Champlain Valley Physicians Hospital Medical Center
Champlain Valley Physicians Hospital Medical Center in Plattsburgh, NY publishes cash prices for 70 common procedures listed here, from its own machine-readable price file updated Apr 28, 2026. Click a procedure to compare it with other hospitals nearby.
75 Beekman Street, Plattsburgh, NY 12901 Collected Sep 23, 2026 Source price file
Scans and imaging
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 HC - CT ABDOMEN & PELVIS W/CONTRAST MATERIAL | $5,613.00 | $5,613.00 | — |
| CT scan of the head or brain, no contrast dye CPT 70450 HC - CT HEAD/BRAIN W/O CONTRAST MATERIAL | $3,128.00 | $3,128.00 | — |
| CT scan of the pelvis, with contrast dye CPT 72193 HC - CT PELVIS W/CONTRAST MATERIAL | $3,688.00 | $3,688.00 | — |
| Diagnostic mammogram, both breasts both sides CPT 77066 HC - DIAGNOSTIC MAMMOGRAPHY COMPUTER-AIDED DETCJ BI | $799.00 | $799.00 | — |
| Diagnostic mammogram, one breast CPT 77065 HC - DIAGNOSTIC MAMMOGRAPHY COMPUTER-AIDED DETCJ UNI | $611.00 | $611.00 | — |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 HC - MRI ANY JT LOWER EXTREM W/O CONTRAST MATRL | $4,725.00 | $4,725.00 | — |
| MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 HC - MRI ANY JT LOWER EXTREM W/O & W/CONTRAST MATRL | $4,218.00 | $4,218.00 | — |
| MRI of the brain, no contrast dye CPT 70551 HC - MRI BRAIN BRAIN STEM W/O CONTRAST MATERIAL | $5,689.00 | $5,689.00 | — |
| MRI of the brain, no contrast dye CPT 70551 HC - MRI QUICK BRAIN BRAIN STEM W/O CONTRAST MATERIAL | $5,689.00 | $5,689.00 | — |
| MRI of the brain, with and without contrast dye CPT 70553 HC - MRI BRAIN BRAIN STEM W/O W/CONTRAST MATERIAL | $8,046.00 | $8,046.00 | — |
| MRI of the lower back, no contrast dye CPT 72148 HC - MRI SPINAL CANAL LUMBAR W/O CONTRAST MATERIAL | $5,653.00 | $5,653.00 | — |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 CHG US PREG UTERUS AFTER 1ST TRIMEST 1/1ST GESTATION | $286.00 | $286.00 | — |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 HC - US PREG UTERUS AFTER 1ST TRIMEST 1/1ST GESTATION | $1,006.00 | $1,006.00 | — |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 CHG US PREG UTERUS AFTER 1ST TRIMEST 1/1ST GESTATION | $286.00 | $286.00 | — |
| Screening mammogram, both breasts both sides CPT 77067 HC - SCREENING MAMMOGRAPHY BI 2-VIEW BREAST INC CAD | $640.00 | $640.00 | — |
| Sleep study in a lab (polysomnography) CPT 95810 HC - POLYSOM 6/>YRS SLEEP 4/> ADDL PARAM ATTND | $1,795.00 | $1,795.00 | — |
| Sleep study in a lab (polysomnography) CPT 95810 PR POLYSOM 6/>YRS SLEEP 4/> ADDL PARAM ATTND | $2,882.00 | $2,882.00 | — |
| Sleep study in a lab (polysomnography) inpatient CPT 95810 PR POLYSOM 6/>YRS SLEEP 4/> ADDL PARAM ATTND | $2,882.00 | $2,882.00 | — |
