Hospital

Pomerene Hospital

Pomerene Hospital in Millersburg, OH publishes cash prices for 358 common procedures listed here, from its own machine-readable price file updated Mar 24, 2026. Compared with other hospitals in the state, its outpatient cash prices are below the Ohio median for 256 of 353 procedures and above it for 91. By typical cash price it ranks #42 of 139 Ohio hospitals, cheapest first. Select a procedure to compare it with other hospitals nearby.

981 Wooster Road, Millersburg, OH, 44654 Collected Sep 21, 2026 Source price file Check a bill from this hospital (330) 674-1015

Acute care hospital Nonprofit hospital Emergency department CMS star rating 3 of 5 CCN 360148 · CMS hospital register

Financial assistance

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

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

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

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

State law

This state limits hospital bills for lower-income patients

Ohio's Hospital Care Assurance Program (HCAP): Ohio residents who are not on Medicaid and whose income is at or below 100% of the federal poverty level get basic, medically necessary hospital services free at hospitals in the program; physician bills are not included. Ask the hospital's billing office for an HCAP application. Other states' laws.

CMS price transparency record

The federal Centers for Medicare & Medicaid Services (CMS) enforces the rule that makes hospitals publish their prices. Its public enforcement list shows 1 action for a hospital named Pomerene Hospital in Millersburg, OH:

Jul 11, 2025 Met requirements

Met requirements: CMS reviewed the hospital and found it met the requirements, so no further action was taken.

A notice records a step in a CMS review; it is not a court finding. Source: CMS, Hospital Price Transparency Enforcement Activities and Outcomes, actions through Jul 31, 2026.

