Hospital Cleveland, OH

The Cleveland Clinic Foundation

The Cleveland Clinic Foundation in Cleveland, OH publishes cash prices for 484 common procedures listed here, from its own machine-readable price file updated Jun 16, 2026. Compared with other hospitals in the state, its outpatient cash prices are above the Ohio median for 250 of 474 procedures and below it for 146. By typical cash price it ranks #84 of 139 Ohio hospitals and #12 of 26 hospitals in the Cleveland, OH area, cheapest first. Select a procedure to compare it with other hospitals nearby.

9500 Euclid Avenue, Cleveland, OH 44195 Collected Sep 23, 2026 Source price file Check a bill from this hospital (216) 952-9829

Acute care hospital Nonprofit hospital Emergency department CMS star rating 4 of 5 CCN 360180 · CMS hospital register NPI 1679525919

Financial assistance

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

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

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

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

State law

This state limits hospital bills for lower-income patients

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

Scans and imaging

Procedure	Cash price	List price	Insurers pay	vs Ohio	Off list
Abdominal CT scan without and with contrast CPT 74170 CT ABDOMEN W/O & W/CONTRAST MATERIAL	$798.20	$1,228.00	$341.38–$1,228.00	40% below	35%
Abdominal CT scan without and with contrast inpatient CPT 74170 CT ABDOMEN W/O & W/CONTRAST MATERIAL	$798.20	$1,228.00	$341.38–$1,228.00	—	35%
Abdominal X-ray, 2 views CPT 74019 RADIOLOGIC EXAM ABDOMEN 2 VIEWS	$477.10	$734.00	$204.05–$734.00	41% above	35%
Abdominal X-ray, 2 views inpatient CPT 74019 RADIOLOGIC EXAM ABDOMEN 2 VIEWS	$477.10	$734.00	$204.05–$734.00	—	35%
Ankle X-ray, complete, 3 or more views CPT 73610 RADEX ANKLE COMPLETE MINIMUM 3 VIEWS	$395.20	$608.00	$49.25–$90.57	24% above	35%
Ankle X-ray, complete, 3 or more views inpatient CPT 73610 RADEX ANKLE COMPLETE MINIMUM 3 VIEWS	$395.20	$608.00	$169.02–$608.00	—	35%
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 NON-INVAS PHYSIOLOGIC STD EXTREMITY ART 2 LEVEL	$481.65	$741.00	$97.71–$138.46	at median	35%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 NON-INVAS PHYSIOLOGIC STD EXTREMITY ART 2 LEVEL	$481.65	$741.00	$206.00–$741.00	—	35%
Arm CT scan without contrast (shoulder to hand, any part) CPT 73200 CT UPPER EXTREMITY W/O CONTRAST MATERIAL	$477.10	$734.00	$204.05–$734.00	49% below	35%
Arm CT scan without contrast (shoulder to hand, any part) inpatient CPT 73200 CT UPPER EXTREMITY W/O CONTRAST MATERIAL	$477.10	$734.00	$204.05–$734.00	—	35%
Barium swallow (esophagus X-ray with contrast) CPT 74220 RADIOLOGIC EXAM ESOPHAGUS SINGLE CONTRAST STUDY	$798.20	$1,228.00	$56.78–$182.54	80% above	35%
Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 RADIOLOGIC EXAM ESOPHAGUS SINGLE CONTRAST STUDY	$798.20	$1,228.00	$341.38–$1,228.00	—	35%
Bone scan, whole body (nuclear medicine) CPT 78306 BONE &/JOINT IMAGING WHOLE BODY	$1,802.45	$2,773.00	$770.89–$2,773.00	17% above	35%
Bone scan, whole body (nuclear medicine) inpatient CPT 78306 BONE &/JOINT IMAGING WHOLE BODY	$1,802.45	$2,773.00	$770.89–$2,773.00	—	35%
Breast ultrasound, complete, one breast CPT 76641 US BREAST UNI REAL TIME WITH IMAGE COMPLETE	$477.10	$734.00	$245.18–$89,594.23	at median	35%
Breast ultrasound, complete, one breast inpatient CPT 76641 US BREAST UNI REAL TIME WITH IMAGE COMPLETE	$477.10	$734.00	$204.05–$734.00	—	35%
Breast ultrasound, limited (one breast or one area) CPT 76642 US BREAST UNI REAL TIME WITH IMAGE LIMITED	$395.20	$608.00	$182.03–$89,595.40	4% below	35%
Breast ultrasound, limited (one breast or one area) inpatient CPT 76642 US BREAST UNI REAL TIME WITH IMAGE LIMITED	$395.20	$608.00	$169.02–$608.00	—	35%
CT angiography (CTA) of the abdomen and pelvis CPT 74174 CT ANGIO ABD&PLVIS CNTRST MTRL W/WO CNTRST IMG	$1,601.60	$2,464.00	$828.27–$1,863.61	25% below	35%
CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174 CT ANGIO ABD&PLVIS CNTRST MTRL W/WO CNTRST IMG	$1,601.60	$2,464.00	$684.99–$2,464.00	—	35%
CT angiography (CTA) of the head CPT 70496 CT ANGIOGRAPHY HEAD W/CONTRAST/NONCONTRAST	$798.20	$1,228.00	$401.74–$82,410.65	40% below	35%
CT angiography (CTA) of the head inpatient CPT 70496 CT ANGIOGRAPHY HEAD W/CONTRAST/NONCONTRAST	$798.20	$1,228.00	$341.38–$1,228.00	—	35%
CT angiography (CTA) of the neck CPT 70498 CT ANGIOGRAPHY NECK W/CONTRAST/NONCONTRAST	$798.20	$1,228.00	$159.40–$525.05	39% below	35%
CT angiography (CTA) of the neck inpatient CPT 70498 CT ANGIOGRAPHY NECK W/CONTRAST/NONCONTRAST	$798.20	$1,228.00	$341.38–$1,228.00	—	35%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT ANGIOGRAPHY CHEST W/CONTRAST/NONCONTRAST	$798.20	$1,228.00	$159.40–$525.05	44% below	35%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CT ANGIOGRAPHY CHEST W/CONTRAST/NONCONTRAST	$798.20	$1,228.00	$341.38–$1,228.00	—	35%
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 CTA HRT CORNRY ART/BYPASS GRFTS CONTRST 3D POST	$1,601.60	$2,464.00	$159.40–$525.05	at median	35%
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score inpatient CPT 75574 CTA HRT CORNRY ART/BYPASS GRFTS CONTRST 3D POST	$1,601.60	$2,464.00	$684.99–$2,464.00	—	35%
CT of the heart without contrast dye to measure coronary calcium CPT 75571 CT HRT W/O DYE W/CA TEST	$395.20	$608.00	$78.83–$212.67	41% above	35%
CT of the heart without contrast dye to measure coronary calcium CPT 75571 CT CALCIUM SCORING - SELF PAY	$395.20	$608.00	$169.02–$608.00	41% above	35%
CT of the heart without contrast dye to measure coronary calcium CPT 75571 CT HEART NO CONTRAST QUANT EVAL CORONRY CALCIUM	$395.20	$608.00	$169.02–$608.00	41% above	35%
CT of the heart without contrast dye to measure coronary calcium inpatient CPT 75571 CT CALCIUM SCORING - SELF PAY	$395.20	$608.00	$169.02–$608.00	—	35%
CT of the heart without contrast dye to measure coronary calcium inpatient CPT 75571 CT HRT W/O DYE W/CA TEST	$395.20	$608.00	$169.02–$608.00	—	35%
CT of the heart without contrast dye to measure coronary calcium inpatient CPT 75571 CT HEART NO CONTRAST QUANT EVAL CORONRY CALCIUM	$395.20	$608.00	$169.02–$608.00	—	35%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT ABDOMEN & PELVIS W/O CONTRAST MATERIAL	$1,084.20	$1,668.00	$463.70–$1,668.00	32% below	35%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT ABDOMEN & PELVIS W/O CONTRAST MATERIAL	$1,084.20	$1,668.00	$463.70–$1,668.00	—	35%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ABDOMEN & PELVIS W/CONTRAST MATERIAL	$1,601.60	$2,464.00	$684.99–$2,464.00	19% below	35%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT ABDOMEN & PELVIS W/CONTRAST MATERIAL	$1,601.60	$2,464.00	$684.99–$2,464.00	—	35%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT ABDOMEN & PELVIS W/WO CONTRST 1/> BODY RE	$1,601.60	$2,464.00	$828.27–$1,863.61	31% below	35%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT ABDOMEN & PELVIS W/WO CONTRST 1/> BODY RE	$1,601.60	$2,464.00	$684.99–$2,464.00	—	35%
CT scan of the abdomen with contrast CPT 74160 CT ABDOMEN W/CONTRAST MATERIAL	$798.20	$1,228.00	$341.38–$1,228.00	32% below	35%
CT scan of the abdomen with contrast inpatient CPT 74160 CT ABDOMEN W/CONTRAST MATERIAL	$798.20	$1,228.00	$341.38–$1,228.00	—	35%
CT scan of the abdomen without contrast CPT 74150 CT ABDOMEN W/O CONTRAST MATERIAL	$477.10	$734.00	$204.05–$734.00	55% below	35%
CT scan of the abdomen without contrast inpatient CPT 74150 CT ABDOMEN W/O CONTRAST MATERIAL	$477.10	$734.00	$204.05–$734.00	—	35%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT MAXILLOFACIAL W/O CONTRAST MATERIAL	$477.10	$734.00	$245.18–$82,398.97	46% below	35%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT MAXILLOFACIAL W/O CONTRAST MATERIAL	$477.10	$734.00	$204.05–$734.00	—	35%
CT scan of the head or brain, no contrast dye CPT 70450 CT HEAD/BRAIN W/O CONTRAST MATERIAL	$477.10	$734.00	$95.38–$455.92	43% below	35%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT HEAD/BRAIN W/O CONTRAST MATERIAL	$477.10	$734.00	$204.05–$734.00	—	35%
CT scan of the head with contrast CPT 70460 CT HEAD/BRAIN W/CONTRAST MATERIAL	$798.20	$1,228.00	$159.40–$455.92	21% below	35%
CT scan of the head with contrast inpatient CPT 70460 CT HEAD/BRAIN W/CONTRAST MATERIAL	$798.20	$1,228.00	$341.38–$1,228.00	—	35%
CT scan of the head without and with contrast CPT 70470 CT HEAD/BRAIN W/O & W/CONTRAST MATERIAL	$798.20	$1,228.00	$159.40–$455.92	33% below	35%
CT scan of the head without and with contrast inpatient CPT 70470 CT HEAD/BRAIN W/O & W/CONTRAST MATERIAL	$798.20	$1,228.00	$341.38–$1,228.00	—	35%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT LUMBAR SPINE W/O CONTRAST MATERIAL	$477.10	$734.00	$95.38–$212.67	57% below	35%
CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 CT LUMBAR SPINE W/O CONTRAST MATERIAL	$477.10	$734.00	$204.05–$734.00	—	35%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT CERVICAL SPINE W/O CONTRAST MATERIAL	$477.10	$734.00	$95.38–$212.67	56% below	35%
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CT CERVICAL SPINE W/O CONTRAST MATERIAL	$477.10	$734.00	$204.05–$734.00	—	35%
CT scan of the pelvis, with contrast dye CPT 72193 CT PELVIS W/CONTRAST MATERIAL	$798.20	$1,228.00	$341.38–$1,228.00	35% below	35%
CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT PELVIS W/CONTRAST MATERIAL	$798.20	$1,228.00	$341.38–$1,228.00	—	35%
Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 DUPLEX SCAN EXTRACRANIAL ART COMPL BI STUDY	$903.50	$1,390.00	$386.42–$1,390.00	—	35%
Carotid artery ultrasound (duplex), both sides of the neck inpatient both sides CPT 93880 DUPLEX SCAN EXTRACRANIAL ART COMPL BI STUDY	$903.50	$1,390.00	$386.42–$1,390.00	—	35%
Chest CT scan without and with contrast CPT 71270 DIAGNOSTIC COMPUTED TOMOGRAPHY THORAX C-/C+	$798.20	$1,228.00	$159.40–$455.92	47% below	35%
Chest CT scan without and with contrast inpatient CPT 71270 DIAGNOSTIC COMPUTED TOMOGRAPHY THORAX C-/C+	$798.20	$1,228.00	$341.38–$1,228.00	—	35%
Chest X-ray, 2 views CPT 71046 RADIOLOGIC EXAM CHEST 2 VIEWS	$395.20	$608.00	$44.47–$90.57	50% above	35%
Chest X-ray, 2 views inpatient CPT 71046 RADIOLOGIC EXAM CHEST 2 VIEWS	$395.20	$608.00	$169.02–$608.00	—	35%
Chest X-ray, single view CPT 71045 RADIOLOGIC EXAM CHEST SINGLE VIEW	$395.20	$608.00	$33.63–$90.57	77% above	35%
Chest X-ray, single view inpatient CPT 71045 RADIOLOGIC EXAM CHEST SINGLE VIEW	$395.20	$608.00	$169.02–$608.00	—	35%
Collarbone (clavicle) X-ray, complete CPT 73000 RADEX CLAVICLE COMPLETE	$395.20	$608.00	$43.72–$90.57	46% above	35%
Collarbone (clavicle) X-ray, complete inpatient CPT 73000 RADEX CLAVICLE COMPLETE	$395.20	$608.00	$169.02–$608.00	—	35%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US RETROPERITONEAL REAL TIME W/IMAGE COMPLETE	$477.10	$734.00	$95.38–$174.00	33% below	35%
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US RETROPERITONEAL REAL TIME W/IMAGE COMPLETE	$477.10	$734.00	$204.05–$734.00	—	35%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 DXA BONE DENSITY STUDY 1/> SITES AXIAL SKEL	$477.10	$734.00	$101.80–$90,107.43	5% above	35%
DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 DXA BONE DENSITY STUDY 1/> SITES AXIAL SKEL	$477.10	$734.00	$204.05–$734.00	—	35%
DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 DXA BONE DENSITY STUDY 1/>SITES APPENDICLR SKEL	$395.20	$608.00	$44.01–$90,108.59	54% above	35%
DEXA bone density scan of the wrist, heel or finger (peripheral) inpatient CPT 77081 DXA BONE DENSITY STUDY 1/>SITES APPENDICLR SKEL	$395.20	$608.00	$169.02–$608.00	—	35%
Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 US PREG UTERUS W/DETAIL FETAL ANAT 1ST GESTATION	$1,084.20	$1,668.00	$463.70–$1,668.00	28% above	35%
Detailed fetal anatomy ultrasound, through the belly, one baby inpatient CPT 76811 US PREG UTERUS W/DETAIL FETAL ANAT 1ST GESTATION	$1,084.20	$1,668.00	$463.70–$1,668.00	—	35%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 DIAGNOSTIC COMPUTED TOMOGRAPHY THORAX W/O CNTRST	$477.10	$734.00	$95.38–$212.67	49% below	35%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 DIAGNOSTIC COMPUTED TOMOGRAPHY THORAX W/O CNTRST	$477.10	$734.00	$204.05–$734.00	—	35%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 DIAGNOSTIC COMPUTED TOMOGRAPHY THORAX W/CONTRAST	$798.20	$1,228.00	$159.40–$455.92	34% below	35%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 DIAGNOSTIC COMPUTED TOMOGRAPHY THORAX W/CONTRAST	$798.20	$1,228.00	$341.38–$1,228.00	—	35%
Diagnostic mammogram, both breasts both sides CPT 77066 DIAGNOSTIC MAMMOGRAPHY COMPUTER-AIDED DETCJ BI	$458.90	$706.00	$196.27–$706.00	—	35%
