Hospital

Gundersen Tri-County Hospital & Clinics

Listed in its price file as “Tri-County Memorial Hospital Inc”.

Gundersen Tri-County Hospital & Clinics in Whitehall, WI publishes cash prices for 398 common procedures listed here, from its own machine-readable price file updated Jun 27, 2026. Compared with other hospitals in the state, its outpatient cash prices are below the Wisconsin median for 293 of 386 procedures and above it for 90. By typical cash price it ranks #34 of 103 Wisconsin hospitals, cheapest first. Select a procedure to compare it with other hospitals nearby.

18601 Lincoln St, Whitehall, WI 54773 Collected Sep 23, 2026 Source price file Check a bill from this hospital (715) 538-4361

Critical access hospital (rural, 25 beds or fewer) Nonprofit hospital Emergency department CCN 521316 · CMS hospital register NPI 1124063573

Financial assistance

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

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

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

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

Scans and imaging

Procedure	Cash price	List price	Insurers pay	vs Wisconsin	Off list
Abdominal CT scan without and with contrast CPT 74170 HCHG 74170 CT ABD W&W/O IV CONT	$1,426.50	$2,250.00	$144.33–$2,570.00	40% below	37%
Abdominal CT scan without and with contrast inpatient CPT 74170 HCHG 74170 CT ABD W&W/O IV CONT	$1,426.50	$2,250.00	$951.75–$2,137.50	—	37%
Abdominal X-ray, 2 views CPT 74019 HCHG 74019 RADIOLOGIC EXAM, ABDOMEN; 2 VIEWS	$236.48	$373.00	$24.82–$354.35	1% below	37%
Abdominal X-ray, 2 views inpatient CPT 74019 HCHG 74019 RADIOLOGIC EXAM, ABDOMEN; 2 VIEWS	$236.48	$373.00	$157.78–$354.35	—	37%
Ankle X-ray, complete, 3 or more views CPT 73610 HCHG 73610 ANKLE 3VW ROUTINE L/R	$183.86	$290.00	$24.82–$275.50	22% below	37%
Ankle X-ray, complete, 3 or more views inpatient CPT 73610 HCHG 73610 ANKLE 3VW ROUTINE L/R	$183.86	$290.00	$122.67–$275.50	—	37%
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 HCHG 93922 NON-INVAS PHYSIOLOGIC STD EXTREMITY ART 1-2	$405.13	$639.00	$48.71–$607.05	5% above	37%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 HCHG 93922 NON-INVAS PHYSIOLOGIC STD EXTREMITY ART 1-2	$405.13	$639.00	$270.30–$607.05	—	37%
Arm CT scan without contrast (shoulder to hand, any part) CPT 73200 HCHG 73200 CT UPR EXT W/O IV CONT	$877.46	$1,384.00	$47.05–$2,570.00	39% below	37%
Arm CT scan without contrast (shoulder to hand, any part) inpatient CPT 73200 HCHG 73200 CT UPR EXT W/O IV CONT	$877.46	$1,384.00	$585.43–$1,314.80	—	37%
Barium swallow (esophagus X-ray with contrast) CPT 74220 HCHG 74220 XRAY, ESOPHAGUS, INCL SCOUT CHEST; SINGLE CONTRAST ST	$355.04	$560.00	$24.82–$532.00	33% below	37%
Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 HCHG 74220 XRAY, ESOPHAGUS, INCL SCOUT CHEST; SINGLE CONTRAST ST	$355.04	$560.00	$236.88–$532.00	—	37%
Bone scan, whole body (nuclear medicine) CPT 78306 HCHG 78306 BONE SCAN-ROUTINE	$971.92	$1,533.00	$648.46–$1,456.35	35% below	37%
Bone scan, whole body (nuclear medicine) inpatient CPT 78306 HCHG 78306 BONE SCAN-ROUTINE	$971.92	$1,533.00	$648.46–$1,456.35	—	37%
Breast ultrasound, complete, one breast one side CPT 76641 HCHG 76641 US BREAST UNILATERAL COMPLETE	$525.59	$829.00	$48.71–$646.00	1% below	37%
Breast ultrasound, complete, one breast inpatient one side CPT 76641 HCHG 76641 US BREAST UNILATERAL COMPLETE	$525.59	$829.00	$350.67–$787.55	—	37%
CT angiography (CTA) of the abdomen and pelvis CPT 74174 HCHG 74174 CTA ABD & PELVIS W/CONTRAST,INCL NONCONT	$2,169.55	$3,422.00	$1,447.51–$3,250.90	29% below	37%
CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174 HCHG 74174 CTA ABD & PELVIS W/CONTRAST,INCL NONCONT	$2,169.55	$3,422.00	$1,447.51–$3,250.90	—	37%
CT angiography (CTA) of the head CPT 70496 HCHG 70496 CT ANGIO HEAD W/O&W IV CONT	$1,426.50	$2,250.00	$951.75–$2,137.50	31% below	37%
CT angiography (CTA) of the head inpatient CPT 70496 HCHG 70496 CT ANGIO HEAD W/O&W IV CONT	$1,426.50	$2,250.00	$951.75–$2,137.50	—	37%
CT angiography (CTA) of the neck CPT 70498 HCHG 70498 CT ANGIO NECK W/O&W IV CONT	$1,427.13	$2,251.00	$952.17–$2,138.45	30% below	37%
CT angiography (CTA) of the neck inpatient CPT 70498 HCHG 70498 CT ANGIO NECK W/O&W IV CONT	$1,427.13	$2,251.00	$952.17–$2,138.45	—	37%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 HCHG 71275 CT ANGIO CHEST WO&W IV CONT	$1,341.54	$2,116.00	$895.07–$2,010.20	34% below	37%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 HCHG 71275 CT ANGIO CHEST WO&W IV CONT	$1,341.54	$2,116.00	$895.07–$2,010.20	—	37%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 HCHG 74176 CT ABD&PELVIS; W/O CONTRAST	$1,257.86	$1,984.00	$144.33–$2,570.00	50% below	37%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 HCHG 74176 CT ABD&PELVIS; W/O CONTRAST	$1,257.86	$1,984.00	$839.23–$1,884.80	—	37%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 HCHG 74177 CT ABD&PELVIS;W/CONTRAST	$1,739.06	$2,743.00	$144.33–$2,605.85	46% below	37%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 HCHG 74177 CT ABD&PELVIS;W/CONTRAST	$1,739.06	$2,743.00	$1,160.29–$2,605.85	—	37%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 HCHG 74178 CT ABD&PELVIS;W/O,W/CONTRAST	$2,889.77	$4,558.00	$144.33–$4,330.10	22% below	37%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 HCHG 74178 CT ABD&PELVIS;W/O,W/CONTRAST	$2,889.77	$4,558.00	$1,928.03–$4,330.10	—	37%
CT scan of the abdomen with contrast CPT 74160 HCHG 74160 CT ABDOMEN W/IV CONT	$1,426.50	$2,250.00	$144.33–$2,570.00	13% below	37%
CT scan of the abdomen with contrast inpatient CPT 74160 HCHG 74160 CT ABDOMEN W/IV CONT	$1,426.50	$2,250.00	$951.75–$2,137.50	—	37%
CT scan of the abdomen without contrast CPT 74150 HCHG 74150 CT ABDOMEN W/O IV CONT	$876.82	$1,383.00	$47.05–$2,570.00	31% below	37%
CT scan of the abdomen without contrast inpatient CPT 74150 HCHG 74150 CT ABDOMEN W/O IV CONT	$876.82	$1,383.00	$585.01–$1,313.85	—	37%
CT scan of the face and sinuses, no contrast dye CPT 70486 HCHG 70486 CT MAXILLA W/O IV CONT	$876.82	$1,383.00	$47.05–$2,570.00	37% below	37%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 HCHG 70486 CT MAXILLA W/O IV CONT	$876.82	$1,383.00	$585.01–$1,313.85	—	37%
CT scan of the head or brain, no contrast dye CPT 70450 HCHG 70450 CT HEAD W/O IV CONT	$876.19	$1,382.00	$144.33–$2,570.00	32% below	37%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 HCHG 70450 CT HEAD W/O IV CONT	$876.19	$1,382.00	$584.59–$1,312.90	—	37%
CT scan of the head with contrast CPT 70460 HCHG 70460 CT HEAD W/IV CONT	$1,319.35	$2,081.00	$144.33–$2,570.00	15% below	37%
CT scan of the head with contrast inpatient CPT 70460 HCHG 70460 CT HEAD W/IV CONT	$1,319.35	$2,081.00	$880.26–$1,976.95	—	37%
CT scan of the head without and with contrast CPT 70470 HCHG 70470 CT HEAD W&W/O IV CONT	$1,426.50	$2,250.00	$144.33–$2,570.00	22% below	37%
CT scan of the head without and with contrast inpatient CPT 70470 HCHG 70470 CT HEAD W&W/O IV CONT	$1,426.50	$2,250.00	$951.75–$2,137.50	—	37%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 HCHG 72131 CT SPINE L W/O IV CONT	$877.46	$1,384.00	$47.05–$2,570.00	43% below	37%
CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 HCHG 72131 CT SPINE L W/O IV CONT	$877.46	$1,384.00	$585.43–$1,314.80	—	37%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 HCHG 72125 CT SPINE C W/O IV CONT	$876.82	$1,383.00	$47.05–$2,570.00	43% below	37%
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 HCHG 72125 CT SPINE C W/O IV CONT	$876.82	$1,383.00	$585.01–$1,313.85	—	37%
CT scan of the pelvis, with contrast dye CPT 72193 HCHG 72193 CT PELVIS W/IV CONT	$1,481.02	$2,336.00	$144.33–$2,570.00	10% below	37%
CT scan of the pelvis, with contrast dye inpatient CPT 72193 HCHG 72193 CT PELVIS W/IV CONT	$1,481.02	$2,336.00	$988.13–$2,219.20	—	37%
Carotid artery ultrasound (duplex), both sides of the neck CPT 93880 HCHG 93880 US CAROTID/DOPPLER	$1,053.07	$1,661.00	$73.45–$1,121.34	7% above	37%
Carotid artery ultrasound (duplex), both sides of the neck inpatient CPT 93880 HCHG 93880 US CAROTID/DOPPLER	$1,053.07	$1,661.00	$702.60–$1,577.95	—	37%
Chest CT scan without and with contrast CPT 71270 HCHG 71270 CT THORAX, DIAGNOSTIC; W/O & W/IV CONTRAST	$1,427.13	$2,251.00	$144.33–$2,570.00	38% below	37%
Chest CT scan without and with contrast inpatient CPT 71270 HCHG 71270 CT THORAX, DIAGNOSTIC; W/O & W/IV CONTRAST	$1,427.13	$2,251.00	$952.17–$2,138.45	—	37%
Chest X-ray, 2 views CPT 71046 HCHG 71046 RADIOLOGIC EXAM, CHEST; 2 VIEWS	$175.62	$277.00	$24.82–$263.15	18% below	37%
Chest X-ray, 2 views inpatient CPT 71046 HCHG 71046 RADIOLOGIC EXAM, CHEST; 2 VIEWS	$175.62	$277.00	$117.17–$263.15	—	37%
Chest X-ray, single view CPT 71045 HCHG 71045 RADIOLOGIC EXAM, CHEST; SINGLE VIEW	$133.77	$211.00	$24.82–$200.45	17% below	37%
Chest X-ray, single view inpatient CPT 71045 HCHG 71045 RADIOLOGIC EXAM, CHEST; SINGLE VIEW	$133.77	$211.00	$89.25–$200.45	—	37%
Collarbone (clavicle) X-ray, complete CPT 73000 HCHG 73000 CLAVICLE COMPLETE 1-2 VIEWS	$154.06	$243.00	$24.82–$230.85	26% below	37%
Collarbone (clavicle) X-ray, complete inpatient CPT 73000 HCHG 73000 CLAVICLE COMPLETE 1-2 VIEWS	$154.06	$243.00	$102.79–$230.85	—	37%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 HCHG 76770 US RENAL	$551.58	$870.00	$73.45–$646.00	at median	37%
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 HCHG 76770 US RENAL	$551.58	$870.00	$368.01–$826.50	—	37%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 HCHG 77080 BONE DENSTOMETRY	$282.13	$445.00	$188.24–$422.75	29% below	37%
DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 HCHG 77080 BONE DENSTOMETRY	$282.13	$445.00	$188.24–$422.75	—	37%
DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 HCHG 77081 BONE DENSITY-PERIPHERAL	$105.88	$167.00	$70.64–$158.65	63% below	37%
DEXA bone density scan of the wrist, heel or finger (peripheral) inpatient CPT 77081 HCHG 77081 BONE DENSITY-PERIPHERAL	$105.88	$167.00	$70.64–$158.65	—	37%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 HCHG 71250 CT, THORAX, DIAGNOSTIC; W/O CONTRAST	$877.46	$1,384.00	$47.05–$2,570.00	39% below	37%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 HCHG 71250 CT, THORAX, DIAGNOSTIC; W/O CONTRAST	$877.46	$1,384.00	$585.43–$1,314.80	—	37%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 HCHG 71260 CT, THORAX, DIAGNOSTIC; W/CONTRAST	$1,427.13	$2,251.00	$144.33–$2,570.00	13% below	37%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 HCHG 71260 CT, THORAX, DIAGNOSTIC; W/CONTRAST	$1,427.13	$2,251.00	$952.17–$2,138.45	—	37%
Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 HCHG 93925 US LWR EXT ARTERY BILAT	$670.14	$1,057.00	$73.45–$1,004.15	—	37%
Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 HCHG 93925 US LWR EXT ARTERY BILAT	$670.14	$1,057.00	$447.11–$1,004.15	—	37%
Duplex ultrasound of the leg veins, both legs CPT 93970 HCHG 93970 DUPLEX SCAN EXT VEINS BIL	$980.16	$1,546.00	$73.45–$1,121.34	17% below	37%
Duplex ultrasound of the leg veins, both legs inpatient CPT 93970 HCHG 93970 DUPLEX SCAN EXT VEINS BIL	$980.16	$1,546.00	$653.96–$1,468.70	—	37%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 HCHG 93306 TRANSTHO ECHO W/CONTRAST	$2,040.21	$3,218.00	$208.67–$2,567.95	16% above	37%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 HCHG 93306 TRANSTHOR ECHO COMPLETE	$2,040.21	$3,218.00	$208.67–$2,567.95	16% above	37%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 HCHG 93306 TRANSTHOR ECHO COMPLETE	$2,040.21	$3,218.00	$1,361.21–$3,057.10	—	37%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 HCHG 93306 TRANSTHO ECHO W/CONTRAST	$2,040.21	$3,218.00	$1,361.21–$3,057.10	—	37%
Elbow X-ray, 2 views CPT 73070 HCHG 73070 ELBOW 2VW L/R	$152.79	$241.00	$24.82–$228.95	20% below	37%
Elbow X-ray, 2 views inpatient CPT 73070 HCHG 73070 ELBOW 2VW L/R	$152.79	$241.00	$101.94–$228.95	—	37%
Elbow X-ray, complete, 3 or more views CPT 73080 HCHG 73080 ELBOW TRAUMA 3VW L/R	$204.78	$323.00	$24.82–$306.85	13% below	37%
Elbow X-ray, complete, 3 or more views inpatient CPT 73080 HCHG 73080 ELBOW TRAUMA 3VW L/R	$204.78	$323.00	$136.63–$306.85	—	37%
Eye socket (orbit) CT scan without contrast CPT 70480 HCHG 70480 CT ORB TEMP B IAC W/O IV CONT	$876.82	$1,383.00	$47.05–$2,570.00	39% below	37%
Eye socket (orbit) CT scan without contrast inpatient CPT 70480 HCHG 70480 CT ORB TEMP B IAC W/O IV CONT	$876.82	$1,383.00	$585.01–$1,313.85	—	37%
Facial bones X-ray, complete, 3 or more views CPT 70150 HCHG 70150 FACIAL BONES	$240.29	$379.00	$160.32–$360.05	20% below	37%
Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 HCHG 70150 FACIAL BONES	$240.29	$379.00	$160.32–$360.05	—	37%
Forearm X-ray (radius and ulna), 2 views CPT 73090 HCHG 73090 FOREARM L/R	$154.06	$243.00	$24.82–$230.85	22% below	37%
Forearm X-ray (radius and ulna), 2 views inpatient CPT 73090 HCHG 73090 FOREARM L/R	$154.06	$243.00	$102.79–$230.85	—	37%
Hand X-ray, 2 views CPT 73120 HCHG 73120 HAND 1-2 VIEWS	$133.14	$210.00	$24.82–$199.50	29% below	37%
Hand X-ray, 2 views inpatient CPT 73120 HCHG 73120 HAND 1-2 VIEWS	$133.14	$210.00	$88.83–$199.50	—	37%
Heel bone (calcaneus) X-ray, 2 or more views CPT 73650 HCHG 73650 HEEL 1-2VW L/R	$154.06	$243.00	$24.82–$230.85	22% below	37%
Heel bone (calcaneus) X-ray, 2 or more views inpatient CPT 73650 HCHG 73650 HEEL 1-2VW L/R	$154.06	$243.00	$102.79–$230.85	—	37%
Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 HCHG 95806 SLEEP STUDY UNATTENDED, SIMULTANEOUS RECORDING	$713.25	$1,125.00	$475.88–$1,068.75	16% above	37%
Home sleep apnea test, unattended, recording breathing and oxygen inpatient CPT 95806 HCHG 95806 SLEEP STUDY UNATTENDED, SIMULTANEOUS RECORDING	$713.25	$1,125.00	$475.88–$1,068.75	—	37%
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 HCHG 95811 POLYSOMNOGRAPHY 6/+ YRS W/CPAP	$2,517.61	$3,971.00	$1,679.73–$3,772.45	31% below	37%
In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 HCHG 95811 POLYSOMNOGRAPHY 6/+ YRS W/CPAP	$2,517.61	$3,971.00	$1,679.73–$3,772.45	—	37%
Knee X-ray, 3 views CPT 73562 HCHG 73562 KNEE 3 VW SPCFY L/R	$201.61	$318.00	$24.82–$302.10	21% below	37%
Knee X-ray, 3 views inpatient CPT 73562 HCHG 73562 KNEE 3 VW SPCFY L/R	$201.61	$318.00	$134.51–$302.10	—	37%
Knee X-ray, complete, 4 or more views CPT 73564 HCHG 73564 KNEE 4 VW SPCFY L/R	$232.68	$367.00	$24.82–$348.65	16% below	37%
Knee X-ray, complete, 4 or more views inpatient CPT 73564 HCHG 73564 KNEE 4 VW SPCFY L/R	$232.68	$367.00	$155.24–$348.65	—	37%
Leg CT scan without contrast (hip to foot, any part) CPT 73700 HCHG 73700 CT LWR EXT W/O IV CONT	$876.82	$1,383.00	$47.05–$2,570.00	40% below	37%
Leg CT scan without contrast (hip to foot, any part) inpatient CPT 73700 HCHG 73700 CT LWR EXT W/O IV CONT	$876.82	$1,383.00	$585.01–$1,313.85	—	37%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 HCHG 76705 US ABDOMEN; LIMITED	$443.80	$700.00	$48.71–$646.00	at median	37%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 HCHG 76705 US ABDOMEN; LIMITED	$443.80	$700.00	$296.10–$665.00	—	37%
Limited ultrasound of an arm or leg (non-vascular) CPT 76882 HCHG 76882 ULTRASOUND, LIMITED, JOINT OR OTHER NONVASC STRUCTURE	$129.97	$205.00	$48.71–$646.00	55% below	37%
Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 HCHG 76882 ULTRASOUND, LIMITED, JOINT OR OTHER NONVASC STRUCTURE	$129.97	$205.00	$86.72–$194.75	—	37%
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 HCHG 71271 CT, THORAX, LOW DOSE FOR CA SCREENING, WO CONTRAST	$242.19	$382.00	$161.59–$362.90	46% below	37%
Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 HCHG 71271 CT, THORAX, LOW DOSE FOR CA SCREENING, WO CONTRAST	$242.19	$382.00	$161.59–$362.90	—	37%
Lower leg X-ray (tibia and fibula), 2 views CPT 73590 HCHG 73590 TIBIA+FIBULA L/R	$154.06	$243.00	$24.82–$230.85	28% below	37%
Lower leg X-ray (tibia and fibula), 2 views inpatient CPT 73590 HCHG 73590 TIBIA+FIBULA L/R	$154.06	$243.00	$102.79–$230.85	—	37%
MR angiography (MRA) of the head without contrast CPT 70544 HCHG 70544 MRA-HEAD W/O CONTRAST	$1,983.79	$3,129.00	$209.44–$4,106.00	10% below	37%
MR angiography (MRA) of the head without contrast inpatient CPT 70544 HCHG 70544 MRA-HEAD W/O CONTRAST	$1,983.79	$3,129.00	$1,323.57–$2,972.55	—	37%
MRI of knee or other lower-limb joint, no contrast dye CPT 73721 HCHG 73721 MRI LOWER EXT;W/O CONTRAST	$1,983.15	$3,128.00	$106.82–$4,106.00	10% below	37%
MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 HCHG 73721 MRI LOWER EXT;W/O CONTRAST	$1,983.15	$3,128.00	$1,323.14–$2,971.60	—	37%
MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 HCHG 73723 MRI LOWER EXT;W/O,W/CONT	$3,199.16	$5,046.00	$177.62–$4,793.70	6% below	37%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 HCHG 73723 MRI LOWER EXT;W/O,W/CONT	$3,199.16	$5,046.00	$2,134.46–$4,793.70	—	37%
