	$702.00	$519.48–$638.82	—	50%
Speech therapy session, individual CPT 92507 HC ST SPEECH TREATMENT INDIVID	$174.00	$348.00	$173.70–$313.20	36% below	50%
Speech therapy session, individual inpatient CPT 92507 HC ST SPEECH TREATMENT INDIVID	$174.00	$348.00	$257.52–$316.68	—	50%
Spirometry (breathing test) CPT 94010 HC SPIROMETRY	$127.50	$255.00	$153.00–$382.93	8% below	50%
Spirometry (breathing test) inpatient CPT 94010 HC SPIROMETRY	$127.50	$255.00	$188.70–$232.05	—	50%
Spirometry before and after a bronchodilator CPT 94060 HC SPIROMETRY PRE POST BRONCH	$256.50	$513.00	$307.80–$661.76	at median	50%
Spirometry before and after a bronchodilator inpatient CPT 94060 HC SPIROMETRY PRE POST BRONCH	$256.50	$513.00	$379.62–$466.83	—	50%
Therapeutic activities (functional training), 15 minutes CPT 97530 HC PT THER ACTIVITY EA 15MIN	$69.00	$138.00	$82.80–$281.00	41% below	50%
Therapeutic activities (functional training), 15 minutes CPT 97530 HC OT THER ACTIVITY EA 15MIN	$69.00	$138.00	$82.80–$281.00	41% below	50%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 HC PT THER ACTIVITY EA 15MIN	$69.00	$138.00	$102.12–$125.58	—	50%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 HC OT THER ACTIVITY EA 15MIN	$69.00	$138.00	$102.12–$125.58	—	50%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 HC PHLEBOTOMY THERPAPEUTIC	$125.50	$251.00	$135.93–$235.96	50% below	50%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 HC PHLEBOTOMY THERPAPEUTIC	$125.50	$251.00	$185.74–$228.41	—	50%

Vaccines

Procedure	Cash price	List price	Insurers pay	vs North Dakota	Off list
Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older CPT 90653 HC INFLUENZA VACCINE INACT SUBUNIT ADJUVANT IM	$37.50	$75.00	$27.75–$75.00	49% below	50%
Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older CPT 90653 FLU VACC 2025-26(65YR UP)-MF59C(PF) 45 MCG(15 MCGX3)/0.5 ML IM SYRINGE	$54.50	$109.00	$40.33–$98.16	25% below	50%
Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older inpatient CPT 90653 HC INFLUENZA VACCINE INACT SUBUNIT ADJUVANT IM	$37.50	$75.00	$27.75–$68.25	—	50%
Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older inpatient CPT 90653 FLU VACC 2025-26(65YR UP)-MF59C(PF) 45 MCG(15 MCGX3)/0.5 ML IM SYRINGE	$54.50	$109.00	$40.33–$99.19	—	50%
COVID-19 vaccine (Pfizer-BioNTech), age 12 and older CPT 91320 COVID VACC 2025-2026 (12 YRS UP) (PFIZER)(PF) 30 MCG/0.3 ML IM SYRINGE	$229.15	$458.30	$274.98–$412.47	9% above	50%
COVID-19 vaccine (Pfizer-BioNTech), age 12 and older inpatient CPT 91320 COVID VACC 2025-2026 (12 YRS UP) (PFIZER)(PF) 30 MCG/0.3 ML IM SYRINGE	$229.15	$458.30	$339.15–$417.06	—	50%
Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 HC CHICKEN POX VACCINELIVESUB-Q	$98.00	$196.00	$117.60–$196.00	41% below	50%
Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 VARICELLA VIRUS VACCINE LIVE (PF) 1350 UNIT/0.5 ML SUBCUTANEOUS SUSP	$237.05	$474.10	$195.83–$426.69	42% above	50%
Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 HC CHICKEN POX VACCINELIVESUB-Q	$98.00	$196.00	$145.04–$178.36	—	50%
Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 VARICELLA VIRUS VACCINE LIVE (PF) 1350 UNIT/0.5 ML SUBCUTANEOUS SUSP	$237.05	$474.10	$350.84–$431.44	—	50%
DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) CPT 90696 HC DTAP-IPV IM AGE 4-6 YEAR	$47.00	$94.00	$56.40–$84.60	50% below	50%
DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) CPT 90696 DIPHPERTUS(ACELL)TETPOLIO (PF) 25 LF-58 MCG-10 LF/0.5 ML IM SYRINGE	$124.92	$249.84	$67.53–$224.86	33% above	50%
DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) inpatient CPT 90696 HC DTAP-IPV IM AGE 4-6 YEAR	$47.00	$94.00	$69.56–$85.54	—	50%
DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) inpatient CPT 90696 DIPHPERTUS(ACELL)TETPOLIO (PF) 25 LF-58 MCG-10 LF/0.5 ML IM SYRINGE	$124.92	$249.84	$184.89–$227.36	—	50%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 HC DTAP IMMUNIZATION IM <7 YO	$26.00	$52.00	$31.20–$46.80	50% below	50%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 DIPHPERTUS(ACEL)TET PED(PF) 25 LF UNIT-58 MCG-10 LF/0.5ML IM SYRINGE	$57.33	$114.65	$31.81–$103.19	10% above	50%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 DIPHPERTUS(ACEL)TET PEDI (PF) 15 LF UNIT-10 MCG-5 LF/0.5 ML IM SUSP	$73.37	$146.73	$31.81–$132.06	41% above	50%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 inpatient CPT 90700 HC DTAP IMMUNIZATION IM <7 YO	$26.00	$52.00	$38.48–$47.32	—	50%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 inpatient CPT 90700 DIPHPERTUS(ACEL)TET PED(PF) 25 LF UNIT-58 MCG-10 LF/0.5ML IM SYRINGE	$57.33	$114.65	$84.85–$104.34	—	50%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 inpatient CPT 90700 DIPHPERTUS(ACEL)TET PEDI (PF) 15 LF UNIT-10 MCG-5 LF/0.5 ML IM SUSP	$73.37	$146.73	$108.59–$133.53	—	50%
DTaP, hepatitis B and polio combination vaccine (Pediarix) CPT 90723 HC DTAP-HEPB-IPV VACCINE INTRAMUSCULAR	$46.50	$93.00	$55.80–$93.00	61% below	50%
DTaP, hepatitis B and polio combination vaccine (Pediarix) CPT 90723 HEP B-DP(A)T-POLIO VACC (PF) 10 MCG-25LF-25 MCG-10LF/0.5 ML IM SYRINGE	$168.88	$337.76	$111.39–$303.99	43% above	50%
DTaP, hepatitis B and polio combination vaccine (Pediarix) inpatient CPT 90723 HC DTAP-HEPB-IPV VACCINE INTRAMUSCULAR	$46.50	$93.00	$68.82–$84.63	—	50%
DTaP, hepatitis B and polio combination vaccine (Pediarix) inpatient CPT 90723 HEP B-DP(A)T-POLIO VACC (PF) 10 MCG-25LF-25 MCG-10LF/0.5 ML IM SYRINGE	$168.88	$337.76	$249.95–$307.37	—	50%
DTaP, polio and Hib combination vaccine (Pentacel) CPT 90698 DTAP-IPV COMPONENT 1OF2(PF) 15 LF-48MCG-5 LF-62 DU/0.5ML IM SUSPENSION	$49.75	$99.50	$59.70–$99.50	60% below	50%
DTaP, polio and Hib combination vaccine (Pentacel) CPT 90698 HC DTAP-HIB-IP VACCINE IM	$54.00	$108.00	$64.80–$108.00	57% below	50%
DTaP, polio and Hib combination vaccine (Pentacel) inpatient CPT 90698 DTAP-IPV COMPONENT 1OF2(PF) 15 LF-48MCG-5 LF-62 DU/0.5ML IM SUSPENSION	$49.75	$99.50	$73.63–$90.55	—	50%
DTaP, polio and Hib combination vaccine (Pentacel) inpatient CPT 90698 HC DTAP-HIB-IP VACCINE IM	$54.00	$108.00	$79.92–$98.28	—	50%
Flu shot, recombinant, egg-free (Flublok) CPT 90673 HC INFLUENZA VIRUS VACCINE TRIVALEN RIV3 PRSR FR IM	$20.00	$40.00	$14.80–$40.00	65% below	50%
Flu shot, recombinant, egg-free (Flublok) inpatient CPT 90673 HC INFLUENZA VIRUS VACCINE TRIVALEN RIV3 PRSR FR IM	$20.00	$40.00	$14.80–$36.40	—	50%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 HC INFLUENZA VIRUS VACC SPLIT PRSRV FREE 3 YRS/> IM	$12.50	$25.00	$9.25–$23.22	62% below	50%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 FLU VACCINE TS 2025-26(6MOS UP)(PF) 45 MCG(15MCG X3)/0.5 ML IM SYRINGE	$24.50	$49.00	$18.13–$44.10	26% below	50%
Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 HC INFLUENZA VIRUS VACC SPLIT PRSRV FREE 3 YRS/> IM	$12.50	$25.00	$9.25–$22.75	—	50%
Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 FLU VACCINE TS 2025-26(6MOS UP)(PF) 45 MCG(15MCG X3)/0.5 ML IM SYRINGE	$24.50	$49.00	$18.13–$44.59	—	50%
HPV vaccine, 9-valent (Gardasil 9) CPT 90651 HC HUMAN PAPILLOMA VIRUS NONAVALENT HPV 3 DOSE IM	$84.00	$168.00	$100.80–$168.00	76% below	50%
HPV vaccine, 9-valent (Gardasil 9) inpatient CPT 90651 HC HUMAN PAPILLOMA VIRUS NONAVALENT HPV 3 DOSE IM	$84.00	$168.00	$124.32–$152.88	—	50%
Hepatitis A vaccine, adult dose CPT 90632 HC HEPA VACCINE ADULT IM	$47.00	$94.00	$56.40–$84.60	52% below	50%
Hepatitis A vaccine, adult dose CPT 90632 HEPATITIS A VIRUS VACCINE (PF) 720 ELISA UNIT/0.5 ML IM SYRINGE	$72.92	$145.84	$78.28–$131.26	26% below	50%
Hepatitis A vaccine, adult dose CPT 90632 HEPATITIS A VACCINE (PF) 1440 ELISA UNIT/ML INTRAMUSCULAR SYRINGE	$176.94	$353.87	$78.28–$318.49	80% above	50%
Hepatitis A vaccine, adult dose inpatient CPT 90632 HC HEPA VACCINE ADULT IM	$47.00	$94.00	$69.56–$85.54	—	50%
Hepatitis A vaccine, adult dose inpatient CPT 90632 HEPATITIS A VIRUS VACCINE (PF) 720 ELISA UNIT/0.5 ML IM SYRINGE	$72.92	$145.84	$107.93–$132.72	—	50%
Hepatitis A vaccine, adult dose inpatient CPT 90632 HEPATITIS A VACCINE (PF) 1440 ELISA UNIT/ML INTRAMUSCULAR SYRINGE	$176.94	$353.87	$261.87–$322.03	—	50%
Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 HC HEPA VACCINE PED/ADOL-2 DOSE	$26.50	$53.00	$31.80–$47.70	55% below	50%
Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 HEPATITIS A VIRUS VACCINE (PF) 25 UNIT/0.5 ML INTRAMUSCULAR SYRINGE	$71.93	$143.85	$41.76–$129.47	22% above	50%
Hepatitis A vaccine, child and teen dose (2-dose schedule) inpatient CPT 90633 HC HEPA VACCINE PED/ADOL-2 DOSE	$26.50	$53.00	$39.22–$48.23	—	50%
Hepatitis A vaccine, child and teen dose (2-dose schedule) inpatient CPT 90633 HEPATITIS A VIRUS VACCINE (PF) 25 UNIT/0.5 ML INTRAMUSCULAR SYRINGE	$71.93	$143.85	$106.45–$130.91	—	50%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 HC HEPATITIS B VACCINE ADULT 3 DOSE IM	$57.00	$114.00	$42.18–$102.60	44% below	50%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 HEPATITIS B VIRUS VACCINE RECOMB (PF) 10 MCG/ML INTRAMUSCULAR SUSP	$96.70	$193.40	$71.56–$174.06	5% below	50%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 HEPATITIS B VIRUS VACCINE RECOMB (PF) 20 MCG/ML INTRAMUSCULAR SYRINGE	$118.47	$236.93	$73.53–$213.24	17% above	50%
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 HC HEPATITIS B VACCINE ADULT 3 DOSE IM	$57.00	$114.00	$42.18–$103.74	—	50%
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 HEPATITIS B VIRUS VACCINE RECOMB (PF) 10 MCG/ML INTRAMUSCULAR SUSP	$96.70	$193.40	$71.56–$176.00	—	50%
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 HEPATITIS B VIRUS VACCINE RECOMB (PF) 20 MCG/ML INTRAMUSCULAR SYRINGE	$118.47	$236.93	$87.67–$215.61	—	50%
Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 HC HEP B VACCINEPED/ADOLIM	$14.50	$29.00	$10.73–$29.00	64% below	50%
Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 HEPATITIS B VIRUS VACCINE RECOMB (PF) 10 MCG/0.5 ML IM SYRINGE	$50.80	$101.60	$29.72–$91.44	27% above	50%
Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 HEPATITIS B VIRUS VACCINE RECOMB (PF) 10 MCG/ML INTRAMUSCULAR SYRINGE	$96.70	$193.40	$29.72–$174.06	142% above	50%
Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 HC HEP B VACCINEPED/ADOLIM	$14.50	$29.00	$10.73–$26.39	—	50%
Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 HEPATITIS B VIRUS VACCINE RECOMB (PF) 10 MCG/0.5 ML IM SYRINGE	$50.80	$101.60	$37.60–$92.46	—	50%
Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 HEPATITIS B VIRUS VACCINE RECOMB (PF) 10 MCG/ML INTRAMUSCULAR SYRINGE	$96.70	$193.40	$71.56–$176.00	—	50%
Hib vaccine (Haemophilus influenzae type b), 3-dose schedule (PedvaxHIB) CPT 90647 HC HB HIB VACCINE PRP-OMP IM	$18.00	$36.00	$21.60–$33.83	47% below	50%
Hib vaccine (Haemophilus influenzae type b), 3-dose schedule (PedvaxHIB) CPT 90647 HAEMOPH B POLYSAC CONJ-MENING (PF) 7.5 MCG/0.5 ML INTRAMUSCULAR SOLN	$72.29	$144.58	$32.87–$130.13	113% above	50%
Hib vaccine (Haemophilus influenzae type b), 3-dose schedule (PedvaxHIB) inpatient CPT 90647 HC HB HIB VACCINE PRP-OMP IM	$18.00	$36.00	$26.64–$32.76	—	50%
Hib vaccine (Haemophilus influenzae type b), 3-dose schedule (PedvaxHIB) inpatient CPT 90647 HAEMOPH B POLYSAC CONJ-MENING (PF) 7.5 MCG/0.5 ML INTRAMUSCULAR SOLN	$72.29	$144.58	$106.99–$131.57	—	50%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) CPT 90648 HC HB VACCINE PRP-T IM	$20.00	$40.00	$14.16–$36.00	36% below	50%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) CPT 90648 HAEMOPHILUS B POLYSACCHARID CONJ-TETANUS TOX(PF) 10 MCG/0.5 ML IM SOLN	$141.09	$282.18	$14.16–$253.97	353% above	50%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) inpatient CPT 90648 HC HB VACCINE PRP-T IM	$20.00	$40.00	$29.60–$36.40	—	50%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) inpatient CPT 90648 HAEMOPHILUS B POLYSACCHARID CONJ-TETANUS TOX(PF) 10 MCG/0.5 ML IM SOLN	$141.09	$282.18	$208.82–$256.79	—	50%
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 HC FLU VACCINE INCREASED ANTIGEN PRESV FREE	$32.50	$65.00	$24.05–$65.00	50% below	50%
High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 HC FLU VACCINE INCREASED ANTIGEN PRESV FREE	$32.50	$65.00	$24.05–$59.15	—	50%
MMR vaccine (measles, mumps and rubella), live CPT 90707 HC MMR VIRUS IMMUNIZATION SUBCUT	$62.50	$125.00	$75.00–$112.50	48% below	50%
MMR vaccine (measles, mumps and rubella), live CPT 90707 MEASLESMUMPSRUBELLA VACCINE LIVE(PF)1000-12500TCID50/0.5 ML SUBCUT	$220.43	$440.86	$102.34–$396.78	82% above	50%
MMR vaccine (measles, mumps and rubella), live CPT 90707 RSVPREF3 ANTIGEN-AS01E ADJUVANT(PF) 120 MCG/0.5 ML IM SUSPENSION KIT	$598.06	$1,196.12	$102.34–$1,076.51	394% above	50%
MMR vaccine (measles, mumps and rubella), live CPT 90707 RESP SYNCYTIAL VIRUS VAC PREF A AND B (PF) 120 MCG/0.5 ML IM SOLUTION	$740.15	$1,480.30	$102.34–$1,332.27	512% above	50%
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 HC MMR VIRUS IMMUNIZATION SUBCUT	$62.50	$125.00	$92.50–$113.75	—	50%
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 MEASLESMUMPSRUBELLA VACCINE LIVE(PF)1000-12500TCID50/0.5 ML SUBCUT	$220.43	$440.86	$326.24–$401.19	—	50%
