Aspirus Iron River Hospital
Aspirus Iron River Hospital in Iron River, MI publishes cash prices for 72 common procedures listed here, from its own machine-readable price file updated Apr 1, 2026. Click a procedure to compare it with other hospitals nearby.
1400 W Ice Lake Road, Iron River, MI 49935 Collected Sep 23, 2026 Source price file
Scans and imaging
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 Pro CT Scan,Abdomen and Pelvis,W Contrast | $583.70 | $898.00 | 35% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT Abd Pelvis W/Contrast | $3,208.40 | $4,936.00 | 35% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ABDOMEN & PELVIS W/CONTRAST MATERIAL | $3,792.10 | $5,834.00 | 35% |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 Pro CT Scan,Abdomen and Pelvis,W Contrast | $583.70 | $898.00 | 35% |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT Abd Pelvis W/Contrast | $3,208.40 | $4,936.00 | 35% |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT ABDOMEN & PELVIS W/CONTRAST MATERIAL | $3,792.10 | $5,834.00 | 35% |
| CT scan of the head or brain, no contrast dye CPT 70450 Pro CT Head/Brain W/O Dye | $273.65 | $421.00 | 35% |
| CT scan of the head or brain, no contrast dye CPT 70450 Fac CT Head/Brain W/O Dye | $1,288.30 | $1,982.00 | 35% |
| CT scan of the head or brain, no contrast dye CPT 70450 CT HEAD/BRAIN W/O CONTRAST MATERIAL | $1,561.95 | $2,403.00 | 35% |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 Pro CT Head/Brain W/O Dye | $273.65 | $421.00 | 35% |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 Fac CT Head/Brain W/O Dye | $1,288.30 | $1,982.00 | 35% |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT HEAD/BRAIN W/O CONTRAST MATERIAL | $1,561.95 | $2,403.00 | 35% |
| CT scan of the pelvis, with contrast dye CPT 72193 Pro CT Pelvis W/Dye | $459.55 | $707.00 | 35% |
| CT scan of the pelvis, with contrast dye CPT 72193 Pelvis CT Scan With Contrast | $2,367.95 | $3,643.00 | 35% |
| CT scan of the pelvis, with contrast dye CPT 72193 CT PELVIS W/CONTRAST MATERIAL | $2,827.50 | $4,350.00 | 35% |
| CT scan of the pelvis, with contrast dye inpatient CPT 72193 Pro CT Pelvis W/Dye | $459.55 | $707.00 | 35% |
| CT scan of the pelvis, with contrast dye inpatient CPT 72193 Pelvis CT Scan With Contrast | $2,367.95 | $3,643.00 | 35% |
| CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT PELVIS W/CONTRAST MATERIAL | $2,827.50 | $4,350.00 | 35% |
| Diagnostic mammogram, both breasts both sides CPT 77066 Pro Diagnostic Mammography Computer-Aided Detcj Bi | $234.65 | $361.00 | 35% |
| Diagnostic mammogram, both breasts both sides CPT 77066 Pro Diagnostic Mammography Computer-Aided Detcj Bi|TECHNICAL COMPONENT|BILATERAL PROCEDURE | $351.98 | $541.50 | 35% |
| Diagnostic mammogram, both breasts both sides CPT 77066 Fac Diagnostic Mammography Computer-Aided Detcj Bi | $544.05 | $837.00 | 35% |
| Diagnostic mammogram, both breasts both sides CPT 77066 DIAGNOSTIC MAMMOGRAPHY COMPUTER-AIDED DETCJ BI | $778.70 | $1,198.00 | 35% |
| Diagnostic mammogram, both breasts both sides CPT 77066 Fac Diagnostic Mammography Computer-Aided Detcj Bi|TECHNICAL COMPONENT|BILATERAL PROCEDURE | $816.08 | $1,255.50 | 35% |
| Diagnostic mammogram, both breasts inpatient both sides CPT 77066 Pro Diagnostic Mammography Computer-Aided Detcj Bi | $234.65 | $361.00 | 35% |
| Diagnostic mammogram, both breasts inpatient both sides CPT 77066 Pro Diagnostic Mammography Computer-Aided Detcj Bi|TECHNICAL COMPONENT|BILATERAL PROCEDURE | $351.98 | $541.50 | 35% |
| Diagnostic mammogram, both breasts inpatient both sides CPT 77066 Fac Diagnostic Mammography Computer-Aided Detcj Bi | $544.05 | $837.00 | 35% |
| Diagnostic mammogram, both breasts inpatient both sides CPT 77066 DIAGNOSTIC MAMMOGRAPHY COMPUTER-AIDED DETCJ BI | $778.70 | $1,198.00 | 35% |
| Diagnostic mammogram, both breasts inpatient both sides CPT 77066 Fac Diagnostic Mammography Computer-Aided Detcj Bi|TECHNICAL COMPONENT|BILATERAL PROCEDURE | $816.08 | $1,255.50 | 35% |
| Diagnostic mammogram, one breast CPT 77065 Pro Diagnostic Mammography Computer-Aided Detcj Uni | $189.80 | $292.00 | 35% |
| Diagnostic mammogram, one breast CPT 77065 DIAGNOSTIC MAMMOGRAPHY COMPUTER-AIDED DETCJ UNI | $616.20 | $948.00 | 35% |
| Diagnostic mammogram, one breast one side CPT 77065 Mm Dm Rt Diag Post Procedure Images Wwo Cad-C | $426.40 | $656.00 | 35% |
| Diagnostic mammogram, one breast inpatient CPT 77065 Pro Diagnostic Mammography Computer-Aided Detcj Uni | $189.80 | $292.00 | 35% |
| Diagnostic mammogram, one breast inpatient CPT 77065 DIAGNOSTIC MAMMOGRAPHY COMPUTER-AIDED DETCJ UNI | $616.20 | $948.00 | 35% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 Mm Dm Rt Diag Post Procedure Images Wwo Cad-C | $426.40 | $656.00 | 35% |
| MRI of knee or other lower-limb joint, no contrast dye both sides CPT 73721 Pro MRI Jnt of Lwr Extre W/O Dye|TECHNICAL COMPONENT|BILATERAL PROCEDURE | $860.92 | $1,324.50 | 35% |
| MRI of knee or other lower-limb joint, no contrast dye both sides CPT 73721 Rt Joint Lower Ext MRI W/O Contrast|TECHNICAL COMPONENT|BILATERAL PROCEDURE | $3,980.92 | $6,124.50 | 35% |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 Pro MRI Jnt of Lwr Extre W/O Dye | $573.95 | $883.00 | 35% |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 Rt Joint Lower Ext MRI W/O Contrast | $2,653.95 | $4,083.00 | 35% |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MRI ANY JT LOWER EXTREM W/O CONTRAST MATRL | $3,227.90 | $4,966.00 | 35% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient both sides CPT 73721 Pro MRI Jnt of Lwr Extre W/O Dye|TECHNICAL COMPONENT|BILATERAL PROCEDURE | $860.92 | $1,324.50 | 35% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient both sides CPT 73721 Rt Joint Lower Ext MRI W/O Contrast|TECHNICAL COMPONENT|BILATERAL PROCEDURE | $3,980.92 | $6,124.50 | 35% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 Pro MRI Jnt of Lwr Extre W/O Dye | $573.95 | $883.00 | 35% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 Rt Joint Lower Ext MRI W/O Contrast | $2,653.95 | $4,083.00 | 35% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 MRI ANY JT LOWER EXTREM W/O CONTRAST MATRL | $3,227.90 | $4,966.00 | 35% |
| MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 Pro MRI Joint Lwr Extr W/O&W/Dye | $799.50 | $1,230.00 | 35% |
| MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 Rt Joint Low Ext MRI W/O &W/Contrast | $5,423.60 | $8,344.00 | 35% |
| MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 MRI ANY JT LOWER EXTREM W/O & W/CONTRAST MATRL | $6,223.10 | $9,574.00 | 35% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 Pro MRI Joint Lwr Extr W/O&W/Dye | $799.50 | $1,230.00 | 35% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 Rt Joint Low Ext MRI W/O &W/Contrast | $5,423.60 | $8,344.00 | 35% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 MRI ANY JT LOWER EXTREM W/O & W/CONTRAST MATRL | $6,223.10 | $9,574.00 | 35% |
| MRI of the brain, no contrast dye CPT 70551 Pro MRI Brain W/O Dye | $625.95 | $963.00 | 35% |
| MRI of the brain, no contrast dye CPT 70551 Brain MRI Without Contrast | $2,962.70 | $4,558.00 | 35% |
| MRI of the brain, no contrast dye CPT 70551 MRI BRAIN BRAIN STEM W/O CONTRAST MATERIAL | $3,588.65 | $5,521.00 | 35% |
| MRI of the brain, no contrast dye inpatient CPT 70551 Pro MRI Brain W/O Dye | $625.95 | $963.00 | 35% |
| MRI of the brain, no contrast dye inpatient CPT 70551 Brain MRI Without Contrast | $2,962.70 | $4,558.00 | 35% |
| MRI of the brain, no contrast dye inpatient CPT 70551 MRI BRAIN BRAIN STEM W/O CONTRAST MATERIAL | $3,588.65 | $5,521.00 | 35% |
| MRI of the brain, with and without contrast dye CPT 70553 Pro MRI Brain W/O & W/Dye | $970.45 | $1,493.00 | 35% |
| MRI of the brain, with and without contrast dye CPT 70553 Brain MRI Without and With Contrast | $4,596.80 | $7,072.00 | 35% |
| MRI of the brain, with and without contrast dye CPT 70553 MRI BRAIN BRAIN STEM W/O W/CONTRAST MATERIAL | $5,567.25 | $8,565.00 | 35% |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 Pro MRI Brain W/O & W/Dye | $970.45 | $1,493.00 | 35% |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 Brain MRI Without and With Contrast | $4,596.80 | $7,072.00 | 35% |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI BRAIN BRAIN STEM W/O W/CONTRAST MATERIAL | $5,567.25 | $8,565.00 | 35% |
| MRI of the lower back, no contrast dye CPT 72148 Pro MRI Lumbar Spine W/O Dye | $629.20 | $968.00 | 35% |
| MRI of the lower back, no contrast dye CPT 72148 L Spine MRI Without Contrast | $2,948.40 | $4,536.00 | 35% |
| MRI of the lower back, no contrast dye CPT 72148 MRI SPINAL CANAL LUMBAR W/O CONTRAST MATERIAL | $3,577.60 | $5,504.00 | 35% |
| MRI of the lower back, no contrast dye inpatient CPT 72148 Pro MRI Lumbar Spine W/O Dye | $629.20 | $968.00 | 35% |
| MRI of the lower back, no contrast dye inpatient CPT 72148 L Spine MRI Without Contrast | $2,948.40 | $4,536.00 | 35% |
| MRI of the lower back, no contrast dye inpatient CPT 72148 MRI SPINAL CANAL LUMBAR W/O CONTRAST MATERIAL | $3,577.60 | $5,504.00 | 35% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 Pro OB US >/= 14 Wks, Sngl Fetus | $286.00 | $440.00 | 35% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 OB Greater or Equal to 14wks US | $484.90 | $746.00 | 35% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US PREG UTERUS AFTER 1ST TRIMEST 1/1ST GESTATION | $770.90 | $1,186.00 | 35% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 Pro OB US >/= 14 Wks, Sngl Fetus | $286.00 | $440.00 | 35% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 OB Greater or Equal to 14wks US | $484.90 | $746.00 | 35% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US PREG UTERUS AFTER 1ST TRIMEST 1/1ST GESTATION | $770.90 | $1,186.00 | 35% |
| Screening mammogram, both breasts both sides CPT 77067 Pro Screening Mammography Bi 2-View Breast Inc Cad | $124.80 | $192.00 | 35% |
| Screening mammogram, both breasts both sides CPT 77067 Fac Screening Mammography Bi 2-View Breast Inc Cad | $343.20 | $528.00 | 35% |
| Screening mammogram, both breasts both sides CPT 77067 SCREENING MAMMOGRAPHY BI 2-VIEW BREAST INC CAD | $468.00 | $720.00 | 35% |
| Screening mammogram, both breasts inpatient both sides CPT 77067 Pro Screening Mammography Bi 2-View Breast Inc Cad | $124.80 | $192.00 | 35% |
| Screening mammogram, both breasts inpatient both sides CPT 77067 Fac Screening Mammography Bi 2-View Breast Inc Cad | $343.20 | $528.00 | 35% |
| Screening mammogram, both breasts inpatient both sides CPT 77067 SCREENING MAMMOGRAPHY BI 2-VIEW BREAST INC CAD | $468.00 | $720.00 | 35% |
| Sleep study in a lab (polysomnography) CPT 95810 Fac Polysomnography, 4 or More | $3,408.60 | $5,244.00 | 35% |
| Sleep study in a lab (polysomnography) CPT 95810 Pro Polysomnography, 4 or More | $4,240.60 | $6,524.00 | 35% |
| Sleep study in a lab (polysomnography) CPT 95810 POLYSOM 6/>YRS SLEEP 4/> ADDL PARAM ATTND | $4,240.60 | $6,524.00 | 35% |
| Sleep study in a lab (polysomnography) inpatient CPT 95810 Fac Polysomnography, 4 or More | $3,408.60 | $5,244.00 | 35% |
| Sleep study in a lab (polysomnography) inpatient CPT 95810 POLYSOM 6/>YRS SLEEP 4/> ADDL PARAM ATTND | $4,240.60 | $6,524.00 | 35% |
| Sleep study in a lab (polysomnography) inpatient CPT 95810 Pro Polysomnography, 4 or More | $4,240.60 | $6,524.00 | 35% |
| Transvaginal pelvic ultrasound CPT 76830 Pro US Trvg | $237.90 | $366.00 | 35% |
| Transvaginal pelvic ultrasound CPT 76830 Transvaginal Non OB | $445.25 | $685.00 | 35% |
| Transvaginal pelvic ultrasound CPT 76830 US TRANSVAGINAL | $683.15 | $1,051.00 | 35% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 Pro US Trvg | $237.90 | $366.00 | 35% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 Transvaginal Non OB | $445.25 | $685.00 | 35% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 US TRANSVAGINAL | $683.15 | $1,051.00 | 35% |
| Ultrasound of the abdomen, complete CPT 76700 Pro US Exam, Abdom, Complete | $356.20 | $548.00 | 35% |
| Ultrasound of the abdomen, complete CPT 76700 Abdomen Complete US | $590.20 | $908.00 | 35% |
| Ultrasound of the abdomen, complete CPT 76700 US ABDOMINAL REAL TIME W/IMAGE DOCUMENTATION | $946.40 | $1,456.00 | 35% |
| Ultrasound of the abdomen, complete inpatient CPT 76700 Pro US Exam, Abdom, Complete | $356.20 | $548.00 | 35% |
| Ultrasound of the abdomen, complete inpatient CPT 76700 Abdomen Complete US | $590.20 | $908.00 | 35% |