| Transvaginal pelvic ultrasound CPT 76830 CHG US TRANSVAGINAL | $253.00 | $253.00 | — |
| Transvaginal pelvic ultrasound CPT 76830 HC - US TRANSVAGINAL | $605.00 | $605.00 | — |
| Transvaginal pelvic ultrasound inpatient CPT 76830 CHG US TRANSVAGINAL | $253.00 | $253.00 | — |
| Ultrasound of the abdomen, complete CPT 76700 CHG US ABDOMINAL REAL TIME W/IMAGE DOCUMENTATION | $180.00 | $180.00 | — |
| Ultrasound of the abdomen, complete CPT 76700 HC - US ABDOMINAL REAL TIME W/IMAGE DOCUMENTATION | $489.00 | $489.00 | — |
| Ultrasound of the abdomen, complete inpatient CPT 76700 CHG US ABDOMINAL REAL TIME W/IMAGE DOCUMENTATION | $180.00 | $180.00 | — |
| X-ray of the lower back, 4 or more views CPT 72110 CHG RADEX SPINE LUMBOSACRAL MINIMUM 4 VIEWS | $342.00 | $342.00 | — |
| X-ray of the lower back, 4 or more views CPT 72110 HC - RADEX SPINE LUMBOSACRAL MINIMUM 4 VIEWS | $1,004.00 | $1,004.00 | — |
| X-ray of the lower back, 4 or more views inpatient CPT 72110 CHG RADEX SPINE LUMBOSACRAL MINIMUM 4 VIEWS | $342.00 | $342.00 | — |
Lab tests
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Basic metabolic panel (blood test) CPT 80048 HC - BASIC METABOLIC PANEL CALCIUM TOTAL | $239.00 | $239.00 | — |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 HC - LIPOEL LIPID PANEL | $298.00 | $298.00 | — |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 HC - LIPID PROFILE | $298.00 | $298.00 | — |
| Complete blood count (CBC) with differential CPT 85025 HC - BLOOD COUNT COMPLETE AUTO&AUTO DIFRNTL WBC | $210.00 | $210.00 | — |
| Complete blood count (CBC), no differential CPT 85027 HC - HEMAGRAM | $109.00 | $109.00 | — |
| Comprehensive metabolic panel (blood test) CPT 80053 HC - COMPREHENSIVE METABOLIC PANEL | $361.00 | $361.00 | — |
| Kidney function blood test panel CPT 80069 HC - RENAL FUNCTION PANEL | $273.00 | $273.00 | — |
| Liver function blood test panel CPT 80076 HC - HEPATIC FUNCTION PANEL | $236.00 | $236.00 | — |
| PSA (prostate-specific antigen) blood test, free CPT 84154 HC - PSA FREE MAYO | $252.00 | $252.00 | — |
| PSA (prostate-specific antigen) blood test, free CPT 84154 HC - FREE PSA, PHI | $252.00 | $252.00 | — |
| PSA (prostate-specific antigen) blood test, total CPT 84153 HC - PROSTATE SPECIFIC AG, PHI | $265.00 | $265.00 | — |
| PSA (prostate-specific antigen) blood test, total CPT 84153 HC - ASSAY OF PROSTATE SPECIFIC ANTIGEN TOTAL | $265.00 | $265.00 | — |
| PSA (prostate-specific antigen) blood test, total CPT 84153 HC - DIAGNOSTIC PROSTATIC SPEC AG | $265.00 | $265.00 | — |
| PSA (prostate-specific antigen) blood test, total CPT 84153 HC - PSA TOTAL MAYO | $265.00 | $265.00 | — |
| PSA (prostate-specific antigen) blood test, total CPT 84153 HC - PROSTATIC SPEC AG SCREEN | $265.00 | $265.00 | — |