Scans and imaging

Procedure	Cash price	List price	Insurers pay	vs Ohio	Off list
Abdominal CT scan without and with contrast CPT 74170 CT ABD W/WO CONTRAST	$1,520.00	$1,900.00	$162.62–$1,767.00	14% above	20%
Abdominal CT scan without and with contrast CPT 74170 CT PANCREAS W/WO CONTRAST	$1,520.00	$1,900.00	$162.62–$1,767.00	14% above	20%
Abdominal CT scan without and with contrast CPT 74170 CT KIDNEYS W/WO CONTRAST	$1,520.00	$1,900.00	$162.62–$1,767.00	14% above	20%
Abdominal CT scan without and with contrast inpatient CPT 74170 CT KIDNEYS W/WO CONTRAST	$1,520.00	$1,900.00	$162.62–$1,767.00	—	20%
Abdominal CT scan without and with contrast inpatient CPT 74170 CT PANCREAS W/WO CONTRAST	$1,520.00	$1,900.00	$162.62–$1,767.00	—	20%
Abdominal CT scan without and with contrast inpatient CPT 74170 CT ABD W/WO CONTRAST	$1,520.00	$1,900.00	$162.62–$1,767.00	—	20%
Abdominal X-ray, 2 views CPT 74019 ABDOMEN 2 VIEWS	$253.60	$317.00	$32.97–$294.81	25% below	20%
Abdominal X-ray, 2 views inpatient CPT 74019 ABDOMEN 2 VIEWS	$253.60	$317.00	$32.97–$294.81	—	20%
Ankle X-ray, complete, 3 or more views one side CPT 73610 ANKLE COMPLETE LT	$288.80	$361.00	$33.72–$335.73	10% below	20%
Ankle X-ray, complete, 3 or more views one side CPT 73610 ANKLE COMPLETE RT	$288.80	$361.00	$33.72–$335.73	10% below	20%
Ankle X-ray, complete, 3 or more views one side CPT 73610 ANKLE COMPLETE LT,Left Side	$288.80	$361.00	$33.72–$335.73	10% below	20%
Ankle X-ray, complete, 3 or more views one side CPT 73610 ANKLE COMPLETE RT,Right Side	$288.80	$361.00	$33.72–$335.73	10% below	20%
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 ANKLE COMPLETE LT,Left Side	$288.80	$361.00	$33.72–$335.73	—	20%
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 ANKLE COMPLETE RT,Right Side	$288.80	$361.00	$33.72–$335.73	—	20%
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 ANKLE COMPLETE LT	$288.80	$361.00	$33.72–$335.73	—	20%
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 ANKLE COMPLETE RT	$288.80	$361.00	$33.72–$335.73	—	20%
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 CV ARTERIAL U OR L SINGLE PHYSIOLO	$248.00	$310.00	$75.25–$288.30	49% below	20%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 CV ARTERIAL U OR L SINGLE PHYSIOLO	$248.00	$310.00	$75.25–$288.30	—	20%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT HUMERUS W/O RT,Right Side	$880.00	$1,100.00	$96.93–$1,023.00	7% below	20%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT FOREARM W/O LT,Left Side	$880.00	$1,100.00	$96.93–$1,023.00	7% below	20%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT SHOULDER W/O LT,Left Side	$880.00	$1,100.00	$96.93–$1,023.00	7% below	20%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT HUMERUS W/O LT,Left Side	$880.00	$1,100.00	$96.93–$1,023.00	7% below	20%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT WRIST W/O RT,Right Side	$880.00	$1,100.00	$96.93–$1,023.00	7% below	20%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT SHOULDER W/O RT,Right Side	$880.00	$1,100.00	$96.93–$1,023.00	7% below	20%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT HAND W/O RT,Right Side	$880.00	$1,100.00	$96.93–$1,023.00	7% below	20%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT FOREARM W/O RT,Right Side	$880.00	$1,100.00	$96.93–$1,023.00	7% below	20%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT ELBOW W/O RT,Right Side	$880.00	$1,100.00	$96.93–$1,023.00	7% below	20%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT HAND W/O LT,Left Side	$880.00	$1,100.00	$96.93–$1,023.00	7% below	20%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT ELBOW W/O LT,Left Side	$880.00	$1,100.00	$96.93–$1,023.00	7% below	20%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT WRIST W/O LT,Left Side	$880.00	$1,100.00	$96.93–$1,023.00	7% below	20%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT HUMERUS W/O LT,Left Side	$880.00	$1,100.00	$96.93–$1,023.00	—	20%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT HUMERUS W/O RT,Right Side	$880.00	$1,100.00	$96.93–$1,023.00	—	20%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT SHOULDER W/O RT,Right Side	$880.00	$1,100.00	$96.93–$1,023.00	—	20%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT HAND W/O LT,Left Side	$880.00	$1,100.00	$96.93–$1,023.00	—	20%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT ELBOW W/O RT,Right Side	$880.00	$1,100.00	$96.93–$1,023.00	—	20%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT WRIST W/O RT,Right Side	$880.00	$1,100.00	$96.93–$1,023.00	—	20%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT FOREARM W/O RT,Right Side	$880.00	$1,100.00	$96.93–$1,023.00	—	20%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT FOREARM W/O LT,Left Side	$880.00	$1,100.00	$96.93–$1,023.00	—	20%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT HAND W/O RT,Right Side	$880.00	$1,100.00	$96.93–$1,023.00	—	20%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT ELBOW W/O LT,Left Side	$880.00	$1,100.00	$96.93–$1,023.00	—	20%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT WRIST W/O LT,Left Side	$880.00	$1,100.00	$96.93–$1,023.00	—	20%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT SHOULDER W/O LT,Left Side	$880.00	$1,100.00	$96.93–$1,023.00	—	20%
Barium swallow (esophagus X-ray with contrast) CPT 74220 ESOPHAGRAM	$356.80	$446.00	$86.08–$414.78	19% below	20%
Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 ESOPHAGRAM	$356.80	$446.00	$86.08–$414.78	—	20%
Bone scan, whole body (nuclear medicine) CPT 78306 NM BONE SCAN WHOLE BODY	$848.80	$1,061.00	$234.55–$986.73	45% below	20%
Bone scan, whole body (nuclear medicine) inpatient CPT 78306 NM BONE SCAN WHOLE BODY	$848.80	$1,061.00	$234.55–$986.73	—	20%
Breast ultrasound, complete, one breast one side CPT 76641 US BREAST LT UNILATERAL COMPLETE,Left Side	$320.00	$400.00	$91.84–$372.00	33% below	20%
Breast ultrasound, complete, one breast one side CPT 76641 US BREAST RT UNILATERAL COMPLETE,Right Side	$320.00	$400.00	$91.84–$372.00	33% below	20%
Breast ultrasound, complete, one breast inpatient one side CPT 76641 US BREAST RT UNILATERAL COMPLETE,Right Side	$320.00	$400.00	$91.84–$372.00	—	20%
Breast ultrasound, complete, one breast inpatient one side CPT 76641 US BREAST LT UNILATERAL COMPLETE,Left Side	$320.00	$400.00	$91.84–$372.00	—	20%
Breast ultrasound, limited (one breast or one area) one side CPT 76642 US BREAST LT UNILATERAL LIMITED,Left Side	$278.40	$348.00	$76.74–$323.64	32% below	20%
Breast ultrasound, limited (one breast or one area) one side CPT 76642 US BREAST RT UNILATERAL LIMITED,Right Side	$278.40	$348.00	$76.74–$323.64	32% below	20%
Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 US BREAST RT UNILATERAL LIMITED,Right Side	$278.40	$348.00	$76.74–$323.64	—	20%
Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 US BREAST LT UNILATERAL LIMITED,Left Side	$278.40	$348.00	$76.74–$323.64	—	20%
CT angiography (CTA) of the abdomen and pelvis CPT 74174 CT ANGIOGRAPHY ABDOMEN & PELVIS	$1,426.40	$1,783.00	$323.46–$1,658.19	33% below	20%
CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174 CT ANGIOGRAPHY ABDOMEN & PELVIS	$1,426.40	$1,783.00	$323.46–$1,658.19	—	20%
CT angiography (CTA) of the head CPT 70496 CT ANGIOGRAPHY HEAD W/CONTRAST	$1,069.60	$1,337.00	$162.62–$1,243.41	20% below	20%
CT angiography (CTA) of the head inpatient CPT 70496 CT ANGIOGRAPHY HEAD W/CONTRAST	$1,069.60	$1,337.00	$162.62–$1,243.41	—	20%
CT angiography (CTA) of the neck CPT 70498 CT ANGIOGRAPHY NECK	$1,148.00	$1,435.00	$162.62–$1,334.55	12% below	20%
CT angiography (CTA) of the neck inpatient CPT 70498 CT ANGIOGRAPHY NECK	$1,148.00	$1,435.00	$162.62–$1,334.55	—	20%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT ANGIOGRAPHY CHEST	$1,515.20	$1,894.00	$162.62–$1,761.42	7% above	20%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CT ANGIOGRAPHY CHEST	$1,515.20	$1,894.00	$162.62–$1,761.42	—	20%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT KUB (KIDNEY STONE PROTOCOL)	$1,180.80	$1,476.00	$168.95–$1,372.68	26% below	20%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT ABDOMEN/PELVIS WO	$1,180.80	$1,476.00	$168.95–$1,372.68	26% below	20%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT KUB (KIDNEY STONE PROTOCOL)	$1,180.80	$1,476.00	$168.95–$1,372.68	—	20%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT ABDOMEN/PELVIS WO	$1,180.80	$1,476.00	$168.95–$1,372.68	—	20%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ABDOMEN/PELVIS W	$1,986.40	$2,483.00	$274.12–$2,309.19	at median	20%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT ABDOMEN/PELVIS W	$1,986.40	$2,483.00	$274.12–$2,309.19	—	20%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT ABDOMEN/PELVIS W/WO	$2,051.20	$2,564.00	$308.48–$2,384.52	12% below	20%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT ABDOMEN/PELVIS W/WO	$2,051.20	$2,564.00	$308.48–$2,384.52	—	20%
CT scan of the abdomen with contrast CPT 74160 CT KIDNEYS W/CONTRAST	$1,280.00	$1,600.00	$162.62–$1,488.00	10% above	20%
CT scan of the abdomen with contrast CPT 74160 CT PANCREAS W CONTRAST	$1,280.00	$1,600.00	$162.62–$1,488.00	10% above	20%
CT scan of the abdomen with contrast CPT 74160 CT ABD W/CONTRAST	$1,280.00	$1,600.00	$162.62–$1,488.00	10% above	20%
CT scan of the abdomen with contrast inpatient CPT 74160 CT KIDNEYS W/CONTRAST	$1,280.00	$1,600.00	$162.62–$1,488.00	—	20%
CT scan of the abdomen with contrast inpatient CPT 74160 CT PANCREAS W CONTRAST	$1,280.00	$1,600.00	$162.62–$1,488.00	—	20%
CT scan of the abdomen with contrast inpatient CPT 74160 CT ABD W/CONTRAST	$1,280.00	$1,600.00	$162.62–$1,488.00	—	20%
CT scan of the abdomen without contrast CPT 74150 CT KIDNEYS W/O CONTRAST	$1,040.00	$1,300.00	$96.93–$1,209.00	1% below	20%
CT scan of the abdomen without contrast CPT 74150 CT ABD W/O CONTRAST	$1,040.00	$1,300.00	$96.93–$1,209.00	1% below	20%
CT scan of the abdomen without contrast CPT 74150 CT PANCREAS W/O CONTRAST	$1,040.00	$1,300.00	$96.93–$1,209.00	1% below	20%
CT scan of the abdomen without contrast inpatient CPT 74150 CT PANCREAS W/O CONTRAST	$1,040.00	$1,300.00	$96.93–$1,209.00	—	20%
CT scan of the abdomen without contrast inpatient CPT 74150 CT KIDNEYS W/O CONTRAST	$1,040.00	$1,300.00	$96.93–$1,209.00	—	20%
CT scan of the abdomen without contrast inpatient CPT 74150 CT ABD W/O CONTRAST	$1,040.00	$1,300.00	$96.93–$1,209.00	—	20%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT MAXILLO-MANDI SPEC. VIEWS (1) ARCH	$888.00	$1,110.00	$96.93–$1,032.30	1% above	20%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT SINUSES W/O CONTRAST	$888.00	$1,110.00	$96.93–$1,032.30	1% above	20%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT MAXILLO-MANDI SPEC. VIEWS (2) ARCH	$888.00	$1,110.00	$96.93–$1,032.30	1% above	20%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT FACIAL BONES W/O CONTRAST	$888.00	$1,110.00	$96.93–$1,032.30	1% above	20%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT MAXILLO-MANDI SPEC. VIEWS (2) ARCH	$888.00	$1,110.00	$96.93–$1,032.30	—	20%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT SINUSES W/O CONTRAST	$888.00	$1,110.00	$96.93–$1,032.30	—	20%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT FACIAL BONES W/O CONTRAST	$888.00	$1,110.00	$96.93–$1,032.30	—	20%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT MAXILLO-MANDI SPEC. VIEWS (1) ARCH	$888.00	$1,110.00	$96.93–$1,032.30	—	20%
CT scan of the head or brain, no contrast dye CPT 70450 CT BRAIN W/O CONTRAST	$900.00	$1,125.00	$96.93–$1,046.25	8% above	20%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT BRAIN W/O CONTRAST	$900.00	$1,125.00	$96.93–$1,046.25	—	20%
CT scan of the head with contrast CPT 70460 CT BRAIN W/CONTRAST	$1,069.60	$1,337.00	$136.10–$1,243.41	6% above	20%
CT scan of the head with contrast inpatient CPT 70460 CT BRAIN W/CONTRAST	$1,069.60	$1,337.00	$136.10–$1,243.41	—	20%
CT scan of the head without and with contrast CPT 70470 CT BRAIN W/WO CONTRAST	$1,693.60	$2,117.00	$158.61–$1,968.81	42% above	20%
CT scan of the head without and with contrast inpatient CPT 70470 CT BRAIN W/WO CONTRAST	$1,693.60	$2,117.00	$158.61–$1,968.81	—	20%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT LUMBAR W/O CONTRAST	$1,069.60	$1,337.00	$96.93–$1,243.41	3% below	20%
CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 CT LUMBAR W/O CONTRAST	$1,069.60	$1,337.00	$96.93–$1,243.41	—	20%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT CERVICAL W/O CONTRAST	$1,124.80	$1,406.00	$96.93–$1,307.58	5% above	20%
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CT CERVICAL W/O CONTRAST	$1,124.80	$1,406.00	$96.93–$1,307.58	—	20%
CT scan of the pelvis, with contrast dye CPT 72193 CT PELVIS W/CONTRAST	$1,225.60	$1,532.00	$162.62–$1,424.76	at median	20%
CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT PELVIS W/CONTRAST	$1,225.60	$1,532.00	$162.62–$1,424.76	—	20%
Carotid artery ultrasound (duplex), both sides of the neck CPT 93880 CV CAROTID STUDY	$697.60	$872.00	$171.69–$810.96	4% below	20%
Carotid artery ultrasound (duplex), both sides of the neck inpatient CPT 93880 CV CAROTID STUDY	$697.60	$872.00	$171.69–$810.96	—	20%
Chest CT scan without and with contrast CPT 71270 CT CHEST W/WO CONTRAST	$1,269.60	$1,587.00	$162.62–$1,475.91	16% below	20%
Chest CT scan without and with contrast inpatient CPT 71270 CT CHEST W/WO CONTRAST	$1,269.60	$1,587.00	$162.62–$1,475.91	—	20%
Chest X-ray, 2 views CPT 71046 CHEST 2 VIEWS	$212.80	$266.00	$30.24–$247.38	19% below	20%
Chest X-ray, 2 views inpatient CPT 71046 CHEST 2 VIEWS	$212.80	$266.00	$30.24–$247.38	—	20%
Chest X-ray, single view CPT 71045 CHEST EXPIRATION	$152.00	$190.00	$23.28–$176.70	32% below	20%
Chest X-ray, single view CPT 71045 CHEST 1 VIEW	$152.00	$190.00	$23.28–$176.70	32% below	20%
Chest X-ray, single view inpatient CPT 71045 CHEST EXPIRATION	$152.00	$190.00	$23.28–$176.70	—	20%
Chest X-ray, single view inpatient CPT 71045 CHEST 1 VIEW	$152.00	$190.00	$23.28–$176.70	—	20%
Collarbone (clavicle) X-ray, complete one side CPT 73000 CLAVICLE LT,Left Side	$276.00	$345.00	$30.40–$320.85	2% above	20%
Collarbone (clavicle) X-ray, complete one side CPT 73000 CLAVICLE LT	$276.00	$345.00	$30.40–$320.85	2% above	20%
Collarbone (clavicle) X-ray, complete one side CPT 73000 CLAVICLE RT,Right Side	$276.00	$345.00	$30.40–$320.85	2% above	20%
Collarbone (clavicle) X-ray, complete one side CPT 73000 CLAVICLE RT	$276.00	$345.00	$30.40–$320.85	2% above	20%
Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 CLAVICLE LT,Left Side	$276.00	$345.00	$30.40–$320.85	—	20%
Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 CLAVICLE RT,Right Side	$276.00	$345.00	$30.40–$320.85	—	20%
Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 CLAVICLE LT	$276.00	$345.00	$30.40–$320.85	—	20%
Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 CLAVICLE RT	$276.00	$345.00	$30.40–$320.85	—	20%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US KIDNEY / BLADDER	$454.40	$568.00	$96.93–$528.24	36% below	20%
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US KIDNEY / BLADDER	$454.40	$568.00	$96.93–$528.24	—	20%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 BONE DENSITY STUDY	$259.20	$324.00	$35.90–$301.32	43% below	20%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 BONE DENSITY SPECIAL	$259.20	$324.00	$35.90–$301.32	43% below	20%
DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 BONE DENSITY SPECIAL	$259.20	$324.00	$35.90–$301.32	—	20%
DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 BONE DENSITY STUDY	$259.20	$324.00	$35.90–$301.32	—	20%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT HI RES CHEST W/O CONTRAST	$940.00	$1,175.00	$96.93–$1,092.75	at median	20%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT CHEST W/O CONTRAST	$940.00	$1,175.00	$96.93–$1,092.75	at median	20%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT CHEST W/O CONTRAST	$940.00	$1,175.00	$96.93–$1,092.75	—	20%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT HI RES CHEST W/O CONTRAST	$940.00	$1,175.00	$96.93–$1,092.75	—	20%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT CHEST W/CONTRAST	$1,240.00	$1,550.00	$152.63–$1,441.50	2% above	20%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT CHEST (PE PROTOCOL)	$1,240.00	$1,550.00	$152.63–$1,441.50	2% above	20%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT CHEST W/CONTRAST	$1,240.00	$1,550.00	$152.63–$1,441.50	—	20%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT CHEST (PE PROTOCOL)	$1,240.00	$1,550.00	$152.63–$1,441.50	—	20%
Diagnostic mammogram, both breasts both sides CPT 77066 MAMM DIGITAL BILAT DIAGNOSTIC BCCP	$208.80	$261.00	$98.98–$242.73	—	20%
Diagnostic mammogram, both breasts both sides CPT 77066 MAMM DIGITAL BILAT DIAGNOSTIC	$208.80	$261.00	$98.98–$242.73	—	20%
Diagnostic mammogram, both breasts both sides CPT 77066 3D MAMM BILAT DIAG BCCP	$208.80	$261.00	$98.98–$242.73	—	20%
Diagnostic mammogram, both breasts both sides CPT 77066 3D MAMM BILAT DIAG SPECIAL	$208.80	$261.00	$98.98–$242.73	—	20%
Diagnostic mammogram, both breasts both sides CPT 77066 3D MAMM HOFFNUNG BILAT DIAGNOSTIC	$208.80	$261.00	$98.98–$242.73	—	20%
Diagnostic mammogram, both breasts both sides CPT 77066 MAMMOGRAM HOFFNUNG BILAT DIAGNOSTIC	$208.80	$261.00	$98.98–$242.73	—	20%
Diagnostic mammogram, both breasts both sides CPT 77066 3D MAMM BILAT DIAGNOSTIC	$208.80	$261.00	$98.98–$242.73	—	20%
Diagnostic mammogram, both breasts both sides CPT 77066 MAMM DIGITAL BILAT DIAGNOSTIC SPECIAL	$208.80	$261.00	$98.98–$242.73	—	20%
Diagnostic mammogram, both breasts inpatient both sides CPT 77066 3D MAMM HOFFNUNG BILAT DIAGNOSTIC	$208.80	$261.00	$98.98–$242.73	—	20%
Diagnostic mammogram, both breasts inpatient both sides CPT 77066 MAMM DIGITAL BILAT DIAGNOSTIC SPECIAL	$208.80	$261.00	$98.98–$242.73	—	20%
Diagnostic mammogram, both breasts inpatient both sides CPT 77066 3D MAMM BILAT DIAGNOSTIC	$208.80	$261.00	$98.98–$242.73	—	20%
Diagnostic mammogram, both breasts inpatient both sides CPT 77066 3D MAMM BILAT DIAG BCCP	$208.80	$261.00	$98.98–$242.73	—	20%
Diagnostic mammogram, both breasts inpatient both sides CPT 77066 MAMM DIGITAL BILAT DIAGNOSTIC BCCP	$208.80	$261.00	$98.98–$242.73	—	20%
Diagnostic mammogram, both breasts inpatient both sides CPT 77066 MAMM DIGITAL BILAT DIAGNOSTIC	$208.80	$261.00	$98.98–$242.73	—	20%
Diagnostic mammogram, both breasts inpatient both sides CPT 77066 3D MAMM BILAT DIAG SPECIAL	$208.80	$261.00	$98.98–$242.73	—	20%
Diagnostic mammogram, both breasts inpatient both sides CPT 77066 MAMMOGRAM HOFFNUNG BILAT DIAGNOSTIC	$208.80	$261.00	$98.98–$242.73	—	20%
Diagnostic mammogram, one breast one side CPT 77065 3D MAMM DIGITAL LT SPOT VIEWS,Left Side	$184.00	$230.00	$77.14–$213.90	49% below	20%
Diagnostic mammogram, one breast one side CPT 77065 MAMM DIGITAL RT SPOT VIEWS,Right Side	$184.00	$230.00	$77.14–$213.90	49% below	20%
Diagnostic mammogram, one breast one side CPT 77065 3D MAMM UNILAT RT DIAG SPECIAL,Right Side	$184.00	$230.00	$77.14–$213.90	49% below	20%
Diagnostic mammogram, one breast one side CPT 77065 MAMM DIGITAL LT SPOT VIEWS,Left Side	$184.00	$230.00	$77.14–$213.90	49% below	20%
Diagnostic mammogram, one breast one side CPT 77065 3D MAMM UNILAT RT DIAG BCCP,Right Side	$184.00	$230.00	$77.14–$213.90	49% below	20%
Diagnostic mammogram, one breast one side CPT 77065 MAMM DIGITAL DIAGNOSTIC UNILAT LT,Left Side	$184.00	$230.00	$77.14–$213.90	49% below	20%
Diagnostic mammogram, one breast one side CPT 77065 3D MAMM UNILAT RT DIAGNOSTIC	$184.00	$230.00	$77.14–$213.90	49% below	20%
Diagnostic mammogram, one breast one side CPT 77065 MAMM DIGITAL UNILAT DIAG ST JOHNS	$184.00	$230.00	$77.14–$213.90	49% below	20%
Diagnostic mammogram, one breast one side CPT 77065 3D MAMM UNILAT LT DIAG SPECIAL,Left Side	$184.00	$230.00	$77.14–$213.90	49% below	20%
Diagnostic mammogram, one breast one side CPT 77065 3D MAMM UNILAT LT DIAG HOFFNUNG,Left Side	$184.00	$230.00	$77.14–$213.90	49% below	20%
Diagnostic mammogram, one breast one side CPT 77065 3D MAMM UNILAT RT DIAG HOFFNUNG,Right Side	$184.00	$230.00	$77.14–$213.90	49% below	20%
Diagnostic mammogram, one breast one side CPT 77065 MAMM DIGITAL UNILAT DIAGNOSTIC RT	$184.00	$230.00	$77.14–$213.90	49% below	20%
Diagnostic mammogram, one breast one side CPT 77065 3D MAMM UNILAT LT DIAGNOSTIC	$184.00	$230.00	$77.14–$213.90	49% below	20%
Diagnostic mammogram, one breast one side CPT 77065 MAMM DIGITAL UNILAT LT DIAGNOSTIC BCCP,Left Side	$184.00	$230.00	$77.14–$213.90	49% below	20%
Diagnostic mammogram, one breast one side CPT 77065 3D MAMM UNILAT RT DIAGNOSTIC,Right Side	$184.00	$230.00	$77.14–$213.90	49% below	20%
Diagnostic mammogram, one breast one side CPT 77065 MAMM DIGITAL UNILAT RT DIAGNOSTIC BCCP,Right Side	$184.00	$230.00	$77.14–$213.90	49% below	20%
Diagnostic mammogram, one breast one side CPT 77065 MAMM DIGITAL UNILAT LT DIAGNOSTIC SPECIA,Left Side	$184.00	$230.00	$77.14–$213.90	49% below	20%
Diagnostic mammogram, one breast one side CPT 77065 MAMM DIGITAL UNILAT RT DIAGNOSTIC SPECIA,Right Side	$184.00	$230.00	$77.14–$213.90	49% below	20%
Diagnostic mammogram, one breast one side CPT 77065 3D MAMM DIGITAL RT SPOT VIEWS,Right Side	$184.00	$230.00	$77.14–$213.90	49% below	20%
Diagnostic mammogram, one breast one side CPT 77065 3D MAMM UNILAT LT DIAG BCCP,Left Side	$184.00	$230.00	$77.14–$213.90	49% below	20%
Diagnostic mammogram, one breast one side CPT 77065 3D MAMM UNILAT LT DIAGNOSTIC,Left Side	$184.00	$230.00	$77.14–$213.90	49% below	20%
Diagnostic mammogram, one breast one side CPT 77065 MAMM DIGITAL UNILAT DIAGNOSTIC RT,Right Side	$184.00	$230.00	$77.14–$213.90	49% below	20%
Diagnostic mammogram, one breast one side CPT 77065 MAMM DIGITAL UNILAT LT DIAG HOFFNUNG,Left Side	$184.00	$230.00	$77.14–$213.90	49% below	20%
Diagnostic mammogram, one breast one side CPT 77065 MAMM DIGITAL DIAGNOSTIC UNILAT LT	$184.00	$230.00	$77.14–$213.90	49% below	20%
Diagnostic mammogram, one breast one side CPT 77065 MAMM DIGITAL UNILAT RT DIAG HOFFNUNG,Right Side	$184.00	$230.00	$77.14–$213.90	49% below	20%
Diagnostic mammogram, one breast inpatient one side CPT 77065 3D MAMM UNILAT RT DIAGNOSTIC,Right Side	$184.00	$230.00	$77.14–$213.90	—	20%
Diagnostic mammogram, one breast inpatient one side CPT 77065 MAMM DIGITAL UNILAT DIAG ST JOHNS	$184.00	$230.00	$77.14–$213.90	—	20%
Diagnostic mammogram, one breast inpatient one side CPT 77065 3D MAMM UNILAT LT DIAGNOSTIC	$184.00	$230.00	$77.14–$213.90	—	20%
Diagnostic mammogram, one breast inpatient one side CPT 77065 3D MAMM UNILAT LT DIAG HOFFNUNG,Left Side	$184.00	$230.00	$77.14–$213.90	—	20%
Diagnostic mammogram, one breast inpatient one side CPT 77065 3D MAMM UNILAT RT DIAG SPECIAL,Right Side	$184.00	$230.00	$77.14–$213.90	—	20%
Diagnostic mammogram, one breast inpatient one side CPT 77065 MAMM DIGITAL UNILAT LT DIAGNOSTIC BCCP,Left Side	$184.00	$230.00	$77.14–$213.90	—	20%
Diagnostic mammogram, one breast inpatient one side CPT 77065 MAMM DIGITAL LT SPOT VIEWS,Left Side	$184.00	$230.00	$77.14–$213.90	—	20%
Diagnostic mammogram, one breast inpatient one side CPT 77065 3D MAMM UNILAT LT DIAG SPECIAL,Left Side	$184.00	$230.00	$77.14–$213.90	—	20%
Diagnostic mammogram, one breast inpatient one side CPT 77065 3D MAMM DIGITAL RT SPOT VIEWS,Right Side	$184.00	$230.00	$77.14–$213.90	—	20%
Diagnostic mammogram, one breast inpatient one side CPT 77065 3D MAMM UNILAT RT DIAG BCCP,Right Side	$184.00	$230.00	$77.14–$213.90	—	20%
Diagnostic mammogram, one breast inpatient one side CPT 77065 MAMM DIGITAL UNILAT RT DIAG HOFFNUNG,Right Side	$184.00	$230.00	$77.14–$213.90	—	20%
Diagnostic mammogram, one breast inpatient one side CPT 77065 MAMM DIGITAL UNILAT RT DIAGNOSTIC SPECIA,Right Side	$184.00	$230.00	$77.14–$213.90	—	20%
Diagnostic mammogram, one breast inpatient one side CPT 77065 MAMM DIGITAL UNILAT DIAGNOSTIC RT	$184.00	$230.00	$77.14–$213.90	—	20%
Diagnostic mammogram, one breast inpatient one side CPT 77065 MAMM DIGITAL DIAGNOSTIC UNILAT LT,Left Side	$184.00	$230.00	$77.14–$213.90	—	20%
Diagnostic mammogram, one breast inpatient one side CPT 77065 3D MAMM UNILAT LT DIAGNOSTIC,Left Side	$184.00	$230.00	$77.14–$213.90	—	20%
Diagnostic mammogram, one breast inpatient one side CPT 77065 3D MAMM UNILAT RT DIAGNOSTIC	$184.00	$230.00	$77.14–$213.90	—	20%
Diagnostic mammogram, one breast inpatient one side CPT 77065 MAMM DIGITAL RT SPOT VIEWS,Right Side	$184.00	$230.00	$77.14–$213.90	—	20%
Diagnostic mammogram, one breast inpatient one side CPT 77065 MAMM DIGITAL UNILAT DIAGNOSTIC RT,Right Side	$184.00	$230.00	$77.14–$213.90	—	20%
Diagnostic mammogram, one breast inpatient one side CPT 77065 MAMM DIGITAL UNILAT LT DIAGNOSTIC SPECIA,Left Side	$184.00	$230.00	$77.14–$213.90	—	20%
Diagnostic mammogram, one breast inpatient one side CPT 77065 3D MAMM DIGITAL LT SPOT VIEWS,Left Side	$184.00	$230.00	$77.14–$213.90	—	20%
Diagnostic mammogram, one breast inpatient one side CPT 77065 3D MAMM UNILAT LT DIAG BCCP,Left Side	$184.00	$230.00	$77.14–$213.90	—	20%
Diagnostic mammogram, one breast inpatient one side CPT 77065 MAMM DIGITAL UNILAT RT DIAGNOSTIC BCCP,Right Side	$184.00	$230.00	$77.14–$213.90	—	20%
Diagnostic mammogram, one breast inpatient one side CPT 77065 MAMM DIGITAL DIAGNOSTIC UNILAT LT	$184.00	$230.00	$77.14–$213.90	—	20%
Diagnostic mammogram, one breast inpatient one side CPT 77065 MAMM DIGITAL UNILAT LT DIAG HOFFNUNG,Left Side	$184.00	$230.00	$77.14–$213.90	—	20%
Diagnostic mammogram, one breast inpatient one side CPT 77065 3D MAMM UNILAT RT DIAG HOFFNUNG,Right Side	$184.00	$230.00	$77.14–$213.90	—	20%
Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 CV ARTERIAL BILAT DUPLEX LOWER EXT	$668.00	$835.00	$215.05–$776.55	—	20%
Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 CV ARTERIAL BILAT DUPLEX LOWER EXT	$668.00	$835.00	$215.05–$776.55	—	20%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 CV VENOUS BILATERAL LOWER	$605.60	$757.00	$166.88–$704.01	—	20%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 CV VENOUS BILATERAL UPPER	$605.60	$757.00	$166.88–$704.01	—	20%
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 CV VENOUS BILATERAL UPPER	$605.60	$757.00	$166.88–$704.01	—	20%
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 CV VENOUS BILATERAL LOWER	$605.60	$757.00	$166.88–$704.01	—	20%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 CV ECHO COMPLETE W/SALINE	$1,254.40	$1,568.00	$180.32–$1,458.24	26% below	20%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 CV ECHO COMPLETE	$1,254.40	$1,568.00	$180.32–$1,458.24	26% below	20%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 CV ECHO COMPLETE WITHOUT CONTRAST	$1,344.00	$1,680.00	$180.32–$1,562.40	20% below	20%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 CV ECHO COMPLETE W/SALINE W/O CONTRAST	$1,344.00	$1,680.00	$180.32–$1,562.40	20% below	20%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 CV ECHO COMPLETE W/CONTRAST PER PROTOCOL	$1,400.00	$1,750.00	$180.32–$1,627.50	17% below	20%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 CV ECHO COMPLETE W/SALINE	$1,254.40	$1,568.00	$180.32–$1,458.24	—	20%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 CV ECHO COMPLETE	$1,254.40	$1,568.00	$180.32–$1,458.24	—	20%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 CV ECHO COMPLETE W/SALINE W/O CONTRAST	$1,344.00	$1,680.00	$180.32–$1,562.40	—	20%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 CV ECHO COMPLETE WITHOUT CONTRAST	$1,344.00	$1,680.00	$180.32–$1,562.40	—	20%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 CV ECHO COMPLETE W/CONTRAST PER PROTOCOL	$1,400.00	$1,750.00	$180.32–$1,627.50	—	20%
Elbow X-ray, 2 views one side CPT 73070 ELBOW 2 VIEW RT,Right Side	$177.60	$222.00	$26.81–$206.46	32% below	20%
Elbow X-ray, 2 views one side CPT 73070 ELBOW 2 VIEW LT,Left Side	$177.60	$222.00	$26.81–$206.46	32% below	20%
Elbow X-ray, 2 views one side CPT 73070 ELBOW 2 VIEW LT	$177.60	$222.00	$26.81–$206.46	32% below	20%
Elbow X-ray, 2 views one side CPT 73070 ELBOW 2 VIEW RT	$177.60	$222.00	$26.81–$206.46	32% below	20%
Elbow X-ray, 2 views inpatient one side CPT 73070 ELBOW 2 VIEW RT,Right Side	$177.60	$222.00	$26.81–$206.46	—	20%
Elbow X-ray, 2 views inpatient one side CPT 73070 ELBOW 2 VIEW LT,Left Side	$177.60	$222.00	$26.81–$206.46	—	20%
Elbow X-ray, 2 views inpatient one side CPT 73070 ELBOW 2 VIEW RT	$177.60	$222.00	$26.81–$206.46	—	20%
Elbow X-ray, 2 views inpatient one side CPT 73070 ELBOW 2 VIEW LT	$177.60	$222.00	$26.81–$206.46	—	20%
Elbow X-ray, complete, 3 or more views one side CPT 73080 ELBOW COMPLETE LT,Left Side	$280.00	$350.00	$30.14–$325.50	11% below	20%
Elbow X-ray, complete, 3 or more views one side CPT 73080 ELBOW COMPLETE LT	$280.00	$350.00	$30.14–$325.50	11% below	20%
Elbow X-ray, complete, 3 or more views one side CPT 73080 ELBOW COMPLETE RT	$280.00	$350.00	$30.14–$325.50	11% below	20%
Elbow X-ray, complete, 3 or more views one side CPT 73080 ELBOW COMPLETE RT,Right Side	$280.00	$350.00	$30.14–$325.50	11% below	20%
Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 ELBOW COMPLETE LT	$280.00	$350.00	$30.14–$325.50	—	20%
Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 ELBOW COMPLETE RT	$280.00	$350.00	$30.14–$325.50	—	20%
Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 ELBOW COMPLETE LT,Left Side	$280.00	$350.00	$30.14–$325.50	—	20%
Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 ELBOW COMPLETE RT,Right Side	$280.00	$350.00	$30.14–$325.50	—	20%
Eye socket (orbit) CT scan without contrast CPT 70480 CT POST FOSSA W/O CONTRAST	$913.60	$1,142.00	$96.93–$1,062.06	6% above	20%
Eye socket (orbit) CT scan without contrast CPT 70480 CT IAC OR MASTOID W/O CONTRAST	$913.60	$1,142.00	$96.93–$1,062.06	6% above	20%
Eye socket (orbit) CT scan without contrast CPT 70480 CT ORBITS W/O CONTRAST	$913.60	$1,142.00	$96.93–$1,062.06	6% above	20%
Eye socket (orbit) CT scan without contrast CPT 70480 CT SELLA W/O CONTRAST	$913.60	$1,142.00	$96.93–$1,062.06	6% above	20%
Eye socket (orbit) CT scan without contrast inpatient CPT 70480 CT ORBITS W/O CONTRAST	$913.60	$1,142.00	$96.93–$1,062.06	—	20%
Eye socket (orbit) CT scan without contrast inpatient CPT 70480 CT IAC OR MASTOID W/O CONTRAST	$913.60	$1,142.00	$96.93–$1,062.06	—	20%
Eye socket (orbit) CT scan without contrast inpatient CPT 70480 CT POST FOSSA W/O CONTRAST	$913.60	$1,142.00	$96.93–$1,062.06	—	20%
Eye socket (orbit) CT scan without contrast inpatient CPT 70480 CT SELLA W/O CONTRAST	$913.60	$1,142.00	$96.93–$1,062.06	—	20%
Facial bones X-ray, complete, 3 or more views CPT 70150 FACIAL BONES	$316.80	$396.00	$42.61–$368.28	16% below	20%
Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 FACIAL BONES	$316.80	$396.00	$42.61–$368.28	—	20%
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 FOREARM RT,Right Side	$277.60	$347.00	$26.52–$322.71	2% above	20%
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 FOREARM LT	$277.60	$347.00	$26.52–$322.71	2% above	20%
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 FOREARM LT,Left Side	$277.60	$347.00	$26.52–$322.71	2% above	20%
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 FOREARM RT	$277.60	$347.00	$26.52–$322.71	2% above	20%
Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 FOREARM LT	$277.60	$347.00	$26.52–$322.71	—	20%
Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 FOREARM RT	$277.60	$347.00	$26.52–$322.71	—	20%
Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 FOREARM RT,Right Side	$277.60	$347.00	$26.52–$322.71	—	20%
Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 FOREARM LT,Left Side	$277.60	$347.00	$26.52–$322.71	—	20%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 NM HIDA SCANS	$1,440.00	$1,800.00	$257.25–$1,674.00	9% below	20%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 NM COMMON BILE DUCT PATENCY	$1,440.00	$1,800.00	$257.25–$1,674.00	9% below	20%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 NM HIDA SCAN	$1,570.40	$1,963.00	$257.25–$1,825.59	1% below	20%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 NM HIDA SCANS	$1,440.00	$1,800.00	$257.25–$1,674.00	—	20%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 NM COMMON BILE DUCT PATENCY	$1,440.00	$1,800.00	$257.25–$1,674.00	—	20%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 NM HIDA SCAN	$1,570.40	$1,963.00	$257.25–$1,825.59	—	20%
Hand X-ray, 2 views one side CPT 73120 HAND 2 VIEW LT,Left Side	$179.20	$224.00	$28.61–$208.32	33% below	20%
Hand X-ray, 2 views one side CPT 73120 HAND 2 VIEW RT	$179.20	$224.00	$28.61–$208.32	33% below	20%
Hand X-ray, 2 views one side CPT 73120 HAND 2 VIEW RT,Right Side	$179.20	$224.00	$28.61–$208.32	33% below	20%
Hand X-ray, 2 views one side CPT 73120 HAND 2 VIEW LT	$179.20	$224.00	$28.61–$208.32	33% below	20%
Hand X-ray, 2 views inpatient one side CPT 73120 HAND 2 VIEW RT	$179.20	$224.00	$28.61–$208.32	—	20%
Hand X-ray, 2 views inpatient one side CPT 73120 HAND 2 VIEW LT,Left Side	$179.20	$224.00	$28.61–$208.32	—	20%
Hand X-ray, 2 views inpatient one side CPT 73120 HAND 2 VIEW RT,Right Side	$179.20	$224.00	$28.61–$208.32	—	20%
Hand X-ray, 2 views inpatient one side CPT 73120 HAND 2 VIEW LT	$179.20	$224.00	$28.61–$208.32	—	20%
Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 OS CALCIS RT,Right Side	$267.20	$334.00	$25.92–$310.62	2% below	20%
Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 OS CALCIS LT	$267.20	$334.00	$25.92–$310.62	2% below	20%
Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 OS CALCIS LT,Left Side	$267.20	$334.00	$25.92–$310.62	2% below	20%
Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 OS CALCIS LT	$267.20	$334.00	$25.92–$310.62	—	20%
Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 OS CALCIS LT,Left Side	$267.20	$334.00	$25.92–$310.62	—	20%
Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 OS CALCIS RT,Right Side	$267.20	$334.00	$25.92–$310.62	—	20%
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 SLEEP LAB PSG TITRATION	$4,216.80	$5,271.00	$641.37–$4,902.03	3% above	20%
In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 SLEEP LAB PSG TITRATION	$4,216.80	$5,271.00	$641.37–$4,902.03	—	20%
Knee X-ray, 3 views one side CPT 73562 KNEE 3 VIEW LT,Left Side	$250.40	$313.00	$38.53–$291.09	29% below	20%
Knee X-ray, 3 views one side CPT 73562 KNEE 3 VIEW RT	$250.40	$313.00	$38.53–$291.09	29% below	20%
Knee X-ray, 3 views one side CPT 73562 KNEE 3 VIEW LT	$250.40	$313.00	$38.53–$291.09	29% below	20%
Knee X-ray, 3 views one side CPT 73562 KNEE 3 VIEW RT,Right Side	$250.40	$313.00	$38.53–$291.09	29% below	20%
Knee X-ray, 3 views inpatient one side CPT 73562 KNEE 3 VIEW RT,Right Side	$250.40	$313.00	$38.53–$291.09	—	20%
Knee X-ray, 3 views inpatient one side CPT 73562 KNEE 3 VIEW LT	$250.40	$313.00	$38.53–$291.09	—	20%
Knee X-ray, 3 views inpatient one side CPT 73562 KNEE 3 VIEW RT	$250.40	$313.00	$38.53–$291.09	—	20%
Knee X-ray, 3 views inpatient one side CPT 73562 KNEE 3 VIEW LT,Left Side	$250.40	$313.00	$38.53–$291.09	—	20%
Knee X-ray, complete, 4 or more views one side CPT 73564 KNEE COMPLETE RT MIN 4 VIEWS,Right Side	$328.00	$410.00	$44.89–$381.30	17% below	20%
Knee X-ray, complete, 4 or more views one side CPT 73564 KNEE COMPLETE LT MIN 4 VIEWS	$328.00	$410.00	$44.89–$381.30	17% below	20%
Knee X-ray, complete, 4 or more views one side CPT 73564 KNEE COMPLETE RT MIN 4 VIEWS	$328.00	$410.00	$44.89–$381.30	17% below	20%
Knee X-ray, complete, 4 or more views one side CPT 73564 KNEE COMPLETE LT MIN 4 VIEWS,Left Side	$328.00	$410.00	$44.89–$381.30	17% below	20%
Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 KNEE COMPLETE RT MIN 4 VIEWS,Right Side	$328.00	$410.00	$44.89–$381.30	—	20%
Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 KNEE COMPLETE RT MIN 4 VIEWS	$328.00	$410.00	$44.89–$381.30	—	20%
Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 KNEE COMPLETE LT MIN 4 VIEWS,Left Side	$328.00	$410.00	$44.89–$381.30	—	20%
Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 KNEE COMPLETE LT MIN 4 VIEWS	$328.00	$410.00	$44.89–$381.30	—	20%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT TIB/FIB W/O LT,Left Side	$880.00	$1,100.00	$96.93–$1,023.00	7% below	20%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT TIB/FIB W/O RT,Right Side	$880.00	$1,100.00	$96.93–$1,023.00	7% below	20%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT KNEE W/O LT,Left Side	$880.00	$1,100.00	$96.93–$1,023.00	7% below	20%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT ANKLE W/O RT,Right Side	$880.00	$1,100.00	$96.93–$1,023.00	7% below	20%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT LOWER EXTREMITY RT WO,Right Side	$880.00	$1,100.00	$96.93–$1,023.00	7% below	20%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT KNEE W/O RT,Right Side	$880.00	$1,100.00	$96.93–$1,023.00	7% below	20%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT LOWER EXTREMITY LT WO,Left Side	$880.00	$1,100.00	$96.93–$1,023.00	7% below	20%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT HIP W/O RT,Right Side	$880.00	$1,100.00	$96.93–$1,023.00	7% below	20%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT FEMUR W/O RT,Right Side	$880.00	$1,100.00	$96.93–$1,023.00	7% below	20%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT ANKLE W/O LT,Left Side	$880.00	$1,100.00	$96.93–$1,023.00	7% below	20%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT FEMUR W/O LT,Left Side	$880.00	$1,100.00	$96.93–$1,023.00	7% below	20%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT FOOT W/O LT,Left Side	$880.00	$1,100.00	$96.93–$1,023.00	7% below	20%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT HIP W/O LT,Left Side	$880.00	$1,100.00	$96.93–$1,023.00	7% below	20%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT FOOT W/O RT,Right Side	$880.00	$1,100.00	$96.93–$1,023.00	7% below	20%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT TIB/FIB W/O RT,Right Side	$880.00	$1,100.00	$96.93–$1,023.00	—	20%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT HIP W/O LT,Left Side	$880.00	$1,100.00	$96.93–$1,023.00	—	20%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT LOWER EXTREMITY RT WO,Right Side	$880.00	$1,100.00	$96.93–$1,023.00	—	20%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT KNEE W/O RT,Right Side	$880.00	$1,100.00	$96.93–$1,023.00	—	20%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT LOWER EXTREMITY LT WO,Left Side	$880.00	$1,100.00	$96.93–$1,023.00	—	20%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT FOOT W/O RT,Right Side	$880.00	$1,100.00	$96.93–$1,023.00	—	20%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT HIP W/O RT,Right Side	$880.00	$1,100.00	$96.93–$1,023.00	—	20%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT TIB/FIB W/O LT,Left Side	$880.00	$1,100.00	$96.93–$1,023.00	—	20%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT KNEE W/O LT,Left Side	$880.00	$1,100.00	$96.93–$1,023.00	—	20%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT FEMUR W/O RT,Right Side	$880.00	$1,100.00	$96.93–$1,023.00	—	20%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT ANKLE W/O RT,Right Side	$880.00	$1,100.00	$96.93–$1,023.00	—	20%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT ANKLE W/O LT,Left Side	$880.00	$1,100.00	$96.93–$1,023.00	—	20%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT FEMUR W/O LT,Left Side	$880.00	$1,100.00	$96.93–$1,023.00	—	20%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT FOOT W/O LT,Left Side	$880.00	$1,100.00	$96.93–$1,023.00	—	20%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US PYLORUS	$560.00	$700.00	$78.88–$651.00	1% above	20%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US GALLBLADDER	$560.00	$700.00	$78.88–$651.00	1% above	20%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US RUQ (GB/PANCREAS)	$560.00	$700.00	$78.88–$651.00	1% above	20%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US PANCREAS	$560.00	$700.00	$78.88–$651.00	1% above	20%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US SPLEEN	$560.00	$700.00	$78.88–$651.00	1% above	20%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US LIVER	$560.00	$700.00	$78.88–$651.00	1% above	20%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US RUQ (GB/PANCREAS)	$560.00	$700.00	$78.88–$651.00	—	20%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US PANCREAS	$560.00	$700.00	$78.88–$651.00	—	20%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US SPLEEN	$560.00	$700.00	$78.88–$651.00	—	20%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US LIVER	$560.00	$700.00	$78.88–$651.00	—	20%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US PYLORUS	$560.00	$700.00	$78.88–$651.00	—	20%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US GALLBLADDER	$560.00	$700.00	$78.88–$651.00	—	20%