| Ultrasound of the abdomen, complete inpatient CPT 76700 US ABDOMINAL REAL TIME W/IMAGE DOCUMENTATION | $946.40 | $1,456.00 | 35% |
| X-ray of the lower back, 4 or more views CPT 72110 Pro X-Ray Exam of Lower Spine | $112.45 | $173.00 | 35% |
| X-ray of the lower back, 4 or more views CPT 72110 Lumbar Spine,Min 4 Views | $324.35 | $499.00 | 35% |
| X-ray of the lower back, 4 or more views CPT 72110 RADEX SPINE LUMBOSACRAL MINIMUM 4 VIEWS | $357.50 | $550.00 | 35% |
| X-ray of the lower back, 4 or more views inpatient CPT 72110 Pro X-Ray Exam of Lower Spine | $112.45 | $173.00 | 35% |
| X-ray of the lower back, 4 or more views inpatient CPT 72110 Lumbar Spine,Min 4 Views | $324.35 | $499.00 | 35% |
| X-ray of the lower back, 4 or more views inpatient CPT 72110 RADEX SPINE LUMBOSACRAL MINIMUM 4 VIEWS | $357.50 | $550.00 | 35% |
Lab tests
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Basic metabolic panel (blood test) CPT 80048 Fac Metabolic Panel Total Ca | $92.30 | $142.00 | 35% |
| Basic metabolic panel (blood test) CPT 80048 BASIC METABOLIC PANEL CALCIUM TOTAL | $92.30 | $142.00 | 35% |
| Basic metabolic panel (blood test) inpatient CPT 80048 Fac Metabolic Panel Total Ca | $92.30 | $142.00 | 35% |
| Basic metabolic panel (blood test) inpatient CPT 80048 BASIC METABOLIC PANEL CALCIUM TOTAL | $92.30 | $142.00 | 35% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PANEL | $107.25 | $165.00 | 35% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Fac Lipid Panel | $107.25 | $165.00 | 35% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 Fac Lipid Panel | $107.25 | $165.00 | 35% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PANEL | $107.25 | $165.00 | 35% |
| Complete blood count (CBC) with differential CPT 85025 BLOOD COUNT COMPLETE AUTO&AUTO DIFRNTL WBC | $79.95 | $123.00 | 35% |
| Complete blood count (CBC) with differential CPT 85025 Fac Complete Cbc W/Auto Diff Wbc | $79.95 | $123.00 | 35% |
| Complete blood count (CBC) with differential inpatient CPT 85025 BLOOD COUNT COMPLETE AUTO&AUTO DIFRNTL WBC | $79.95 | $123.00 | 35% |
| Complete blood count (CBC) with differential inpatient CPT 85025 Fac Complete Cbc W/Auto Diff Wbc | $79.95 | $123.00 | 35% |
| Complete blood count (CBC), no differential CPT 85027 BLOOD COUNT COMPLETE AUTOMATED | $61.10 | $94.00 | 35% |
| Complete blood count (CBC), no differential CPT 85027 Fac Complete Cbc, Automated | $61.10 | $94.00 | 35% |
| Complete blood count (CBC), no differential inpatient CPT 85027 BLOOD COUNT COMPLETE AUTOMATED | $61.10 | $94.00 | 35% |
| Complete blood count (CBC), no differential inpatient CPT 85027 Fac Complete Cbc, Automated | $61.10 | $94.00 | 35% |
| Comprehensive metabolic panel (blood test) CPT 80053 COMPREHENSIVE METABOLIC PANEL | $113.75 | $175.00 | 35% |
| Comprehensive metabolic panel (blood test) CPT 80053 Fac Comprehen Metabolic Panel | $113.75 | $175.00 | 35% |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 Fac Comprehen Metabolic Panel | $113.75 | $175.00 | 35% |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 COMPREHENSIVE METABOLIC PANEL | $113.75 | $175.00 | 35% |
| Kidney function blood test panel CPT 80069 Fac Renal Function Panel | $102.70 | $158.00 | 35% |
| Kidney function blood test panel CPT 80069 RENAL FUNCTION PANEL | $102.70 | $158.00 | 35% |
| Kidney function blood test panel inpatient CPT 80069 Fac Renal Function Panel | $102.70 | $158.00 | 35% |
| Kidney function blood test panel inpatient CPT 80069 RENAL FUNCTION PANEL | $102.70 | $158.00 | 35% |
| Liver function blood test panel CPT 80076 Fac Hepatic Function Panel | $102.05 | $157.00 | 35% |
| Liver function blood test panel CPT 80076 HEPATIC FUNCTION PANEL | $102.05 | $157.00 | 35% |
| Liver function blood test panel inpatient CPT 80076 HEPATIC FUNCTION PANEL | $102.05 | $157.00 | 35% |
| Liver function blood test panel inpatient CPT 80076 Fac Hepatic Function Panel | $102.05 | $157.00 | 35% |
| Obstetric blood test panel CPT 80055 Fac Obstetric Panel | $316.55 | $487.00 | 35% |
| Obstetric blood test panel CPT 80055 OBSTETRIC PANEL | $316.55 | $487.00 | 35% |
| Obstetric blood test panel inpatient CPT 80055 Fac Obstetric Panel | $316.55 | $487.00 | 35% |
| Obstetric blood test panel inpatient CPT 80055 OBSTETRIC PANEL | $316.55 | $487.00 | 35% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 ASSAY OF PROSTATE SPECIFIC ANTIGEN FREE | $114.40 | $176.00 | 35% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 Fac Assay of Psa, Free | $114.40 | $176.00 | 35% |
| PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 Fac Assay of Psa, Free | $114.40 | $176.00 | 35% |
| PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 ASSAY OF PROSTATE SPECIFIC ANTIGEN FREE | $114.40 | $176.00 | 35% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 ASSAY OF PROSTATE SPECIFIC ANTIGEN TOTAL | $118.30 | $182.00 | 35% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 Fac Assay of Psa, Total | $118.30 | $182.00 | 35% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 Fac Assay of Psa, Total | $118.30 | $182.00 | 35% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 ASSAY OF PROSTATE SPECIFIC ANTIGEN TOTAL | $118.30 | $182.00 | 35% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 THROMBOPLASTIN TIME PARTIAL PLASMA/WHOLE BLOOD | $65.00 | $100.00 | 35% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 Fac Thromboplastin Time, Partial | $65.00 | $100.00 | 35% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 Ptt, Partial Thromboplastin Beaker1 | $65.00 | $100.00 | 35% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 Fac Thromboplastin Time, Partial | $65.00 | $100.00 | 35% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 THROMBOPLASTIN TIME PARTIAL PLASMA/WHOLE BLOOD | $65.00 | $100.00 | 35% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 Ptt, Partial Thromboplastin Beaker1 | $65.00 | $100.00 | 35% |
| Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME | $46.15 | $71.00 | 35% |
| Prothrombin time (PT/INR) clotting test CPT 85610 Fac Prothrombin Tm | $46.15 | $71.00 | 35% |