Diagnostic mammogram, both breasts inpatient both sides CPT 77066 DIAGNOSTIC MAMMOGRAPHY COMPUTER-AIDED DETCJ BI	$458.90	$706.00	$196.27–$706.00	—	35%
Diagnostic mammogram, one breast CPT 77065 DIAGNOSTIC MAMMOGRAPHY COMPUTER-AIDED DETCJ UNI	$365.95	$563.00	$156.51–$563.00	2% above	35%
Diagnostic mammogram, one breast inpatient CPT 77065 DIAGNOSTIC MAMMOGRAPHY COMPUTER-AIDED DETCJ UNI	$365.95	$563.00	$156.51–$563.00	—	35%
Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 DUP-SCAN LXTR ART/ARTL BPGS COMPL BI STUDY	$903.50	$1,390.00	$386.42–$1,390.00	—	35%
Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 DUP-SCAN LXTR ART/ARTL BPGS COMPL BI STUDY	$903.50	$1,390.00	$386.42–$1,390.00	—	35%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 DUP SCAN EXT VEIN BILAT	$903.50	$1,390.00	$150.27–$255.12	—	35%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 TECH DUPLEX SCAN COMPL BILATERAL STUDY	$903.50	$1,390.00	$150.27–$255.12	—	35%
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 TECH DUPLEX SCAN COMPL BILATERAL STUDY	$903.50	$1,390.00	$386.42–$1,390.00	—	35%
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 DUP SCAN EXT VEIN BILAT	$903.50	$1,390.00	$386.42–$1,390.00	—	35%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 ECHO TTHRC R-T 2D W/WOM-MODE COMPL SPEC&COLR D	$2,049.45	$3,153.00	$876.53–$3,153.00	21% above	35%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 ECHO TTHRC R-T 2D M-MODE COMPL SPEC&COLR D W/O CONTRAST	$2,049.45	$3,153.00	$258.45–$568.65	21% above	35%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 ECHO TTHRC R-T 2D M-MODE COMPL SPEC&COLR D W/O CONTRAST	$2,049.45	$3,153.00	$876.53–$3,153.00	—	35%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 ECHO TTHRC R-T 2D W/WOM-MODE COMPL SPEC&COLR D	$2,049.45	$3,153.00	$876.53–$3,153.00	—	35%
Elbow X-ray, 2 views CPT 73070 RADEX ELBOW 2 VIEWS	$395.20	$608.00	$54.27–$85,419.69	51% above	35%
Elbow X-ray, 2 views inpatient CPT 73070 RADEX ELBOW 2 VIEWS	$395.20	$608.00	$169.02–$608.00	—	35%
Elbow X-ray, complete, 3 or more views CPT 73080 RADEX ELBOW COMPLETE MINIMUM 3 VIEWS	$395.20	$608.00	$169.02–$608.00	26% above	35%
Elbow X-ray, complete, 3 or more views inpatient CPT 73080 RADEX ELBOW COMPLETE MINIMUM 3 VIEWS	$395.20	$608.00	$169.02–$608.00	—	35%
Eye socket (orbit) CT scan without contrast CPT 70480 CT ORBIT SELLA/POST FOSSA/EAR W/O CONTRAST MATRL	$477.10	$734.00	$95.38–$213.15	45% below	35%
Eye socket (orbit) CT scan without contrast inpatient CPT 70480 CT ORBIT SELLA/POST FOSSA/EAR W/O CONTRAST MATRL	$477.10	$734.00	$204.05–$734.00	—	35%
Facial bones X-ray, complete, 3 or more views CPT 70150 RADEX FACIAL BONES COMPLETE MINIMUM 3 VIEWS	$477.10	$734.00	$56.78–$108.80	27% above	35%
Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 RADEX FACIAL BONES COMPLETE MINIMUM 3 VIEWS	$477.10	$734.00	$204.05–$734.00	—	35%
Forearm X-ray (radius and ulna), 2 views CPT 73090 RADEX FOREARM 2 VIEWS	$395.20	$608.00	$169.02–$608.00	45% above	35%
Forearm X-ray (radius and ulna), 2 views inpatient CPT 73090 RADEX FOREARM 2 VIEWS	$395.20	$608.00	$169.02–$608.00	—	35%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 HEPATOBILIARY SYST IMAGING INCLUDING GALLBLADDER	$1,802.45	$2,773.00	$770.89–$2,773.00	14% above	35%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 HEPATOBILIARY SYST IMAGING INCLUDING GALLBLADDER	$1,802.45	$2,773.00	$770.89–$2,773.00	—	35%
Hand X-ray, 2 views CPT 73120 RADEX HAND 2 VIEWS	$477.10	$734.00	$42.31–$108.80	79% above	35%
Hand X-ray, 2 views inpatient CPT 73120 RADEX HAND 2 VIEWS	$477.10	$734.00	$204.05–$734.00	—	35%
Heel bone (calcaneus) X-ray, 2 or more views CPT 73650 RADEX CALCANEUS MINIMUM 2 VIEWS	$395.20	$608.00	$38.08–$90.57	45% above	35%
Heel bone (calcaneus) X-ray, 2 or more views inpatient CPT 73650 RADEX CALCANEUS MINIMUM 2 VIEWS	$395.20	$608.00	$169.02–$608.00	—	35%
Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 SLEEP STD AIRFLOW HRT RATE&O2 SAT EFFORT UNATT	$702.00	$1,080.00	$300.24–$1,080.00	at median	35%
Home sleep apnea test, unattended, recording breathing and oxygen inpatient CPT 95806 SLEEP STD AIRFLOW HRT RATE&O2 SAT EFFORT UNATT	$702.00	$1,080.00	$300.24–$1,080.00	—	35%
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 POLYSOM 6/>YRS SLEEP W/CPAP 4/> ADDL PARAM ATTND	$4,563.00	$7,020.00	$1,951.56–$7,020.00	11% above	35%
In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 POLYSOM 6/>YRS SLEEP W/CPAP 4/> ADDL PARAM ATTND	$4,563.00	$7,020.00	$1,951.56–$7,020.00	—	35%
Knee X-ray, 3 views CPT 73562 RADIOLOGIC EXAMINATION KNEE 3 VIEWS	$395.20	$608.00	$55.25–$90.57	12% above	35%
Knee X-ray, 3 views inpatient CPT 73562 RADIOLOGIC EXAMINATION KNEE 3 VIEWS	$395.20	$608.00	$169.02–$608.00	—	35%
Knee X-ray, complete, 4 or more views CPT 73564 RADIOLOGIC EXAM KNEE COMPLETE 4/MORE VIEWS	$477.10	$734.00	$56.78–$108.80	21% above	35%
Knee X-ray, complete, 4 or more views inpatient CPT 73564 RADIOLOGIC EXAM KNEE COMPLETE 4/MORE VIEWS	$477.10	$734.00	$204.05–$734.00	—	35%
Leg CT scan without contrast (hip to foot, any part) CPT 73700 CT LOWER EXTREMITY W/O CONTRAST MATERIAL	$477.10	$734.00	$95.38–$212.67	49% below	35%
Leg CT scan without contrast (hip to foot, any part) inpatient CPT 73700 CT LOWER EXTREMITY W/O CONTRAST MATERIAL	$477.10	$734.00	$204.05–$734.00	—	35%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US ABDOMINAL REAL TIME W/IMAGE LIMITED	$477.10	$734.00	$95.38–$116.62	14% below	35%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US ABDOMINAL REAL TIME W/IMAGE LIMITED	$477.10	$734.00	$204.05–$734.00	—	35%
Limited ultrasound of an arm or leg (non-vascular) CPT 76882 US LMTD JOINT/OTH NONVASC XTR STRUX R-T W/IMG	$477.10	$734.00	$29.10–$89,875.97	at median	35%
Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 US LMTD JOINT/OTH NONVASC XTR STRUX R-T W/IMG	$477.10	$734.00	$204.05–$734.00	—	35%
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 COMPUTED TOMOGRAPHY THORAX LW DOSE LNG CA SCR C-	$477.10	$734.00	$95.38–$212.67	62% above	35%
Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 COMPUTED TOMOGRAPHY THORAX LW DOSE LNG CA SCR C-	$477.10	$734.00	$204.05–$734.00	—	35%
Lower leg X-ray (tibia and fibula), 2 views CPT 73590 RADIOLOGIC EXAMINATION TIBIA & FIBULA 2 VIEWS	$395.20	$608.00	$42.31–$90.57	45% above	35%
Lower leg X-ray (tibia and fibula), 2 views inpatient CPT 73590 RADIOLOGIC EXAMINATION TIBIA & FIBULA 2 VIEWS	$395.20	$608.00	$169.02–$608.00	—	35%
MR angiography (MRA) of the head without contrast CPT 70544 MRA HEAD W/O CONTRST MATERIAL	$1,084.20	$1,668.00	$212.58–$359.84	25% below	35%
MR angiography (MRA) of the head without contrast inpatient CPT 70544 MRA HEAD W/O CONTRST MATERIAL	$1,084.20	$1,668.00	$463.70–$1,668.00	—	35%
MRI of both breasts, without and then with contrast dye both sides CPT 77049 MRI BREAST WITHOUT&WITH CONTRAST W/CAD BILATERAL	$3,889.60	$5,984.00	$1,304.51–$5,984.00	—	35%
MRI of both breasts, without and then with contrast dye both sides CPT 77049 MRI BREAST BILAT WO/W CONTR	$3,889.60	$5,984.00	$1,304.51–$5,984.00	—	35%
MRI of both breasts, without and then with contrast dye CPT 77049 MRI BREAST BIL W/ CONTR	$3,889.60	$5,984.00	$1,304.51–$5,984.00	at median	35%
MRI of both breasts, without and then with contrast dye inpatient both sides CPT 77049 MRI BREAST BILAT WO/W CONTR	$3,889.60	$5,984.00	$1,304.51–$5,984.00	—	35%
MRI of both breasts, without and then with contrast dye inpatient both sides CPT 77049 MRI BREAST WITHOUT&WITH CONTRAST W/CAD BILATERAL	$3,889.60	$5,984.00	$1,304.51–$5,984.00	—	35%
MRI of both breasts, without and then with contrast dye inpatient CPT 77049 MRI BREAST BIL W/ CONTR	$3,889.60	$5,984.00	$1,304.51–$5,984.00	—	35%
MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MRI ANY JT LOWER EXTREM W/O CONTRAST MATRL	$1,084.20	$1,668.00	$715.82–$1,354.98	38% below	35%
MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 MRI ANY JT LOWER EXTREM W/O CONTRAST MATRL	$1,084.20	$1,668.00	$463.70–$1,668.00	—	35%
MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 MRI ANY JT LOWER EXTREM W/O & W/CONTRAST MATRL	$1,601.60	$2,464.00	$330.06–$531.56	33% below	35%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 MRI ANY JT LOWER EXTREM W/O & W/CONTRAST MATRL	$1,601.60	$2,464.00	$684.99–$2,464.00	—	35%
MRI of the abdomen without contrast CPT 74181 MRI ABDOMEN W/O CONTRAST MATERIAL	$1,084.20	$1,668.00	$212.58–$295.82	41% below	35%
MRI of the abdomen without contrast inpatient CPT 74181 MRI ABDOMEN W/O CONTRAST MATERIAL	$1,084.20	$1,668.00	$463.70–$1,668.00	—	35%
MRI of the abdomen, without and then with contrast dye CPT 74183 MRI ABDOMEN W/O & W/CONTRAST MATERIAL	$1,601.60	$2,464.00	$684.99–$2,464.00	30% below	35%
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MRI ABDOMEN W/O & W/CONTRAST MATERIAL	$1,601.60	$2,464.00	$684.99–$2,464.00	—	35%
MRI of the brain, no contrast dye CPT 70551 MRI BRAIN BRAIN STEM W/O CONTRAST MATERIAL	$1,084.20	$1,668.00	$517.79–$1,354.98	33% below	35%
MRI of the brain, no contrast dye inpatient CPT 70551 MRI BRAIN BRAIN STEM W/O CONTRAST MATERIAL	$1,084.20	$1,668.00	$463.70–$1,668.00	—	35%
MRI of the brain, with and without contrast dye CPT 70553 MRI BRAIN BRAIN STEM W/O W/CONTRAST MATERIAL	$1,601.60	$2,464.00	$330.06–$447.04	27% below	35%
MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI BRAIN BRAIN STEM W/O W/CONTRAST MATERIAL	$1,601.60	$2,464.00	$684.99–$2,464.00	—	35%
MRI of the lower back, no contrast dye CPT 72148 MRI SPINAL CANAL LUMBAR W/O CONTRAST MATERIAL	$1,084.20	$1,668.00	$517.79–$1,354.98	35% below	35%
MRI of the lower back, no contrast dye inpatient CPT 72148 MRI SPINAL CANAL LUMBAR W/O CONTRAST MATERIAL	$1,084.20	$1,668.00	$463.70–$1,668.00	—	35%
MRI of the lower back, without and then with contrast dye CPT 72158 MRI SPINAL CANAL LUMBAR W/O & W/CONTR MATRL	$1,601.60	$2,464.00	$330.06–$447.04	31% below	35%
MRI of the lower back, without and then with contrast dye inpatient CPT 72158 MRI SPINAL CANAL LUMBAR W/O & W/CONTR MATRL	$1,601.60	$2,464.00	$684.99–$2,464.00	—	35%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI SPINAL CANAL THORACIC W/O CONTRAST MATRL	$1,084.20	$1,668.00	$517.79–$1,354.98	35% below	35%
MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 MRI SPINAL CANAL THORACIC W/O CONTRAST MATRL	$1,084.20	$1,668.00	$463.70–$1,668.00	—	35%
MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI SPINAL CANAL CERVICAL W/O & W/CONTR MATRL	$1,601.60	$2,464.00	$828.27–$1,863.61	29% below	35%
MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 MRI SPINAL CANAL CERVICAL W/O & W/CONTR MATRL	$1,601.60	$2,464.00	$684.99–$2,464.00	—	35%
MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI SPINAL CANAL CERVICAL W/O CONTRAST MATRL	$1,084.20	$1,668.00	$517.79–$1,354.98	34% below	35%
MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 MRI SPINAL CANAL CERVICAL W/O CONTRAST MATRL	$1,084.20	$1,668.00	$463.70–$1,668.00	—	35%
MRI of the pelvis without and with contrast CPT 72197 MRI PELVIS W/O & W/CONTRAST MATERIAL	$1,601.60	$2,464.00	$684.99–$2,464.00	18% below	35%
MRI of the pelvis without and with contrast inpatient CPT 72197 MRI PELVIS W/O & W/CONTRAST MATERIAL	$1,601.60	$2,464.00	$684.99–$2,464.00	—	35%
MRI of the pelvis, no contrast dye CPT 72195 MRI PELVIS W/O CONTRAST MATERIAL	$1,084.20	$1,668.00	$463.70–$1,668.00	29% below	35%
MRI of the pelvis, no contrast dye inpatient CPT 72195 MRI PELVIS W/O CONTRAST MATERIAL	$1,084.20	$1,668.00	$463.70–$1,668.00	—	35%
MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 MRI ANY JT UPPER EXTREMITY W/O CONTRAST MATRL	$1,084.20	$1,668.00	$715.82–$1,354.98	28% below	35%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 MRI ANY JT UPPER EXTREMITY W/O CONTRAST MATRL	$1,084.20	$1,668.00	$463.70–$1,668.00	—	35%
Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 RADEX SPINE CERVICAL 4 OR 5 VIEWS	$477.10	$734.00	$204.05–$734.00	6% above	35%
Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 RADEX SPINE CERVICAL 4 OR 5 VIEWS	$477.10	$734.00	$204.05–$734.00	—	35%
Neck soft tissue CT scan with contrast CPT 70491 CT SOFT TISSUE NECK W/CONTRAST MATERIAL	$798.20	$1,228.00	$159.40–$455.92	32% below	35%
Neck soft tissue CT scan with contrast inpatient CPT 70491 CT SOFT TISSUE NECK W/CONTRAST MATERIAL	$798.20	$1,228.00	$341.38–$1,228.00	—	35%
Neck soft tissue CT scan without contrast CPT 70490 CT SOFT TISSUE NECK W/O CONTRAST MATERIAL	$477.10	$734.00	$95.38–$212.67	48% below	35%
Neck soft tissue CT scan without contrast inpatient CPT 70490 CT SOFT TISSUE NECK W/O CONTRAST MATERIAL	$477.10	$734.00	$204.05–$734.00	—	35%
Neck soft tissue X-ray CPT 70360 RADIOLOGIC EXAMINATION NECK SOFT TISSUE	$395.20	$608.00	$169.02–$608.00	52% above	35%