| Partial thromboplastin time (PTT) clotting test CPT 85730 HC - THROMBOPLASTIN TIME PARTIAL PLASMA/WHOLE BLOOD | $55.00 | $55.00 | — |
| Prothrombin time (PT/INR) clotting test CPT 85610 HC - PROTHROMBIN TIME | $25.00 | $25.00 | — |
| Prothrombin time (PT/INR) clotting test CPT 85610 HC - PROTIME, LUPUS CASCADE REFLEX | $25.00 | $25.00 | — |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 HC - ASSAY OF THYROID STIMULATING HORMONE TSH | $281.00 | $281.00 | — |
| Urinalysis with microscope exam, automated CPT 81001 CHG URNLS DIP STICK/TABLET REAGENT AUTO MICROSCOPY | $5.00 | $5.00 | — |
| Urinalysis with microscope exam, automated CPT 81001 HC - URINALYSIS, CHEMICAL AND SEDIMENT, AUTOMATED | $131.00 | $131.00 | — |
| Urinalysis with microscope exam, automated inpatient CPT 81001 CHG URNLS DIP STICK/TABLET REAGENT AUTO MICROSCOPY | $5.00 | $5.00 | — |
| Urinalysis with microscope exam, manual CPT 81000 CHG URINLS DIP STICK/TABLET REAGNT NON-AUTO MICRSCPY | $14.00 | $14.00 | — |
| Urinalysis with microscope exam, manual inpatient CPT 81000 CHG URINLS DIP STICK/TABLET REAGNT NON-AUTO MICRSCPY | $14.00 | $14.00 | — |
| Urinalysis without microscope exam, automated CPT 81003 CHG URNLS DIP STICK/TABLET RGNT AUTO W/O MICROSCOPY | $4.00 | $4.00 | — |
| Urinalysis without microscope exam, automated CPT 81003 HC - URNLS DIP STICK/TABLET RGNT AUTO W/O MICROSCOPY | $143.00 | $143.00 | — |
| Urinalysis without microscope exam, automated inpatient CPT 81003 CHG URNLS DIP STICK/TABLET RGNT AUTO W/O MICROSCOPY | $4.00 | $4.00 | — |
| Urinalysis without microscope exam, manual CPT 81002 CHG URNLS DIP STICK/TABLET RGNT NON-AUTO W/O MICRSCP | $11.00 | $11.00 | — |
| Urinalysis without microscope exam, manual inpatient CPT 81002 CHG URNLS DIP STICK/TABLET RGNT NON-AUTO W/O MICRSCP | $11.00 | $11.00 | — |
Surgery and procedures
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Cesarean delivery, including prenatal and postpartum care CPT 59510 PR OB ANTEPARTUM CARE CESAREAN DLVR & POSTPARTUM | $5,597.00 | $5,597.00 | — |
| Cesarean delivery, including prenatal and postpartum care inpatient CPT 59510 PR OB ANTEPARTUM CARE CESAREAN DLVR & POSTPARTUM | $5,597.00 | $5,597.00 | — |
| Colonoscopy with endoscopic ultrasound CPT 45391 PR COLSC FLX W/NDSC US XM RCTM ET AL LMTD&ADJ STRUX | $658.00 | $658.00 | — |
| Colonoscopy with endoscopic ultrasound CPT 45391 HC - COLSC FLX W/NDSC US XM RCTM ET AL LMTD&ADJ STRUX | $4,017.00 | $4,017.00 | — |
| Colonoscopy with endoscopic ultrasound inpatient CPT 45391 PR COLSC FLX W/NDSC US XM RCTM ET AL LMTD&ADJ STRUX | $658.00 | $658.00 | — |
| Colonoscopy with polyp removal CPT 45385 PR COLSC FLX W/RMVL OF TUMOR POLYP LESION SNARE TQ | $1,489.00 | $1,489.00 | — |