MRI of the abdomen without contrast CPT 74181 HCHG 74181 MRI-ABDOMEN W/O CONTRAST	$1,959.69	$3,091.00	$106.82–$4,106.00	11% below	37%
MRI of the abdomen without contrast inpatient CPT 74181 HCHG 74181 MRI-ABDOMEN W/O CONTRAST	$1,959.69	$3,091.00	$1,307.49–$2,936.45	—	37%
MRI of the abdomen, without and then with contrast dye CPT 74183 HCHG 74183 MRI-ABDOMEN WO & W/CONTRAST	$3,209.31	$5,062.00	$177.62–$4,808.90	6% below	37%
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 HCHG 74183 MRI-ABDOMEN WO & W/CONTRAST	$3,209.31	$5,062.00	$2,141.23–$4,808.90	—	37%
MRI of the brain, no contrast dye CPT 70551 HCHG 70551 MRI HEAD (3 SEQ)	$1,983.79	$3,129.00	$106.82–$4,106.00	10% below	37%
MRI of the brain, no contrast dye inpatient CPT 70551 HCHG 70551 MRI HEAD (3 SEQ)	$1,983.79	$3,129.00	$1,323.57–$2,972.55	—	37%
MRI of the brain, with and without contrast dye CPT 70553 HCHG 70553 MRI HEAD W&WO CONTRAST	$3,387.46	$5,343.00	$177.62–$5,075.85	1% below	37%
MRI of the brain, with and without contrast dye inpatient CPT 70553 HCHG 70553 MRI HEAD W&WO CONTRAST	$3,387.46	$5,343.00	$2,260.09–$5,075.85	—	37%
MRI of the lower back, no contrast dye CPT 72148 HCHG 72148 MRI-LUMBAR SPINE W/O CONTRAST	$1,983.79	$3,129.00	$106.82–$4,106.00	10% below	37%
MRI of the lower back, no contrast dye inpatient CPT 72148 HCHG 72148 MRI-LUMBAR SPINE W/O CONTRAST	$1,983.79	$3,129.00	$1,323.57–$2,972.55	—	37%
MRI of the lower back, without and then with contrast dye CPT 72158 HCHG 72158 MRI L-SPINE W&WO CONTRAST	$3,326.60	$5,247.00	$177.62–$4,984.65	3% below	37%
MRI of the lower back, without and then with contrast dye inpatient CPT 72158 HCHG 72158 MRI L-SPINE W&WO CONTRAST	$3,326.60	$5,247.00	$2,219.48–$4,984.65	—	37%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 HCHG 72146 MRI-THORACIC SPINE W/O CONTRAS	$1,983.15	$3,128.00	$106.82–$4,106.00	10% below	37%
MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 HCHG 72146 MRI-THORACIC SPINE W/O CONTRAS	$1,983.15	$3,128.00	$1,323.14–$2,971.60	—	37%
MRI of the neck (cervical spine) without and with contrast CPT 72156 HCHG 72156 MRI C-SPINE W&WO CONTRAST	$3,374.15	$5,322.00	$177.62–$5,055.90	1% below	37%
MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 HCHG 72156 MRI C-SPINE W&WO CONTRAST	$3,374.15	$5,322.00	$2,251.21–$5,055.90	—	37%
MRI of the neck (cervical spine), no contrast dye CPT 72141 HCHG 72141 MRI-CERVICAL SPINE W/O CONTRAS	$1,983.79	$3,129.00	$106.82–$4,106.00	10% below	37%
MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 HCHG 72141 MRI-CERVICAL SPINE W/O CONTRAS	$1,983.79	$3,129.00	$1,323.57–$2,972.55	—	37%
MRI of the pelvis without and with contrast CPT 72197 HCHG 72197 MRI-PELVIS WO & W/CONTRAST	$3,249.88	$5,126.00	$177.62–$4,869.70	5% below	37%
MRI of the pelvis without and with contrast inpatient CPT 72197 HCHG 72197 MRI-PELVIS WO & W/CONTRAST	$3,249.88	$5,126.00	$2,168.30–$4,869.70	—	37%
MRI of the pelvis, no contrast dye CPT 72195 HCHG 72195 MRI PELVIS W/O CONTRAST	$1,983.79	$3,129.00	$106.82–$4,106.00	10% below	37%
MRI of the pelvis, no contrast dye inpatient CPT 72195 HCHG 72195 MRI PELVIS W/O CONTRAST	$1,983.79	$3,129.00	$1,323.57–$2,972.55	—	37%
MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 HCHG 73221 MRI-UP EXTRM-JOINT W/O CONTRAS	$1,983.15	$3,128.00	$106.82–$4,106.00	10% below	37%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 HCHG 73221 MRI-UP EXTRM-JOINT W/O CONTRAS	$1,983.15	$3,128.00	$1,323.14–$2,971.60	—	37%
Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 HCHG 72050 SPINE CERVICAL 4-5 VIEWS SPEC	$304.95	$481.00	$24.82–$456.95	5% below	37%
Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 HCHG 72050 SPINE CERVICAL 4-5 VIEWS SPEC	$304.95	$481.00	$203.46–$456.95	—	37%
Neck soft tissue CT scan with contrast CPT 70491 HCHG 70491 CT NECK SOFT TIS W/IV CONT	$1,427.13	$2,251.00	$144.33–$2,570.00	13% below	37%
Neck soft tissue CT scan with contrast inpatient CPT 70491 HCHG 70491 CT NECK SOFT TIS W/IV CONT	$1,427.13	$2,251.00	$952.17–$2,138.45	—	37%
Neck soft tissue CT scan without contrast CPT 70490 HCHG 70490 CT NECK SOFT TIS W/O IV CONT	$876.82	$1,383.00	$47.05–$2,570.00	38% below	37%
Neck soft tissue CT scan without contrast inpatient CPT 70490 HCHG 70490 CT NECK SOFT TIS W/O IV CONT	$876.82	$1,383.00	$585.01–$1,313.85	—	37%
Neck soft tissue X-ray CPT 70360 HCHG 70360 NECK SOFT TISSUE 1VW	$155.96	$246.00	$104.06–$233.70	26% below	37%
Neck soft tissue X-ray inpatient CPT 70360 HCHG 70360 NECK SOFT TISSUE 1VW	$155.96	$246.00	$104.06–$233.70	—	37%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 HCHG 78452 MYOCARDIAL PERFUSION IMAGING, TOMOGRAPHIC (SPECT); MU	$2,167.01	$3,418.00	$1,445.81–$3,247.10	30% below	37%
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 HCHG 78452 MYOCARDIAL PERFUSION IMAGING, TOMOGRAPHIC (SPECT); MU	$2,167.01	$3,418.00	$1,445.81–$3,247.10	—	37%
OCT scan of the retina (optical coherence tomography) CPT 92134 HCHG 92134 COMPUTERIZED OPHTHALMIC DIAG IMAGING RETINA	$45.01	$71.00	$30.03–$67.45	5% above	37%
OCT scan of the retina (optical coherence tomography) inpatient CPT 92134 HCHG 92134 COMPUTERIZED OPHTHALMIC DIAG IMAGING RETINA	$45.01	$71.00	$30.03–$67.45	—	37%
PET/CT scan from the base of the skull to mid-thigh CPT 78815 HCHG 78815 PET/CT;SKULL BASE TO MID-THIGH	$3,067.93	$4,839.00	$631.16–$4,597.05	28% below	37%
PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 HCHG 78815 PET/CT;SKULL BASE TO MID-THIGH	$3,067.93	$4,839.00	$2,046.90–$4,597.05	—	37%
Pelvic CT scan without contrast CPT 72192 HCHG 72192 CT PELVIS W/O IV CONT	$876.82	$1,383.00	$47.05–$2,570.00	31% below	37%
Pelvic CT scan without contrast inpatient CPT 72192 HCHG 72192 CT PELVIS W/O IV CONT	$876.82	$1,383.00	$585.01–$1,313.85	—	37%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 HCHG 76857 US, PELVIC (NON-OB); LIMITED	$427.32	$674.00	$48.71–$646.00	7% above	37%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 HCHG 76857 US, PELVIC (NON-OB); LIMITED	$427.32	$674.00	$285.10–$640.30	—	37%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 HCHG 76856 US PELVIS	$523.68	$826.00	$73.45–$646.00	at median	37%
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 HCHG 76856 US PELVIS	$523.68	$826.00	$349.40–$784.70	—	37%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 HCHG 76805 US OB-AFTER 1ST TRIMESTER	$606.74	$957.00	$43.84–$646.00	6% above	37%
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 HCHG 76805 US OB-AFTER 1ST TRIMESTER	$606.74	$957.00	$404.81–$909.15	—	37%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 HCHG 76801 US OB <14WKS,SNGL FETUS	$522.42	$824.00	$43.84–$646.00	2% above	37%
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 HCHG 76801 US OB <14WKS,SNGL FETUS	$522.42	$824.00	$348.55–$782.80	—	37%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 HCHG 76815 US OB-LIMITED (SINGLE)	$251.70	$397.00	$43.84–$646.00	31% below	37%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 HCHG 76815 US OB-LIMITED (SINGLE)	$251.70	$397.00	$167.93–$377.15	—	37%
Rib X-ray, one side, 2 views one side CPT 71100 HCHG 71100 RIB UNILAT (1-2 VW) L/R	$185.76	$293.00	$24.82–$278.35	17% below	37%
Rib X-ray, one side, 2 views inpatient one side CPT 71100 HCHG 71100 RIB UNILAT (1-2 VW) L/R	$185.76	$293.00	$123.94–$278.35	—	37%
Rib X-ray, one side, with a chest view, 3 or more views CPT 71101 HCHG 71101 X/R-RIBS-W/PA CHEST-MIN 3 VIEW	$282.13	$445.00	$24.82–$422.75	2% above	37%
Rib X-ray, one side, with a chest view, 3 or more views inpatient CPT 71101 HCHG 71101 X/R-RIBS-W/PA CHEST-MIN 3 VIEW	$282.13	$445.00	$188.24–$422.75	—	37%
Screening mammogram, both breasts both sides CPT 77067 HCHG 77067 SCREENING MAMMOGRAPHY, BILATERAL, INCL CAD	$263.74	$416.00	$20.47–$395.20	—	37%
Screening mammogram, both breasts inpatient both sides CPT 77067 HCHG 77067 SCREENING MAMMOGRAPHY, BILATERAL, INCL CAD	$263.74	$416.00	$175.97–$395.20	—	37%
Shoulder X-ray, complete, 2 or more views CPT 73030 HCHG 73030 SHOULDER 2VW L/R (ROUT)	$168.01	$265.00	$24.82–$251.75	28% below	37%
Shoulder X-ray, complete, 2 or more views inpatient CPT 73030 HCHG 73030 SHOULDER 2VW L/R (ROUT)	$168.01	$265.00	$112.10–$251.75	—	37%
Sinus X-ray, complete, 3 or more views CPT 70220 HCHG 70220 SINUS MORE THAN 3VW (ROUTINE)	$213.02	$336.00	$142.13–$319.20	19% below	37%
Sinus X-ray, complete, 3 or more views inpatient CPT 70220 HCHG 70220 SINUS MORE THAN 3VW (ROUTINE)	$213.02	$336.00	$142.13–$319.20	—	37%
Skull X-ray, fewer than 4 views CPT 70250 HCHG 70250 SKULL; LESS THAN 4VW	$203.51	$321.00	$135.78–$304.95	17% below	37%
Skull X-ray, fewer than 4 views inpatient CPT 70250 HCHG 70250 SKULL; LESS THAN 4VW	$203.51	$321.00	$135.78–$304.95	—	37%
Sleep study in a lab (polysomnography) CPT 95810 HCHG 95810 POLYSOMNOGRAPHY 6/+ YRS	$2,440.90	$3,850.00	$1,628.55–$3,657.50	28% below	37%
Sleep study in a lab (polysomnography) inpatient CPT 95810 HCHG 95810 POLYSOMNOGRAPHY 6/+ YRS	$2,440.90	$3,850.00	$1,628.55–$3,657.50	—	37%
Stress echocardiogram, complete, including the stress test and supervision CPT 93351 HCHG 93351 STRESS ECHO W/CONT ELECT MONIT	$1,752.38	$2,764.00	$208.67–$2,567.95	15% below	37%
Stress echocardiogram, complete, including the stress test and supervision inpatient CPT 93351 HCHG 93351 STRESS ECHO W/CONT ELECT MONIT	$1,752.38	$2,764.00	$1,169.17–$2,625.80	—	37%
Swallow study (modified barium swallow, video X-ray) CPT 74230 HCHG 74230 SWALLOW FUNCTION W/CINE/VIDEO INCL SCOUT NECK IMAGES,	$363.92	$574.00	$52.35–$545.30	20% below	37%
Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 HCHG 74230 SWALLOW FUNCTION W/CINE/VIDEO INCL SCOUT NECK IMAGES,	$363.92	$574.00	$242.80–$545.30	—	37%
Thigh bone (femur) X-ray, 2 or more views CPT 73552 HCHG 73552 X/R FEMUR MINIMUM OF 2 VIEWS	$161.67	$255.00	$24.82–$242.25	34% below	37%
Thigh bone (femur) X-ray, 2 or more views inpatient CPT 73552 HCHG 73552 X/R FEMUR MINIMUM OF 2 VIEWS	$161.67	$255.00	$107.87–$242.25	—	37%
Thoracic spine (mid back) CT scan without contrast CPT 72128 HCHG 72128 CT SPINE T W/O IV CONT	$876.19	$1,382.00	$47.05–$2,570.00	43% below	37%
Thoracic spine (mid back) CT scan without contrast inpatient CPT 72128 HCHG 72128 CT SPINE T W/O IV CONT	$876.19	$1,382.00	$584.59–$1,312.90	—	37%
Toe X-ray, 2 or more views CPT 73660 HCHG 73660 TOES SPECIFY L/R	$168.01	$265.00	$24.82–$251.75	17% below	37%
Toe X-ray, 2 or more views inpatient CPT 73660 HCHG 73660 TOES SPECIFY L/R	$168.01	$265.00	$112.10–$251.75	—	37%
Transvaginal pelvic ultrasound CPT 76830 HCHG 76830 US PELVIS TRANSVAG	$519.25	$819.00	$48.71–$646.00	11% above	37%
Transvaginal pelvic ultrasound inpatient CPT 76830 HCHG 76830 US PELVIS TRANSVAG	$519.25	$819.00	$346.44–$778.05	—	37%
Transvaginal ultrasound during pregnancy CPT 76817 HCHG 76817 US OB TRANSVAGINAL	$414.00	$653.00	$43.84–$646.00	6% above	37%
Transvaginal ultrasound during pregnancy inpatient CPT 76817 HCHG 76817 US OB TRANSVAGINAL	$414.00	$653.00	$276.22–$620.35	—	37%
Ultrasound of the abdomen, complete CPT 76700 HCHG 76700 US ABDOMEN (SPCFY)	$511.64	$807.00	$73.45–$646.00	25% below	37%
Ultrasound of the abdomen, complete inpatient CPT 76700 HCHG 76700 US ABDOMEN (SPCFY)	$511.64	$807.00	$341.36–$766.65	—	37%
Ultrasound of the scrotum and testicles CPT 76870 HCHG 76870 US TESTICULAR	$521.78	$823.00	$48.71–$646.00	6% above	37%
Ultrasound of the scrotum and testicles inpatient CPT 76870 HCHG 76870 US TESTICULAR	$521.78	$823.00	$348.13–$781.85	—	37%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 HCHG 76536 US SOFT TISSUES HEAD AND NECK	$483.74	$763.00	$48.71–$646.00	5% below	37%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 HCHG 76536 US SOFT TISSUES HEAD AND NECK	$483.74	$763.00	$322.75–$724.85	—	37%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 HCHG 74240 RADIOLOGIC EXAM, UPPER GI TRACT, INCL ABD/DELAYED IMA	$431.12	$680.00	$52.35–$646.00	37% below	37%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 HCHG 74240 RADIOLOGIC EXAM, UPPER GI TRACT, INCL ABD/DELAYED IMA	$431.12	$680.00	$287.64–$646.00	—	37%
Upper arm X-ray (humerus), 2 views CPT 73060 HCHG 73060 HUMERUS L/R	$168.01	$265.00	$24.82–$251.75	20% below	37%
Upper arm X-ray (humerus), 2 views inpatient CPT 73060 HCHG 73060 HUMERUS L/R	$168.01	$265.00	$112.10–$251.75	—	37%
Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 HCHG 93971 DUPLEX SCAN EXT VEINS UNI	$710.08	$1,120.00	$48.71–$491.33	1% below	37%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 HCHG 93971 DUPLEX SCAN EXT VEINS UNI	$710.08	$1,120.00	$473.76–$1,064.00	—	37%
Wrist X-ray, 2 views CPT 73100 HCHG 73100 WRIST 1-2 VIEWS	$168.01	$265.00	$24.82–$251.75	22% below	37%
Wrist X-ray, 2 views inpatient CPT 73100 HCHG 73100 WRIST 1-2 VIEWS	$168.01	$265.00	$112.10–$251.75	—	37%
Wrist X-ray, complete, 3 or more views CPT 73110 HCHG 73110 WRIST 3VWS ROUTINE L/R	$204.78	$323.00	$24.82–$306.85	19% below	37%
Wrist X-ray, complete, 3 or more views inpatient CPT 73110 HCHG 73110 WRIST 3VWS ROUTINE L/R	$204.78	$323.00	$136.63–$306.85	—	37%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 HCHG 73502 X/R HIP, UNILATERAL, W/PELVIS WHEN PERFORMED, 2-3 VIE	$216.19	$341.00	$24.82–$323.95	26% below	37%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 HCHG 73502 X/R HIP, UNILATERAL, W/PELVIS WHEN PERFORMED, 2-3 VIE	$216.19	$341.00	$144.24–$323.95	—	37%
X-ray of the abdomen, 1 view CPT 74018 HCHG 74018 RADIOLOGIC EXAM, ABDOMEN; 1 VIEW	$139.48	$220.00	$24.82–$209.00	34% below	37%
X-ray of the abdomen, 1 view inpatient CPT 74018 HCHG 74018 RADIOLOGIC EXAM, ABDOMEN; 1 VIEW	$139.48	$220.00	$93.06–$209.00	—	37%
X-ray of the ankle, 2 views CPT 73600 HCHG 73600 ANKLE 1-2 VIEWS	$157.87	$249.00	$24.82–$236.55	21% below	37%
X-ray of the ankle, 2 views inpatient CPT 73600 HCHG 73600 ANKLE 1-2 VIEWS	$157.87	$249.00	$105.33–$236.55	—	37%
X-ray of the finger(s), 2 or more views CPT 73140 HCHG 73140 FINGER (SPCFY) L/R	$173.72	$274.00	$24.82–$260.30	29% below	37%
X-ray of the finger(s), 2 or more views inpatient CPT 73140 HCHG 73140 FINGER (SPCFY) L/R	$173.72	$274.00	$115.90–$260.30	—	37%
X-ray of the foot, 2 views CPT 73620 HCHG 73620 FOOT L/R 1-2 VIEWS	$148.99	$235.00	$24.82–$223.25	22% below	37%
X-ray of the foot, 2 views inpatient CPT 73620 HCHG 73620 FOOT L/R 1-2 VIEWS	$148.99	$235.00	$99.41–$223.25	—	37%
X-ray of the foot, complete, 3 or more views CPT 73630 HCHG 73630 FOOT 3V ROUTINE L/R	$177.52	$280.00	$24.82–$266.00	26% below	37%
X-ray of the foot, complete, 3 or more views inpatient CPT 73630 HCHG 73630 FOOT 3V ROUTINE L/R	$177.52	$280.00	$118.44–$266.00	—	37%
X-ray of the hand, 3 or more views CPT 73130 HCHG 73130 HAND 3V ROUTINE L/R	$179.42	$283.00	$24.82–$268.85	24% below	37%
X-ray of the hand, 3 or more views inpatient CPT 73130 HCHG 73130 HAND 3V ROUTINE L/R	$179.42	$283.00	$119.71–$268.85	—	37%
X-ray of the knee, 1 or 2 views CPT 73560 HCHG 73560 KNEE 1-2 VIEWS SPEC	$163.57	$258.00	$24.82–$245.10	23% below	37%
X-ray of the knee, 1 or 2 views inpatient CPT 73560 HCHG 73560 KNEE 1-2 VIEWS SPEC	$163.57	$258.00	$109.13–$245.10	—	37%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 HCHG 72100 SPINE LUMBAR (ROUT) 2-3VWS	$225.70	$356.00	$24.82–$338.20	22% below	37%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 HCHG 72100 SPINE LUMBAR (ROUT) 2-3VWS	$225.70	$356.00	$150.59–$338.20	—	37%
X-ray of the lower back, 4 or more views CPT 72110 HCHG 72110 SPINE LUMBAR W/OBLIQ (4 VWS)	$319.54	$504.00	$24.82–$478.80	14% below	37%
X-ray of the lower back, 4 or more views inpatient CPT 72110 HCHG 72110 SPINE LUMBAR W/OBLIQ (4 VWS)	$319.54	$504.00	$213.19–$478.80	—	37%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 HCHG 72070 SPINE DORSAL AP+LAT (2VW)	$190.20	$300.00	$24.82–$285.00	20% below	37%
X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 HCHG 72070 SPINE DORSAL AP+LAT (2VW)	$190.20	$300.00	$126.90–$285.00	—	37%
X-ray of the nasal bones, 3 or more views CPT 70160 HCHG 70160 NASAL BONES ROUTINE	$187.03	$295.00	$124.79–$280.25	23% below	37%
X-ray of the nasal bones, 3 or more views inpatient CPT 70160 HCHG 70160 NASAL BONES ROUTINE	$187.03	$295.00	$124.79–$280.25	—	37%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 HCHG 72040 SPINE CERV AP+LAT 3 VWS	$216.19	$341.00	$24.82–$323.95	10% below	37%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 HCHG 72040 SPINE CERV AP+LAT 3 VWS	$216.19	$341.00	$144.24–$323.95	—	37%
X-ray of the pelvis, 1 or 2 views CPT 72170 HCHG 72170 PELVIS 1 OR 2 VIEWS	$147.09	$232.00	$24.82–$220.40	34% below	37%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 HCHG 72170 PELVIS 1 OR 2 VIEWS	$147.09	$232.00	$98.14–$220.40	—	37%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 HCHG 72220 SACRUM & COCCYX	$168.01	$265.00	$24.82–$251.75	22% below	37%
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 HCHG 72220 SACRUM & COCCYX	$168.01	$265.00	$112.10–$251.75	—	37%