| Prothrombin time (PT/INR) clotting test CPT 85610 Prothrombin Time Beaker1 | $46.15 | $71.00 | 35% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 Fac Prothrombin Tm | $46.15 | $71.00 | 35% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTHROMBIN TIME | $46.15 | $71.00 | 35% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 Prothrombin Time Beaker1 | $46.15 | $71.00 | 35% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 Fac Thyr Stimulating Horm | $112.45 | $173.00 | 35% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 ASSAY OF THYROID STIMULATING HORMONE TSH | $112.45 | $173.00 | 35% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 ASSAY OF THYROID STIMULATING HORMONE TSH | $112.45 | $173.00 | 35% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 Fac Thyr Stimulating Horm | $112.45 | $173.00 | 35% |
| Urinalysis with microscope exam, automated CPT 81001 Urine Macro and Microscopic Beaker1 | $40.30 | $62.00 | 35% |
| Urinalysis with microscope exam, automated CPT 81001 URNLS DIP STICK/TABLET REAGENT AUTO MICROSCOPY | $40.30 | $62.00 | 35% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 URNLS DIP STICK/TABLET REAGENT AUTO MICROSCOPY | $40.30 | $62.00 | 35% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 Urine Macro and Microscopic Beaker1 | $40.30 | $62.00 | 35% |
| Urinalysis without microscope exam, automated CPT 81003 Urine Dipstick,Nonautomated (Clini | $30.55 | $47.00 | 35% |
| Urinalysis without microscope exam, automated CPT 81003 URNLS DIP STICK/TABLET RGNT AUTO W/O MICROSCOPY | $30.55 | $47.00 | 35% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 Urine Dipstick,Nonautomated (Clini | $30.55 | $47.00 | 35% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 URNLS DIP STICK/TABLET RGNT AUTO W/O MICROSCOPY | $30.55 | $47.00 | 35% |
| Urinalysis without microscope exam, manual CPT 81002 Fac Urinalysis Nonauto W/O Scope | $30.55 | $47.00 | 35% |
| Urinalysis without microscope exam, manual CPT 81002 URNLS DIP STICK/TABLET RGNT NON-AUTO W/O MICRSCP | $30.55 | $47.00 | 35% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 URNLS DIP STICK/TABLET RGNT NON-AUTO W/O MICRSCP | $30.55 | $47.00 | 35% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 Fac Urinalysis Nonauto W/O Scope | $30.55 | $47.00 | 35% |
Surgery and procedures
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Cataract surgery with lens implant CPT 66984 Pro Xcapsl Ctrc Rmvl Insj Io Lens Prosth W/O Ecp | $4,623.45 | $7,113.00 | 35% |
| Cataract surgery with lens implant CPT 66984 XCAPSL CTRC RMVL INSJ IO LENS PROSTH W/O ECP | $4,623.45 | $7,113.00 | 35% |
| Cataract surgery with lens implant inpatient CPT 66984 Pro Xcapsl Ctrc Rmvl Insj Io Lens Prosth W/O Ecp | $4,623.45 | $7,113.00 | 35% |
| Cataract surgery with lens implant inpatient CPT 66984 XCAPSL CTRC RMVL INSJ IO LENS PROSTH W/O ECP | $4,623.45 | $7,113.00 | 35% |
| Cesarean delivery, including prenatal and postpartum care CPT 59510 OB ANTEPARTUM CARE CESAREAN DLVR & POSTPARTUM | $5,792.80 | $8,912.00 | 35% |
| Cesarean delivery, including prenatal and postpartum care inpatient CPT 59510 OB ANTEPARTUM CARE CESAREAN DLVR & POSTPARTUM | $5,792.80 | $8,912.00 | 35% |
| Colonoscopy with endoscopic ultrasound CPT 45391 Fac Colsc Flx W/Ndsc US Xm Rctm Et Al Lmtd&Adj Strux | $2,501.85 | $3,849.00 | 35% |
| Colonoscopy with endoscopic ultrasound inpatient CPT 45391 Fac Colsc Flx W/Ndsc US Xm Rctm Et Al Lmtd&Adj Strux | $2,501.85 | $3,849.00 | 35% |
| Colonoscopy with polyp removal CPT 45385 COLSC FLX W/RMVL OF TUMOR POLYP LESION SNARE TQ | $2,424.50 | $3,730.00 | 35% |
| Colonoscopy with polyp removal CPT 45385 Pro Colsc Flx W/Rmvl of Tumor Polyp Lesion Snare Tq | $2,424.50 | $3,730.00 | 35% |
| Colonoscopy with polyp removal CPT 45385 Fac Colsc Flx W/Rmvl of Tumor Polyp Lesion Snare Tq | $2,533.05 | $3,897.00 | 35% |
| Colonoscopy with polyp removal inpatient CPT 45385 COLSC FLX W/RMVL OF TUMOR POLYP LESION SNARE TQ | $2,424.50 | $3,730.00 | 35% |
| Colonoscopy with polyp removal inpatient CPT 45385 Pro Colsc Flx W/Rmvl of Tumor Polyp Lesion Snare Tq | $2,424.50 | $3,730.00 | 35% |
| Colonoscopy with polyp removal inpatient CPT 45385 Fac Colsc Flx W/Rmvl of Tumor Polyp Lesion Snare Tq | $2,533.05 | $3,897.00 | 35% |
| Colonoscopy with tissue sample CPT 45380 Fac Colonoscopy W/Biopsy Single/Multiple | $2,092.35 | $3,219.00 | 35% |
| Colonoscopy with tissue sample CPT 45380 COLONOSCOPY W/BIOPSY SINGLE/MULTIPLE | $2,157.35 | $3,319.00 | 35% |
| Colonoscopy with tissue sample CPT 45380 Pro Colonoscopy W/Biopsy Single/Multiple | $2,157.35 | $3,319.00 | 35% |
| Colonoscopy with tissue sample inpatient CPT 45380 Fac Colonoscopy W/Biopsy Single/Multiple | $2,092.35 | $3,219.00 | 35% |
| Colonoscopy with tissue sample inpatient CPT 45380 COLONOSCOPY W/BIOPSY SINGLE/MULTIPLE | $2,157.35 | $3,319.00 | 35% |
| Colonoscopy with tissue sample inpatient CPT 45380 Pro Colonoscopy W/Biopsy Single/Multiple | $2,157.35 | $3,319.00 | 35% |
| Colonoscopy, diagnostic CPT 45378 COLONOSCOPY FLX DX W/COLLJ SPEC WHEN PFRMD | $1,805.70 | $2,778.00 | 35% |
| Colonoscopy, diagnostic CPT 45378 Pro Colonoscopy Flx Dx W/Collj Spec When Pfrmd | $1,805.70 | $2,778.00 | 35% |
| Colonoscopy, diagnostic CPT 45378 Fac Colonoscopy Flx Dx W/Collj Spec When Pfrmd | $1,922.70 | $2,958.00 | 35% |
| Colonoscopy, diagnostic inpatient CPT 45378 COLONOSCOPY FLX DX W/COLLJ SPEC WHEN PFRMD | $1,805.70 | $2,778.00 | 35% |
| Colonoscopy, diagnostic inpatient CPT 45378 Pro Colonoscopy Flx Dx W/Collj Spec When Pfrmd | $1,805.70 | $2,778.00 | 35% |
| Colonoscopy, diagnostic inpatient CPT 45378 Fac Colonoscopy Flx Dx W/Collj Spec When Pfrmd | $1,922.70 | $2,958.00 | 35% |
| Gallbladder removal, laparoscopic CPT 47562 Pro Laparoscopic Cholecystectomy | $4,053.40 | $6,236.00 | 35% |
| Gallbladder removal, laparoscopic CPT 47562 LAPAROSCOPY SURG CHOLECYSTECTOMY | $4,053.40 | $6,236.00 | 35% |
| Gallbladder removal, laparoscopic CPT 47562 Fac Laparoscopic Cholecystectomy | $9,250.80 | $14,232.00 | 35% |
| Gallbladder removal, laparoscopic inpatient CPT 47562 Pro Laparoscopic Cholecystectomy | $4,053.40 | $6,236.00 | 35% |
| Gallbladder removal, laparoscopic inpatient CPT 47562 LAPAROSCOPY SURG CHOLECYSTECTOMY | $4,053.40 | $6,236.00 | 35% |
| Gallbladder removal, laparoscopic inpatient CPT 47562 Fac Laparoscopic Cholecystectomy | $9,250.80 | $14,232.00 | 35% |