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 RSVPREF3 ANTIGEN-AS01E ADJUVANT(PF) 120 MCG/0.5 ML IM SUSPENSION KIT	$598.06	$1,196.12	$885.13–$1,088.47	—	50%
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 RESP SYNCYTIAL VIRUS VAC PREF A AND B (PF) 120 MCG/0.5 ML IM SOLUTION	$740.15	$1,480.30	$1,095.43–$1,347.08	—	50%
MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) CPT 90710 HC COMBINED VACCINEMMR+VARICELLASUB-Q	$84.00	$168.00	$100.80–$168.00	78% below	50%
MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) CPT 90710 MEASLESMUMPSRUBELVARICEL LIV(PF)10E3-4.3-3-3.99TCID50/0.5 ML SUBCUT	$400.49	$800.98	$294.44–$720.89	4% above	50%
MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) inpatient CPT 90710 HC COMBINED VACCINEMMR+VARICELLASUB-Q	$84.00	$168.00	$124.32–$152.88	—	50%
MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) inpatient CPT 90710 MEASLESMUMPSRUBELVARICEL LIV(PF)10E3-4.3-3-3.99TCID50/0.5 ML SUBCUT	$400.49	$800.98	$592.73–$728.90	—	50%
Meningococcal ACWY (MenACWY) vaccine CPT 90734 HC MENINGOCOCCAL CONJ VACCINE QUADRAVALENT IM	$98.00	$196.00	$117.60–$189.96	45% below	50%
Meningococcal ACWY (MenACWY) vaccine CPT 90734 MENINGOC VAC ACYW-135 DIP(PF) 10 MCG-5 MCG/0.5 ML IM KIT (2 VIALS)	$282.04	$564.08	$179.26–$507.68	58% above	50%
Meningococcal ACWY (MenACWY) vaccine CPT 90734 MENINGOC VAC ACYW-135 DIP (PF) 4 MCG/0.5 ML INTRAMUSCULAR SOLUTION	$313.50	$626.99	$179.26–$564.30	76% above	50%
Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 HC MENINGOCOCCAL CONJ VACCINE QUADRAVALENT IM	$98.00	$196.00	$145.04–$178.36	—	50%
Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 MENINGOC VAC ACYW-135 DIP(PF) 10 MCG-5 MCG/0.5 ML IM KIT (2 VIALS)	$282.04	$564.08	$417.42–$513.32	—	50%
Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 MENINGOC VAC ACYW-135 DIP (PF) 4 MCG/0.5 ML INTRAMUSCULAR SOLUTION	$313.50	$626.99	$463.98–$570.57	—	50%
Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 MENINGOCOCCAL B VAC4-CMP 50 MCG-50 MCG-50 MCG-25 MCG/0.5ML IM SYRINGE	$377.98	$755.96	$254.91–$680.37	12% above	50%
Meningococcal B vaccine (Bexsero), 2-dose schedule inpatient CPT 90620 MENINGOCOCCAL B VAC4-CMP 50 MCG-50 MCG-50 MCG-25 MCG/0.5ML IM SYRINGE	$377.98	$755.96	$559.42–$687.93	—	50%
Mpox and smallpox vaccine (Jynneos), 2-dose schedule CPT 90611 HC SMALLPOX&MONKEYPOX VAC 0.5ML	$100.00	$200.00	$120.00–$180.00	45% below	50%
Mpox and smallpox vaccine (Jynneos), 2-dose schedule CPT 90611 SMALLPOXMPOX LIVE VACCINE(PF) 0.5X TO 3.95X 10EXP8/0.5 ML SUBCUT SUSP	$136.19	$272.38	$163.43–$245.15	25% below	50%
Mpox and smallpox vaccine (Jynneos), 2-dose schedule inpatient CPT 90611 HC SMALLPOX&MONKEYPOX VAC 0.5ML	$100.00	$200.00	$148.00–$182.00	—	50%
Mpox and smallpox vaccine (Jynneos), 2-dose schedule inpatient CPT 90611 SMALLPOXMPOX LIVE VACCINE(PF) 0.5X TO 3.95X 10EXP8/0.5 ML SUBCUT SUSP	$136.19	$272.38	$201.57–$247.87	—	50%
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) CPT 90670 HC PNEUMOCOCCAL CONJ VACCINE 13 VALENT IM	$95.00	$190.00	$70.30–$190.00	66% below	50%