Neck soft tissue X-ray inpatient CPT 70360 RADIOLOGIC EXAMINATION NECK SOFT TISSUE	$395.20	$608.00	$169.02–$608.00	—	35%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 MYOCARDIAL SPECT MULTIPLE STUDIES	$5,855.20	$9,008.00	$589.06–$1,347.32	46% above	35%
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 MYOCARDIAL SPECT MULTIPLE STUDIES	$5,855.20	$9,008.00	$2,504.22–$9,008.00	—	35%
OCT scan of the retina (optical coherence tomography) both sides CPT 92134 CPTRIZED OPH DX IMG PST SEGMENT UNI/BI RETINA	$177.45	$273.00	$75.89–$273.00	—	35%
OCT scan of the retina (optical coherence tomography) inpatient both sides CPT 92134 CPTRIZED OPH DX IMG PST SEGMENT UNI/BI RETINA	$177.45	$273.00	$75.89–$273.00	—	35%
PET/CT scan from the base of the skull to mid-thigh CPT 78815 PET IMAGING CT ATTENUATION SKULL BASE MID-THIGH	$6,541.60	$10,064.00	$2,797.79–$10,064.00	35% above	35%
PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 PET IMAGING CT ATTENUATION SKULL BASE MID-THIGH	$6,541.60	$10,064.00	$2,797.79–$10,064.00	—	35%
Pelvic CT scan without contrast CPT 72192 CT PELVIS W/O CONTRAST MATERIAL	$477.10	$734.00	$204.05–$734.00	53% below	35%
Pelvic CT scan without contrast inpatient CPT 72192 CT PELVIS W/O CONTRAST MATERIAL	$477.10	$734.00	$204.05–$734.00	—	35%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US PELVIC NONOBSTETRIC IMAGE DCMTN LIMITED/F/U	$477.10	$734.00	$91.55–$89,846.73	10% above	35%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US PELVIC NONOBSTETRIC IMAGE DCMTN LIMITED/F/U	$477.10	$734.00	$204.05–$734.00	—	35%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US PELVIC NONOBSTETRIC REAL-TIME IMAGE COMPLETE	$477.10	$734.00	$236.97–$89,845.57	5% below	35%
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 US PELVIC NONOBSTETRIC REAL-TIME IMAGE COMPLETE	$477.10	$734.00	$204.05–$734.00	—	35%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US PREG UTERUS AFTER 1ST TRIMEST 1/1ST GESTATION	$477.10	$734.00	$204.05–$734.00	20% below	35%
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US PREG UTERUS AFTER 1ST TRIMEST 1/1ST GESTATION	$477.10	$734.00	$204.05–$734.00	—	35%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 US PREGNANT UTERUS 14 WK TRANSABDL 1/1ST GESTAT	$477.10	$734.00	$204.05–$734.00	13% below	35%
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 US PREGNANT UTERUS 14 WK TRANSABDL 1/1ST GESTAT	$477.10	$734.00	$204.05–$734.00	—	35%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US PREGNANT UTERUS LIMITED 1/> FETUSES	$477.10	$734.00	$204.05–$734.00	at median	35%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 US PREGNANT UTERUS LIMITED 1/> FETUSES	$477.10	$734.00	$204.05–$734.00	—	35%
Rib X-ray, one side, 2 views one side CPT 71100 RADEX RIBS UNILATERAL 2 VIEWS	$395.20	$608.00	$169.02–$608.00	30% above	35%
Rib X-ray, one side, 2 views inpatient one side CPT 71100 RADEX RIBS UNILATERAL 2 VIEWS	$395.20	$608.00	$169.02–$608.00	—	35%
Rib X-ray, one side, with a chest view, 3 or more views CPT 71101 RADEX RIBS UNI W/POSTEROANT CH MINIMUM 3 VIEWS	$477.10	$734.00	$204.05–$734.00	25% above	35%
Rib X-ray, one side, with a chest view, 3 or more views inpatient CPT 71101 RADEX RIBS UNI W/POSTEROANT CH MINIMUM 3 VIEWS	$477.10	$734.00	$204.05–$734.00	—	35%
Screening mammogram, both breasts both sides CPT 77067 SCREENING MAMMOGRAPHY BI 2-VIEW BREAST INC CAD	$395.85	$609.00	$169.30–$609.00	—	35%
Screening mammogram, both breasts inpatient both sides CPT 77067 SCREENING MAMMOGRAPHY BI 2-VIEW BREAST INC CAD	$395.85	$609.00	$169.30–$609.00	—	35%
Shoulder X-ray, complete, 2 or more views CPT 73030 RADEX SHOULDER COMPLETE MINIMUM 2 VIEWS	$395.20	$608.00	$56.13–$85,372.93	17% above	35%
Shoulder X-ray, complete, 2 or more views inpatient CPT 73030 RADEX SHOULDER COMPLETE MINIMUM 2 VIEWS	$395.20	$608.00	$169.02–$608.00	—	35%
Sinus X-ray, complete, 3 or more views CPT 70220 RADEX SINUSES PARANASAL COMPL MINIMUM 3 VIEWS	$395.20	$608.00	$169.02–$608.00	9% above	35%
Sinus X-ray, complete, 3 or more views inpatient CPT 70220 RADEX SINUSES PARANASAL COMPL MINIMUM 3 VIEWS	$395.20	$608.00	$169.02–$608.00	—	35%
Skull X-ray, fewer than 4 views CPT 70250 RADIOLOGIC EXAMINATION SKULL 4< VIEWS	$477.10	$734.00	$204.05–$734.00	65% above	35%
Skull X-ray, fewer than 4 views inpatient CPT 70250 RADIOLOGIC EXAMINATION SKULL 4< VIEWS	$477.10	$734.00	$204.05–$734.00	—	35%
Sleep study in a lab (polysomnography) CPT 95810 POLYSOM 6/>YRS SLEEP 4/> ADDL PARAM ATTND	$4,563.00	$7,020.00	$1,951.56–$7,020.00	27% above	35%
Sleep study in a lab (polysomnography) inpatient CPT 95810 POLYSOM 6/>YRS SLEEP 4/> ADDL PARAM ATTND	$4,563.00	$7,020.00	$1,951.56–$7,020.00	—	35%
Stress echocardiogram, complete, including the stress test and supervision CPT 93351 ECHO TTHRC R-T 2D W/WO M-MODE REST&STRS CONT ECG	$2,049.45	$3,153.00	$876.53–$3,153.00	at median	35%
Stress echocardiogram, complete, including the stress test and supervision inpatient CPT 93351 ECHO TTHRC R-T 2D W/WO M-MODE REST&STRS CONT ECG	$2,049.45	$3,153.00	$876.53–$3,153.00	—	35%
Swallow study (modified barium swallow, video X-ray) CPT 74230 RADIOLOGIC EXAM SWALLOW FUNCTION CONTRAST STUDY	$798.20	$1,228.00	$142.61–$182.54	58% above	35%
Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 RADIOLOGIC EXAM SWALLOW FUNCTION CONTRAST STUDY	$798.20	$1,228.00	$341.38–$1,228.00	—	35%
Thigh bone (femur) X-ray, 2 or more views CPT 73552 RADIOLOGIC EXAMINATION FEMUR MINIMUM 2 VIEWS	$395.20	$608.00	$182.03–$85,983.15	46% above	35%
Thigh bone (femur) X-ray, 2 or more views inpatient CPT 73552 RADIOLOGIC EXAMINATION FEMUR MINIMUM 2 VIEWS	$395.20	$608.00	$169.02–$608.00	—	35%
Thoracic spine (mid back) CT scan without contrast CPT 72128 CT THORACIC SPINE W/O CONTRAST MATERIAL	$477.10	$734.00	$95.38–$212.67	47% below	35%
Thoracic spine (mid back) CT scan without contrast inpatient CPT 72128 CT THORACIC SPINE W/O CONTRAST MATERIAL	$477.10	$734.00	$204.05–$734.00	—	35%
Toe X-ray, 2 or more views CPT 73660 RADEX TOE MINIMUM 2 VIEWS	$395.20	$608.00	$39.35–$90.57	58% above	35%
Toe X-ray, 2 or more views inpatient CPT 73660 RADEX TOE MINIMUM 2 VIEWS	$395.20	$608.00	$169.02–$608.00	—	35%
Transvaginal pelvic ultrasound CPT 76830 US TRANSVAGINAL	$477.10	$734.00	$241.63–$89,815.18	15% below	35%
Transvaginal pelvic ultrasound inpatient CPT 76830 US TRANSVAGINAL	$477.10	$734.00	$204.05–$734.00	—	35%
Transvaginal ultrasound during pregnancy CPT 76817 US PREG UTERUS REAL TIME W/IMAGE DCMTN TRANSVAG	$477.10	$734.00	$95.38–$135.34	5% below	35%
Transvaginal ultrasound during pregnancy inpatient CPT 76817 US PREG UTERUS REAL TIME W/IMAGE DCMTN TRANSVAG	$477.10	$734.00	$204.05–$734.00	—	35%
Ultrasound of the abdomen, complete CPT 76700 US ABDOMINAL REAL TIME W/IMAGE DOCUMENTATION	$477.10	$734.00	$204.05–$734.00	24% below	35%
Ultrasound of the abdomen, complete inpatient CPT 76700 US ABDOMINAL REAL TIME W/IMAGE DOCUMENTATION	$477.10	$734.00	$204.05–$734.00	—	35%
Ultrasound of the scrotum and testicles CPT 76870 US SCROTUM & CONTENTS	$477.10	$734.00	$110.19–$89,861.94	11% below	35%
Ultrasound of the scrotum and testicles inpatient CPT 76870 US SCROTUM & CONTENTS	$477.10	$734.00	$204.05–$734.00	—	35%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US SOFT TISSUE HEAD & NECK REAL TIME IMGE DOCM	$477.10	$734.00	$245.18–$89,471.48	17% below	35%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US SOFT TISSUE HEAD & NECK REAL TIME IMGE DOCM	$477.10	$734.00	$204.05–$734.00	—	35%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 RADIOLOGIC EXAM UPR GI TRC SINGLE CONTRAST STUDY	$798.20	$1,228.00	$142.61–$182.54	35% above	35%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 RADIOLOGIC EXAM UPR GI TRC SINGLE CONTRAST STUDY	$798.20	$1,228.00	$341.38–$1,228.00	—	35%
Upper arm X-ray (humerus), 2 views CPT 73060 RADEX HUMERUS MINIMUM 2 VIEWS	$395.20	$608.00	$54.27–$85,408.00	44% above	35%
Upper arm X-ray (humerus), 2 views inpatient CPT 73060 RADEX HUMERUS MINIMUM 2 VIEWS	$395.20	$608.00	$169.02–$608.00	—	35%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 DUP-SCAN XTR VEINS UNILATERAL/LIMITED STUDY	$397.15	$611.00	$95.38–$161.38	46% below	35%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 DUP-SCAN XTR VEINS UNILATERAL/LIMITED STUDY	$397.15	$611.00	$169.86–$611.00	—	35%
Wrist X-ray, 2 views CPT 73100 RADEX WRIST 2 VIEWS	$395.20	$608.00	$45.60–$90.57	51% above	35%
Wrist X-ray, 2 views inpatient CPT 73100 RADEX WRIST 2 VIEWS	$395.20	$608.00	$169.02–$608.00	—	35%
Wrist X-ray, complete, 3 or more views CPT 73110 RADEX WRIST COMPLETE MINIMUM 3 VIEWS	$395.20	$608.00	$55.83–$90.57	18% above	35%
Wrist X-ray, complete, 3 or more views inpatient CPT 73110 RADEX WRIST COMPLETE MINIMUM 3 VIEWS	$395.20	$608.00	$169.02–$608.00	—	35%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 RADEX HIP UNILATERAL WITH PELVIS 2-3 VIEWS	$395.20	$608.00	$56.78–$90.57	28% above	35%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 RADEX HIP UNILATERAL WITH PELVIS 2-3 VIEWS	$395.20	$608.00	$169.02–$608.00	—	35%
X-ray of the abdomen, 1 view CPT 74018 RADIOLOGIC EXAM ABDOMEN 1 VIEW	$395.20	$608.00	$169.02–$608.00	54% above	35%
X-ray of the abdomen, 1 view inpatient CPT 74018 RADIOLOGIC EXAM ABDOMEN 1 VIEW	$395.20	$608.00	$169.02–$608.00	—	35%
X-ray of the ankle, 2 views CPT 73600 RADIOLOGIC EXAMINATION ANKLE 2 VIEWS	$395.20	$608.00	$43.25–$90.57	59% above	35%
X-ray of the ankle, 2 views inpatient CPT 73600 RADIOLOGIC EXAMINATION ANKLE 2 VIEWS	$395.20	$608.00	$169.02–$608.00	—	35%
X-ray of the finger(s), 2 or more views CPT 73140 RADEX FINGR MINIMUM 2 VIEWS	$395.20	$608.00	$52.04–$90.57	53% above	35%
X-ray of the finger(s), 2 or more views inpatient CPT 73140 RADEX FINGR MINIMUM 2 VIEWS	$395.20	$608.00	$169.02–$608.00	—	35%
X-ray of the foot, 2 views CPT 73620 RADIOLOGIC EXAMINATION FOOT 2 VIEWS	$395.20	$608.00	$38.08–$90.57	70% above	35%
X-ray of the foot, 2 views inpatient CPT 73620 RADIOLOGIC EXAMINATION FOOT 2 VIEWS	$395.20	$608.00	$169.02–$608.00	—	35%
X-ray of the foot, complete, 3 or more views CPT 73630 RADEX FOOT COMPLETE MINIMUM 3 VIEWS	$395.20	$608.00	$45.96–$90.57	29% above	35%
X-ray of the foot, complete, 3 or more views inpatient CPT 73630 RADEX FOOT COMPLETE MINIMUM 3 VIEWS	$395.20	$608.00	$169.02–$608.00	—	35%
X-ray of the hand, 3 or more views CPT 73130 RADEX HAND MINIMUM 3 VIEWS	$395.20	$608.00	$50.19–$90.57	21% above	35%
X-ray of the hand, 3 or more views inpatient CPT 73130 RADEX HAND MINIMUM 3 VIEWS	$395.20	$608.00	$169.02–$608.00	—	35%
X-ray of the knee, 1 or 2 views CPT 73560 RADIOLOGIC EXAMINATION KNEE 1/2 VIEWS	$395.20	$608.00	$46.07–$90.57	45% above	35%
X-ray of the knee, 1 or 2 views inpatient CPT 73560 RADIOLOGIC EXAMINATION KNEE 1/2 VIEWS	$395.20	$608.00	$169.02–$608.00	—	35%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 RADEX SPINE LUMBOSACRAL 2/3 VIEWS	$477.10	$734.00	$204.05–$734.00	48% above	35%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 RADEX SPINE LUMBOSACRAL 2/3 VIEWS	$477.10	$734.00	$204.05–$734.00	—	35%
X-ray of the lower back, 4 or more views CPT 72110 RADEX SPINE LUMBOSACRAL MINIMUM 4 VIEWS	$477.10	$734.00	$204.05–$734.00	2% above	35%
X-ray of the lower back, 4 or more views inpatient CPT 72110 RADEX SPINE LUMBOSACRAL MINIMUM 4 VIEWS	$477.10	$734.00	$204.05–$734.00	—	35%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 RADEX SPINE THORACIC 2 VIEWS	$477.10	$734.00	$204.05–$734.00	58% above	35%
X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 RADEX SPINE THORACIC 2 VIEWS	$477.10	$734.00	$204.05–$734.00	—	35%
X-ray of the nasal bones, 3 or more views CPT 70160 RADEX NASAL BONES COMPLETE MINIMUM 3 VIEWS	$395.20	$608.00	$169.02–$608.00	35% above	35%
X-ray of the nasal bones, 3 or more views inpatient CPT 70160 RADEX NASAL BONES COMPLETE MINIMUM 3 VIEWS	$395.20	$608.00	$169.02–$608.00	—	35%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 RADEX SPINE CERVICAL 2 OR 3 VIEWS	$395.20	$608.00	$169.02–$608.00	18% above	35%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 RADEX SPINE CERVICAL 2 OR 3 VIEWS	$395.20	$608.00	$169.02–$608.00	—	35%
X-ray of the pelvis, 1 or 2 views CPT 72170 RADIOLOGIC EXAMINATION PELVIS 1/2 VIEWS	$477.10	$734.00	$204.05–$734.00	90% above	35%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 RADIOLOGIC EXAMINATION PELVIS 1/2 VIEWS	$477.10	$734.00	$204.05–$734.00	—	35%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 RADEX SACRUM & COCCYX MINIMUM 2 VIEWS	$395.20	$608.00	$54.27–$84,426.03	33% above	35%
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 RADEX SACRUM & COCCYX MINIMUM 2 VIEWS	$395.20	$608.00	$169.02–$608.00	—	35%