| Inguinal (groin) hernia repair, age 5 or older both sides CPT 49505 Pro Prp I/Hern Init Reduc >5 Yr|BILATERAL PROCEDURE | $4,058.92 | $6,244.50 | 35% |
| Inguinal (groin) hernia repair, age 5 or older both sides CPT 49505 Fac Prp I/Hern Init Reduc >5 Yr|BILATERAL PROCEDURE | $10,578.75 | $16,275.00 | 35% |
| Inguinal (groin) hernia repair, age 5 or older CPT 49505 R1ST INGUN HRNA AGE 5 YRS/> REDUCIBLE | $2,705.95 | $4,163.00 | 35% |
| Inguinal (groin) hernia repair, age 5 or older CPT 49505 Pro Prp I/Hern Init Reduc >5 Yr | $2,705.95 | $4,163.00 | 35% |
| Inguinal (groin) hernia repair, age 5 or older CPT 49505 Fac Prp I/Hern Init Reduc >5 Yr | $7,052.50 | $10,850.00 | 35% |
| Inguinal (groin) hernia repair, age 5 or older inpatient both sides CPT 49505 Pro Prp I/Hern Init Reduc >5 Yr|BILATERAL PROCEDURE | $4,058.92 | $6,244.50 | 35% |
| Inguinal (groin) hernia repair, age 5 or older inpatient both sides CPT 49505 Fac Prp I/Hern Init Reduc >5 Yr|BILATERAL PROCEDURE | $10,578.75 | $16,275.00 | 35% |
| Inguinal (groin) hernia repair, age 5 or older inpatient CPT 49505 Pro Prp I/Hern Init Reduc >5 Yr | $2,705.95 | $4,163.00 | 35% |
| Inguinal (groin) hernia repair, age 5 or older inpatient CPT 49505 R1ST INGUN HRNA AGE 5 YRS/> REDUCIBLE | $2,705.95 | $4,163.00 | 35% |
| Inguinal (groin) hernia repair, age 5 or older inpatient CPT 49505 Fac Prp I/Hern Init Reduc >5 Yr | $7,052.50 | $10,850.00 | 35% |
| Knee arthroscopy with meniscus trim both sides CPT 29881 Pro Arthrs Kne Surg W/Meniscectomy Med/Lat W/Shvg|BILATERAL PROCEDURE | $4,277.32 | $6,580.50 | 35% |
| Knee arthroscopy with meniscus trim CPT 29881 Pro Arthrs Kne Surg W/Meniscectomy Med/Lat W/Shvg | $2,851.55 | $4,387.00 | 35% |
| Knee arthroscopy with meniscus trim CPT 29881 ARTHRS KNEE SURG W/MENISCECTOMY MED/LAT W/SHVG | $2,851.55 | $4,387.00 | 35% |
| Knee arthroscopy with meniscus trim inpatient both sides CPT 29881 Pro Arthrs Kne Surg W/Meniscectomy Med/Lat W/Shvg|BILATERAL PROCEDURE | $4,277.32 | $6,580.50 | 35% |
| Knee arthroscopy with meniscus trim inpatient CPT 29881 Pro Arthrs Kne Surg W/Meniscectomy Med/Lat W/Shvg | $2,851.55 | $4,387.00 | 35% |
| Knee arthroscopy with meniscus trim inpatient CPT 29881 ARTHRS KNEE SURG W/MENISCECTOMY MED/LAT W/SHVG | $2,851.55 | $4,387.00 | 35% |
| Laser treatment of clouding after cataract surgery (YAG) CPT 66821 Fac Post-Cataract Laser Surgery | $1,175.20 | $1,808.00 | 35% |
| Laser treatment of clouding after cataract surgery (YAG) CPT 66821 Pro Post-Cataract Laser Surgery | $1,925.95 | $2,963.00 | 35% |
| Laser treatment of clouding after cataract surgery (YAG) CPT 66821 POST-CATARACT LASER SURGERY | $1,925.95 | $2,963.00 | 35% |
| Laser treatment of clouding after cataract surgery (YAG) inpatient CPT 66821 Fac Post-Cataract Laser Surgery | $1,175.20 | $1,808.00 | 35% |
| Laser treatment of clouding after cataract surgery (YAG) inpatient CPT 66821 POST-CATARACT LASER SURGERY | $1,925.95 | $2,963.00 | 35% |
| Laser treatment of clouding after cataract surgery (YAG) inpatient CPT 66821 Pro Post-Cataract Laser Surgery | $1,925.95 | $2,963.00 | 35% |
| Left heart catheterization, diagnostic CPT 93452 L HRT CATH W/NJX L VENTRICULOGRAPHY IMG S&I | $4,159.35 | $6,399.00 | 35% |
| Left heart catheterization, diagnostic CPT 93452 Fac L Hrt Cath W/Njx L Ventriculography Img S&I | $6,824.35 | $10,499.00 | 35% |
| Left heart catheterization, diagnostic inpatient CPT 93452 L HRT CATH W/NJX L VENTRICULOGRAPHY IMG S&I | $4,159.35 | $6,399.00 | 35% |
| Left heart catheterization, diagnostic inpatient CPT 93452 Fac L Hrt Cath W/Njx L Ventriculography Img S&I | $6,824.35 | $10,499.00 | 35% |
| Lower-back epidural injection, with imaging guidance CPT 62323 NJX DX/THER SBST INTRLMNR LMBR/SAC W/IMG GDN | $549.90 | $846.00 | 35% |
| Lower-back epidural injection, with imaging guidance CPT 62323 Pro Njx Dx/Ther Sbst Intrlmnr Lmbr/Sac W/Img Gdn | $549.90 | $846.00 | 35% |
| Lower-back epidural injection, with imaging guidance CPT 62323 Fac Njx Dx/Ther Sbst Intrlmnr Lmbr/Sac W/Img Gdn | $1,303.90 | $2,006.00 | 35% |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 NJX DX/THER SBST INTRLMNR LMBR/SAC W/IMG GDN | $549.90 | $846.00 | 35% |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 Pro Njx Dx/Ther Sbst Intrlmnr Lmbr/Sac W/Img Gdn | $549.90 | $846.00 | 35% |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 Fac Njx Dx/Ther Sbst Intrlmnr Lmbr/Sac W/Img Gdn | $1,303.90 | $2,006.00 | 35% |
| Lower-back epidural injection, without imaging guidance CPT 62322 Fac Njx Dx/Ther Sbst Intrlmnr Lmbr/Sac W/O Img Gdn | $824.85 | $1,269.00 | 35% |
| Lower-back epidural injection, without imaging guidance CPT 62322 NJX DX/THER SBST INTRLMNR LMBR/SAC W/O IMG GDN | $824.85 | $1,269.00 | 35% |
| Lower-back epidural injection, without imaging guidance CPT 62322 Pro Njx Dx/Ther Sbst Intrlmnr Lmbr/Sac W/O Img Gdn | $824.85 | $1,269.00 | 35% |
| Lower-back epidural injection, without imaging guidance inpatient CPT 62322 Pro Njx Dx/Ther Sbst Intrlmnr Lmbr/Sac W/O Img Gdn | $824.85 | $1,269.00 | 35% |
| Lower-back epidural injection, without imaging guidance inpatient CPT 62322 NJX DX/THER SBST INTRLMNR LMBR/SAC W/O IMG GDN | $824.85 | $1,269.00 | 35% |
| Lower-back epidural injection, without imaging guidance inpatient CPT 62322 Fac Njx Dx/Ther Sbst Intrlmnr Lmbr/Sac W/O Img Gdn | $824.85 | $1,269.00 | 35% |
| Lower-back nerve root steroid injection, with imaging guidance both sides CPT 64483 Pro Njx Aa&/Strd Tfrml Epi Lumbar/Sacral 1 Level|BILATERAL PROCEDURE | $1,019.85 | $1,569.00 | 35% |
| Lower-back nerve root steroid injection, with imaging guidance both sides CPT 64483 Pro Njx Aa&/Strd Tfrml Epi Lumbar/Sacral 1 Level|TECHNICAL COMPONENT|BILATERAL PROCEDURE | $1,019.85 | $1,569.00 | 35% |
| Lower-back nerve root steroid injection, with imaging guidance both sides CPT 64483 Pro Njx Aa&/Strd Tfrml Epi Lumbar/Sacral 1 Level|BILATERAL PROCEDURE|DISC OP HOSP/AMB SURGR CENT (ASC) PROC AFTER ADMIN OF ANESTHES | $1,019.85 | $1,569.00 | 35% |
| Lower-back nerve root steroid injection, with imaging guidance both sides CPT 64483 Transfor Epidural L/S Single Lvl-CT|BILATERAL PROCEDURE|DISC OP HOSP/AMB SURGR CENT (ASC) PROC AFTER ADMIN OF ANESTHES | $1,603.88 | $2,467.50 | 35% |