| Colonoscopy with polyp removal CPT 45385 HC - COLSC FLX W/RMVL OF TUMOR POLYP LESION SNARE TQ | $5,005.00 | $5,005.00 | — |
| Colonoscopy with polyp removal inpatient CPT 45385 PR COLSC FLX W/RMVL OF TUMOR POLYP LESION SNARE TQ | $1,489.00 | $1,489.00 | — |
| Colonoscopy with tissue sample CPT 45380 PR COLONOSCOPY W/BIOPSY SINGLE/MULTIPLE | $1,454.00 | $1,454.00 | — |
| Colonoscopy with tissue sample CPT 45380 HC - COLONOSCOPY W/BIOPSY SINGLE/MULTIPLE | $4,975.00 | $4,975.00 | — |
| Colonoscopy with tissue sample inpatient CPT 45380 PR COLONOSCOPY W/BIOPSY SINGLE/MULTIPLE | $1,454.00 | $1,454.00 | — |
| Colonoscopy, diagnostic CPT 45378 PR COLONOSCOPY FLX DX W/COLLJ SPEC WHEN PFRMD | $1,247.00 | $1,247.00 | — |
| Colonoscopy, diagnostic CPT 45378 HC - COLONOSCOPY FLX DX W/COLLJ SPEC WHEN PFRMD SCREENING LOW RISK | $4,336.00 | $4,336.00 | — |
| Colonoscopy, diagnostic CPT 45378 HC - COLONOSCOPY FLX DX W/COLLJ SPEC WHEN PFRMD SCREENING HIGH RISK | $4,336.00 | $4,336.00 | — |
| Colonoscopy, diagnostic CPT 45378 HC - COLONOSCOPY FLX DX W/COLLJ SPEC WHEN PFRMD | $4,336.00 | $4,336.00 | — |
| Colonoscopy, diagnostic inpatient CPT 45378 PR COLONOSCOPY FLX DX W/COLLJ SPEC WHEN PFRMD | $1,247.00 | $1,247.00 | — |
| Gallbladder removal, laparoscopic CPT 47562 PR LAPAROSCOPY SURG CHOLECYSTECTOMY | $1,617.00 | $1,617.00 | — |
| Gallbladder removal, laparoscopic inpatient CPT 47562 PR LAPAROSCOPY SURG CHOLECYSTECTOMY | $1,617.00 | $1,617.00 | — |
| Inguinal (groin) hernia repair, age 5 or older CPT 49505 PR RPR 1ST INGUN HRNA AGE 5 YRS/> REDUCIBLE | $1,278.00 | $1,278.00 | — |
| Inguinal (groin) hernia repair, age 5 or older inpatient CPT 49505 PR RPR 1ST INGUN HRNA AGE 5 YRS/> REDUCIBLE | $1,278.00 | $1,278.00 | — |
| Knee arthroscopy with meniscus trim CPT 29881 PR ARTHRS KNE SURG W/MENISCECTOMY MED/LAT W/SHVG | $1,299.00 | $1,299.00 | — |
| Knee arthroscopy with meniscus trim inpatient CPT 29881 PR ARTHRS KNE SURG W/MENISCECTOMY MED/LAT W/SHVG | $1,299.00 | $1,299.00 | — |
| Left heart catheterization, diagnostic CPT 93452 HC - L HRT CATH W/NJX L VENTRICULOGRAPHY IMG S&I | $14,183.00 | $14,183.00 | — |
| Lower-back epidural injection, with imaging guidance CPT 62323 PR NJX DX/THER SBST INTRLMNR LMBR/SAC W/IMG GDN | $841.00 | $841.00 | — |
| Lower-back epidural injection, with imaging guidance CPT 62323 HC - NJX DX/THER SBST INTRLMNR LMBR/SAC W/IMG GDN | $1,746.00 | $1,746.00 | — |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 PR NJX DX/THER SBST INTRLMNR LMBR/SAC W/IMG GDN | $841.00 | $841.00 | — |
| Lower-back epidural injection, without imaging guidance CPT 62322 PR NJX DX/THER SBST INTRLMNR LMBR/SAC W/O IMG GDN | $636.00 | $636.00 | — |
| Lower-back epidural injection, without imaging guidance CPT 62322 HC - NJX DX/THER SBST INTRLMNR LMBR/SAC W/O IMG GDN | $1,732.00 | $1,732.00 | — |