Lab tests

Procedure	Cash price	List price	Insurers pay	vs Ohio	Off list
ACTH blood test CPT 82024 ACTH	$172.90	$266.00	$27.68–$42.48	31% above	35%
ACTH blood test inpatient CPT 82024 ACTH	$172.90	$266.00	$75.22–$266.00	—	35%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 %LIVFIB ALANINE AMINO	$24.05	$37.00	$10.46–$37.00	14% below	35%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 %HCVSUR ALT (SGPT)	$24.05	$37.00	$5.30–$13.61	14% below	35%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 ALT/SGPT	$24.05	$37.00	$5.30–$13.61	14% below	35%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 %NASH AST	$24.05	$37.00	$10.46–$37.00	14% below	35%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 ALANINE AMINOTRANSFERASE, FIBROMETER	$24.05	$37.00	$10.46–$37.00	14% below	35%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 %LIVFIB ALANINE AMINO	$24.05	$37.00	$10.46–$37.00	—	35%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 ALANINE AMINOTRANSFERASE, FIBROMETER	$24.05	$37.00	$10.46–$37.00	—	35%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 ALT/SGPT	$24.05	$37.00	$10.46–$37.00	—	35%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 %HCVSUR ALT (SGPT)	$24.05	$37.00	$10.46–$37.00	—	35%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 %NASH AST	$24.05	$37.00	$10.46–$37.00	—	35%
AST (aspartate aminotransferase) enzyme test CPT 84450 AST/SGOT	$23.40	$36.00	$5.18–$13.61	7% below	35%
AST (aspartate aminotransferase) enzyme test CPT 84450 %NASH AST	$23.40	$36.00	$10.18–$36.00	7% below	35%
AST (aspartate aminotransferase) enzyme test CPT 84450 ASPARTATE AMINOTRANSFERASE, FIBROMETER	$23.40	$36.00	$10.18–$36.00	7% below	35%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 AST/SGOT	$23.40	$36.00	$10.18–$36.00	—	35%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 ASPARTATE AMINOTRANSFERASE, FIBROMETER	$23.40	$36.00	$10.18–$36.00	—	35%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 %NASH AST	$23.40	$36.00	$10.18–$36.00	—	35%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 HEPATITIS ACUTE PANEL	$213.85	$329.00	$93.04–$329.00	2% below	35%
Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 HEPATITIS ACUTE PANEL	$213.85	$329.00	$93.04–$329.00	—	35%
Albumin blood test CPT 82040 ALBUMIN SERUM ASSAY	$22.10	$34.00	$4.95–$13.61	at median	35%
Albumin blood test CPT 82040 LYMRFX SERUM ALBUMIN	$22.10	$34.00	$9.62–$34.00	at median	35%
Albumin blood test inpatient CPT 82040 ALBUMIN SERUM ASSAY	$22.10	$34.00	$9.62–$34.00	—	35%
Albumin blood test inpatient CPT 82040 LYMRFX SERUM ALBUMIN	$22.10	$34.00	$9.62–$34.00	—	35%
Aldosterone blood test CPT 82088 ALDOSTERONE	$182.65	$281.00	$27.68–$44.83	31% above	35%
Aldosterone blood test inpatient CPT 82088 ALDOSTERONE	$182.65	$281.00	$79.47–$281.00	—	35%
Alkaline phosphatase (ALP) blood test CPT 84075 ALKA PHOSPHTA	$23.40	$36.00	$5.18–$13.61	2% below	35%
Alkaline phosphatase (ALP) blood test inpatient CPT 84075 ALKA PHOSPHTA	$23.40	$36.00	$10.18–$36.00	—	35%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, FOOD, LIMA BEAN/WHITE BEAN	$23.40	$36.00	$2.96–$23.26	at median	35%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, FOOD, GINGER IGE	$23.40	$36.00	$10.18–$36.00	at median	35%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, FOOD, GOAT MILK IGE	$23.40	$36.00	$10.18–$36.00	at median	35%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, FOOD, CAULIFLOWER IGE	$23.40	$36.00	$2.96–$23.26	at median	35%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, FOOD, BLACK OLIVE IGE	$23.40	$36.00	$2.96–$23.26	at median	35%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, FOOD, TURMERIC IGE	$23.40	$36.00	$2.96–$23.26	at median	35%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, FOOD, TEA IGE	$23.40	$36.00	$2.96–$23.26	at median	35%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, FOOD, SPINACH	$23.40	$36.00	$2.96–$23.26	at median	35%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, FOOD, SUMMER SQUASH IGE	$23.40	$36.00	$2.96–$23.26	at median	35%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, WEED, SAGEBRUSH/WORMWOOD IGE	$23.40	$36.00	$2.96–$23.26	at median	35%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, FOOD, NUTMEG IGE	$23.40	$36.00	$10.18–$36.00	at median	35%
Allergy blood test, specific IgE, per allergen CPT 86003 HYPERSENSITIVITY PNEUMO IGE QUANT	$23.40	$36.00	$5.22–$26.72	at median	35%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, INSECT, MOSQUITO, IGE	$23.40	$36.00	$5.22–$26.72	at median	35%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, FOOD, APRICOT	$23.40	$36.00	$10.18–$36.00	at median	35%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, REGION 3 SOUTH ATLANTIC RESPIRATORY PANEL IGE	$23.40	$36.00	$5.22–$26.72	at median	35%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, FUNGI/MOLD, CURVULARIA LUNATA	$23.40	$36.00	$2.96–$23.26	at median	35%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, FUNGI/MOLD, B. SPICIFERA IGE	$23.40	$36.00	$2.96–$23.26	at median	35%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, FOOD, ASPARAGUS IGE	$23.40	$36.00	$2.96–$23.26	at median	35%
Allergy blood test, specific IgE, per allergen CPT 86003 HOPS, IGE ALLERGEN	$23.40	$36.00	$5.22–$26.72	at median	35%
Allergy blood test, specific IgE, per allergen CPT 86003 CHEESE SWISS IGE	$23.40	$36.00	$10.18–$36.00	at median	35%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, TREE, PALM/QUEEN TREE IGE	$23.40	$36.00	$5.22–$26.72	at median	35%
Allergy blood test, specific IgE, per allergen CPT 86003 CHEESE PARMESAN IGE	$23.40	$36.00	$10.18–$36.00	at median	35%
Allergy blood test, specific IgE, per allergen CPT 86003 CHEESE MOZZARELLA IGE	$23.40	$36.00	$10.18–$36.00	at median	35%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, FOOD, CAROB GUM IGE	$23.40	$36.00	$5.22–$26.72	at median	35%
Allergy blood test, specific IgE, per allergen CPT 86003 LUPINE SEED (LUPINUS ALBUS) IGE	$23.40	$36.00	$10.18–$36.00	at median	35%
Allergy blood test, specific IgE, per allergen CPT 86003 F324-IGE HOP (FOOD)	$23.40	$36.00	$2.96–$23.26	at median	35%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, INSECT, BUMBLE BEE VENOM IGE	$23.40	$36.00	$5.22–$26.72	at median	35%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, TOTAL VENOM PANEL IGE WITH REFLEX TO COMPONENTS	$23.40	$36.00	$10.18–$36.00	at median	35%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, PAPER WASP IGE WITH REFLEX TO COMPONENT	$23.40	$36.00	$10.18–$36.00	at median	35%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, FOOD, SARDINE IGE	$23.40	$36.00	$5.22–$26.72	at median	35%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, YELLOW JACKET (COMMON WASP) IGE WITH REFLEX TO COMPONE	$23.40	$36.00	$10.18–$36.00	at median	35%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, HONEY BEE IGE WITH REFLEX TO COMPONENTS	$23.40	$36.00	$10.18–$36.00	at median	35%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, INSECT, FIRE ANT, IMPORTED	$23.40	$36.00	$5.22–$26.72	at median	35%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, WHEAT WITH COMPONENT REFLEX	$23.40	$36.00	$10.18–$36.00	at median	35%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, SESAME SEED WITH COMPONENT REFLEX	$23.40	$36.00	$10.18–$36.00	at median	35%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, FOOD, EGGPLANT	$23.40	$36.00	$5.22–$26.72	at median	35%
Allergy blood test, specific IgE, per allergen CPT 86003 ALGN OCCUPATNL TOBACCO	$23.40	$36.00	$5.22–$26.72	at median	35%
Allergy blood test, specific IgE, per allergen CPT 86003 ALGN CHAETOMIUM GLOB IGE	$23.40	$36.00	$10.18–$36.00	at median	35%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, FOOD, ANNATTO SEED IGE	$23.40	$36.00	$2.96–$23.26	at median	35%
Allergy blood test, specific IgE, per allergen CPT 86003 ALGN ORRIS ROOT IGE	$23.40	$36.00	$10.18–$36.00	at median	35%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, EGG IGE X2	$23.40	$36.00	$10.18–$36.00	at median	35%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, FOOD, ANCHOVY IGE	$23.40	$36.00	$2.96–$23.26	at median	35%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, MILK IGE X4	$23.40	$36.00	$10.18–$36.00	at median	35%
Allergy blood test, specific IgE, per allergen CPT 86003 ATOPIC ALGN IGE QNT X11	$23.40	$36.00	$10.18–$36.00	at median	35%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, FOOD, NAVY BEAN IGE	$23.40	$36.00	$2.96–$23.26	at median	35%
Allergy blood test, specific IgE, per allergen CPT 86003 *ALLERG SP IGE;QT OR QUAL	$23.40	$36.00	$10.18–$36.00	at median	35%
Allergy blood test, specific IgE, per allergen CPT 86003 %PNUTCP ALLG SPEC IGE	$23.40	$36.00	$2.96–$23.26	at median	35%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, FOOD, LAMB	$23.40	$36.00	$2.96–$23.26	at median	35%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN IGE EACH	$23.40	$36.00	$10.18–$36.00	at median	35%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN IGE QUANT/SEMI EA	$23.40	$36.00	$10.18–$36.00	at median	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HOPS, IGE ALLERGEN	$23.40	$36.00	$10.18–$36.00	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HYPERSENSITIVITY PNEUMO IGE QUANT	$23.40	$36.00	$10.18–$36.00	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, REGION 3 SOUTH ATLANTIC RESPIRATORY PANEL IGE	$23.40	$36.00	$10.18–$36.00	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, TREE, PALM/QUEEN TREE IGE	$23.40	$36.00	$10.18–$36.00	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, FOOD, CAROB GUM IGE	$23.40	$36.00	$10.18–$36.00	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, INSECT, BUMBLE BEE VENOM IGE	$23.40	$36.00	$10.18–$36.00	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, FOOD, SARDINE IGE	$23.40	$36.00	$10.18–$36.00	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, INSECT, FIRE ANT, IMPORTED	$23.40	$36.00	$10.18–$36.00	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, FOOD, EGGPLANT	$23.40	$36.00	$10.18–$36.00	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, FOOD, ANNATTO SEED IGE	$23.40	$36.00	$10.18–$36.00	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, FOOD, ANCHOVY IGE	$23.40	$36.00	$10.18–$36.00	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, FOOD, NAVY BEAN IGE	$23.40	$36.00	$10.18–$36.00	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, FOOD, LAMB	$23.40	$36.00	$10.18–$36.00	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, FOOD, LIMA BEAN/WHITE BEAN	$23.40	$36.00	$10.18–$36.00	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, FOOD, GINGER IGE	$23.40	$36.00	$10.18–$36.00	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, FOOD, GOAT MILK IGE	$23.40	$36.00	$10.18–$36.00	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, FOOD, CAULIFLOWER IGE	$23.40	$36.00	$10.18–$36.00	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, FOOD, BLACK OLIVE IGE	$23.40	$36.00	$10.18–$36.00	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, FOOD, TURMERIC IGE	$23.40	$36.00	$10.18–$36.00	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, FOOD, TEA IGE	$23.40	$36.00	$10.18–$36.00	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, FOOD, SPINACH	$23.40	$36.00	$10.18–$36.00	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, FOOD, SUMMER SQUASH IGE	$23.40	$36.00	$10.18–$36.00	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, WEED, SAGEBRUSH/WORMWOOD IGE	$23.40	$36.00	$10.18–$36.00	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, FOOD, NUTMEG IGE	$23.40	$36.00	$10.18–$36.00	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, INSECT, MOSQUITO, IGE	$23.40	$36.00	$10.18–$36.00	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, FOOD, APRICOT	$23.40	$36.00	$10.18–$36.00	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, FUNGI/MOLD, CURVULARIA LUNATA	$23.40	$36.00	$10.18–$36.00	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, FUNGI/MOLD, B. SPICIFERA IGE	$23.40	$36.00	$10.18–$36.00	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, FOOD, ASPARAGUS IGE	$23.40	$36.00	$10.18–$36.00	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CHEESE SWISS IGE	$23.40	$36.00	$10.18–$36.00	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CHEESE PARMESAN IGE	$23.40	$36.00	$10.18–$36.00	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CHEESE