Limited ultrasound of an arm or leg (non-vascular) CPT 76882 US EXTREMITY NONVASCULAR LIMITED	$243.20	$304.00	$59.45–$282.72	49% below	20%
Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 US EXTREMITY NONVASCULAR LIMITED	$243.20	$304.00	$59.45–$282.72	—	20%
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 CT THORAX LOW DOSE	$208.00	$260.00	$96.93–$241.80	29% below	20%
Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 CT THORAX LOW DOSE	$208.00	$260.00	$96.93–$241.80	—	20%
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 TIBIA-FIBULA LT,Left Side	$244.80	$306.00	$28.61–$284.58	10% below	20%
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 TIBIA-FIBULA RT,Right Side	$244.80	$306.00	$28.61–$284.58	10% below	20%
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 TIBIA-FIBULA LT	$244.80	$306.00	$28.61–$284.58	10% below	20%
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 TIBIA-FIBULA RT	$244.80	$306.00	$28.61–$284.58	10% below	20%
Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 TIBIA-FIBULA RT,Right Side	$244.80	$306.00	$28.61–$284.58	—	20%
Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 TIBIA-FIBULA LT,Left Side	$244.80	$306.00	$28.61–$284.58	—	20%
Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 TIBIA-FIBULA LT	$244.80	$306.00	$28.61–$284.58	—	20%
Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 TIBIA-FIBULA RT	$244.80	$306.00	$28.61–$284.58	—	20%
MR angiography (MRA) of the head without contrast CPT 70544 MR MRA BRAIN WO CONTRAST	$1,620.00	$2,025.00	$195.80–$1,883.25	12% above	20%
MR angiography (MRA) of the head without contrast inpatient CPT 70544 MR MRA BRAIN WO CONTRAST	$1,620.00	$2,025.00	$195.80–$1,883.25	—	20%
MRI of both breasts, without and then with contrast dye both sides CPT 77049 MR BREAST BILATERAL W/WO CONTRAST	$2,160.00	$2,700.00	$310.81–$2,511.00	—	20%
MRI of both breasts, without and then with contrast dye inpatient both sides CPT 77049 MR BREAST BILATERAL W/WO CONTRAST	$2,160.00	$2,700.00	$310.81–$2,511.00	—	20%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MR HIP WO RT,Right Side	$2,058.40	$2,573.00	$186.94–$2,392.89	17% above	20%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MR ANKLE WO RT,Right Side	$2,058.40	$2,573.00	$186.94–$2,392.89	17% above	20%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MR KNEE W/O LT,Left Side	$2,058.40	$2,573.00	$186.94–$2,392.89	17% above	20%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MR HIP W/O LT,Left Side	$2,058.40	$2,573.00	$186.94–$2,392.89	17% above	20%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MR KNEE WO RT,Right Side	$2,058.40	$2,573.00	$186.94–$2,392.89	17% above	20%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MR ANKLE W/O LT,Left Side	$2,058.40	$2,573.00	$186.94–$2,392.89	17% above	20%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MR KNEE WO RT,Right Side	$2,058.40	$2,573.00	$186.94–$2,392.89	—	20%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MR KNEE W/O LT,Left Side	$2,058.40	$2,573.00	$186.94–$2,392.89	—	20%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MR ANKLE W/O LT,Left Side	$2,058.40	$2,573.00	$186.94–$2,392.89	—	20%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MR HIP WO RT,Right Side	$2,058.40	$2,573.00	$186.94–$2,392.89	—	20%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MR ANKLE WO RT,Right Side	$2,058.40	$2,573.00	$186.94–$2,392.89	—	20%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MR HIP W/O LT,Left Side	$2,058.40	$2,573.00	$186.94–$2,392.89	—	20%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MR LOWER EXT JT W/WO LT,Left Side	$2,339.20	$2,924.00	$323.46–$2,719.32	2% below	20%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MR ANKLE W/WO LT,Left Side	$2,339.20	$2,924.00	$323.46–$2,719.32	2% below	20%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MR ANKLE W/WO RT,Right Side	$2,339.20	$2,924.00	$323.46–$2,719.32	2% below	20%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MR HIP W/WO RT,Right Side	$2,339.20	$2,924.00	$323.46–$2,719.32	2% below	20%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MR LOWER EXT JT W/WO RT,Right Side	$2,339.20	$2,924.00	$323.46–$2,719.32	2% below	20%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MR KNEE W/WO RT,Right Side	$2,339.20	$2,924.00	$323.46–$2,719.32	2% below	20%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MR KNEE W/WO LT,Left Side	$2,339.20	$2,924.00	$323.46–$2,719.32	2% below	20%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MR HIP W/WO LT,Left Side	$2,339.20	$2,924.00	$323.46–$2,719.32	2% below	20%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MR KNEE W/WO RT,Right Side	$2,339.20	$2,924.00	$323.46–$2,719.32	—	20%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MR KNEE W/WO LT,Left Side	$2,339.20	$2,924.00	$323.46–$2,719.32	—	20%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MR HIP W/WO LT,Left Side	$2,339.20	$2,924.00	$323.46–$2,719.32	—	20%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MR LOWER EXT JT W/WO LT,Left Side	$2,339.20	$2,924.00	$323.46–$2,719.32	—	20%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MR ANKLE W/WO RT,Right Side	$2,339.20	$2,924.00	$323.46–$2,719.32	—	20%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MR ANKLE W/WO LT,Left Side	$2,339.20	$2,924.00	$323.46–$2,719.32	—	20%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MR LOWER EXT JT W/WO RT,Right Side	$2,339.20	$2,924.00	$323.46–$2,719.32	—	20%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MR HIP W/WO RT,Right Side	$2,339.20	$2,924.00	$323.46–$2,719.32	—	20%
MRI of the abdomen without contrast CPT 74181 MR ABDOMEN WO CONTRAST	$1,709.60	$2,137.00	$177.65–$1,987.41	7% below	20%
MRI of the abdomen without contrast inpatient CPT 74181 MR ABDOMEN WO CONTRAST	$1,709.60	$2,137.00	$177.65–$1,987.41	—	20%
MRI of the abdomen, without and then with contrast dye CPT 74183 MR ABDOMEN W & W/O CONTRAST	$2,400.00	$3,000.00	$307.27–$2,790.00	5% above	20%
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MR ABDOMEN W & W/O CONTRAST	$2,400.00	$3,000.00	$307.27–$2,790.00	—	20%
MRI of the brain, no contrast dye CPT 70551 MR MRI BRAIN W/O CONTRAST	$1,635.20	$2,044.00	$179.24–$1,900.92	1% above	20%
MRI of the brain, no contrast dye inpatient CPT 70551 MR MRI BRAIN W/O CONTRAST	$1,635.20	$2,044.00	$179.24–$1,900.92	—	20%
MRI of the brain, with and without contrast dye CPT 70553 MR MRI BRAIN W/WO CONTRAST	$2,475.20	$3,094.00	$290.46–$2,877.42	13% above	20%
MRI of the brain, with and without contrast dye inpatient CPT 70553 MR MRI BRAIN W/WO CONTRAST	$2,475.20	$3,094.00	$290.46–$2,877.42	—	20%
MRI of the lower back, no contrast dye CPT 72148 MR LUMBAR SP WO CONTRAST	$1,840.00	$2,300.00	$175.95–$2,139.00	10% above	20%
MRI of the lower back, no contrast dye inpatient CPT 72148 MR LUMBAR SP WO CONTRAST	$1,840.00	$2,300.00	$175.95–$2,139.00	—	20%
MRI of the lower back, without and then with contrast dye CPT 72158 MR LUMBAR SP W/WO CONTRAST	$2,254.40	$2,818.00	$291.66–$2,620.74	3% below	20%
MRI of the lower back, without and then with contrast dye inpatient CPT 72158 MR LUMBAR SP W/WO CONTRAST	$2,254.40	$2,818.00	$291.66–$2,620.74	—	20%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MR THORACIC SP W/O CONTRAST	$1,748.80	$2,186.00	$174.75–$2,032.98	4% above	20%
MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 MR THORACIC SP W/O CONTRAST	$1,748.80	$2,186.00	$174.75–$2,032.98	—	20%
MRI of the neck (cervical spine) without and with contrast CPT 72156 MR CERVICAL SP W/WO CONTRAST	$2,264.00	$2,830.00	$291.35–$2,631.90	at median	20%
MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 MR CERVICAL SP W/WO CONTRAST	$2,264.00	$2,830.00	$291.35–$2,631.90	—	20%
MRI of the neck (cervical spine), no contrast dye CPT 72141 MR CERVICAL SP WO CONTRAST	$1,771.20	$2,214.00	$175.06–$2,059.02	7% above	20%
MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 MR CERVICAL SP WO CONTRAST	$1,771.20	$2,214.00	$175.06–$2,059.02	—	20%
MRI of the pelvis without and with contrast CPT 72197 MR PELVIS W & W/O CONTRAST	$2,182.40	$2,728.00	$305.77–$2,537.04	12% above	20%
MRI of the pelvis without and with contrast inpatient CPT 72197 MR PELVIS W & W/O CONTRAST	$2,182.40	$2,728.00	$305.77–$2,537.04	—	20%
MRI of the pelvis, no contrast dye CPT 72195 MR PELVIS W/O CONTRAST	$1,687.20	$2,109.00	$207.84–$1,961.37	11% above	20%
MRI of the pelvis, no contrast dye inpatient CPT 72195 MR PELVIS W/O CONTRAST	$1,687.20	$2,109.00	$207.84–$1,961.37	—	20%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MR SHOULDER W/O RT,Right Side	$1,622.40	$2,028.00	$187.53–$1,886.04	7% above	20%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MR SHOULDER W/O LT,Left Side	$1,703.20	$2,129.00	$187.53–$1,979.97	13% above	20%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MR WRIST W/O LT,Left Side	$1,703.20	$2,129.00	$187.53–$1,979.97	13% above	20%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MR UPPER EXT JT W/O LT,Left Side	$1,703.20	$2,129.00	$187.53–$1,979.97	13% above	20%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MR ELBOW W/O RT,Right Side	$1,703.20	$2,129.00	$187.53–$1,979.97	13% above	20%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MR WRIST W/O RT,Right Side	$1,703.20	$2,129.00	$187.53–$1,979.97	13% above	20%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MR ELBOW W/O LT,Left Side	$1,703.20	$2,129.00	$187.53–$1,979.97	13% above	20%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MR SHOULDER W/O RT,Right Side	$1,622.40	$2,028.00	$187.53–$1,886.04	—	20%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MR SHOULDER W/O LT,Left Side	$1,703.20	$2,129.00	$187.53–$1,979.97	—	20%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MR ELBOW W/O RT,Right Side	$1,703.20	$2,129.00	$187.53–$1,979.97	—	20%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MR UPPER EXT JT W/O LT,Left Side	$1,703.20	$2,129.00	$187.53–$1,979.97	—	20%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MR WRIST W/O RT,Right Side	$1,703.20	$2,129.00	$187.53–$1,979.97	—	20%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MR WRIST W/O LT,Left Side	$1,703.20	$2,129.00	$187.53–$1,979.97	—	20%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MR ELBOW W/O LT,Left Side	$1,703.20	$2,129.00	$187.53–$1,979.97	—	20%
Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 CERVICAL SP COMPLETE, 4 OR 5 VIEWS	$445.60	$557.00	$50.15–$518.01	1% below	20%
Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 CERVICAL SP COMPLETE, 4 OR 5 VIEWS	$445.60	$557.00	$50.15–$518.01	—	20%
Neck soft tissue CT scan with contrast CPT 70491 CT NECK W/CONTRAST	$1,158.40	$1,448.00	$162.62–$1,346.64	2% below	20%
Neck soft tissue CT scan with contrast inpatient CPT 70491 CT NECK W/CONTRAST	$1,158.40	$1,448.00	$162.62–$1,346.64	—	20%
Neck soft tissue CT scan without contrast CPT 70490 CT NECK W/O CONTRAST	$880.00	$1,100.00	$96.93–$1,023.00	5% below	20%
Neck soft tissue CT scan without contrast inpatient CPT 70490 CT NECK W/O CONTRAST	$880.00	$1,100.00	$96.93–$1,023.00	—	20%
Neck soft tissue X-ray CPT 70360 NECK SOFT TISSUE	$280.80	$351.00	$28.37–$326.43	8% above	20%
Neck soft tissue X-ray inpatient CPT 70360 NECK SOFT TISSUE	$280.80	$351.00	$28.37–$326.43	—	20%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 NM CARDIAC STRESS (SPECT) W/ADENOSINE	$2,600.00	$3,250.00	$387.74–$3,022.50	35% below	20%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 NM CARDIAC STRESS (SPECT) W/LEXISCAN	$2,600.00	$3,250.00	$387.74–$3,022.50	35% below	20%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 NM CARDIAC STRESS (SPECT) W/TREADMILL	$2,600.00	$3,250.00	$387.74–$3,022.50	35% below	20%
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 NM CARDIAC STRESS (SPECT) W/LEXISCAN	$2,600.00	$3,250.00	$387.74–$3,022.50	—	20%
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 NM CARDIAC STRESS (SPECT) W/ADENOSINE	$2,600.00	$3,250.00	$387.74–$3,022.50	—	20%
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 NM CARDIAC STRESS (SPECT) W/TREADMILL	$2,600.00	$3,250.00	$387.74–$3,022.50	—	20%
Pelvic CT scan without contrast CPT 72192 CT PELVIS W/O CONTRAST	$958.40	$1,198.00	$96.93–$1,114.14	5% below	20%
Pelvic CT scan without contrast inpatient CPT 72192 CT PELVIS W/O CONTRAST	$958.40	$1,198.00	$96.93–$1,114.14	—	20%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US PELVIC (NON OB) LIMITED	$277.60	$347.00	$47.25–$322.71	36% below	20%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US PELVIC (NON OB) LIMITED	$277.60	$347.00	$47.25–$322.71	—	20%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US PELVIC	$600.00	$750.00	$96.20–$697.50	19% above	20%
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 US PELVIC	$600.00	$750.00	$96.20–$697.50	—	20%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US OB INITIAL >or= 14 WEEKS; 1st GESTAT	$352.80	$441.00	$96.93–$410.13	41% below	20%
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US OB INITIAL >or= 14 WEEKS; 1st GESTAT	$352.80	$441.00	$96.93–$410.13	—	20%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 US OB INITIAL< 14 WEEKS; 1st GESTATION	$291.20	$364.00	$96.93–$338.52	47% below	20%
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 US OB INITIAL< 14 WEEKS; 1st GESTATION	$291.20	$364.00	$96.93–$338.52	—	20%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US OB LIMITED(CERV LENGTH,AFI OR POSITIO	$240.80	$301.00	$74.87–$279.93	50% below	20%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US LIMITED 1 OR MORE FETUSES	$240.80	$301.00	$74.87–$279.93	50% below	20%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 BI PARIETAL DIAMETER	$240.80	$301.00	$74.87–$279.93	50% below	20%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 US OB LIMITED(CERV LENGTH,AFI OR POSITIO	$240.80	$301.00	$74.87–$279.93	—	20%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 BI PARIETAL DIAMETER	$240.80	$301.00	$74.87–$279.93	—	20%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 US LIMITED 1 OR MORE FETUSES	$240.80	$301.00	$74.87–$279.93	—	20%
Rib X-ray, one side, 2 views one side CPT 71100 RIBS UNILATERAL LT,Left Side	$177.60	$222.00	$32.94–$206.46	42% below	20%
Rib X-ray, one side, 2 views one side CPT 71100 RIBS UNILATERAL RT,Right Side	$177.60	$222.00	$32.94–$206.46	42% below	20%
Rib X-ray, one side, 2 views one side CPT 71100 RIBS UNILATERAL RT	$177.60	$222.00	$32.94–$206.46	42% below	20%
Rib X-ray, one side, 2 views one side CPT 71100 RIBS UNILATERAL LT	$177.60	$222.00	$32.94–$206.46	42% below	20%
Rib X-ray, one side, 2 views inpatient one side CPT 71100 RIBS UNILATERAL LT,Left Side	$177.60	$222.00	$32.94–$206.46	—	20%
Rib X-ray, one side, 2 views inpatient one side CPT 71100 RIBS UNILATERAL LT	$177.60	$222.00	$32.94–$206.46	—	20%
Rib X-ray, one side, 2 views inpatient one side CPT 71100 RIBS UNILATERAL RT	$177.60	$222.00	$32.94–$206.46	—	20%
Rib X-ray, one side, 2 views inpatient one side CPT 71100 RIBS UNILATERAL RT,Right Side	$177.60	$222.00	$32.94–$206.46	—	20%
Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 RIBS RT UNILAT W/CHEST EXPIRATION,Right Side	$320.00	$400.00	$38.19–$372.00	16% below	20%
Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 RIBS LT UNILAT W/CHEST EXPIRATION	$320.00	$400.00	$38.19–$372.00	16% below	20%
Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 RIBS LT UNILAT W/CHEST EXPIRATION,Left Side	$320.00	$400.00	$38.19–$372.00	16% below	20%
Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 RIBS RT UNILAT W/CHEST EXPIRATION	$320.00	$400.00	$38.19–$372.00	16% below	20%
Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 RIBS LT UNILAT W/CHEST EXPIRATION,Left Side	$320.00	$400.00	$38.19–$372.00	—	20%
Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 RIBS LT UNILAT W/CHEST EXPIRATION	$320.00	$400.00	$38.19–$372.00	—	20%
Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 RIBS RT UNILAT W/CHEST EXPIRATION,Right Side	$320.00	$400.00	$38.19–$372.00	—	20%
Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 RIBS RT UNILAT W/CHEST EXPIRATION	$320.00	$400.00	$38.19–$372.00	—	20%
Screening mammogram, both breasts both sides CPT 77067 MAMM DIGITAL BILAT SCREEN SPECIAL	$223.20	$279.00	$81.61–$259.47	—	20%
Screening mammogram, both breasts both sides CPT 77067 MAMM DIGITAL BILAT SCREEN	$223.20	$279.00	$81.61–$259.47	—	20%
Screening mammogram, both breasts both sides CPT 77067 MAMMOGRAM HOFFNUNG BILAT SCREENING	$223.20	$279.00	$81.61–$259.47	—	20%
Screening mammogram, both breasts both sides CPT 77067 3D MAMM BILAT SCREEN BCCP	$223.20	$279.00	$81.61–$259.47	—	20%
Screening mammogram, both breasts both sides CPT 77067 3D MAMM BILAT SCREEN SPECIAL	$223.20	$279.00	$81.61–$259.47	—	20%
Screening mammogram, both breasts both sides CPT 77067 3D MAMM BILAT SCREEN	$223.20	$279.00	$81.61–$259.47	—	20%
Screening mammogram, both breasts both sides CPT 77067 MAMM DIGITAL BILAT SCREENING BCCP	$223.20	$279.00	$81.61–$259.47	—	20%
Screening mammogram, both breasts both sides CPT 77067 3D MAMM HOFFNUNG BILAT SCREENING	$223.20	$279.00	$81.61–$259.47	—	20%
Screening mammogram, both breasts inpatient both sides CPT 77067 MAMM DIGITAL BILAT SCREEN SPECIAL	$223.20	$279.00	$81.61–$259.47	—	20%
Screening mammogram, both breasts inpatient both sides CPT 77067 MAMMOGRAM HOFFNUNG BILAT SCREENING	$223.20	$279.00	$81.61–$259.47	—	20%
Screening mammogram, both breasts inpatient both sides CPT 77067 3D MAMM BILAT SCREEN BCCP	$223.20	$279.00	$81.61–$259.47	—	20%
Screening mammogram, both breasts inpatient both sides CPT 77067 3D MAMM BILAT SCREEN SPECIAL	$223.20	$279.00	$81.61–$259.47	—	20%
Screening mammogram, both breasts inpatient both sides CPT 77067 3D MAMM HOFFNUNG BILAT SCREENING	$223.20	$279.00	$81.61–$259.47	—	20%
Screening mammogram, both breasts inpatient both sides CPT 77067 MAMM DIGITAL BILAT SCREENING BCCP	$223.20	$279.00	$81.61–$259.47	—	20%
Screening mammogram, both breasts inpatient both sides CPT 77067 3D MAMM BILAT SCREEN	$223.20	$279.00	$81.61–$259.47	—	20%
Screening mammogram, both breasts inpatient both sides CPT 77067 MAMM DIGITAL BILAT SCREEN	$223.20	$279.00	$81.61–$259.47	—	20%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 SHOULDER COMPLETE RT,Right Side	$284.00	$355.00	$32.56–$330.15	16% below	20%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 SHOULDER COMPLETE LT,Left Side	$284.00	$355.00	$32.56–$330.15	16% below	20%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 SHOULDER COMPLETE LT	$284.00	$355.00	$32.56–$330.15	16% below	20%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 SHOULDER COMPLETE RT	$284.00	$355.00	$32.56–$330.15	16% below	20%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 SHOULDER COMPLETE RT	$284.00	$355.00	$32.56–$330.15	—	20%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 SHOULDER COMPLETE LT	$284.00	$355.00	$32.56–$330.15	—	20%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 SHOULDER COMPLETE LT,Left Side	$284.00	$355.00	$32.56–$330.15	—	20%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 SHOULDER COMPLETE RT,Right Side	$284.00	$355.00	$32.56–$330.15	—	20%
Sinus X-ray, complete, 3 or more views CPT 70220 SINUSES COMPLETE	$303.20	$379.00	$34.43–$352.47	16% below	20%
Sinus X-ray, complete, 3 or more views inpatient CPT 70220 SINUSES COMPLETE	$303.20	$379.00	$34.43–$352.47	—	20%
Skull X-ray, fewer than 4 views CPT 70250 SKULL AP/LAT	$264.00	$330.00	$32.56–$306.90	9% below	20%
Skull X-ray, fewer than 4 views inpatient CPT 70250 SKULL AP/LAT	$264.00	$330.00	$32.56–$306.90	—	20%
Sleep study in a lab (polysomnography) CPT 95810 SLEEP LAB PSG DIAGNOSTIC	$3,869.60	$4,837.00	$610.54–$4,498.41	8% above	20%
Sleep study in a lab (polysomnography) inpatient CPT 95810 SLEEP LAB PSG DIAGNOSTIC	$3,869.60	$4,837.00	$610.54–$4,498.41	—	20%
Swallow study (modified barium swallow, video X-ray) CPT 74230 MODIFIED BARIUM SWALLOW	$338.40	$423.00	$109.19–$393.39	33% below	20%
Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 MODIFIED BARIUM SWALLOW	$338.40	$423.00	$109.19–$393.39	—	20%
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 HIP PINNING RT WCARM,Right Side	$174.40	$218.00	$32.56–$202.74	36% below	20%
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 HIP PINNING RT WCARM	$174.40	$218.00	$32.56–$202.74	36% below	20%
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 FEMUR LT 2+ VIEWS	$174.40	$218.00	$32.56–$202.74	36% below	20%
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 FEMUR RT 2+ VIEWS,Right Side	$174.40	$218.00	$32.56–$202.74	36% below	20%
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 FEMUR LT 2+ VIEWS,Left Side	$174.40	$218.00	$32.56–$202.74	36% below	20%
Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 FEMUR LT 2+ VIEWS	$174.40	$218.00	$32.56–$202.74	—	20%
Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 HIP PINNING RT WCARM	$174.40	$218.00	$32.56–$202.74	—	20%
Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 FEMUR RT 2+ VIEWS,Right Side	$174.40	$218.00	$32.56–$202.74	—	20%
Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 FEMUR LT 2+ VIEWS,Left Side	$174.40	$218.00	$32.56–$202.74	—	20%
Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 HIP PINNING RT WCARM,Right Side	$174.40	$218.00	$32.56–$202.74	—	20%
Thoracic spine (mid back) CT scan without contrast CPT 72128 CT DORSAL W/O CONTRAST	$869.60	$1,087.00	$96.93–$1,010.91	4% below	20%
Thoracic spine (mid back) CT scan without contrast inpatient CPT 72128 CT DORSAL W/O CONTRAST	$869.60	$1,087.00	$96.93–$1,010.91	—	20%
Toe X-ray, 2 or more views one side CPT 73660 TOES RT,Right Side	$231.20	$289.00	$26.14–$268.77	7% below	20%
Toe X-ray, 2 or more views one side CPT 73660 TOES LT,Left Side	$231.20	$289.00	$26.14–$268.77	7% below	20%
Toe X-ray, 2 or more views one side CPT 73660 TOES LT	$231.20	$289.00	$26.14–$268.77	7% below	20%
Toe X-ray, 2 or more views inpatient one side CPT 73660 TOES RT,Right Side	$231.20	$289.00	$26.14–$268.77	—	20%
Toe X-ray, 2 or more views inpatient one side CPT 73660 TOES LT,Left Side	$231.20	$289.00	$26.14–$268.77	—	20%
Toe X-ray, 2 or more views inpatient one side CPT 73660 TOES LT	$231.20	$289.00	$26.14–$268.77	—	20%
Transvaginal pelvic ultrasound CPT 76830 US PELVIC ENDO VAGINAL	$468.00	$585.00	$96.93–$544.05	17% below	20%
Transvaginal pelvic ultrasound inpatient CPT 76830 US PELVIC ENDO VAGINAL	$468.00	$585.00	$96.93–$544.05	—	20%
Transvaginal ultrasound during pregnancy CPT 76817 US OB ENDO VAGINAL	$242.40	$303.00	$85.32–$281.79	52% below	20%
Transvaginal ultrasound during pregnancy inpatient CPT 76817 US OB ENDO VAGINAL	$242.40	$303.00	$85.32–$281.79	—	20%
Ultrasound of the abdomen, complete CPT 76700 US ABD COMPLETE	$640.00	$800.00	$96.93–$744.00	2% above	20%
Ultrasound of the abdomen, complete inpatient CPT 76700 US ABD COMPLETE	$640.00	$800.00	$96.93–$744.00	—	20%
Ultrasound of the scrotum and testicles CPT 76870 US SCROTAL	$500.00	$625.00	$90.08–$581.25	7% below	20%
Ultrasound of the scrotum and testicles inpatient CPT 76870 US SCROTAL	$500.00	$625.00	$90.08–$581.25	—	20%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US SOFT TISSUE NECK/HEAD	$565.60	$707.00	$96.93–$657.51	1% below	20%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US THYROID	$565.60	$707.00	$96.93–$657.51	1% below	20%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US SOFT TISSUE NECK/HEAD	$565.60	$707.00	$96.93–$657.51	—	20%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US THYROID	$565.60	$707.00	$96.93–$657.51	—	20%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 UGI	$356.80	$446.00	$111.46–$414.78	40% below	20%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 UGI	$356.80	$446.00	$111.46–$414.78	—	20%
Upper arm X-ray (humerus), 2 views one side CPT 73060 HUMERUS LT	$253.60	$317.00	$29.20–$294.81	8% below	20%
Upper arm X-ray (humerus), 2 views one side CPT 73060 HUMERUS LT,Left Side	$253.60	$317.00	$29.20–$294.81	8% below	20%
Upper arm X-ray (humerus), 2 views one side CPT 73060 HUMERUS RT	$253.60	$317.00	$29.20–$294.81	8% below	20%
Upper arm X-ray (humerus), 2 views one side CPT 73060 HUMERUS RT,Right Side	$253.60	$317.00	$29.20–$294.81	8% below	20%
Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 HUMERUS RT	$253.60	$317.00	$29.20–$294.81	—	20%
Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 HUMERUS LT,Left Side	$253.60	$317.00	$29.20–$294.81	—	20%
Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 HUMERUS LT	$253.60	$317.00	$29.20–$294.81	—	20%
Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 HUMERUS RT,Right Side	$253.60	$317.00	$29.20–$294.81	—	20%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 CV VENOUS DOPPLER REFLUX RT	$480.00	$600.00	$96.93–$558.00	35% below	20%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 CV VENOUS LEG LT	$480.00	$600.00	$96.93–$558.00	35% below	20%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 CV VENOUS DOPPLER REFLUX LT	$480.00	$600.00	$96.93–$558.00	35% below	20%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 CV VENOUS ARM RT	$480.00	$600.00	$96.93–$558.00	35% below	20%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 CV VENOUS LEG RT	$480.00	$600.00	$96.93–$558.00	35% below	20%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 CV VENOUS ARM LT	$480.00	$600.00	$96.93–$558.00	35% below	20%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 CV VENOUS LEG LT	$480.00	$600.00	$96.93–$558.00	—	20%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 CV VENOUS ARM LT	$480.00	$600.00	$96.93–$558.00	—	20%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 CV VENOUS ARM RT	$480.00	$600.00	$96.93–$558.00	—	20%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 CV VENOUS DOPPLER REFLUX RT	$480.00	$600.00	$96.93–$558.00	—	20%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 CV VENOUS LEG RT	$480.00	$600.00	$96.93–$558.00	—	20%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 CV VENOUS DOPPLER REFLUX LT	$480.00	$600.00	$96.93–$558.00	—	20%
Wrist X-ray, 2 views one side CPT 73100 WRIST 2 VIEW RT	$174.40	$218.00	$31.30–$202.74	33% below	20%
Wrist X-ray, 2 views one side CPT 73100 WRIST 2 VIEW RT,Right Side	$174.40	$218.00	$31.30–$202.74	33% below	20%
Wrist X-ray, 2 views one side CPT 73100 NAVICULAR VIEWS LT,Left Side	$174.40	$218.00	$31.30–$202.74	33% below	20%
Wrist X-ray, 2 views one side CPT 73100 NAVICULAR VIEWS RT	$174.40	$218.00	$31.30–$202.74	33% below	20%
Wrist X-ray, 2 views one side CPT 73100 NAVICULAR VIEWS RT,Right Side	$174.40	$218.00	$31.30–$202.74	33% below	20%
Wrist X-ray, 2 views one side CPT 73100 WRIST 2 VIEW LT	$174.40	$218.00	$31.30–$202.74	33% below	20%
Wrist X-ray, 2 views one side CPT 73100 WRIST 2 VIEW LT,Left Side	$174.40	$218.00	$31.30–$202.74	33% below	20%
Wrist X-ray, 2 views one side CPT 73100 NAVICULAR VIEWS LT	$174.40	$218.00	$31.30–$202.74	33% below	20%
Wrist X-ray, 2 views inpatient one side CPT 73100 NAVICULAR VIEWS RT	$174.40	$218.00	$31.30–$202.74	—	20%
Wrist X-ray, 2 views inpatient one side CPT 73100 NAVICULAR VIEWS LT,Left Side	$174.40	$218.00	$31.30–$202.74	—	20%
Wrist X-ray, 2 views inpatient one side CPT 73100 WRIST 2 VIEW RT	$174.40	$218.00	$31.30–$202.74	—	20%
Wrist X-ray, 2 views inpatient one side CPT 73100 NAVICULAR VIEWS RT,Right Side	$174.40	$218.00	$31.30–$202.74	—	20%
Wrist X-ray, 2 views inpatient one side CPT 73100 WRIST 2 VIEW LT,Left Side	$174.40	$218.00	$31.30–$202.74	—	20%
Wrist X-ray, 2 views inpatient one side CPT 73100 WRIST 2 VIEW LT	$174.40	$218.00	$31.30–$202.74	—	20%
Wrist X-ray, 2 views inpatient one side CPT 73100 NAVICULAR VIEWS LT	$174.40	$218.00	$31.30–$202.74	—	20%
Wrist X-ray, 2 views inpatient one side CPT 73100 WRIST 2 VIEW RT,Right Side	$174.40	$218.00	$31.30–$202.74	—	20%
Wrist X-ray, complete, 3 or more views one side CPT 73110 WRIST COMPLETE LT	$280.80	$351.00	$38.80–$326.43	16% below	20%
Wrist X-ray, complete, 3 or more views one side CPT 73110 WRIST COMPLETE LT,Left Side	$280.80	$351.00	$38.80–$326.43	16% below	20%
Wrist X-ray, complete, 3 or more views one side CPT 73110 WRIST COMPLETE RT,Right Side	$280.80	$351.00	$38.80–$326.43	16% below	20%
Wrist X-ray, complete, 3 or more views one side CPT 73110 WRIST COMPLETE RT	$280.80	$351.00	$38.80–$326.43	16% below	20%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 WRIST COMPLETE RT,Right Side	$280.80	$351.00	$38.80–$326.43	—	20%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 WRIST COMPLETE LT	$280.80	$351.00	$38.80–$326.43	—	20%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 WRIST COMPLETE LT,Left Side	$280.80	$351.00	$38.80–$326.43	—	20%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 WRIST COMPLETE RT	$280.80	$351.00	$38.80–$326.43	—	20%
X-ray of one hip, 2 or 3 views, with the pelvis when included CPT 73502 PELVIS FROGLEGS CHILD W/PELVIS 2+ VIEWS	$200.00	$250.00	$44.30–$232.50	35% below	20%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 HIP COMPLETE LT MIN 2 VIEWS W/PELVIS,Left Side	$200.00	$250.00	$44.30–$232.50	35% below	20%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 HIP COMPLETE RT MIN 2 VIEWS W/PELVIS,Right Side	$200.00	$250.00	$44.30–$232.50	35% below	20%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient CPT 73502 PELVIS FROGLEGS CHILD W/PELVIS 2+ VIEWS	$200.00	$250.00	$44.30–$232.50	—	20%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 HIP COMPLETE RT MIN 2 VIEWS W/PELVIS,Right Side	$200.00	$250.00	$44.30–$232.50	—	20%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 HIP COMPLETE LT MIN 2 VIEWS W/PELVIS,Left Side	$200.00	$250.00	$44.30–$232.50	—	20%
X-ray of the abdomen, 1 view CPT 74018 ABDOMEN 1 VIEW	$214.40	$268.00	$27.18–$249.24	16% below	20%
X-ray of the abdomen, 1 view inpatient CPT 74018 ABDOMEN 1 VIEW	$214.40	$268.00	$27.18–$249.24	—	20%
X-ray of the ankle, 2 views one side CPT 73600 ANKLE 2 VIEW LT	$176.00	$220.00	$29.51–$204.60	29% below	20%
X-ray of the ankle, 2 views one side CPT 73600 ANKLE 2 VIEW LT,Left Side	$176.00	$220.00	$29.51–$204.60	29% below	20%
X-ray of the ankle, 2 views one side CPT 73600 ANKLE 2 VIEW RT	$176.00	$220.00	$29.51–$204.60	29% below	20%
X-ray of the ankle, 2 views one side CPT 73600 ANKLE 2 VIEW RT,Right Side	$176.00	$220.00	$29.51–$204.60	29% below	20%
X-ray of the ankle, 2 views inpatient one side CPT 73600 ANKLE 2 VIEW LT,Left Side	$176.00	$220.00	$29.51–$204.60	—	20%
X-ray of the ankle, 2 views inpatient one side CPT 73600 ANKLE 2 VIEW LT	$176.00	$220.00	$29.51–$204.60	—	20%
X-ray of the ankle, 2 views inpatient one side CPT 73600 ANKLE 2 VIEW RT,Right Side	$176.00	$220.00	$29.51–$204.60	—	20%
X-ray of the ankle, 2 views inpatient one side CPT 73600 ANKLE 2 VIEW RT	$176.00	$220.00	$29.51–$204.60	—	20%
X-ray of the finger(s), 2 or more views one side CPT 73140 FINGERS RT,Right Side	$229.60	$287.00	$35.70–$266.91	11% below	20%
X-ray of the finger(s), 2 or more views one side CPT 73140 FINGERS LT	$229.60	$287.00	$35.70–$266.91	11% below	20%
X-ray of the finger(s), 2 or more views one side CPT 73140 FINGERS RT	$229.60	$287.00	$35.70–$266.91	11% below	20%
X-ray of the finger(s), 2 or more views one side CPT 73140 FINGERS LT,Left Side	$229.60	$287.00	$35.70–$266.91	11% below	20%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 FINGERS LT,Left Side	$229.60	$287.00	$35.70–$266.91	—	20%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 FINGERS RT,Right Side	$229.60	$287.00	$35.70–$266.91	—	20%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 FINGERS LT	$229.60	$287.00	$35.70–$266.91	—	20%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 FINGERS RT	$229.60	$287.00	$35.70–$266.91	—	20%
X-ray of the foot, 2 views one side CPT 73620 FOOT 2 VIEW LT	$164.80	$206.00	$26.22–$191.58	29% below	20%
X-ray of the foot, 2 views one side CPT 73620 FOOT 2 VIEW LT,Left Side	$164.80	$206.00	$26.22–$191.58	29% below	20%
X-ray of the foot, 2 views one side CPT 73620 FOOT 2 VIEW RT,Right Side	$164.80	$206.00	$26.22–$191.58	29% below	20%
X-ray of the foot, 2 views one side CPT 73620 FOOT 2 VIEW RT	$164.80	$206.00	$26.22–$191.58	29% below	20%
X-ray of the foot, 2 views inpatient one side CPT 73620 FOOT 2 VIEW LT	$164.80	$206.00	$26.22–$191.58	—	20%
X-ray of the foot, 2 views inpatient one side CPT 73620 FOOT 2 VIEW LT,Left Side	$164.80	$206.00	$26.22–$191.58	—	20%
X-ray of the foot, 2 views inpatient one side CPT 73620 FOOT 2 VIEW RT,Right Side	$164.80	$206.00	$26.22–$191.58	—	20%
X-ray of the foot, 2 views inpatient one side CPT 73620 FOOT 2 VIEW RT	$164.80	$206.00	$26.22–$191.58	—	20%
X-ray of the foot, complete, 3 or more views one side CPT 73630 FOOT COMPLETE RT,Right Side	$292.00	$365.00	$31.03–$339.45	5% below	20%
X-ray of the foot, complete, 3 or more views one side CPT 73630 FOOT COMPLETE LT,Left Side	$292.00	$365.00	$31.03–$339.45	5% below	20%
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 FOOT COMPLETE RT,Right Side	$292.00	$365.00	$31.03–$339.45	—	20%
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 FOOT COMPLETE LT,Left Side	$292.00	$365.00	$31.03–$339.45	—	20%
X-ray of the hand, 3 or more views one side CPT 73130 HAND RT MIN 3 VIEWS	$284.80	$356.00	$34.61–$331.08	13% below	20%
X-ray of the hand, 3 or more views one side CPT 73130 HAND LT MIN 3 VIEWS	$284.80	$356.00	$34.61–$331.08	13% below	20%
X-ray of the hand, 3 or more views one side CPT 73130 HAND LT MIN 3 VIEWS,Left Side	$284.80	$356.00	$34.61–$331.08	13% below	20%
X-ray of the hand, 3 or more views one side CPT 73130 HAND RT MIN 3 VIEWS,Right Side	$284.80	$356.00	$34.61–$331.08	13% below	20%
X-ray of the hand, 3 or more views inpatient one side CPT 73130 HAND LT MIN 3 VIEWS,Left Side	$284.80	$356.00	$34.61–$331.08	—	20%
X-ray of the hand, 3 or more views inpatient one side CPT 73130 HAND RT MIN 3 VIEWS	$284.80	$356.00	$34.61–$331.08	—	20%
X-ray of the hand, 3 or more views inpatient one side CPT 73130 HAND LT MIN 3 VIEWS	$284.80	$356.00	$34.61–$331.08	—	20%
X-ray of the hand, 3 or more views inpatient one side CPT 73130 HAND RT MIN 3 VIEWS,Right Side	$284.80	$356.00	$34.61–$331.08	—	20%
X-ray of the knee, 1 or 2 views one side CPT 73560 KNEE 2 VIEWS RT	$199.20	$249.00	$31.30–$231.57	27% below	20%
X-ray of the knee, 1 or 2 views one side CPT 73560 KNEE 2 VIEWS LT	$199.20	$249.00	$31.30–$231.57	27% below	20%
X-ray of the knee, 1 or 2 views one side CPT 73560 KNEE 2 VIEWS RT,Right Side	$199.20	$249.00	$31.30–$231.57	27% below	20%
X-ray of the knee, 1 or 2 views one side CPT 73560 KNEE 2 VIEWS LT,Left Side	$199.20	$249.00	$31.30–$231.57	27% below	20%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 KNEE 2 VIEWS LT	$199.20	$249.00	$31.30–$231.57	—	20%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 KNEE 2 VIEWS RT	$199.20	$249.00	$31.30–$231.57	—	20%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 KNEE 2 VIEWS RT,Right Side	$199.20	$249.00	$31.30–$231.57	—	20%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 KNEE 2 VIEWS LT,Left Side	$199.20	$249.00	$31.30–$231.57	—	20%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 LUMBO SACRAL AP LAT	$284.80	$356.00	$36.82–$331.08	12% below	20%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 LUMBO SACRAL AP LAT	$284.80	$356.00	$36.82–$331.08	—	20%
X-ray of the lower back, 4 or more views CPT 72110 LUMBO SACRAL COMPLETE MIN 4 VIEWS	$420.80	$526.00	$48.62–$489.18	10% below	20%
X-ray of the lower back, 4 or more views inpatient CPT 72110 LUMBO SACRAL COMPLETE MIN 4 VIEWS	$420.80	$526.00	$48.62–$489.18	—	20%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 DORSAL SPINE 2 VIEWS	$222.40	$278.00	$30.21–$258.54	26% below	20%
X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 DORSAL SPINE 2 VIEWS	$222.40	$278.00	$30.21–$258.54	—	20%
X-ray of the nasal bones, 3 or more views CPT 70160 NASAL BONES MIN 3 V	$284.80	$356.00	$34.02–$331.08	3% below	20%
X-ray of the nasal bones, 3 or more views inpatient CPT 70160 NASAL BONES MIN 3 V	$284.80	$356.00	$34.02–$331.08	—	20%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 CERVICAL SP AP LAT, 3 VIEWS OR LESS	$312.00	$390.00	$36.22–$362.70	7% below	20%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 CERVICAL SP AP LAT, 3 VIEWS OR LESS	$312.00	$390.00	$36.22–$362.70	—	20%
X-ray of the pelvis, 1 or 2 views CPT 72170 PELVIS 1 or 2 VIEWS	$196.00	$245.00	$25.65–$227.85	22% below	20%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 PELVIS 1 or 2 VIEWS	$196.00	$245.00	$25.65–$227.85	—	20%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 SACRUM AND COCCYX	$284.80	$356.00	$29.23–$331.08	4% below	20%
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 SACRUM AND COCCYX	$284.80	$356.00	$29.23–$331.08	—	20%