Lab tests

Procedure	Cash price	List price	Insurers pay	vs Wisconsin	Off list
ACTH blood test CPT 82024 ADRENOCORTICOTROPIC HORMONE (ACTH)	$199.71	$315.00	$12.19–$299.25	9% below	37%
ACTH blood test inpatient CPT 82024 ADRENOCORTICOTROPIC HORMONE (ACTH)	$199.71	$315.00	$133.25–$299.25	—	37%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 TRANSFERASE; ALANINE AMINO (ALT) (SGPT)	$27.26	$43.00	$1.91–$40.85	22% below	37%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 TRANSFERASE; ALANINE AMINO (ALT) (SGPT)	$27.26	$43.00	$18.19–$40.85	—	37%
AST (aspartate aminotransferase) enzyme test CPT 84450 TRANSFERASE; ASPARTATE AMINO (AST) (SGOT)	$26.63	$42.00	$1.91–$39.90	44% below	37%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 TRANSFERASE; ASPARTATE AMINO (AST) (SGOT)	$26.63	$42.00	$17.77–$39.90	—	37%
Albumin blood test CPT 82040 ALBUMIN; ISERUM, PLASMA OR WHOLE BLOOD	$25.36	$40.00	$1.91–$38.00	32% below	37%
Albumin blood test inpatient CPT 82040 ALBUMIN; ISERUM, PLASMA OR WHOLE BLOOD	$25.36	$40.00	$16.92–$38.00	—	37%
Aldosterone blood test CPT 82088 ALDOSTERONE, URINE	$210.49	$332.00	$12.19–$315.40	8% above	37%
Aldosterone blood test CPT 82088 ALDOSTERONE, BLOOD	$210.49	$332.00	$12.19–$315.40	8% above	37%
Aldosterone blood test inpatient CPT 82088 ALDOSTERONE, BLOOD	$210.49	$332.00	$140.44–$315.40	—	37%
Aldosterone blood test inpatient CPT 82088 ALDOSTERONE, URINE	$210.49	$332.00	$140.44–$315.40	—	37%
Alkaline phosphatase (ALP) blood test CPT 84075 PHOSPHATASE, ALKALINE	$26.63	$42.00	$1.91–$39.90	45% below	37%
Alkaline phosphatase (ALP) blood test inpatient CPT 84075 PHOSPHATASE, ALKALINE	$26.63	$42.00	$17.77–$39.90	—	37%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST-DOG DANDER IGE	$27.26	$43.00	$3.84–$40.85	9% above	37%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST-CHEESE-CHEDDAR TYPE	$27.26	$43.00	$3.84–$40.85	9% above	37%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST-CHEESE-MOLD TYPE	$27.26	$43.00	$3.84–$40.85	9% above	37%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST-BETA-LACTOALBUMIN	$27.26	$43.00	$3.84–$40.85	9% above	37%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST-EGG WHITE	$27.26	$43.00	$3.84–$40.85	9% above	37%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST-ASPERGILLUS FUMIGATUS	$27.26	$43.00	$3.84–$40.85	9% above	37%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST-ALTERNARIA TENS	$27.26	$43.00	$3.84–$40.85	9% above	37%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST-DUST MITES DERM PT	$27.26	$43.00	$3.84–$40.85	9% above	37%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST-DUST MITES DERM FA	$27.26	$43.00	$3.84–$40.85	9% above	37%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST-HSE DUST HOL STIER	$27.26	$43.00	$3.84–$40.85	9% above	37%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST-HSE DUST GREER	$27.26	$43.00	$3.84–$40.85	9% above	37%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST-GLUTEN IGE	$27.26	$43.00	$3.84–$40.85	9% above	37%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST-BEEF IGE	$27.26	$43.00	$3.84–$40.85	9% above	37%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST-CORN IGE	$27.26	$43.00	$3.84–$40.85	9% above	37%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST-CODFISH	$27.26	$43.00	$3.84–$40.85	9% above	37%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST-CLAM	$27.26	$43.00	$3.84–$40.85	9% above	37%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST-CACAO-COCOA IGE	$27.26	$43.00	$3.84–$40.85	9% above	37%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST-CRAB	$27.26	$43.00	$3.84–$40.85	9% above	37%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN SPECIFIC IGE; QUANT/SEMI-QUANTITATIVE, CRUDE ALLERGEN E	$27.26	$43.00	$3.84–$40.85	9% above	37%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST-BAKERS YEAST	$27.26	$43.00	$3.84–$40.85	9% above	37%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST-TOMATO	$27.26	$43.00	$3.84–$40.85	9% above	37%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST-OAT	$27.26	$43.00	$3.84–$40.85	9% above	37%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST-YELLOW JACKET	$27.26	$43.00	$3.84–$40.85	9% above	37%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST-YELLOW JACKET VENOM	$27.26	$43.00	$3.84–$40.85	9% above	37%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST-WASP VENOM	$27.26	$43.00	$3.84–$40.85	9% above	37%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST-YELLOW FACE HORNET VENOM	$27.26	$43.00	$3.84–$40.85	9% above	37%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST-WHITE FACE HORNET VENOM	$27.26	$43.00	$3.84–$40.85	9% above	37%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST-HORSE DANDER	$27.26	$43.00	$3.84–$40.85	9% above	37%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST-DOG EPITHELIUM	$27.26	$43.00	$3.84–$40.85	9% above	37%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST-CHICKEN FEATHERS	$27.26	$43.00	$3.84–$40.85	9% above	37%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST-LATEX IGE	$27.26	$43.00	$3.84–$40.85	9% above	37%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST-EGG YOLK	$27.26	$43.00	$3.84–$40.85	9% above	37%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST-MILK	$27.26	$43.00	$3.84–$40.85	9% above	37%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST-MOLD	$27.26	$43.00	$3.84–$40.85	9% above	37%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST-WEED PNL 4	$27.26	$43.00	$3.84–$40.85	9% above	37%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST-TREE PNL 1	$27.26	$43.00	$3.84–$40.85	9% above	37%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST-HONEY BEE VENOM	$27.26	$43.00	$3.84–$40.85	9% above	37%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST-PEANUT	$27.26	$43.00	$3.84–$40.85	9% above	37%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST-CASHEW	$27.26	$43.00	$3.84–$40.85	9% above	37%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST-WEED PNL 3	$27.26	$43.00	$3.84–$40.85	9% above	37%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST-GRASS PNL 1	$27.26	$43.00	$3.84–$40.85	9% above	37%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST-WHEAT	$27.26	$43.00	$3.84–$40.85	9% above	37%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST-ALMOND	$27.26	$43.00	$3.84–$40.85	9% above	37%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST-PECAN	$27.26	$43.00	$3.84–$40.85	9% above	37%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST-TUNA	$27.26	$43.00	$3.84–$40.85	9% above	37%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST-TROUT	$27.26	$43.00	$3.84–$40.85	9% above	37%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST-SHRIMP	$27.26	$43.00	$3.84–$40.85	9% above	37%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST-SALMON	$27.26	$43.00	$3.84–$40.85	9% above	37%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST-PERCH	$27.26	$43.00	$3.84–$40.85	9% above	37%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST-SOYBEAN	$27.26	$43.00	$3.84–$40.85	9% above	37%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST-WALNUT	$27.26	$43.00	$3.84–$40.85	9% above	37%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST-OYSTER	$27.26	$43.00	$3.84–$40.85	9% above	37%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST-LOBSTER	$27.26	$43.00	$3.84–$40.85	9% above	37%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST-GIANT RAGWEED	$27.26	$43.00	$3.84–$40.85	9% above	37%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST-CAT EPITHELIUM	$27.26	$43.00	$3.84–$40.85	9% above	37%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST-WHEAT	$27.26	$43.00	$18.19–$40.85	—	37%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST-PERCH	$27.26	$43.00	$18.19–$40.85	—	37%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST-MOLD	$27.26	$43.00	$18.19–$40.85	—	37%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST-ASPERGILLUS FUMIGATUS	$27.26	$43.00	$18.19–$40.85	—	37%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST-HONEY BEE VENOM	$27.26	$43.00	$18.19–$40.85	—	37%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST-WEED PNL 4	$27.26	$43.00	$18.19–$40.85	—	37%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST-CAT EPITHELIUM	$27.26	$43.00	$18.19–$40.85	—	37%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST-OYSTER	$27.26	$43.00	$18.19–$40.85	—	37%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST-CHICKEN FEATHERS	$27.26	$43.00	$18.19–$40.85	—	37%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST-SHRIMP	$27.26	$43.00	$18.19–$40.85	—	37%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST-CRAB	$27.26	$43.00	$18.19–$40.85	—	37%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST-LATEX IGE	$27.26	$43.00	$18.19–$40.85	—	37%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST-SALMON	$27.26	$43.00	$18.19–$40.85	—	37%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST-EGG YOLK	$27.26	$43.00	$18.19–$40.85	—	37%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST-CHEESE-MOLD TYPE	$27.26	$43.00	$18.19–$40.85	—	37%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST-PEANUT	$27.26	$43.00	$18.19–$40.85	—	37%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST-CASHEW	$27.26	$43.00	$18.19–$40.85	—	37%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST-TREE PNL 1	$27.26	$43.00	$18.19–$40.85	—	37%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST-PECAN	$27.26	$43.00	$18.19–$40.85	—	37%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST-ALMOND	$27.26	$43.00	$18.19–$40.85	—	37%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST-HORSE DANDER	$27.26	$43.00	$18.19–$40.85	—	37%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST-WEED PNL 3	$27.26	$43.00	$18.19–$40.85	—	37%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST-CHEESE-CHEDDAR TYPE	$27.26	$43.00	$18.19–$40.85	—	37%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST-HSE DUST GREER	$27.26	$43.00	$18.19–$40.85	—	37%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST-HSE DUST HOL STIER	$27.26	$43.00	$18.19–$40.85	—	37%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST-GIANT RAGWEED	$27.26	$43.00	$18.19–$40.85	—	37%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST-CODFISH	$27.26	$43.00	$18.19–$40.85	—	37%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST-DUST MITES DERM FA	$27.26	$43.00	$18.19–$40.85	—	37%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST-CACAO-COCOA IGE	$27.26	$43.00	$18.19–$40.85	—	37%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST-EGG WHITE	$27.26	$43.00	$18.19–$40.85	—	37%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST-DUST MITES DERM PT	$27.26	$43.00	$18.19–$40.85	—	37%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST-CLAM	$27.26	$43.00	$18.19–$40.85	—	37%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST-DOG DANDER IGE	$27.26	$43.00	$18.19–$40.85	—	37%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST-ALTERNARIA TENS	$27.26	$43.00	$18.19–$40.85	—	37%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN SPECIFIC IGE; QUANT/SEMI-QUANTITATIVE, CRUDE ALLERGEN E	$27.26	$43.00	$18.19–$40.85	—	37%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST-CORN IGE	$27.26	$43.00	$18.19–$40.85	—	37%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST-BEEF IGE	$27.26	$43.00	$18.19–$40.85	—	37%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST-GLUTEN IGE	$27.26	$43.00	$18.19–$40.85	—	37%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST-GRASS PNL 1	$27.26	$43.00	$18.19–$40.85	—	37%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST-SOYBEAN	$27.26	$43.00	$18.19–$40.85	—	37%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST-BAKERS YEAST	$27.26	$43.00	$18.19–$40.85	—	37%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST-BETA-LACTOALBUMIN	$27.26	$43.00	$18.19–$40.85	—	37%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST-TOMATO	$27.26	$43.00	$18.19–$40.85	—	37%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST-TUNA	$27.26	$43.00	$18.19–$40.85	—	37%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST-OAT	$27.26	$43.00	$18.19–$40.85	—	37%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST-YELLOW JACKET	$27.26	$43.00	$18.19–$40.85	—	37%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST-YELLOW JACKET VENOM	$27.26	$43.00	$18.19–$40.85	—	37%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST-WASP VENOM	$27.26	$43.00	$18.19–$40.85	—	37%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST-MILK	$27.26	$43.00	$18.19–$40.85	—	37%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST-YELLOW FACE HORNET VENOM	$27.26	$43.00	$18.19–$40.85	—	37%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST-WALNUT	$27.26	$43.00	$18.19–$40.85	—	37%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST-WHITE FACE HORNET VENOM	$27.26	$43.00	$18.19–$40.85	—	37%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST-LOBSTER	$27.26	$43.00	$18.19–$40.85	—	37%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST-TROUT	$27.26	$43.00	$18.19–$40.85	—	37%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST-DOG EPITHELIUM	$27.26	$43.00	$18.19–$40.85	—	37%
Alpha-fetoprotein (AFP) blood test CPT 82105 ALPHA-FETOPROTEIN, NTD FIRST TRIMESTER SCREEN NTD LAB	$86.86	$137.00	$4.25–$130.15	4% above	37%
Alpha-fetoprotein (AFP) blood test CPT 82105 ALPHA-FETOPROTEIN (AFP); SERUM (IMS2 AFP)	$86.86	$137.00	$4.25–$130.15	4% above	37%
Alpha-fetoprotein (AFP) blood test CPT 82105 ALPHA-FETOPROTEIN (AFP); SERUM	$86.86	$137.00	$4.25–$130.15	4% above	37%
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 ALPHA-FETOPROTEIN (AFP); SERUM (IMS2 AFP)	$86.86	$137.00	$57.95–$130.15	—	37%
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 ALPHA-FETOPROTEIN (AFP); SERUM	$86.86	$137.00	$57.95–$130.15	—	37%
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 ALPHA-FETOPROTEIN, NTD FIRST TRIMESTER SCREEN NTD LAB	$86.86	$137.00	$57.95–$130.15	—	37%
Ammonia blood test CPT 82140 AMMONIA	$75.45	$119.00	$4.25–$113.05	16% below	37%
Ammonia blood test inpatient CPT 82140 AMMONIA	$75.45	$119.00	$50.34–$113.05	—	37%
Amylase blood test CPT 82150 AMYLASE, FLUID	$33.60	$53.00	$1.91–$50.35	46% below	37%
Amylase blood test CPT 82150 AMYLASE, URINE, 2HR	$33.60	$53.00	$1.91–$50.35	46% below	37%
Amylase blood test CPT 82150 AMYLASE	$33.60	$53.00	$1.91–$50.35	46% below	37%
Amylase blood test CPT 82150 AMYLASE, BLOOD	$33.60	$53.00	$1.91–$50.35	46% below	37%
Amylase blood test inpatient CPT 82150 AMYLASE, URINE, 2HR	$33.60	$53.00	$22.42–$50.35	—	37%
Amylase blood test inpatient CPT 82150 AMYLASE, FLUID	$33.60	$53.00	$22.42–$50.35	—	37%
Amylase blood test inpatient CPT 82150 AMYLASE, BLOOD	$33.60	$53.00	$22.42–$50.35	—	37%
Amylase blood test inpatient CPT 82150 AMYLASE	$33.60	$53.00	$22.42–$50.35	—	37%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CYCLIC CITRULLINATED PEPTIDE A	$67.20	$106.00	$3.84–$100.70	19% below	37%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 CYCLIC CITRULLINATED PEPTIDE A	$67.20	$106.00	$44.84–$100.70	—	37%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANTINUCLEAR ANTIBODIES	$62.77	$99.00	$3.84–$94.05	9% below	37%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANTINUCLEAR ANTIBODIES	$62.77	$99.00	$41.88–$94.05	—	37%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 NATRIURETIC PEPTIDE (BNP)	$202.88	$320.00	$9.84–$304.00	42% above	37%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 NATRIURETIC PEPTIDE	$202.88	$320.00	$9.84–$304.00	42% above	37%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 NATRIURETIC PEPTIDE (BNP)	$202.88	$320.00	$135.36–$304.00	—	37%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 NATRIURETIC PEPTIDE	$202.88	$320.00	$135.36–$304.00	—	37%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE, BACTERIAL; OTHER SOURCE	$44.38	$70.00	$2.97–$66.50	15% below	37%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE, BACTERIAL; WOUND	$44.38	$70.00	$2.97–$66.50	15% below	37%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE, BACTERIAL; OTHER SOURCE (CSF)	$44.38	$70.00	$2.97–$66.50	15% below	37%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE, BACTERIAL; BONE MARROW	$44.38	$70.00	$2.97–$66.50	15% below	37%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE, BACTERIAL; EYE	$44.38	$70.00	$2.97–$66.50	15% below	37%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE, BACTERIAL; MISC (NONPT SOURCE)	$44.38	$70.00	$2.97–$66.50	15% below	37%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE, BACTERIAL; OTHER SOURCE (NEEDLE TIP)	$44.38	$70.00	$2.97–$66.50	15% below	37%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE, BACTERIAL; RESPIRATORY CF	$44.38	$70.00	$2.97–$66.50	15% below	37%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE, BACTERIAL; RESPIRATORY	$44.38	$70.00	$2.97–$66.50	15% below	37%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE, BACTERIAL; EYE	$44.38	$70.00	$29.61–$66.50	—	37%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE, BACTERIAL; OTHER SOURCE (CSF)	$44.38	$70.00	$29.61–$66.50	—	37%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE, BACTERIAL; OTHER SOURCE (NEEDLE TIP)	$44.38	$70.00	$29.61–$66.50	—	37%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE, BACTERIAL; OTHER SOURCE	$44.38	$70.00	$29.61–$66.50	—	37%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE, BACTERIAL; WOUND	$44.38	$70.00	$29.61–$66.50	—	37%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE, BACTERIAL; BONE MARROW	$44.38	$70.00	$29.61–$66.50	—	37%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE, BACTERIAL; MISC (NONPT SOURCE)	$44.38	$70.00	$29.61–$66.50	—	37%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE, BACTERIAL; RESPIRATORY	$44.38	$70.00	$29.61–$66.50	—	37%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE, BACTERIAL; RESPIRATORY CF	$44.38	$70.00	$29.61–$66.50	—	37%
Basic metabolic panel (blood test) CPT 80048 BASIC METABOLIC PANEL	$43.75	$69.00	$3.16–$65.55	50% below	37%
Basic metabolic panel (blood test) inpatient CPT 80048 BASIC METABOLIC PANEL	$43.75	$69.00	$29.19–$65.55	—	37%
Bilirubin blood test, total CPT 82247 BILIRUBIN TOTAL	$25.99	$41.00	$1.91–$38.95	44% below	37%
Bilirubin blood test, total CPT 82247 BILIRUBIN; TOTAL (AMNIOTIC FLUID)	$25.99	$41.00	$1.91–$38.95	44% below	37%
Bilirubin blood test, total CPT 82247 BILIRUBIN; TOTAL	$25.99	$41.00	$1.91–$38.95	44% below	37%
Bilirubin blood test, total CPT 82247 BILIRUBIN; TOTAL (FLUID)	$25.99	$41.00	$1.91–$38.95	44% below	37%
Bilirubin blood test, total CPT 82247 BILIRUBIN; TOTAL (WB)	$25.99	$41.00	$1.91–$38.95	44% below	37%
Bilirubin blood test, total inpatient CPT 82247 BILIRUBIN; TOTAL (FLUID)	$25.99	$41.00	$17.34–$38.95	—	37%
Bilirubin blood test, total inpatient CPT 82247 BILIRUBIN; TOTAL	$25.99	$41.00	$17.34–$38.95	—	37%
Bilirubin blood test, total inpatient CPT 82247 BILIRUBIN TOTAL	$25.99	$41.00	$17.34–$38.95	—	37%
Bilirubin blood test, total inpatient CPT 82247 BILIRUBIN; TOTAL (AMNIOTIC FLUID)	$25.99	$41.00	$17.34–$38.95	—	37%
Bilirubin blood test, total inpatient CPT 82247 BILIRUBIN; TOTAL (WB)	$25.99	$41.00	$17.34–$38.95	—	37%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 SURGICAL PATHOLOGY, GROSS AND MICROSCOPIC EXAM, LEVEL 4	$217.46	$343.00	$145.09–$325.85	1% above	37%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 SURGICAL PATHOLOGY, GROSS AND MICROSCOPIC EXAM, LEVEL 4	$217.46	$343.00	$145.09–$325.85	—	37%
Blood culture for bacteria CPT 87040 CULTURE, BACTERIAL; BLOOD	$53.26	$84.00	$2.97–$79.80	38% below	37%
Blood culture for bacteria CPT 87040 CULTURE, BACTERIAL; BLOOD, LEGIONELLA	$53.26	$84.00	$2.97–$79.80	38% below	37%
Blood culture for bacteria CPT 87040 CULTURE, BACTERIAL; BLOOD, ABR	$53.26	$84.00	$2.97–$79.80	38% below	37%
Blood culture for bacteria inpatient CPT 87040 CULTURE, BACTERIAL; BLOOD, LEGIONELLA	$53.26	$84.00	$35.53–$79.80	—	37%
Blood culture for bacteria inpatient CPT 87040 CULTURE, BACTERIAL; BLOOD	$53.26	$84.00	$35.53–$79.80	—	37%
Blood culture for bacteria inpatient CPT 87040 CULTURE, BACTERIAL; BLOOD, ABR	$53.26	$84.00	$35.53–$79.80	—	37%
Blood glucose (sugar) test CPT 82947 GLUCOSE; QUANTITATIVE, BLOOD	$20.29	$32.00	$1.91–$30.40	17% below	37%
Blood glucose (sugar) test CPT 82947 GLUCOSE; QUANT, BLOOD POCT	$21.56	$34.00	$1.91–$32.30	12% below	37%
Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE; QUANTITATIVE, BLOOD	$20.29	$32.00	$13.54–$30.40	—	37%
Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE; QUANT, BLOOD POCT	$21.56	$34.00	$14.38–$32.30	—	37%
Blood lead test CPT 83655 LEAD	$62.77	$99.00	$4.25–$94.05	14% above	37%
Blood lead test CPT 83655 LEAD-24HR URINE	$62.77	$99.00	$4.25–$94.05	14% above	37%
Blood lead test CPT 83655 LEAD, BLOOD	$62.77	$99.00	$4.25–$94.05	14% above	37%
Blood lead test inpatient CPT 83655 LEAD	$62.77	$99.00	$41.88–$94.05	—	37%
Blood lead test inpatient CPT 83655 LEAD, BLOOD	$62.77	$99.00	$41.88–$94.05	—	37%
Blood lead test inpatient CPT 83655 LEAD-24HR URINE	$62.77	$99.00	$41.88–$94.05	—	37%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 GONADOTROPIN, CHORIONIC (HCG); QUALITATIVE, SERUM	$38.67	$61.00	$1.91–$57.95	38% below	37%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 GONADOTROPIN, CHORIONIC (HCG); QUALITATIVE, SERUM	$38.67	$61.00	$25.80–$57.95	—	37%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 BLOOD TYPING, SEROLOGIC; ABO	$15.22	$24.00	$1.53–$22.80	64% below	37%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 BLOOD TYPING, SEROLOGIC; ABO	$15.22	$24.00	$10.15–$22.80	—	37%
Blood urea nitrogen (BUN) test CPT 84520 UREA NITROGEN; QUANTITATIVE	$20.29	$32.00	$1.91–$30.40	21% below	37%
Blood urea nitrogen (BUN) test inpatient CPT 84520 UREA NITROGEN; QUANTITATIVE	$20.29	$32.00	$13.54–$30.40	—	37%
C-peptide blood test CPT 84681 C-PEPTIDE	$107.78	$170.00	$4.25–$161.50	24% above	37%