MOZZARELLA IGE	$23.40	$36.00	$10.18–$36.00	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 LUPINE SEED (LUPINUS ALBUS) IGE	$23.40	$36.00	$10.18–$36.00	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F324-IGE HOP (FOOD)	$23.40	$36.00	$10.18–$36.00	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, TOTAL VENOM PANEL IGE WITH REFLEX TO COMPONENTS	$23.40	$36.00	$10.18–$36.00	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, PAPER WASP IGE WITH REFLEX TO COMPONENT	$23.40	$36.00	$10.18–$36.00	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, YELLOW JACKET (COMMON WASP) IGE WITH REFLEX TO COMPONE	$23.40	$36.00	$10.18–$36.00	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, HONEY BEE IGE WITH REFLEX TO COMPONENTS	$23.40	$36.00	$10.18–$36.00	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, WHEAT WITH COMPONENT REFLEX	$23.40	$36.00	$10.18–$36.00	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, SESAME SEED WITH COMPONENT REFLEX	$23.40	$36.00	$10.18–$36.00	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALGN OCCUPATNL TOBACCO	$23.40	$36.00	$10.18–$36.00	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALGN CHAETOMIUM GLOB IGE	$23.40	$36.00	$10.18–$36.00	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALGN ORRIS ROOT IGE	$23.40	$36.00	$10.18–$36.00	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, EGG IGE X2	$23.40	$36.00	$10.18–$36.00	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, MILK IGE X4	$23.40	$36.00	$10.18–$36.00	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ATOPIC ALGN IGE QNT X11	$23.40	$36.00	$10.18–$36.00	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 *ALLERG SP IGE;QT OR QUAL	$23.40	$36.00	$10.18–$36.00	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 %PNUTCP ALLG SPEC IGE	$23.40	$36.00	$10.18–$36.00	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN IGE EACH	$23.40	$36.00	$10.18–$36.00	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN IGE QUANT/SEMI EA	$23.40	$36.00	$10.18–$36.00	—	35%
Alpha-fetoprotein (AFP) blood test CPT 82105 ALPHA-FETOPROTEIN SERUM	$75.40	$116.00	$16.77–$21.01	24% above	35%
Alpha-fetoprotein (AFP) blood test CPT 82105 %2ND TRI AFP	$75.40	$116.00	$32.80–$116.00	24% above	35%
Alpha-fetoprotein (AFP) blood test CPT 82105 %SEQ2 ALPHA FETOPROTEIN	$75.40	$116.00	$8.28–$43.14	24% above	35%
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 %2ND TRI AFP	$75.40	$116.00	$32.80–$116.00	—	35%
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 ALPHA-FETOPROTEIN SERUM	$75.40	$116.00	$32.80–$116.00	—	35%
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 %SEQ2 ALPHA FETOPROTEIN	$75.40	$116.00	$32.80–$116.00	—	35%
Ammonia blood test CPT 82140 %SSAT24 AMMONIUM	$65.65	$101.00	$28.56–$101.00	20% above	35%
Ammonia blood test CPT 82140 AMMONIA	$65.65	$101.00	$28.56–$101.00	20% above	35%
Ammonia blood test CPT 82140 AMMONIUM, RANDOM, URINE	$65.65	$101.00	$28.56–$101.00	20% above	35%
Ammonia blood test CPT 82140 AMMONIUM, 24 HOUR, URINE	$65.65	$101.00	$28.56–$101.00	20% above	35%
Ammonia blood test inpatient CPT 82140 %SSAT24 AMMONIUM	$65.65	$101.00	$28.56–$101.00	—	35%
Ammonia blood test inpatient CPT 82140 AMMONIUM, 24 HOUR, URINE	$65.65	$101.00	$28.56–$101.00	—	35%
Ammonia blood test inpatient CPT 82140 AMMONIUM, RANDOM, URINE	$65.65	$101.00	$28.56–$101.00	—	35%
Ammonia blood test inpatient CPT 82140 AMMONIA	$65.65	$101.00	$28.56–$101.00	—	35%
Amylase blood test CPT 82150 *AMYLASE ASSAY	$29.25	$45.00	$12.73–$45.00	39% below	35%
Amylase blood test CPT 82150 AMYLASE	$29.25	$45.00	$12.73–$45.00	39% below	35%
Amylase blood test inpatient CPT 82150 AMYLASE	$29.25	$45.00	$12.73–$45.00	—	35%
Amylase blood test inpatient CPT 82150 *AMYLASE ASSAY	$29.25	$45.00	$12.73–$45.00	—	35%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CYCLIC CITRU PEPT ANTI IG	$57.85	$89.00	$6.39–$39.01	at median	35%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 CYCLIC CITRU PEPT ANTI IG	$57.85	$89.00	$25.17–$89.00	—	35%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANTINUCLEAR	$53.95	$83.00	$23.47–$83.00	2% below	35%
Antinuclear antibody (ANA) blood test, screen CPT 86038 %FANA ANA AB	$53.95	$83.00	$12.09–$26.72	2% below	35%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 %FANA ANA AB	$53.95	$83.00	$23.47–$83.00	—	35%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANTINUCLEAR	$53.95	$83.00	$23.47–$83.00	—	35%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 B-TUP NATRIURETC PEPTIDE (POINT OF CARE LAB)	$176.15	$271.00	$45.06–$88.34	18% above	35%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 NT PRO BNP	$176.15	$271.00	$76.64–$271.00	18% above	35%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 NATRIURETIC PEPTIDE ASSAY	$176.15	$271.00	$45.06–$88.34	18% above	35%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 B-TUP NATRIURETC PEPTIDE (POINT OF CARE LAB)	$176.15	$271.00	$76.64–$271.00	—	35%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 NATRIURETIC PEPTIDE ASSAY	$176.15	$271.00	$76.64–$271.00	—	35%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 NT PRO BNP	$176.15	$271.00	$76.64–$271.00	—	35%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 TRFX MED MISC SCRN	$38.35	$59.00	$4.26–$32.18	42% below	35%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE, BACTERIAL, AEROBIC	$38.35	$59.00	$16.69–$59.00	42% below	35%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 TRFX MED FUNGAL SCRN	$38.35	$59.00	$4.26–$32.18	42% below	35%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 %IOHWC CULTURE	$38.35	$59.00	$4.26–$32.18	42% below	35%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 TRFX MED FUNGAL SCRN	$38.35	$59.00	$16.69–$59.00	—	35%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 %IOHWC CULTURE	$38.35	$59.00	$16.69–$59.00	—	35%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE, BACTERIAL, AEROBIC	$38.35	$59.00	$16.69–$59.00	—	35%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 TRFX MED MISC SCRN	$38.35	$59.00	$16.69–$59.00	—	35%
Basic metabolic panel (blood test) CPT 80048 BASIC METABOLIC PANEL	$37.70	$58.00	$16.40–$58.00	43% below	35%
Basic metabolic panel (blood test) inpatient CPT 80048 BASIC METABOLIC PANEL	$37.70	$58.00	$16.40–$58.00	—	35%
Bilirubin blood test, total CPT 82247 TOTAL BILIRUBIN	$22.75	$35.00	$9.90–$35.00	5% below	35%
Bilirubin blood test, total CPT 82247 BILIRUBIN TOTAL (BACK OFFICE)	$22.75	$35.00	$5.02–$13.61	5% below	35%
Bilirubin blood test, total CPT 82247 BILIRUBIN TOTAL	$22.75	$35.00	$4.36–$11.30	5% below	35%
Bilirubin blood test, total CPT 82247 %NASH BILIRUBIN TOTAL	$22.75	$35.00	$5.02–$13.61	5% below	35%
Bilirubin blood test, total CPT 82247 %LIVFIB BILIRUBIN	$22.75	$35.00	$9.90–$35.00	5% below	35%
Bilirubin blood test, total CPT 82247 %GMAPS BILIRUBIN TOTAL	$22.75	$35.00	$5.02–$13.61	5% below	35%
Bilirubin blood test, total inpatient CPT 82247 %LIVFIB BILIRUBIN	$22.75	$35.00	$9.90–$35.00	—	35%
Bilirubin blood test, total inpatient CPT 82247 TOTAL BILIRUBIN	$22.75	$35.00	$9.90–$35.00	—	35%
Bilirubin blood test, total inpatient CPT 82247 BILIRUBIN TOTAL	$22.75	$35.00	$9.90–$35.00	—	35%
Bilirubin blood test, total inpatient CPT 82247 BILIRUBIN TOTAL (BACK OFFICE)	$22.75	$35.00	$9.90–$35.00	—	35%
Bilirubin blood test, total inpatient CPT 82247 %NASH BILIRUBIN TOTAL	$22.75	$35.00	$9.90–$35.00	—	35%
Bilirubin blood test, total inpatient CPT 82247 %GMAPS BILIRUBIN TOTAL	$22.75	$35.00	$9.90–$35.00	—	35%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 EM THICK ONLY	$239.85	$369.00	$104.35–$369.00	18% above	35%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 SP BIOPSY PROSTATE	$239.85	$369.00	$37.39–$92.44	18% above	35%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 SURGERY PATH GROSS MICRO LEVEL 4	$239.85	$369.00	$104.35–$369.00	18% above	35%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 SKIN MICRO LEVEL 4	$239.85	$369.00	$74.64–$111.96	18% above	35%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 SKIN MICRO LEVEL 4	$239.85	$369.00	$104.35–$369.00	—	35%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 SP BIOPSY PROSTATE	$239.85	$369.00	$104.35–$369.00	—	35%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 EM THICK ONLY	$239.85	$369.00	$104.35–$369.00	—	35%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 SURGERY PATH GROSS MICRO LEVEL 4	$239.85	$369.00	$104.35–$369.00	—	35%
Blood culture for bacteria CPT 87040 CULTURE, BACTERIAL, BLOOD, AEROBIC AND ANAEROBIC	$46.15	$71.00	$5.10–$31.80	51% below	35%
Blood culture for bacteria inpatient CPT 87040 CULTURE, BACTERIAL, BLOOD, AEROBIC AND ANAEROBIC	$46.15	$71.00	$20.08–$71.00	—	35%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 ROUTINE VENIPUNCTURE	$40.95	$63.00	$2.64–$10.27	157% above	35%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 VENIPUNCTURE	$40.95	$63.00	$2.64–$10.27	157% above	35%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 COLLECTION VENOUS BLOOD VENIPUNCTURE	$40.95	$63.00	$2.64–$10.27	157% above	35%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 COLLECTION VENOUS BLOOD VENIPUNCTURE	$40.95	$63.00	$17.82–$63.00	—	35%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 VENIPUNCTURE	$40.95	$63.00	$17.82–$63.00	—	35%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 ROUTINE VENIPUNCTURE	$40.95	$63.00	$17.82–$63.00	—	35%
Blood glucose (sugar) test CPT 82947 %NASH GLUC QUANT	$17.55	$27.00	$3.93–$13.61	26% below	35%
Blood glucose (sugar) test CPT 82947 %GMAPS GLUCOSE QT	$17.55	$27.00	$3.93–$13.61	26% below	35%
Blood glucose (sugar) test CPT 82947 GLUCOSE QUANT (POINT OF CARE LAB)	$17.55	$27.00	$3.93–$13.61	26% below	35%
Blood glucose (sugar) test CPT 82947 GLUCOSE QUANT	$17.55	$27.00	$1.94–$10.56	26% below	35%
Blood glucose (sugar) test CPT 82947 GLUC, FASTING	$17.55	$27.00	$3.93–$13.61	26% below	35%
Blood glucose (sugar) test CPT 82947 GLUC BLOOD QUANT ASSAY	$17.55	$27.00	$1.94–$10.56	26% below	35%
Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE QUANT	$17.55	$27.00	$7.64–$27.00	—	35%
Blood glucose (sugar) test inpatient CPT 82947 GLUC, FASTING	$17.55	$27.00	$7.64–$27.00	—	35%
Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE QUANT (POINT OF CARE LAB)	$17.55	$27.00	$7.64–$27.00	—	35%
Blood glucose (sugar) test inpatient CPT 82947 %GMAPS GLUCOSE QT	$17.55	$27.00	$7.64–$27.00	—	35%
Blood glucose (sugar) test inpatient CPT 82947 %NASH GLUC QUANT	$17.55	$27.00	$7.64–$27.00	—	35%
Blood glucose (sugar) test inpatient CPT 82947 GLUC BLOOD QUANT ASSAY	$17.55	$27.00	$7.64–$27.00	—	35%
Blood lead test CPT 83655 %UTXM4 LEAD	$54.60	$84.00	$16.07–$32.63	12% above	35%
Blood lead test CPT 83655 LEAD UR 24HR	$54.60	$84.00	$23.76–$84.00	12% above	35%
Blood lead test CPT 83655 %OSHA LEAD	$54.60	$84.00	$23.76–$84.00	12% above	35%
Blood lead test CPT 83655 %UTXM3 LEAD	$54.60	$84.00	$16.07–$32.63	12% above	35%
Blood lead test CPT 83655 LEAD CONCENTRATION	$54.60	$84.00	$23.76–$84.00	12% above	35%
Blood lead test inpatient CPT 83655 LEAD CONCENTRATION	$54.60	$84.00	$23.76–$84.00	—	35%
Blood lead test inpatient CPT 83655 %UTXM3 LEAD	$54.60	$84.00	$23.76–$84.00	—	35%
Blood lead test inpatient CPT 83655 %OSHA LEAD	$54.60	$84.00	$23.76–$84.00	—	35%
Blood lead test inpatient CPT 83655 %UTXM4 LEAD	$54.60	$84.00	$23.76–$84.00	—	35%
Blood lead test inpatient CPT 83655 LEAD UR 24HR	$54.60	$84.00	$23.76–$84.00	—	35%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 CHORIONIC GONADOTROPIN ASSAY	$33.80	$52.00	$9.98–$20.26	38% below	35%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 UA DIP URINE HCG (POINT OF CARE LAB)	$33.80	$52.00	$7.52–$13.61	38% below	35%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 HCG TEST QUAL	$33.80	$52.00	$14.71–$52.00	38% below	35%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 HCG TEST QUAL (POINT OF CARE LAB)	$33.80	$52.00	$7.52–$13.61	38% below	35%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 UA DIP URINE HCG (POINT OF CARE LAB)	$33.80	$52.00	$14.71–$52.00	—	35%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 HCG TEST QUAL	$33.80	$52.00	$14.71–$52.00	—	35%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 CHORIONIC GONADOTROPIN ASSAY	$33.80	$52.00	$14.71–$52.00	—	35%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 HCG TEST QUAL (POINT OF CARE LAB)	$33.80	$52.00	$14.71–$52.00	—	35%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 PAT ABO BLOOD TYPING	$13.65	$21.00	$5.94–$21.00	77% below	35%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 WHIVF BLD BYPE ABO	$13.65	$21.00	$5.94–$21.00	77% below	35%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 ABO BLOOD TYPING	$13.65	$21.00	$27.84–$138.46	77% below	35%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 ABO TYPRING (FULL)	$13.65	$21.00	$1.48–$22.96	77% below	35%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 PAT ABO BLOOD TYPING	$13.65	$21.00	$5.94–$21.00	—	35%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 ABO TYPRING (FULL)	$13.65	$21.00	$5.94–$21.00	—	35%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 ABO BLOOD TYPING	$13.65	$21.00	$5.94–$21.00	—	35%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 WHIVF BLD BYPE ABO	$13.65	$21.00	$5.94–$21.00	—	35%