Lab tests

Procedure	Cash price	List price	Insurers pay	vs Ohio	Off list
ACTH blood test CPT 82024 ACTH [CCL]	$80.00	$100.00	$37.85–$93.00	39% below	20%
ACTH blood test inpatient CPT 82024 ACTH [CCL]	$80.00	$100.00	$37.85–$93.00	—	20%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 SGPT (ALT)	$35.20	$44.00	$5.19–$40.92	26% above	20%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 SGPT (ALT)	$35.20	$44.00	$5.19–$40.92	—	20%
AST (aspartate aminotransferase) enzyme test CPT 84450 SGOT (AST)	$35.20	$44.00	$5.08–$40.92	40% above	20%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 SGOT (AST)	$35.20	$44.00	$5.08–$40.92	—	20%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 HEPATITIS ACUTE PANEL [CCL]	$76.00	$95.00	$46.68–$88.35	65% below	20%
Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 HEPATITIS ACUTE PANEL [CCL]	$76.00	$95.00	$46.68–$88.35	—	20%
Albumin blood test CPT 82040 ALBUMIN PLASMA	$28.00	$35.00	$4.85–$32.55	27% above	20%
Albumin blood test inpatient CPT 82040 ALBUMIN PLASMA	$28.00	$35.00	$4.85–$32.55	—	20%
Aldosterone blood test CPT 82088 ALDOSTERONE [CCL]	$88.00	$110.00	$39.94–$102.30	37% below	20%
Aldosterone blood test CPT 82088 ALDOSTERONE, 24 HR URINE [CCL]	$88.00	$110.00	$39.94–$102.30	37% below	20%
Aldosterone blood test inpatient CPT 82088 ALDOSTERONE [CCL]	$88.00	$110.00	$39.94–$102.30	—	20%
Aldosterone blood test inpatient CPT 82088 ALDOSTERONE, 24 HR URINE [CCL]	$88.00	$110.00	$39.94–$102.30	—	20%
Alkaline phosphatase (ALP) blood test CPT 84075 ALK PHOS	$33.60	$42.00	$5.08–$39.06	40% above	20%
Alkaline phosphatase (ALP) blood test CPT 84075 ALKALINE PHOSPHATASE	$33.60	$42.00	$5.08–$39.06	40% above	20%
Alkaline phosphatase (ALP) blood test inpatient CPT 84075 ALK PHOS	$33.60	$42.00	$5.08–$39.06	—	20%
Alkaline phosphatase (ALP) blood test inpatient CPT 84075 ALKALINE PHOSPHATASE	$33.60	$42.00	$5.08–$39.06	—	20%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERG, RESP DISEASE PROFILE REG 5 [CCL]	$20.80	$26.00	$5.12–$24.18	11% below	20%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN TEA, IgE [CCL]	$21.60	$27.00	$5.12–$25.11	8% below	20%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, INDOOR ALLERGY PANEL [CCL]	$21.60	$27.00	$5.12–$25.11	8% below	20%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, EGG YOLK IGE [CCL]	$21.60	$27.00	$5.12–$25.11	8% below	20%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, RABBIT EPITHELIUM IgE [CCL]	$21.60	$27.00	$5.12–$25.11	8% below	20%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, LINSEED IgE [CCL]	$21.60	$27.00	$5.12–$25.11	8% below	20%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, SHEEP EPITHELIUM, IgE [CCL]	$21.60	$27.00	$5.12–$25.11	8% below	20%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, CLADOSPORIUM HERBARU IgE [CCL]	$21.60	$27.00	$5.12–$25.11	8% below	20%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, CATFISH IgE [CCL]	$21.60	$27.00	$5.12–$25.11	8% below	20%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, ELM TREE IgE [CCL]	$21.60	$27.00	$5.12–$25.11	8% below	20%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, SALMON IgE [CCL]	$21.60	$27.00	$5.12–$25.11	8% below	20%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, CORN IgE [CCL]	$21.60	$27.00	$5.12–$25.11	8% below	20%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, PIGWEED IgE [CCL]	$21.60	$27.00	$5.12–$25.11	8% below	20%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, SHRIMP IgE [CCL]	$21.60	$27.00	$5.12–$25.11	8% below	20%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, CLAM IgE [CCL]	$21.60	$27.00	$5.12–$25.11	8% below	20%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, SOYBEAN IgE [CCL]	$21.60	$27.00	$5.12–$25.11	8% below	20%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, STEMPHYLIUM [CCL]	$21.60	$27.00	$5.12–$25.11	8% below	20%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, POPPY SEED, IgE [CCL]	$21.60	$27.00	$5.12–$25.11	8% below	20%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN GINGER, IgE [CCL]	$21.60	$27.00	$5.12–$25.11	8% below	20%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, BRAZIL NUT IgE [CCL]	$21.60	$27.00	$5.12–$25.11	8% below	20%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLG SPEC IGE CRUDE XTRC EA	$21.60	$27.00	$5.12–$25.11	8% below	20%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, MOLD GROUP [CCL]	$21.60	$27.00	$5.12–$25.11	8% below	20%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, GOLDENROD IgE [CCL]	$21.60	$27.00	$5.12–$25.11	8% below	20%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN NUTMEG, IgE [CCL]	$21.60	$27.00	$5.12–$25.11	8% below	20%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN CAULIFLOWER, IgE [CCL]	$21.60	$27.00	$5.12–$25.11	8% below	20%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERG FUNGI AND MOLDS,PHOM BE IgE [CCL]	$21.60	$27.00	$5.12–$25.11	8% below	20%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN OCCUP, COTTON SEED, IgE [CCL]	$21.60	$27.00	$5.12–$25.11	8% below	20%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN PEPPER C. ANNUUM, IgE [CCL]	$21.60	$27.00	$5.12–$25.11	8% below	20%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, RUSSIAN THISTLE IgE [CCL]	$21.60	$27.00	$5.12–$25.11	8% below	20%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, ALTERNARIA TENUIS IgE [CCL}	$21.60	$27.00	$5.12–$25.11	8% below	20%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, TREE GROUP CURRENTLY [CCL]	$21.60	$27.00	$5.12–$25.11	8% below	20%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN THYME, IgE [CCL]	$21.60	$27.00	$5.12–$25.11	8% below	20%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, BARLEY IgE [CCL]	$21.60	$27.00	$5.12–$25.11	8% below	20%
Allergy blood test, specific IgE, per allergen CPT 86003 HELMINTHOSPORIUM HALODES IgE [CCL]	$21.60	$27.00	$5.12–$25.11	8% below	20%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERG WEED,SAGEBRUSH/WORMWOOD IgE [CCL]	$21.60	$27.00	$5.12–$25.11	8% below	20%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN BLACKBERRY, IgE [CCL]	$21.60	$27.00	$5.12–$25.11	8% below	20%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, BIRCH TREE IgE [CCL]	$21.60	$27.00	$5.12–$25.11	8% below	20%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, WEED GROUP CURRENTLY [CCL]	$21.60	$27.00	$5.12–$25.11	8% below	20%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN PUMPKIN, IgE [CCL]	$21.60	$27.00	$5.12–$25.11	8% below	20%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, BERMUDA GRASS IgE [CCL]	$21.60	$27.00	$5.12–$25.11	8% below	20%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEY TEST MISC [CCL]	$21.60	$27.00	$5.12–$25.11	8% below	20%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, MUCOR RACEMOSUS IgE [CCL}	$21.60	$27.00	$5.12–$25.11	8% below	20%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, WHITE HICKORY IgE [CCL]	$21.60	$27.00	$5.12–$25.11	8% below	20%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, PHOMA BETAE IgE [CCL]	$21.60	$27.00	$5.12–$25.11	8% below	20%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, PINEAPPLE, IgE [CCL]	$21.60	$27.00	$5.12–$25.11	8% below	20%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, CODFISH IgE [CCL]	$21.60	$27.00	$5.12–$25.11	8% below	20%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, BANANA, IgE [CCL]	$21.60	$27.00	$5.12–$25.11	8% below	20%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, BOX ELDER (MAPLE) TR IgE [CCL}	$21.60	$27.00	$5.12–$25.11	8% below	20%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN SUNFLOWER SEED IgE [CCL]	$21.60	$27.00	$5.12–$25.11	8% below	20%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, COW MILK IgE [CCL]	$21.60	$27.00	$5.12–$25.11	8% below	20%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, TIMOTHY GRASS IgE [CCL]	$21.60	$27.00	$5.12–$25.11	8% below	20%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLER, JUNE GRASS (KY BLUE, MEA)IgE [CCL	$21.60	$27.00	$5.12–$25.11	8% below	20%
Allergy blood test, specific IgE, per allergen CPT 86003 MUSHROOM IgE	$21.60	$27.00	$5.12–$25.11	8% below	20%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN FOOD, EGGPLANT [CCL]	$21.60	$27.00	$5.12–$25.11	8% below	20%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, DANDELION IgE [CCL]	$21.60	$27.00	$5.12–$25.11	8% below	20%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, WHITE PINE TREE IgE [CCL]	$21.60	$27.00	$5.12–$25.11	8% below	20%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, COCONUT IgE [CCL]	$21.60	$27.00	$5.12–$25.11	8% below	20%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, CANDIDA ALBICANS IgE [CCL]	$21.60	$27.00	$5.12–$25.11	8% below	20%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, FOOD, ASPARAGUS IgE [CCL]	$21.60	$27.00	$5.12–$25.11	8% below	20%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, JOHNSON GRASS IgE [CCL	$21.60	$27.00	$5.12–$25.11	8% below	20%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, SCALLOP IgE [CCL]	$21.60	$27.00	$5.12–$25.11	8% below	20%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, SHEEP SORREL IgE [CCL]	$21.60	$27.00	$5.12–$25.11	8% below	20%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, WHEAT IgE [CCL]	$21.60	$27.00	$5.12–$25.11	8% below	20%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, EGG WHITE IgE [CCL]	$21.60	$27.00	$5.12–$25.11	8% below	20%
Allergy blood test, specific IgE, per allergen CPT 86003 RESP. ALLERGY PROFILE,REGION V	$21.60	$27.00	$5.12–$25.11	8% below	20%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, PEANUT IgE [CCL]	$21.60	$27.00	$5.12–$25.11	8% below	20%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, ROUGH MARSHELDER IgE [CCL]	$21.60	$27.00	$5.12–$25.11	8% below	20%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, POTATO IgE [CCL]	$21.60	$27.00	$5.12–$25.11	8% below	20%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, HORSE DANDER IgE [CCL]	$21.60	$27.00	$5.12–$25.11	8% below	20%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, MINI SCREEN [CCL]	$21.60	$27.00	$5.12–$25.11	8% below	20%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, CASHEW NUT IgE [CCL]	$21.60	$27.00	$5.12–$25.11	8% below	20%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, ASPERGILLUS FUMIGATU IgE [CCL]	$21.60	$27.00	$5.12–$25.11	8% below	20%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLER, LAMB'S QTR (GOOSEFOOT) IgE [CCL]	$21.60	$27.00	$5.12–$25.11	8% below	20%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, WALNUT IgE [CCL]	$21.60	$27.00	$5.12–$25.11	8% below	20%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, LOBSTER IgE [CCL]	$21.60	$27.00	$5.12–$25.11	8% below	20%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN OREGANO, IgE [CCL]	$21.60	$27.00	$5.12–$25.11	8% below	20%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, GLUTEN IgE [CCL]	$21.60	$27.00	$5.12–$25.11	8% below	20%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN HOPS, IgE [CCL]	$21.60	$27.00	$5.12–$25.11	8% below	20%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN MEASUREMENT OF AB TO IgE [CCL]	$21.60	$27.00	$5.12–$25.11	8% below	20%
Allergy blood test, specific IgE, per allergen CPT 86003 PEDIATRIC ALLERGY PANEL	$21.60	$27.00	$5.12–$25.11	8% below	20%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, PISTACHIO IgE [CCL]	$21.60	$27.00	$5.12–$25.11	8% below	20%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, SYCAMORE TREE IgE [CCL]	$21.60	$27.00	$5.12–$25.11	8% below	20%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN CLOVE, IgE [CCL]	$21.60	$27.00	$5.12–$25.11	8% below	20%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, MEADOW FESCUE IgE [CCL]	$21.60	$27.00	$5.12–$25.11	8% below	20%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLER, PENICILLIUM CHRYSOGENUM IgE [CCL]	$21.60	$27.00	$5.12–$25.11	8% below	20%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLER, SHORT (COMMON) RAGWEED IgE [CCL]	$21.60	$27.00	$5.12–$25.11	8% below	20%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN FOOD CORIAN/CILANTRO, IgE [CCL]	$21.60	$27.00	$5.12–$25.11	8% below	20%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERG, PEANUT IgE W/REFLEX TO COMP [CCL	$85.60	$107.00	$5.12–$99.51	266% above	20%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, FLORIDA PERENNIAL [CCL]	$128.80	$161.00	$5.12–$149.73	450% above	20%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERG, INHALANT/FOOD/ENVIRO PROF [CCL]	$132.80	$166.00	$5.12–$154.38	468% above	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERG, RESP DISEASE PROFILE REG 5 [CCL]	$20.80	$26.00	$5.12–$24.18	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, SCALLOP IgE [CCL]	$21.60	$27.00	$5.12–$25.11	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, FOOD, ASPARAGUS IgE [CCL]	$21.60	$27.00	$5.12–$25.11	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, CANDIDA ALBICANS IgE [CCL]	$21.60	$27.00	$5.12–$25.11	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, COCONUT IgE [CCL]	$21.60	$27.00	$5.12–$25.11	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, WHITE PINE TREE IgE [CCL]	$21.60	$27.00	$5.12–$25.11	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, DANDELION IgE [CCL]	$21.60	$27.00	$5.12–$25.11	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 MUSHROOM IgE	$21.60	$27.00	$5.12–$25.11	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLER, JUNE GRASS (KY BLUE, MEA)IgE [CCL	$21.60	$27.00	$5.12–$25.11	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, TIMOTHY GRASS IgE [CCL]	$21.60	$27.00	$5.12–$25.11	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, COW MILK IgE [CCL]	$21.60	$27.00	$5.12–$25.11	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN SUNFLOWER SEED IgE [CCL]	$21.60	$27.00	$5.12–$25.11	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, BOX ELDER (MAPLE) TR IgE [CCL}	$21.60	$27.00	$5.12–$25.11	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, BANANA, IgE [CCL]	$21.60	$27.00	$5.12–$25.11	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, CODFISH IgE [CCL]	$21.60	$27.00	$5.12–$25.11	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, PINEAPPLE, IgE [CCL]	$21.60	$27.00	$5.12–$25.11	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, PHOMA BETAE IgE [CCL]	$21.60	$27.00	$5.12–$25.11	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, WHITE HICKORY IgE [CCL]	$21.60	$27.00	$5.12–$25.11	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, MUCOR RACEMOSUS IgE [CCL}	$21.60	$27.00	$5.12–$25.11	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEY TEST MISC [CCL]	$21.60	$27.00	$5.12–$25.11	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, BERMUDA GRASS IgE [CCL]	$21.60	$27.00	$5.12–$25.11	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN PUMPKIN, IgE [CCL]	$21.60	$27.00	$5.12–$25.11	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, WEED GROUP CURRENTLY [CCL]	$21.60	$27.00	$5.12–$25.11	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, BIRCH TREE IgE [CCL]	$21.60	$27.00	$5.12–$25.11	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN FOOD, EGGPLANT [CCL]	$21.60	$27.00	$5.12–$25.11	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERG WEED,SAGEBRUSH/WORMWOOD IgE [CCL]	$21.60	$27.00	$5.12–$25.11	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HELMINTHOSPORIUM HALODES IgE [CCL]	$21.60	$27.00	$5.12–$25.11	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN BLACKBERRY, IgE [CCL]	$21.60	$27.00	$5.12–$25.11	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, BARLEY IgE [CCL]	$21.60	$27.00	$5.12–$25.11	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN THYME, IgE [CCL]	$21.60	$27.00	$5.12–$25.11	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, TREE GROUP CURRENTLY [CCL]	$21.60	$27.00	$5.12–$25.11	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, ALTERNARIA TENUIS IgE [CCL}	$21.60	$27.00	$5.12–$25.11	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, JOHNSON GRASS IgE [CCL	$21.60	$27.00	$5.12–$25.11	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, RUSSIAN THISTLE IgE [CCL]	$21.60	$27.00	$5.12–$25.11	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN PEPPER C. ANNUUM, IgE [CCL]	$21.60	$27.00	$5.12–$25.11	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN OCCUP, COTTON SEED, IgE [CCL]	$21.60	$27.00	$5.12–$25.11	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERG FUNGI AND MOLDS,PHOM BE IgE [CCL]	$21.60	$27.00	$5.12–$25.11	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN CAULIFLOWER, IgE [CCL]	$21.60	$27.00	$5.12–$25.11	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN NUTMEG, IgE [CCL]	$21.60	$27.00	$5.12–$25.11	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, GOLDENROD IgE [CCL]	$21.60	$27.00	$5.12–$25.11	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, MOLD GROUP [CCL]	$21.60	$27.00	$5.12–$25.11	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLG SPEC IGE CRUDE XTRC EA	$21.60	$27.00	$5.12–$25.11	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, BRAZIL NUT IgE [CCL]	$21.60	$27.00	$5.12–$25.11	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN GINGER, IgE [CCL]	$21.60	$27.00	$5.12–$25.11	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, POPPY SEED, IgE [CCL]	$21.60	$27.00	$5.12–$25.11	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, STEMPHYLIUM [CCL]	$21.60	$27.00	$5.12–$25.11	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, SOYBEAN IgE [CCL]	$21.60	$27.00	$5.12–$25.11	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, CLAM IgE [CCL]	$21.60	$27.00	$5.12–$25.11	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, SHRIMP IgE [CCL]	$21.60	$27.00	$5.12–$25.11	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, PIGWEED IgE [CCL]	$21.60	$27.00	$5.12–$25.11	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, CORN IgE [CCL]	$21.60	$27.00	$5.12–$25.11	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, SALMON IgE [CCL]	$21.60	$27.00	$5.12–$25.11	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, ELM TREE IgE [CCL]	$21.60	$27.00	$5.12–$25.11	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, CATFISH IgE [CCL]	$21.60	$27.00	$5.12–$25.11	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, CLADOSPORIUM HERBARU IgE [CCL]	$21.60	$27.00	$5.12–$25.11	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, SHEEP EPITHELIUM, IgE [CCL]	$21.60	$27.00	$5.12–$25.11	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, LINSEED IgE [CCL]	$21.60	$27.00	$5.12–$25.11	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, RABBIT EPITHELIUM IgE [CCL]	$21.60	$27.00	$5.12–$25.11	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, EGG YOLK IGE [CCL]	$21.60	$27.00	$5.12–$25.11	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, INDOOR ALLERGY PANEL [CCL]	$21.60	$27.00	$5.12–$25.11	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN TEA, IgE [CCL]	$21.60	$27.00	$5.12–$25.11	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN FOOD CORIAN/CILANTRO, IgE [CCL]	$21.60	$27.00	$5.12–$25.11	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLER, SHORT (COMMON) RAGWEED IgE [CCL]	$21.60	$27.00	$5.12–$25.11	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLER, PENICILLIUM CHRYSOGENUM IgE [CCL]	$21.60	$27.00	$5.12–$25.11	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, MEADOW FESCUE IgE [CCL]	$21.60	$27.00	$5.12–$25.11	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN CLOVE, IgE [CCL]	$21.60	$27.00	$5.12–$25.11	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, SYCAMORE TREE IgE [CCL]	$21.60	$27.00	$5.12–$25.11	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, PISTACHIO IgE [CCL]	$21.60	$27.00	$5.12–$25.11	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PEDIATRIC ALLERGY PANEL	$21.60	$27.00	$5.12–$25.11	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN MEASUREMENT OF AB TO IgE [CCL]	$21.60	$27.00	$5.12–$25.11	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN HOPS, IgE [CCL]	$21.60	$27.00	$5.12–$25.11	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, GLUTEN IgE [CCL]	$21.60	$27.00	$5.12–$25.11	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN OREGANO, IgE [CCL]	$21.60	$27.00	$5.12–$25.11	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, LOBSTER IgE [CCL]	$21.60	$27.00	$5.12–$25.11	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, WALNUT IgE [CCL]	$21.60	$27.00	$5.12–$25.11	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLER, LAMB'S QTR (GOOSEFOOT) IgE [CCL]	$21.60	$27.00	$5.12–$25.11	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, ASPERGILLUS FUMIGATU IgE [CCL]	$21.60	$27.00	$5.12–$25.11	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, CASHEW NUT IgE [CCL]	$21.60	$27.00	$5.12–$25.11	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, MINI SCREEN [CCL]	$21.60	$27.00	$5.12–$25.11	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, HORSE DANDER IgE [CCL]	$21.60	$27.00	$5.12–$25.11	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, POTATO IgE [CCL]	$21.60	$27.00	$5.12–$25.11	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, ROUGH MARSHELDER IgE [CCL]	$21.60	$27.00	$5.12–$25.11	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, PEANUT IgE [CCL]	$21.60	$27.00	$5.12–$25.11	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RESP. ALLERGY PROFILE,REGION V	$21.60	$27.00	$5.12–$25.11	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, EGG WHITE IgE [CCL]	$21.60	$27.00	$5.12–$25.11	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, WHEAT IgE [CCL]	$21.60	$27.00	$5.12–$25.11	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, SHEEP SORREL IgE [CCL]	$21.60	$27.00	$5.12–$25.11	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERG, PEANUT IgE W/REFLEX TO COMP [CCL	$85.60	$107.00	$5.12–$99.51	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, FLORIDA PERENNIAL [CCL]	$128.80	$161.00	$5.12–$149.73	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERG, INHALANT/FOOD/ENVIRO PROF [CCL]	$132.80	$166.00	$5.12–$154.38	—	20%
Alpha-fetoprotein (AFP) blood test CPT 82105 AFP (TUMOR MARKER) [CCL]	$46.40	$58.00	$16.43–$53.94	23% below	20%
Alpha-fetoprotein (AFP) blood test CPT 82105 ALPHA-FETOPROTEIN (AFP)	$46.40	$58.00	$16.43–$53.94	23% below	20%
Alpha-fetoprotein (AFP) blood test CPT 82105 AFP--MATERNAL [CCL]	$46.40	$58.00	$16.43–$53.94	23% below	20%
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 AFP (TUMOR MARKER) [CCL]	$46.40	$58.00	$16.43–$53.94	—	20%
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 AFP--MATERNAL [CCL]	$46.40	$58.00	$16.43–$53.94	—	20%
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 ALPHA-FETOPROTEIN (AFP)	$46.40	$58.00	$16.43–$53.94	—	20%
Ammonia blood test CPT 82140 AMMONIA	$61.60	$77.00	$14.28–$71.61	13% above	20%
Ammonia blood test CPT 82140 AMMONIA [CCL]	$61.60	$77.00	$14.28–$71.61	13% above	20%
Ammonia blood test inpatient CPT 82140 AMMONIA [CCL]	$61.60	$77.00	$14.28–$71.61	—	20%
Ammonia blood test inpatient CPT 82140 AMMONIA	$61.60	$77.00	$14.28–$71.61	—	20%
Amylase blood test CPT 82150 AMYLASE	$44.80	$56.00	$6.35–$52.08	6% below	20%
Amylase blood test CPT 82150 AMYLASE URINE RANDOM [CCL]	$44.80	$56.00	$6.35–$52.08	6% below	20%
Amylase blood test inpatient CPT 82150 AMYLASE	$44.80	$56.00	$6.35–$52.08	—	20%
Amylase blood test inpatient CPT 82150 AMYLASE URINE RANDOM [CCL]	$44.80	$56.00	$6.35–$52.08	—	20%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CYCLIC CITRULLINATED PEP AB IGG [OLD]	$53.60	$67.00	$12.69–$62.31	7% below	20%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CYCLIC CITRULLINATED PEP AB IGG [CCL]	$55.20	$69.00	$12.69–$64.17	5% below	20%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CCP AB, IgG AND IgA [CCL]	$98.40	$123.00	$12.69–$114.39	70% above	20%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 CYCLIC CITRULLINATED PEP AB IGG [OLD]	$53.60	$67.00	$12.69–$62.31	—	20%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 CYCLIC CITRULLINATED PEP AB IGG [CCL]	$55.20	$69.00	$12.69–$64.17	—	20%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 CCP AB, IgG AND IgA [CCL]	$98.40	$123.00	$12.69–$114.39	—	20%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA PANEL 1 [CCL]	$48.80	$61.00	$11.85–$56.73	12% below	20%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA BY IFA SCREEN [CCL]	$48.80	$61.00	$11.85–$56.73	12% below	20%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA PANEL 1 [CCL]	$48.80	$61.00	$11.85–$56.73	—	20%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA BY IFA SCREEN [CCL]	$48.80	$61.00	$11.85–$56.73	—	20%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 BNP LAB TEST COMMUNITY OUTREACH	$33.60	$42.00	$35.07–$39.26	78% below	20%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 NT PRO BNP [CCL]	$116.00	$145.00	$38.47–$134.85	22% below	20%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 NT-proBNP	$116.00	$145.00	$38.47–$134.85	22% below	20%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 BNP LAB TEST COMMUNITY OUTREACH	$33.60	$42.00	$35.07–$39.26	—	20%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 NT-proBNP	$116.00	$145.00	$38.47–$134.85	—	20%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 NT PRO BNP [CCL]	$116.00	$145.00	$38.47–$134.85	—	20%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE EYE [AULTMAN]	$64.00	$80.00	$8.45–$74.40	3% below	20%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 BACTERIAL CULTURE THROAT [CCL]	$64.00	$80.00	$8.45–$74.40	3% below	20%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE OTHER [AULTMAN]	$64.00	$80.00	$8.45–$74.40	3% below	20%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE BODY FLUID [AULTMAN]	$64.00	$80.00	$8.45–$74.40	3% below	20%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE CSF [AULTMAN]	$64.00	$80.00	$8.45–$74.40	3% below	20%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE GENITAL TRACT [AULTMAN]	$64.00	$80.00	$8.45–$74.40	3% below	20%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE SPUTUM [AULTMAN]	$64.00	$80.00	$8.45–$74.40	3% below	20%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 THROAT CULTURE, ROUTINE [AULT]	$64.00	$80.00	$8.45–$74.40	3% below	20%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE AEROBIC - AULTMAN	$64.00	$80.00	$8.45–$74.40	3% below	20%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 MRSA SCREEN NARES	$64.00	$80.00	$8.45–$74.40	3% below	20%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE WOUND [AULTMAN]	$64.00	$80.00	$8.45–$74.40	3% below	20%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE PRENATAL GBS SCREEN	$64.00	$80.00	$8.45–$74.40	3% below	20%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE WOUND [CCL]	$64.00	$80.00	$8.45–$74.40	3% below	20%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 MRSA CULTURE [CCL]	$64.00	$80.00	$8.45–$74.40	3% below	20%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE EAR	$64.00	$80.00	$8.45–$74.40	3% below	20%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE RESPIRATORY [AULTMAN]	$64.00	$80.00	$8.45–$74.40	3% below	20%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE CATHETER TIP [AULTMAN]	$64.00	$80.00	$8.45–$74.40	3% below	20%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE PRENATAL GBS SCREEN	$64.00	$80.00	$8.45–$74.40	—	20%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE RESPIRATORY [AULTMAN]	$64.00	$80.00	$8.45–$74.40	—	20%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 THROAT CULTURE, ROUTINE [AULT]	$64.00	$80.00	$8.45–$74.40	—	20%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 BACTERIAL CULTURE THROAT [CCL]	$64.00	$80.00	$8.45–$74.40	—	20%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE EYE [AULTMAN]	$64.00	$80.00	$8.45–$74.40	—	20%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 MRSA SCREEN NARES	$64.00	$80.00	$8.45–$74.40	—	20%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE AEROBIC - AULTMAN	$64.00	$80.00	$8.45–$74.40	—	20%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE GENITAL TRACT [AULTMAN]	$64.00	$80.00	$8.45–$74.40	—	20%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE CSF [AULTMAN]	$64.00	$80.00	$8.45–$74.40	—	20%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE CATHETER TIP [AULTMAN]	$64.00	$80.00	$8.45–$74.40	—	20%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE SPUTUM [AULTMAN]	$64.00	$80.00	$8.45–$74.40	—	20%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE WOUND [CCL]	$64.00	$80.00	$8.45–$74.40	—	20%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE EAR	$64.00	$80.00	$8.45–$74.40	—	20%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE OTHER [AULTMAN]	$64.00	$80.00	$8.45–$74.40	—	20%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE BODY FLUID [AULTMAN]	$64.00	$80.00	$8.45–$74.40	—	20%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 MRSA CULTURE [CCL]	$64.00	$80.00	$8.45–$74.40	—	20%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE WOUND [AULTMAN]	$64.00	$80.00	$8.45–$74.40	—	20%
Basic metabolic panel (blood test) CPT 80048 BMP with eGFR Q4H	$56.00	$70.00	$8.29–$65.10	15% below	20%
Basic metabolic panel (blood test) CPT 80048 BMP with eGFR	$56.00	$70.00	$8.29–$65.10	15% below	20%
Basic metabolic panel (blood test) CPT 80048 BMP with MG DAILY	$56.00	$70.00	$8.29–$65.10	15% below	20%
Basic metabolic panel (blood test) CPT 80048 BMP with eGFR DAILY	$56.00	$70.00	$8.29–$65.10	15% below	20%
Basic metabolic panel (blood test) inpatient CPT 80048 BMP with eGFR	$56.00	$70.00	$8.29–$65.10	—	20%
Basic metabolic panel (blood test) inpatient CPT 80048 BMP with eGFR DAILY	$56.00	$70.00	$8.29–$65.10	—	20%
Basic metabolic panel (blood test) inpatient CPT 80048 BMP with MG DAILY	$56.00	$70.00	$8.29–$65.10	—	20%
Basic metabolic panel (blood test) inpatient CPT 80048 BMP with eGFR Q4H	$56.00	$70.00	$8.29–$65.10	—	20%
Bilirubin blood test, total CPT 82247 BILIRUBIN TOTAL [CCL]	$31.20	$39.00	$4.92–$36.27	30% above	20%
Bilirubin blood test, total CPT 82247 BILIRUBIN FRACTIONATED [CCL]	$31.20	$39.00	$4.92–$36.27	30% above	20%
Bilirubin blood test, total CPT 82247 BILIRUBIN TOTAL	$31.20	$39.00	$4.92–$36.27	30% above	20%
Bilirubin blood test, total inpatient CPT 82247 BILIRUBIN TOTAL [CCL]	$31.20	$39.00	$4.92–$36.27	—	20%
Bilirubin blood test, total inpatient CPT 82247 BILIRUBIN TOTAL	$31.20	$39.00	$4.92–$36.27	—	20%
Bilirubin blood test, total inpatient CPT 82247 BILIRUBIN FRACTIONATED [CCL]	$31.20	$39.00	$4.92–$36.27	—	20%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 SURGICAL PATHOLOGY LEVEL 4	$106.40	$133.00	$48.31–$123.69	48% below	20%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 SUR PATH LEVEL 4 [AULTMAN]	$106.40	$133.00	$48.31–$123.69	48% below	20%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 CELL BLOCK SCREEN	$106.40	$133.00	$48.31–$123.69	48% below	20%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 SUR PATH LEVEL 4 [AULTMAN]	$106.40	$133.00	$48.31–$123.69	—	20%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 SURGICAL PATHOLOGY LEVEL 4	$106.40	$133.00	$48.31–$123.69	—	20%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 CELL BLOCK SCREEN	$106.40	$133.00	$48.31–$123.69	—	20%
Blood culture for bacteria CPT 87040 CULTURE BLOOD [AULTMAN]	$60.80	$76.00	$10.11–$70.68	35% below	20%
Blood culture for bacteria inpatient CPT 87040 CULTURE BLOOD [AULTMAN]	$60.80	$76.00	$10.11–$70.68	—	20%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 DRUG SCREEN COLLECTION	$20.80	$26.00	$9.15–$24.18	31% above	20%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 VENIPUNCTURE	$20.80	$26.00	$9.15–$24.18	31% above	20%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 BLOOD DRAW FROM IV	$20.80	$26.00	$9.15–$24.18	31% above	20%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 BLOOD DRAW FROM IV	$20.80	$26.00	$9.15–$24.18	—	20%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 DRUG SCREEN COLLECTION	$20.80	$26.00	$9.15–$24.18	—	20%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 VENIPUNCTURE	$20.80	$26.00	$9.15–$24.18	—	20%
Blood glucose (sugar) test CPT 82947 GLUCOSE 1 HR PP AFTER 50G	$28.00	$35.00	$3.85–$32.55	19% above	20%
Blood glucose (sugar) test CPT 82947 GLUCOSE	$28.00	$35.00	$3.85–$32.55	19% above	20%
Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE	$28.00	$35.00	$3.85–$32.55	—	20%
Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE 1 HR PP AFTER 50G	$28.00	$35.00	$3.85–$32.55	—	20%
Blood lead test CPT 83655 LEAD, BLOOD [OLD]	$51.20	$64.00	$11.87–$59.52	5% above	20%
Blood lead test CPT 83655 ASSAY OF LEAD	$52.80	$66.00	$11.87–$61.38	9% above	20%
Blood lead test CPT 83655 LEAD, RANDOM URINE	$52.80	$66.00	$11.87–$61.38	9% above	20%
Blood lead test CPT 83655 LEAD, BLOOD [CCL]	$52.80	$66.00	$11.87–$61.38	9% above	20%
Blood lead test inpatient CPT 83655 LEAD, BLOOD [OLD]	$51.20	$64.00	$11.87–$59.52	—	20%
Blood lead test inpatient CPT 83655 ASSAY OF LEAD	$52.80	$66.00	$11.87–$61.38	—	20%
Blood lead test inpatient CPT 83655 LEAD, BLOOD [CCL]	$52.80	$66.00	$11.87–$61.38	—	20%
Blood lead test inpatient CPT 83655 LEAD, RANDOM URINE	$52.80	$66.00	$11.87–$61.38	—	20%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 PREGNANCY SERUM QUAL	$52.80	$66.00	$7.37–$61.38	3% below	20%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 PREGNANCY URINE	$52.80	$66.00	$7.37–$61.38	3% below	20%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 PREGNANCY URINE	$52.80	$66.00	$7.37–$61.38	—	20%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 PREGNANCY SERUM QUAL	$52.80	$66.00	$7.37–$61.38	—	20%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 BB ABO RH	$44.80	$56.00	$2.93–$125.82	25% below	20%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 BB ABO RH [AULTMAN]	$44.80	$56.00	$2.93–$125.82	25% below	20%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 TYPE AND SCREEN, PRENATAL WORKUP [CCL]	$44.80	$56.00	$2.93–$125.82	25% below	20%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 BB CORD BLOOD	$44.80	$56.00	$2.93–$125.82	25% below	20%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 TYPE AND SCREEN [CCL]	$44.80	$56.00	$2.93–$125.82	25% below	20%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 TYPE AND SCREEN, PRENATAL WORKUP [CCL]	$44.80	$56.00	$2.93–$125.82	—	20%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 BB ABO RH	$44.80	$56.00	$2.93–$125.82	—	20%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 BB CORD BLOOD	$44.80	$56.00	$2.93–$125.82	—	20%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 BB ABO RH [AULTMAN]	$44.80	$56.00	$2.93–$125.82	—	20%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 TYPE AND SCREEN [CCL]	$44.80	$56.00	$2.93–$125.82	—	20%