C-peptide blood test inpatient CPT 84681 C-PEPTIDE	$107.78	$170.00	$71.91–$161.50	—	37%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C-REACTIVE PROTEIN (CRP)	$26.63	$42.00	$3.84–$39.90	51% below	37%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C-REACTIVE PROTEIN; IBD PANEL	$26.63	$42.00	$3.84–$39.90	51% below	37%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 C-REACTIVE PROTEIN; IBD PANEL	$26.63	$42.00	$17.77–$39.90	—	37%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 C-REACTIVE PROTEIN (CRP)	$26.63	$42.00	$17.77–$39.90	—	37%
C. difficile toxin gene test (stool PCR) CPT 87493 INFECTIOUS AGENT ANTIGEN DETECT; C DIFF PCR ARUP	$192.74	$304.00	$18.84–$288.80	28% above	37%
C. difficile toxin gene test (stool PCR) CPT 87493 INFECTIOUS AGENT ANTIGEN DETECTION; C DIFF TOXIN GENE(S) AMP PRO	$192.74	$304.00	$18.84–$288.80	28% above	37%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 INFECTIOUS AGENT ANTIGEN DETECTION; C DIFF TOXIN GENE(S) AMP PRO	$192.74	$304.00	$128.59–$288.80	—	37%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 INFECTIOUS AGENT ANTIGEN DETECT; C DIFF PCR ARUP	$192.74	$304.00	$128.59–$288.80	—	37%
CA 19-9 blood test (tumor marker) CPT 86301 IMMUNOASSAY FOR TUMOR ANTIGEN, QUANTITATIVE; CA 19-9	$107.78	$170.00	$3.84–$161.50	4% below	37%
CA 19-9 blood test (tumor marker) inpatient CPT 86301 IMMUNOASSAY FOR TUMOR ANTIGEN, QUANTITATIVE; CA 19-9	$107.78	$170.00	$71.91–$161.50	—	37%
CA-125 blood test (ovarian cancer marker) CPT 86304 IMMUNOASSAY FOR TUMOR ANTIGEN, QUANTITATIVE; CA 125	$107.78	$170.00	$3.84–$161.50	10% below	37%
CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 IMMUNOASSAY FOR TUMOR ANTIGEN, QUANTITATIVE; CA 125	$107.78	$170.00	$71.91–$161.50	—	37%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 NON-CDC 2019-NCOV CORONAVIRUS COVID-19	$198.44	$313.00	$18.84–$297.35	47% above	37%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 COVID-19 PCR	$198.44	$313.00	$18.84–$297.35	47% above	37%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 COVID-19 MCLAB	$198.44	$313.00	$18.84–$297.35	47% above	37%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 SARS-COV-2 COVID-19 AMP PROBE TECH	$198.44	$313.00	$18.84–$297.35	47% above	37%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 CDC 2019-NCOV CORONAVIRUS COVID-19	$198.44	$313.00	$18.84–$297.35	47% above	37%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 SARS-COV-2 COVID-19 AMP PROBE TECH	$198.44	$313.00	$132.40–$297.35	—	37%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 COVID-19 PCR	$198.44	$313.00	$132.40–$297.35	—	37%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 NON-CDC 2019-NCOV CORONAVIRUS COVID-19	$198.44	$313.00	$132.40–$297.35	—	37%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 COVID-19 MCLAB	$198.44	$313.00	$132.40–$297.35	—	37%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 CDC 2019-NCOV CORONAVIRUS COVID-19	$198.44	$313.00	$132.40–$297.35	—	37%
Calcium blood test, total CPT 82310 CALCIUM; TOTAL	$26.63	$42.00	$1.91–$39.90	49% below	37%
Calcium blood test, total inpatient CPT 82310 CALCIUM; TOTAL	$26.63	$42.00	$17.77–$39.90	—	37%
Carcinoembryonic antigen (CEA) test CPT 82378 CARCINOEMBRYONIC ANTIGEN (CEA)	$98.27	$155.00	$4.25–$147.25	28% below	37%
Carcinoembryonic antigen (CEA) test inpatient CPT 82378 CARCINOEMBRYONIC ANTIGEN (CEA)	$98.27	$155.00	$65.57–$147.25	—	37%
Chickenpox (varicella) immunity blood test CPT 86787 ANTIBODY; VARICELLA-ZOSTER	$66.57	$105.00	$3.84–$99.75	9% below	37%
Chickenpox (varicella) immunity blood test CPT 86787 ANTIBODY; VARICELLA ZOSTER IMM STAT	$66.57	$105.00	$3.84–$99.75	9% below	37%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 ANTIBODY; VARICELLA-ZOSTER	$66.57	$105.00	$44.42–$99.75	—	37%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 ANTIBODY; VARICELLA ZOSTER IMM STAT	$66.57	$105.00	$44.42–$99.75	—	37%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 INFECTIOUS AGENT ANTIGEN DETECTION; CHLAMYDIA DNA/RNA ASSAY	$181.32	$286.00	$18.84–$271.70	27% above	37%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 INFECTIOUS AGENT ANTIGEN DETECTION; CHLAMYDIA ASSAY	$181.32	$286.00	$18.84–$271.70	27% above	37%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 INFECTIOUS AGENT ANTIGEN DETECTION; CHLAMYDIA DNA/RNA ASSAY	$181.32	$286.00	$120.98–$271.70	—	37%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 INFECTIOUS AGENT ANTIGEN DETECTION; CHLAMYDIA ASSAY	$181.32	$286.00	$120.98–$271.70	—	37%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PANEL (NMR)	$69.11	$109.00	$3.16–$103.55	22% below	37%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PANEL	$69.11	$109.00	$3.16–$103.55	22% below	37%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PANEL (NMR)	$69.11	$109.00	$46.11–$103.55	—	37%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PANEL	$69.11	$109.00	$46.11–$103.55	—	37%
Complete blood count (CBC) with differential CPT 85025 BLOOD COUNT; COMPLETE (CBC)	$39.94	$63.00	$2.09–$59.85	45% below	37%
Complete blood count (CBC) with differential CPT 85025 BLOOD COUNT; COMPLETE CBC	$39.94	$63.00	$2.09–$59.85	45% below	37%
Complete blood count (CBC) with differential inpatient CPT 85025 BLOOD COUNT; COMPLETE CBC	$39.94	$63.00	$26.65–$59.85	—	37%
Complete blood count (CBC) with differential inpatient CPT 85025 BLOOD COUNT; COMPLETE (CBC)	$39.94	$63.00	$26.65–$59.85	—	37%
Complete blood count (CBC), no differential CPT 85027 BLOOD COUNT; COMPLETE (CBC) AUTOMATED	$33.60	$53.00	$2.09–$50.35	36% below	37%
Complete blood count (CBC), no differential CPT 85027 HEMOGRAM W/O PLATELETS	$33.60	$53.00	$2.09–$50.35	36% below	37%
Complete blood count (CBC), no differential inpatient CPT 85027 HEMOGRAM W/O PLATELETS	$33.60	$53.00	$22.42–$50.35	—	37%
Complete blood count (CBC), no differential inpatient CPT 85027 BLOOD COUNT; COMPLETE (CBC) AUTOMATED	$33.60	$53.00	$22.42–$50.35	—	37%
Comprehensive metabolic panel (blood test) CPT 80053 COMPREHENSIVE METABOLIC PANEL	$54.52	$86.00	$3.16–$81.70	52% below	37%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 COMPREHENSIVE METABOLIC PANEL	$54.52	$86.00	$36.38–$81.70	—	37%
Cortisol blood test, total CPT 82533 CORTISOL; TOTAL	$84.32	$133.00	$4.65–$126.35	30% below	37%
Cortisol blood test, total inpatient CPT 82533 CORTISOL; TOTAL	$84.32	$133.00	$56.26–$126.35	—	37%
Creatine kinase (CK) blood test, total CPT 82550 CREATINE KINASE (CK), (CPK); TOTAL	$33.60	$53.00	$1.91–$50.35	47% below	37%
Creatine kinase (CK) blood test, total inpatient CPT 82550 CREATINE KINASE (CK), (CPK); TOTAL	$33.60	$53.00	$22.42–$50.35	—	37%
Creatinine blood test CPT 82565 CREATININE; BLOOD	$26.63	$42.00	$1.91–$39.90	16% below	37%
Creatinine blood test CPT 82565 CREATININE, BLOOD	$26.63	$42.00	$1.91–$39.90	16% below	37%
Creatinine blood test inpatient CPT 82565 CREATININE, BLOOD	$26.63	$42.00	$17.77–$39.90	—	37%
Creatinine blood test inpatient CPT 82565 CREATININE; BLOOD	$26.63	$42.00	$17.77–$39.90	—	37%
Cytomegalovirus (CMV) antibody test CPT 86644 ANTIBODY; CYTOMEGALOVIRUS (CMV) IGG	$74.18	$117.00	$3.84–$111.15	5% above	37%
Cytomegalovirus (CMV) antibody test CPT 86644 ANTIBODY; CYTOMEGALOVIRUS (CMV) NEG PRODUCT	$74.18	$117.00	$3.84–$111.15	5% above	37%
Cytomegalovirus (CMV) antibody test CPT 86644 ANTIBODY; CYTOMEGALOVIRUS (CMV) AB, IGG, S MCLAB	$74.18	$117.00	$3.84–$111.15	5% above	37%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 ANTIBODY; CYTOMEGALOVIRUS (CMV) IGG	$74.18	$117.00	$49.49–$111.15	—	37%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 ANTIBODY; CYTOMEGALOVIRUS (CMV) AB, IGG, S MCLAB	$74.18	$117.00	$49.49–$111.15	—	37%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 ANTIBODY; CYTOMEGALOVIRUS (CMV) NEG PRODUCT	$74.18	$117.00	$49.49–$111.15	—	37%
D-dimer blood test (blood clot marker) CPT 85379 FIBRIN DEGRADATION PRODUCTS, D-DIMER; QUANTITATIVE	$52.62	$83.00	$1.56–$78.85	34% below	37%
D-dimer blood test (blood clot marker) inpatient CPT 85379 FIBRIN DEGRADATION PRODUCTS, D-DIMER; QUANTITATIVE	$52.62	$83.00	$35.11–$78.85	—	37%
DHEA sulfate (DHEA-S) blood test CPT 82627 DEHYDROEPIANDROSTERONE-SULFATE (DHEA-S)	$114.75	$181.00	$4.65–$171.95	19% below	37%
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 DEHYDROEPIANDROSTERONE-SULFATE (DHEA-S)	$114.75	$181.00	$76.56–$171.95	—	37%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG SCREEN NOS PRSMPTV PROC	$21.56	$34.00	$24.27–$119.29	81% below	37%
Drug screen by lab instrument (any number of drug classes) CPT 80307 PR RAPID DRUG SCREEN (NEGATIVE TEST)	$23.46	$37.00	$24.27–$119.29	80% below	37%
Drug screen by lab instrument (any number of drug classes) CPT 80307 MEDTOX/LABCORP - DRUG SCREEN PRSMPTV SGL DR CLASS	$44.38	$70.00	$24.27–$119.29	62% below	37%
Drug screen by lab instrument (any number of drug classes) CPT 80307 PR RAPID DRUG SCREEN (NON-NEGATIVE TO MEDTOX) W/MRO	$46.28	$73.00	$24.27–$119.29	60% below	37%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG TEST PRESUMPT; INSTR CHEM ANALYZER	$59.60	$94.00	$24.27–$119.29	49% below	37%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG TEST PRESUMPTIVE CHEM ANALYZER MEDTOX	$63.40	$100.00	$24.27–$119.29	45% below	37%
Drug screen by lab instrument (any number of drug classes) CPT 80307 COMPLIANCE DRUG SCREEN BLOOD	$129.34	$204.00	$24.27–$193.80	12% above	37%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG SCREEN LIST A - MEDTOX DOA SCREEN	$164.21	$259.00	$24.27–$246.05	42% above	37%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG SCREEN PRSMPTV SNGL CLASS	$320.80	$506.00	$24.27–$480.70	177% above	37%
Drug screen by lab instrument (any number of drug classes) CPT 80307 OHM DRUG PANEL-DRUG SCREEN LIST A	$320.80	$506.00	$24.27–$480.70	177% above	37%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG SCREEN LIST A	$320.80	$506.00	$24.27–$480.70	177% above	37%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG SCREEN NOS PRSMPTV PROC	$21.56	$34.00	$14.38–$32.30	—	37%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 PR RAPID DRUG SCREEN (NEGATIVE TEST)	$23.46	$37.00	$15.65–$35.15	—	37%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 MEDTOX/LABCORP - DRUG SCREEN PRSMPTV SGL DR CLASS	$44.38	$70.00	$29.61–$66.50	—	37%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 PR RAPID DRUG SCREEN (NON-NEGATIVE TO MEDTOX) W/MRO	$46.28	$73.00	$30.88–$69.35	—	37%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG TEST PRESUMPT; INSTR CHEM ANALYZER	$59.60	$94.00	$39.76–$89.30	—	37%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG TEST PRESUMPTIVE CHEM ANALYZER MEDTOX	$63.40	$100.00	$42.30–$95.00	—	37%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 COMPLIANCE DRUG SCREEN BLOOD	$129.34	$204.00	$86.29–$193.80	—	37%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG SCREEN LIST A - MEDTOX DOA SCREEN	$164.21	$259.00	$109.56–$246.05	—	37%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG SCREEN PRSMPTV SNGL CLASS	$320.80	$506.00	$214.04–$480.70	—	37%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 OHM DRUG PANEL-DRUG SCREEN LIST A	$320.80	$506.00	$214.04–$480.70	—	37%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG SCREEN LIST A	$320.80	$506.00	$214.04–$480.70	—	37%
Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 ELECTROLYTE PANEL	$36.14	$57.00	$3.16–$54.15	26% below	37%
Electrolyte panel (sodium, potassium, chloride, CO2) inpatient CPT 80051 ELECTROLYTE PANEL	$36.14	$57.00	$24.11–$54.15	—	37%
Epstein-Barr virus (EBV) antibody test CPT 86665 ANTIBODY; EPSTEIN-BARR (EB) VIRUS, VIRAL CAPSID (VCA), EBV IGG	$93.83	$148.00	$3.84–$140.60	14% above	37%
Epstein-Barr virus (EBV) antibody test CPT 86665 EPSTEIN-BARR (EB) VIRUS; VIRAL CAPSID (VCA)	$93.83	$148.00	$3.84–$140.60	14% above	37%
Epstein-Barr virus (EBV) antibody test CPT 86665 ANTIBODY; EPSTEIN-BARR (EB) VIRUS, VIRAL CAPSID (VCA), EBV IGM	$93.83	$148.00	$3.84–$140.60	14% above	37%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 EPSTEIN-BARR (EB) VIRUS; VIRAL CAPSID (VCA)	$93.83	$148.00	$62.60–$140.60	—	37%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 ANTIBODY; EPSTEIN-BARR (EB) VIRUS, VIRAL CAPSID (VCA), EBV IGG	$93.83	$148.00	$62.60–$140.60	—	37%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 ANTIBODY; EPSTEIN-BARR (EB) VIRUS, VIRAL CAPSID (VCA), EBV IGM	$93.83	$148.00	$62.60–$140.60	—	37%
Estradiol blood test CPT 82670 ESTRADIOL; TOTAL	$144.55	$228.00	$4.65–$216.60	13% above	37%
Estradiol blood test inpatient CPT 82670 ESTRADIOL; TOTAL	$144.55	$228.00	$96.44–$216.60	—	37%
FSH (follicle-stimulating hormone) test CPT 83001 GONADOTROPIN; FOLLCLE STIMULATING HORMONE (FSH)	$95.73	$151.00	$4.65–$143.45	17% below	37%
FSH (follicle-stimulating hormone) test CPT 83001 GONADOTROPIN; FOLLCLE STIMULATING HORMONE (FSH), URINE	$95.73	$151.00	$4.65–$143.45	17% below	37%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 GONADOTROPIN; FOLLCLE STIMULATING HORMONE (FSH)	$95.73	$151.00	$63.87–$143.45	—	37%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 GONADOTROPIN; FOLLCLE STIMULATING HORMONE (FSH), URINE	$95.73	$151.00	$63.87–$143.45	—	37%
Fecal calprotectin (stool inflammation test) CPT 83993 CALPROTECTIN, FECAL	$101.44	$160.00	$4.25–$152.00	46% below	37%
Fecal calprotectin (stool inflammation test) inpatient CPT 83993 CALPROTECTIN, FECAL	$101.44	$160.00	$67.68–$152.00	—	37%
Ferritin blood test (iron stores) CPT 82728 FERRITIN	$70.37	$111.00	$4.25–$105.45	22% below	37%
Ferritin blood test (iron stores) inpatient CPT 82728 FERRITIN	$70.37	$111.00	$46.95–$105.45	—	37%
Fibrinogen blood test CPT 85384 FIBRINOGEN; ACTIVITY	$50.09	$79.00	$1.56–$75.05	26% below	37%
Fibrinogen blood test inpatient CPT 85384 FIBRINOGEN; ACTIVITY	$50.09	$79.00	$33.42–$75.05	—	37%
Folate (folic acid) blood test CPT 82746 FOLIC ACID; SERUM	$76.08	$120.00	$4.25–$114.00	23% below	37%
Folate (folic acid) blood test inpatient CPT 82746 FOLIC ACID; SERUM	$76.08	$120.00	$50.76–$114.00	—	37%
Free T3 thyroid hormone test CPT 84481 TRIIODOTHYRONINE T3; FREE	$87.49	$138.00	$4.65–$131.10	10% below	37%
Free T3 thyroid hormone test inpatient CPT 84481 TRIIODOTHYRONINE T3; FREE	$87.49	$138.00	$58.37–$131.10	—	37%
Free T4 (free thyroxine) thyroid blood test CPT 84439 THYROXINE; FREE (FT4)	$46.92	$74.00	$4.65–$70.30	42% below	37%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 THYROXINE; FREE (FT4)	$46.92	$74.00	$31.30–$70.30	—	37%
Free testosterone test CPT 84402 TESTOSTERONE FREE	$131.87	$208.00	$4.65–$197.60	12% above	37%
Free testosterone test inpatient CPT 84402 TESTOSTERONE FREE	$131.87	$208.00	$87.98–$197.60	—	37%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 GLUTAMYLTRANSFERASE, GAMMA (GGT)	$37.41	$59.00	$1.91–$56.05	30% below	37%
Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 GLUTAMYLTRANSFERASE, GAMMA (GGT)	$37.41	$59.00	$24.96–$56.05	—	37%
General health panel: metabolic panel, blood count and TSH in one order CPT 80050 GENERAL HEALTH PANEL	$430.49	$679.00	$287.22–$645.05	56% above	37%
General health panel: metabolic panel, blood count and TSH in one order inpatient CPT 80050 GENERAL HEALTH PANEL	$430.49	$679.00	$287.22–$645.05	—	37%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GLUCOSE; POST GLUCOSE DOSE (GLU2)	$24.73	$39.00	$1.91–$37.05	50% below	37%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GLUCOSE; POST GLUCOSE DOSE (1HR DEXICOLA)	$24.73	$39.00	$1.91–$37.05	50% below	37%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 GLUCOSE; POST GLUCOSE DOSE (GLU2)	$24.73	$39.00	$16.50–$37.05	—	37%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 GLUCOSE; POST GLUCOSE DOSE (1HR DEXICOLA)	$24.73	$39.00	$16.50–$37.05	—	37%
Glucose tolerance test, 3 samples CPT 82951 GLUCOSE; TOLERANCE TEST (GTT)	$66.57	$105.00	$4.25–$99.75	26% below	37%
Glucose tolerance test, 3 samples inpatient CPT 82951 GLUCOSE; TOLERANCE TEST (GTT)	$66.57	$105.00	$44.42–$99.75	—	37%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 INFECTIOUS AGENT ANTIGEN DETECTION; GC-DNA/RNA	$181.32	$286.00	$18.84–$271.70	27% above	37%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 INFECTIOUS AGENT ANTIGEN DETECTION; GC-DNA	$181.32	$286.00	$18.84–$271.70	27% above	37%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 INFECTIOUS AGENT ANTIGEN DETECTION; GC-DNA	$181.32	$286.00	$120.98–$271.70	—	37%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 INFECTIOUS AGENT ANTIGEN DETECTION; GC-DNA/RNA	$181.32	$286.00	$120.98–$271.70	—	37%
H. pylori antibody blood test CPT 86677 ANTIBODY; H PYLORI	$86.86	$137.00	$3.84–$130.15	7% below	37%
H. pylori antibody blood test inpatient CPT 86677 ANTIBODY; H PYLORI	$86.86	$137.00	$57.95–$130.15	—	37%
H. pylori stool antigen test CPT 87338 INFECTIOUS AGENT ANTIGEN DETECTION; H PYLORI ANTIGEN, STOOL	$74.18	$117.00	$2.97–$111.15	43% below	37%
H. pylori stool antigen test inpatient CPT 87338 INFECTIOUS AGENT ANTIGEN DETECTION; H PYLORI ANTIGEN, STOOL	$74.18	$117.00	$49.49–$111.15	—	37%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 INFECTIOUS AGENT ANTIGEN DETECTION; HIV VIRAL LOAD	$440.00	$694.00	$18.84–$659.30	14% above	37%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 INFECTIOUS AGENT ANTIGEN DETECTION; HIV RNA DETECTION AND QUANT,	$440.00	$694.00	$18.84–$659.30	14% above	37%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 INFECTIOUS AGENT ANTIGEN DETECTION; HIV VIRAL LOAD	$440.00	$694.00	$293.56–$659.30	—	37%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 INFECTIOUS AGENT ANTIGEN DETECTION; HIV RNA DETECTION AND QUANT,	$440.00	$694.00	$293.56–$659.30	—	37%
HIV-1 and HIV-2 antibody test CPT 86703 ANTIBODY; HIV-1 AND HIV-2, SINGLE RESULT	$71.01	$112.00	$3.84–$106.40	8% below	37%
HIV-1 and HIV-2 antibody test inpatient CPT 86703 ANTIBODY; HIV-1 AND HIV-2, SINGLE RESULT	$71.01	$112.00	$47.38–$106.40	—	37%
HPV test for high-risk types, one combined (pooled) result CPT 87624 INFECTIOUS AGENT ANTIGEN DETECTION; HPV HIGH-RISK TYPES, POOLED	$181.32	$286.00	$18.84–$271.70	27% above	37%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 INFECTIOUS AGENT ANTIGEN DETECTION; HPV HIGH-RISK TYPES, POOLED	$181.32	$286.00	$120.98–$271.70	—	37%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HEMOGLOBIN; GLYCOSYLTED (A1C)	$50.09	$79.00	$1.91–$75.05	27% below	37%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HEMOGLOBIN; GLYCOSYLTED (A1C)	$50.09	$79.00	$33.42–$75.05	—	37%
Hemoglobin blood test CPT 85018 BLOOD COUNT; HEMOGLOBIN (HGB)	$12.05	$19.00	$2.09–$18.05	31% below	37%
Hemoglobin blood test inpatient CPT 85018 BLOOD COUNT; HEMOGLOBIN (HGB)	$12.05	$19.00	$8.04–$18.05	—	37%
Hepatitis B core antibody test (total) CPT 86704 HEPATITIS B CORE ANTIBODY; TOTAL	$62.13	$98.00	$3.84–$93.10	22% below	37%
Hepatitis B core antibody test (total) inpatient CPT 86704 HEPATITIS B CORE ANTIBODY; TOTAL	$62.13	$98.00	$41.45–$93.10	—	37%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEPATITIS B SURFACE ANTIBODY	$55.79	$88.00	$3.84–$83.60	25% below	37%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HEPATITIS B SURFACE ANTIBODY	$55.79	$88.00	$37.22–$83.60	—	37%
Hepatitis B surface antigen (HBsAg) test CPT 87340 INFECTIOUS AGENT ANTIGEN DETECTION; HEPATITIS B SURFACE ANTIGEN	$53.26	$84.00	$2.97–$79.80	18% below	37%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 INFECTIOUS AGENT ANTIGEN DETECTION; HEPATITIS B SURFACE ANTIGEN	$53.26	$84.00	$35.53–$79.80	—	37%
Hepatitis C antibody blood test (screening) CPT 86803 HEPATITIS C ANTIBODY	$73.54	$116.00	$3.84–$110.20	8% below	37%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 HEPATITIS C ANTIBODY	$73.54	$116.00	$49.07–$110.20	—	37%
Hepatitis C viral load (HCV RNA) test CPT 87522 INFECTIOUS AGENT ANTIGEN DETECTION; HEPATITIS C QUANT, PCR	$221.27	$349.00	$18.84–$331.55	7% below	37%
Hepatitis C viral load (HCV RNA) test one side CPT 87522 INFECTIOUS AGENT ANTIGEN DETECTION; HCV RNA DET AND QUANT BY RT-	$221.27	$349.00	$18.84–$331.55	7% below	37%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 INFECTIOUS AGENT ANTIGEN DETECTION; HEPATITIS C QUANT, PCR	$221.27	$349.00	$147.63–$331.55	—	37%
Hepatitis C viral load (HCV RNA) test inpatient one side CPT 87522 INFECTIOUS AGENT ANTIGEN DETECTION; HCV RNA DET AND QUANT BY RT-	$221.27	$349.00	$147.63–$331.55	—	37%
Herpes blood test, HSV-1 antibody CPT 86695 ANTIBODY; HERPES SIMPLEX (HSV TYPE 1 AB)	$67.84	$107.00	$3.84–$101.65	at median	37%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 ANTIBODY; HERPES SIMPLEX (HSV TYPE 1 AB)	$67.84	$107.00	$45.26–$101.65	—	37%
Herpes blood test, HSV-2 antibody CPT 86696 ANTIBODY; HERPES SIMPLEX, TYPE 2	$100.17	$158.00	$3.84–$150.10	23% above	37%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 ANTIBODY; HERPES SIMPLEX, TYPE 2	$100.17	$158.00	$66.83–$150.10	—	37%
High-sensitivity CRP (hs-CRP) test CPT 86141 C-REACTIVE PROTEIN; HIGH SENSITIVITY	$67.20	$106.00	$3.84–$100.70	16% below	37%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 C-REACTIVE PROTEIN; HIGH SENSITIVITY	$67.20	$106.00	$44.84–$100.70	—	37%
Homocysteine blood test CPT 83090 HOMOCYSTINE, URINE	$92.56	$146.00	$4.65–$138.70	22% below	37%
Homocysteine blood test CPT 83090 HOMOCYSTINE, BLOOD	$92.56	$146.00	$4.65–$138.70	22% below	37%
Homocysteine blood test inpatient CPT 83090 HOMOCYSTINE, BLOOD	$92.56	$146.00	$61.76–$138.70	—	37%
Homocysteine blood test inpatient CPT 83090 HOMOCYSTINE, URINE	$92.56	$146.00	$61.76–$138.70	—	37%
Insulin blood test CPT 83525 INSULIN; TOTAL	$58.96	$93.00	$4.65–$88.35	13% below	37%
Insulin blood test inpatient CPT 83525 INSULIN; TOTAL	$58.96	$93.00	$39.34–$88.35	—	37%
Iron blood test (serum iron) CPT 83540 IRON	$33.60	$53.00	$1.91–$50.35	37% below	37%
Iron blood test (serum iron) inpatient CPT 83540 IRON	$33.60	$53.00	$22.42–$50.35	—	37%
Iron-binding capacity (TIBC) test CPT 83550 IRON BINDING CAPACITY	$45.01	$71.00	$1.91–$67.45	27% below	37%
Iron-binding capacity (TIBC) test inpatient CPT 83550 IRON BINDING CAPACITY	$45.01	$71.00	$30.03–$67.45	—	37%
Kidney function blood test panel CPT 80069 RENAL FUNCTION PANEL	$45.01	$71.00	$3.16–$67.45	56% below	37%
Kidney function blood test panel inpatient CPT 80069 RENAL FUNCTION PANEL	$45.01	$71.00	$30.03–$67.45	—	37%
LH (luteinizing hormone) test CPT 83002 GONADOTROPIN; LUTEINIZING HORMONE (LH)	$95.73	$151.00	$4.65–$143.45	2% below	37%