Blood urea nitrogen (BUN) test CPT 84520 I STAT BUN DETERMINATION (POINT OF CARE LAB)	$17.55	$27.00	$1.95–$10.65	25% below	35%
Blood urea nitrogen (BUN) test CPT 84520 UREA NITROGEN, SERUM, FIBROMETER	$17.55	$27.00	$7.64–$27.00	25% below	35%
Blood urea nitrogen (BUN) test CPT 84520 BUN	$17.55	$27.00	$1.95–$10.65	25% below	35%
Blood urea nitrogen (BUN) test inpatient CPT 84520 UREA NITROGEN, SERUM, FIBROMETER	$17.55	$27.00	$7.64–$27.00	—	35%
Blood urea nitrogen (BUN) test inpatient CPT 84520 I STAT BUN DETERMINATION (POINT OF CARE LAB)	$17.55	$27.00	$7.64–$27.00	—	35%
Blood urea nitrogen (BUN) test inpatient CPT 84520 BUN	$17.55	$27.00	$7.64–$27.00	—	35%
C-peptide blood test CPT 84681 UCPEP C PEPTIDE URINE	$93.60	$144.00	$40.72–$144.00	18% above	35%
C-peptide blood test CPT 84681 C-PEPTIDE SERUM	$93.60	$144.00	$40.72–$144.00	18% above	35%
C-peptide blood test inpatient CPT 84681 C-PEPTIDE SERUM	$93.60	$144.00	$40.72–$144.00	—	35%
C-peptide blood test inpatient CPT 84681 UCPEP C PEPTIDE URINE	$93.60	$144.00	$40.72–$144.00	—	35%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C-REACTIVE PROTEIN	$23.40	$36.00	$10.18–$36.00	53% below	35%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 %IBDSGI C REAC PROTEIN	$23.40	$36.00	$10.18–$36.00	53% below	35%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 C-REACTIVE PROTEIN	$23.40	$36.00	$10.18–$36.00	—	35%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 %IBDSGI C REAC PROTEIN	$23.40	$36.00	$10.18–$36.00	—	35%
C. difficile toxin gene test (stool PCR) CPT 87493 AMPLIFICATION, CLOSTRIDIUM DIFFICILE	$167.05	$257.00	$33.62–$41.00	28% above	35%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 AMPLIFICATION, CLOSTRIDIUM DIFFICILE	$167.05	$257.00	$72.68–$257.00	—	35%
CA 19-9 blood test (tumor marker) CPT 86301 IMMUNOASSY TUMOR CA 19-9	$93.60	$144.00	$40.72–$144.00	28% above	35%
CA 19-9 blood test (tumor marker) inpatient CPT 86301 IMMUNOASSY TUMOR CA 19-9	$93.60	$144.00	$40.72–$144.00	—	35%
CA-125 blood test (ovarian cancer marker) CPT 86304 IMMUNOASSY TUMOR CA 125	$93.60	$144.00	$40.72–$144.00	at median	35%
CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 IMMUNOASSY TUMOR CA 125	$93.60	$144.00	$40.72–$144.00	—	35%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 COVID19 INHOUSE	$230.10	$354.00	$100.11–$354.00	63% above	35%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 COVID19 SENDOUT	$230.10	$354.00	$100.11–$354.00	63% above	35%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 COVID-19 MOLECULAR (POINT OF CARE LAB)	$230.10	$354.00	$20.52–$154.57	63% above	35%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 COVID19 INHOUSE (POINT OF CARE LAB)	$230.10	$354.00	$33.62–$56.44	63% above	35%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 COVID-19 MOLECULAR (POINT OF CARE LAB)	$230.10	$354.00	$100.11–$354.00	—	35%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 COVID19 INHOUSE	$230.10	$354.00	$100.11–$354.00	—	35%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 COVID19 SENDOUT	$230.10	$354.00	$100.11–$354.00	—	35%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 COVID19 INHOUSE (POINT OF CARE LAB)	$230.10	$354.00	$100.11–$354.00	—	35%
Calcium blood test, total CPT 82310 CALCIUM	$23.40	$36.00	$10.18–$36.00	26% below	35%
Calcium blood test, total inpatient CPT 82310 CALCIUM	$23.40	$36.00	$10.18–$36.00	—	35%
Carcinoembryonic antigen (CEA) test CPT 82378 CEA AG	$85.15	$131.00	$37.05–$131.00	2% below	35%
Carcinoembryonic antigen (CEA) test inpatient CPT 82378 CEA AG	$85.15	$131.00	$37.05–$131.00	—	35%
Chickenpox (varicella) immunity blood test CPT 86787 VARICELLA ZOSTER IGG AB	$57.85	$89.00	$25.17–$89.00	at median	35%
Chickenpox (varicella) immunity blood test CPT 86787 VZV IGG AB, CSF	$57.85	$89.00	$25.17–$89.00	at median	35%
Chickenpox (varicella) immunity blood test CPT 86787 VARICELLA ZOSTER IGM	$57.85	$89.00	$6.36–$38.80	at median	35%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 VARICELLA ZOSTER IGG AB	$57.85	$89.00	$25.17–$89.00	—	35%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 VZV IGG AB, CSF	$57.85	$89.00	$25.17–$89.00	—	35%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 VARICELLA ZOSTER IGM	$57.85	$89.00	$25.17–$89.00	—	35%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 %CTNG CTRACH SUREPATH TMA	$157.30	$242.00	$68.44–$242.00	70% above	35%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 WHIIVF CHLAMYDIA TRACH AM	$157.30	$242.00	$68.44–$242.00	70% above	35%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 LYMPHOGRANULOMA VENEREUM PCR	$157.30	$242.00	$68.44–$242.00	70% above	35%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 UCTGC CHLAMYDIA TRACH AMP	$157.30	$242.00	$19.88–$131.03	70% above	35%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 %CTNGAO CHLAMYDIA OCULAR	$157.30	$242.00	$33.62–$38.93	70% above	35%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIATRACH AMP OCULAR	$157.30	$242.00	$33.62–$38.93	70% above	35%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA DNA PROBE	$157.30	$242.00	$33.62–$38.93	70% above	35%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 *CHLAMYDIA TRACH DNA AMPL PROB	$157.30	$242.00	$68.44–$242.00	70% above	35%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA TRACH AMPLIFY	$157.30	$242.00	$33.62–$38.93	70% above	35%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 %CTNGAO CHLAMYDIA OCULAR	$157.30	$242.00	$68.44–$242.00	—	35%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMYDIA DNA PROBE	$157.30	$242.00	$68.44–$242.00	—	35%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 WHIIVF CHLAMYDIA TRACH AM	$157.30	$242.00	$68.44–$242.00	—	35%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 UCTGC CHLAMYDIA TRACH AMP	$157.30	$242.00	$68.44–$242.00	—	35%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 LYMPHOGRANULOMA VENEREUM PCR	$157.30	$242.00	$68.44–$242.00	—	35%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMYDIA TRACH AMPLIFY	$157.30	$242.00	$68.44–$242.00	—	35%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 *CHLAMYDIA TRACH DNA AMPL PROB	$157.30	$242.00	$68.44–$242.00	—	35%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 %CTNG CTRACH SUREPATH TMA	$157.30	$242.00	$68.44–$242.00	—	35%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMYDIATRACH AMP OCULAR	$157.30	$242.00	$68.44–$242.00	—	35%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPOEL LIPID PANEL	$59.80	$92.00	$13.39–$22.77	13% above	35%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID-LIPO PANEL 1	$59.80	$92.00	$26.02–$92.00	13% above	35%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 %NMRLIP CHOLESTEROL	$59.80	$92.00	$13.39–$22.77	13% above	35%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID-LIPO PANEL 1 (POINT OF CARE LAB)	$59.80	$92.00	$13.39–$22.77	13% above	35%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID-LIPO PANEL 1	$59.80	$92.00	$26.02–$92.00	—	35%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPOEL LIPID PANEL	$59.80	$92.00	$26.02–$92.00	—	35%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 %NMRLIP CHOLESTEROL	$59.80	$92.00	$26.02–$92.00	—	35%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID-LIPO PANEL 1 (POINT OF CARE LAB)	$59.80	$92.00	$26.02–$92.00	—	35%
Complete blood count (CBC) with differential CPT 85025 CBC AUTO W AUTO DIFF	$35.10	$54.00	$15.27–$54.00	4% below	35%
Complete blood count (CBC) with differential inpatient CPT 85025 CBC AUTO W AUTO DIFF	$35.10	$54.00	$15.27–$54.00	—	35%
Complete blood count (CBC), no differential CPT 85027 CBC AUTO WO DIFF	$29.25	$45.00	$12.73–$45.00	14% below	35%
Complete blood count (CBC), no differential inpatient CPT 85027 CBC AUTO WO DIFF	$29.25	$45.00	$12.73–$45.00	—	35%
Comprehensive metabolic panel (blood test) CPT 80053 COMPRE META PANL	$47.45	$73.00	$20.64–$73.00	25% below	35%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 COMPRE META PANL	$47.45	$73.00	$20.64–$73.00	—	35%
Cortisol blood test, total CPT 82533 CORTISOL PLASMA	$72.80	$112.00	$31.67–$112.00	at median	35%
Cortisol blood test, total CPT 82533 %GMAPS CORTISOL TOTAL	$72.80	$112.00	$16.30–$25.48	at median	35%
Cortisol blood test, total CPT 82533 CORTISOL TOTAL	$72.80	$112.00	$31.67–$112.00	at median	35%
Cortisol blood test, total CPT 82533 CAHSP TOTAL CORTISOL	$72.80	$112.00	$31.67–$112.00	at median	35%
Cortisol blood test, total CPT 82533 CORTISOL SERUM RFLX	$72.80	$112.00	$31.67–$112.00	at median	35%
Cortisol blood test, total CPT 82533 CORTISOL	$72.80	$112.00	$16.30–$25.48	at median	35%
Cortisol blood test, total inpatient CPT 82533 CAHSP TOTAL CORTISOL	$72.80	$112.00	$31.67–$112.00	—	35%
Cortisol blood test, total inpatient CPT 82533 CORTISOL TOTAL	$72.80	$112.00	$31.67–$112.00	—	35%
Cortisol blood test, total inpatient CPT 82533 CORTISOL PLASMA	$72.80	$112.00	$31.67–$112.00	—	35%
Cortisol blood test, total inpatient CPT 82533 CORTISOL SERUM RFLX	$72.80	$112.00	$31.67–$112.00	—	35%
Cortisol blood test, total inpatient CPT 82533 %GMAPS CORTISOL TOTAL	$72.80	$112.00	$31.67–$112.00	—	35%
Cortisol blood test, total inpatient CPT 82533 CORTISOL	$72.80	$112.00	$31.67–$112.00	—	35%
Creatine kinase (CK) blood test, total CPT 82550 *CREATINE KINASE TOTAL ASSAY	$29.25	$45.00	$12.73–$45.00	17% below	35%
Creatine kinase (CK) blood test, total inpatient CPT 82550 *CREATINE KINASE TOTAL ASSAY	$29.25	$45.00	$12.73–$45.00	—	35%
Creatinine blood test CPT 82565 %GMAPS CREATININE BLD	$22.75	$35.00	$5.12–$13.61	8% below	35%
Creatinine blood test CPT 82565 CREATININE BLOOD (POINT OF CARE LAB)	$22.75	$35.00	$9.90–$35.00	8% below	35%
Creatinine blood test CPT 82565 CREATININE BLOOD ASSAY	$22.75	$35.00	$9.90–$35.00	8% below	35%
Creatinine blood test CPT 82565 STRNGVIL ISTAT CREATININE	$22.75	$35.00	$9.90–$35.00	8% below	35%
Creatinine blood test CPT 82565 CREATININE SERUM (TRPHOS)	$22.75	$35.00	$5.12–$13.61	8% below	35%
Creatinine blood test CPT 82565 *CREATININE BLOOD	$22.75	$35.00	$9.90–$35.00	8% below	35%
Creatinine blood test inpatient CPT 82565 CREATININE SERUM (TRPHOS)	$22.75	$35.00	$9.90–$35.00	—	35%
Creatinine blood test inpatient CPT 82565 %GMAPS CREATININE BLD	$22.75	$35.00	$9.90–$35.00	—	35%
Creatinine blood test inpatient CPT 82565 CREATININE BLOOD (POINT OF CARE LAB)	$22.75	$35.00	$9.90–$35.00	—	35%
Creatinine blood test inpatient CPT 82565 *CREATININE BLOOD	$22.75	$35.00	$9.90–$35.00	—	35%
Creatinine blood test inpatient CPT 82565 STRNGVIL ISTAT CREATININE	$22.75	$35.00	$9.90–$35.00	—	35%
Creatinine blood test inpatient CPT 82565 CREATININE BLOOD ASSAY	$22.75	$35.00	$9.90–$35.00	—	35%
Cytomegalovirus (CMV) antibody test CPT 86644 CMV AB	$64.35	$99.00	$28.00–$99.00	6% below	35%
Cytomegalovirus (CMV) antibody test CPT 86644 %IDM CMV	$64.35	$99.00	$14.39–$26.72	6% below	35%
Cytomegalovirus (CMV) antibody test CPT 86644 CMV IGG ANTIBODY	$64.35	$99.00	$27.52–$99.00	6% below	35%
Cytomegalovirus (CMV) antibody test CPT 86644 %TORCH AB CMV IGG	$64.35	$99.00	$7.11–$53.75	6% below	35%
Cytomegalovirus (CMV) antibody test CPT 86644 CMV IGG AVIDITY	$64.35	$99.00	$14.39–$26.72	6% below	35%