Blood urea nitrogen (BUN) test CPT 84520 BUN	$28.80	$36.00	$3.87–$33.48	23% above	20%
Blood urea nitrogen (BUN) test inpatient CPT 84520 BUN	$28.80	$36.00	$3.87–$33.48	—	20%
C-peptide blood test CPT 84681 C-PEPTIDE [CCL]	$64.80	$81.00	$20.39–$75.33	18% below	20%
C-peptide blood test inpatient CPT 84681 C-PEPTIDE [CCL]	$64.80	$81.00	$20.39–$75.33	—	20%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C-REACTIVE PROTEIN - DAILY	$52.80	$66.00	$5.08–$61.38	5% above	20%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C-REACTIVE PROTEIN [CCL]	$52.80	$66.00	$5.08–$61.38	5% above	20%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C-REACTIVE PROTEIN	$52.80	$66.00	$5.08–$61.38	5% above	20%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 C-REACTIVE PROTEIN	$52.80	$66.00	$5.08–$61.38	—	20%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 C-REACTIVE PROTEIN [CCL]	$52.80	$66.00	$5.08–$61.38	—	20%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 C-REACTIVE PROTEIN - DAILY	$52.80	$66.00	$5.08–$61.38	—	20%
C. difficile toxin gene test (stool PCR) CPT 87493 C DIFF TOXIN	$72.00	$90.00	$36.52–$83.70	45% below	20%
C. difficile toxin gene test (stool PCR) CPT 87493 CLOSTRIDIUM DIFFICLE TOXIN PCR [CCL]	$72.00	$90.00	$36.52–$83.70	45% below	20%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 CLOSTRIDIUM DIFFICLE TOXIN PCR [CCL]	$72.00	$90.00	$36.52–$83.70	—	20%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 C DIFF TOXIN	$72.00	$90.00	$36.52–$83.70	—	20%
CA 19-9 blood test (tumor marker) CPT 86301 CA 19-9 [CCL]	$35.20	$44.00	$20.39–$40.92	52% below	20%
CA 19-9 blood test (tumor marker) CPT 86301 CA19-9	$35.20	$44.00	$20.39–$40.92	52% below	20%
CA 19-9 blood test (tumor marker) inpatient CPT 86301 CA 19-9 [CCL]	$35.20	$44.00	$20.39–$40.92	—	20%
CA 19-9 blood test (tumor marker) inpatient CPT 86301 CA19-9	$35.20	$44.00	$20.39–$40.92	—	20%
CA-125 blood test (ovarian cancer marker) CPT 86304 CA 125 [CCL]	$70.40	$88.00	$20.39–$81.84	25% below	20%
CA-125 blood test (ovarian cancer marker) CPT 86304 CA-125	$70.40	$88.00	$20.39–$81.84	25% below	20%
CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 CA-125	$70.40	$88.00	$20.39–$81.84	—	20%
CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 CA 125 [CCL]	$70.40	$88.00	$20.39–$81.84	—	20%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 CORONAVIRUS PCR - POMERENE	$94.40	$118.00	$50.28–$109.74	33% below	20%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 COVID-19 PCR {COLL} [ODH & LabCorp]	$94.40	$118.00	$50.28–$109.74	33% below	20%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 CORONAVIRUS SALIVA PCR [CCL]	$94.40	$118.00	$50.28–$109.74	33% below	20%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 CORONAVIRUS PCR [AULTMAN]	$94.40	$118.00	$50.28–$109.74	33% below	20%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 CORONAVIRUS SALIVA PCR [CCL]	$94.40	$118.00	$50.28–$109.74	—	20%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 COVID-19 PCR {COLL} [ODH & LabCorp]	$94.40	$118.00	$50.28–$109.74	—	20%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 CORONAVIRUS PCR [AULTMAN]	$94.40	$118.00	$50.28–$109.74	—	20%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 CORONAVIRUS PCR - POMERENE	$94.40	$118.00	$50.28–$109.74	—	20%
Calcium blood test, total CPT 82310 CALCIUM TOTAL	$31.20	$39.00	$5.06–$36.27	1% below	20%
Calcium blood test, total inpatient CPT 82310 CALCIUM TOTAL	$31.20	$39.00	$5.06–$36.27	—	20%
Carcinoembryonic antigen (CEA) test CPT 82378 CEA [CCL]	$92.80	$116.00	$18.58–$107.88	7% above	20%
Carcinoembryonic antigen (CEA) test inpatient CPT 82378 CEA [CCL]	$92.80	$116.00	$18.58–$107.88	—	20%
Chickenpox (varicella) immunity blood test CPT 86787 VARICELLA-ZOSTER IgM AB [CCL]	$52.80	$66.00	$12.62–$61.38	9% below	20%
Chickenpox (varicella) immunity blood test CPT 86787 VARICELLA ZOSTER IGG AB [CCL]	$52.80	$66.00	$12.62–$61.38	9% below	20%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 VARICELLA-ZOSTER IgM AB [CCL]	$52.80	$66.00	$12.62–$61.38	—	20%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 VARICELLA ZOSTER IGG AB [CCL]	$52.80	$66.00	$12.62–$61.38	—	20%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 GC/CHLAM AMPLIFICATION URINE [OLD]	$112.80	$141.00	$34.39–$131.13	22% above	20%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 GC/CHLAM AMPLIFICATION SWAB [OLD]	$112.80	$141.00	$34.39–$131.13	22% above	20%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 GC/CHLAM AMPLIFICATION URINE [CCL]	$116.00	$145.00	$34.39–$134.85	26% above	20%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 GC/CHLAM AMPLIFICATION [CCL]	$116.00	$145.00	$34.39–$134.85	26% above	20%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA AMPLIFICATION [CCL]	$116.00	$145.00	$34.39–$134.85	26% above	20%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 C. TRACHOMSTIS PCR [AULTMAN]	$116.00	$145.00	$34.39–$134.85	26% above	20%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 GC/CHLAM AMPLIFICATION SWAB [OLD]	$112.80	$141.00	$34.39–$131.13	—	20%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 GC/CHLAM AMPLIFICATION URINE [OLD]	$112.80	$141.00	$34.39–$131.13	—	20%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 GC/CHLAM AMPLIFICATION [CCL]	$116.00	$145.00	$34.39–$134.85	—	20%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 C. TRACHOMSTIS PCR [AULTMAN]	$116.00	$145.00	$34.39–$134.85	—	20%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMYDIA AMPLIFICATION [CCL]	$116.00	$145.00	$34.39–$134.85	—	20%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 GC/CHLAM AMPLIFICATION URINE [CCL]	$116.00	$145.00	$34.39–$134.85	—	20%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PANEL, BASIC [CCL]	$88.80	$111.00	$13.12–$103.23	68% above	20%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 NMR LIPOPROFILE [CCL]	$88.80	$111.00	$13.12–$103.23	68% above	20%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PROFILE	$88.80	$111.00	$13.12–$103.23	68% above	20%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PANEL, BASIC [CCL]	$88.80	$111.00	$13.12–$103.23	—	20%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 NMR LIPOPROFILE [CCL]	$88.80	$111.00	$13.12–$103.23	—	20%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PROFILE	$88.80	$111.00	$13.12–$103.23	—	20%
Complete blood count (CBC) with differential CPT 85025 CBC W/ MANUAL DIFF	$47.20	$59.00	$7.61–$54.87	30% above	20%
Complete blood count (CBC) with differential CPT 85025 CBC + DIFF DAILY	$47.20	$59.00	$7.61–$54.87	30% above	20%
Complete blood count (CBC) with differential CPT 85025 CBC DAILY	$47.20	$59.00	$7.61–$54.87	30% above	20%
Complete blood count (CBC) with differential CPT 85025 CBC + DIFF	$47.20	$59.00	$7.61–$54.87	30% above	20%
Complete blood count (CBC) with differential inpatient CPT 85025 CBC + DIFF	$47.20	$59.00	$7.61–$54.87	—	20%
Complete blood count (CBC) with differential inpatient CPT 85025 CBC DAILY	$47.20	$59.00	$7.61–$54.87	—	20%
Complete blood count (CBC) with differential inpatient CPT 85025 CBC + DIFF DAILY	$47.20	$59.00	$7.61–$54.87	—	20%
Complete blood count (CBC) with differential inpatient CPT 85025 CBC W/ MANUAL DIFF	$47.20	$59.00	$7.61–$54.87	—	20%
Complete blood count (CBC), no differential CPT 85027 CBC (NO DIFF)	$37.60	$47.00	$6.34–$43.71	11% above	20%
Complete blood count (CBC), no differential inpatient CPT 85027 CBC (NO DIFF)	$37.60	$47.00	$6.34–$43.71	—	20%
Comprehensive metabolic panel (blood test) CPT 80053 CMP with eGFR - DAILY	$112.80	$141.00	$10.35–$131.13	77% above	20%
Comprehensive metabolic panel (blood test) CPT 80053 CMP with eGFR [CCL]	$112.80	$141.00	$10.35–$131.13	77% above	20%
Comprehensive metabolic panel (blood test) CPT 80053 CMP with eGFR	$112.80	$141.00	$10.35–$131.13	77% above	20%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 CMP with eGFR	$112.80	$141.00	$10.35–$131.13	—	20%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 CMP with eGFR - DAILY	$112.80	$141.00	$10.35–$131.13	—	20%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 CMP with eGFR [CCL]	$112.80	$141.00	$10.35–$131.13	—	20%
Cortisol blood test, total CPT 82533 ACTH STIM,3TIME POINTS (CPT 82533) [CCL]	$58.40	$73.00	$15.97–$67.89	19% below	20%
Cortisol blood test, total CPT 82533 CORTISOL [CCL]	$58.40	$73.00	$15.97–$67.89	19% below	20%
Cortisol blood test, total CPT 82533 CORTISOL, SALIVA [CCL]	$58.40	$73.00	$15.97–$67.89	19% below	20%
Cortisol blood test, total CPT 82533 CORTISOL	$58.40	$73.00	$15.97–$67.89	19% below	20%
Cortisol blood test, total inpatient CPT 82533 CORTISOL, SALIVA [CCL]	$58.40	$73.00	$15.97–$67.89	—	20%
Cortisol blood test, total inpatient CPT 82533 ACTH STIM,3TIME POINTS (CPT 82533) [CCL]	$58.40	$73.00	$15.97–$67.89	—	20%
Cortisol blood test, total inpatient CPT 82533 CORTISOL [CCL]	$58.40	$73.00	$15.97–$67.89	—	20%
Cortisol blood test, total inpatient CPT 82533 CORTISOL	$58.40	$73.00	$15.97–$67.89	—	20%
Creatine kinase (CK) blood test, total CPT 82550 CK, TOTAL [CCL]	$44.80	$56.00	$6.38–$52.08	27% above	20%
Creatine kinase (CK) blood test, total CPT 82550 CPK	$44.80	$56.00	$6.38–$52.08	27% above	20%
Creatine kinase (CK) blood test, total CPT 82550 CPK - DAILY	$44.80	$56.00	$6.38–$52.08	27% above	20%
Creatine kinase (CK) blood test, total CPT 82550 CPK (PART OF ISOENZYME PANEL)	$44.80	$56.00	$6.38–$52.08	27% above	20%
Creatine kinase (CK) blood test, total CPT 82550 CK [CCL]	$44.80	$56.00	$6.38–$52.08	27% above	20%
Creatine kinase (CK) blood test, total inpatient CPT 82550 CPK (PART OF ISOENZYME PANEL)	$44.80	$56.00	$6.38–$52.08	—	20%
Creatine kinase (CK) blood test, total inpatient CPT 82550 CK [CCL]	$44.80	$56.00	$6.38–$52.08	—	20%
Creatine kinase (CK) blood test, total inpatient CPT 82550 CK, TOTAL [CCL]	$44.80	$56.00	$6.38–$52.08	—	20%
Creatine kinase (CK) blood test, total inpatient CPT 82550 CPK - DAILY	$44.80	$56.00	$6.38–$52.08	—	20%
Creatine kinase (CK) blood test, total inpatient CPT 82550 CPK	$44.80	$56.00	$6.38–$52.08	—	20%
Creatinine blood test CPT 82565 CREATININE	$33.60	$42.00	$5.02–$39.06	36% above	20%
Creatinine blood test CPT 82565 CREATININE RAPID	$33.60	$42.00	$5.02–$39.06	36% above	20%
Creatinine blood test CPT 82565 BUN/CREAT eGFR (NON-AFRICAN AMERICAN)	$33.60	$42.00	$5.02–$39.06	36% above	20%
Creatinine blood test CPT 82565 BUN/CREAT eGFR (AFRICAN AMERICAN)	$33.60	$42.00	$5.02–$39.06	36% above	20%
Creatinine blood test inpatient CPT 82565 CREATININE	$33.60	$42.00	$5.02–$39.06	—	20%
Creatinine blood test inpatient CPT 82565 CREATININE RAPID	$33.60	$42.00	$5.02–$39.06	—	20%
Creatinine blood test inpatient CPT 82565 BUN/CREAT eGFR (NON-AFRICAN AMERICAN)	$33.60	$42.00	$5.02–$39.06	—	20%
Creatinine blood test inpatient CPT 82565 BUN/CREAT eGFR (AFRICAN AMERICAN)	$33.60	$42.00	$5.02–$39.06	—	20%
Cytomegalovirus (CMV) antibody test CPT 86644 CMV, IgG [OLD]	$43.20	$54.00	$14.10–$50.22	37% below	20%
Cytomegalovirus (CMV) antibody test CPT 86644 CMV, IgG [CCL]	$44.80	$56.00	$14.10–$52.08	35% below	20%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 CMV, IgG [OLD]	$43.20	$54.00	$14.10–$50.22	—	20%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 CMV, IgG [CCL]	$44.80	$56.00	$14.10–$52.08	—	20%
D-dimer blood test (blood clot marker) CPT 85379 D-DIMER, QUANTITATIVE	$76.00	$95.00	$9.98–$88.35	9% above	20%
D-dimer blood test (blood clot marker) CPT 85379 D-DIMER, QUANTITATIVE - DAILY	$76.00	$95.00	$9.98–$88.35	9% above	20%
D-dimer blood test (blood clot marker) inpatient CPT 85379 D-DIMER, QUANTITATIVE - DAILY	$76.00	$95.00	$9.98–$88.35	—	20%
D-dimer blood test (blood clot marker) inpatient CPT 85379 D-DIMER, QUANTITATIVE	$76.00	$95.00	$9.98–$88.35	—	20%
DHEA sulfate (DHEA-S) blood test CPT 82627 DHEA-S [CCL]	$88.00	$110.00	$21.79–$102.30	12% below	20%
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 DHEA-S [CCL]	$88.00	$110.00	$21.79–$102.30	—	20%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG DETECT PANEL, MECONIUM, QUALI [CCL]	$106.40	$133.00	$60.90–$123.69	11% above	20%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG SCREEN, BLOOD [CCL]	$106.40	$133.00	$60.90–$123.69	11% above	20%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG SCREEN URINE MEDIC	$106.40	$133.00	$60.90–$123.69	11% above	20%
Drug screen by lab instrument (any number of drug classes) CPT 80307 TOXICOLOGY SCREEN, URINE [CCL]	$106.40	$133.00	$60.90–$123.69	11% above	20%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG PANEL7,URN,SCN w/RFLX TO CONF [CCL]	$106.40	$133.00	$60.90–$123.69	11% above	20%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG TEST, PRESUMPTIVE, ANY NUMBER OF	$106.40	$133.00	$60.90–$123.69	11% above	20%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG ANALYSIS URINE [CCL]	$106.40	$133.00	$60.90–$123.69	11% above	20%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG SCREEN MULT CLASSES PER ENCOUNTER	$110.40	$138.00	$60.90–$128.34	16% above	20%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG PANEL7,URN,SCN w/RFLX TO CONF [CCL]	$106.40	$133.00	$60.90–$123.69	—	20%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG ANALYSIS URINE [CCL]	$106.40	$133.00	$60.90–$123.69	—	20%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG DETECT PANEL, MECONIUM, QUALI [CCL]	$106.40	$133.00	$60.90–$123.69	—	20%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG SCREEN, BLOOD [CCL]	$106.40	$133.00	$60.90–$123.69	—	20%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 TOXICOLOGY SCREEN, URINE [CCL]	$106.40	$133.00	$60.90–$123.69	—	20%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG SCREEN URINE MEDIC	$106.40	$133.00	$60.90–$123.69	—	20%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG TEST, PRESUMPTIVE, ANY NUMBER OF	$106.40	$133.00	$60.90–$123.69	—	20%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG SCREEN MULT CLASSES PER ENCOUNTER	$110.40	$138.00	$60.90–$128.34	—	20%
Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 ELECTROLYTES-PANEL 4	$56.00	$70.00	$6.87–$65.10	17% above	20%
Electrolyte panel (sodium, potassium, chloride, CO2) inpatient CPT 80051 ELECTROLYTES-PANEL 4	$56.00	$70.00	$6.87–$65.10	—	20%
Epstein-Barr virus (EBV) antibody test CPT 86665 EBV AB TO VIRAL CAPSID ATIGEN,IgM [CCL]	$35.20	$44.00	$17.78–$40.92	46% below	20%
Epstein-Barr virus (EBV) antibody test CPT 86665 EBV AB TO VIRAL CAPSID ANTIGEN IgG [CCL]	$35.20	$44.00	$17.78–$40.92	46% below	20%
Epstein-Barr virus (EBV) antibody test CPT 86665 EPSTEIN-BARR VCA IGG AB	$35.20	$44.00	$17.78–$40.92	46% below	20%
Epstein-Barr virus (EBV) antibody test CPT 86665 EPSTEIN-BARR VCA IGM AB	$35.20	$44.00	$17.78–$40.92	46% below	20%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 EBV AB TO VIRAL CAPSID ANTIGEN IgG [CCL]	$35.20	$44.00	$17.78–$40.92	—	20%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 EPSTEIN-BARR VCA IGG AB	$35.20	$44.00	$17.78–$40.92	—	20%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 EPSTEIN-BARR VCA IGM AB	$35.20	$44.00	$17.78–$40.92	—	20%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 EBV AB TO VIRAL CAPSID ATIGEN,IgM [CCL]	$35.20	$44.00	$17.78–$40.92	—	20%
Estradiol blood test CPT 82670 ESTRADIOL	$70.40	$88.00	$27.38–$81.84	37% below	20%
Estradiol blood test CPT 82670 ESTRADIOL-17B [CCL]	$70.40	$88.00	$27.38–$81.84	37% below	20%
Estradiol blood test inpatient CPT 82670 ESTRADIOL	$70.40	$88.00	$27.38–$81.84	—	20%
Estradiol blood test inpatient CPT 82670 ESTRADIOL-17B [CCL]	$70.40	$88.00	$27.38–$81.84	—	20%
FSH (follicle-stimulating hormone) test CPT 83001 FSH (PEDIATRICS)	$80.00	$100.00	$18.21–$93.00	7% below	20%
FSH (follicle-stimulating hormone) test CPT 83001 FOLLICLE-STIMULATING HORMONE (FSH)	$80.00	$100.00	$18.21–$93.00	7% below	20%
FSH (follicle-stimulating hormone) test CPT 83001 FSH [CCL]	$80.00	$100.00	$18.21–$93.00	7% below	20%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 FSH [CCL]	$80.00	$100.00	$18.21–$93.00	—	20%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 FSH (PEDIATRICS)	$80.00	$100.00	$18.21–$93.00	—	20%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 FOLLICLE-STIMULATING HORMONE (FSH)	$80.00	$100.00	$18.21–$93.00	—	20%
Fecal calprotectin (stool inflammation test) CPT 83993 CALPROTECTIN, FECAL [OLD]	$103.20	$129.00	$19.24–$119.97	31% below	20%
Fecal calprotectin (stool inflammation test) CPT 83993 CALPROTECTIN, FECAL [CCL]	$106.40	$133.00	$19.24–$123.69	29% below	20%
Fecal calprotectin (stool inflammation test) inpatient CPT 83993 CALPROTECTIN, FECAL [OLD]	$103.20	$129.00	$19.24–$119.97	—	20%
Fecal calprotectin (stool inflammation test) inpatient CPT 83993 CALPROTECTIN, FECAL [CCL]	$106.40	$133.00	$19.24–$123.69	—	20%
Ferritin blood test (iron stores) CPT 82728 FERRITIN [CCL]	$61.60	$77.00	$13.36–$71.61	19% below	20%
Ferritin blood test (iron stores) CPT 82728 FERRITIN	$61.60	$77.00	$13.36–$71.61	19% below	20%
Ferritin blood test (iron stores) CPT 82728 FERRITIN - DAILY	$61.60	$77.00	$13.36–$71.61	19% below	20%
Ferritin blood test (iron stores) inpatient CPT 82728 FERRITIN - DAILY	$61.60	$77.00	$13.36–$71.61	—	20%
Ferritin blood test (iron stores) inpatient CPT 82728 FERRITIN	$61.60	$77.00	$13.36–$71.61	—	20%
Ferritin blood test (iron stores) inpatient CPT 82728 FERRITIN [CCL]	$61.60	$77.00	$13.36–$71.61	—	20%
Fibrinogen blood test CPT 85384 FIBRINOGEN - DAILY	$48.80	$61.00	$9.53–$56.73	8% above	20%
Fibrinogen blood test CPT 85384 FIBRINOGEN	$48.80	$61.00	$9.53–$56.73	8% above	20%
Fibrinogen blood test inpatient CPT 85384 FIBRINOGEN - DAILY	$48.80	$61.00	$9.53–$56.73	—	20%
Fibrinogen blood test inpatient CPT 85384 FIBRINOGEN	$48.80	$61.00	$9.53–$56.73	—	20%
Folate (folic acid) blood test CPT 82746 FOLATES	$55.20	$69.00	$14.41–$64.17	18% below	20%
Folate (folic acid) blood test CPT 82746 FOLATE RBC [CCL]	$55.20	$69.00	$14.41–$64.17	18% below	20%
Folate (folic acid) blood test CPT 82746 FOLATE, SERUM [CCL]	$55.20	$69.00	$14.41–$64.17	18% below	20%
Folate (folic acid) blood test inpatient CPT 82746 FOLATE RBC [CCL]	$55.20	$69.00	$14.41–$64.17	—	20%
Folate (folic acid) blood test inpatient CPT 82746 FOLATE, SERUM [CCL]	$55.20	$69.00	$14.41–$64.17	—	20%
Folate (folic acid) blood test inpatient CPT 82746 FOLATES	$55.20	$69.00	$14.41–$64.17	—	20%
Free T3 thyroid hormone test CPT 84481 T3, FREE [CCL]	$36.80	$46.00	$16.60–$42.78	52% below	20%
Free T3 thyroid hormone test CPT 84481 FREE T3	$36.80	$46.00	$16.60–$42.78	52% below	20%
Free T3 thyroid hormone test inpatient CPT 84481 T3, FREE [CCL]	$36.80	$46.00	$16.60–$42.78	—	20%
Free T3 thyroid hormone test inpatient CPT 84481 FREE T3	$36.80	$46.00	$16.60–$42.78	—	20%
Free T4 (free thyroxine) thyroid blood test CPT 84439 T4, FREE [CCL]	$63.20	$79.00	$8.84–$73.47	49% above	20%
Free T4 (free thyroxine) thyroid blood test CPT 84439 T4-FREE (FREE THYROXINE)	$63.20	$79.00	$8.84–$73.47	49% above	20%
Free T4 (free thyroxine) thyroid blood test CPT 84439 THYROXINE FR EQ DIALYSIS/HPCL [CCL]	$63.20	$79.00	$8.84–$73.47	49% above	20%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 T4-FREE (FREE THYROXINE)	$63.20	$79.00	$8.84–$73.47	—	20%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 THYROXINE FR EQ DIALYSIS/HPCL [CCL]	$63.20	$79.00	$8.84–$73.47	—	20%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 T4, FREE [CCL]	$63.20	$79.00	$8.84–$73.47	—	20%
Free testosterone test CPT 84402 TESTOSTERONE, FREE & TOTAL [TEST]	$47.20	$59.00	$24.96–$54.87	51% below	20%
Free testosterone test CPT 84402 TESTOSTERONE, TOTAL & FREE, SERUM [CCL]	$48.80	$61.00	$24.96–$56.73	50% below	20%
Free testosterone test CPT 84402 TESTOST,FR/TOT,MALES BY ED/LC MSMS [CCL]	$48.80	$61.00	$24.96–$56.73	50% below	20%
Free testosterone test CPT 84402 FREE TESTOSTERONE	$48.80	$61.00	$24.96–$56.73	50% below	20%
Free testosterone test CPT 84402 TESTOSTERONE, FREE & TOTAL [CCL]	$48.80	$61.00	$24.96–$56.73	50% below	20%
Free testosterone test inpatient CPT 84402 TESTOSTERONE, FREE & TOTAL [TEST]	$47.20	$59.00	$24.96–$54.87	—	20%
Free testosterone test inpatient CPT 84402 FREE TESTOSTERONE	$48.80	$61.00	$24.96–$56.73	—	20%
Free testosterone test inpatient CPT 84402 TESTOST,FR/TOT,MALES BY ED/LC MSMS [CCL]	$48.80	$61.00	$24.96–$56.73	—	20%
Free testosterone test inpatient CPT 84402 TESTOSTERONE, FREE & TOTAL [CCL]	$48.80	$61.00	$24.96–$56.73	—	20%
Free testosterone test inpatient CPT 84402 TESTOSTERONE, TOTAL & FREE, SERUM [CCL]	$48.80	$61.00	$24.96–$56.73	—	20%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 GAMMA GT [CCL]	$36.80	$46.00	$7.06–$42.78	14% below	20%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 GAMMA GT	$36.80	$46.00	$7.06–$42.78	14% below	20%
Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 GAMMA GT [CCL]	$36.80	$46.00	$7.06–$42.78	—	20%
Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 GAMMA GT	$36.80	$46.00	$7.06–$42.78	—	20%
General health panel: metabolic panel, blood count and TSH in one order CPT 80050 CBC W/ MANUAL DIFF	$47.20	$59.00	$49.26–$54.87	79% below	20%
General health panel: metabolic panel, blood count and TSH in one order CPT 80050 CMP with eGFR - DAILY	$112.80	$141.00	$117.74–$131.13	49% below	20%
General health panel: metabolic panel, blood count and TSH in one order inpatient CPT 80050 CBC W/ MANUAL DIFF	$47.20	$59.00	$49.26–$54.87	—	20%
General health panel: metabolic panel, blood count and TSH in one order inpatient CPT 80050 CMP with eGFR - DAILY	$112.80	$141.00	$117.74–$131.13	—	20%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GLUCOSE CHALLENGE 50GM 1 HOUR	$35.20	$44.00	$4.66–$40.92	8% below	20%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GLUCOSE 2 HR POSTPRANDIAL	$35.20	$44.00	$4.66–$40.92	8% below	20%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 GLUCOSE CHALLENGE 50GM 1 HOUR	$35.20	$44.00	$4.66–$40.92	—	20%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 GLUCOSE 2 HR POSTPRANDIAL	$35.20	$44.00	$4.66–$40.92	—	20%
Glucose tolerance test, 3 samples CPT 82951 GLUCOSE TOLERANCE-4 HOUR	$99.20	$124.00	$12.61–$115.32	48% above	20%
Glucose tolerance test, 3 samples CPT 82951 GLUCOSE CHALLENGE 75 GM 2 HOUR	$99.20	$124.00	$12.61–$115.32	48% above	20%
Glucose tolerance test, 3 samples CPT 82951 GLUCOSE TOLERANCE-5 HOUR	$99.20	$124.00	$12.61–$115.32	48% above	20%
Glucose tolerance test, 3 samples CPT 82951 GLUCOSE TOLERANCE-2 HOUR	$99.20	$124.00	$12.61–$115.32	48% above	20%
Glucose tolerance test, 3 samples CPT 82951 GLUCOSE TOLERANCE-3 HOUR	$99.20	$124.00	$12.61–$115.32	48% above	20%
Glucose tolerance test, 3 samples CPT 82951 GLUCOSE TOLERANCE-1 HOUR	$99.20	$124.00	$12.61–$115.32	48% above	20%
Glucose tolerance test, 3 samples inpatient CPT 82951 GLUCOSE TOLERANCE-3 HOUR	$99.20	$124.00	$12.61–$115.32	—	20%
Glucose tolerance test, 3 samples inpatient CPT 82951 GLUCOSE TOLERANCE-5 HOUR	$99.20	$124.00	$12.61–$115.32	—	20%
Glucose tolerance test, 3 samples inpatient CPT 82951 GLUCOSE TOLERANCE-2 HOUR	$99.20	$124.00	$12.61–$115.32	—	20%
Glucose tolerance test, 3 samples inpatient CPT 82951 GLUCOSE TOLERANCE-4 HOUR	$99.20	$124.00	$12.61–$115.32	—	20%
Glucose tolerance test, 3 samples inpatient CPT 82951 GLUCOSE TOLERANCE-1 HOUR	$99.20	$124.00	$12.61–$115.32	—	20%
Glucose tolerance test, 3 samples inpatient CPT 82951 GLUCOSE CHALLENGE 75 GM 2 HOUR	$99.20	$124.00	$12.61–$115.32	—	20%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 N. GONORRHEA PCR [AULTMAN]	$120.80	$151.00	$34.39–$140.43	30% above	20%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 N GONORRHOEAE RNA TMA	$120.80	$151.00	$34.39–$140.43	30% above	20%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 N GONORRHOEAE RNA TMA	$120.80	$151.00	$34.39–$140.43	—	20%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 N. GONORRHEA PCR [AULTMAN]	$120.80	$151.00	$34.39–$140.43	—	20%
H. pylori antibody blood test CPT 86677 HELIOBACTER PYLORI AB, IgG [TEST]	$38.40	$48.00	$16.51–$44.64	49% below	20%
H. pylori antibody blood test CPT 86677 H.PYLORI ANTIBODIES IGG & IGM &IGA	$39.20	$49.00	$16.51–$45.57	48% below	20%
H. pylori antibody blood test CPT 86677 H.PYLORI IGG SCREEN	$39.20	$49.00	$16.51–$45.57	48% below	20%
H. pylori antibody blood test CPT 86677 HELIOBACTER PYLORI AB, IgG [CCL]	$39.20	$49.00	$16.51–$45.57	48% below	20%
H. pylori antibody blood test CPT 86677 H.PYLORI AB IGA	$39.20	$49.00	$16.51–$45.57	48% below	20%
H. pylori antibody blood test CPT 86677 H.PYLORI AB IGM	$39.20	$49.00	$16.51–$45.57	48% below	20%
H. pylori antibody blood test inpatient CPT 86677 HELIOBACTER PYLORI AB, IgG [TEST]	$38.40	$48.00	$16.51–$44.64	—	20%
H. pylori antibody blood test inpatient CPT 86677 HELIOBACTER PYLORI AB, IgG [CCL]	$39.20	$49.00	$16.51–$45.57	—	20%
H. pylori antibody blood test inpatient CPT 86677 H.PYLORI AB IGM	$39.20	$49.00	$16.51–$45.57	—	20%
H. pylori antibody blood test inpatient CPT 86677 H.PYLORI ANTIBODIES IGG & IGM &IGA	$39.20	$49.00	$16.51–$45.57	—	20%
H. pylori antibody blood test inpatient CPT 86677 H.PYLORI AB IGA	$39.20	$49.00	$16.51–$45.57	—	20%
H. pylori antibody blood test inpatient CPT 86677 H.PYLORI IGG SCREEN	$39.20	$49.00	$16.51–$45.57	—	20%
H. pylori stool antigen test CPT 87338 H PYLORI AG BY EIA, STOOL [OLD]	$85.60	$107.00	$14.09–$99.51	22% above	20%
H. pylori stool antigen test CPT 87338 H PYLORI AG BY EIA, STOOL [CCL]	$88.00	$110.00	$14.09–$102.30	26% above	20%
H. pylori stool antigen test inpatient CPT 87338 H PYLORI AG BY EIA, STOOL [OLD]	$85.60	$107.00	$14.09–$99.51	—	20%
H. pylori stool antigen test inpatient CPT 87338 H PYLORI AG BY EIA, STOOL [CCL]	$88.00	$110.00	$14.09–$102.30	—	20%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV-1 RNA,QUANTITATIVE REAL TIME PCR	$116.80	$146.00	$83.40–$135.78	67% below	20%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV-1 RNA, QUANTITATIVE PCR PLASMA [CCL]	$120.00	$150.00	$83.40–$139.50	66% below	20%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HIV-1 RNA,QUANTITATIVE REAL TIME PCR	$116.80	$146.00	$83.40–$135.78	—	20%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HIV-1 RNA, QUANTITATIVE PCR PLASMA [CCL]	$120.00	$150.00	$83.40–$139.50	—	20%
HIV-1 and HIV-2 antibody test CPT 86703 RAPID HIV ANTIBODY TEST	$57.60	$72.00	$13.44–$66.96	7% below	20%
HIV-1 and HIV-2 antibody test inpatient CPT 86703 RAPID HIV ANTIBODY TEST	$57.60	$72.00	$13.44–$66.96	—	20%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV 1/2 COMBO (AG/AB) [CCL]	$34.40	$43.00	$23.60–$39.99	54% below	20%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV-1 p24 Ag +HIV-1-2 Ab	$35.20	$44.00	$23.60–$40.92	52% below	20%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HIV 1/2 COMBO (AG/AB) [CCL]	$34.40	$43.00	$23.60–$39.99	—	20%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HIV-1 p24 Ag +HIV-1-2 Ab	$35.20	$44.00	$23.60–$40.92	—	20%
HPV test for high-risk types, one combined (pooled) result CPT 87624 HPV SCREEN LOW RISK (AULTMAN HOSPITAL)	$97.60	$122.00	$34.39–$113.46	18% below	20%
HPV test for high-risk types, one combined (pooled) result CPT 87624 HPV,DNA [AULTMAN]	$97.60	$122.00	$34.39–$113.46	18% below	20%
HPV test for high-risk types, one combined (pooled) result CPT 87624 HPV RNA AMP PROBE	$97.60	$122.00	$34.39–$113.46	18% below	20%
HPV test for high-risk types, one combined (pooled) result CPT 87624 UROGENITAL UREAPLASMA MYCR BY PCR [CCL]	$97.60	$122.00	$34.39–$113.46	18% below	20%
HPV test for high-risk types, one combined (pooled) result CPT 87624 HPV SCREEN HIGH RISK [AULTMAN HOSPITAL]	$97.60	$122.00	$34.39–$113.46	18% below	20%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HPV,DNA [AULTMAN]	$97.60	$122.00	$34.39–$113.46	—	20%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HPV SCREEN HIGH RISK [AULTMAN HOSPITAL]	$97.60	$122.00	$34.39–$113.46	—	20%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HPV RNA AMP PROBE	$97.60	$122.00	$34.39–$113.46	—	20%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 UROGENITAL UREAPLASMA MYCR BY PCR [CCL]	$97.60	$122.00	$34.39–$113.46	—	20%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HPV SCREEN LOW RISK (AULTMAN HOSPITAL)	$97.60	$122.00	$34.39–$113.46	—	20%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HEMOGLOBIN A1C (POM)	$44.00	$55.00	$9.52–$51.15	4% below	20%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HGB A1C [CCL]	$44.00	$55.00	$9.52–$51.15	4% below	20%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HEMOGLOBIN A1C (POM)	$44.00	$55.00	$9.52–$51.15	—	20%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HGB A1C [CCL]	$44.00	$55.00	$9.52–$51.15	—	20%
Hemoglobin blood test CPT 85018 HEMOGLOBIN	$18.40	$23.00	$2.32–$21.39	14% above	20%
Hemoglobin blood test inpatient CPT 85018 HEMOGLOBIN	$18.40	$23.00	$2.32–$21.39	—	20%
Hepatitis B core antibody test (total) CPT 86704 HEPATITIS B CORE AB TOTAL W/ RFLX TO IGM	$26.40	$33.00	$11.81–$30.69	51% below	20%
Hepatitis B core antibody test (total) CPT 86704 HEP B CORE AB TOTAL QUALITATIVE	$26.40	$33.00	$11.81–$30.69	51% below	20%
Hepatitis B core antibody test (total) CPT 86704 HEP B CORE AB, TOTAL (IgM & IgG) [CCL]	$26.40	$33.00	$11.81–$30.69	51% below	20%
Hepatitis B core antibody test (total) inpatient CPT 86704 HEP B CORE AB, TOTAL (IgM & IgG) [CCL]	$26.40	$33.00	$11.81–$30.69	—	20%
Hepatitis B core antibody test (total) inpatient CPT 86704 HEP B CORE AB TOTAL QUALITATIVE	$26.40	$33.00	$11.81–$30.69	—	20%
Hepatitis B core antibody test (total) inpatient CPT 86704 HEPATITIS B CORE AB TOTAL W/ RFLX TO IGM	$26.40	$33.00	$11.81–$30.69	—	20%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEPATITIS B SURFACE AB QUAL [CCL]	$52.80	$66.00	$10.53–$61.38	9% above	20%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HEPATITIS B SURFACE AB QUAL [CCL]	$52.80	$66.00	$10.53–$61.38	—	20%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HEP B SURFACE AG [CCL]	$49.60	$62.00	$10.12–$57.66	5% above	20%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HEP B SURFACE AG (HBsAg) QUALITATIVE	$49.60	$62.00	$10.12–$57.66	5% above	20%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HEP B SURFACE AG (HBsAg) QUALITATIVE	$49.60	$62.00	$10.12–$57.66	—	20%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HEP B SURFACE AG [CCL]	$49.60	$62.00	$10.12–$57.66	—	20%
Hepatitis C antibody blood test (screening) CPT 86803 HEPATITIS C AB IA W/CONFIRM [OLD]	$64.00	$80.00	$13.98–$74.40	at median	20%
Hepatitis C antibody blood test (screening) CPT 86803 HEPATITIS C AB IA W/CONFIRM [CCL]	$65.60	$82.00	$13.98–$76.26	2% above	20%
Hepatitis C antibody blood test (screening) CPT 86803 HEPATITIS C AB IA [CCL]	$65.60	$82.00	$13.98–$76.26	2% above	20%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 HEPATITIS C AB IA W/CONFIRM [OLD]	$64.00	$80.00	$13.98–$74.40	—	20%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 HEPATITIS C AB IA W/CONFIRM [CCL]	$65.60	$82.00	$13.98–$76.26	—	20%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 HEPATITIS C AB IA [CCL]	$65.60	$82.00	$13.98–$76.26	—	20%
Hepatitis C viral load (HCV RNA) test CPT 87522 HEPATITIS C RNA BY PCR [OLD]	$128.80	$161.00	$41.98–$149.73	33% below	20%
Hepatitis C viral load (HCV RNA) test CPT 87522 HEPATITIS C RNA BY PCR [CCL]	$132.80	$166.00	$41.98–$154.38	31% below	20%
Hepatitis C viral load (HCV RNA) test CPT 87522 HCV RNA,QUANT,REAL TIME PCR	$132.80	$166.00	$41.98–$154.38	31% below	20%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HEPATITIS C RNA BY PCR [OLD]	$128.80	$161.00	$41.98–$149.73	—	20%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HCV RNA,QUANT,REAL TIME PCR	$132.80	$166.00	$41.98–$154.38	—	20%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HEPATITIS C RNA BY PCR [CCL]	$132.80	$166.00	$41.98–$154.38	—	20%
Herpes blood test, HSV-1 antibody CPT 86695 HERPES SIMPLEX TYPE 1 TEST [CCL]	$36.00	$45.00	$12.93–$41.85	39% below	20%
Herpes blood test, HSV-1 antibody CPT 86695 HERPES SIMPLEX TYPE 1 TEST	$36.80	$46.00	$12.93–$42.78	38% below	20%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 HERPES SIMPLEX TYPE 1 TEST [CCL]	$36.00	$45.00	$12.93–$41.85	—	20%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 HERPES SIMPLEX TYPE 1 TEST	$36.80	$46.00	$12.93–$42.78	—	20%
Herpes blood test, HSV-2 antibody CPT 86696 HERPES SIMPLEX TYPE 2 TEST [CCL]	$36.00	$45.00	$18.96–$41.85	46% below	20%
Herpes blood test, HSV-2 antibody CPT 86696 HERPES SIMPLEX TYPE 2 TEST	$36.80	$46.00	$18.96–$42.78	44% below	20%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HERPES SIMPLEX TYPE 2 TEST [CCL]	$36.00	$45.00	$18.96–$41.85	—	20%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HERPES SIMPLEX TYPE 2 TEST	$36.80	$46.00	$18.96–$42.78	—	20%
High-sensitivity CRP (hs-CRP) test CPT 86141 HIGH SENSITIVITY CRP [CCL]	$35.20	$44.00	$12.69–$40.92	48% below	20%
High-sensitivity CRP (hs-CRP) test CPT 86141 HIGH SENSITIVITY CRP	$35.20	$44.00	$12.69–$40.92	48% below	20%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 HIGH SENSITIVITY CRP [CCL]	$35.20	$44.00	$12.69–$40.92	—	20%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 HIGH SENSITIVITY CRP	$35.20	$44.00	$12.69–$40.92	—	20%
Homocysteine blood test CPT 83090 HOMOCYSTEINE LEVEL	$80.00	$100.00	$17.56–$93.00	1% below	20%
Homocysteine blood test CPT 83090 HOMOCYSTEINE, SERUM [CCL]	$80.00	$100.00	$17.56–$93.00	1% below	20%
Homocysteine blood test CPT 83090 HOMOCYSTEINE,NUTRITIONAL AND CONGENITAL	$80.00	$100.00	$17.56–$93.00	1% below	20%
Homocysteine blood test inpatient CPT 83090 HOMOCYSTEINE,NUTRITIONAL AND CONGENITAL	$80.00	$100.00	$17.56–$93.00	—	20%
Homocysteine blood test inpatient CPT 83090 HOMOCYSTEINE LEVEL	$80.00	$100.00	$17.56–$93.00	—	20%
Homocysteine blood test inpatient CPT 83090 HOMOCYSTEINE, SERUM [CCL]	$80.00	$100.00	$17.56–$93.00	—	20%
Insulin blood test CPT 83525 INSULIN [CCL]	$44.80	$56.00	$11.20–$52.08	13% below	20%
Insulin blood test CPT 83525 INSULIN	$44.80	$56.00	$11.20–$52.08	13% below	20%
Insulin blood test CPT 83525 INSULIN, SERUM	$44.80	$56.00	$11.20–$52.08	13% below	20%
Insulin blood test inpatient CPT 83525 INSULIN [CCL]	$44.80	$56.00	$11.20–$52.08	—	20%