LH (luteinizing hormone) test inpatient CPT 83002 GONADOTROPIN; LUTEINIZING HORMONE (LH)	$95.73	$151.00	$63.87–$143.45	—	37%
Lactate (lactic acid) blood test CPT 83605 D-LACTATE, PLASMA	$59.60	$94.00	$4.25–$89.30	14% below	37%
Lactate (lactic acid) blood test CPT 83605 LACTATE	$59.60	$94.00	$4.25–$89.30	14% below	37%
Lactate (lactic acid) blood test inpatient CPT 83605 LACTATE	$59.60	$94.00	$39.76–$89.30	—	37%
Lactate (lactic acid) blood test inpatient CPT 83605 D-LACTATE, PLASMA	$59.60	$94.00	$39.76–$89.30	—	37%
Lactate dehydrogenase (LDH) blood test CPT 83615 LACTATE DEHYDROGENASE (LD), (LDH); CSF	$31.07	$49.00	$1.91–$46.55	38% below	37%
Lactate dehydrogenase (LDH) blood test CPT 83615 TOTAL LD ACTIVITY	$31.07	$49.00	$1.91–$46.55	38% below	37%
Lactate dehydrogenase (LDH) blood test CPT 83615 LACTATE DEHYDROGENASE (LD), (LDH); BLOOD	$31.07	$49.00	$1.91–$46.55	38% below	37%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 LACTATE DEHYDROGENASE (LD), (LDH); CSF	$31.07	$49.00	$20.73–$46.55	—	37%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 TOTAL LD ACTIVITY	$31.07	$49.00	$20.73–$46.55	—	37%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 LACTATE DEHYDROGENASE (LD), (LDH); BLOOD	$31.07	$49.00	$20.73–$46.55	—	37%
Lipase blood test (pancreas enzyme) CPT 83690 LIPASE, URINE	$35.50	$56.00	$1.91–$53.20	48% below	37%
Lipase blood test (pancreas enzyme) CPT 83690 LIPASE	$35.50	$56.00	$1.91–$53.20	48% below	37%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 LIPASE, URINE	$35.50	$56.00	$23.69–$53.20	—	37%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 LIPASE	$35.50	$56.00	$23.69–$53.20	—	37%
Liver function blood test panel CPT 80076 HEPATIC FUNCTION PANEL	$42.48	$67.00	$3.16–$63.65	58% below	37%
Liver function blood test panel inpatient CPT 80076 HEPATIC FUNCTION PANEL	$42.48	$67.00	$28.34–$63.65	—	37%
Lyme disease antibody test CPT 86618 ANTIBODY; BORRELIA BURGDORFERI (LYME IGG/IGM SCREEN)	$88.13	$139.00	$3.84–$132.05	6% above	37%
Lyme disease antibody test CPT 86618 ANTIBODY; BORRELIA BURGDORFERI (LYME) MCLAB	$88.13	$139.00	$3.84–$132.05	6% above	37%
Lyme disease antibody test inpatient CPT 86618 ANTIBODY; BORRELIA BURGDORFERI (LYME IGG/IGM SCREEN)	$88.13	$139.00	$58.80–$132.05	—	37%
Lyme disease antibody test inpatient CPT 86618 ANTIBODY; BORRELIA BURGDORFERI (LYME) MCLAB	$88.13	$139.00	$58.80–$132.05	—	37%
Magnesium blood test CPT 83735 MAGNESIUM	$34.87	$55.00	$1.91–$52.25	34% below	37%
Magnesium blood test CPT 83735 MAGNESIUM, RBC ARUP	$34.87	$55.00	$1.91–$52.25	34% below	37%
Magnesium blood test CPT 83735 UROCHEM PANEL-MAGNESIUM	$34.87	$55.00	$1.91–$52.25	34% below	37%
Magnesium blood test inpatient CPT 83735 UROCHEM PANEL-MAGNESIUM	$34.87	$55.00	$23.27–$52.25	—	37%
Magnesium blood test inpatient CPT 83735 MAGNESIUM	$34.87	$55.00	$23.27–$52.25	—	37%
Magnesium blood test inpatient CPT 83735 MAGNESIUM, RBC ARUP	$34.87	$55.00	$23.27–$52.25	—	37%
Measles (rubeola) antibody test CPT 86765 ANTIBODY; RUBEOLA	$66.57	$105.00	$3.84–$99.75	19% below	37%
Measles (rubeola) antibody test CPT 86765 ANTIBODY; RUBEOLA, IMMUNE STATUS	$66.57	$105.00	$3.84–$99.75	19% below	37%
Measles (rubeola) antibody test inpatient CPT 86765 ANTIBODY; RUBEOLA	$66.57	$105.00	$44.42–$99.75	—	37%
Measles (rubeola) antibody test inpatient CPT 86765 ANTIBODY; RUBEOLA, IMMUNE STATUS	$66.57	$105.00	$44.42–$99.75	—	37%
Mono test (heterophile antibody, Monospot) CPT 86308 HETEROPHILE ANTIBODIES; SCREENING (MONOTEST)	$26.63	$42.00	$3.84–$39.90	52% below	37%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 HETEROPHILE ANTIBODIES; SCREENING (MONOTEST)	$26.63	$42.00	$17.77–$39.90	—	37%
Mumps immunity blood test CPT 86735 ANTIBODY; MUMPS	$67.20	$106.00	$3.84–$100.70	22% below	37%
Mumps immunity blood test CPT 86735 ANTIBODY; MUMPS ARUP	$67.20	$106.00	$3.84–$100.70	22% below	37%
Mumps immunity blood test CPT 86735 ANTIBODY; MUMPS, SKIN TEST	$67.20	$106.00	$3.84–$100.70	22% below	37%
Mumps immunity blood test inpatient CPT 86735 ANTIBODY; MUMPS, SKIN TEST	$67.20	$106.00	$44.84–$100.70	—	37%
Mumps immunity blood test inpatient CPT 86735 ANTIBODY; MUMPS	$67.20	$106.00	$44.84–$100.70	—	37%
Mumps immunity blood test inpatient CPT 86735 ANTIBODY; MUMPS ARUP	$67.20	$106.00	$44.84–$100.70	—	37%
Obstetric blood test panel CPT 80055 OBSTETRIC PANEL	$247.26	$390.00	$3.16–$370.50	2% above	37%
Obstetric blood test panel inpatient CPT 80055 OBSTETRIC PANEL	$247.26	$390.00	$164.97–$370.50	—	37%
PSA (prostate-specific antigen) blood test, free CPT 84154 PROSTATIC SPECIFIC ANTIGEN (PSA); FREE	$95.10	$150.00	$4.25–$142.50	3% above	37%
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 PROSTATIC SPECIFIC ANTIGEN (PSA); FREE	$95.10	$150.00	$63.45–$142.50	—	37%
PSA (prostate-specific antigen) blood test, total CPT 84153 PROSTATIC SPECIFIC ANTIGEN (PSA); TOTAL	$95.10	$150.00	$4.25–$142.50	at median	37%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PROSTATIC SPECIFIC ANTIGEN (PSA); TOTAL	$95.10	$150.00	$63.45–$142.50	—	37%
Pap test (liquid-based, automated screening with review) CPT 88175 CYTOPATHOLOGY, CERVICAL/VAGINAL, FLUID BASED; AUTOMATED SCREEN	$137.58	$217.00	$7.30–$217.00	31% above	37%
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 CYTOPATHOLOGY, CERVICAL/VAGINAL, FLUID BASED; AUTOMATED SCREEN	$137.58	$217.00	$91.79–$206.15	—	37%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 CYTOPATHOLOGY, CERVICAL/VAGINAL, LIQUID BASED PREP; MANUAL SCREE	$104.61	$165.00	$7.30–$165.00	16% above	37%
Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 CYTOPATHOLOGY, CERVICAL/VAGINAL, LIQUID BASED PREP; MANUAL SCREE	$104.61	$165.00	$69.80–$156.75	—	37%
Parathyroid hormone (PTH) blood test CPT 83970 PARATHORMONE	$213.02	$336.00	$12.19–$319.20	at median	37%
Parathyroid hormone (PTH) blood test CPT 83970 PARATHORMONE (PARATHYROID HORMONE)	$213.02	$336.00	$12.19–$319.20	at median	37%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 PARATHORMONE	$213.02	$336.00	$142.13–$319.20	—	37%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 PARATHORMONE (PARATHYROID HORMONE)	$213.02	$336.00	$142.13–$319.20	—	37%
Partial thromboplastin time (PTT) clotting test CPT 85730 THROMBOPLASTIN TIME, PARTIAL (PTT); PLASMA OR WHOLE BLOOD	$31.07	$49.00	$1.56–$46.55	41% below	37%
Partial thromboplastin time (PTT) clotting test CPT 85730 THROMBOPLASTIN TIME, PARTIAL (PTT)	$31.07	$49.00	$1.56–$46.55	41% below	37%
Partial thromboplastin time (PTT) clotting test CPT 85730 THROMBOPLASTIN TIME, PARTIAL (PTT); HEPARIN ABSORBED	$31.07	$49.00	$1.56–$46.55	41% below	37%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 THROMBOPLASTIN TIME, PARTIAL (PTT); HEPARIN ABSORBED	$31.07	$49.00	$20.73–$46.55	—	37%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 THROMBOPLASTIN TIME, PARTIAL (PTT)	$31.07	$49.00	$20.73–$46.55	—	37%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 THROMBOPLASTIN TIME, PARTIAL (PTT); PLASMA OR WHOLE BLOOD	$31.07	$49.00	$20.73–$46.55	—	37%
Phosphorus (phosphate) blood test CPT 84100 PHOSPHOROUS INORGANIC (PHOSPHATE)	$24.73	$39.00	$1.91–$37.05	41% below	37%
Phosphorus (phosphate) blood test inpatient CPT 84100 PHOSPHOROUS INORGANIC (PHOSPHATE)	$24.73	$39.00	$16.50–$37.05	—	37%
Potassium blood test CPT 84132 POTASSIUM; SERUM, PLASMA OR WHOLE BLOOD	$24.73	$39.00	$1.91–$37.05	10% below	37%
Potassium blood test inpatient CPT 84132 POTASSIUM; SERUM, PLASMA OR WHOLE BLOOD	$24.73	$39.00	$16.50–$37.05	—	37%
Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) CPT 81420 FETAL CHROMOSOMAL ANEUPLOIDY (MATERNIT21 PLUS)	$3,921.92	$6,186.00	$238.79–$6,186.00	225% above	37%
Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) inpatient CPT 81420 FETAL CHROMOSOMAL ANEUPLOIDY (MATERNIT21 PLUS)	$3,921.92	$6,186.00	$2,616.68–$5,876.70	—	37%
Progesterone blood test CPT 84144 PROGESTERONE	$107.78	$170.00	$4.65–$161.50	11% below	37%
Progesterone blood test inpatient CPT 84144 PROGESTERONE	$107.78	$170.00	$71.91–$161.50	—	37%
Prolactin blood test CPT 84146 PROLACTIN	$100.17	$158.00	$4.65–$150.10	17% below	37%
Prolactin blood test inpatient CPT 84146 PROLACTIN	$100.17	$158.00	$66.83–$150.10	—	37%
Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME, WHOLE BLOOD	$22.19	$35.00	$1.56–$33.25	34% below	37%
Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME	$22.19	$35.00	$1.56–$33.25	34% below	37%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTHROMBIN TIME	$22.19	$35.00	$14.81–$33.25	—	37%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTHROMBIN TIME, WHOLE BLOOD	$22.19	$35.00	$14.81–$33.25	—	37%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 INFECTIOUS AGENT ANTIGEN DETECTION; SCREEN-B STREP GRP A	$85.59	$135.00	$2.97–$128.25	88% above	37%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 INFECTIOUS AGENT ANTIGEN DETECTION; STREPTOCOCCUS	$85.59	$135.00	$2.97–$128.25	88% above	37%
Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 INFECTIOUS AGENT ANTIGEN DETECTION; SCREEN-B STREP GRP A	$85.59	$135.00	$57.11–$128.25	—	37%
Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 INFECTIOUS AGENT ANTIGEN DETECTION; STREPTOCOCCUS	$85.59	$135.00	$57.11–$128.25	—	37%
Renin blood test CPT 84244 RENIN, BLOOD	$113.49	$179.00	$4.65–$170.05	23% below	37%
Renin blood test inpatient CPT 84244 RENIN, BLOOD	$113.49	$179.00	$75.72–$170.05	—	37%
Rh blood typing CPT 86901 BLOOD TYPING, SEROLOGIC; RH (D)	$15.22	$24.00	$1.53–$22.80	62% below	37%
Rh blood typing inpatient CPT 86901 BLOOD TYPING, SEROLOGIC; RH (D)	$15.22	$24.00	$10.15–$22.80	—	37%
Rheumatoid factor (RF) test CPT 86431 RHEUMATOID FACTOR; QUANTITATIVE	$29.16	$46.00	$3.84–$43.70	50% below	37%
Rheumatoid factor (RF) test inpatient CPT 86431 RHEUMATOID FACTOR; QUANTITATIVE	$29.16	$46.00	$19.46–$43.70	—	37%
Rubella antibody test (immunity check) CPT 86762 ANTIBODY; RUBELLA, IMMM STATUS	$74.18	$117.00	$3.84–$111.15	10% below	37%
Rubella antibody test (immunity check) CPT 86762 ANTIBODY; RUBELLA	$74.18	$117.00	$3.84–$111.15	10% below	37%
Rubella antibody test (immunity check) inpatient CPT 86762 ANTIBODY; RUBELLA	$74.18	$117.00	$49.49–$111.15	—	37%
Rubella antibody test (immunity check) inpatient CPT 86762 ANTIBODY; RUBELLA, IMMM STATUS	$74.18	$117.00	$49.49–$111.15	—	37%
Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 SEDIMENTATION RATE, ERYTHROCYTE; AUTOMATED (ESR)	$13.95	$22.00	$2.09–$20.90	66% below	37%
Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 SEDIMENTATION RATE, ERYTHROCYTE; AUTOMATED (ESR)	$13.95	$22.00	$9.31–$20.90	—	37%
Sodium blood test CPT 84295 SODIUM; SERUM, PLASMA OR WHOLE BLOOD	$24.73	$39.00	$1.91–$37.05	at median	37%
Sodium blood test inpatient CPT 84295 SODIUM; SERUM, PLASMA OR WHOLE BLOOD	$24.73	$39.00	$16.50–$37.05	—	37%
Stool ova and parasites exam CPT 87177 OVA AND PARASITES, DIRECT SMEARS ARUP	$46.28	$73.00	$2.97–$69.35	29% below	37%
Stool ova and parasites exam CPT 87177 OVA AND PARASITES, DIRECT SMEARS MCLAB	$46.28	$73.00	$2.97–$69.35	29% below	37%
Stool ova and parasites exam CPT 87177 OVA AND PARASITES, DIRECT SMEARS, CONCENTRATION AND ID	$46.28	$73.00	$2.97–$69.35	29% below	37%
Stool ova and parasites exam inpatient CPT 87177 OVA AND PARASITES, DIRECT SMEARS MCLAB	$46.28	$73.00	$30.88–$69.35	—	37%
Stool ova and parasites exam inpatient CPT 87177 OVA AND PARASITES, DIRECT SMEARS, CONCENTRATION AND ID	$46.28	$73.00	$30.88–$69.35	—	37%
Stool ova and parasites exam inpatient CPT 87177 OVA AND PARASITES, DIRECT SMEARS ARUP	$46.28	$73.00	$30.88–$69.35	—	37%
Stool test for hidden blood (guaiac FOBT) CPT 82270 BLOOD, OCCULT, BY PEROXIDASE ACTIVITY; FECES (HEMOCCULT SLIDE)	$22.82	$36.00	$1.91–$34.20	8% above	37%
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 BLOOD, OCCULT, BY PEROXIDASE ACTIVITY; FECES (HEMOCCULT SLIDE)	$22.82	$36.00	$15.23–$34.20	—	37%
Stool test for hidden blood by immunoassay (FIT) CPT 82274 BLOOD, OCCULT, QUAL, FECES, 1-3 DETERMINATIONS, BY IMMUNOASSAY,	$82.42	$130.00	$4.25–$123.50	36% above	37%
Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 BLOOD, OCCULT, QUAL, FECES, 1-3 DETERMINATIONS, BY IMMUNOASSAY,	$82.42	$130.00	$54.99–$123.50	—	37%
Syphilis antibody test (Treponema pallidum) CPT 86780 ANTIBODY; TREPONEMA PALLIDUM, SYPHILIS AB MCLAB	$68.47	$108.00	$3.84–$102.60	24% above	37%
Syphilis antibody test (Treponema pallidum) CPT 86780 ANTIBODY; TREPONEMA PALLIDUM	$68.47	$108.00	$3.84–$102.60	24% above	37%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 ANTIBODY; TREPONEMA PALLIDUM, SYPHILIS AB MCLAB	$68.47	$108.00	$45.68–$102.60	—	37%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 ANTIBODY; TREPONEMA PALLIDUM	$68.47	$108.00	$45.68–$102.60	—	37%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 SYPHILIS TEST, NON-TREPONEMAL ANTIBODY; QUALITATIVE (RPR, RESPON	$22.19	$35.00	$3.84–$33.25	44% below	37%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 SYPHILIS TEST, NON-TREPONEMAL ANTIBODY; QUALITATIVE (VDRL)	$22.19	$35.00	$3.84–$33.25	44% below	37%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 SYPHILIS TEST, NON-TREPONEMAL ANTIBODY; QUALITATIVE (VDRL) MCLA	$22.19	$35.00	$3.84–$33.25	44% below	37%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 SYPHILIS TEST, NON-TREPONEMAL ANTIBODY; QUALITATIVE (RPR, RESPON	$22.19	$35.00	$14.81–$33.25	—	37%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 SYPHILIS TEST, NON-TREPONEMAL ANTIBODY; QUALITATIVE (VDRL)	$22.19	$35.00	$14.81–$33.25	—	37%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 SYPHILIS TEST, NON-TREPONEMAL ANTIBODY; QUALITATIVE (VDRL) MCLA	$22.19	$35.00	$14.81–$33.25	—	37%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 TUBERCULOSIS TEST, CELL MEDIATED IMMUNITY ANTIGEN RESPONSE MEASU	$320.17	$505.00	$14.31–$479.75	27% above	37%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 TUBERCULOSIS TEST, CELL MEDIATED IMMUNITY ANTIGEN RESPONSE MEASU	$320.17	$505.00	$213.62–$479.75	—	37%
Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE TOTAL	$133.14	$210.00	$4.65–$199.50	16% above	37%
Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE; TOTAL	$133.14	$210.00	$4.65–$199.50	16% above	37%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE; TOTAL	$133.14	$210.00	$88.83–$199.50	—	37%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE TOTAL	$133.14	$210.00	$88.83–$199.50	—	37%
Thyroid peroxidase (TPO) antibody test CPT 86376 MICROSOMAL ANTIBODIES, THYROPEROXIDASE	$75.45	$119.00	$3.84–$113.05	8% above	37%
Thyroid peroxidase (TPO) antibody test CPT 86376 MICROSOMAL ANTIBODIES, LIVER/KIDNEY	$75.45	$119.00	$3.84–$113.05	8% above	37%
Thyroid peroxidase (TPO) antibody test CPT 86376 MICROSOMAL ANTIBODIES, ANTI-THYROID PEROXIDASE AUTOAB	$75.45	$119.00	$3.84–$113.05	8% above	37%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 MICROSOMAL ANTIBODIES, THYROPEROXIDASE	$75.45	$119.00	$50.34–$113.05	—	37%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 MICROSOMAL ANTIBODIES, LIVER/KIDNEY	$75.45	$119.00	$50.34–$113.05	—	37%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 MICROSOMAL ANTIBODIES, ANTI-THYROID PEROXIDASE AUTOAB	$75.45	$119.00	$50.34–$113.05	—	37%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 THYROID STIMULATING HORMONE (TSH)	$86.86	$137.00	$4.65–$130.15	3% below	37%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 THYROID STIMULATING HORMONE (TSH)	$86.86	$137.00	$57.95–$130.15	—	37%
Total IgE blood test CPT 82785 GAMMAGLOBULIN (IMMUNOGLOBULIN); IGE, TOTAL	$84.96	$134.00	$4.25–$127.30	17% below	37%
Total IgE blood test inpatient CPT 82785 GAMMAGLOBULIN (IMMUNOGLOBULIN); IGE, TOTAL	$84.96	$134.00	$56.68–$127.30	—	37%
Total cholesterol blood test CPT 82465 CHOLESTEROL, SERUM OR WHOLE BLOOD, TOTAL	$22.19	$35.00	$1.91–$33.25	52% below	37%
Total cholesterol blood test inpatient CPT 82465 CHOLESTEROL, SERUM OR WHOLE BLOOD, TOTAL	$22.19	$35.00	$14.81–$33.25	—	37%
Total thyroxine (T4) blood test CPT 84436 THYROXINE; TOTAL	$35.50	$56.00	$4.65–$53.20	32% below	37%
Total thyroxine (T4) blood test inpatient CPT 84436 THYROXINE; TOTAL	$35.50	$56.00	$23.69–$53.20	—	37%
Total triiodothyronine (T3) blood test CPT 84480 TRIIODOTHYRONINE T3; TOTAL (TT-3)	$73.54	$116.00	$4.65–$110.20	31% below	37%
Total triiodothyronine (T3) blood test inpatient CPT 84480 TRIIODOTHYRONINE T3; TOTAL (TT-3)	$73.54	$116.00	$49.07–$110.20	—	37%
Transferrin blood test CPT 84466 TRANSFERRIN	$65.94	$104.00	$4.25–$98.80	31% below	37%
Transferrin blood test inpatient CPT 84466 TRANSFERRIN	$65.94	$104.00	$43.99–$98.80	—	37%
Trichomonas test (NAAT) CPT 87661 INFECTIOUS AGENT ANTIGEN DETECTION; TRICHOMONAS RNA	$181.32	$286.00	$18.84–$271.70	33% above	37%
Trichomonas test (NAAT) CPT 87661 INFECTIOUS AGENT ANTIGEN DETECTION; TRICHOMONAS VAGINALIS	$181.32	$286.00	$18.84–$271.70	33% above	37%
Trichomonas test (NAAT) inpatient CPT 87661 INFECTIOUS AGENT ANTIGEN DETECTION; TRICHOMONAS RNA	$181.32	$286.00	$120.98–$271.70	—	37%
Trichomonas test (NAAT) inpatient CPT 87661 INFECTIOUS AGENT ANTIGEN DETECTION; TRICHOMONAS VAGINALIS	$181.32	$286.00	$120.98–$271.70	—	37%
Triglycerides blood test CPT 84478 TRIGLYCERIDES, FLUID	$29.80	$47.00	$1.91–$44.65	45% below	37%
Triglycerides blood test CPT 84478 TRIGLYCERIDE	$29.80	$47.00	$1.91–$44.65	45% below	37%
Triglycerides blood test inpatient CPT 84478 TRIGLYCERIDE	$29.80	$47.00	$19.88–$44.65	—	37%
Triglycerides blood test inpatient CPT 84478 TRIGLYCERIDES, FLUID	$29.80	$47.00	$19.88–$44.65	—	37%
Troponin test, quantitative CPT 84484 TROPONIN, QUANTITATIVE	$64.67	$102.00	$4.25–$96.90	23% below	37%
Troponin test, quantitative inpatient CPT 84484 TROPONIN, QUANTITATIVE	$64.67	$102.00	$43.15–$96.90	—	37%
Uric acid blood test CPT 84550 URIC ACID; BLOOD	$23.46	$37.00	$1.91–$35.15	54% below	37%
Uric acid blood test inpatient CPT 84550 URIC ACID; BLOOD	$23.46	$37.00	$15.65–$35.15	—	37%
Urinalysis with microscope exam, automated CPT 81001 URINALYSIS; AUTOMATED W/MICROSCOPY	$16.48	$26.00	$1.05–$24.70	54% below	37%
Urinalysis with microscope exam, automated CPT 81001 URINALYSIS; AUTOMATED WITH MICROSCOPY	$16.48	$26.00	$1.05–$24.70	54% below	37%
Urinalysis with microscope exam, automated inpatient CPT 81001 URINALYSIS; AUTOMATED W/MICROSCOPY	$16.48	$26.00	$11.00–$24.70	—	37%
Urinalysis with microscope exam, automated inpatient CPT 81001 URINALYSIS; AUTOMATED WITH MICROSCOPY	$16.48	$26.00	$11.00–$24.70	—	37%
Urinalysis with microscope exam, manual CPT 81000 URINALYSIS; NON-AUTOMATED W/MICROSCOPY	$20.92	$33.00	$1.05–$31.35	67% above	37%
Urinalysis with microscope exam, manual inpatient CPT 81000 URINALYSIS; NON-AUTOMATED W/MICROSCOPY	$20.92	$33.00	$13.96–$31.35	—	37%
Urinalysis without microscope exam, automated CPT 81003 URINALYSIS; AUTOMATED WO MICROSCOPY (DIPSTICK ONLY)	$11.41	$18.00	$1.05–$17.10	54% below	37%
Urinalysis without microscope exam, automated CPT 81003 URINALYSIS; AUTOMATED WO MICROSCOPY (UA DIP ONLY)	$11.41	$18.00	$1.05–$17.10	54% below	37%
Urinalysis without microscope exam, automated inpatient CPT 81003 URINALYSIS; AUTOMATED WO MICROSCOPY (DIPSTICK ONLY)	$11.41	$18.00	$7.61–$17.10	—	37%
Urinalysis without microscope exam, automated inpatient CPT 81003 URINALYSIS; AUTOMATED WO MICROSCOPY (UA DIP ONLY)	$11.41	$18.00	$7.61–$17.10	—	37%
Urinalysis without microscope exam, manual CPT 81002 URINALYSIS; NON-AUTOMATED WO MICROSCOPY	$17.75	$28.00	$1.05–$26.60	29% above	37%
Urinalysis without microscope exam, manual inpatient CPT 81002 URINALYSIS; NON-AUTOMATED WO MICROSCOPY	$17.75	$28.00	$11.84–$26.60	—	37%
Urine culture for bacteria, with colony count CPT 87086 CULTURE, BACTERIAL; QUANTITATIVE COLONY COUNT, URINE	$41.84	$66.00	$2.97–$62.70	45% below	37%
Urine culture for bacteria, with colony count inpatient CPT 87086 CULTURE, BACTERIAL; QUANTITATIVE COLONY COUNT, URINE	$41.84	$66.00	$27.92–$62.70	—	37%
Urine microalbumin (albumin) test CPT 82043 ALBUMIN; URINE (EG, MICROALBUMIN 24 HR), QUANTITATIVE	$29.80	$47.00	$1.05–$44.65	54% below	37%
Urine microalbumin (albumin) test CPT 82043 ALBUMIN; URINE (EG, MICROALBUMIN), QUANTITATIVE	$29.80	$47.00	$1.05–$44.65	54% below	37%
Urine microalbumin (albumin) test inpatient CPT 82043 ALBUMIN; URINE (EG, MICROALBUMIN), QUANTITATIVE	$29.80	$47.00	$19.88–$44.65	—	37%
Urine microalbumin (albumin) test inpatient CPT 82043 ALBUMIN; URINE (EG, MICROALBUMIN 24 HR), QUANTITATIVE	$29.80	$47.00	$19.88–$44.65	—	37%
Urine pregnancy test, read by color change CPT 81025 URINE PREGNANCY TEST	$44.38	$70.00	$1.05–$66.50	10% below	37%
Urine pregnancy test, read by color change inpatient CPT 81025 URINE PREGNANCY TEST	$44.38	$70.00	$29.61–$66.50	—	37%
Vitamin B12 (cobalamin) blood test CPT 82607 CYANOCOBALAMIN (VITAMIN B12)	$77.98	$123.00	$4.65–$116.85	24% below	37%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 CYANOCOBALAMIN (VITAMIN B12)	$77.98	$123.00	$52.03–$116.85	—	37%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D; 25 HYDROXY	$152.79	$241.00	$9.84–$228.95	1% below	37%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 VITAMIN D; 25 HYDROXY	$152.79	$241.00	$101.94–$228.95	—	37%
Vitamin D, 1,25-dihydroxy blood test CPT 82652 VITAMIN D, 1,25 DIHYDROXY	$199.08	$314.00	$9.84–$298.30	24% above	37%
Vitamin D, 1,25-dihydroxy blood test CPT 82652 VITAMIN D; 1,25 DIHYDROXY,INCL FRACTIONS	$199.08	$314.00	$9.84–$298.30	24% above	37%
Vitamin D, 1,25-dihydroxy blood test inpatient CPT 82652 VITAMIN D; 1,25 DIHYDROXY,INCL FRACTIONS	$199.08	$314.00	$132.82–$298.30	—	37%
Vitamin D, 1,25-dihydroxy blood test inpatient CPT 82652 VITAMIN D, 1,25 DIHYDROXY	$199.08	$314.00	$132.82–$298.30	—	37%
Zinc blood test CPT 84630 ZINC,BLOOD	$58.96	$93.00	$4.25–$88.35	26% below	37%
Zinc blood test inpatient CPT 84630 ZINC,BLOOD	$58.96	$93.00	$39.34–$88.35	—	37%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 GONADOTROPIN, CHORIONIC (HCG); QUANTITATIVE	$77.98	$123.00	$4.65–$116.85	34% below	37%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 IMS2 HCG	$77.98	$123.00	$4.65–$116.85	34% below	37%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 IMS2 HCG	$77.98	$123.00	$52.03–$116.85	—	37%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 GONADOTROPIN, CHORIONIC (HCG); QUANTITATIVE	$77.98	$123.00	$52.03–$116.85	—	37%