Cytomegalovirus (CMV) antibody test CPT 86644 WHIIVF2 CMV IGG AB	$64.35	$99.00	$7.11–$53.75	6% below	35%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 CMV AB	$64.35	$99.00	$28.00–$99.00	—	35%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 CMV IGG AVIDITY	$64.35	$99.00	$27.52–$99.00	—	35%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 WHIIVF2 CMV IGG AB	$64.35	$99.00	$27.52–$99.00	—	35%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 %IDM CMV	$64.35	$99.00	$27.52–$99.00	—	35%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 CMV IGG ANTIBODY	$64.35	$99.00	$27.52–$99.00	—	35%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 %TORCH AB CMV IGG	$64.35	$99.00	$27.52–$99.00	—	35%
D-dimer blood test (blood clot marker) CPT 85379 D-DIMER (POINT OF CARE LAB)	$45.50	$70.00	$5.02–$35.92	35% below	35%
D-dimer blood test (blood clot marker) CPT 85379 D-DIMER QUANT	$45.50	$70.00	$5.02–$35.92	35% below	35%
D-dimer blood test (blood clot marker) inpatient CPT 85379 D-DIMER QUANT	$45.50	$70.00	$19.80–$70.00	—	35%
D-dimer blood test (blood clot marker) inpatient CPT 85379 D-DIMER (POINT OF CARE LAB)	$45.50	$70.00	$19.80–$70.00	—	35%
DHEA sulfate (DHEA-S) blood test CPT 82627 DHEA-S	$99.45	$153.00	$43.27–$153.00	at median	35%
DHEA sulfate (DHEA-S) blood test CPT 82627 HIRSUT DHEA-SULFATE	$99.45	$153.00	$10.98–$50.03	at median	35%
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 HIRSUT DHEA-SULFATE	$99.45	$153.00	$43.27–$153.00	—	35%
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 DHEA-S	$99.45	$153.00	$43.27–$153.00	—	35%
Drug screen by lab instrument (any number of drug classes) CPT 80307 G HYDROXYBUTYRIC	$278.85	$429.00	$31.92–$139.82	192% above	35%
Drug screen by lab instrument (any number of drug classes) CPT 80307 MEPHEDRONE MDPV CONF UR	$278.85	$429.00	$121.32–$429.00	192% above	35%
Drug screen by lab instrument (any number of drug classes) CPT 80307 FLUNITRAZEPAM SCREEN UR	$278.85	$429.00	$121.32–$429.00	192% above	35%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG SCRN, BLD	$278.85	$429.00	$121.32–$429.00	192% above	35%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG ABUSE SURVEY UR	$278.85	$429.00	$121.32–$429.00	192% above	35%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUGS OF ABUSE ORAL FLUID	$278.85	$429.00	$121.32–$429.00	192% above	35%
Drug screen by lab instrument (any number of drug classes) CPT 80307 OXYCODONE SCRN, UR	$278.85	$429.00	$121.32–$429.00	192% above	35%
Drug screen by lab instrument (any number of drug classes) CPT 80307 ETHYL GLUC UR SCRN	$278.85	$429.00	$31.92–$139.82	192% above	35%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG TEST PRSMV CHEM ANLYZR	$278.85	$429.00	$34.82–$68.35	192% above	35%
Drug screen by lab instrument (any number of drug classes) CPT 80307 MATERNAL 8PC DRUG SCREEN	$278.85	$429.00	$121.32–$429.00	192% above	35%
Drug screen by lab instrument (any number of drug classes) CPT 80307 LSD, UR	$278.85	$429.00	$121.32–$429.00	192% above	35%
Drug screen by lab instrument (any number of drug classes) CPT 80307 UR BARBITURATE CONF RFLX	$278.85	$429.00	$34.82–$68.35	192% above	35%
Drug screen by lab instrument (any number of drug classes) CPT 80307 UR BENZODIAZ CONF RFLX	$278.85	$429.00	$34.82–$68.35	192% above	35%
Drug screen by lab instrument (any number of drug classes) CPT 80307 UR FLUNITRAZ CONF RFLX	$278.85	$429.00	$34.82–$68.35	192% above	35%
Drug screen by lab instrument (any number of drug classes) CPT 80307 UR KETAMINE CONF RFLX	$278.85	$429.00	$121.32–$429.00	192% above	35%
Drug screen by lab instrument (any number of drug classes) CPT 80307 UR ALCOHOL CONF RFLX	$278.85	$429.00	$121.32–$429.00	192% above	35%
Drug screen by lab instrument (any number of drug classes) CPT 80307 MECONIUM DRG SCRN 9	$278.85	$429.00	$121.32–$429.00	192% above	35%
Drug screen by lab instrument (any number of drug classes) CPT 80307 %DRANCO PRESUMPTIVE DRGS	$278.85	$429.00	$121.32–$429.00	192% above	35%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG ANALYSIS UR	$278.85	$429.00	$121.32–$429.00	192% above	35%
Drug screen by lab instrument (any number of drug classes) CPT 80307 MECONIUM DRG SCRN 5	$278.85	$429.00	$121.32–$429.00	192% above	35%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DATE RAPE PANEL	$278.85	$429.00	$121.32–$429.00	192% above	35%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUGS OF ABUSE 9A SCRN UR	$278.85	$429.00	$121.32–$429.00	192% above	35%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DRG SCRN 9 PANEL SER OR PL	$278.85	$429.00	$121.32–$429.00	192% above	35%
Drug screen by lab instrument (any number of drug classes) CPT 80307 MEPHEDRONE MDPV & METHYLONE	$278.85	$429.00	$121.32–$429.00	192% above	35%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG DETECT PNL, UMB CORD	$278.85	$429.00	$121.32–$429.00	192% above	35%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG TESTS PRESUMPTIVE	$278.85	$429.00	$121.32–$429.00	192% above	35%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG DET PNL UMB CRD	$278.85	$429.00	$121.32–$429.00	192% above	35%
Drug screen by lab instrument (any number of drug classes) CPT 80307 MITRAGYNINE (KRATOM), URINE	$278.85	$429.00	$34.82–$68.35	192% above	35%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DRG SCRN 9 PANEL	$278.85	$429.00	$34.82–$68.35	192% above	35%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG DETECT PNL, UMB CORD	$278.85	$429.00	$121.32–$429.00	—	35%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 UR FLUNITRAZ CONF RFLX	$278.85	$429.00	$121.32–$429.00	—	35%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 UR KETAMINE CONF RFLX	$278.85	$429.00	$121.32–$429.00	—	35%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUGS OF ABUSE 9A SCRN UR	$278.85	$429.00	$121.32–$429.00	—	35%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 LSD, UR	$278.85	$429.00	$121.32–$429.00	—	35%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 MECONIUM DRG SCRN 9	$278.85	$429.00	$121.32–$429.00	—	35%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 %DRANCO PRESUMPTIVE DRGS	$278.85	$429.00	$121.32–$429.00	—	35%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 FLUNITRAZEPAM SCREEN UR	$278.85	$429.00	$121.32–$429.00	—	35%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG TESTS PRESUMPTIVE	$278.85	$429.00	$121.32–$429.00	—	35%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 MEPHEDRONE MDPV & METHYLONE	$278.85	$429.00	$121.32–$429.00	—	35%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 MEPHEDRONE MDPV CONF UR	$278.85	$429.00	$121.32–$429.00	—	35%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 OXYCODONE SCRN, UR	$278.85	$429.00	$121.32–$429.00	—	35%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG SCRN, BLD	$278.85	$429.00	$121.32–$429.00	—	35%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 MECONIUM DRG SCRN 5	$278.85	$429.00	$121.32–$429.00	—	35%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DATE RAPE PANEL	$278.85	$429.00	$121.32–$429.00	—	35%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG ABUSE SURVEY UR	$278.85	$429.00	$121.32–$429.00	—	35%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG DET PNL UMB CRD	$278.85	$429.00	$121.32–$429.00	—	35%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 ETHYL GLUC UR SCRN	$278.85	$429.00	$121.32–$429.00	—	35%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG TEST PRSMV CHEM ANLYZR	$278.85	$429.00	$121.32–$429.00	—	35%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 MATERNAL 8PC DRUG SCREEN	$278.85	$429.00	$121.32–$429.00	—	35%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUGS OF ABUSE ORAL FLUID	$278.85	$429.00	$121.32–$429.00	—	35%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 G HYDROXYBUTYRIC	$278.85	$429.00	$121.32–$429.00	—	35%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 UR BARBITURATE CONF RFLX	$278.85	$429.00	$121.32–$429.00	—	35%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 UR ALCOHOL CONF RFLX	$278.85	$429.00	$121.32–$429.00	—	35%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 UR BENZODIAZ CONF RFLX	$278.85	$429.00	$121.32–$429.00	—	35%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 MITRAGYNINE (KRATOM), URINE	$278.85	$429.00	$121.32–$429.00	—	35%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG ANALYSIS UR	$278.85	$429.00	$121.32–$429.00	—	35%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRG SCRN 9 PANEL	$278.85	$429.00	$121.32–$429.00	—	35%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRG SCRN 9 PANEL SER OR PL	$278.85	$429.00	$121.32–$429.00	—	35%
Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 ELECTROLYTE PANEL	$31.20	$48.00	$13.57–$48.00	35% below	35%
Electrolyte panel (sodium, potassium, chloride, CO2) inpatient CPT 80051 ELECTROLYTE PANEL	$31.20	$48.00	$13.57–$48.00	—	35%
Epstein-Barr virus (EBV) antibody test CPT 86665 EBV-VCA IFA IGG	$81.25	$125.00	$35.35–$125.00	25% above	35%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 EBV-VCA IFA IGG	$81.25	$125.00	$35.35–$125.00	—	35%
Estradiol blood test CPT 82670 ESTRADIOL-17B	$125.45	$193.00	$13.80–$62.87	12% above	35%
Estradiol blood test CPT 82670 ESTRADIOL TANDEM MASS SP	$125.45	$193.00	$54.58–$193.00	12% above	35%
Estradiol blood test inpatient CPT 82670 ESTRADIOL-17B	$125.45	$193.00	$54.58–$193.00	—	35%
Estradiol blood test inpatient CPT 82670 ESTRADIOL TANDEM MASS SP	$125.45	$193.00	$54.58–$193.00	—	35%
FSH (follicle-stimulating hormone) test CPT 83001 GONADOTROPIN FSH	$83.20	$128.00	$36.20–$128.00	3% below	35%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 GONADOTROPIN FSH	$83.20	$128.00	$36.20–$128.00	—	35%
Fecal calprotectin (stool inflammation test) CPT 83993 ASSAY FOR CALPROTECTIN FECAL	$87.75	$135.00	$38.18–$135.00	41% below	35%
Fecal calprotectin (stool inflammation test) inpatient CPT 83993 ASSAY FOR CALPROTECTIN FECAL	$87.75	$135.00	$38.18–$135.00	—	35%
Ferritin blood test (iron stores) CPT 82728 FERRITIN ASSAY	$61.10	$94.00	$6.73–$30.68	20% below	35%
Ferritin blood test (iron stores) inpatient CPT 82728 FERRITIN ASSAY	$61.10	$94.00	$26.58–$94.00	—	35%
Fibrinogen blood test CPT 85384 FIBRINOGEN	$43.55	$67.00	$4.20–$29.28	3% below	35%
Fibrinogen blood test CPT 85384 MANUAL HEME- FIBRINOGEN	$43.55	$67.00	$18.95–$67.00	3% below	35%
Fibrinogen blood test CPT 85384 MANUAL HEME - FIBRINOGEN	$43.55	$67.00	$18.95–$67.00	3% below	35%
Fibrinogen blood test inpatient CPT 85384 FIBRINOGEN	$43.55	$67.00	$18.95–$67.00	—	35%
Fibrinogen blood test inpatient CPT 85384 MANUAL HEME- FIBRINOGEN	$43.55	$67.00	$18.95–$67.00	—	35%
Fibrinogen blood test inpatient CPT 85384 MANUAL HEME - FIBRINOGEN	$43.55	$67.00	$18.95–$67.00	—	35%
Folate (folic acid) blood test CPT 82746 %GMAPS FOLIC ACID	$65.65	$101.00	$14.70–$21.01	3% below	35%
Folate (folic acid) blood test CPT 82746 FOLIC ACID SERUM ASSAY	$65.65	$101.00	$7.26–$33.08	3% below	35%
Folate (folic acid) blood test inpatient CPT 82746 %GMAPS FOLIC ACID	$65.65	$101.00	$28.56–$101.00	—	35%
Folate (folic acid) blood test inpatient CPT 82746 FOLIC ACID SERUM ASSAY	$65.65	$101.00	$28.56–$101.00	—	35%
Free T3 thyroid hormone test CPT 84481 TRIIODOTHYRONINE FREE(FT-3)	$76.05	$117.00	$8.37–$52.19	at median	35%
Free T3 thyroid hormone test CPT 84481 T3 DIAL FREE	$76.05	$117.00	$16.94–$25.48	at median	35%
Free T3 thyroid hormone test inpatient CPT 84481 TRIIODOTHYRONINE FREE(FT-3)	$76.05	$117.00	$33.09–$117.00	—	35%
Free T3 thyroid hormone test inpatient CPT 84481 T3 DIAL FREE	$76.05	$117.00	$33.09–$117.00	—	35%
Free T4 (free thyroxine) thyroid blood test CPT 84439 THYROXINE FREE ASSAY	$40.30	$62.00	$5.11–$20.63	5% below	35%
Free T4 (free thyroxine) thyroid blood test CPT 84439 THYROXIN FREE	$40.30	$62.00	$5.11–$20.63	5% below	35%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 THYROXIN FREE	$40.30	$62.00	$17.53–$62.00	—	35%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 THYROXINE FREE ASSAY	$40.30	$62.00	$17.53–$62.00	—	35%
Free testosterone test CPT 84402 TESTOSTERONE, FREE, SERUM	$114.40	$176.00	$49.77–$176.00	18% above	35%
Free testosterone test CPT 84402 BTSTFC TESTOSTERONE FR	$114.40	$176.00	$12.58–$95.10	18% above	35%
Free testosterone test CPT 84402 TESTOSTERONE FREE	$114.40	$176.00	$49.77–$176.00	18% above	35%
Free testosterone test CPT 84402 FTTESM TESTO FR AD MALE	$114.40	$176.00	$49.77–$176.00	18% above	35%
Free testosterone test CPT 84402 TESTOSTERONE FR AD MALE	$114.40	$176.00	$12.58–$95.10	18% above	35%
Free testosterone test inpatient CPT 84402 FTTESM TESTO FR AD MALE	$114.40	$176.00	$49.77–$176.00	—	35%
Free testosterone test inpatient CPT 84402 TESTOSTERONE FREE	$114.40	$176.00	$49.77–$176.00	—	35%