Insulin blood test inpatient CPT 83525 INSULIN	$44.80	$56.00	$11.20–$52.08	—	20%
Insulin blood test inpatient CPT 83525 INSULIN, SERUM	$44.80	$56.00	$11.20–$52.08	—	20%
Iron blood test (serum iron) CPT 83540 IRON	$39.20	$49.00	$6.34–$45.57	3% above	20%
Iron blood test (serum iron) CPT 83540 IRON [CCL]	$39.20	$49.00	$6.34–$45.57	3% above	20%
Iron blood test (serum iron) CPT 83540 IRON AND TIBC [CCL]	$39.20	$49.00	$6.34–$45.57	3% above	20%
Iron blood test (serum iron) CPT 83540 IRON AND TIBC	$39.20	$49.00	$6.34–$45.57	3% above	20%
Iron blood test (serum iron) inpatient CPT 83540 IRON AND TIBC	$39.20	$49.00	$6.34–$45.57	—	20%
Iron blood test (serum iron) inpatient CPT 83540 IRON [CCL]	$39.20	$49.00	$6.34–$45.57	—	20%
Iron blood test (serum iron) inpatient CPT 83540 IRON	$39.20	$49.00	$6.34–$45.57	—	20%
Iron blood test (serum iron) inpatient CPT 83540 IRON AND TIBC [CCL]	$39.20	$49.00	$6.34–$45.57	—	20%
Iron-binding capacity (TIBC) test CPT 83550 IRON AND TIBC	$38.40	$48.00	$8.57–$44.64	2% below	20%
Iron-binding capacity (TIBC) test CPT 83550 TIBC	$39.20	$49.00	$8.57–$45.57	1% above	20%
Iron-binding capacity (TIBC) test CPT 83550 UIBC	$39.20	$49.00	$8.57–$45.57	1% above	20%
Iron-binding capacity (TIBC) test inpatient CPT 83550 IRON AND TIBC	$38.40	$48.00	$8.57–$44.64	—	20%
Iron-binding capacity (TIBC) test inpatient CPT 83550 UIBC	$39.20	$49.00	$8.57–$45.57	—	20%
Iron-binding capacity (TIBC) test inpatient CPT 83550 TIBC	$39.20	$49.00	$8.57–$45.57	—	20%
Kidney function blood test panel CPT 80069 RENAL FUNCTION PANEL	$61.60	$77.00	$8.51–$71.61	14% below	20%
Kidney function blood test panel CPT 80069 RENAL FUNCTION PANEL WITH eGFR	$63.20	$79.00	$8.51–$73.47	12% below	20%
Kidney function blood test panel CPT 80069 RENAL FUNCTION PANEL [CCL]	$63.20	$79.00	$8.51–$73.47	12% below	20%
Kidney function blood test panel inpatient CPT 80069 RENAL FUNCTION PANEL	$61.60	$77.00	$8.51–$71.61	—	20%
Kidney function blood test panel inpatient CPT 80069 RENAL FUNCTION PANEL WITH eGFR	$63.20	$79.00	$8.51–$73.47	—	20%
Kidney function blood test panel inpatient CPT 80069 RENAL FUNCTION PANEL [CCL]	$63.20	$79.00	$8.51–$73.47	—	20%
LH (luteinizing hormone) test CPT 83002 LUTEINIZING HORMONE LH	$80.00	$100.00	$18.15–$93.00	16% below	20%
LH (luteinizing hormone) test CPT 83002 LUTEINIZING HORMONE [CCL]	$80.00	$100.00	$18.15–$93.00	16% below	20%
LH (luteinizing hormone) test inpatient CPT 83002 LUTEINIZING HORMONE [CCL]	$80.00	$100.00	$18.15–$93.00	—	20%
LH (luteinizing hormone) test inpatient CPT 83002 LUTEINIZING HORMONE LH	$80.00	$100.00	$18.15–$93.00	—	20%
Lactate (lactic acid) blood test CPT 83605 LACTATE [i-STAT]	$48.80	$61.00	$11.34–$56.73	6% below	20%
Lactate (lactic acid) blood test CPT 83605 LACTATE	$48.80	$61.00	$11.34–$56.73	6% below	20%
Lactate (lactic acid) blood test CPT 83605 LACTATE/PYRUVATE	$48.80	$61.00	$11.34–$56.73	6% below	20%
Lactate (lactic acid) blood test inpatient CPT 83605 LACTATE [i-STAT]	$48.80	$61.00	$11.34–$56.73	—	20%
Lactate (lactic acid) blood test inpatient CPT 83605 LACTATE	$48.80	$61.00	$11.34–$56.73	—	20%
Lactate (lactic acid) blood test inpatient CPT 83605 LACTATE/PYRUVATE	$48.80	$61.00	$11.34–$56.73	—	20%
Lactate dehydrogenase (LDH) blood test CPT 83615 LACTATE DEHYDROGENASE BODY FLUID [CCL]	$26.40	$33.00	$5.92–$30.69	3% below	20%
Lactate dehydrogenase (LDH) blood test CPT 83615 LD ISOENZYMES [CCL]	$26.40	$33.00	$5.92–$30.69	3% below	20%
Lactate dehydrogenase (LDH) blood test CPT 83615 LDH - DAILY	$26.40	$33.00	$5.92–$30.69	3% below	20%
Lactate dehydrogenase (LDH) blood test CPT 83615 LDH	$26.40	$33.00	$5.92–$30.69	3% below	20%
Lactate dehydrogenase (LDH) blood test CPT 83615 LD TOTAL [AULTMAN]	$26.40	$33.00	$5.92–$30.69	3% below	20%
Lactate dehydrogenase (LDH) blood test CPT 83615 LDH, PLEURAL FLUID	$26.40	$33.00	$5.92–$30.69	3% below	20%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 LACTATE DEHYDROGENASE BODY FLUID [CCL]	$26.40	$33.00	$5.92–$30.69	—	20%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 LDH, PLEURAL FLUID	$26.40	$33.00	$5.92–$30.69	—	20%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 LDH	$26.40	$33.00	$5.92–$30.69	—	20%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 LDH - DAILY	$26.40	$33.00	$5.92–$30.69	—	20%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 LD TOTAL [AULTMAN]	$26.40	$33.00	$5.92–$30.69	—	20%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 LD ISOENZYMES [CCL]	$26.40	$33.00	$5.92–$30.69	—	20%
Lipase blood test (pancreas enzyme) CPT 83690 LIPASE	$44.80	$56.00	$6.75–$52.08	23% below	20%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 LIPASE	$44.80	$56.00	$6.75–$52.08	—	20%
Liver function blood test panel CPT 80076 LIVER FUNCTION/COMMUNITY OUTREACH ONLY	$36.00	$45.00	$8.01–$41.85	41% below	20%
Liver function blood test panel CPT 80076 HEPATIC FUNCTION PANEL	$70.40	$88.00	$8.01–$81.84	16% above	20%
Liver function blood test panel inpatient CPT 80076 LIVER FUNCTION/COMMUNITY OUTREACH ONLY	$36.00	$45.00	$8.01–$41.85	—	20%
Liver function blood test panel inpatient CPT 80076 HEPATIC FUNCTION PANEL	$70.40	$88.00	$8.01–$81.84	—	20%
Lyme disease antibody test CPT 86618 LYME LATE (SIGNS/SYMP >30 DAYS) [CCL]	$59.20	$74.00	$16.69–$68.82	23% below	20%
Lyme disease antibody test CPT 86618 LYME EARLY (SIGNS/SYMP <=30 DAYS) [CCL]	$59.20	$74.00	$16.69–$68.82	23% below	20%
Lyme disease antibody test CPT 86618 LYME DISEASE IGG AND IGM, WB	$59.20	$74.00	$16.69–$68.82	23% below	20%
Lyme disease antibody test inpatient CPT 86618 LYME DISEASE IGG AND IGM, WB	$59.20	$74.00	$16.69–$68.82	—	20%
Lyme disease antibody test inpatient CPT 86618 LYME EARLY (SIGNS/SYMP <=30 DAYS) [CCL]	$59.20	$74.00	$16.69–$68.82	—	20%
Lyme disease antibody test inpatient CPT 86618 LYME LATE (SIGNS/SYMP >30 DAYS) [CCL]	$59.20	$74.00	$16.69–$68.82	—	20%
Magnesium blood test CPT 83735 MAGNESIUM,24 HOUR URINE	$44.80	$56.00	$6.57–$52.08	33% above	20%
Magnesium blood test CPT 83735 MAGNESIUM RBC [CCL]	$44.80	$56.00	$6.57–$52.08	33% above	20%
Magnesium blood test CPT 83735 MAGNESIUM	$44.80	$56.00	$6.57–$52.08	33% above	20%
Magnesium blood test CPT 83735 MAGNESIUM DAILY	$44.80	$56.00	$6.57–$52.08	33% above	20%
Magnesium blood test inpatient CPT 83735 MAGNESIUM	$44.80	$56.00	$6.57–$52.08	—	20%
Magnesium blood test inpatient CPT 83735 MAGNESIUM,24 HOUR URINE	$44.80	$56.00	$6.57–$52.08	—	20%
Magnesium blood test inpatient CPT 83735 MAGNESIUM DAILY	$44.80	$56.00	$6.57–$52.08	—	20%
Magnesium blood test inpatient CPT 83735 MAGNESIUM RBC [CCL]	$44.80	$56.00	$6.57–$52.08	—	20%
Measles (rubeola) antibody test CPT 86765 MEASLES IGG ANTIBODY [CCL]	$52.80	$66.00	$12.62–$61.38	8% below	20%
Measles (rubeola) antibody test CPT 86765 MEASLES IgM [CCL]	$52.80	$66.00	$12.62–$61.38	8% below	20%
Measles (rubeola) antibody test inpatient CPT 86765 MEASLES IGG ANTIBODY [CCL]	$52.80	$66.00	$12.62–$61.38	—	20%
Measles (rubeola) antibody test inpatient CPT 86765 MEASLES IgM [CCL]	$52.80	$66.00	$12.62–$61.38	—	20%
Mono test (heterophile antibody, Monospot) CPT 86308 MONO TEST	$48.00	$60.00	$5.08–$55.80	10% below	20%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 MONO TEST	$48.00	$60.00	$5.08–$55.80	—	20%
Mumps immunity blood test CPT 86735 MMR PROFILE	$46.40	$58.00	$12.79–$53.94	21% below	20%
Mumps immunity blood test CPT 86735 MUMPS VIRUS AB IGM	$48.00	$60.00	$12.79–$55.80	18% below	20%
Mumps immunity blood test CPT 86735 MUMPS IGG AB [CCL]	$48.00	$60.00	$12.79–$55.80	18% below	20%
Mumps immunity blood test CPT 86735 MUMPS VIRUS AB (IGG)	$48.00	$60.00	$12.79–$55.80	18% below	20%
Mumps immunity blood test CPT 86735 MUMPS IgM ANTIBODY [CCL]	$48.00	$60.00	$12.79–$55.80	18% below	20%
Mumps immunity blood test inpatient CPT 86735 MMR PROFILE	$46.40	$58.00	$12.79–$53.94	—	20%
Mumps immunity blood test inpatient CPT 86735 MUMPS VIRUS AB (IGG)	$48.00	$60.00	$12.79–$55.80	—	20%
Mumps immunity blood test inpatient CPT 86735 MUMPS IgM ANTIBODY [CCL]	$48.00	$60.00	$12.79–$55.80	—	20%
Mumps immunity blood test inpatient CPT 86735 MUMPS IGG AB [CCL]	$48.00	$60.00	$12.79–$55.80	—	20%
Mumps immunity blood test inpatient CPT 86735 MUMPS VIRUS AB IGM	$48.00	$60.00	$12.79–$55.80	—	20%
Obstetric blood test panel CPT 80055 OB PANEL	$88.00	$110.00	$46.85–$102.30	59% below	20%
Obstetric blood test panel inpatient CPT 80055 OB PANEL	$88.00	$110.00	$46.85–$102.30	—	20%
PSA (prostate-specific antigen) blood test, free CPT 84154 PSA, FREE [CCL]	$35.20	$44.00	$18.02–$40.92	57% below	20%
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 PSA, FREE [CCL]	$35.20	$44.00	$18.02–$40.92	—	20%
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA CANCER SCREENING (G0103)	$51.20	$64.00	$18.02–$59.52	35% below	20%
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA SCREENING [CCL]	$61.60	$77.00	$18.02–$71.61	22% below	20%
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA TOTAL 84153 (Cancer/Elevated)	$61.60	$77.00	$18.02–$71.61	22% below	20%
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA [CCL]	$61.60	$77.00	$18.02–$71.61	22% below	20%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA CANCER SCREENING (G0103)	$51.20	$64.00	$18.02–$59.52	—	20%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA SCREENING [CCL]	$61.60	$77.00	$18.02–$71.61	—	20%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA TOTAL 84153 (Cancer/Elevated)	$61.60	$77.00	$18.02–$71.61	—	20%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA [CCL]	$61.60	$77.00	$18.02–$71.61	—	20%
Pap test (liquid-based, automated screening with review) CPT 88175 THIN PREP (Ault) HPV DNA	$88.00	$110.00	$26.08–$102.30	10% below	20%
Pap test (liquid-based, automated screening with review) CPT 88175 THIN PREP (Ault) PAP WITH HPV REFLEX	$88.00	$110.00	$26.08–$102.30	10% below	20%
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 THIN PREP (Ault) PAP WITH HPV REFLEX	$88.00	$110.00	$26.08–$102.30	—	20%
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 THIN PREP (Ault) HPV DNA	$88.00	$110.00	$26.08–$102.30	—	20%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 CYTOPATH C/V THINLAYER	$88.00	$110.00	$19.85–$102.30	3% below	20%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 THIN PREP (Ault) PAP	$88.00	$110.00	$19.85–$102.30	3% below	20%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 PAP (Ault) LIQUID WITH/HPV	$88.00	$110.00	$19.85–$102.30	3% below	20%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 PAP (Ault) LIQUID REFLEX TO HPV	$88.00	$110.00	$19.85–$102.30	3% below	20%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 PAP (Ault) LIQUID BASED	$88.00	$110.00	$19.85–$102.30	3% below	20%
Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 THIN PREP (Ault) PAP	$88.00	$110.00	$19.85–$102.30	—	20%
Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 CYTOPATH C/V THINLAYER	$88.00	$110.00	$19.85–$102.30	—	20%
Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 PAP (Ault) LIQUID BASED	$88.00	$110.00	$19.85–$102.30	—	20%
Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 PAP (Ault) LIQUID REFLEX TO HPV	$88.00	$110.00	$19.85–$102.30	—	20%
Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 PAP (Ault) LIQUID WITH/HPV	$88.00	$110.00	$19.85–$102.30	—	20%
Parathyroid hormone (PTH) blood test CPT 83970 PARATHYROID HORMONE (PTH) INTACT	$88.00	$110.00	$40.45–$102.30	38% below	20%
Parathyroid hormone (PTH) blood test CPT 83970 PTH, INTACT [CCL]	$88.00	$110.00	$40.45–$102.30	38% below	20%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 PARATHYROID HORMONE (PTH) INTACT	$88.00	$110.00	$40.45–$102.30	—	20%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 PTH, INTACT [CCL]	$88.00	$110.00	$40.45–$102.30	—	20%
Partial thromboplastin time (PTT) clotting test CPT 85730 APTT	$39.20	$49.00	$5.89–$45.57	4% above	20%
Partial thromboplastin time (PTT) clotting test CPT 85730 APTT-HEPARIN	$39.20	$49.00	$5.89–$45.57	4% above	20%
Partial thromboplastin time (PTT) clotting test CPT 85730 PTT-LA	$39.20	$49.00	$5.89–$45.57	4% above	20%
Partial thromboplastin time (PTT) clotting test CPT 85730 APTT [CCL]	$39.20	$49.00	$5.89–$45.57	4% above	20%
Partial thromboplastin time (PTT) clotting test CPT 85730 PROLONGED aPTT ASYMPOTMATIC EVA	$39.20	$49.00	$5.89–$45.57	4% above	20%
Partial thromboplastin time (PTT) clotting test CPT 85730 APTT - DAILY	$39.20	$49.00	$5.89–$45.57	4% above	20%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PTT-LA	$39.20	$49.00	$5.89–$45.57	—	20%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 APTT	$39.20	$49.00	$5.89–$45.57	—	20%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 APTT - DAILY	$39.20	$49.00	$5.89–$45.57	—	20%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 APTT-HEPARIN	$39.20	$49.00	$5.89–$45.57	—	20%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 APTT [CCL]	$39.20	$49.00	$5.89–$45.57	—	20%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PROLONGED aPTT ASYMPOTMATIC EVA	$39.20	$49.00	$5.89–$45.57	—	20%
Phosphorus (phosphate) blood test CPT 84100 PHOSPHORUS	$28.00	$35.00	$4.65–$32.55	22% below	20%
Phosphorus (phosphate) blood test CPT 84100 PHOSPHOROUS [CCL]	$28.00	$35.00	$4.65–$32.55	22% below	20%
Phosphorus (phosphate) blood test inpatient CPT 84100 PHOSPHOROUS [CCL]	$28.00	$35.00	$4.65–$32.55	—	20%
Phosphorus (phosphate) blood test inpatient CPT 84100 PHOSPHORUS	$28.00	$35.00	$4.65–$32.55	—	20%
Potassium blood test CPT 84132 POTASSIUM	$30.40	$38.00	$4.66–$35.34	30% above	20%
Potassium blood test inpatient CPT 84132 POTASSIUM	$30.40	$38.00	$4.66–$35.34	—	20%
Progesterone blood test CPT 84144 PROGESTERONE	$48.80	$61.00	$20.44–$56.73	40% below	20%
Progesterone blood test CPT 84144 PROGESTERONE [CCL]	$48.80	$61.00	$20.44–$56.73	40% below	20%
Progesterone blood test inpatient CPT 84144 PROGESTERONE [CCL]	$48.80	$61.00	$20.44–$56.73	—	20%
Progesterone blood test inpatient CPT 84144 PROGESTERONE	$48.80	$61.00	$20.44–$56.73	—	20%
Prolactin blood test CPT 84146 PROLACTIN	$80.00	$100.00	$18.99–$93.00	8% below	20%
Prolactin blood test CPT 84146 PROLACTIN DILUTION STUDY [CCL]	$80.00	$100.00	$18.99–$93.00	8% below	20%
Prolactin blood test CPT 84146 PROLACTIN [CCL]	$80.00	$100.00	$18.99–$93.00	8% below	20%
Prolactin blood test inpatient CPT 84146 PROLACTIN [CCL]	$80.00	$100.00	$18.99–$93.00	—	20%
Prolactin blood test inpatient CPT 84146 PROLACTIN	$80.00	$100.00	$18.99–$93.00	—	20%
Prolactin blood test inpatient CPT 84146 PROLACTIN DILUTION STUDY [CCL]	$80.00	$100.00	$18.99–$93.00	—	20%
Prothrombin time (PT/INR) clotting test CPT 85610 PT/INR DAILY PATIENT ON COUMADIN	$24.00	$30.00	$4.20–$27.90	at median	20%
Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME AND INR	$24.00	$30.00	$4.20–$27.90	at median	20%
Prothrombin time (PT/INR) clotting test CPT 85610 PROTIME [CCL]	$24.00	$30.00	$4.20–$27.90	at median	20%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTHROMBIN TIME AND INR	$24.00	$30.00	$4.20–$27.90	—	20%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PT/INR DAILY PATIENT ON COUMADIN	$24.00	$30.00	$4.20–$27.90	—	20%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTIME [CCL]	$24.00	$30.00	$4.20–$27.90	—	20%
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 9 PANEL RAPID DRUG SCREEN	$26.40	$33.00	$12.35–$30.69	54% below	20%
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 5 PANEL RAPID DRUG SCREEN	$26.40	$33.00	$12.35–$30.69	54% below	20%
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 10 PANEL RAPID DRUG SCREEN	$26.40	$33.00	$12.35–$30.69	54% below	20%
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 DRUG TEST PRESUMP ANY NUMBER OF	$26.40	$33.00	$12.35–$30.69	54% below	20%
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 13 PANEL URINE DRUG TEST	$26.40	$33.00	$12.35–$30.69	54% below	20%
Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 10 PANEL RAPID DRUG SCREEN	$26.40	$33.00	$12.35–$30.69	—	20%
Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 9 PANEL RAPID DRUG SCREEN	$26.40	$33.00	$12.35–$30.69	—	20%
Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 13 PANEL URINE DRUG TEST	$26.40	$33.00	$12.35–$30.69	—	20%
Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 DRUG TEST PRESUMP ANY NUMBER OF	$26.40	$33.00	$12.35–$30.69	—	20%
Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 5 PANEL RAPID DRUG SCREEN	$26.40	$33.00	$12.35–$30.69	—	20%
Rapid flu test (influenza antigen) CPT 87804 INFLUENZA ASSAY W/OPTIC	$64.80	$81.00	$16.22–$75.33	1% below	20%
Rapid flu test (influenza antigen) inpatient CPT 87804 INFLUENZA ASSAY W/OPTIC	$64.80	$81.00	$16.22–$75.33	—	20%
Renin blood test CPT 84244 RENIN, PLASMA [CCL]	$59.20	$74.00	$21.55–$68.82	31% below	20%
Renin blood test inpatient CPT 84244 RENIN, PLASMA [CCL]	$59.20	$74.00	$21.55–$68.82	—	20%
Rh blood typing CPT 86901 GAMULIN [AULTMAN]	$52.80	$66.00	$2.93–$61.38	42% above	20%
Rh blood typing CPT 86901 Rh TYPE	$52.80	$66.00	$2.93–$61.38	42% above	20%
Rh blood typing CPT 86901 TYPE AND SCREEN [CCL]	$52.80	$66.00	$2.93–$61.38	42% above	20%
Rh blood typing CPT 86901 BB GAMULIN WORKUP	$52.80	$66.00	$2.93–$61.38	42% above	20%
Rh blood typing CPT 86901 TYPE AND SCREEN, PRENATAL WORKUP [CCL]	$52.80	$66.00	$2.93–$61.38	42% above	20%
Rh blood typing inpatient CPT 86901 TYPE AND SCREEN, PRENATAL WORKUP [CCL]	$52.80	$66.00	$2.93–$61.38	—	20%
Rh blood typing inpatient CPT 86901 GAMULIN [AULTMAN]	$52.80	$66.00	$2.93–$61.38	—	20%
Rh blood typing inpatient CPT 86901 TYPE AND SCREEN [CCL]	$52.80	$66.00	$2.93–$61.38	—	20%
Rh blood typing inpatient CPT 86901 BB GAMULIN WORKUP	$52.80	$66.00	$2.93–$61.38	—	20%
Rh blood typing inpatient CPT 86901 Rh TYPE	$52.80	$66.00	$2.93–$61.38	—	20%
Rheumatoid factor (RF) test CPT 86431 RHEUMATOID FACTOR IgM ABS [CCL]	$47.20	$59.00	$5.56–$54.87	42% above	20%
Rheumatoid factor (RF) test CPT 86431 RHEUMATOID FACTOR (RF)	$47.20	$59.00	$5.56–$54.87	42% above	20%
Rheumatoid factor (RF) test CPT 86431 RHEUMATOID FACTOR [CCL]	$47.20	$59.00	$5.56–$54.87	42% above	20%
Rheumatoid factor (RF) test inpatient CPT 86431 RHEUMATOID FACTOR (RF)	$47.20	$59.00	$5.56–$54.87	—	20%
Rheumatoid factor (RF) test inpatient CPT 86431 RHEUMATOID FACTOR [CCL]	$47.20	$59.00	$5.56–$54.87	—	20%
Rheumatoid factor (RF) test inpatient CPT 86431 RHEUMATOID FACTOR IgM ABS [CCL]	$47.20	$59.00	$5.56–$54.87	—	20%
Rubella antibody test (immunity check) CPT 86762 RUBELLA ANTIBODIES IgG	$60.00	$75.00	$14.10–$69.75	22% above	20%
Rubella antibody test (immunity check) CPT 86762 RUBELLA IgG ANTIBODY [CCL]	$60.00	$75.00	$14.10–$69.75	22% above	20%
Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA IgG ANTIBODY [CCL]	$60.00	$75.00	$14.10–$69.75	—	20%
Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA ANTIBODIES IgG	$60.00	$75.00	$14.10–$69.75	—	20%
Semen analysis: volume, sperm count, motility and morphology CPT 89320 SEMEN ANALYSIS FERTILITY	$44.80	$56.00	$12.06–$52.08	66% below	20%
Semen analysis: volume, sperm count, motility and morphology inpatient CPT 89320 SEMEN ANALYSIS FERTILITY	$44.80	$56.00	$12.06–$52.08	—	20%
Sodium blood test CPT 84295 SODIUM; SERUM, PLASMA	$32.80	$41.00	$4.71–$38.13	21% above	20%
Sodium blood test inpatient CPT 84295 SODIUM; SERUM, PLASMA	$32.80	$41.00	$4.71–$38.13	—	20%
Stool ova and parasites exam CPT 87177 OVA & PARASITES DIRECT SMEAR CON & ID	$22.40	$28.00	$8.72–$26.04	44% below	20%
Stool ova and parasites exam inpatient CPT 87177 OVA & PARASITES DIRECT SMEAR CON & ID	$22.40	$28.00	$8.72–$26.04	—	20%
Stool test for hidden blood (guaiac FOBT) CPT 82270 OCCULT BLOOD STOOL (CANCER SCREENING)	$24.00	$30.00	$4.29–$27.90	17% below	20%
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 OCCULT BLOOD STOOL (CANCER SCREENING)	$24.00	$30.00	$4.29–$27.90	—	20%
Stool test for hidden blood by immunoassay (FIT) CPT 82274 FECAL OCCULT BLOOD TEST [CCL]	$26.40	$33.00	$15.60–$30.69	51% below	20%
Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 FECAL OCCULT BLOOD TEST [CCL]	$26.40	$33.00	$15.60–$30.69	—	20%
Syphilis antibody test (Treponema pallidum) CPT 86780 SYPHILIS TOTAL W/REFLEX [TEST]	$25.60	$32.00	$12.98–$29.76	56% below	20%
Syphilis antibody test (Treponema pallidum) CPT 86780 SYPHILIS IgG (T PALLIDUM) [OLD]	$25.60	$32.00	$12.98–$29.76	56% below	20%
Syphilis antibody test (Treponema pallidum) CPT 86780 FTA-ABS, SERUM	$26.40	$33.00	$12.98–$30.69	54% below	20%
Syphilis antibody test (Treponema pallidum) CPT 86780 SYPHILIS TOTAL (IgG AND IgM) AB QUALIT	$26.40	$33.00	$12.98–$30.69	54% below	20%
Syphilis antibody test (Treponema pallidum) CPT 86780 SYPHILIS TOTAL W/REFLEX [CCL]	$26.40	$33.00	$12.98–$30.69	54% below	20%
Syphilis antibody test (Treponema pallidum) CPT 86780 SYPHILIS IgG (T PALLIDUM) [CCL]	$26.40	$33.00	$12.98–$30.69	54% below	20%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 SYPHILIS TOTAL W/REFLEX [TEST]	$25.60	$32.00	$12.98–$29.76	—	20%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 SYPHILIS IgG (T PALLIDUM) [OLD]	$25.60	$32.00	$12.98–$29.76	—	20%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 FTA-ABS, SERUM	$26.40	$33.00	$12.98–$30.69	—	20%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 SYPHILIS TOTAL W/REFLEX [CCL]	$26.40	$33.00	$12.98–$30.69	—	20%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 SYPHILIS TOTAL (IgG AND IgM) AB QUALIT	$26.40	$33.00	$12.98–$30.69	—	20%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 SYPHILIS IgG (T PALLIDUM) [CCL]	$26.40	$33.00	$12.98–$30.69	—	20%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 RPR QUANTITATIVE TITER [CCL]	$39.20	$49.00	$4.18–$45.57	64% above	20%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 RPR [CCL]	$39.20	$49.00	$4.18–$45.57	64% above	20%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 RPR QUANTITATIVE TITER [CCL]	$39.20	$49.00	$4.18–$45.57	—	20%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 RPR [CCL]	$39.20	$49.00	$4.18–$45.57	—	20%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 QUANTIFERON TB INCUBATED [CCL]	$145.60	$182.00	$60.74–$169.26	24% above	20%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 QUANTIFERON TB INCUBATED PRE-EMPL [CCL]	$145.60	$182.00	$60.74–$169.26	24% above	20%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 QUANTIFERON TB INCUBATED [CCL]	$145.60	$182.00	$60.74–$169.26	—	20%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 QUANTIFERON TB INCUBATED PRE-EMPL [CCL]	$145.60	$182.00	$60.74–$169.26	—	20%
Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE, FREE AND TOTAL,LC/MS/MS	$57.60	$72.00	$25.29–$66.96	37% below	20%
Testosterone blood test, total (not free testosterone) CPT 84403 TESTOST,FR/TOT,MALES BY ED/LC MSMS [CCL]	$57.60	$72.00	$25.29–$66.96	37% below	20%
Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE, TOTAL, BY MS [CCL]	$57.60	$72.00	$25.29–$66.96	37% below	20%
Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE, TOTAL (WOMEN,CHILDREN)	$57.60	$72.00	$25.29–$66.96	37% below	20%
Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE, TOTAL & FREE, SERUM [CCL]	$57.60	$72.00	$25.29–$66.96	37% below	20%
Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE, TOTAL	$57.60	$72.00	$25.29–$66.96	37% below	20%
Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE [CCL]	$57.60	$72.00	$25.29–$66.96	37% below	20%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE, FREE AND TOTAL,LC/MS/MS	$57.60	$72.00	$25.29–$66.96	—	20%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE, TOTAL	$57.60	$72.00	$25.29–$66.96	—	20%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE, TOTAL & FREE, SERUM [CCL]	$57.60	$72.00	$25.29–$66.96	—	20%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE, TOTAL (WOMEN,CHILDREN)	$57.60	$72.00	$25.29–$66.96	—	20%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE, TOTAL, BY MS [CCL]	$57.60	$72.00	$25.29–$66.96	—	20%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOST,FR/TOT,MALES BY ED/LC MSMS [CCL]	$57.60	$72.00	$25.29–$66.96	—	20%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE [CCL]	$57.60	$72.00	$25.29–$66.96	—	20%
Thyroid peroxidase (TPO) antibody test CPT 86376 MICROSOMAL AB	$57.60	$72.00	$14.26–$66.96	11% below	20%
Thyroid peroxidase (TPO) antibody test CPT 86376 THYROGLOBULIN AB & THYROID PEROXIDASE AB	$57.60	$72.00	$14.26–$66.96	11% below	20%
Thyroid peroxidase (TPO) antibody test CPT 86376 THYROID PEROXIDASE AB [CCL]	$57.60	$72.00	$14.26–$66.96	11% below	20%
Thyroid peroxidase (TPO) antibody test CPT 86376 LIVER KIDNEY MICROSOME IgG AUTOABS [CCL]	$57.60	$72.00	$14.26–$66.96	11% below	20%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 THYROID PEROXIDASE AB [CCL]	$57.60	$72.00	$14.26–$66.96	—	20%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 LIVER KIDNEY MICROSOME IgG AUTOABS [CCL]	$57.60	$72.00	$14.26–$66.96	—	20%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 THYROGLOBULIN AB & THYROID PEROXIDASE AB	$57.60	$72.00	$14.26–$66.96	—	20%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 MICROSOMAL AB	$57.60	$72.00	$14.26–$66.96	—	20%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 THYROID CASCADING REFLEX	$77.60	$97.00	$16.46–$90.21	3% above	20%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH	$80.80	$101.00	$16.46–$93.93	7% above	20%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH W/ REFLEX TO FREE T4	$80.80	$101.00	$16.46–$93.93	7% above	20%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH [AULTMAN]	$80.80	$101.00	$16.46–$93.93	7% above	20%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH [CCL]	$80.80	$101.00	$16.46–$93.93	7% above	20%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH 3RD GENERATION	$80.80	$101.00	$16.46–$93.93	7% above	20%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 THYROID CASCADING REFLEX	$77.60	$97.00	$16.46–$90.21	—	20%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH 3RD GENERATION	$80.80	$101.00	$16.46–$93.93	—	20%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH	$80.80	$101.00	$16.46–$93.93	—	20%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH W/ REFLEX TO FREE T4	$80.80	$101.00	$16.46–$93.93	—	20%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH [AULTMAN]	$80.80	$101.00	$16.46–$93.93	—	20%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH [CCL]	$80.80	$101.00	$16.46–$93.93	—	20%
Total IgE blood test CPT 82785 IGE [CCL]	$28.80	$36.00	$16.13–$33.48	54% below	20%
Total IgE blood test inpatient CPT 82785 IGE [CCL]	$28.80	$36.00	$16.13–$33.48	—	20%
Total cholesterol blood test CPT 82465 CHOLESTEROL	$33.60	$42.00	$4.26–$39.06	8% below	20%
Total cholesterol blood test inpatient CPT 82465 CHOLESTEROL	$33.60	$42.00	$4.26–$39.06	—	20%
Total thyroxine (T4) blood test CPT 84436 T4 [CCL]	$39.20	$49.00	$6.73–$45.57	6% below	20%
Total thyroxine (T4) blood test CPT 84436 T4 (THYROXINE) TOTAL	$39.20	$49.00	$6.73–$45.57	6% below	20%
Total thyroxine (T4) blood test inpatient CPT 84436 T4 [CCL]	$39.20	$49.00	$6.73–$45.57	—	20%
Total thyroxine (T4) blood test inpatient CPT 84436 T4 (THYROXINE) TOTAL	$39.20	$49.00	$6.73–$45.57	—	20%
Total triiodothyronine (T3) blood test CPT 84480 T3 ( TRIIODOTHYRONINE) TOTAL	$61.60	$77.00	$13.90–$71.61	2% above	20%
Total triiodothyronine (T3) blood test CPT 84480 T3 ( TRIIODOTHYRONINE) [CCL]	$61.60	$77.00	$13.90–$71.61	2% above	20%
Total triiodothyronine (T3) blood test inpatient CPT 84480 T3 ( TRIIODOTHYRONINE) TOTAL	$61.60	$77.00	$13.90–$71.61	—	20%
Total triiodothyronine (T3) blood test inpatient CPT 84480 T3 ( TRIIODOTHYRONINE) [CCL]	$61.60	$77.00	$13.90–$71.61	—	20%
Transferrin blood test CPT 84466 TRANSFERRIN [CCL]	$48.80	$61.00	$12.50–$56.73	34% below	20%
Transferrin blood test inpatient CPT 84466 TRANSFERRIN [CCL]	$48.80	$61.00	$12.50–$56.73	—	20%
Trichomonas test (NAAT) CPT 87661 TRICHOMONAS VAGINALIS AMPLIFICATION[OLD]	$85.60	$107.00	$34.39–$99.51	1% below	20%
Trichomonas test (NAAT) CPT 87661 TRICHOMONAS VAGINAILIS AMPLIF [AULTMAN]	$88.00	$110.00	$34.39–$102.30	2% above	20%
Trichomonas test (NAAT) CPT 87661 TRICHOMONAS VAGINALIS AMPLIFICATION[CCL]	$88.00	$110.00	$34.39–$102.30	2% above	20%
Trichomonas test (NAAT) inpatient CPT 87661 TRICHOMONAS VAGINALIS AMPLIFICATION[OLD]	$85.60	$107.00	$34.39–$99.51	—	20%
Trichomonas test (NAAT) inpatient CPT 87661 TRICHOMONAS VAGINAILIS AMPLIF [AULTMAN]	$88.00	$110.00	$34.39–$102.30	—	20%
Trichomonas test (NAAT) inpatient CPT 87661 TRICHOMONAS VAGINALIS AMPLIFICATION[CCL]	$88.00	$110.00	$34.39–$102.30	—	20%
Triglycerides blood test CPT 84478 VLDL CHOLESTEROL	$40.00	$50.00	$5.63–$46.50	16% above	20%
Triglycerides blood test CPT 84478 TRIGLYCERIDES	$40.00	$50.00	$5.63–$46.50	16% above	20%
Triglycerides blood test inpatient CPT 84478 TRIGLYCERIDES	$40.00	$50.00	$5.63–$46.50	—	20%
Triglycerides blood test inpatient CPT 84478 VLDL CHOLESTEROL	$40.00	$50.00	$5.63–$46.50	—	20%
Troponin test, quantitative CPT 84484 TROPONIN I	$76.00	$95.00	$12.22–$88.35	10% below	20%
Troponin test, quantitative CPT 84484 TROPONIN I, HIGH SENSITIVITY	$80.00	$100.00	$12.22–$93.00	5% below	20%
Troponin test, quantitative CPT 84484 HIGH SENSITIVITY TROPONIN T [CCL]	$80.00	$100.00	$12.22–$93.00	5% below	20%
Troponin test, quantitative CPT 84484 TROPONIN	$80.00	$100.00	$12.22–$93.00	5% below	20%
Troponin test, quantitative CPT 84484 TROPONIN I, HIGH SENSITIVITY - DAILY	$80.00	$100.00	$12.22–$93.00	5% below	20%
Troponin test, quantitative inpatient CPT 84484 TROPONIN I	$76.00	$95.00	$12.22–$88.35	—	20%
Troponin test, quantitative inpatient CPT 84484 TROPONIN I, HIGH SENSITIVITY	$80.00	$100.00	$12.22–$93.00	—	20%
Troponin test, quantitative inpatient CPT 84484 TROPONIN	$80.00	$100.00	$12.22–$93.00	—	20%
Troponin test, quantitative inpatient CPT 84484 HIGH SENSITIVITY TROPONIN T [CCL]	$80.00	$100.00	$12.22–$93.00	—	20%
Troponin test, quantitative inpatient CPT 84484 TROPONIN I, HIGH SENSITIVITY - DAILY	$80.00	$100.00	$12.22–$93.00	—	20%
Uric acid blood test CPT 84550 URIC ACID [CCL]	$36.80	$46.00	$4.43–$42.78	5% above	20%
Uric acid blood test CPT 84550 URIC ACID	$36.80	$46.00	$4.43–$42.78	5% above	20%
Uric acid blood test inpatient CPT 84550 URIC ACID	$36.80	$46.00	$4.43–$42.78	—	20%
Uric acid blood test inpatient CPT 84550 URIC ACID [CCL]	$36.80	$46.00	$4.43–$42.78	—	20%
Urinalysis with microscope exam, automated CPT 81001 URINALYSIS	$32.00	$40.00	$3.11–$37.20	19% above	20%
Urinalysis with microscope exam, automated CPT 81001 URINALYSIS WITH MICROSCOPY	$32.00	$40.00	$3.11–$37.20	19% above	20%
Urinalysis with microscope exam, automated inpatient CPT 81001 URINALYSIS	$32.00	$40.00	$3.11–$37.20	—	20%
Urinalysis with microscope exam, automated inpatient CPT 81001 URINALYSIS WITH MICROSCOPY	$32.00	$40.00	$3.11–$37.20	—	20%
Urinalysis without microscope exam, automated CPT 81003 URINALYSIS WITHOUT MICROSCOPY	$20.00	$25.00	$2.20–$23.25	15% below	20%
Urinalysis without microscope exam, automated inpatient CPT 81003 URINALYSIS WITHOUT MICROSCOPY	$20.00	$25.00	$2.20–$23.25	—	20%
Urinalysis without microscope exam, manual CPT 81002 KETONE URINE	$18.40	$23.00	$3.41–$21.39	14% above	20%
Urinalysis without microscope exam, manual CPT 81002 SPEC GRAVITY	$18.40	$23.00	$3.41–$21.39	14% above	20%
Urinalysis without microscope exam, manual inpatient CPT 81002 KETONE URINE	$18.40	$23.00	$3.41–$21.39	—	20%
Urinalysis without microscope exam, manual inpatient CPT 81002 SPEC GRAVITY	$18.40	$23.00	$3.41–$21.39	—	20%
Urine microalbumin (albumin) test CPT 82043 URINE MICROALBUMIN, RANDOM	$28.00	$35.00	$5.66–$32.55	45% below	20%
Urine microalbumin (albumin) test CPT 82043 URINE MICROALBUMIN, 24 HR	$28.00	$35.00	$5.66–$32.55	45% below	20%
Urine microalbumin (albumin) test inpatient CPT 82043 URINE MICROALBUMIN, 24 HR	$28.00	$35.00	$5.66–$32.55	—	20%
Urine microalbumin (albumin) test inpatient CPT 82043 URINE MICROALBUMIN, RANDOM	$28.00	$35.00	$5.66–$32.55	—	20%
Vitamin B12 (cobalamin) blood test CPT 82607 VITB12 [CCL]	$70.40	$88.00	$14.78–$81.84	5% below	20%
Vitamin B12 (cobalamin) blood test CPT 82607 VITAMIN B-12	$70.40	$88.00	$14.78–$81.84	5% below	20%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 VITB12 [CCL]	$70.40	$88.00	$14.78–$81.84	—	20%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 VITAMIN B-12	$70.40	$88.00	$14.78–$81.84	—	20%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 25-HYDROXY D2+D3 [CCL]	$60.00	$75.00	$29.01–$69.75	36% below	20%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D, 25 HYDROXY	$61.60	$77.00	$29.01–$71.61	35% below	20%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D [CCL]	$61.60	$77.00	$29.01–$71.61	35% below	20%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 25-HYDROXY D2+D3 [CCL]	$60.00	$75.00	$29.01–$69.75	—	20%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 VITAMIN D, 25 HYDROXY	$61.60	$77.00	$29.01–$71.61	—	20%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 VITAMIN D [CCL]	$61.60	$77.00	$29.01–$71.61	—	20%
Vitamin D, 1,25-dihydroxy blood test CPT 82652 VITAMIN D, 1,25 - DIHYDROXY [CCL]	$65.60	$82.00	$37.73–$76.26	57% below	20%
Vitamin D, 1,25-dihydroxy blood test inpatient CPT 82652 VITAMIN D, 1,25 - DIHYDROXY [CCL]	$65.60	$82.00	$37.73–$76.26	—	20%
Zinc blood test CPT 84630 ZINC, PLASMA [CCL]	$33.60	$42.00	$11.16–$39.06	35% below	20%
Zinc blood test inpatient CPT 84630 ZINC, PLASMA [CCL]	$33.60	$42.00	$11.16–$39.06	—	20%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HCG, QUANTITATIVE [CCL]	$57.60	$72.00	$14.75–$66.96	15% below	20%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 BETA HCG TUMOR MARKER SERUM [CCL]	$57.60	$72.00	$14.75–$66.96	15% below	20%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HCG	$57.60	$72.00	$14.75–$66.96	15% below	20%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HCG TOTAL, QUANT (TUMOR)	$57.60	$72.00	$14.75–$66.96	15% below	20%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 PREG SERUM QUANT	$57.60	$72.00	$14.75–$66.96	15% below	20%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HCG, QUANTITATIVE [CCL]	$57.60	$72.00	$14.75–$66.96	—	20%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 PREG SERUM QUANT	$57.60	$72.00	$14.75–$66.96	—	20%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 BETA HCG TUMOR MARKER SERUM [CCL]	$57.60	$72.00	$14.75–$66.96	—	20%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HCG	$57.60	$72.00	$14.75–$66.96	—	20%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HCG TOTAL, QUANT (TUMOR)	$57.60	$72.00	$14.75–$66.96	—	20%