| Lower-back nerve root steroid injection, with imaging guidance both sides CPT 64483 Transfor Epidural L/S Single Lvl-CT|TECHNICAL COMPONENT|BILATERAL PROCEDURE | $1,603.88 | $2,467.50 | 35% |
| Lower-back nerve root steroid injection, with imaging guidance both sides CPT 64483 Transfor Epidural L/S Single Lvl-CT|BILATERAL PROCEDURE | $1,603.88 | $2,467.50 | 35% |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 NJX AA&/STRD TFRML EPI LUMBAR/SACRAL 1 LEVEL | $679.90 | $1,046.00 | 35% |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 Pro Njx Aa&/Strd Tfrml Epi Lumbar/Sacral 1 Level | $679.90 | $1,046.00 | 35% |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 Transfor Epidural L/S Single Lvl-CT | $1,069.25 | $1,645.00 | 35% |
| Lower-back nerve root steroid injection, with imaging guidance inpatient both sides CPT 64483 Pro Njx Aa&/Strd Tfrml Epi Lumbar/Sacral 1 Level|TECHNICAL COMPONENT|BILATERAL PROCEDURE | $1,019.85 | $1,569.00 | 35% |
| Lower-back nerve root steroid injection, with imaging guidance inpatient both sides CPT 64483 Pro Njx Aa&/Strd Tfrml Epi Lumbar/Sacral 1 Level|BILATERAL PROCEDURE|DISC OP HOSP/AMB SURGR CENT (ASC) PROC AFTER ADMIN OF ANESTHES | $1,019.85 | $1,569.00 | 35% |
| Lower-back nerve root steroid injection, with imaging guidance inpatient both sides CPT 64483 Pro Njx Aa&/Strd Tfrml Epi Lumbar/Sacral 1 Level|BILATERAL PROCEDURE | $1,019.85 | $1,569.00 | 35% |
| Lower-back nerve root steroid injection, with imaging guidance inpatient both sides CPT 64483 Transfor Epidural L/S Single Lvl-CT|BILATERAL PROCEDURE|DISC OP HOSP/AMB SURGR CENT (ASC) PROC AFTER ADMIN OF ANESTHES | $1,603.88 | $2,467.50 | 35% |
| Lower-back nerve root steroid injection, with imaging guidance inpatient both sides CPT 64483 Transfor Epidural L/S Single Lvl-CT|TECHNICAL COMPONENT|BILATERAL PROCEDURE | $1,603.88 | $2,467.50 | 35% |
| Lower-back nerve root steroid injection, with imaging guidance inpatient both sides CPT 64483 Transfor Epidural L/S Single Lvl-CT|BILATERAL PROCEDURE | $1,603.88 | $2,467.50 | 35% |
| Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 NJX AA&/STRD TFRML EPI LUMBAR/SACRAL 1 LEVEL | $679.90 | $1,046.00 | 35% |
| Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 Pro Njx Aa&/Strd Tfrml Epi Lumbar/Sacral 1 Level | $679.90 | $1,046.00 | 35% |
| Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 Transfor Epidural L/S Single Lvl-CT | $1,069.25 | $1,645.00 | 35% |
| Prostate biopsy CPT 55700 Pro Biopsy of Prostate | $949.00 | $1,460.00 | 35% |
| Prostate biopsy CPT 55700 PROSTATE NEEDLE BIOPSY ANY APPROACH | $949.00 | $1,460.00 | 35% |
| Prostate biopsy CPT 55700 Fac Biopsy of Prostate | $1,526.85 | $2,349.00 | 35% |
| Prostate biopsy inpatient CPT 55700 Pro Biopsy of Prostate | $949.00 | $1,460.00 | 35% |
| Prostate biopsy inpatient CPT 55700 PROSTATE NEEDLE BIOPSY ANY APPROACH | $949.00 | $1,460.00 | 35% |
| Prostate biopsy inpatient CPT 55700 Fac Biopsy of Prostate | $1,526.85 | $2,349.00 | 35% |
| Prostate removal (prostatectomy), laparoscopic CPT 55866 LAPS SURG PRST8ECT RPBIC RAD W/NERVE SPARING | $6,440.20 | $9,908.00 | 35% |
| Prostate removal (prostatectomy), laparoscopic inpatient CPT 55866 LAPS SURG PRST8ECT RPBIC RAD W/NERVE SPARING | $6,440.20 | $9,908.00 | 35% |
| Removal of a breast lump, open surgery both sides CPT 19120 Pro Exc Cyst/Aberrant Breast Tissue Open 1/> Les|BILATERAL PROCEDURE | $3,229.20 | $4,968.00 | 35% |
| Removal of a breast lump, open surgery CPT 19120 Pro Exc Cyst/Aberrant Breast Tissue Open 1/> Les | $2,152.80 | $3,312.00 | 35% |
| Removal of a breast lump, open surgery CPT 19120 EXC CYST/ABERRANT BREAST TISSUE OPEN 1/> LESION | $2,152.80 | $3,312.00 | 35% |
| Removal of a breast lump, open surgery inpatient both sides CPT 19120 Pro Exc Cyst/Aberrant Breast Tissue Open 1/> Les|BILATERAL PROCEDURE | $3,229.20 | $4,968.00 | 35% |
| Removal of a breast lump, open surgery inpatient CPT 19120 Pro Exc Cyst/Aberrant Breast Tissue Open 1/> Les | $2,152.80 | $3,312.00 | 35% |
| Removal of a breast lump, open surgery inpatient CPT 19120 EXC CYST/ABERRANT BREAST TISSUE OPEN 1/> LESION | $2,152.80 | $3,312.00 | 35% |
| Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) CPT 29826 SURGICAL ARTHROSCOPY SHO W/CORACOACRM LIGM RLS | $2,617.55 | $4,027.00 | 35% |
| Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) CPT 29826 Pro Shoulder Scope, Bone Shaving | $2,617.55 | $4,027.00 | 35% |
| Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) inpatient CPT 29826 Pro Shoulder Scope, Bone Shaving | $2,617.55 | $4,027.00 | 35% |
| Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) inpatient CPT 29826 SURGICAL ARTHROSCOPY SHO W/CORACOACRM LIGM RLS | $2,617.55 | $4,027.00 | 35% |
| Tonsil and adenoid removal, child under 12 CPT 42820 TONSILLECTOMY & ADENOIDECTOMY <AGE 12 | $1,547.65 | $2,381.00 | 35% |
| Tonsil and adenoid removal, child under 12 inpatient CPT 42820 TONSILLECTOMY & ADENOIDECTOMY <AGE 12 | $1,547.65 | $2,381.00 | 35% |
| Total hip replacement both sides CPT 27130 Pro Arthrp Acetblr/Prox Fem Prostc Agrft/Algrft|BILATERAL PROCEDURE | $10,009.35 | $15,399.00 | 35% |
| Total hip replacement CPT 27130 ARTHRP ACETBLR/PROX FEM PROSTC AGRFT/ALGRFT | $6,672.90 | $10,266.00 | 35% |
| Total hip replacement CPT 27130 Pro Arthrp Acetblr/Prox Fem Prostc Agrft/Algrft | $6,672.90 | $10,266.00 | 35% |
| Total hip replacement inpatient both sides CPT 27130 Pro Arthrp Acetblr/Prox Fem Prostc Agrft/Algrft|BILATERAL PROCEDURE | $10,009.35 | $15,399.00 | 35% |
| Total hip replacement inpatient CPT 27130 Pro Arthrp Acetblr/Prox Fem Prostc Agrft/Algrft | $6,672.90 | $10,266.00 | 35% |
| Total hip replacement inpatient CPT 27130 ARTHRP ACETBLR/PROX FEM PROSTC AGRFT/ALGRFT | $6,672.90 | $10,266.00 | 35% |
| Total knee replacement both sides CPT 27447 Pro Arthrp Kne Condyle&Platu Medial&Lat Cmprts|BILATERAL PROCEDURE | $10,257.98 | $15,781.50 | 35% |
| Total knee replacement CPT 27447 Pro Arthrp Kne Condyle&Platu Medial&Lat Cmprts | $6,838.65 | $10,521.00 | 35% |
| Total knee replacement CPT 27447 ARTHRP KNE CONDYLE&PLATU MEDIAL&LAT COMPARTMENTS | $6,838.65 | $10,521.00 | 35% |