| Lower-back epidural injection, without imaging guidance inpatient CPT 62322 PR NJX DX/THER SBST INTRLMNR LMBR/SAC W/O IMG GDN | $636.00 | $636.00 | — |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 PR NJX AA&/STRD TFRML EPI LUMBAR/SACRAL 1 LEVEL | $565.00 | $565.00 | — |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 HC - NJX AA&/STRD TFRML EPI LUMBAR/SACRAL 1 LEVEL | $2,301.00 | $2,301.00 | — |
| Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 PR NJX AA&/STRD TFRML EPI LUMBAR/SACRAL 1 LEVEL | $565.00 | $565.00 | — |
| Prostate biopsy CPT 55700 PR PROSTATE NEEDLE BIOPSY ANY APPROACH | $5,612.00 | $5,612.00 | — |
| Prostate biopsy inpatient CPT 55700 PR PROSTATE NEEDLE BIOPSY ANY APPROACH | $5,612.00 | $5,612.00 | — |
| Prostate removal (prostatectomy), laparoscopic CPT 55866 PR LAPS SURG PRST8ECT RPBIC RAD W/NRV SPARING ROBOT | $3,510.00 | $3,510.00 | — |
| Prostate removal (prostatectomy), laparoscopic inpatient CPT 55866 PR LAPS SURG PRST8ECT RPBIC RAD W/NRV SPARING ROBOT | $3,510.00 | $3,510.00 | — |
| Removal of a breast lump, open surgery CPT 19120 PR EXC CYST/ABERRANT BREAST TISSUE OPEN 1/> LESION | $1,463.00 | $1,463.00 | — |
| Removal of a breast lump, open surgery inpatient CPT 19120 PR EXC CYST/ABERRANT BREAST TISSUE OPEN 1/> LESION | $1,463.00 | $1,463.00 | — |
| Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) CPT 29826 PR SURGICAL ARTHROSCOPY SHO W/CORACOACRM LIGM RLS | $422.00 | $422.00 | — |
| Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) inpatient CPT 29826 PR SURGICAL ARTHROSCOPY SHO W/CORACOACRM LIGM RLS | $422.00 | $422.00 | — |
| Tonsil and adenoid removal, child under 12 CPT 42820 PR TONSILLECTOMY & ADENOIDECTOMY <AGE 12 | $716.00 | $716.00 | — |
| Tonsil and adenoid removal, child under 12 inpatient CPT 42820 PR TONSILLECTOMY & ADENOIDECTOMY <AGE 12 | $716.00 | $716.00 | — |
| Total hip replacement CPT 27130 PR ARTHRP ACETBLR/PROX FEM PROSTC AGRFT/ALGRFT | $3,254.00 | $3,254.00 | — |
| Total hip replacement inpatient CPT 27130 PR ARTHRP ACETBLR/PROX FEM PROSTC AGRFT/ALGRFT | $3,254.00 | $3,254.00 | — |
| Total knee replacement CPT 27447 PR ARTHRP KNE CONDYLE&PLATU MEDIAL&LAT COMPARTMENTS | $3,250.00 | $3,250.00 | — |
| Total knee replacement inpatient CPT 27447 PR ARTHRP KNE CONDYLE&PLATU MEDIAL&LAT COMPARTMENTS | $3,250.00 | $3,250.00 | — |
| Upper endoscopy (EGD) with biopsy CPT 43239 PR EGD TRANSORAL BIOPSY SINGLE/MULTIPLE | $1,332.00 | $1,332.00 | — |
| Upper endoscopy (EGD) with biopsy CPT 43239 HC - EGD TRANSORAL BIOPSY SINGLE/MULTIPLE | $2,602.00 | $2,602.00 | — |
| Upper endoscopy (EGD) with biopsy inpatient CPT 43239 PR EGD TRANSORAL BIOPSY SINGLE/MULTIPLE | $1,332.00 | $1,332.00 | — |