Surgery and procedures

Procedure	Cash price	List price	Insurers pay	vs Ohio	Off list
Adenoid removal (adenoidectomy), child under 12 CPT 42830 ADENOIDECTOMY PRIMARY LESS THAN AGE 12	$3,495.20	$4,369.00	$183.36–$4,063.17	51% below	20%
Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 CLTX DSTL FIBULAR FX LAT MALLS W/O MANJ	$311.20	$389.00	$228.70–$361.77	18% below	20%
Broken ankle (outer ankle bone) treatment without surgery or setting inpatient CPT 27786 CLTX DSTL FIBULAR FX LAT MALLS W/O MANJ	$311.20	$389.00	$228.70–$361.77	—	20%
Broken foot (metatarsal) treatment without surgery or setting CPT 28470 CLTX METATARSAL FX W/O MANIPULATION	$311.20	$389.00	$218.73–$361.77	14% below	20%
Broken foot (metatarsal) treatment without surgery or setting inpatient CPT 28470 CLTX METATARSAL FX W/O MANIPULATION	$311.20	$389.00	$218.73–$361.77	—	20%
Cardioversion, elective (restoring heart rhythm) CPT 92960 DEFIBRILLATION CARDIOVERSION	$169.60	$212.00	$114.95–$612.79	92% below	20%
Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION ELECTIVE - OB	$1,280.00	$1,600.00	$144.38–$1,488.00	38% below	20%
Cardioversion, elective (restoring heart rhythm) CPT 92960 CV CARDIOVERSION ELECTIVE	$1,280.00	$1,600.00	$144.38–$1,488.00	38% below	20%
Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION ELECTIVE	$1,280.00	$1,600.00	$144.38–$1,488.00	38% below	20%
Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION	$2,243.00	$2,803.75	$144.38–$2,607.49	9% above	20%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 DEFIBRILLATION CARDIOVERSION	$169.60	$212.00	$114.95–$612.79	—	20%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 CARDIOVERSION ELECTIVE	$1,280.00	$1,600.00	$144.38–$1,488.00	—	20%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 CARDIOVERSION ELECTIVE - OB	$1,280.00	$1,600.00	$144.38–$1,488.00	—	20%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 CV CARDIOVERSION ELECTIVE	$1,280.00	$1,600.00	$144.38–$1,488.00	—	20%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 CARDIOVERSION	$2,243.00	$2,803.75	$144.38–$2,607.49	—	20%
Carpal tunnel release, open surgery one side CPT 64721 NEUROPLASTY AND-TRANSPOS MEDIAN NRV CARPAL TUNNEL UNILATERAL	$3,201.60	$4,002.00	$448.73–$3,721.86	61% below	20%
Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 CIRCUMCISION	$568.00	$710.00	$141.99–$1,977.66	68% below	20%
Circumcision with a clamp or device and a numbing nerve block, usually newborns inpatient CPT 54150 CIRCUMCISION	$568.00	$710.00	$141.99–$1,977.66	—	20%
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 CLTX DSTL RADIAL FX/EPIPHYSL SEP W/O MAN	$311.20	$389.00	$228.70–$361.77	24% below	20%
Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 CLTX DSTL RADIAL FX/EPIPHYSL SEP W/O MAN	$311.20	$389.00	$228.70–$361.77	—	20%
Colonoscopy with polyp removal CPT 45385 COLSC FLX W-RMVL OF TUMOR POLYP LESION SNARE TQ	$3,055.64	$3,819.55	$461.67–$3,552.18	9% below	20%
Colonoscopy with tissue sample CPT 45380 COLONOSCOPY W-BIOPSY SINGLE-MULTIPLE	$3,035.35	$3,794.19	$440.64–$3,528.60	9% below	20%
Colonoscopy, diagnostic CPT 45378 COLONOSCOPY FLX DX W-COLLJ SPEC WHEN PFRMD	$2,649.03	$3,311.29	$348.64–$3,079.50	3% below	20%
Earwax removal by irrigation (rinsing), one ear CPT 69209 REMOVAL IMPACTED CERUMEN IRRIGATION/LVG	$25.60	$32.00	$9.96–$54.69	83% below	20%
Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 REMOVAL IMPACTED CERUMEN IRRIGATION/LVG	$25.60	$32.00	$9.96–$54.69	—	20%
Earwax removal with instruments, one ear CPT 69210 REMOVE CERUMEN	$100.80	$126.00	$44.63–$117.18	35% below	20%
Earwax removal with instruments, one ear one side CPT 69210 REMOVE CERUMEN UNILATERAL	$52.00	$65.00	$27.88–$103.76	66% below	20%
Earwax removal with instruments, one ear inpatient CPT 69210 REMOVE CERUMEN	$100.80	$126.00	$44.63–$117.18	—	20%
Earwax removal with instruments, one ear inpatient one side CPT 69210 REMOVE CERUMEN UNILATERAL	$52.00	$65.00	$27.88–$103.76	—	20%
Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 INJECT ,SINGLE,CERV / THORA W/ IMAGING	$998.40	$1,248.00	$253.42–$1,160.64	55% below	20%
Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 NJX DX/THER SBST INTRLMNR CRV/THRC W/IMG	$998.40	$1,248.00	$253.42–$1,160.64	55% below	20%
Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 CF/PK NJX DX/THER SBST INTRLMNR CRV/	$1,540.80	$1,926.00	$253.42–$1,791.18	31% below	20%
Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 NJX DX-THER SBST INTRLMNR CRV-THRC W-IMG GDN	$1,973.68	$2,467.10	$253.42–$2,294.40	12% below	20%
Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 INJECT ,SINGLE,CERV / THORA W/ IMAGING	$998.40	$1,248.00	$253.42–$1,160.64	—	20%
Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 NJX DX/THER SBST INTRLMNR CRV/THRC W/IMG	$998.40	$1,248.00	$253.42–$1,160.64	—	20%
Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 CF/PK NJX DX/THER SBST INTRLMNR CRV/	$1,540.80	$1,926.00	$253.42–$1,791.18	—	20%
First repair of a small front abdominal hernia (e.g. umbilical), under 3 cm CPT 49591 RPR AA HERNIA 1ST LESS THAN 3 CM REDUCIBLE	$9,462.70	$11,828.37	$303.59–$11,000.38	42% below	20%
Gallbladder removal, laparoscopic CPT 47562 LAPAROSCOPY SURG CHOLECYSTECTOMY	$11,266.21	$14,082.76	$602.81–$13,096.97	35% below	20%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 INJ PROC HYSTERSALPINGOGRAPHY	$152.00	$190.00	$158.65–$186.20	60% below	20%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes inpatient CPT 58340 INJ PROC HYSTERSALPINGOGRAPHY	$152.00	$190.00	$158.65–$186.20	—	20%
Incision and drainage of a simple or single skin abscess CPT 10060 I&D ABSCESS SIMPLE / SINGLE	$171.20	$214.00	$76.45–$271.02	56% below	20%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 I&D ABSCESS SIMPLE / SINGLE	$171.20	$214.00	$76.45–$271.02	—	20%
Inguinal (groin) hernia repair, age 5 or older CPT 49505 RPR 1ST INGUN HRNA AGE 5 YRS-GREATER THAN REDUCIBLE	$7,971.70	$9,964.63	$483.02–$9,267.11	24% below	20%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 CF/PK INJ 1 TENDON SHEATH/LIGAMENT APONE	$446.40	$558.00	$56.45–$518.94	32% above	20%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 INJ 1 TENDON SHEATH/LIGAMENT APONE	$446.40	$558.00	$56.45–$518.94	32% above	20%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 INJ 1 TENDON SHEATH/LIGAMENT APONE	$446.40	$558.00	$56.45–$518.94	—	20%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 CF/PK INJ 1 TENDON SHEATH/LIGAMENT APONE	$446.40	$558.00	$56.45–$518.94	—	20%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ASP/INJ MAJOR (SHLD/HIP/KNEE/SUBAC)	$72.80	$91.00	$51.36–$284.59	90% below	20%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA	$570.40	$713.00	$64.16–$663.09	18% below	20%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ASPIRATION/INJ SHOULDER/HIP/KNEE	$570.40	$713.00	$64.16–$663.09	18% below	20%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 STEROID INJECTION	$570.40	$713.00	$64.16–$663.09	18% below	20%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 CF/PK ARTHROCENTESIS ASPIR&/INJ MAJOR	$570.40	$713.00	$64.16–$663.09	18% below	20%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ASP/INJ MAJOR (SHLD/HIP/KNEE/SUBAC)	$72.80	$91.00	$51.36–$284.59	—	20%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ASPIRATION/INJ SHOULDER/HIP/KNEE	$570.40	$713.00	$64.16–$663.09	—	20%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 STEROID INJECTION	$570.40	$713.00	$64.16–$663.09	—	20%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA	$570.40	$713.00	$64.16–$663.09	—	20%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 CF/PK ARTHROCENTESIS ASPIR&/INJ MAJOR	$570.40	$713.00	$64.16–$663.09	—	20%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ASP / INJ INTERMED JOINT	$58.40	$73.00	$42.45–$284.59	91% below	20%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ARTHROCENTESIS ASPIR&/INJ INTERM JT/BURS	$440.00	$550.00	$53.23–$511.50	29% below	20%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 CF/PK ARTHROCENTESIS ASPIR&/INJ INTERM	$440.00	$550.00	$53.23–$511.50	29% below	20%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 ASP / INJ INTERMED JOINT	$58.40	$73.00	$42.45–$284.59	—	20%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 ARTHROCENTESIS ASPIR&/INJ INTERM JT/BURS	$440.00	$550.00	$53.23–$511.50	—	20%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 CF/PK ARTHROCENTESIS ASPIR&/INJ INTERM	$440.00	$550.00	$53.23–$511.50	—	20%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 ASP JOINT SMALL (FINGER / TOE)	$56.80	$71.00	$38.61–$284.59	88% below	20%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 ARTHROCENTESIS ASPIR&/INJ SMALL JT/BURSA	$388.00	$485.00	$52.28–$451.05	21% below	20%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 CF/PK ARTHROCENTESIS ASPIR&/INJ SMALL	$388.00	$485.00	$52.28–$451.05	21% below	20%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 ASP JOINT SMALL (FINGER / TOE)	$56.80	$71.00	$38.61–$284.59	—	20%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 ARTHROCENTESIS ASPIR&/INJ SMALL JT/BURSA	$388.00	$485.00	$52.28–$451.05	—	20%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 CF/PK ARTHROCENTESIS ASPIR&/INJ SMALL	$388.00	$485.00	$52.28–$451.05	—	20%
Knee arthroscopy with meniscus trim CPT 29881 ARTHRS KNE SURG W-MENISCECTOMY MED-LAT W-SHVG	$7,370.46	$9,213.07	$485.29–$8,568.16	42% below	20%
Laparoscopic appendectomy (appendix removal through small cuts) CPT 44970 LAPAROSCOPIC APPENDECTOMY	$14,525.62	$18,157.03	$550.94–$16,886.04	17% below	20%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 INTERMED RPR 2.5CM< TRK/SCALP/NECK/AXILL	$241.60	$302.00	$136.70–$567.03	55% below	20%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 INTERMED RPR 2.5CM< TRK/SCALP/NECK/AXILL	$241.60	$302.00	$136.70–$567.03	—	20%
Lower-back epidural injection, with imaging guidance CPT 62323 INJECT,SINGLE,LUMBAR/SACRAL W/ IMAGING	$971.20	$1,214.00	$250.00–$1,129.02	52% below	20%
Lower-back epidural injection, with imaging guidance CPT 62323 NJX DX-THER SBST INTRLMNR LMBR-SAC W-IMG GDN	$1,967.39	$2,459.24	$250.00–$2,287.09	3% below	20%
Lower-back epidural injection, with imaging guidance inpatient CPT 62323 INJECT,SINGLE,LUMBAR/SACRAL W/ IMAGING	$971.20	$1,214.00	$250.00–$1,129.02	—	20%
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 NJX ANES&/STRD W/IMG TFRML EDRL LMBR/SAC	$1,080.00	$1,350.00	$242.79–$1,255.50	48% below	20%
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 NJX AAAND-STRD TFRML EPI LUMBAR-SACRAL 1 LEVEL	$1,958.86	$2,448.57	$242.79–$2,277.17	5% below	20%
Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 NJX ANES&/STRD W/IMG TFRML EDRL LMBR/SAC	$1,080.00	$1,350.00	$242.79–$1,255.50	—	20%
Nail removal (partial or complete), one nail CPT 11730 AVUL NAIL PLT, PT/COMP SIMP SING	$85.60	$107.00	$59.35–$248.10	73% below	20%
Nail removal (partial or complete), one nail inpatient CPT 11730 AVUL NAIL PLT, PT/COMP SIMP SING	$85.60	$107.00	$59.35–$248.10	—	20%
Occipital nerve block (injection for headaches) CPT 64405 NJX AA&/STRD GR OCPL NRV	$84.00	$105.00	$58.55–$284.59	89% below	20%
Occipital nerve block (injection for headaches) CPT 64405 SPHENOPALATINE GANGLION BLOCK	$329.60	$412.00	$73.80–$383.16	58% below	20%
Occipital nerve block (injection for headaches) CPT 64405 INJECTION AA&/STRD GREATER OCCIPITAL NER	$329.60	$412.00	$73.80–$383.16	58% below	20%
Occipital nerve block (injection for headaches) CPT 64405 CF/PK INJECTION AA&/STRD GREATER OCCIPIT	$595.20	$744.00	$73.80–$691.92	24% below	20%
Occipital nerve block (injection for headaches) inpatient CPT 64405 NJX AA&/STRD GR OCPL NRV	$84.00	$105.00	$58.55–$284.59	—	20%
Occipital nerve block (injection for headaches) inpatient CPT 64405 INJECTION AA&/STRD GREATER OCCIPITAL NER	$329.60	$412.00	$73.80–$383.16	—	20%
Occipital nerve block (injection for headaches) inpatient CPT 64405 SPHENOPALATINE GANGLION BLOCK	$329.60	$412.00	$73.80–$383.16	—	20%
Occipital nerve block (injection for headaches) inpatient CPT 64405 CF/PK INJECTION AA&/STRD GREATER OCCIPIT	$595.20	$744.00	$73.80–$691.92	—	20%
Paracentesis with imaging guidance CPT 49083 PARACENTESIS W/IMAGE GUIDANCE	$166.40	$208.00	$173.68–$840.92	90% below	20%
Paracentesis with imaging guidance CPT 49083 US GUIDED PARACENTESIS	$1,136.80	$1,421.00	$260.53–$1,321.53	35% below	20%
Paracentesis with imaging guidance CPT 49083 CT PARACENTESIS	$1,136.80	$1,421.00	$260.53–$1,321.53	35% below	20%
Paracentesis with imaging guidance inpatient CPT 49083 PARACENTESIS W/IMAGE GUIDANCE	$166.40	$208.00	$173.68–$840.92	—	20%
Paracentesis with imaging guidance inpatient CPT 49083 CT PARACENTESIS	$1,136.80	$1,421.00	$260.53–$1,321.53	—	20%
Paracentesis with imaging guidance inpatient CPT 49083 US GUIDED PARACENTESIS	$1,136.80	$1,421.00	$260.53–$1,321.53	—	20%
Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 DSTR NROLYTC AGNT PARVERTEB FCT SNGL LMBR-SACRAL	$2,548.80	$3,186.00	$426.13–$2,962.98	24% below	20%
Removal of a breast lump, open surgery CPT 19120 EXC CYST-ABERRANT BREAST TISSUE OPEN 1-GREATER THAN LESION	$3,904.80	$4,881.00	$533.77–$4,539.33	12% below	20%
Removal of a foreign object under the skin, simple CPT 10120 FB REMOVAL SUBQ SIMPLE	$169.60	$212.00	$77.17–$376.90	75% below	20%
Removal of a foreign object under the skin, simple inpatient CPT 10120 FB REMOVAL SUBQ SIMPLE	$169.60	$212.00	$77.17–$376.90	—	20%
Screening colonoscopy for a person at average risk (Medicare code) HCPCS G0121 COLON CA SCRN NOT HI RSK IND	$2,633.42	$3,291.78	$348.96–$3,061.36	1% above	20%
Screening colonoscopy, high risk of colorectal cancer (Medicare code) HCPCS G0105 COLORECTAL SCRN; HI RISK IND	$2,529.04	$3,161.30	$348.64–$2,940.01	3% below	20%
Short arm cast (elbow to hand) CPT 29075 SHORT ARM CAST	$100.80	$126.00	$80.14–$259.32	66% below	20%
Short arm cast (elbow to hand) inpatient CPT 29075 SHORT ARM CAST	$100.80	$126.00	$80.14–$259.32	—	20%
Short arm splint (forearm and hand) CPT 29125 SPLINTING ARM	$64.80	$81.00	$58.61–$143.58	78% below	20%
Short arm splint (forearm and hand) CPT 29125 SHORT ARM SPLINT APPLICATION	$209.60	$262.00	$72.50–$243.66	28% below	20%
Short arm splint (forearm and hand) inpatient CPT 29125 SPLINTING ARM	$64.80	$81.00	$58.61–$143.58	—	20%
Short arm splint (forearm and hand) inpatient CPT 29125 SHORT ARM SPLINT APPLICATION	$209.60	$262.00	$72.50–$243.66	—	20%
Short leg cast (below the knee) CPT 29405 SHORT LEG CAST	$94.40	$118.00	$75.50–$259.32	75% below	20%
Short leg cast (below the knee) inpatient CPT 29405 SHORT LEG CAST	$94.40	$118.00	$75.50–$259.32	—	20%
Short leg splint (calf to foot) CPT 29515 SHORT LEG SPLINT	$80.00	$100.00	$66.19–$155.67	73% below	20%
Short leg splint (calf to foot) CPT 29515 SHORT LEG SPLINT APPLICATION	$240.80	$301.00	$76.21–$279.93	18% below	20%
Short leg splint (calf to foot) inpatient CPT 29515 SHORT LEG SPLINT	$80.00	$100.00	$66.19–$155.67	—	20%
Short leg splint (calf to foot) inpatient CPT 29515 SHORT LEG SPLINT APPLICATION	$240.80	$301.00	$76.21–$279.93	—	20%
Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) CPT 29826 SURGICAL ARTHROSCOPY SHO W-CORACOACRM LIGM RLS	$19,372.03	$24,215.04	$142.24–$22,519.99	14% below	20%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 SIMPLE RPR 2.5CM or < SCALP/NECK/AXILL	$71.20	$89.00	$70.72–$204.38	78% below	20%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 SIMPLE RPR 2.5CM or < SCALP/NECK/AXILL	$71.20	$89.00	$70.72–$204.38	—	20%
Skin tag removal, up to 15 tags CPT 11200 REMOVAL ACCESSORY AURICLE SKIN TAG	$279.20	$349.00	$85.01–$324.57	5% below	20%
Skin tag removal, up to 15 tags inpatient CPT 11200 REMOVAL ACCESSORY AURICLE SKIN TAG	$279.20	$349.00	$85.01–$324.57	—	20%
Spinal tap (lumbar puncture), diagnostic CPT 62270 LUMBAR PUNCTURE	$100.80	$126.00	$68.69–$654.46	91% below	20%
Spinal tap (lumbar puncture), diagnostic CPT 62270 DIAGNOSTIC LUMBAR SPINAL FRACTURE	$796.00	$995.00	$151.92–$925.35	26% below	20%
Spinal tap (lumbar puncture), diagnostic CPT 62270 CF/PK DIAGNOSTIC LUMBAR SPINAL FRACTURE	$858.40	$1,073.00	$151.92–$997.89	20% below	20%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 LUMBAR PUNCTURE	$100.80	$126.00	$68.69–$654.46	—	20%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 DIAGNOSTIC LUMBAR SPINAL FRACTURE	$796.00	$995.00	$151.92–$925.35	—	20%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 CF/PK DIAGNOSTIC LUMBAR SPINAL FRACTURE	$858.40	$1,073.00	$151.92–$997.89	—	20%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 SIMP 2.6cm to 7.5cm SCAL/NECK/TRUNK/EXTR	$93.60	$117.00	$81.88–$248.00	73% below	20%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 SIMP 2.6cm to 7.5cm SCAL/NECK/TRUNK/EXTR	$93.60	$117.00	$81.88–$248.00	—	20%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 SIMP RP 2.5cm< FACE/EAR/LIDS/NOSE/LIPS	$88.80	$111.00	$77.95–$244.52	72% below	20%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 SIMP RP 2.5cm< FACE/EAR/LIDS/NOSE/LIPS	$88.80	$111.00	$77.95–$244.52	—	20%
Thoracentesis with imaging guidance CPT 32555 ASPIRATE PLEURA W/ IMAGING	$170.40	$213.00	$177.86–$677.43	90% below	20%
Thoracentesis with imaging guidance CPT 32555 CT THORACENTESIS	$1,121.60	$1,402.00	$285.21–$1,303.86	35% below	20%
Thoracentesis with imaging guidance CPT 32555 US THORACENTESIS	$1,121.60	$1,402.00	$285.21–$1,303.86	35% below	20%
Thoracentesis with imaging guidance inpatient CPT 32555 ASPIRATE PLEURA W/ IMAGING	$170.40	$213.00	$177.86–$677.43	—	20%
Thoracentesis with imaging guidance inpatient CPT 32555 US THORACENTESIS	$1,121.60	$1,402.00	$285.21–$1,303.86	—	20%
Thoracentesis with imaging guidance inpatient CPT 32555 CT THORACENTESIS	$1,121.60	$1,402.00	$285.21–$1,303.86	—	20%
Tonsil and adenoid removal, age 12 or older CPT 42821 TONSILLECTOMY AND ADENOIDECTOMY AGE 12-GREATER THAN	$5,172.00	$6,465.00	$257.56–$6,012.45	at median	20%
Tonsil and adenoid removal, child under 12 CPT 42820 TONSILLECTOMY AND ADENOIDECTOMY LESS THAN AGE 12	$4,929.89	$6,162.36	$246.94–$5,730.99	41% below	20%
Tonsil removal (tonsillectomy) only, age 12 or older CPT 42826 TONSILLECTOMY PRIMARY-SECONDARY AGE 12-GREATER THAN	$5,940.14	$7,425.17	$218.17–$6,905.41	48% below	20%
Total hip replacement CPT 27130 ARTHRP ACETBLR-PROX FEM PROSTC AGRFT-ALGRFT	$30,323.90	$37,904.87	$1,106.71–$35,251.53	32% below	20%
Total knee replacement CPT 27447 ARTHRP KNE CONDYLEANDPLATU MEDIALANDLAT COMPARTMENTS	$25,577.56	$31,971.95	$1,104.23–$29,733.91	40% below	20%
Trigger point injections, 1 or 2 muscles CPT 20552 INJ SINGLE/MLT TRIGGER POINT 1/2 M	$444.80	$556.00	$48.36–$517.08	36% below	20%
Trigger point injections, 1 or 2 muscles CPT 20552 CF/PK INJ SINGLE/MLT TRIGGER POINT 1/2 M	$444.80	$556.00	$48.36–$517.08	36% below	20%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 CF/PK INJ SINGLE/MLT TRIGGER POINT 1/2 M	$444.80	$556.00	$48.36–$517.08	—	20%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 INJ SINGLE/MLT TRIGGER POINT 1/2 M	$444.80	$556.00	$48.36–$517.08	—	20%
Ultrasound-guided breast needle biopsy with marker clip, first lesion one side CPT 19083 US CORE BX BREAST LEFT 1ST LESION,Left Side	$2,016.00	$2,520.00	$435.22–$2,343.60	39% below	20%
Ultrasound-guided breast needle biopsy with marker clip, first lesion one side CPT 19083 US CORE BX BREAST RIGHT 1ST LESION,Right Side	$2,016.00	$2,520.00	$435.22–$2,343.60	39% below	20%
Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient one side CPT 19083 US CORE BX BREAST RIGHT 1ST LESION,Right Side	$2,016.00	$2,520.00	$435.22–$2,343.60	—	20%
Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient one side CPT 19083 US CORE BX BREAST LEFT 1ST LESION,Left Side	$2,016.00	$2,520.00	$435.22–$2,343.60	—	20%
Upper endoscopy (EGD) with balloon widening of the esophagus CPT 43249 EGD BALLOON DILATION ESOPHAGUS LESS THAN 30 MM DIAM	$3,659.44	$4,574.30	$1,064.48–$4,254.10	4% above	20%
Upper endoscopy (EGD) with biopsy CPT 43239 EGD TRANSORAL BIOPSY SINGLE-MULTIPLE	$3,120.37	$3,900.46	$382.24–$3,627.43	11% above	20%
Upper endoscopy (EGD), diagnostic CPT 43235 ESOPHAGOGASTRODUODENOSCOPY TRANSORAL DIAGNOSTIC	$3,082.76	$3,853.45	$295.24–$3,583.71	19% above	20%
Wart removal, up to 14 warts CPT 17110 DESTRUCTION BENIGN LESIONS UP TO 14	$108.00	$135.00	$66.48–$242.62	66% below	20%
Wart removal, up to 14 warts inpatient CPT 17110 DESTRUCTION BENIGN LESIONS UP TO 14	$108.00	$135.00	$66.48–$242.62	—	20%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEB SUBQ TISSUE 20 SQ CM/<	$96.80	$121.00	$66.97–$376.90	88% below	20%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 SKIN & SUBQ TISSUE DEBRIDE 1st 20 sq cm	$458.40	$573.00	$121.84–$532.89	41% below	20%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DEB SUBQ TISSUE 20 SQ CM/<	$96.80	$121.00	$66.97–$376.90	—	20%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 SKIN & SUBQ TISSUE DEBRIDE 1st 20 sq cm	$458.40	$573.00	$121.84–$532.89	—	20%