| Total knee replacement inpatient both sides CPT 27447 Pro Arthrp Kne Condyle&Platu Medial&Lat Cmprts|BILATERAL PROCEDURE | $10,257.98 | $15,781.50 | 35% |
| Total knee replacement inpatient CPT 27447 Pro Arthrp Kne Condyle&Platu Medial&Lat Cmprts | $6,838.65 | $10,521.00 | 35% |
| Total knee replacement inpatient CPT 27447 ARTHRP KNE CONDYLE&PLATU MEDIAL&LAT COMPARTMENTS | $6,838.65 | $10,521.00 | 35% |
| Upper endoscopy (EGD) with biopsy CPT 43239 Fac Egd Transoral Biopsy Single/Multiple | $1,580.80 | $2,432.00 | 35% |
| Upper endoscopy (EGD) with biopsy CPT 43239 Pro Egd Transoral Biopsy Single/Multiple | $1,582.10 | $2,434.00 | 35% |
| Upper endoscopy (EGD) with biopsy CPT 43239 EGD TRANSORAL BIOPSY SINGLE/MULTIPLE | $1,582.10 | $2,434.00 | 35% |
| Upper endoscopy (EGD) with biopsy inpatient CPT 43239 Fac Egd Transoral Biopsy Single/Multiple | $1,580.80 | $2,432.00 | 35% |
| Upper endoscopy (EGD) with biopsy inpatient CPT 43239 EGD TRANSORAL BIOPSY SINGLE/MULTIPLE | $1,582.10 | $2,434.00 | 35% |
| Upper endoscopy (EGD) with biopsy inpatient CPT 43239 Pro Egd Transoral Biopsy Single/Multiple | $1,582.10 | $2,434.00 | 35% |
| Upper endoscopy (EGD), diagnostic CPT 43235 Pro Esophagogastroduodenoscopy Transoral Diagnostic | $1,369.55 | $2,107.00 | 35% |
| Upper endoscopy (EGD), diagnostic CPT 43235 ESOPHAGOGASTRODUODENOSCOPY TRANSORAL DIAGNOSTIC | $1,369.55 | $2,107.00 | 35% |
| Upper endoscopy (EGD), diagnostic CPT 43235 Fac Esophagogastroduodenoscopy Transoral Diagnostic | $1,446.90 | $2,226.00 | 35% |
| Upper endoscopy (EGD), diagnostic inpatient CPT 43235 ESOPHAGOGASTRODUODENOSCOPY TRANSORAL DIAGNOSTIC | $1,369.55 | $2,107.00 | 35% |
| Upper endoscopy (EGD), diagnostic inpatient CPT 43235 Pro Esophagogastroduodenoscopy Transoral Diagnostic | $1,369.55 | $2,107.00 | 35% |
| Upper endoscopy (EGD), diagnostic inpatient CPT 43235 Fac Esophagogastroduodenoscopy Transoral Diagnostic | $1,446.90 | $2,226.00 | 35% |
| Vaginal birth after cesarean (VBAC), including prenatal and postpartum care CPT 59610 ROUTINE OB CARE VAG DLVRY & POSTPARTUM CARE VB | $5,544.50 | $8,530.00 | 35% |
| Vaginal birth after cesarean (VBAC), including prenatal and postpartum care inpatient CPT 59610 ROUTINE OB CARE VAG DLVRY & POSTPARTUM CARE VB | $5,544.50 | $8,530.00 | 35% |
| Vaginal delivery, including prenatal and postpartum care CPT 59400 OB CARE ANTEPARTUM VAG DLVR & POSTPARTUM | $4,890.60 | $7,524.00 | 35% |
| Vaginal delivery, including prenatal and postpartum care inpatient CPT 59400 OB CARE ANTEPARTUM VAG DLVR & POSTPARTUM | $4,890.60 | $7,524.00 | 35% |
Doctor visits and therapy
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Electrocardiogram (ECG/EKG) with interpretation CPT 93000 ECG ROUTINE ECG W/LEAST 12 LDS W/I&R | $154.05 | $237.00 | 35% |
| Electrocardiogram (ECG/EKG) with interpretation inpatient CPT 93000 ECG ROUTINE ECG W/LEAST 12 LDS W/I&R | $154.05 | $237.00 | 35% |
| Family therapy with the patient, 50 minutes CPT 90847 Fac Family Psychotherapy W/Patient Present 50 Mins | $189.80 | $292.00 | 35% |
| Family therapy with the patient, 50 minutes CPT 90847 FAMILY PSYCHOTHERAPY W/PATIENT PRESENT 50 MINS | $306.15 | $471.00 | 35% |
| Family therapy with the patient, 50 minutes CPT 90847 Pro Family Psychotherapy W/Patient Present 50 Mins | $306.15 | $471.00 | 35% |
| Family therapy with the patient, 50 minutes inpatient CPT 90847 Fac Family Psychotherapy W/Patient Present 50 Mins | $189.80 | $292.00 | 35% |
| Family therapy with the patient, 50 minutes inpatient CPT 90847 Pro Family Psychotherapy W/Patient Present 50 Mins | $306.15 | $471.00 | 35% |
| Family therapy with the patient, 50 minutes inpatient CPT 90847 FAMILY PSYCHOTHERAPY W/PATIENT PRESENT 50 MINS | $306.15 | $471.00 | 35% |
| Family therapy without the patient, 50 minutes CPT 90846 Fac Family Psychotherapy W/O Patient Present 50 Mins | $182.65 | $281.00 | 35% |
| Family therapy without the patient, 50 minutes CPT 90846 Pro Family Psychotherapy W/O Patient Present 50 Mins | $294.45 | $453.00 | 35% |
| Family therapy without the patient, 50 minutes CPT 90846 FAMILY PSYCHOTHERAPY W/O PATIENT PRESENT 50 MINS | $294.45 | $453.00 | 35% |
| Family therapy without the patient, 50 minutes inpatient CPT 90846 Fac Family Psychotherapy W/O Patient Present 50 Mins | $182.65 | $281.00 | 35% |
| Family therapy without the patient, 50 minutes inpatient CPT 90846 FAMILY PSYCHOTHERAPY W/O PATIENT PRESENT 50 MINS | $294.45 | $453.00 | 35% |
| Family therapy without the patient, 50 minutes inpatient CPT 90846 Pro Family Psychotherapy W/O Patient Present 50 Mins | $294.45 | $453.00 | 35% |
| Group psychotherapy session CPT 90853 Grp Psyctx Pbb | $31.20 | $48.00 | 35% |
| Group psychotherapy session CPT 90853 GROUP PSYCHOTHERAPY | $85.15 | $131.00 | 35% |
| Group psychotherapy session inpatient CPT 90853 Grp Psyctx Pbb | $31.20 | $48.00 | 35% |
| Group psychotherapy session inpatient CPT 90853 GROUP PSYCHOTHERAPY | $85.15 | $131.00 | 35% |
| New patient office visit, about 30 minutes CPT 99203 Pro Office/Outpatient New Low Mdm 30-44 Minutes | $204.75 | $315.00 | 35% |
| New patient office visit, about 30 minutes CPT 99203 OFFICE/OUTPATIENT NEW LOW MDM 30 MINUTES | $204.75 | $315.00 | 35% |
| New patient office visit, about 30 minutes CPT 99203 Fac Office/Outpatient New Low Mdm | $257.40 | $396.00 | 35% |
| New patient office visit, about 30 minutes inpatient CPT 99203 OFFICE/OUTPATIENT NEW LOW MDM 30 MINUTES | $204.75 | $315.00 | 35% |
| New patient office visit, about 30 minutes inpatient CPT 99203 Pro Office/Outpatient New Low Mdm 30-44 Minutes | $204.75 | $315.00 | 35% |
| New patient office visit, about 30 minutes inpatient CPT 99203 Fac Office/Outpatient New Low Mdm | $257.40 | $396.00 | 35% |
| New patient office visit, about 45 minutes CPT 99204 OFFICE/OUTPATIENT NEW MODERATE MDM 45 MINUTES | $351.00 | $540.00 | 35% |
| New patient office visit, about 45 minutes CPT 99204 Pro Office/Outpatient New Moderate Mdm 45-59 Minutes | $351.00 | $540.00 | 35% |
| New patient office visit, about 45 minutes CPT 99204 Fac Office/Outpatient New Moderate Mdm | $351.65 | $541.00 | 35% |
| New patient office visit, about 45 minutes inpatient CPT 99204 OFFICE/OUTPATIENT NEW MODERATE MDM 45 MINUTES | $351.00 | $540.00 | 35% |