| Upper endoscopy (EGD), diagnostic CPT 43235 PR ESOPHAGOGASTRODUODENOSCOPY TRANSORAL DIAGNOSTIC | $965.00 | $965.00 | — |
| Upper endoscopy (EGD), diagnostic CPT 43235 HC - ESOPHAGOGASTRODUODENOSCOPY TRANSORAL DIAGNOSTIC | $4,016.00 | $4,016.00 | — |
| Upper endoscopy (EGD), diagnostic inpatient CPT 43235 PR ESOPHAGOGASTRODUODENOSCOPY TRANSORAL DIAGNOSTIC | $965.00 | $965.00 | — |
| Vaginal birth after cesarean (VBAC), including prenatal and postpartum care CPT 59610 PR ROUTINE OB CARE VAG DLVRY & POSTPARTUM CARE VB | $5,307.00 | $5,307.00 | — |
| Vaginal birth after cesarean (VBAC), including prenatal and postpartum care inpatient CPT 59610 PR ROUTINE OB CARE VAG DLVRY & POSTPARTUM CARE VB | $5,307.00 | $5,307.00 | — |
| Vaginal delivery, including prenatal and postpartum care CPT 59400 PR OB CARE ANTEPARTUM VAG DLVR & POSTPARTUM | $5,064.00 | $5,064.00 | — |
| Vaginal delivery, including prenatal and postpartum care inpatient CPT 59400 PR OB CARE ANTEPARTUM VAG DLVR & POSTPARTUM | $5,064.00 | $5,064.00 | — |
Doctor visits and therapy
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Electrocardiogram (ECG/EKG) with interpretation CPT 93000 PR ECG ROUTINE ECG W/LEAST 12 LDS W/I&R | $40.00 | $40.00 | — |
| Electrocardiogram (ECG/EKG) with interpretation inpatient CPT 93000 PR ECG ROUTINE ECG W/LEAST 12 LDS W/I&R | $40.00 | $40.00 | — |
| Family therapy with the patient, 50 minutes CPT 90847 PR FAMILY PSYCHOTHERAPY W/PATIENT PRESENT 50 MINS | $281.00 | $281.00 | — |
| Family therapy with the patient, 50 minutes inpatient CPT 90847 PR FAMILY PSYCHOTHERAPY W/PATIENT PRESENT 50 MINS | $281.00 | $281.00 | — |
| Family therapy without the patient, 50 minutes CPT 90846 PR FAMILY PSYCHOTHERAPY W/O PATIENT PRESENT 50 MINS | $210.00 | $210.00 | — |
| Family therapy without the patient, 50 minutes inpatient CPT 90846 PR FAMILY PSYCHOTHERAPY W/O PATIENT PRESENT 50 MINS | $210.00 | $210.00 | — |
| Group psychotherapy session CPT 90853 PR GROUP PSYCHOTHERAPY | $59.00 | $59.00 | — |
| Group psychotherapy session inpatient CPT 90853 PR GROUP PSYCHOTHERAPY | $59.00 | $59.00 | — |
| New patient office visit, about 30 minutes CPT 99203 PR OFFICE/OUTPATIENT NEW LOW MDM 30 MINUTES | $400.00 | $400.00 | — |
| New patient office visit, about 30 minutes CPT 99203 HC - OFFICE/OUTPATIENT NEW LOW MDM 30 MINUTES | $493.00 | $493.00 | — |
| New patient office visit, about 30 minutes inpatient CPT 99203 PR OFFICE/OUTPATIENT NEW LOW MDM 30 MINUTES | $400.00 | $400.00 | — |
| New patient office visit, about 45 minutes CPT 99204 HC - OFFICE/OUTPATIENT NEW MODERATE MDM 45 MINUTES | $635.00 | $635.00 | — |
| New patient office visit, about 45 minutes CPT 99204 PR OFFICE/OUTPATIENT NEW MODERATE MDM 45 MINUTES | $636.00 | $636.00 | — |