Surgery and procedures

Procedure	Cash price	List price	Insurers pay	vs Wisconsin	Off list
Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 HCHG 27786 CLSD TX DISTAL FIB FX W/O MAN	$401.32	$633.00	$267.76–$601.35	27% below	37%
Broken ankle (outer ankle bone) treatment without surgery or setting inpatient CPT 27786 HCHG 27786 CLSD TX DISTAL FIB FX W/O MAN	$401.32	$633.00	$267.76–$601.35	—	37%
Broken foot (metatarsal) treatment without surgery or setting CPT 28470 HCHG 28470 CLSD TX METATARS FX W/O MAN,EA	$251.06	$396.00	$167.51–$376.20	58% below	37%
Broken foot (metatarsal) treatment without surgery or setting inpatient CPT 28470 HCHG 28470 CLSD TX METATARS FX W/O MAN,EA	$251.06	$396.00	$167.51–$376.20	—	37%
Cardioversion, elective (restoring heart rhythm) CPT 92960 HCHG 92960 CARDIOVERSION ELECTRICAL EXT	$707.54	$1,116.00	$472.07–$1,060.20	28% below	37%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 HCHG 92960 CARDIOVERSION ELECTRICAL EXT	$707.54	$1,116.00	$472.07–$1,060.20	—	37%
Cervical biopsy CPT 57500 HCHG 57500 BIOPSY, SINGLE/MULT WWO FULG	$488.81	$771.00	$326.13–$732.45	18% below	37%
Cervical biopsy inpatient CPT 57500 HCHG 57500 BIOPSY, SINGLE/MULT WWO FULG	$488.81	$771.00	$326.13–$732.45	—	37%
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 HCHG 25600 CLS TX DISTAL RADIAL FX W/O MN	$443.17	$699.00	$295.68–$664.05	28% below	37%
Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 HCHG 25600 CLS TX DISTAL RADIAL FX W/O MN	$443.17	$699.00	$295.68–$664.05	—	37%
Colonoscopy with polyp removal CPT 45385 HCHG 45385P COLONOSCOPY W/REM POLYP,TUMOR,LESION-SNARE	$2,630.47	$4,149.00	$444.28–$3,941.55	7% above	37%
Colonoscopy with polyp removal inpatient CPT 45385 HCHG 45385P COLONOSCOPY W/REM POLYP,TUMOR,LESION-SNARE	$2,630.47	$4,149.00	$1,755.03–$3,941.55	—	37%
Colonoscopy with tissue sample CPT 45380 HCHG 45380P COLONOSCOPY W/BIOPSY, SGL OR MULT	$2,248.16	$3,546.00	$444.28–$3,368.70	10% above	37%
Colonoscopy with tissue sample inpatient CPT 45380 HCHG 45380P COLONOSCOPY W/BIOPSY, SGL OR MULT	$2,248.16	$3,546.00	$1,499.96–$3,368.70	—	37%
Colonoscopy, diagnostic CPT 45378 HCHG 45378P COLONOSCOPY; DIAGNOSTIC	$1,990.76	$3,140.00	$444.28–$2,983.00	14% above	37%
Colonoscopy, diagnostic inpatient CPT 45378 HCHG 45378P COLONOSCOPY; DIAGNOSTIC	$1,990.76	$3,140.00	$1,328.22–$2,983.00	—	37%
Colposcopy with LEEP (loop electrosurgical excision) CPT 57460 HCHG 57460 LEEP PROCEDURE	$1,756.18	$2,770.00	$1,171.71–$2,631.50	104% above	37%
Colposcopy with LEEP (loop electrosurgical excision) inpatient CPT 57460 HCHG 57460 LEEP PROCEDURE	$1,756.18	$2,770.00	$1,171.71–$2,631.50	—	37%
Colposcopy with cervical biopsy and scraping of the cervical canal CPT 57454 HCHG 57454 COLPOSCOY WITH BIOPSY(S)	$576.94	$910.00	$384.93–$864.50	27% above	37%
Colposcopy with cervical biopsy and scraping of the cervical canal inpatient CPT 57454 HCHG 57454 COLPOSCOY WITH BIOPSY(S)	$576.94	$910.00	$384.93–$864.50	—	37%
Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 HCHG 52000 CYSTOURETHROSCOPY	$763.34	$1,204.00	$509.29–$1,143.80	23% below	37%
Cystoscopy, diagnostic look inside the bladder and urethra inpatient CPT 52000 HCHG 52000 CYSTOURETHROSCOPY	$763.34	$1,204.00	$509.29–$1,143.80	—	37%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 HCHG 17000 DEST BENIGN/PREMALIGN, 1ST LESION	$180.06	$284.00	$120.13–$269.80	at median	37%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 HCHG 17000 DEST BENIGN/PREMALIGN, 1ST LESION	$180.06	$284.00	$120.13–$269.80	—	37%
Ear tube placement (tympanostomy) with local anesthesia, one ear CPT 69433 HCHG 69433 TYMPANOSTOMY-INSERT TUBE	$566.16	$893.00	$377.74–$848.35	8% above	37%
Ear tube placement (tympanostomy) with local anesthesia, one ear inpatient CPT 69433 HCHG 69433 TYMPANOSTOMY-INSERT TUBE	$566.16	$893.00	$377.74–$848.35	—	37%
Earwax removal by irrigation (rinsing), one ear one side CPT 69209 HCHG 69209 REMOVAL IMPACTED CERUMEN IRRIGATION/LAVAGE UNILATERAL	$70.37	$111.00	$46.95–$105.45	24% below	37%
Earwax removal by irrigation (rinsing), one ear inpatient one side CPT 69209 HCHG 69209 REMOVAL IMPACTED CERUMEN IRRIGATION/LAVAGE UNILATERAL	$70.37	$111.00	$46.95–$105.45	—	37%
Earwax removal with instruments, one ear one side CPT 69210 HCHG 69210 REM IMPACTED CERUMEN, UNILATERAL	$77.98	$123.00	$52.03–$116.85	7% below	37%
Earwax removal with instruments, one ear inpatient one side CPT 69210 HCHG 69210 REM IMPACTED CERUMEN, UNILATERAL	$77.98	$123.00	$52.03–$116.85	—	37%
Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 HCHG 58100 ENDOMETRIAL SAMPLING	$365.18	$576.00	$243.65–$547.20	34% above	37%
Endometrial biopsy (uterine lining sample) without dilating the cervix inpatient CPT 58100 HCHG 58100 ENDOMETRIAL SAMPLING	$365.18	$576.00	$243.65–$547.20	—	37%
Eye injection into the vitreous (intravitreal injection) CPT 67028 HCHG 67028 INTRAVITREAL INJ PHARM AGENT	$511.64	$807.00	$341.36–$766.65	26% above	37%
Eye injection into the vitreous (intravitreal injection) inpatient CPT 67028 HCHG 67028 INTRAVITREAL INJ PHARM AGENT	$511.64	$807.00	$341.36–$766.65	—	37%
Facet joint injection, lower back, one level, with imaging guidance CPT 64493 HCHG 64493 INJECTION PARAVERTEBRAL FACET JOINT W/GUIDANCE LUMB/S	$1,048.00	$1,653.00	$699.22–$1,570.35	35% below	37%
Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 HCHG 64493 INJECTION PARAVERTEBRAL FACET JOINT W/GUIDANCE LUMB/S	$1,048.00	$1,653.00	$699.22–$1,570.35	—	37%
Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 HCHG 45330P SIGMOIDOSCOPY; DIAGNOSTIC	$895.21	$1,412.00	$597.28–$1,341.40	4% above	37%
Flexible sigmoidoscopy, diagnostic (lower colon only) inpatient CPT 45330 HCHG 45330P SIGMOIDOSCOPY; DIAGNOSTIC	$895.21	$1,412.00	$597.28–$1,341.40	—	37%
Hemorrhoid banding (rubber band ligation) CPT 46221 HCHG 46221 HEMORRHOIDECTOMY, INTERNAL, BY RUBBER BAND LIGATION(S	$898.38	$1,417.00	$599.39–$1,346.15	30% below	37%
Hemorrhoid banding (rubber band ligation) inpatient CPT 46221 HCHG 46221 HEMORRHOIDECTOMY, INTERNAL, BY RUBBER BAND LIGATION(S	$898.38	$1,417.00	$599.39–$1,346.15	—	37%
IUD insertion (the device itself billed separately) CPT 58300 HCHG 58300 INSERT INTRAUTERINE DEVICE-IUD	$257.40	$406.00	$171.74–$385.70	15% below	37%
IUD insertion (the device itself billed separately) inpatient CPT 58300 HCHG 58300 INSERT INTRAUTERINE DEVICE-IUD	$257.40	$406.00	$171.74–$385.70	—	37%
Incision and drainage of a simple or single skin abscess CPT 10060 HCHG 10060 I&D ABSCESS SIMPLE	$289.74	$457.00	$193.31–$434.15	1% below	37%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 HCHG 10060 I&D ABSCESS SIMPLE	$289.74	$457.00	$193.31–$434.15	—	37%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 HCHG 20550 INJ SGL TEND SHEATH OR LIG, APO	$284.03	$448.00	$189.50–$425.60	17% below	37%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 HCHG 20550 INJ SGL TEND SHEATH OR LIG, APO	$284.03	$448.00	$189.50–$425.60	—	37%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 HCHG 20610 ARTHROCENTESIS, ASP/INJ, LRG JNT	$280.86	$443.00	$187.39–$420.85	35% below	37%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 HCHG 20610 ARTHROCENTESIS, ASP/INJ, LRG JNT	$280.86	$443.00	$187.39–$420.85	—	37%
Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 HCHG 11981 INSERTION, DRUG-DELIVERY IMPLANT (IE, RESORB, BIODEGR	$280.23	$442.00	$186.97–$419.90	6% above	37%
Insertion of a drug-delivery implant, such as the arm birth control implant inpatient CPT 11981 HCHG 11981 INSERTION, DRUG-DELIVERY IMPLANT (IE, RESORB, BIODEGR	$280.23	$442.00	$186.97–$419.90	—	37%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 HCHG 20605 ARTHROCENTESIS,ASP/INJ, INT JNT	$221.90	$350.00	$148.05–$332.50	31% below	37%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 HCHG 20605 ARTHROCENTESIS,ASP/INJ, INT JNT	$221.90	$350.00	$148.05–$332.50	—	37%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 HCHG 20600 ARTHORCENTESIS,ASP/INJ SM JNT	$154.06	$243.00	$102.79–$230.85	58% below	37%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 HCHG 20600 ARTHORCENTESIS,ASP/INJ SM JNT	$154.06	$243.00	$102.79–$230.85	—	37%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 HCHG 12031 REPAIR INTERMEDIATE WOUND, SCALP, AXILLAE, TRUNK, EXT	$511.00	$806.00	$340.94–$765.70	3% below	37%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 HCHG 12031 REPAIR INTERMEDIATE WOUND, SCALP, AXILLAE, TRUNK, EXT	$511.00	$806.00	$340.94–$765.70	—	37%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 HCHG 11440 EXCISION BENIGN LESION; <.5CM	$429.22	$677.00	$286.37–$643.15	17% below	37%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 HCHG 11440 EXCISION BENIGN LESION; <.5CM	$429.22	$677.00	$286.37–$643.15	—	37%
Nail removal (partial or complete), one nail CPT 11730 HCHG 11730 AVULSION NAIL PLATE	$146.45	$231.00	$97.71–$219.45	38% below	37%
Nail removal (partial or complete), one nail inpatient CPT 11730 HCHG 11730 AVULSION NAIL PLATE	$146.45	$231.00	$97.71–$219.45	—	37%
Paracentesis with imaging guidance CPT 49083 HCHG 49083 ABD PARACENTESIS; W/IMAGING GUIDANCE	$921.20	$1,453.00	$614.62–$1,380.35	28% below	37%
Paracentesis with imaging guidance inpatient CPT 49083 HCHG 49083 ABD PARACENTESIS; W/IMAGING GUIDANCE	$921.20	$1,453.00	$614.62–$1,380.35	—	37%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 HCHG 11750 REMOVAL NAIL BED PERMANENT	$582.01	$918.00	$388.31–$872.10	78% above	37%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 HCHG 11750 REMOVAL NAIL BED PERMANENT	$582.01	$918.00	$388.31–$872.10	—	37%
Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 HCHG 64635 DESTRUCT FACET JOINT;LUMB/SAC;SINGLE	$1,949.55	$3,075.00	$1,300.73–$2,921.25	21% below	37%
Radiofrequency ablation of facet joint nerves, lower back, one level inpatient CPT 64635 HCHG 64635 DESTRUCT FACET JOINT;LUMB/SAC;SINGLE	$1,949.55	$3,075.00	$1,300.73–$2,921.25	—	37%
Removal of a foreign object under the skin, simple CPT 10120 HCHG 10120 INC&REMOVAL FB SIMPLE	$373.43	$589.00	$249.15–$559.55	11% above	37%
Removal of a foreign object under the skin, simple inpatient CPT 10120 HCHG 10120 INC&REMOVAL FB SIMPLE	$373.43	$589.00	$249.15–$559.55	—	37%
Screening colonoscopy for a person at average risk (Medicare code) HCPCS G0121 HCHG G0121P COLORECTAL CANCER SCREENING; COLONOSCOPY (PT NOT MEE	$1,990.76	$3,140.00	$444.28–$2,983.00	4% above	37%
Screening colonoscopy for a person at average risk (Medicare code) inpatient HCPCS G0121 HCHG G0121P COLORECTAL CANCER SCREENING; COLONOSCOPY (PT NOT MEE	$1,990.76	$3,140.00	$1,328.22–$2,983.00	—	37%
Screening colonoscopy, high risk of colorectal cancer (Medicare code) HCPCS G0105 HCHG G0105P COLORECTAL CANCER SCREENING; COLONOSCOPY, HIGH RISK	$1,990.76	$3,140.00	$444.28–$2,983.00	6% above	37%
Screening colonoscopy, high risk of colorectal cancer (Medicare code) inpatient HCPCS G0105 HCHG G0105P COLORECTAL CANCER SCREENING; COLONOSCOPY, HIGH RISK	$1,990.76	$3,140.00	$1,328.22–$2,983.00	—	37%
Short arm cast (elbow to hand) CPT 29075 HCHG 29075 APPLY SHORT ARM CAST	$268.82	$424.00	$179.35–$402.80	7% above	37%
Short arm cast (elbow to hand) inpatient CPT 29075 HCHG 29075 APPLY SHORT ARM CAST	$268.82	$424.00	$179.35–$402.80	—	37%
Short arm splint (forearm and hand) CPT 29125 HCHG 29125 APPLY SHORT ARM SPLINT	$137.58	$217.00	$91.79–$206.15	22% below	37%
Short arm splint (forearm and hand) inpatient CPT 29125 HCHG 29125 APPLY SHORT ARM SPLINT	$137.58	$217.00	$91.79–$206.15	—	37%
Short leg cast (below the knee) CPT 29405 HCHG 29405 APPLY SHORT LEG CAST(KNEE-TOE)	$274.52	$433.00	$183.16–$411.35	17% above	37%
Short leg cast (below the knee) inpatient CPT 29405 HCHG 29405 APPLY SHORT LEG CAST(KNEE-TOE)	$274.52	$433.00	$183.16–$411.35	—	37%
Short leg splint (calf to foot) CPT 29515 HCHG 29515 APPLY SHT LEG SPLT(CALF-FOOT)	$169.91	$268.00	$113.36–$254.60	18% below	37%
Short leg splint (calf to foot) inpatient CPT 29515 HCHG 29515 APPLY SHT LEG SPLT(CALF-FOOT)	$169.91	$268.00	$113.36–$254.60	—	37%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 HCHG 12001 SIMP LAC<2.6CM BDY/SCLP/HND/FT	$408.30	$644.00	$272.41–$611.80	25% above	37%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 HCHG 12001 SIMP LAC<2.6CM BDY/SCLP/HND/FT	$408.30	$644.00	$272.41–$611.80	—	37%
Skin biopsy, punch, one lesion CPT 11104 HCHG 11104 PUNCH BIOPSY SKIN; SINGLE LESION	$252.33	$398.00	$168.35–$378.10	5% above	37%
Skin biopsy, punch, one lesion inpatient CPT 11104 HCHG 11104 PUNCH BIOPSY SKIN; SINGLE LESION	$252.33	$398.00	$168.35–$378.10	—	37%
Spinal tap (lumbar puncture), diagnostic CPT 62270 HCHG 62270 SPINAL PUNCTURE, LUMBAR,DIAGNOSTIC;	$732.90	$1,156.00	$488.99–$1,098.20	21% above	37%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 HCHG 62270 SPINAL PUNCTURE, LUMBAR,DIAGNOSTIC;	$732.90	$1,156.00	$488.99–$1,098.20	—	37%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 HCHG 12002 SIMPLE LACERATION 2.6-7.5 CM	$445.07	$702.00	$296.95–$666.90	120% above	37%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 HCHG 12002 SIMPLE LACERATION 2.6-7.5 CM	$445.07	$702.00	$296.95–$666.90	—	37%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 HCHG 12011 SIMP LAC FACE/CHIN/EARS <2.5CM	$420.34	$663.00	$280.45–$629.85	36% above	37%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 HCHG 12011 SIMP LAC FACE/CHIN/EARS <2.5CM	$420.34	$663.00	$280.45–$629.85	—	37%
Tangential (shave-style) skin biopsy, one lesion CPT 11102 HCHG 11102 TANGENTIAL BIOPSY OF SKIN; SINGLE LESION	$216.19	$341.00	$144.24–$323.95	10% below	37%
Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 HCHG 11102 TANGENTIAL BIOPSY OF SKIN; SINGLE LESION	$216.19	$341.00	$144.24–$323.95	—	37%
Thoracentesis with imaging guidance CPT 32555 HCHG 32555 THORACENTESIS,ASP PLEURAL SPACE;W/IMAG GUID	$617.52	$974.00	$412.00–$925.30	49% below	37%
Thoracentesis with imaging guidance inpatient CPT 32555 HCHG 32555 THORACENTESIS,ASP PLEURAL SPACE;W/IMAG GUID	$617.52	$974.00	$412.00–$925.30	—	37%
Trigger point injections, 1 or 2 muscles CPT 20552 HCHG 20552 INJ SLG/MULT TRIG PNT 1-2 MUSC	$284.03	$448.00	$189.50–$425.60	20% below	37%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 HCHG 20552 INJ SLG/MULT TRIG PNT 1-2 MUSC	$284.03	$448.00	$189.50–$425.60	—	37%
Upper endoscopy (EGD) with balloon widening of the esophagus CPT 43249 HCHG 43249P EGD W/BALLOON DILATION OF ESOPHAGUS	$2,425.68	$3,826.00	$452.72–$3,634.70	9% below	37%
Upper endoscopy (EGD) with balloon widening of the esophagus inpatient CPT 43249 HCHG 43249P EGD W/BALLOON DILATION OF ESOPHAGUS	$2,425.68	$3,826.00	$1,618.40–$3,634.70	—	37%
Upper endoscopy (EGD) with biopsy CPT 43239 HCHG 43239P EGD W/BIOPSY, SGL OR MULT	$1,708.00	$2,694.00	$452.72–$2,559.30	8% above	37%
Upper endoscopy (EGD) with biopsy inpatient CPT 43239 HCHG 43239P EGD W/BIOPSY, SGL OR MULT	$1,708.00	$2,694.00	$1,139.56–$2,559.30	—	37%
Upper endoscopy (EGD) with injection into the lining CPT 43236 HCHG 43236P EGD W/DIR SUBMUC INJ, ANY SUBSTANCE	$1,595.14	$2,516.00	$452.72–$2,390.20	5% above	37%
Upper endoscopy (EGD) with injection into the lining inpatient CPT 43236 HCHG 43236P EGD W/DIR SUBMUC INJ, ANY SUBSTANCE	$1,595.14	$2,516.00	$1,064.27–$2,390.20	—	37%
Upper endoscopy (EGD) with polyp removal by snare CPT 43251 HCHG 43251P EGD W/REM POLYP,TUMOR,LESION-SNARE	$1,926.73	$3,039.00	$452.72–$2,887.05	13% below	37%
Upper endoscopy (EGD) with polyp removal by snare inpatient CPT 43251 HCHG 43251P EGD W/REM POLYP,TUMOR,LESION-SNARE	$1,926.73	$3,039.00	$1,285.50–$2,887.05	—	37%
Upper endoscopy (EGD) with widening of the esophagus over a guide wire CPT 43248 HCHG 43248P EGD W/INSERT GUIDEWIRE AND DILATION	$1,699.12	$2,680.00	$452.72–$2,546.00	8% below	37%
Upper endoscopy (EGD) with widening of the esophagus over a guide wire inpatient CPT 43248 HCHG 43248P EGD W/INSERT GUIDEWIRE AND DILATION	$1,699.12	$2,680.00	$1,133.64–$2,546.00	—	37%
Upper endoscopy (EGD), diagnostic CPT 43235 HCHG 43235P EGD; DIAGNOSTIC	$1,538.08	$2,426.00	$452.72–$2,304.70	5% above	37%
Upper endoscopy (EGD), diagnostic inpatient CPT 43235 HCHG 43235P EGD; DIAGNOSTIC	$1,538.08	$2,426.00	$1,026.20–$2,304.70	—	37%
Wart removal, up to 14 warts CPT 17110 HCHG 17110 DEST BENIGN LESIONS, UP TO 14	$247.26	$390.00	$164.97–$370.50	26% above	37%
Wart removal, up to 14 warts inpatient CPT 17110 HCHG 17110 DEST BENIGN LESIONS, UP TO 14	$247.26	$390.00	$164.97–$370.50	—	37%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 HCHG 11042 DEBRIDE SUBQ TISS 20 SQ CM/<	$224.44	$354.00	$149.74–$336.30	58% below	37%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 HCHG 11042 DEBRIDE SUBQ TISS 20 SQ CM/<	$224.44	$354.00	$149.74–$336.30	—	37%