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) inpatient CPT 90670 HC PNEUMOCOCCAL CONJ VACCINE 13 VALENT IM	$95.00	$190.00	$70.30–$172.90	—	50%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 PNEUMOCOCCAL 20-VALENT CONJ VACCINE-DIP CRM (PF) 0.5 ML IM SYRINGE	$566.75	$1,133.50	$680.10–$1,020.15	50% above	50%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 PNEUMOCOCCAL 20-VALENT CONJ VACCINE-DIP CRM (PF) 0.5 ML IM SYRINGE	$566.75	$1,133.50	$838.79–$1,031.49	—	50%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 HC PNEUMOCOCCAL VACCINE23-VALENTADULT	$45.00	$90.00	$33.30–$90.00	68% below	50%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PNEUMOCOCCAL 23 POLYVALENT VACCINE 25 MCG/0.5 ML INJECTION SYRINGE	$254.22	$508.43	$119.43–$457.59	82% above	50%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 HC PNEUMOCOCCAL VACCINE23-VALENTADULT	$45.00	$90.00	$33.30–$81.90	—	50%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 PNEUMOCOCCAL 23 POLYVALENT VACCINE 25 MCG/0.5 ML INJECTION SYRINGE	$254.22	$508.43	$188.12–$462.68	—	50%
Polio vaccine, inactivated (IPV) CPT 90713 HC POLIOMYELITIS IMMUNIZATNINACTVSUB-Q	$19.50	$39.00	$23.40–$39.00	85% below	50%
Polio vaccine, inactivated (IPV) CPT 90713 POLIOVIRUS VACCINE 40 UNIT-8 UNIT-32 UNIT/0.5 ML INJECTION SUSPENSION	$1,149.70	$2,299.40	$48.08–$2,069.46	793% above	50%
Polio vaccine, inactivated (IPV) inpatient CPT 90713 HC POLIOMYELITIS IMMUNIZATNINACTVSUB-Q	$19.50	$39.00	$28.86–$35.49	—	50%
Polio vaccine, inactivated (IPV) inpatient CPT 90713 POLIOVIRUS VACCINE 40 UNIT-8 UNIT-32 UNIT/0.5 ML INJECTION SUSPENSION	$1,149.70	$2,299.40	$1,701.56–$2,092.46	—	50%
RSV antibody shot for infants and toddlers, larger dose (1 mL, 100 mg) CPT 90381 NIRSEVIMAB-ALIP 100 MG/ML INTRAMUSCULAR SYRINGE	$1,119.99	$2,239.97	$1,343.99–$2,015.98	38% above	50%
RSV antibody shot for infants and toddlers, larger dose (1 mL, 100 mg) inpatient CPT 90381 NIRSEVIMAB-ALIP 100 MG/ML INTRAMUSCULAR SYRINGE	$1,119.99	$2,239.97	$1,657.58–$2,038.38	—	50%
RSV antibody shot for infants, seasonal dose (0.5 mL) CPT 90380 NIRSEVIMAB-ALIP 50 MG/0.5 ML INTRAMUSCULAR SYRINGE	$1,119.99	$2,239.97	$1,343.99–$2,015.98	10% above	50%
RSV antibody shot for infants, seasonal dose (0.5 mL) inpatient CPT 90380 NIRSEVIMAB-ALIP 50 MG/0.5 ML INTRAMUSCULAR SYRINGE	$1,119.99	$2,239.97	$1,657.58–$2,038.38	—	50%
RSV vaccine with adjuvant (Arexvy), one dose for older adults CPT 90679 HC RSV VACC PREF RECOMB ADJT IM	$387.50	$775.00	$465.00–$697.50	24% above	50%
RSV vaccine with adjuvant (Arexvy), one dose for older adults inpatient CPT 90679 HC RSV VACC PREF RECOMB ADJT IM	$387.50	$775.00	$573.50–$705.25	—	50%
Rabies vaccine, one dose CPT 90675 HC RABIES VACCINE IM	$250.00	$500.00	$300.00–$450.00	61% below	50%
Rabies vaccine, one dose CPT 90675 RABIES VACCINE PURIFIED CHICKEN EMBRYO CELL (PF) 2.5 UNIT IM SUSP	$996.08	$1,992.15	$315.22–$1,792.94	56% above	50%
Rabies vaccine, one dose CPT 90675 RABIES VACCINEHUMAN DIPLOID (PF) 2.5 UNIT INTRAMUSCULAR SOLUTION	$1,087.00	$2,174.00	$315.22–$1,956.60	70% above	50%
Rabies vaccine, one dose inpatient CPT 90675 HC RABIES VACCINE IM	$250.00	$500.00	$370.00–$455.00	—	50%
Rabies vaccine, one dose inpatient CPT 90675 RABIES VACCINE PURIFIED CHICKEN EMBRYO CELL (PF) 2.5 UNIT IM SUSP	$996.08	$1,992.15	$1,474.20–$1,812.86	—	50%
Rabies vaccine, one dose inpatient CPT 90675 RABIES VACCINEHUMAN DIPLOID (PF) 2.5 UNIT INTRAMUSCULAR SOLUTION	$1,087.00	$2,174.00	$1,608.76–$1,978.34	—	50%
Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) CPT 90680 HC ROTOVIRUS VACCINE PENTAVAL 3 DOSE ORAL	$52.50	$105.00	$63.00–$105.00	51% below	50%
Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) CPT 90680 ROTAVIRUS VACCINE LIVE PENTAVALENT 2 ML ORAL SOLUTION	$211.02	$422.04	$106.23–$379.84	96% above	50%
Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) inpatient CPT 90680 HC ROTOVIRUS VACCINE PENTAVAL 3 DOSE ORAL	$52.50	$105.00	$77.70–$95.55	—	50%
Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) inpatient CPT 90680 ROTAVIRUS VACCINE LIVE PENTAVALENT 2 ML ORAL SOLUTION	$211.02	$422.04	$312.31–$384.06	—	50%
Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 VARICELLA-ZOSTER GLYCOE VACC-AS01B ADJ(PF) 50 MCG/0.5 ML IM SUSP KIT	$358.30	$716.60	$231.67–$644.94	26% above	50%
Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 VARICELLA-ZOSTER GLYCOE VACCINE-AS01B ADJ(PF) 50 MCG/0.5 ML IM SYRINGE	$501.47	$1,002.93	$231.67–$902.64	76% above	50%
Shingles vaccine (Shingrix), recombinant, one dose inpatient CPT 90750 VARICELLA-ZOSTER GLYCOE VACC-AS01B ADJ(PF) 50 MCG/0.5 ML IM SUSP KIT	$358.30	$716.60	$530.29–$652.11	—	50%
Shingles vaccine (Shingrix), recombinant, one dose inpatient CPT 90750 VARICELLA-ZOSTER GLYCOE VACCINE-AS01B ADJ(PF) 50 MCG/0.5 ML IM SYRINGE	$501.47	$1,002.93	$742.17–$912.67	—	50%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 HC TD VACCINE NO PRSRV >/= 7 YO IM	$25.50	$51.00	$30.60–$45.90	49% below	50%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TETANUS AND DIPHTHERIA TOX (PF) 5 LF UNIT-2 LF UNIT/0.5 ML IM SYRINGE	$53.80	$107.59	$36.84–$96.84	8% above	50%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TETANUS-DIPHTHERIA TOXOIDS-TD 2 LF UNIT-2 LF UNIT/0.5 ML IM SUSPENSION	$54.39	$108.78	$36.84–$97.91	9% above	50%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TETANUS AND DIPHTHERIA TOX (PF) 5 LF UNIT-2 LF UNIT/0.5 ML IM SUSP	$105.96	$211.91	$36.84–$190.72	112% above	50%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 HC TD VACCINE NO PRSRV >/= 7 YO IM	$25.50	$51.00	$37.74–$46.41	—	50%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 TETANUS AND DIPHTHERIA TOX (PF) 5 LF UNIT-2 LF UNIT/0.5 ML IM SYRINGE	$53.80	$107.59	$79.62–$97.91	—	50%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 TETANUS-DIPHTHERIA TOXOIDS-TD 2 LF UNIT-2 LF UNIT/0.5 ML IM SUSPENSION	$54.39	$108.78	$80.50–$98.99	—	50%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 TETANUS AND DIPHTHERIA TOX (PF) 5 LF UNIT-2 LF UNIT/0.5 ML IM SUSP	$105.96	$211.91	$156.82–$192.84	—	50%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 HC TDAP VACCINE >7 YO IM	$31.00	$62.00	$37.20–$55.80	55% below	50%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 DIPHTHPERTUSSIS(ACEL)TETANUS 2.5 LF UNIT-8 MCG-5 LF/0.5ML IM SYRINGE	$94.71	$189.41	$42.39–$170.47	36% above	50%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 DIPHTHPERTUS(AC)TETANUS(PF)2 LF-(2.5-5-3-5MCG)-5 LF/0.5 ML IM SYRINGE	$122.13	$244.26	$42.39–$219.84	75% above	50%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 DIPHTHPERTUS(ACEL)TETANUS(PF)2LF-(2.5-5-3-5MCG)-5 LF/0.5 ML IM SUSP	$122.14	$244.27	$42.39–$219.85	75% above	50%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 HC TDAP VACCINE >7 YO IM	$31.00	$62.00	$45.88–$56.42	—	50%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 DIPHTHPERTUSSIS(ACEL)TETANUS 2.5 LF UNIT-8 