| New patient office visit, about 45 minutes inpatient CPT 99204 PR OFFICE/OUTPATIENT NEW MODERATE MDM 45 MINUTES | $636.00 | $636.00 | — |
| New patient office visit, about 60 minutes CPT 99205 HC - OFFICE/OUTPATIENT NEW HIGH MDM 60 MINUTES | $796.00 | $796.00 | — |
| New patient office visit, about 60 minutes CPT 99205 PR OFFICE/OUTPATIENT NEW HIGH MDM 60 MINUTES | $809.00 | $809.00 | — |
| New patient office visit, about 60 minutes inpatient CPT 99205 PR OFFICE/OUTPATIENT NEW HIGH MDM 60 MINUTES | $809.00 | $809.00 | — |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HC - OT THERAPEUTIC PX 1/> AREAS EACH 15 MIN EXERCISES | $173.00 | $173.00 | — |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HC - PT THERAPEUTIC PX 1/> AREAS EACH 15 MIN EXERCISES | $173.00 | $173.00 | — |
| Preventive checkup, new patient aged 18–39 CPT 99385 PR INITIAL PREVENTIVE MEDICINE NEW PT AGE 18-39YRS | $270.00 | $270.00 | — |
| Preventive checkup, new patient aged 18–39 inpatient CPT 99385 PR INITIAL PREVENTIVE MEDICINE NEW PT AGE 18-39YRS | $270.00 | $270.00 | — |
| Preventive checkup, new patient aged 40–64 CPT 99386 PR INITIAL PREVENTIVE MEDICINE NEW PATIENT 40-64YRS | $315.00 | $315.00 | — |
| Preventive checkup, new patient aged 40–64 inpatient CPT 99386 PR INITIAL PREVENTIVE MEDICINE NEW PATIENT 40-64YRS | $315.00 | $315.00 | — |
| Psychotherapy session, 30 minutes CPT 90832 HC - PSYCHOTHERAPY W/PATIENT 30 MINUTES | $307.00 | $307.00 | — |
| Psychotherapy session, 30 minutes CPT 90832 PR PSYCHOTHERAPY W/PATIENT 30 MINUTES | $420.00 | $420.00 | — |
| Psychotherapy session, 30 minutes inpatient CPT 90832 PR PSYCHOTHERAPY W/PATIENT 30 MINUTES | $420.00 | $420.00 | — |
| Psychotherapy session, 45 minutes CPT 90834 PR PSYCHOTHERAPY W/PATIENT 45 MINUTES | $197.00 | $197.00 | — |
| Psychotherapy session, 45 minutes inpatient CPT 90834 PR PSYCHOTHERAPY W/PATIENT 45 MINUTES | $197.00 | $197.00 | — |
| Psychotherapy session, 60 minutes CPT 90837 PR PSYCHOTHERAPY W/PATIENT 60 MINUTES | $297.00 | $297.00 | — |
| Psychotherapy session, 60 minutes inpatient CPT 90837 PR PSYCHOTHERAPY W/PATIENT 60 MINUTES | $297.00 | $297.00 | — |
| Specialist consultation, low complexity or 30+ minutes CPT 99243 PR OFFICE/OP CONSLTJ NEW/EST PT LOW MDM 30 MINUTES | $366.00 | $366.00 | — |
| Specialist consultation, low complexity or 30+ minutes inpatient CPT 99243 PR OFFICE/OP CONSLTJ NEW/EST PT LOW MDM 30 MINUTES | $366.00 | $366.00 | — |
| Specialist consultation, moderate complexity or 40+ minutes CPT 99244 PR OFFICE/OP CONSLTJ NEW/EST PT MOD MDM 40 MINUTES | $504.00 | $504.00 | — |
| Specialist consultation, moderate complexity or 40+ minutes inpatient CPT 99244 PR OFFICE/OP CONSLTJ NEW/EST PT MOD MDM 40 MINUTES | $504.00 | $504.00 | — |