Doctor visits and therapy

Procedure	Cash price	List price	Insurers pay	vs Wisconsin	Off list
Blood transfusion (giving blood or blood components) CPT 36430 HCHG 36430 TRANSFUSION-BLOOD/PRODUCTS-OP	$426.05	$672.00	$284.26–$638.40	27% below	37%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 HCHG 36430 TRANSFUSION-BLOOD/PRODUCTS-OP	$426.05	$672.00	$284.26–$638.40	—	37%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HCHG 94640 SPUTUM INDUCTION	$200.34	$316.00	$133.67–$300.20	132% above	37%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HCHG 94640 MDI TREATMENT-INITIAL	$200.34	$316.00	$133.67–$300.20	132% above	37%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HCHG 94640 SMALL VOLUME NEB TRT-INITIAL	$200.34	$316.00	$133.67–$300.20	132% above	37%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HCHG 94640 NON/PRESSURIZED INHALATION TRT	$200.34	$316.00	$133.67–$300.20	132% above	37%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HCHG 94640 PAP THERAPY, INITIAL TREATMENT	$200.34	$316.00	$133.67–$300.20	132% above	37%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HCHG 94640 SM VOLUME NEBULIZER TRT-SUBSEQ	$200.34	$316.00	$133.67–$300.20	132% above	37%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HCHG 94640 MDI TREATMENT-SUBSEQUENT	$200.34	$316.00	$133.67–$300.20	132% above	37%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HCHG 94640 PAP THERAPY,SUBSEQUENT TRTMENT	$200.34	$316.00	$133.67–$300.20	132% above	37%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HCHG 94640 NON/PRESSURIZED INHALATION TRT	$200.34	$316.00	$133.67–$300.20	—	37%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HCHG 94640 SM VOLUME NEBULIZER TRT-SUBSEQ	$200.34	$316.00	$133.67–$300.20	—	37%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HCHG 94640 MDI TREATMENT-INITIAL	$200.34	$316.00	$133.67–$300.20	—	37%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HCHG 94640 MDI TREATMENT-SUBSEQUENT	$200.34	$316.00	$133.67–$300.20	—	37%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HCHG 94640 SPUTUM INDUCTION	$200.34	$316.00	$133.67–$300.20	—	37%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HCHG 94640 SMALL VOLUME NEB TRT-INITIAL	$200.34	$316.00	$133.67–$300.20	—	37%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HCHG 94640 PAP THERAPY, INITIAL TREATMENT	$200.34	$316.00	$133.67–$300.20	—	37%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HCHG 94640 PAP THERAPY,SUBSEQUENT TRTMENT	$200.34	$316.00	$133.67–$300.20	—	37%
Chemotherapy IV infusion, first hour CPT 96413 HCHG 96413 CHEMO ADM IV INF TECH UPTO 1HR	$466.62	$736.00	$311.33–$699.20	17% below	37%
Chemotherapy IV infusion, first hour inpatient CPT 96413 HCHG 96413 CHEMO ADM IV INF TECH UPTO 1HR	$466.62	$736.00	$311.33–$699.20	—	37%
Comprehensive hearing test: tone and speech audiometry, both ears CPT 92557 HCHG 92557 COMPREHENSIVE AUDIOMETRY-THRES	$133.77	$211.00	$89.25–$200.45	14% below	37%
Comprehensive hearing test: tone and speech audiometry, both ears inpatient CPT 92557 HCHG 92557 COMPREHENSIVE AUDIOMETRY-THRES	$133.77	$211.00	$89.25–$200.45	—	37%
Critical care, first 30 to 74 minutes CPT 99291 HCHG 99291 CRITICAL CARE 1ST 30-74 MIN	$1,446.79	$2,282.00	$965.29–$2,167.90	19% below	37%
Critical care, first 30 to 74 minutes inpatient CPT 99291 HCHG 99291 CRITICAL CARE 1ST 30-74 MIN	$1,446.79	$2,282.00	$965.29–$2,167.90	—	37%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 HCHG 93005 ELECTROCARDIOGRAM, ROUTINE ECG, TRACING ONLY	$136.94	$216.00	$11.76–$205.20	7% below	37%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 PR ELECTROCARDIOGRAM, ROUTINE ECG, TRACING ONLY	$136.94	$216.00	$11.76–$205.20	7% below	37%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 HCHG 93005 ELECTROCARDIOGRAM, ROUTINE ECG, TRACING ONLY	$136.94	$216.00	$91.37–$205.20	—	37%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 PR ELECTROCARDIOGRAM, ROUTINE ECG, TRACING ONLY	$136.94	$216.00	$91.37–$205.20	—	37%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 HCHG 99281 EMERGENCY SERVICE I	$168.64	$266.00	$112.52–$252.70	10% below	37%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 HCHG 99281 EMERGENCY SERVICE I	$168.64	$266.00	$112.52–$252.70	—	37%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 HCHG 99282 EMERGENCY SERVICE II	$301.78	$476.00	$201.35–$452.20	7% below	37%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 HCHG 99282 EMERGENCY SERVICE II	$301.78	$476.00	$201.35–$452.20	—	37%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 HCHG 99283 EMERGENCY SERVICE III	$443.17	$699.00	$295.68–$664.05	25% below	37%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 HCHG 99283 EMERGENCY SERVICE III	$443.17	$699.00	$295.68–$664.05	—	37%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 HCHG 99284 EMERGENCY SERVICE IV	$717.05	$1,131.00	$478.41–$1,074.45	22% below	37%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 HCHG 99284 EMERGENCY SERVICE IV	$717.05	$1,131.00	$478.41–$1,074.45	—	37%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 HCHG 99285 EMERGENCY SERVICE V	$1,078.43	$1,701.00	$719.52–$1,615.95	26% below	37%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 HCHG 99285 EMERGENCY SERVICE V	$1,078.43	$1,701.00	$719.52–$1,615.95	—	37%
Exercise stress test, tracing only, the hospital charge CPT 93017 HCHG 93017 CARDIOVASCULAR STRESS TEST, TREADMILL/BICYCLE, CONT M	$556.02	$877.00	$370.97–$833.15	30% below	37%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 HCHG 93017 CARDIOVASCULAR STRESS TEST, TREADMILL/BICYCLE, CONT M	$556.02	$877.00	$370.97–$833.15	—	37%
Family therapy with the patient, 50 minutes CPT 90847 HCHG 90847 FAMILY PSYCHOTHERAPY W/PT PRESENT, 50 MIN	$170.55	$269.00	$113.79–$255.55	10% below	37%
Family therapy with the patient, 50 minutes inpatient CPT 90847 HCHG 90847 FAMILY PSYCHOTHERAPY W/PT PRESENT, 50 MIN	$170.55	$269.00	$113.79–$255.55	—	37%
Family therapy without the patient, 50 minutes CPT 90846 HCHG 90846 FAM PSYCHOTHERAPY W/O PATIENT, 50 MIN	$170.55	$269.00	$113.79–$255.55	7% below	37%
Family therapy without the patient, 50 minutes inpatient CPT 90846 HCHG 90846 FAM PSYCHOTHERAPY W/O PATIENT, 50 MIN	$170.55	$269.00	$113.79–$255.55	—	37%
Group psychotherapy session CPT 90853 HCHG 90853 GROUP PSYCHOTHERAPY	$88.76	$140.00	$59.22–$133.00	18% above	37%
Group psychotherapy session inpatient CPT 90853 HCHG 90853 GROUP PSYCHOTHERAPY	$88.76	$140.00	$59.22–$133.00	—	37%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 HCHG 96360 IV INF HYD;INIT UPTO 1HR	$284.03	$448.00	$189.50–$425.60	at median	37%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 HCHG 96360 IV INF HYD;INIT UPTO 1HR	$284.03	$448.00	$189.50–$425.60	—	37%
IV infusion of a medicine, first hour CPT 96365 HCHG 96365 IV INF THER;UP TO 1 HR	$305.59	$482.00	$203.89–$457.90	4% below	37%
IV infusion of a medicine, first hour inpatient CPT 96365 HCHG 96365 IV INF THER;UP TO 1 HR	$305.59	$482.00	$203.89–$457.90	—	37%
IV push of a medicine, first drug CPT 96374 HCHG 96374 INJ;IV PUSH SNGL/INIT	$232.68	$367.00	$155.24–$348.65	41% above	37%
IV push of a medicine, first drug inpatient CPT 96374 HCHG 96374 INJ;IV PUSH SNGL/INIT	$232.68	$367.00	$155.24–$348.65	—	37%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 HCHG 96372 INJ;SUBCUT/INTRAMUSC	$75.45	$119.00	$50.34–$113.05	6% below	37%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 HCHG 96372 INJ;SUBCUT/INTRAMUSC	$75.45	$119.00	$50.34–$113.05	—	37%
Mental health diagnostic evaluation (intake), without medical services CPT 90791 HCHG 90791 PSYC DIAGNOSTIC EVAL DRUG	$228.24	$360.00	$152.28–$342.00	4% above	37%
Mental health diagnostic evaluation (intake), without medical services CPT 90791 HCHG 90791 PSYC DIAGNOSTIC EVAL MNTL	$228.24	$360.00	$152.28–$342.00	4% above	37%
Mental health diagnostic evaluation (intake), without medical services CPT 90791 HCHG 90791 PSYC DIAGNOSTIC EVAL ALC	$228.24	$360.00	$152.28–$342.00	4% above	37%
Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 HCHG 90791 PSYC DIAGNOSTIC EVAL MNTL	$228.24	$360.00	$152.28–$342.00	—	37%
Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 HCHG 90791 PSYC DIAGNOSTIC EVAL ALC	$228.24	$360.00	$152.28–$342.00	—	37%
Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 HCHG 90791 PSYC DIAGNOSTIC EVAL DRUG	$228.24	$360.00	$152.28–$342.00	—	37%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 HCHG 97112 NEUROMUSCULAR RE-ED	$95.73	$151.00	$63.87–$143.45	—	37%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 HCHG 97802 MED NUTRIT THERAPY-INIT-EA 15M	$41.21	$65.00	$27.50–$61.75	31% below	37%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 PR MEDICAL NUTRITION THERAPY; INITIAL EVAL, INDIVIDUAL, EA 15 MI	$41.21	$65.00	$27.50–$61.75	31% below	37%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 HCHG 97802 MED NUTRIT THERAPY-INIT-EA 15M	$41.21	$65.00	$27.50–$61.75	—	37%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 PR MEDICAL NUTRITION THERAPY; INITIAL EVAL, INDIVIDUAL, EA 15 MI	$41.21	$65.00	$27.50–$61.75	—	37%
Occupational therapy evaluation, low complexity inpatient CPT 97165 HCHG 97165 OT EVALUATION, LOW COMPLEXITY	$211.12	$333.00	$140.86–$316.35	—	37%
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 HCHG 97163 PT EVALUATION, HIGH COMPLEXITY	$247.26	$390.00	$164.97–$370.50	—	37%
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 HCHG 97161 PT EVALUATION, LOW COMPLEXITY	$176.25	$278.00	$117.59–$264.10	—	37%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 HCHG 97162 PT EVALUATION, MODERATE COMPLEXITY	$213.02	$336.00	$142.13–$319.20	—	37%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 HCHG 97140 MANUAL THERAPY(SOFT TISS) 15MIN	$88.13	$139.00	$58.80–$132.05	—	37%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 HCHG 97140 LYMPHEDEMA-15 MIN	$88.13	$139.00	$58.80–$132.05	—	37%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 HCHG 97140 MANUAL THERAPY (JNT MOBIL)15MN	$88.13	$139.00	$58.80–$132.05	—	37%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 HCHG 97110 THERAPUTIC PROCEDURE, EACH 15 MIN; THERAPUTIC EXERCIS	$93.20	$147.00	$62.18–$139.65	—	37%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 HCHG 97110 THERAPUTIC PROCEDURE, 15 MIN; THERAPUTIC EXERCISE, 1:	$93.20	$147.00	$62.18–$139.65	—	37%
Psychiatric evaluation with medical services CPT 90792 HCHG 90792 PSYCHIATRIC DIAGNOSTIC EVAL W/MEDICAL SVC	$236.48	$373.00	$157.78–$354.35	14% below	37%
Psychiatric evaluation with medical services inpatient CPT 90792 HCHG 90792 PSYCHIATRIC DIAGNOSTIC EVAL W/MEDICAL SVC	$236.48	$373.00	$157.78–$354.35	—	37%
Psychotherapy for crisis, first 60 minutes CPT 90839 HCHG 90839 PSYCHOTHERAPY FOR CRISIS; 1ST 60 MIN	$323.97	$511.00	$216.15–$485.45	10% above	37%
Psychotherapy for crisis, first 60 minutes inpatient CPT 90839 HCHG 90839 PSYCHOTHERAPY FOR CRISIS; 1ST 60 MIN	$323.97	$511.00	$216.15–$485.45	—	37%
Psychotherapy session, 30 minutes CPT 90832 HCHG 90832 PSYCHOTHERAPY 30 MIN MNTL	$96.37	$152.00	$64.30–$144.40	9% below	37%
Psychotherapy session, 30 minutes inpatient CPT 90832 HCHG 90832 PSYCHOTHERAPY 30 MIN MNTL	$96.37	$152.00	$64.30–$144.40	—	37%
Psychotherapy session, 45 minutes CPT 90834 HCHG 90834 PSYCHOTHERAPY 45 MIN MNTL	$146.45	$231.00	$97.71–$219.45	3% above	37%
Psychotherapy session, 45 minutes CPT 90834 HCHG 90834 PSYCHOTHERAPY 45 MIN DRUG	$146.45	$231.00	$97.71–$219.45	3% above	37%
Psychotherapy session, 45 minutes CPT 90834 HCHG 90834 PSYCHOTHERAPY 45 MIN ALC	$146.45	$231.00	$97.71–$219.45	3% above	37%
Psychotherapy session, 45 minutes inpatient CPT 90834 HCHG 90834 PSYCHOTHERAPY 45 MIN DRUG	$146.45	$231.00	$97.71–$219.45	—	37%
Psychotherapy session, 45 minutes inpatient CPT 90834 HCHG 90834 PSYCHOTHERAPY 45 MIN ALC	$146.45	$231.00	$97.71–$219.45	—	37%
Psychotherapy session, 45 minutes inpatient CPT 90834 HCHG 90834 PSYCHOTHERAPY 45 MIN MNTL	$146.45	$231.00	$97.71–$219.45	—	37%
Psychotherapy session, 60 minutes CPT 90837 HCHG 90837 PSYCHOTHERAPY 60 MIN MNTL	$170.55	$269.00	$113.79–$255.55	20% below	37%
Psychotherapy session, 60 minutes inpatient CPT 90837 HCHG 90837 PSYCHOTHERAPY 60 MIN MNTL	$170.55	$269.00	$113.79–$255.55	—	37%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 HCHG 99406 SMOKING CESSAT COUNSELING 3-10 MIN	$62.13	$98.00	$41.45–$93.10	115% above	37%
Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 HCHG 99406 SMOKING CESSAT COUNSELING 3-10 MIN	$62.13	$98.00	$41.45–$93.10	—	37%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 HCHG 99215 OFFICE OUTPATIENT VISIT 40 MIN MET/EXCEEDED	$195.27	$308.00	$130.28–$292.60	34% below	37%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 HCHG 99215 URGENT CARE OFFICE/OUTPATIENT VISIT EST 40 MIN MET/EX	$195.27	$308.00	$130.28–$292.60	34% below	37%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 HCHG 99215 URGENT CARE OFFICE/OUTPATIENT VISIT EST 40 MIN MET/EX	$195.27	$308.00	$130.28–$292.60	—	37%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 HCHG 99215 OFFICE OUTPATIENT VISIT 40 MIN MET/EXCEEDED	$195.27	$308.00	$130.28–$292.60	—	37%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 HCHG 99213 URGENT CARE OFFICE/OUTPATIENT VISIT EST 20 MIN MET/EX	$93.20	$147.00	$62.18–$139.65	43% below	37%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 HCHG 99213 OFFICE OUTPATIENT VISIT 20 MIN MET/EXCEEDED	$93.20	$147.00	$62.18–$139.65	43% below	37%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 HCHG 99213 URGENT CARE OFFICE/OUTPATIENT VISIT EST 20 MIN MET/EX	$93.20	$147.00	$62.18–$139.65	—	37%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 HCHG 99213 OFFICE OUTPATIENT VISIT 20 MIN MET/EXCEEDED	$93.20	$147.00	$62.18–$139.65	—	37%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 HCHG 99214 OFFICE OUTPATIENT VISIT 30 MIN MET/EXCEEDED	$140.11	$221.00	$93.48–$209.95	25% below	37%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 HCHG 99214 URGENT CARE OFFICE/OUTPATIENT VISIT EST 30 MIN MET/EX	$140.11	$221.00	$93.48–$209.95	25% below	37%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 HCHG 99214 URGENT CARE OFFICE/OUTPATIENT VISIT EST 30 MIN MET/EX	$140.11	$221.00	$93.48–$209.95	—	37%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 HCHG 99214 OFFICE OUTPATIENT VISIT 30 MIN MET/EXCEEDED	$140.11	$221.00	$93.48–$209.95	—	37%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 HCHG 99212 URGENT CARE OFFICE/OUTPATIENT VISIT EST PT 10 MIN MET	$58.96	$93.00	$39.34–$88.35	39% below	37%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 HCHG 99212 OFFICE OUTPATIENT VISIT 10 MIN MET/EXCEEDED	$58.96	$93.00	$39.34–$88.35	39% below	37%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 HCHG 99212 URGENT CARE OFFICE/OUTPATIENT VISIT EST PT 10 MIN MET	$58.96	$93.00	$39.34–$88.35	—	37%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 HCHG 99212 OFFICE OUTPATIENT VISIT 10 MIN MET/EXCEEDED	$58.96	$93.00	$39.34–$88.35	—	37%
Speech and language evaluation inpatient CPT 92523 HCHG 92523 EVAL SPEECH SOUND PROD W/EVAL LANG COMP	$624.49	$985.00	$416.66–$935.75	—	37%
Speech therapy session, individual inpatient CPT 92507 HCHG 92507 SPEECH LANGUAGE THERAPY, INDIVIDUAL	$268.18	$423.00	$178.93–$401.85	—	37%
Spirometry (breathing test) CPT 94010 HCHG 94010 SPIROMETRY-COMPLETE W REPORT	$198.44	$313.00	$132.40–$297.35	29% below	37%
Spirometry (breathing test) CPT 94010 HCHG 94010 SPIRO-ROUT-SCREENING	$198.44	$313.00	$132.40–$297.35	29% below	37%
Spirometry (breathing test) CPT 94010 HCHG 94010 BEDSIDE SCREENING SPIROMETRY	$198.44	$313.00	$132.40–$297.35	29% below	37%
Spirometry (breathing test) inpatient CPT 94010 HCHG 94010 SPIROMETRY-COMPLETE W REPORT	$198.44	$313.00	$132.40–$297.35	—	37%
Spirometry (breathing test) inpatient CPT 94010 HCHG 94010 SPIRO-ROUT-SCREENING	$198.44	$313.00	$132.40–$297.35	—	37%
Spirometry (breathing test) inpatient CPT 94010 HCHG 94010 BEDSIDE SCREENING SPIROMETRY	$198.44	$313.00	$132.40–$297.35	—	37%
Spirometry before and after a bronchodilator CPT 94060 HCHG 94060 BRONCHODILATION RESPONSIVENESS	$354.41	$559.00	$236.46–$531.05	27% below	37%
Spirometry before and after a bronchodilator inpatient CPT 94060 HCHG 94060 BRONCHODILATION RESPONSIVENESS	$354.41	$559.00	$236.46–$531.05	—	37%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 HCHG 97530 THERAP FUNCT ACTIV 15MIN	$97.64	$154.00	$65.14–$146.30	—	37%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 HCHG 99195 PHLEBOTOMY-THERAPUTIC	$275.16	$434.00	$183.58–$412.30	38% above	37%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 HCHG 99195 PHLEBOTOMY-THERAPUTIC	$275.16	$434.00	$183.58–$412.30	—	37%
Visual field test, extended CPT 92083 PR VISUAL FIELDS EXAMINATION, W/INTERP & RPT; EXTENDED	$101.44	$160.00	$67.68–$152.00	1% below	37%
Visual field test, extended inpatient CPT 92083 PR VISUAL FIELDS EXAMINATION, W/INTERP & RPT; EXTENDED	$101.44	$160.00	$67.68–$152.00	—	37%