Doctor visits and therapy

Procedure	Cash price	List price	Insurers pay	vs Ohio	Off list
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD TRANSFUSION	$616.00	$770.00	$42.53–$716.10	45% below	20%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD TRANSFUSION	$616.00	$770.00	$42.53–$716.10	—	20%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 AERO RX ACCUNEB 1.25mg	$184.80	$231.00	$7.80–$214.83	5% above	20%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 IPV INITIAL -INTRAPULM PERCUSS VENTILATI	$184.80	$231.00	$7.80–$214.83	5% above	20%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 AERO RX PULMICORT 0.25MG UD	$184.80	$231.00	$7.80–$214.83	5% above	20%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 EZPAP SUBSEQUENT	$184.80	$231.00	$7.80–$214.83	5% above	20%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 AERO RX ATROVENT 0.5 MG UD	$184.80	$231.00	$7.80–$214.83	5% above	20%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 AEROSOL RX - ROUTINE INITIAL	$184.80	$231.00	$7.80–$214.83	5% above	20%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 AERO RX ALB/NS UD	$184.80	$231.00	$7.80–$214.83	5% above	20%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 AERO RX RACEMIC EPI 0.5ML UD	$184.80	$231.00	$7.80–$214.83	5% above	20%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 MDI USE PTS HOME MED	$184.80	$231.00	$7.80–$214.83	5% above	20%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 AEROSOL RX	$184.80	$231.00	$7.80–$214.83	5% above	20%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 MDI INITIAL	$184.80	$231.00	$7.80–$214.83	5% above	20%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 AERO RX PULMICORT 0.5 MG UD	$184.80	$231.00	$7.80–$214.83	5% above	20%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 AERO RX ALB/ATRO UD	$184.80	$231.00	$7.80–$214.83	5% above	20%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 IPV SUBSEQUENT	$184.80	$231.00	$7.80–$214.83	5% above	20%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 AEROSOL RX - PRN	$184.80	$231.00	$7.80–$214.83	5% above	20%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 AERO RX XOPENEX .63MG UD	$184.80	$231.00	$7.80–$214.83	5% above	20%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 AERO RX XOPENEX 1.25 MG	$184.80	$231.00	$7.80–$214.83	5% above	20%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 EZPAP INITIAL	$184.80	$231.00	$7.80–$214.83	5% above	20%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 AEROSOL RX - PRN	$184.80	$231.00	$7.80–$214.83	—	20%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 AERO RX ALB/NS UD	$184.80	$231.00	$7.80–$214.83	—	20%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 AERO RX ACCUNEB 1.25mg	$184.80	$231.00	$7.80–$214.83	—	20%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 AERO RX ATROVENT 0.5 MG UD	$184.80	$231.00	$7.80–$214.83	—	20%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 AERO RX PULMICORT 0.25MG UD	$184.80	$231.00	$7.80–$214.83	—	20%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 MDI INITIAL	$184.80	$231.00	$7.80–$214.83	—	20%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 IPV INITIAL -INTRAPULM PERCUSS VENTILATI	$184.80	$231.00	$7.80–$214.83	—	20%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 EZPAP SUBSEQUENT	$184.80	$231.00	$7.80–$214.83	—	20%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 AEROSOL RX - ROUTINE INITIAL	$184.80	$231.00	$7.80–$214.83	—	20%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 AERO RX RACEMIC EPI 0.5ML UD	$184.80	$231.00	$7.80–$214.83	—	20%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 AEROSOL RX	$184.80	$231.00	$7.80–$214.83	—	20%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 AERO RX PULMICORT 0.5 MG UD	$184.80	$231.00	$7.80–$214.83	—	20%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 IPV SUBSEQUENT	$184.80	$231.00	$7.80–$214.83	—	20%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 AERO RX XOPENEX .63MG UD	$184.80	$231.00	$7.80–$214.83	—	20%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 EZPAP INITIAL	$184.80	$231.00	$7.80–$214.83	—	20%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 AERO RX XOPENEX 1.25 MG	$184.80	$231.00	$7.80–$214.83	—	20%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 MDI USE PTS HOME MED	$184.80	$231.00	$7.80–$214.83	—	20%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 AERO RX ALB/ATRO UD	$184.80	$231.00	$7.80–$214.83	—	20%
Chemotherapy IV infusion, first hour CPT 96413 CHEMOTHERAPY SNG/INITIAL 1ST HR	$550.40	$688.00	$120.26–$639.84	28% below	20%
Chemotherapy IV infusion, first hour inpatient CPT 96413 CHEMOTHERAPY SNG/INITIAL 1ST HR	$550.40	$688.00	$120.26–$639.84	—	20%
Critical care, first 30 to 74 minutes CPT 99291 CRITICAL CARE FIRST 30-74 MIN	$616.00	$770.00	$141.20–$770.00	79% below	20%
Critical care, first 30 to 74 minutes CPT 99291 CRITICAL CARE 1ST 30 TO 74 MINUTES	$1,320.00	$1,650.00	$290.69–$1,534.50	55% below	20%
Critical care, first 30 to 74 minutes inpatient CPT 99291 CRITICAL CARE FIRST 30-74 MIN	$616.00	$770.00	$141.20–$770.00	—	20%
Critical care, first 30 to 74 minutes inpatient CPT 99291 CRITICAL CARE 1ST 30 TO 74 MINUTES	$1,320.00	$1,650.00	$290.69–$1,534.50	—	20%
EEG (brain wave test), awake and drowsy, routine CPT 95816 EEG AWAKE ROUTINE	$514.40	$643.00	$200.19–$597.99	46% below	20%
EEG (brain wave test), awake and drowsy, routine inpatient CPT 95816 EEG AWAKE ROUTINE	$514.40	$643.00	$200.19–$597.99	—	20%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG DAILY	$120.00	$150.00	$6.31–$139.50	35% below	20%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG--ED ONLY	$120.00	$150.00	$6.31–$139.50	35% below	20%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG - REPEAT IN 45 MINUTES	$120.00	$150.00	$6.31–$139.50	35% below	20%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG - ALLSCRIPTS	$120.00	$150.00	$6.31–$139.50	35% below	20%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG DR ZAHKA	$120.00	$150.00	$6.31–$139.50	35% below	20%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG	$120.00	$150.00	$6.31–$139.50	35% below	20%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG DAILY X 3 DAYS	$120.00	$150.00	$6.31–$139.50	35% below	20%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG DAILY X 3 DAYS	$120.00	$150.00	$6.31–$139.50	—	20%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG	$120.00	$150.00	$6.31–$139.50	—	20%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG - REPEAT IN 45 MINUTES	$120.00	$150.00	$6.31–$139.50	—	20%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG--ED ONLY	$120.00	$150.00	$6.31–$139.50	—	20%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG DAILY	$120.00	$150.00	$6.31–$139.50	—	20%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG - ALLSCRIPTS	$120.00	$150.00	$6.31–$139.50	—	20%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG DR ZAHKA	$120.00	$150.00	$6.31–$139.50	—	20%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 ED LEVEL 1	$246.40	$308.00	$10.67–$286.44	21% below	20%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 ED LEVEL 1	$246.40	$308.00	$10.67–$286.44	—	20%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 EVAL & TREATMENT LIMITED CARE	$119.20	$149.00	$21.46–$149.00	77% below	20%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 ED LEVEL 2 LIMITED	$349.60	$437.00	$39.15–$406.41	31% below	20%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 EVAL & TREATMENT LIMITED CARE	$119.20	$149.00	$21.46–$149.00	—	20%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 ED LEVEL 2 LIMITED	$349.60	$437.00	$39.15–$406.41	—	20%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 EVAL & TREATMENT INTERMEDIATE CARE	$193.60	$242.00	$37.68–$253.09	77% below	20%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 ED LEVEL 3 INTERMEDIATE	$492.80	$616.00	$67.34–$572.88	42% below	20%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 EVAL & TREATMENT INTERMEDIATE CARE	$193.60	$242.00	$37.68–$253.09	—	20%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 ED LEVEL 3 INTERMEDIATE	$492.80	$616.00	$67.34–$572.88	—	20%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 EVAL & TREATMENT EXTENDED CARE	$323.20	$404.00	$62.91–$404.00	76% below	20%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 ER LEVEL 4 EXTENDED	$594.40	$743.00	$114.69–$690.99	55% below	20%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 EVAL & TREATMENT EXTENDED CARE	$323.20	$404.00	$62.91–$404.00	—	20%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 ER LEVEL 4 EXTENDED	$594.40	$743.00	$114.69–$690.99	—	20%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 EVAL & TREATMENT HIGH	$472.80	$591.00	$94.23–$591.00	73% below	20%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 ED LEVEL 5 COMPREHENSIVE	$896.80	$1,121.00	$166.20–$1,042.53	48% below	20%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 EVAL & TREATMENT HIGH	$472.80	$591.00	$94.23–$591.00	—	20%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 ED LEVEL 5 COMPREHENSIVE	$896.80	$1,121.00	$166.20–$1,042.53	—	20%
Exercise stress test, tracing only, the hospital charge CPT 93017 NUCLEAR STRESS TEST TREADMILL	$566.40	$708.00	$35.03–$658.44	37% below	20%
Exercise stress test, tracing only, the hospital charge CPT 93017 STRESS TEST (DGEST) NO IMAGING	$600.00	$750.00	$35.03–$697.50	33% below	20%
Exercise stress test, tracing only, the hospital charge CPT 93017 CV EXERCISE STRESS TEST	$600.00	$750.00	$35.03–$697.50	33% below	20%
Exercise stress test, tracing only, the hospital charge CPT 93017 NM EXERCISE STRESS TEST (W/CARDIAC STUDY	$600.00	$750.00	$35.03–$697.50	33% below	20%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 NUCLEAR STRESS TEST TREADMILL	$566.40	$708.00	$35.03–$658.44	—	20%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 CV EXERCISE STRESS TEST	$600.00	$750.00	$35.03–$697.50	—	20%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 NM EXERCISE STRESS TEST (W/CARDIAC STUDY	$600.00	$750.00	$35.03–$697.50	—	20%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 STRESS TEST (DGEST) NO IMAGING	$600.00	$750.00	$35.03–$697.50	—	20%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV HYDRATN INITIAL 31-60 MIN	$227.20	$284.00	$30.40–$264.12	46% below	20%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 INTRAVENOUS HYDRATION INITAL UP TO 1 HR	$227.20	$284.00	$30.40–$264.12	46% below	20%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV HYDRATN INITIAL 31-60 MIN	$227.20	$284.00	$30.40–$264.12	—	20%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 INTRAVENOUS HYDRATION INITAL UP TO 1 HR	$227.20	$284.00	$30.40–$264.12	—	20%
IV infusion of a medicine, first hour CPT 96365 IV INFUSION THERAPY/PROPHYLAXIS /DX 1ST	$227.20	$284.00	$60.79–$264.12	48% below	20%
IV infusion of a medicine, first hour CPT 96365 IV THERAPY INITIAL UP TO 1 HOUR	$227.20	$284.00	$60.79–$264.12	48% below	20%
IV infusion of a medicine, first hour CPT 96365 THERAPEUTIC INFUSION INITIAL UP TO 1 HR	$227.20	$284.00	$60.79–$264.12	48% below	20%
IV infusion of a medicine, first hour CPT 96365 CF/PK IV INFUSION THERAPY/PROPHYLAXIS	$464.80	$581.00	$60.79–$540.33	7% above	20%
IV infusion of a medicine, first hour inpatient CPT 96365 IV THERAPY INITIAL UP TO 1 HOUR	$227.20	$284.00	$60.79–$264.12	—	20%
IV infusion of a medicine, first hour inpatient CPT 96365 THERAPEUTIC INFUSION INITIAL UP TO 1 HR	$227.20	$284.00	$60.79–$264.12	—	20%
IV infusion of a medicine, first hour inpatient CPT 96365 IV INFUSION THERAPY/PROPHYLAXIS /DX 1ST	$227.20	$284.00	$60.79–$264.12	—	20%
IV infusion of a medicine, first hour inpatient CPT 96365 CF/PK IV INFUSION THERAPY/PROPHYLAXIS	$464.80	$581.00	$60.79–$540.33	—	20%
IV push of a medicine, first drug CPT 96374 IV PUSH SNG/INITIAL SUBSTANCE/DRUG	$180.80	$226.00	$34.35–$210.18	30% below	20%
IV push of a medicine, first drug CPT 96374 IV PUSH INITIAL SUBSTANCE - OB	$180.80	$226.00	$34.35–$210.18	30% below	20%
IV push of a medicine, first drug CPT 96374 IV PUSH INITIAL SUBSTANCE	$180.80	$226.00	$34.35–$210.18	30% below	20%
IV push of a medicine, first drug inpatient CPT 96374 IV PUSH INITIAL SUBSTANCE - OB	$180.80	$226.00	$34.35–$210.18	—	20%
IV push of a medicine, first drug inpatient CPT 96374 IV PUSH SNG/INITIAL SUBSTANCE/DRUG	$180.80	$226.00	$34.35–$210.18	—	20%
IV push of a medicine, first drug inpatient CPT 96374 IV PUSH INITIAL SUBSTANCE	$180.80	$226.00	$34.35–$210.18	—	20%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 IMMUNIZATION ADMIN EA ADD'TL VACCINE	$41.60	$52.00	$14.26–$68.12	71% below	20%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 IMMUNIZATION ADMINISTRATION	$60.00	$75.00	$14.26–$69.75	58% below	20%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 VACCINE, ADMIN-ODH PEDIATRIC/HEPATITIS B	$60.00	$75.00	$14.26–$69.75	58% below	20%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 IMMUNIZATION ADMIN PNEUMOC	$61.60	$77.00	$14.26–$71.61	56% below	20%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 IMMUNIZATION ADMIN HEP B VACCINE - OB	$61.60	$77.00	$14.26–$71.61	56% below	20%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 IMMUNIZATION INFLUENZA VACCINE - OB	$61.60	$77.00	$14.26–$71.61	56% below	20%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 IMMUNIZATION ADMIN INFLUENZA	$61.60	$77.00	$14.26–$71.61	56% below	20%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 IMMUNIZATION ADMIN PNEUMOC - OB	$61.60	$77.00	$14.26–$71.61	56% below	20%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 IMMUNIZATION ADMIN HEP B VACCINE	$61.60	$77.00	$14.26–$71.61	56% below	20%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 IMMUNIZATION ADMIN MMR - OB	$61.60	$77.00	$14.26–$71.61	56% below	20%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 IM or SUBQ INJECTION	$70.40	$88.00	$14.26–$81.84	50% below	20%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJECTION SALINE	$70.40	$88.00	$14.26–$81.84	50% below	20%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJECTION IM	$70.40	$88.00	$14.26–$81.84	50% below	20%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJECTION IM/OB	$70.40	$88.00	$14.26–$81.84	50% below	20%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJECTION IM OR SUB Q	$70.40	$88.00	$14.26–$81.84	50% below	20%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJECTION IM - OCC MED	$70.40	$88.00	$14.26–$81.84	50% below	20%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 IMMUNIZATION ADMIN EA ADD'TL VACCINE	$41.60	$52.00	$14.26–$68.12	—	20%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 VACCINE, ADMIN-ODH PEDIATRIC/HEPATITIS B	$60.00	$75.00	$14.26–$69.75	—	20%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 IMMUNIZATION ADMINISTRATION	$60.00	$75.00	$14.26–$69.75	—	20%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 IMMUNIZATION ADMIN INFLUENZA	$61.60	$77.00	$14.26–$71.61	—	20%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 IMMUNIZATION INFLUENZA VACCINE - OB	$61.60	$77.00	$14.26–$71.61	—	20%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 IMMUNIZATION ADMIN PNEUMOC	$61.60	$77.00	$14.26–$71.61	—	20%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 IMMUNIZATION ADMIN HEP B VACCINE - OB	$61.60	$77.00	$14.26–$71.61	—	20%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 IMMUNIZATION ADMIN PNEUMOC - OB	$61.60	$77.00	$14.26–$71.61	—	20%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 IMMUNIZATION ADMIN MMR - OB	$61.60	$77.00	$14.26–$71.61	—	20%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 IMMUNIZATION ADMIN HEP B VACCINE	$61.60	$77.00	$14.26–$71.61	—	20%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INJECTION IM	$70.40	$88.00	$14.26–$81.84	—	20%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INJECTION IM/OB	$70.40	$88.00	$14.26–$81.84	—	20%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INJECTION SALINE	$70.40	$88.00	$14.26–$81.84	—	20%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INJECTION IM OR SUB Q	$70.40	$88.00	$14.26–$81.84	—	20%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 IM or SUBQ INJECTION	$70.40	$88.00	$14.26–$81.84	—	20%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INJECTION IM - OCC MED	$70.40	$88.00	$14.26–$81.84	—	20%
New patient office visit, about 30 minutes CPT 99203 NEW PATIENT LEVEL 3 DR ZAHKA	$82.40	$103.00	$67.71–$100.94	25% below	20%
New patient office visit, about 30 minutes CPT 99203 PM OFFICE VISIT NEW - LEVEL 3	$207.20	$259.00	$67.71–$240.87	89% above	20%
New patient office visit, about 30 minutes CPT 99203 CK/PK PM OFFICE VISIT NEW - LEVEL 3	$339.20	$424.00	$67.71–$394.32	209% above	20%
New patient office visit, about 30 minutes inpatient CPT 99203 NEW PATIENT LEVEL 3 DR ZAHKA	$82.40	$103.00	$67.71–$100.94	—	20%
New patient office visit, about 30 minutes inpatient CPT 99203 PM OFFICE VISIT NEW - LEVEL 3	$207.20	$259.00	$67.71–$240.87	—	20%
New patient office visit, about 30 minutes inpatient CPT 99203 CK/PK PM OFFICE VISIT NEW - LEVEL 3	$339.20	$424.00	$67.71–$394.32	—	20%
New patient office visit, about 45 minutes CPT 99204 NEW PATIENT LEVEL 4 DR ZAHKA	$133.60	$167.00	$113.03–$163.66	10% above	20%
New patient office visit, about 45 minutes CPT 99204 PM OFFICE VISIT NEW - LEVEL 4	$324.80	$406.00	$113.03–$377.58	168% above	20%
New patient office visit, about 45 minutes CPT 99204 CF/PK PM OFFICE VISIT NEW - LEVEL 4	$500.80	$626.00	$113.03–$582.18	313% above	20%
New patient office visit, about 45 minutes inpatient CPT 99204 NEW PATIENT LEVEL 4 DR ZAHKA	$133.60	$167.00	$113.03–$163.66	—	20%
New patient office visit, about 45 minutes inpatient CPT 99204 PM OFFICE VISIT NEW - LEVEL 4	$324.80	$406.00	$113.03–$377.58	—	20%
New patient office visit, about 45 minutes inpatient CPT 99204 CF/PK PM OFFICE VISIT NEW - LEVEL 4	$500.80	$626.00	$113.03–$582.18	—	20%
New patient office visit, about 60 minutes CPT 99205 NEW PATIENT LEVEL V DR ZAHKA	$172.80	$216.00	$146.96–$211.68	at median	20%
New patient office visit, about 60 minutes CPT 99205 PM OFFICE VISIT NEW - LEVEL 5	$431.20	$539.00	$146.96–$501.27	150% above	20%
New patient office visit, about 60 minutes CPT 99205 CF/PK PM OFFICE VISIT NEW - LEVEL 5	$607.20	$759.00	$146.96–$705.87	251% above	20%
New patient office visit, about 60 minutes inpatient CPT 99205 NEW PATIENT LEVEL V DR ZAHKA	$172.80	$216.00	$146.96–$211.68	—	20%
New patient office visit, about 60 minutes inpatient CPT 99205 PM OFFICE VISIT NEW - LEVEL 5	$431.20	$539.00	$146.96–$501.27	—	20%
New patient office visit, about 60 minutes inpatient CPT 99205 CF/PK PM OFFICE VISIT NEW - LEVEL 5	$607.20	$759.00	$146.96–$705.87	—	20%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 NEW PATIENT LEVEL 2 DR ZAHKA	$72.80	$91.00	$41.27–$156.66	28% below	20%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 PM OFFICE VISIT NEW - LEVEL 2	$172.00	$215.00	$44.66–$199.95	70% above	20%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 CF/PK PM OFFICE VISIT NEW - LEVEL 2	$260.00	$325.00	$44.66–$302.25	156% above	20%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 NEW PATIENT LEVEL 2 DR ZAHKA	$72.80	$91.00	$41.27–$156.66	—	20%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 PM OFFICE VISIT NEW - LEVEL 2	$172.00	$215.00	$44.66–$199.95	—	20%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 CF/PK PM OFFICE VISIT NEW - LEVEL 2	$260.00	$325.00	$44.66–$302.25	—	20%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 DT COUNSEL INITIAL INDIVIDUAL PER 15 MIN	$72.00	$90.00	$34.42–$83.70	11% above	20%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 DT COUNSEL INITIAL INDIVIDUAL PER 15 MIN	$72.00	$90.00	$34.42–$83.70	—	20%
Occupational therapy evaluation, low complexity CPT 97165 OT EVALUATION - LOW COMPLEXITY 20 MIN	$164.00	$205.00	$94.37–$190.65	37% below	20%
Occupational therapy evaluation, low complexity inpatient CPT 97165 OT EVALUATION - LOW COMPLEXITY 20 MIN	$164.00	$205.00	$94.37–$190.65	—	20%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PT EVAL - COMPLEX COMPLEXITY 45 MIN	$184.00	$230.00	$91.98–$213.90	39% below	20%
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 PT EVAL - COMPLEX COMPLEXITY 45 MIN	$184.00	$230.00	$91.98–$213.90	—	20%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PT EVAL - LOW COMPLEXITY 20 MIN	$160.00	$200.00	$91.98–$186.00	39% below	20%
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 PT EVAL - LOW COMPLEXITY 20 MIN	$160.00	$200.00	$91.98–$186.00	—	20%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PT EVAL - MODERATE COMPLEXITY 30 MIN	$168.00	$210.00	$91.98–$195.30	40% below	20%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 PT EVAL - MODERATE COMPLEXITY 30 MIN	$168.00	$210.00	$91.98–$195.30	—	20%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 SMOKING CESSATION	$40.00	$50.00	$14.49–$46.50	9% below	20%
Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 SMOKING CESSATION	$40.00	$50.00	$14.49–$46.50	—	20%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 EST PAT LEVEL V DR ZAHKA	$222.40	$278.00	$95.01–$390.33	32% above	20%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 PM OFFICE VISIT ESTAB - LEVEL 5	$376.00	$470.00	$97.42–$437.10	123% above	20%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 CONSULT LEVEL 5 DR ZAHKA	$395.20	$494.00	$95.01–$494.00	135% above	20%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 CF/PK PM OFFICE VISIT ESTAB - LEVEL 5	$533.60	$667.00	$97.42–$620.31	217% above	20%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 EST PAT LEVEL V DR ZAHKA	$222.40	$278.00	$95.01–$390.33	—	20%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 PM OFFICE VISIT ESTAB - LEVEL 5	$376.00	$470.00	$97.42–$437.10	—	20%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 CONSULT LEVEL 5 DR ZAHKA	$395.20	$494.00	$95.01–$494.00	—	20%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 CF/PK PM OFFICE VISIT ESTAB - LEVEL 5	$533.60	$667.00	$97.42–$620.31	—	20%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 EST PATIENT LEVEL 3 DR ZAHKA	$101.60	$127.00	$44.21–$196.23	13% below	20%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 CONSULT LEVEL 3 DR ZAHKA	$212.80	$266.00	$44.21–$266.00	83% above	20%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 EST PATIENT LEVEL 3 DR ZAHKA	$101.60	$127.00	$44.21–$196.23	—	20%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 CONSULT LEVEL 3 DR ZAHKA	$212.80	$266.00	$44.21–$266.00	—	20%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 EST PATIENT LEVEL 4 DR ZAHKA	$150.40	$188.00	$68.48–$278.04	10% above	20%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 PM OFFICE VISIT ESTAB - LEVEL 4	$272.00	$340.00	$68.48–$316.20	99% above	20%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 CONSULT LEVEL 4 DR ZAHKA	$315.20	$394.00	$68.48–$394.00	130% above	20%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 CF/PK PM OFFICE VISIT ESTAB - LEVEL 4	$394.40	$493.00	$68.48–$458.49	188% above	20%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 EST PATIENT LEVEL 4 DR ZAHKA	$150.40	$188.00	$68.48–$278.04	—	20%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 PM OFFICE VISIT ESTAB - LEVEL 4	$272.00	$340.00	$68.48–$316.20	—	20%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 CONSULT LEVEL 4 DR ZAHKA	$315.20	$394.00	$68.48–$394.00	—	20%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 CF/PK PM OFFICE VISIT ESTAB - LEVEL 4	$394.40	$493.00	$68.48–$458.49	—	20%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 EST PATIENT LEVEL 2 DR ZAHKA	$54.40	$68.00	$22.91–$122.20	46% below	20%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 CONSULT LEVEL 1 DR ZAHKA	$115.20	$144.00	$22.91–$144.00	14% above	20%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 CONSULT LEVEL 2 DR ZAHKA	$174.40	$218.00	$22.91–$218.00	73% above	20%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 EST PATIENT LEVEL 2 DR ZAHKA	$54.40	$68.00	$22.91–$122.20	—	20%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 CONSULT LEVEL 1 DR ZAHKA	$115.20	$144.00	$22.91–$144.00	—	20%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 CONSULT LEVEL 2 DR ZAHKA	$174.40	$218.00	$22.91–$218.00	—	20%
Spirometry (breathing test) CPT 94010 PFT SCREEN	$214.40	$268.00	$27.15–$249.24	31% below	20%
Spirometry (breathing test) CPT 94010 PFT STRAIGHT	$214.40	$268.00	$27.15–$249.24	31% below	20%
Spirometry (breathing test) CPT 94010 PFT INDUSTRIAL SCREEN	$214.40	$268.00	$27.15–$249.24	31% below	20%
Spirometry (breathing test) inpatient CPT 94010 PFT INDUSTRIAL SCREEN	$214.40	$268.00	$27.15–$249.24	—	20%
Spirometry (breathing test) inpatient CPT 94010 PFT STRAIGHT	$214.40	$268.00	$27.15–$249.24	—	20%
Spirometry (breathing test) inpatient CPT 94010 PFT SCREEN	$214.40	$268.00	$27.15–$249.24	—	20%
Spirometry before and after a bronchodilator CPT 94060 PFT W/ PRE/POST BRONCHODILATOR	$401.60	$502.00	$39.51–$466.86	30% below	20%
Spirometry before and after a bronchodilator CPT 94060 PFT COMPLETE	$966.40	$1,208.00	$39.51–$1,123.44	69% above	20%
Spirometry before and after a bronchodilator inpatient CPT 94060 PFT W/ PRE/POST BRONCHODILATOR	$401.60	$502.00	$39.51–$466.86	—	20%
Spirometry before and after a bronchodilator inpatient CPT 94060 PFT COMPLETE	$966.40	$1,208.00	$39.51–$1,123.44	—	20%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 PHLEBOTOMY THERAPEUTIC	$132.80	$166.00	$88.01–$154.38	44% below	20%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 PHLEBOTOMY THERAPEUTIC	$132.80	$166.00	$88.01–$154.38	—	20%

Vaccines

Procedure	Cash price	List price	Insurers pay	vs Ohio	Off list
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 DIPTH/TET/PERT(DTaP) LESS THAN 7yr OLD	$66.40	$83.00	$69.30–$77.19	2% above	20%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 inpatient CPT 90700 DIPTH/TET/PERT(DTaP) LESS THAN 7yr OLD	$66.40	$83.00	$69.30–$77.19	—	20%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 VACCINE, HEPATITIS B (ADULT) 1ML	$113.60	$142.00	$68.97–$132.06	27% below	20%
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 VACCINE, HEPATITIS B (ADULT) 1ML	$113.60	$142.00	$68.97–$132.06	—	20%
Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 VACCINE, ADMIN-ODH PEDIATRIC/HEPATITIS B	$60.00	$75.00	$31.04–$69.75	at median	20%
Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 VACCINE, ADMIN-ODH PEDIATRIC/HEPATITIS B	$60.00	$75.00	$31.04–$69.75	—	20%
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 FLU VACCINE (HIGH DOSE) 0.5ML TRI	$143.20	$179.00	$96.20–$166.47	39% above	20%
High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 FLU VACCINE (HIGH DOSE) 0.5ML TRI	$143.20	$179.00	$96.20–$166.47	—	20%
MMR vaccine (measles, mumps and rubella), live CPT 90707 VACCINE, MMR	$145.60	$182.00	$151.97–$169.26	30% below	20%
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 VACCINE, MMR	$145.60	$182.00	$151.97–$169.26	—	20%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 DIPTH/TET TOX ADULT (Td) AGE 7yr & OLDER	$67.20	$84.00	$36.62–$78.12	25% below	20%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 DIPTH/TET TOX ADULT (Td) AGE 7yr & OLDER	$67.20	$84.00	$36.62–$78.12	—	20%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 DIPTH/TET/PERT (Tdap) AGE 7 YRS &OLDER	$83.20	$104.00	$39.01–$96.72	25% below	20%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 DIPTH/TET/PERT (Tdap) AGE 7 YRS &OLDER	$83.20	$104.00	$39.01–$96.72	—	20%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMINISTRATION	$60.00	$75.00	$20.24–$69.75	47% above	20%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMIN PNEUMOC - OB	$61.60	$77.00	$20.24–$71.61	51% above	20%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMIN HEP B VACCINE	$61.60	$77.00	$20.24–$71.61	51% above	20%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMIN PNEUMOC	$61.60	$77.00	$20.24–$71.61	51% above	20%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMIN INFLUENZA	$61.60	$77.00	$20.24–$71.61	51% above	20%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMIN HEP B VACCINE - OB	$61.60	$77.00	$20.24–$71.61	51% above	20%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 INFLUENZA IMMUNIZATION ADMIN	$61.60	$77.00	$20.24–$71.61	51% above	20%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMIN MMR - OB	$61.60	$77.00	$20.24–$71.61	51% above	20%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION INFLUENZA VACCINE - OB	$61.60	$77.00	$20.24–$71.61	51% above	20%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMINISTRATION	$60.00	$75.00	$20.24–$69.75	—	20%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMIN HEP B VACCINE	$61.60	$77.00	$20.24–$71.61	—	20%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMIN MMR - OB	$61.60	$77.00	$20.24–$71.61	—	20%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMIN PNEUMOC	$61.60	$77.00	$20.24–$71.61	—	20%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMIN PNEUMOC - OB	$61.60	$77.00	$20.24–$71.61	—	20%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMIN HEP B VACCINE - OB	$61.60	$77.00	$20.24–$71.61	—	20%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 INFLUENZA IMMUNIZATION ADMIN	$61.60	$77.00	$20.24–$71.61	—	20%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMIN INFLUENZA	$61.60	$77.00	$20.24–$71.61	—	20%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION INFLUENZA VACCINE - OB	$61.60	$77.00	$20.24–$71.61	—	20%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMUNIZATION ADMIN EA ADD'TL VACCINE	$41.60	$52.00	$14.81–$48.36	20% above	20%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 IMMUNIZATION ADMIN EA ADD'TL VACCINE	$41.60	$52.00	$14.81–$48.36	—	20%

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://irp.cdn-website.com/94898d03/files/uploaded/311518658_pomerene-hospital_standardcharges.csv