MCG-5 LF/0.5ML IM SYRINGE	$94.71	$189.41	$140.17–$172.37	—	50%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 DIPHTHPERTUS(AC)TETANUS(PF)2 LF-(2.5-5-3-5MCG)-5 LF/0.5 ML IM SYRINGE	$122.13	$244.26	$180.76–$222.28	—	50%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 DIPHTHPERTUS(ACEL)TETANUS(PF)2LF-(2.5-5-3-5MCG)-5 LF/0.5 ML IM SUSP	$122.14	$244.27	$180.76–$222.29	—	50%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 HC ADMIN STATE NEWBORN HEPATITIS B VACCINE	$10.50	$20.99	$12.60–$127.69	78% below	50%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 HC ADMIN HEPATITIS B VACCINE	$52.50	$105.00	$63.00–$127.69	9% above	50%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 HC ADMIN INFLUENZA VACC	$55.50	$111.00	$66.60–$127.69	16% above	50%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 HC ADMIN STATE NEWBORN HEPATITIS B VACCINE	$10.50	$20.99	$15.54–$19.11	—	50%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 HC ADMIN HEPATITIS B VACCINE	$52.50	$105.00	$77.70–$95.55	—	50%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 HC ADMIN INFLUENZA VACC	$55.50	$111.00	$82.14–$101.01	—	50%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 HC IMMUNIZATION ADMIN EACH ADDTL	$21.50	$43.00	$25.80–$38.70	26% below	50%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 HC IMMUNIZATION ADMIN EACH ADDTL	$21.50	$43.00	$31.82–$39.13	—	50%

Procedure The service, with its billing code (CPT or HCPCS) and, in small type, the line exactly as the hospital wrote it in its price file. More

Cash price The hospital's own price for a patient paying without insurance (“discounted cash” in its price file). Hospitals must publish it under federal law, 45 CFR 180.50. Call to confirm it before booking. More

List price The hospital's full chargemaster price (“gross charge”) before any discount. Almost nobody pays it; the gap to the cash price shows what the self-pay discount is worth. More

Insurers pay The lowest and highest rates this hospital has agreed with insurance plans for the same item, from its price file. If the cash price is below what your plan pays and you have not met your deductible, paying cash can cost you less. More

Against the state median This hospital's cash price compared with the median cash price of hospitals in the state for the same code. Shown when at least three hospitals in the state price it.

Off list How much lower the cash price is than the list price.

No cash discount This line's cash price equals the hospital's full list price. Many hospitals still reduce bills for uninsured patients: ask the billing office for its self-pay discount in writing. More

At or below Medicare This cash price is at or below what Medicare pays a hospital for the same service, which is unusually low. It is what the hospital's file says; confirm it and what it includes before booking. More

Check the item The description in the hospital file looks like a supply or device (a catheter, a brace, an implant), not this procedure. The hospital may have filed it under the wrong code: ask before relying on this price.

Source file: https://www.chistalexiushealth.org/content/dam/stalexiushealthorg/documents/financial/price-transparency-standard-charges/450226711-1306832654_st-alexius-medical-center_standardcharges.json