Vaccines

Procedure	Cash price	List price	Insurers pay	vs Wisconsin	Off list
COVID-19 vaccine (Moderna), age 12 and older CPT 91322 PR SARS-COV-2 VACC, 50MCG/0.5ML, MRNA LNP, IM	$219.36	$346.00	$179.92–$328.70	31% above	37%
COVID-19 vaccine (Moderna), age 12 and older CPT 91322 PR SARS-COV-2 VACC, 50MCG/0.5ML, MRNA LNP, IM	$219.36	$346.00	$161.65–$328.70	31% above	37%
COVID-19 vaccine (Moderna), age 12 and older inpatient CPT 91322 PR SARS-COV-2 VACC, 50MCG/0.5ML, MRNA LNP, IM	$219.36	$346.00	$161.65–$328.70	—	37%
COVID-19 vaccine (Moderna), age 12 and older inpatient CPT 91322 PR SARS-COV-2 VACC, 50MCG/0.5ML, MRNA LNP, IM	$219.36	$346.00	$179.92–$328.70	—	37%
COVID-19 vaccine (Pfizer-BioNTech), age 12 and older CPT 91320 COMIRNATY 2023-24 (12Y UP)(PF) 30 MCG/0.3 ML IM SUSP	$193.94	$305.90	$168.37–$290.61	19% above	37%
COVID-19 vaccine (Pfizer-BioNTech), age 12 and older CPT 91320 COMIRNATY 2023-24 (12Y UP)(PF) 30 MCG/0.3 ML IM SUSP	$193.94	$305.90	$159.07–$290.61	19% above	37%
COVID-19 vaccine (Pfizer-BioNTech), age 12 and older CPT 91320 PR SARS-COV-2 VACC, 30MCG/0.3ML, MRNA LNP, IM	$218.10	$344.00	$168.37–$326.80	34% above	37%
COVID-19 vaccine (Pfizer-BioNTech), age 12 and older CPT 91320 PR SARS-COV-2 VACC, 30MCG/0.3ML, MRNA LNP, IM	$218.10	$344.00	$178.88–$326.80	34% above	37%
COVID-19 vaccine (Pfizer-BioNTech), age 12 and older inpatient CPT 91320 COMIRNATY 2023-24 (12Y UP)(PF) 30 MCG/0.3 ML IM SUSP	$193.94	$305.90	$168.37–$290.61	—	37%
COVID-19 vaccine (Pfizer-BioNTech), age 12 and older inpatient CPT 91320 COMIRNATY 2023-24 (12Y UP)(PF) 30 MCG/0.3 ML IM SUSP	$193.94	$305.90	$159.07–$290.61	—	37%
COVID-19 vaccine (Pfizer-BioNTech), age 12 and older inpatient CPT 91320 PR SARS-COV-2 VACC, 30MCG/0.3ML, MRNA LNP, IM	$218.10	$344.00	$178.88–$326.80	—	37%
COVID-19 vaccine (Pfizer-BioNTech), age 12 and older inpatient CPT 91320 PR SARS-COV-2 VACC, 30MCG/0.3ML, MRNA LNP, IM	$218.10	$344.00	$168.37–$326.80	—	37%
Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 PR VARICELLA VIRUS VACCINE (VAR), LIVE, FOR SUBCUTANEOUS USE	$98.90	$156.00	$65.99–$148.20	40% below	37%
Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 PR VARICELLA VIRUS VACCINE (VAR), LIVE, FOR SUBCUTANEOUS USE	$98.90	$156.00	$65.99–$148.20	40% below	37%
Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 PR VARICELLA VIRUS VACCINE (VAR), LIVE, FOR SUBCUTANEOUS USE	$98.90	$156.00	$65.99–$148.20	—	37%
Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 PR VARICELLA VIRUS VACCINE (VAR), LIVE, FOR SUBCUTANEOUS USE	$98.90	$156.00	$65.99–$148.20	—	37%
DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) CPT 90696 PR DIPHTHERIA TETANUS TOXOIDS ACELLULAR PERTUSSIS & INACT POLIO	$72.28	$114.00	$48.22–$108.30	14% below	37%
DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) CPT 90696 PR DIPHTHERIA TETANUS TOXOIDS ACELLULAR PERTUSSIS & INACT POLIO	$72.28	$114.00	$48.22–$108.30	14% below	37%
DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) inpatient CPT 90696 PR DIPHTHERIA TETANUS TOXOIDS ACELLULAR PERTUSSIS & INACT POLIO	$72.28	$114.00	$48.22–$108.30	—	37%
DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) inpatient CPT 90696 PR DIPHTHERIA TETANUS TOXOIDS ACELLULAR PERTUSSIS & INACT POLIO	$72.28	$114.00	$48.22–$108.30	—	37%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 PR DIPHTHERIA, TETANUS TOXOIDS, AND ACELLULAR PERTUSSIS VACCINE	$34.87	$55.00	$23.27–$52.25	16% below	37%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 PR DIPHTHERIA, TETANUS TOXOIDS, AND ACELLULAR PERTUSSIS VACCINE	$34.87	$55.00	$23.27–$52.25	16% below	37%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 inpatient CPT 90700 PR DIPHTHERIA, TETANUS TOXOIDS, AND ACELLULAR PERTUSSIS VACCINE	$34.87	$55.00	$23.27–$52.25	—	37%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 inpatient CPT 90700 PR DIPHTHERIA, TETANUS TOXOIDS, AND ACELLULAR PERTUSSIS VACCINE	$34.87	$55.00	$23.27–$52.25	—	37%
DTaP, hepatitis B and polio combination vaccine (Pediarix) CPT 90723 PR DTAP-HEPB-IPV VACCINE INTRAMUSCULAR	$106.51	$168.00	$71.06–$159.60	23% below	37%
DTaP, hepatitis B and polio combination vaccine (Pediarix) CPT 90723 PR DTAP-HEPB-IPV VACCINE INTRAMUSCULAR	$106.51	$168.00	$71.06–$159.60	23% below	37%
DTaP, hepatitis B and polio combination vaccine (Pediarix) inpatient CPT 90723 PR DTAP-HEPB-IPV VACCINE INTRAMUSCULAR	$106.51	$168.00	$71.06–$159.60	—	37%
DTaP, hepatitis B and polio combination vaccine (Pediarix) inpatient CPT 90723 PR DTAP-HEPB-IPV VACCINE INTRAMUSCULAR	$106.51	$168.00	$71.06–$159.60	—	37%
DTaP, polio and Hib combination vaccine (Pentacel) CPT 90698 PR DTAP-IPV/HIB VACCINE FOR INTRAMUSCULAR USE	$117.29	$185.00	$78.26–$175.75	1% above	37%
DTaP, polio and Hib combination vaccine (Pentacel) CPT 90698 PR DTAP-IPV/HIB VACCINE FOR INTRAMUSCULAR USE	$117.29	$185.00	$78.26–$175.75	1% above	37%
DTaP, polio and Hib combination vaccine (Pentacel) inpatient CPT 90698 PR DTAP-IPV/HIB VACCINE FOR INTRAMUSCULAR USE	$117.29	$185.00	$78.26–$175.75	—	37%
DTaP, polio and Hib combination vaccine (Pentacel) inpatient CPT 90698 PR DTAP-IPV/HIB VACCINE FOR INTRAMUSCULAR USE	$117.29	$185.00	$78.26–$175.75	—	37%
DTaP, polio, Hib and hepatitis B combination vaccine (Vaxelis) CPT 90697 PR DTAP-IPV-HIB-HEPB VACCINE INTRAMUSCULAR	$150.89	$238.00	$100.67–$226.10	18% below	37%
DTaP, polio, Hib and hepatitis B combination vaccine (Vaxelis) CPT 90697 PR DTAP-IPV-HIB-HEPB VACCINE INTRAMUSCULAR	$150.89	$238.00	$100.67–$226.10	18% below	37%
DTaP, polio, Hib and hepatitis B combination vaccine (Vaxelis) inpatient CPT 90697 PR DTAP-IPV-HIB-HEPB VACCINE INTRAMUSCULAR	$150.89	$238.00	$100.67–$226.10	—	37%
DTaP, polio, Hib and hepatitis B combination vaccine (Vaxelis) inpatient CPT 90697 PR DTAP-IPV-HIB-HEPB VACCINE INTRAMUSCULAR	$150.89	$238.00	$100.67–$226.10	—	37%
Flu shot, recombinant, egg-free (Flublok) CPT 90673 PR RIV3 VACCINE PRESERVATIVE FREE FOR IM USE	$91.93	$145.00	$75.40–$137.75	23% above	37%
Flu shot, recombinant, egg-free (Flublok) CPT 90673 PR RIV3 VACCINE PRESERVATIVE FREE FOR IM USE	$91.93	$145.00	$13.14–$137.75	23% above	37%
Flu shot, recombinant, egg-free (Flublok) inpatient CPT 90673 PR RIV3 VACCINE PRESERVATIVE FREE FOR IM USE	$91.93	$145.00	$13.14–$137.75	—	37%
Flu shot, recombinant, egg-free (Flublok) inpatient CPT 90673 PR RIV3 VACCINE PRESERVATIVE FREE FOR IM USE	$91.93	$145.00	$75.40–$137.75	—	37%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 PR IIV3 VACC PRESERVATIVE FREE 0.5 ML DOSAGE IM USE	$47.55	$75.00	$13.14–$71.25	49% above	37%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 PR IIV3 VACC PRESERVATIVE FREE 0.5 ML DOSAGE IM USE	$47.55	$75.00	$39.00–$71.25	49% above	37%
Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 PR IIV3 VACC PRESERVATIVE FREE 0.5 ML DOSAGE IM USE	$47.55	$75.00	$13.14–$71.25	—	37%
Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 PR IIV3 VACC PRESERVATIVE FREE 0.5 ML DOSAGE IM USE	$47.55	$75.00	$39.00–$71.25	—	37%
HPV vaccine, 9-valent (Gardasil 9) CPT 90651 PR HUMAN PAPILLOMAVIRUS VACCINE, NONAVALENT (9VHPV), 2 OR 3 DOSE	$173.72	$274.00	$115.90–$260.30	45% below	37%
HPV vaccine, 9-valent (Gardasil 9) CPT 90651 PR HUMAN PAPILLOMAVIRUS VACCINE, NONAVALENT (9VHPV), 2 OR 3 DOSE	$173.72	$274.00	$115.90–$260.30	45% below	37%
HPV vaccine, 9-valent (Gardasil 9) inpatient CPT 90651 PR HUMAN PAPILLOMAVIRUS VACCINE, NONAVALENT (9VHPV), 2 OR 3 DOSE	$173.72	$274.00	$115.90–$260.30	—	37%
HPV vaccine, 9-valent (Gardasil 9) inpatient CPT 90651 PR HUMAN PAPILLOMAVIRUS VACCINE, NONAVALENT (9VHPV), 2 OR 3 DOSE	$173.72	$274.00	$115.90–$260.30	—	37%
Hepatitis A and B combination vaccine, adult (Twinrix) CPT 90636 PR HEPITITIS A AND HEPATITIS B VACCINE (HEPA-HEPB), ADULT DOSAGE	$135.68	$214.00	$90.52–$203.30	29% below	37%
Hepatitis A and B combination vaccine, adult (Twinrix) CPT 90636 PR HEPITITIS A AND HEPATITIS B VACCINE (HEPA-HEPB), ADULT DOSAGE	$135.68	$214.00	$90.52–$203.30	29% below	37%
Hepatitis A and B combination vaccine, adult (Twinrix) inpatient CPT 90636 PR HEPITITIS A AND HEPATITIS B VACCINE (HEPA-HEPB), ADULT DOSAGE	$135.68	$214.00	$90.52–$203.30	—	37%
Hepatitis A and B combination vaccine, adult (Twinrix) inpatient CPT 90636 PR HEPITITIS A AND HEPATITIS B VACCINE (HEPA-HEPB), ADULT DOSAGE	$135.68	$214.00	$90.52–$203.30	—	37%
Hepatitis A vaccine, adult dose CPT 90632 PR HEPATITIS A VACCINE (HEPA), ADULT DOSE, FOR INTRAMUSCULAR USE	$95.10	$150.00	$78.00–$142.50	28% below	37%
Hepatitis A vaccine, adult dose CPT 90632 PR HEPATITIS A VACCINE (HEPA), ADULT DOSE, FOR INTRAMUSCULAR USE	$95.10	$150.00	$13.14–$142.50	28% below	37%
Hepatitis A vaccine, adult dose inpatient CPT 90632 PR HEPATITIS A VACCINE (HEPA), ADULT DOSE, FOR INTRAMUSCULAR USE	$95.10	$150.00	$78.00–$142.50	—	37%
Hepatitis A vaccine, adult dose inpatient CPT 90632 PR HEPATITIS A VACCINE (HEPA), ADULT DOSE, FOR INTRAMUSCULAR USE	$95.10	$150.00	$13.14–$142.50	—	37%
Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 PR HEPATITIS A VACCINE (HEPA), PED/ADOLESCENT DOSE/2 DOSE SCHEDU	$43.11	$68.00	$28.76–$64.60	17% below	37%
Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 PR HEPATITIS A VACCINE (HEPA), PED/ADOLESCENT DOSE/2 DOSE SCHEDU	$43.11	$68.00	$28.76–$64.60	17% below	37%
Hepatitis A vaccine, child and teen dose (2-dose schedule) inpatient CPT 90633 PR HEPATITIS A VACCINE (HEPA), PED/ADOLESCENT DOSE/2 DOSE SCHEDU	$43.11	$68.00	$28.76–$64.60	—	37%
Hepatitis A vaccine, child and teen dose (2-dose schedule) inpatient CPT 90633 PR HEPATITIS A VACCINE (HEPA), PED/ADOLESCENT DOSE/2 DOSE SCHEDU	$43.11	$68.00	$28.76–$64.60	—	37%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 PR HEPATITIS B VACCINE (HEPB), ADULT, 3 DOSE SCHEDULE FOR IM USE	$76.71	$121.00	$13.14–$114.95	34% below	37%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 PR HEPATITIS B VACCINE (HEPB), ADULT, 3 DOSE SCHEDULE FOR IM USE	$76.71	$121.00	$62.92–$114.95	34% below	37%
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 PR HEPATITIS B VACCINE (HEPB), ADULT, 3 DOSE SCHEDULE FOR IM USE	$76.71	$121.00	$62.92–$114.95	—	37%
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 PR HEPATITIS B VACCINE (HEPB), ADULT, 3 DOSE SCHEDULE FOR IM USE	$76.71	$121.00	$13.14–$114.95	—	37%
Hepatitis B vaccine, adult, 2-dose schedule (Heplisav-B) CPT 90739 PR HEPATITIS B VACCINE (HEP B) ADULT 2 DOSE SCHEDULE FOR IM USE	$131.24	$207.00	$107.64–$196.65	39% below	37%
Hepatitis B vaccine, adult, 2-dose schedule (Heplisav-B) CPT 90739 PR HEPATITIS B VACCINE (HEP B) ADULT 2 DOSE SCHEDULE FOR IM USE	$131.24	$207.00	$13.14–$204.19	39% below	37%
Hepatitis B vaccine, adult, 2-dose schedule (Heplisav-B) CPT 90739 HEPLISAV-B (PF) 20 MCG/0.5 ML IM SYRG	$224.97	$354.85	$13.14–$337.11	5% above	37%
Hepatitis B vaccine, adult, 2-dose schedule (Heplisav-B) CPT 90739 HEPLISAV-B (PF) 20 MCG/0.5 ML IM SYRG	$224.97	$354.85	$184.52–$337.11	5% above	37%
Hepatitis B vaccine, adult, 2-dose schedule (Heplisav-B) inpatient CPT 90739 PR HEPATITIS B VACCINE (HEP B) ADULT 2 DOSE SCHEDULE FOR IM USE	$131.24	$207.00	$107.64–$196.65	—	37%
Hepatitis B vaccine, adult, 2-dose schedule (Heplisav-B) inpatient CPT 90739 PR HEPATITIS B VACCINE (HEP B) ADULT 2 DOSE SCHEDULE FOR IM USE	$131.24	$207.00	$13.14–$204.19	—	37%
Hepatitis B vaccine, adult, 2-dose schedule (Heplisav-B) inpatient CPT 90739 HEPLISAV-B (PF) 20 MCG/0.5 ML IM SYRG	$224.97	$354.85	$13.14–$337.11	—	37%
Hepatitis B vaccine, adult, 2-dose schedule (Heplisav-B) inpatient CPT 90739 HEPLISAV-B (PF) 20 MCG/0.5 ML IM SYRG	$224.97	$354.85	$184.52–$337.11	—	37%
Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 PR HEPATITIS B VACCINE (HEPB) PEDIATRIC/ADOLESCENT, 3 DOSE SCHED	$31.07	$49.00	$13.14–$64.58	45% below	37%
Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 PR HEPATITIS B VACCINE (HEPB) PEDIATRIC/ADOLESCENT, 3 DOSE SCHED	$31.07	$49.00	$25.48–$46.55	45% below	37%
Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 PR HEPATITIS B VACCINE (HEPB) PEDIATRIC/ADOLESCENT, 3 DOSE SCHED	$31.07	$49.00	$13.14–$64.58	—	37%
Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 PR HEPATITIS B VACCINE (HEPB) PEDIATRIC/ADOLESCENT, 3 DOSE SCHED	$31.07	$49.00	$25.48–$46.55	—	37%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) CPT 90648 PR HAEMOPHILUS INFLUENZAE TYPE B VACCINE (HIB), PRP-T CONJUGATE,	$36.77	$58.00	$24.53–$55.10	12% below	37%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) CPT 90648 PR HAEMOPHILUS INFLUENZAE TYPE B VACCINE (HIB), PRP-T CONJUGATE,	$36.77	$58.00	$24.53–$55.10	12% below	37%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) inpatient CPT 90648 PR HAEMOPHILUS INFLUENZAE TYPE B VACCINE (HIB), PRP-T CONJUGATE,	$36.77	$58.00	$24.53–$55.10	—	37%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) inpatient CPT 90648 PR HAEMOPHILUS INFLUENZAE TYPE B VACCINE (HIB), PRP-T CONJUGATE,	$36.77	$58.00	$24.53–$55.10	—	37%
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 PR INFLUENZA VIRUS VACCINE (IIV), SPLIT VIRUS, PERSERVATIVE FREE	$91.93	$145.00	$13.14–$137.75	16% above	37%
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 PR INFLUENZA VIRUS VACCINE (IIV), SPLIT VIRUS, PERSERVATIVE FREE	$91.93	$145.00	$75.40–$137.75	16% above	37%
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 FLUZONE HIGHDOSE QUAD 23-24 PF 240 MCG/0.7 ML IM SYRG	$107.56	$169.65	$13.14–$161.17	36% above	37%
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 FLUZONE HIGHDOSE QUAD 23-24 PF 240 MCG/0.7 ML IM SYRG	$107.56	$169.65	$88.22–$161.17	36% above	37%
High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 PR INFLUENZA VIRUS VACCINE (IIV), SPLIT VIRUS, PERSERVATIVE FREE	$91.93	$145.00	$75.40–$137.75	—	37%
High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 PR INFLUENZA VIRUS VACCINE (IIV), SPLIT VIRUS, PERSERVATIVE FREE	$91.93	$145.00	$13.14–$137.75	—	37%
High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 FLUZONE HIGHDOSE QUAD 23-24 PF 240 MCG/0.7 ML IM SYRG	$107.56	$169.65	$13.14–$161.17	—	37%
High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 FLUZONE HIGHDOSE QUAD 23-24 PF 240 MCG/0.7 ML IM SYRG	$107.56	$169.65	$88.22–$161.17	—	37%
MMR vaccine (measles, mumps and rubella), live CPT 90707 PR MEASLES, MUMPS, RUBELLA VIRUS VACCINE (MMR), LIVE, FOR SUBCUT	$74.18	$117.00	$49.49–$111.15	52% below	37%
MMR vaccine (measles, mumps and rubella), live CPT 90707 PR MEASLES, MUMPS, RUBELLA VIRUS VACCINE (MMR), LIVE, FOR SUBCUT	$74.18	$117.00	$49.49–$111.15	52% below	37%
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 PR MEASLES, MUMPS, RUBELLA VIRUS VACCINE (MMR), LIVE, FOR SUBCUT	$74.18	$117.00	$49.49–$111.15	—	37%
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 PR MEASLES, MUMPS, RUBELLA VIRUS VACCINE (MMR), LIVE, FOR SUBCUT	$74.18	$117.00	$49.49–$111.15	—	37%
MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) CPT 90710 PR MEASLES, MUMPS, RUBELLA, AND VARICELLA VACCINE (MMRV) (PROQUA	$194.64	$307.00	$129.86–$291.65	23% below	37%
MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) CPT 90710 PR MEASLES, MUMPS, RUBELLA, AND VARICELLA VACCINE (MMRV) (PROQUA	$194.64	$307.00	$129.86–$291.65	23% below	37%
MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) inpatient CPT 90710 PR MEASLES, MUMPS, RUBELLA, AND VARICELLA VACCINE (MMRV) (PROQUA	$194.64	$307.00	$129.86–$291.65	—	37%
MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) inpatient CPT 90710 PR MEASLES, MUMPS, RUBELLA, AND VARICELLA VACCINE (MMRV) (PROQUA	$194.64	$307.00	$129.86–$291.65	—	37%
Meningococcal ACWY (MenACWY) vaccine CPT 90734 PR MENINGOCOCCAL CONJUGATE VACCINE, GROUPS ACYW-135, QUADRIVALEN	$161.04	$254.00	$107.44–$241.30	30% below	37%
Meningococcal ACWY (MenACWY) vaccine CPT 90734 PR MENINGOCOCCAL CONJUGATE VACCINE, GROUPS ACYW-135, QUADRIVALEN	$161.04	$254.00	$107.44–$241.30	30% below	37%
Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 PR MENINGOCOCCAL CONJUGATE VACCINE, GROUPS ACYW-135, QUADRIVALEN	$161.04	$254.00	$107.44–$241.30	—	37%
Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 PR MENINGOCOCCAL CONJUGATE VACCINE, GROUPS ACYW-135, QUADRIVALEN	$161.04	$254.00	$107.44–$241.30	—	37%
Meningococcal ACWY vaccine (MenQuadfi) CPT 90619 PR MENINGOCOCCAL CONJUGATE VACCINE (MENACWY-TT), FOR IM USE	$84.96	$134.00	$56.68–$127.30	58% below	37%
Meningococcal ACWY vaccine (MenQuadfi) CPT 90619 PR MENINGOCOCCAL CONJUGATE VACCINE (MENACWY-TT), FOR IM USE	$84.96	$134.00	$56.68–$127.30	58% below	37%
Meningococcal ACWY vaccine (MenQuadfi) inpatient CPT 90619 PR MENINGOCOCCAL CONJUGATE VACCINE (MENACWY-TT), FOR IM USE	$84.96	$134.00	$56.68–$127.30	—	37%
Meningococcal ACWY vaccine (MenQuadfi) inpatient CPT 90619 PR MENINGOCOCCAL CONJUGATE VACCINE (MENACWY-TT), FOR IM USE	$84.96	$134.00	$56.68–$127.30	—	37%
Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 PR MENINGOCCOAL RECOMBINANT PROTEIN/OUTER MEMBRANE VESICLE VACCI	$197.81	$312.00	$131.98–$296.40	15% below	37%
Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 PR MENINGOCCOAL RECOMBINANT PROTEIN/OUTER MEMBRANE VESICLE VACCI	$197.81	$312.00	$131.98–$296.40	15% below	37%
Meningococcal B vaccine (Bexsero), 2-dose schedule inpatient CPT 90620 PR MENINGOCCOAL RECOMBINANT PROTEIN/OUTER MEMBRANE VESICLE VACCI	$197.81	$312.00	$131.98–$296.40	—	37%
Meningococcal B vaccine (Bexsero), 2-dose schedule inpatient CPT 90620 PR MENINGOCCOAL RECOMBINANT PROTEIN/OUTER MEMBRANE VESICLE VACCI	$197.81	$312.00	$131.98–$296.40	—	37%
Meningococcal B vaccine (Trumenba) CPT 90621 PR MENINGOCOCCAL RECOMBINATE LIPOPROTEIN VACCINE, (MENB), 3 DOSE	$195.27	$308.00	$130.28–$292.60	1% above	37%
Meningococcal B vaccine (Trumenba) CPT 90621 PR MENINGOCOCCAL RECOMBINATE LIPOPROTEIN VACCINE, (MENB), 3 DOSE	$195.27	$308.00	$130.28–$292.60	1% above	37%
Meningococcal B vaccine (Trumenba) inpatient CPT 90621 PR MENINGOCOCCAL RECOMBINATE LIPOPROTEIN VACCINE, (MENB), 3 DOSE	$195.27	$308.00	$130.28–$292.60	—	37%
Meningococcal B vaccine (Trumenba) inpatient CPT 90621 PR MENINGOCOCCAL RECOMBINATE LIPOPROTEIN VACCINE, (MENB), 3 DOSE	$195.27	$308.00	$130.28–$292.60	—	37%
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) CPT 90670 PR PNEUMOCOCCAL CONJUGATE VACCINE, 13 VALENT (PCV13), FOR IM USE	$161.04	$254.00	$107.44–$241.30	45% below	37%
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) CPT 90670 PR PNEUMOCOCCAL CONJUGATE VACCINE, 13 VALENT (PCV13), FOR IM USE	$161.04	$254.00	$107.44–$241.30	45% below	37%
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) inpatient CPT 90670 PR PNEUMOCOCCAL CONJUGATE VACCINE, 13 VALENT (PCV13), FOR IM USE	$161.04	$254.00	$107.44–$241.30	—	37%
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) inpatient CPT 90670 PR PNEUMOCOCCAL CONJUGATE VACCINE, 13 VALENT (PCV13), FOR IM USE	$161.04	$254.00	$107.44–$241.30	—	37%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 PR PNEUMOCOCAL CONJUGATE VACCINE, 20 VALENT (PCV20) (PREVNAR) IM	$284.03	$448.00	$58.19–$425.60	3% below	37%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 PR PNEUMOCOCAL CONJUGATE VACCINE, 20 VALENT (PCV20) (PREVNAR) IM	$284.03	$448.00	$232.96–$425.60	3% below	37%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 PR PNEUMOCOCAL CONJUGATE VACCINE, 20 VALENT (PCV20) (PREVNAR) IM	$284.03	$448.00	$232.96–$425.60	—	37%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 PR PNEUMOCOCAL CONJUGATE VACCINE, 20 VALENT (PCV20) (PREVNAR) IM	$284.03	$448.00	$58.19–$425.60	—	37%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PR PNEUMOCOCCAL POLYSACCHARIDE VACCINE (PPSV23) > 2 YRS FOR SUBQ	$85.59	$135.00	$13.14–$135.00	39% below	37%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PR PNEUMOCOCCAL POLYSACCHARIDE VACCINE (PPSV23) > 2 YRS FOR SUBQ	$85.59	$135.00	$70.20–$128.25	39% below	37%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 PR PNEUMOCOCCAL POLYSACCHARIDE VACCINE (PPSV23) > 2 YRS FOR SUBQ	$85.59	$135.00	$13.14–$135.00	—	37%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 PR PNEUMOCOCCAL POLYSACCHARIDE VACCINE (PPSV23) > 2 YRS FOR SUBQ	$85.59	$135.00	$70.20–$128.25	—	37%
Polio vaccine, inactivated (IPV) CPT 90713 PR POLIOVIRUS VACCINE, INACTIVATED (IPV), FOR SUBCUTANEOUS OR IM	$38.67	$61.00	$25.80–$57.95	35% below	37%
Polio vaccine, inactivated (IPV) CPT 90713 PR POLIOVIRUS VACCINE, INACTIVATED (IPV), FOR SUBCUTANEOUS OR IM	$38.67	$61.00	$25.80–$57.95	35% below	37%
Polio vaccine, inactivated (IPV) inpatient CPT 90713 PR POLIOVIRUS VACCINE, INACTIVATED (IPV), FOR SUBCUTANEOUS OR IM	$38.67	$61.00	$25.80–$57.95	—	37%
Polio vaccine, inactivated (IPV) inpatient CPT 90713 PR POLIOVIRUS VACCINE, INACTIVATED (IPV), FOR SUBCUTANEOUS OR IM	$38.67	$61.00	$25.80–$57.95	—	37%
RSV antibody shot for infants and toddlers, larger dose (1 mL, 100 mg) CPT 90381 PR RSV MONOCLONAL ABY,SEASONAL,1ML IM	$941.49	$1,485.00	$628.16–$1,410.75	8% below	37%
RSV antibody shot for infants and toddlers, larger dose (1 mL, 100 mg) CPT 90381 PR RSV MONOCLONAL ABY,SEASONAL,1ML IM	$941.49	$1,485.00	$628.16–$1,410.75	8% below	37%
RSV antibody shot for infants and toddlers, larger dose (1 mL, 100 mg) inpatient CPT 90381 PR RSV MONOCLONAL ABY,SEASONAL,1ML IM	$941.49	$1,485.00	$628.16–$1,410.75	—	37%
RSV antibody shot for infants and toddlers, larger dose (1 mL, 100 mg) inpatient CPT 90381 PR RSV MONOCLONAL ABY,SEASONAL,1ML IM	$941.49	$1,485.00	$628.16–$1,410.75	—	37%
Rabies vaccine, one dose CPT 90675 PR RABIES VACCINE, FOR IM USE	$410.20	$647.00	$58.19–$614.65	29% below	37%
Rabies vaccine, one dose CPT 90675 PR RABIES VACCINE, FOR IM USE	$410.20	$647.00	$336.44–$614.65	29% below	37%
Rabies vaccine, one dose CPT 90675 IMOVAX RABIES VACCINE (PF) 2.5 UNIT IM SOLR	$671.22	$1,058.70	$550.52–$1,005.77	16% above	37%
Rabies vaccine, one dose CPT 90675 IMOVAX RABIES VACCINE (PF) 2.5 UNIT IM SOLR	$671.22	$1,058.70	$58.19–$1,005.77	16% above	37%
Rabies vaccine, one dose inpatient CPT 90675 PR RABIES VACCINE, FOR IM USE	$410.20	$647.00	$336.44–$614.65	—	37%
Rabies vaccine, one dose inpatient CPT 90675 PR RABIES VACCINE, FOR IM USE	$410.20	$647.00	$58.19–$614.65	—	37%
Rabies vaccine, one dose inpatient CPT 90675 IMOVAX RABIES VACCINE (PF) 2.5 UNIT IM SOLR	$671.22	$1,058.70	$550.52–$1,005.77	—	37%
Rabies vaccine, one dose inpatient CPT 90675 IMOVAX RABIES VACCINE (PF) 2.5 UNIT IM SOLR	$671.22	$1,058.70	$58.19–$1,005.77	—	37%
Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) CPT 90680 PR ROTAVIRUS VACCINE, PENTAVALENT (RV5), 3 DOSE SCHEDULE, LIVE,	$106.51	$168.00	$71.06–$159.60	9% below	37%
Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) CPT 90680 PR ROTAVIRUS VACCINE, PENTAVALENT (RV5), 3 DOSE SCHEDULE, LIVE,	$106.51	$168.00	$71.06–$159.60	9% below	37%
Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) inpatient CPT 90680 PR ROTAVIRUS VACCINE, PENTAVALENT (RV5), 3 DOSE SCHEDULE, LIVE,	$106.51	$168.00	$71.06–$159.60	—	37%
Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) inpatient CPT 90680 PR ROTAVIRUS VACCINE, PENTAVALENT (RV5), 3 DOSE SCHEDULE, LIVE,	$106.51	$168.00	$71.06–$159.60	—	37%
Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 PR ZOSTER (SHINGLES) VACCINE (HZV)	$162.94	$257.00	$108.71–$244.15	18% below	37%
Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 PR ZOSTER (SHINGLES) VACCINE (HZV)	$162.94	$257.00	$108.71–$244.15	18% below	37%
Shingles vaccine (Shingrix), recombinant, one dose inpatient CPT 90750 PR ZOSTER (SHINGLES) VACCINE (HZV)	$162.94	$257.00	$108.71–$244.15	—	37%
Shingles vaccine (Shingrix), recombinant, one dose inpatient CPT 90750 PR ZOSTER (SHINGLES) VACCINE (HZV)	$162.94	$257.00	$108.71–$244.15	—	37%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 PR TETANUS AND DIPHTHERIA TOXOIDS ABSORBED (TD) VACCINE PRESERVA	$31.07	$49.00	$13.14–$64.58	25% below	37%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 PR TETANUS AND DIPHTHERIA TOXOIDS ABSORBED (TD) VACCINE PRESERVA	$31.07	$49.00	$25.48–$46.55	25% below	37%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 PR TETANUS AND DIPHTHERIA TOXOIDS ABSORBED (TD) VACCINE PRESERVA	$31.07	$49.00	$13.14–$64.58	—	37%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 PR TETANUS AND DIPHTHERIA TOXOIDS ABSORBED (TD) VACCINE PRESERVA	$31.07	$49.00	$25.48–$46.55	—	37%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 PR TETANUS, DIPHTHERIA TOXOIDS AND ACELLULAR PERTUSSIS VACCINE (	$49.45	$78.00	$40.56–$74.10	39% below	37%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 PR TETANUS, DIPHTHERIA TOXOIDS AND ACELLULAR PERTUSSIS VACCINE (	$49.45	$78.00	$13.14–$74.10	39% below	37%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 ADACEL(TDAP ADOLESN/ADULT)(PF) 2 LF-(2.5-5-3-5 MCG)-5LF/0.5 ML IM SUSP	$81.34	$128.30	$66.72–$121.89	at median	37%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 ADACEL(TDAP ADOLESN/ADULT)(PF) 2 LF-(2.5-5-3-5 MCG)-5LF/0.5 ML IM SUSP	$81.34	$128.30	$13.14–$121.89	at median	37%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 PR TETANUS, DIPHTHERIA TOXOIDS AND ACELLULAR PERTUSSIS VACCINE (	$49.45	$78.00	$13.14–$74.10	—	37%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 PR TETANUS, DIPHTHERIA TOXOIDS AND ACELLULAR PERTUSSIS VACCINE (	$49.45	$78.00	$40.56–$74.10	—	37%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 ADACEL(TDAP ADOLESN/ADULT)(PF) 2 LF-(2.5-5-3-5 MCG)-5LF/0.5 ML IM SUSP	$81.34	$128.30	$66.72–$121.89	—	37%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 ADACEL(TDAP ADOLESN/ADULT)(PF) 2 LF-(2.5-5-3-5 MCG)-5LF/0.5 ML IM SUSP	$81.34	$128.30	$13.14–$121.89	—	37%
Typhoid vaccine, injectable (Vi polysaccharide) CPT 90691 PR TYPHOID VACCINE, VI CAPSULAR POLYSACCHARIDE (VICPS) FOR IM US	$84.96	$134.00	$56.68–$127.30	32% below	37%
Typhoid vaccine, injectable (Vi polysaccharide) CPT 90691 PR TYPHOID VACCINE, VI CAPSULAR POLYSACCHARIDE (VICPS) FOR IM US	$84.96	$134.00	$56.68–$127.30	32% below	37%
Typhoid vaccine, injectable (Vi polysaccharide) inpatient CPT 90691 PR TYPHOID VACCINE, VI CAPSULAR POLYSACCHARIDE (VICPS) FOR IM US	$84.96	$134.00	$56.68–$127.30	—	37%
Typhoid vaccine, injectable (Vi polysaccharide) inpatient CPT 90691 PR TYPHOID VACCINE, VI CAPSULAR POLYSACCHARIDE (VICPS) FOR IM US	$84.96	$134.00	$56.68–$127.30	—	37%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 HCHG 90471/G0008 ADMIN FLU VACCINE	$29.80	$47.00	$19.88–$44.65	23% below	37%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 PR FLU SHOT ADMINISTRATION	$29.80	$47.00	$19.88–$44.65	23% below	37%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 PR HEPATITIS B VAC ADMINISTRATION	$69.74	$110.00	$46.53–$104.50	80% above	37%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 HCHG 90471/G0010 ADMIN HEPATITIS B VACCINE	$69.74	$110.00	$46.53–$104.50	80% above	37%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 HCHG 90471 IMMUNIZATION ADMIN	$88.76	$140.00	$59.22–$133.00	129% above	37%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 PR IMMUNIZATION ADMINISTRATION; 1 VACCINE	$88.76	$140.00	$59.22–$133.00	129% above	37%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 PR PNEUMOVAX ADMINISTRATION	$88.76	$140.00	$59.22–$133.00	129% above	37%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 HCHG 90471/G0009 ADMIN PNEUMOCCOCCAL VACCINE	$88.76	$140.00	$59.22–$133.00	129% above	37%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 PR FLU SHOT ADMINISTRATION	$29.80	$47.00	$19.88–$44.65	—	37%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 HCHG 90471/G0008 ADMIN FLU VACCINE	$29.80	$47.00	$19.88–$44.65	—	37%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 HCHG 90471/G0010 ADMIN HEPATITIS B VACCINE	$69.74	$110.00	$46.53–$104.50	—	37%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 PR HEPATITIS B VAC ADMINISTRATION	$69.74	$110.00	$46.53–$104.50	—	37%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 PR IMMUNIZATION ADMINISTRATION; 1 VACCINE	$88.76	$140.00	$59.22–$133.00	—	37%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 HCHG 90471/G0009 ADMIN PNEUMOCCOCCAL VACCINE	$88.76	$140.00	$59.22–$133.00	—	37%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 HCHG 90471 IMMUNIZATION ADMIN	$88.76	$140.00	$59.22–$133.00	—	37%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 PR PNEUMOVAX ADMINISTRATION	$88.76	$140.00	$59.22–$133.00	—	37%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 HCHG 90472/G0010 ADMIN HEPATITIS B VACCINE, ADDL	$44.38	$70.00	$29.61–$66.50	37% above	37%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 PR IMMUNIZATION ADMINISTRATION; EA ADDL VACCINE	$44.38	$70.00	$29.61–$66.50	37% above	37%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 HCHG 90472/G0009 ADMIN PNEUMOCOCCAL VACCINE, ADDL	$44.38	$70.00	$29.61–$66.50	37% above	37%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 PR 90472/G0009 ADMIN PNEUMOCCAL VACCINE	$44.38	$70.00	$29.61–$66.50	37% above	37%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 PR 90472/G0010 ADMIN HEPATITIS B VACCINE	$44.38	$70.00	$29.61–$66.50	37% above	37%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 HCHG 90472 IMMUN ADMIN EA ADDL	$44.38	$70.00	$29.61–$66.50	37% above	37%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 PR IMMUNIZATION ADMINISTRATION; EA ADDL VACCINE	$44.38	$70.00	$29.61–$66.50	—	37%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 PR 90472/G0010 ADMIN HEPATITIS B VACCINE	$44.38	$70.00	$29.61–$66.50	—	37%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 PR 90472/G0009 ADMIN PNEUMOCCAL VACCINE	$44.38	$70.00	$29.61–$66.50	—	37%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 HCHG 90472/G0010 ADMIN HEPATITIS B VACCINE, ADDL	$44.38	$70.00	$29.61–$66.50	—	37%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 HCHG 90472/G0009 ADMIN PNEUMOCOCCAL VACCINE, ADDL	$44.38	$70.00	$29.61–$66.50	—	37%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 HCHG 90472 IMMUN ADMIN EA ADDL	$44.38	$70.00	$29.61–$66.50	—	37%
Yellow fever vaccine, live CPT 90717 PR YELLOW FEVER VACCINE, LIVE, FOR SUBCUTANEOUS USE	$128.07	$202.00	$85.45–$191.90	26% below	37%
Yellow fever vaccine, live CPT 90717 PR YELLOW FEVER VACCINE, LIVE, FOR SUBCUTANEOUS USE	$128.07	$202.00	$85.45–$191.90	26% below	37%
Yellow fever vaccine, live inpatient CPT 90717 PR YELLOW FEVER VACCINE, LIVE, FOR SUBCUTANEOUS USE	$128.07	$202.00	$85.45–$191.90	—	37%
Yellow fever vaccine, live inpatient CPT 90717 PR YELLOW FEVER VACCINE, LIVE, FOR SUBCUTANEOUS USE	$128.07	$202.00	$85.45–$191.90	—	37%

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://bellin-ghs.pt.panaceainc.com/MRFDownload/bellin-ghs/gundersen-tricounty