| New patient office visit, about 45 minutes inpatient CPT 99204 Pro Office/Outpatient New Moderate Mdm 45-59 Minutes | $351.00 | $540.00 | 35% |
| New patient office visit, about 45 minutes inpatient CPT 99204 Fac Office/Outpatient New Moderate Mdm | $351.65 | $541.00 | 35% |
| New patient office visit, about 60 minutes CPT 99205 OFFICE/OUTPATIENT NEW HIGH MDM 60 MINUTES | $458.90 | $706.00 | 35% |
| New patient office visit, about 60 minutes CPT 99205 Pro Office/Outpatient New High Mdm 60-74 Minutes | $458.90 | $706.00 | 35% |
| New patient office visit, about 60 minutes CPT 99205 Fac Office/Outpatient New High Mdm | $487.50 | $750.00 | 35% |
| New patient office visit, about 60 minutes inpatient CPT 99205 OFFICE/OUTPATIENT NEW HIGH MDM 60 MINUTES | $458.90 | $706.00 | 35% |
| New patient office visit, about 60 minutes inpatient CPT 99205 Pro Office/Outpatient New High Mdm 60-74 Minutes | $458.90 | $706.00 | 35% |
| New patient office visit, about 60 minutes inpatient CPT 99205 Fac Office/Outpatient New High Mdm | $487.50 | $750.00 | 35% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERAPEUTIC PX 1/> AREAS EACH 15 MIN EXERCISES | $96.85 | $149.00 | 35% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 Fac Therapeutic Exercises | $96.85 | $149.00 | 35% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THERAPEUTIC PX 1/> AREAS EACH 15 MIN EXERCISES | $96.85 | $149.00 | 35% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 Fac Therapeutic Exercises | $96.85 | $149.00 | 35% |
| Preventive checkup, new patient aged 18–39 CPT 99385 INITIAL PREVENTIVE MEDICINE NEW PT AGE 18-39YRS | $276.90 | $426.00 | 35% |
| Preventive checkup, new patient aged 18–39 inpatient CPT 99385 INITIAL PREVENTIVE MEDICINE NEW PT AGE 18-39YRS | $276.90 | $426.00 | 35% |
| Preventive checkup, new patient aged 40–64 CPT 99386 INITIAL PREVENTIVE MEDICINE NEW PATIENT 40-64YRS | $336.05 | $517.00 | 35% |
| Preventive checkup, new patient aged 40–64 CPT 99386 Pro Preventive Visit, New, Age 40-64 | $336.05 | $517.00 | 35% |
| Preventive checkup, new patient aged 40–64 inpatient CPT 99386 Pro Preventive Visit, New, Age 40-64 | $336.05 | $517.00 | 35% |
| Preventive checkup, new patient aged 40–64 inpatient CPT 99386 INITIAL PREVENTIVE MEDICINE NEW PATIENT 40-64YRS | $336.05 | $517.00 | 35% |
| Psychotherapy session, 30 minutes CPT 90832 Fac Psychotherapy W/Patient 30 Minutes | $77.35 | $119.00 | 35% |
| Psychotherapy session, 30 minutes CPT 90832 Pro Psychotherapy W/Patient 30 Minutes | $183.30 | $282.00 | 35% |
| Psychotherapy session, 30 minutes CPT 90832 PSYCHOTHERAPY W/PATIENT 30 MINUTES | $183.30 | $282.00 | 35% |
| Psychotherapy session, 30 minutes inpatient CPT 90832 Fac Psychotherapy W/Patient 30 Minutes | $77.35 | $119.00 | 35% |
| Psychotherapy session, 30 minutes inpatient CPT 90832 Pro Psychotherapy W/Patient 30 Minutes | $183.30 | $282.00 | 35% |
| Psychotherapy session, 30 minutes inpatient CPT 90832 PSYCHOTHERAPY W/PATIENT 30 MINUTES | $183.30 | $282.00 | 35% |
| Psychotherapy session, 45 minutes CPT 90834 Fac Psychotherapy W/Patient 45 Minutes | $102.05 | $157.00 | 35% |
| Psychotherapy session, 45 minutes CPT 90834 PSYCHOTHERAPY W/PATIENT 45 MINUTES | $243.75 | $375.00 | 35% |
| Psychotherapy session, 45 minutes CPT 90834 Pro Psychotherapy W/Patient 45 Minutes | $243.75 | $375.00 | 35% |
| Psychotherapy session, 45 minutes inpatient CPT 90834 Fac Psychotherapy W/Patient 45 Minutes | $102.05 | $157.00 | 35% |
| Psychotherapy session, 45 minutes inpatient CPT 90834 PSYCHOTHERAPY W/PATIENT 45 MINUTES | $243.75 | $375.00 | 35% |
| Psychotherapy session, 45 minutes inpatient CPT 90834 Pro Psychotherapy W/Patient 45 Minutes | $243.75 | $375.00 | 35% |
| Psychotherapy session, 60 minutes CPT 90837 Fac Psychotherapy W/Patient 60 Minutes | $152.75 | $235.00 | 35% |
| Psychotherapy session, 60 minutes CPT 90837 Pro Psychotherapy W/Patient 60 Minutes | $365.95 | $563.00 | 35% |
| Psychotherapy session, 60 minutes CPT 90837 PSYCHOTHERAPY W/PATIENT 60 MINUTES | $365.95 | $563.00 | 35% |
| Psychotherapy session, 60 minutes inpatient CPT 90837 Fac Psychotherapy W/Patient 60 Minutes | $152.75 | $235.00 | 35% |
| Psychotherapy session, 60 minutes inpatient CPT 90837 Pro Psychotherapy W/Patient 60 Minutes | $365.95 | $563.00 | 35% |
| Psychotherapy session, 60 minutes inpatient CPT 90837 PSYCHOTHERAPY W/PATIENT 60 MINUTES | $365.95 | $563.00 | 35% |
| Specialist consultation, low complexity or 30+ minutes CPT 99243 Fac Office/OP Consltj New/Est Pt Low Mdm 30 Minutes | $200.20 | $308.00 | 35% |
| Specialist consultation, low complexity or 30+ minutes CPT 99243 OFFICE/OP CONSLTJ NEW/EST PT LOW MDM 30 MINUTES | $322.40 | $496.00 | 35% |
| Specialist consultation, low complexity or 30+ minutes CPT 99243 Pro Office/OP Consltj New/Est Pt Low Mdm 30 Minutes | $322.40 | $496.00 | 35% |
| Specialist consultation, low complexity or 30+ minutes inpatient CPT 99243 Fac Office/OP Consltj New/Est Pt Low Mdm 30 Minutes | $200.20 | $308.00 | 35% |
| Specialist consultation, low complexity or 30+ minutes inpatient CPT 99243 Pro Office/OP Consltj New/Est Pt Low Mdm 30 Minutes | $322.40 | $496.00 | 35% |
| Specialist consultation, low complexity or 30+ minutes inpatient CPT 99243 OFFICE/OP CONSLTJ NEW/EST PT LOW MDM 30 MINUTES | $322.40 | $496.00 | 35% |
| Specialist consultation, moderate complexity or 40+ minutes CPT 99244 Fac Office/OP Consltj New/Est Pt Mod Mdm 40 Minutes | $320.45 | $493.00 | 35% |
| Specialist consultation, moderate complexity or 40+ minutes CPT 99244 OFFICE/OP CONSLTJ NEW/EST PT MOD MDM 40 MINUTES | $516.75 | $795.00 | 35% |
| Specialist consultation, moderate complexity or 40+ minutes CPT 99244 Pro Office/OP Consltj New/Est Pt Mod Mdm 40 Minutes | $516.75 | $795.00 | 35% |
| Specialist consultation, moderate complexity or 40+ minutes inpatient CPT 99244 Fac Office/OP Consltj New/Est Pt Mod Mdm 40 Minutes | $320.45 | $493.00 | 35% |
| Specialist consultation, moderate complexity or 40+ minutes inpatient CPT 99244 OFFICE/OP CONSLTJ NEW/EST PT MOD MDM 40 MINUTES | $516.75 | $795.00 | 35% |
| Specialist consultation, moderate complexity or 40+ minutes inpatient CPT 99244 Pro Office/OP Consltj New/Est Pt Mod Mdm 40 Minutes | $516.75 | $795.00 | 35% |