Free testosterone test inpatient CPT 84402 TESTOSTERONE FR AD MALE	$114.40	$176.00	$49.77–$176.00	—	35%
Free testosterone test inpatient CPT 84402 BTSTFC TESTOSTERONE FR	$114.40	$176.00	$49.77–$176.00	—	35%
Free testosterone test inpatient CPT 84402 TESTOSTERONE, FREE, SERUM	$114.40	$176.00	$49.77–$176.00	—	35%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 %HCVSUR GLUTTRANS GAMMA	$32.50	$50.00	$9.55–$16.20	24% below	35%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 GAMMA GLUTAMYL TRANSFERASE, FIBROMETER	$32.50	$50.00	$14.14–$50.00	24% below	35%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 %NASH GGT	$32.50	$50.00	$7.20–$13.61	24% below	35%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 %LIVFIB GGT	$32.50	$50.00	$14.14–$50.00	24% below	35%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 GGT ASSAY	$32.50	$50.00	$9.55–$16.20	24% below	35%
Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 %LIVFIB GGT	$32.50	$50.00	$14.14–$50.00	—	35%
Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 %HCVSUR GLUTTRANS GAMMA	$32.50	$50.00	$14.14–$50.00	—	35%
Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 %NASH GGT	$32.50	$50.00	$14.14–$50.00	—	35%
Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 GGT ASSAY	$32.50	$50.00	$14.14–$50.00	—	35%
Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 GAMMA GLUTAMYL TRANSFERASE, FIBROMETER	$32.50	$50.00	$14.14–$50.00	—	35%
General health panel: metabolic panel, blood count and TSH in one order CPT 80050 GENERAL HEALTH PANEL	$323.05	$497.00	$108.35–$497.00	46% above	35%
General health panel: metabolic panel, blood count and TSH in one order inpatient CPT 80050 GENERAL HEALTH PANEL	$323.05	$497.00	$108.35–$497.00	—	35%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GLUC NON GEST TOLERANCE	$21.45	$33.00	$4.75–$13.61	44% below	35%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GLUCOSE SCRN POST DOSE	$21.45	$33.00	$9.33–$33.00	44% below	35%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 GLUC NON GEST TOLERANCE	$21.45	$33.00	$9.33–$33.00	—	35%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 GLUCOSE SCRN POST DOSE	$21.45	$33.00	$9.33–$33.00	—	35%
Glucose tolerance test, 3 samples CPT 82951 GTT 3SPEC	$57.85	$89.00	$25.17–$89.00	14% below	35%
Glucose tolerance test, 3 samples inpatient CPT 82951 GTT 3SPEC	$57.85	$89.00	$25.17–$89.00	—	35%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 GC AMPLIFICATION	$157.30	$242.00	$68.44–$242.00	69% above	35%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 WHIIVF GC AMP	$157.30	$242.00	$19.88–$114.60	69% above	35%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 UCTGC GC AMPLIFICATION	$157.30	$242.00	$33.62–$38.93	69% above	35%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 %CTNGAO NGONORRHOEAE OCUL	$157.30	$242.00	$33.62–$38.93	69% above	35%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 NGONORRHOEAE AMP OCULAR	$157.30	$242.00	$33.62–$38.93	69% above	35%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 %CTNG NGONORRHAE SUREPATH	$157.30	$242.00	$68.44–$242.00	69% above	35%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 GC DNA PROBE	$157.30	$242.00	$68.44–$242.00	69% above	35%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 *NEISSERIA GONORR DNA AMPL	$157.30	$242.00	$68.44–$242.00	69% above	35%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 %CTNGAO NGONORRHOEAE OCUL	$157.30	$242.00	$68.44–$242.00	—	35%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 GC AMPLIFICATION	$157.30	$242.00	$68.44–$242.00	—	35%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 *NEISSERIA GONORR DNA AMPL	$157.30	$242.00	$68.44–$242.00	—	35%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 GC DNA PROBE	$157.30	$242.00	$68.44–$242.00	—	35%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 %CTNG NGONORRHAE SUREPATH	$157.30	$242.00	$68.44–$242.00	—	35%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 NGONORRHOEAE AMP OCULAR	$157.30	$242.00	$68.44–$242.00	—	35%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 WHIIVF GC AMP	$157.30	$242.00	$68.44–$242.00	—	35%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 UCTGC GC AMPLIFICATION	$157.30	$242.00	$68.44–$242.00	—	35%
H. pylori antibody blood test CPT 86677 *H PYLORI AB	$75.40	$116.00	$32.80–$116.00	at median	35%
H. pylori antibody blood test CPT 86677 H PYLORI AB	$75.40	$116.00	$32.80–$116.00	at median	35%
H. pylori antibody blood test CPT 86677 H PYLORI AB (BACK OFFICE)	$75.40	$116.00	$7.16–$73.11	at median	35%
H. pylori antibody blood test inpatient CPT 86677 *H PYLORI AB	$75.40	$116.00	$32.80–$116.00	—	35%
H. pylori antibody blood test inpatient CPT 86677 H PYLORI AB	$75.40	$116.00	$32.80–$116.00	—	35%
H. pylori antibody blood test inpatient CPT 86677 H PYLORI AB (BACK OFFICE)	$75.40	$116.00	$32.80–$116.00	—	35%
H. pylori stool antigen test CPT 87338 IMMUNOASSAY, H. PYLORI	$64.35	$99.00	$28.00–$99.00	8% below	35%
H. pylori stool antigen test inpatient CPT 87338 IMMUNOASSAY, H. PYLORI	$64.35	$99.00	$28.00–$99.00	—	35%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 QUANTIFICATION, HIV-1	$381.55	$587.00	$42.02–$317.76	7% above	35%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 QUANTIFICATION, HIV-1	$381.55	$587.00	$166.00–$587.00	—	35%
HIV-1 and HIV-2 antibody test CPT 86703 HIV 1&2 ANTIBODY SCREEN	$61.75	$95.00	$6.77–$41.30	at median	35%
HIV-1 and HIV-2 antibody test CPT 86703 HIV-1/HIV2 SNG ASSY (POINT OF CARE LAB)	$61.75	$95.00	$6.77–$41.30	at median	35%
HIV-1 and HIV-2 antibody test CPT 86703 HIV 1 HIV 2 SNGL ASSAY AB	$61.75	$95.00	$26.41–$95.00	at median	35%
HIV-1 and HIV-2 antibody test CPT 86703 HIV1 HIV2 SNGL ASSAY AB	$61.75	$95.00	$6.77–$41.30	at median	35%
HIV-1 and HIV-2 antibody test inpatient CPT 86703 HIV1 HIV2 SNGL ASSAY AB	$61.75	$95.00	$26.41–$95.00	—	35%
HIV-1 and HIV-2 antibody test inpatient CPT 86703 HIV 1&2 ANTIBODY SCREEN	$61.75	$95.00	$26.41–$95.00	—	35%
HIV-1 and HIV-2 antibody test inpatient CPT 86703 HIV-1/HIV2 SNG ASSY (POINT OF CARE LAB)	$61.75	$95.00	$26.41–$95.00	—	35%
HIV-1 and HIV-2 antibody test inpatient CPT 86703 HIV 1 HIV 2 SNGL ASSAY AB	$61.75	$95.00	$26.41–$95.00	—	35%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 %HEXP HIV 1&2 AG/AB	$107.90	$166.00	$46.94–$166.00	46% above	35%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV 1&2 ANTIGEN/ANTIBODY	$107.90	$166.00	$46.94–$166.00	46% above	35%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 POMER4 HIV12C	$107.90	$166.00	$46.94–$166.00	46% above	35%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 WHIIVF HIV 1&2 AG/AB	$107.90	$166.00	$46.94–$166.00	46% above	35%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 WHIIVF HIV 1&2 AG/AB	$107.90	$166.00	$46.94–$166.00	—	35%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 %HEXP HIV 1&2 AG/AB	$107.90	$166.00	$46.94–$166.00	—	35%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 POMER4 HIV12C	$107.90	$166.00	$46.94–$166.00	—	35%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HIV 1&2 ANTIGEN/ANTIBODY	$107.90	$166.00	$46.94–$166.00	—	35%
HPV test for high-risk types, one combined (pooled) result CPT 87624 HPV SCREEN BY TMA (ARUP)	$157.30	$242.00	$68.44–$242.00	32% above	35%
HPV test for high-risk types, one combined (pooled) result CPT 87624 HPV DNA HI RISK ANL RECT	$157.30	$242.00	$19.10–$105.71	32% above	35%
HPV test for high-risk types, one combined (pooled) result CPT 87624 HPV DNA PROBE REFLEX	$157.30	$242.00	$19.10–$105.71	32% above	35%
HPV test for high-risk types, one combined (pooled) result CPT 87624 HPV DNA 16 18 PCR	$157.30	$242.00	$68.44–$242.00	32% above	35%
HPV test for high-risk types, one combined (pooled) result CPT 87624 HPV DNA PROBE SUREPATH	$157.30	$242.00	$33.62–$38.93	32% above	35%
HPV test for high-risk types, one combined (pooled) result CPT 87624 HPV DNA ASSAY	$157.30	$242.00	$68.44–$242.00	32% above	35%
HPV test for high-risk types, one combined (pooled) result CPT 87624 HPVSFX HPV HIGH-RISK TYPE	$157.30	$242.00	$68.44–$242.00	32% above	35%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HPV DNA PROBE REFLEX	$157.30	$242.00	$68.44–$242.00	—	35%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HPV DNA ASSAY	$157.30	$242.00	$68.44–$242.00	—	35%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HPV SCREEN BY TMA (ARUP)	$157.30	$242.00	$68.44–$242.00	—	35%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HPVSFX HPV HIGH-RISK TYPE	$157.30	$242.00	$68.44–$242.00	—	35%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HPV DNA HI RISK ANL RECT	$157.30	$242.00	$68.44–$242.00	—	35%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HPV DNA PROBE SUREPATH	$157.30	$242.00	$68.44–$242.00	—	35%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HPV DNA 16 18 PCR	$157.30	$242.00	$68.44–$242.00	—	35%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HGB A1C GLYCOSYLATED (POINT OF CARE LAB)	$43.55	$67.00	$9.71–$13.61	4% below	35%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HGB A1C GLYCOSYLATED	$43.55	$67.00	$9.71–$13.61	4% below	35%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HGB A1C GLYCOSYLATED	$43.55	$67.00	$18.95–$67.00	—	35%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HGB A1C GLYCOSYLATED (POINT OF CARE LAB)	$43.55	$67.00	$18.95–$67.00	—	35%
Hemoglobin blood test CPT 85018 BLOOD COUNT HGB	$10.40	$16.00	$2.56–$7.13	36% below	35%
Hemoglobin blood test CPT 85018 BLOOD COUNT HGB (POINT OF CARE LAB)	$10.40	$16.00	$4.52–$16.00	36% below	35%
Hemoglobin blood test CPT 85018 *BLOOD COUNT HGB	$10.40	$16.00	$4.52–$16.00	36% below	35%
Hemoglobin blood test inpatient CPT 85018 *BLOOD COUNT HGB	$10.40	$16.00	$4.52–$16.00	—	35%
Hemoglobin blood test inpatient CPT 85018 BLOOD COUNT HGB	$10.40	$16.00	$4.52–$16.00	—	35%
Hemoglobin blood test inpatient CPT 85018 BLOOD COUNT HGB (POINT OF CARE LAB)	$10.40	$16.00	$4.52–$16.00	—	35%
Hepatitis B core antibody test (total) CPT 86704 IDM HEP B CORE AB TOTAL	$53.95	$83.00	$12.05–$26.72	at median	35%
Hepatitis B core antibody test (total) CPT 86704 *HEP B CORE AB TOTAL	$53.95	$83.00	$5.95–$36.30	at median	35%
Hepatitis B core antibody test (total) CPT 86704 WHIIVF HEP B CORE AB TOTA	$53.95	$83.00	$5.95–$36.30	at median	35%
Hepatitis B core antibody test (total) CPT 86704 HEP B CORE AB TOTAL	$53.95	$83.00	$23.47–$83.00	at median	35%
Hepatitis B core antibody test (total) inpatient CPT 86704 HEP B CORE AB TOTAL	$53.95	$83.00	$23.47–$83.00	—	35%
Hepatitis B core antibody test (total) inpatient CPT 86704 *HEP B CORE AB TOTAL	$53.95	$83.00	$23.07–$83.00	—	35%
Hepatitis B core antibody test (total) inpatient CPT 86704 IDM HEP B CORE AB TOTAL	$53.95	$83.00	$23.07–$83.00	—	35%
Hepatitis B core antibody test (total) inpatient CPT 86704 WHIIVF HEP B CORE AB TOTA	$53.95	$83.00	$23.07–$83.00	—	35%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 *HEP B SURFACE AB	$48.10	$74.00	$5.30–$32.35	1% below	35%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 *HEP B SURFACE AB	$48.10	$74.00	$20.93–$74.00	—	35%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HEP B SURF ANTIG W/REF	$46.15	$71.00	$19.74–$71.00	2% below	35%
Hepatitis B surface antigen (HBsAg) test CPT 87340 WHIIVF *%HEP HBSAG	$46.15	$71.00	$5.10–$34.76	2% below	35%
Hepatitis B surface antigen (HBsAg) test CPT 87340 *%HEP HBSAG	$46.15	$71.00	$19.74–$71.00	2% below	35%
Hepatitis B surface antigen (HBsAg) test CPT 87340 POMER4 HBSAG	$46.15	$71.00	$19.74–$71.00	2% below	35%
Hepatitis B surface antigen (HBsAg) test CPT 87340 *HEP B SURFACE AG EIA	$46.15	$71.00	$5.10–$34.76	2% below	35%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HEP B SURFACE AG EIA	$46.15	$71.00	$10.33–$19.27	2% below	35%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HEP B SURF ANTIG W/REF	$46.15	$71.00	$19.74–$71.00	—	35%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 WHIIVF *%HEP HBSAG	$46.15	$71.00	$19.74–$71.00	—	35%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 *HEP B SURFACE AG EIA	$46.15	$71.00	$19.74–$71.00	—	35%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 POMER4 HBSAG	$46.15	$71.00	$19.74–$71.00	—	35%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HEP B SURFACE AG EIA	$46.15	$71.00	$20.08–$71.00	—	35%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 *%HEP HBSAG	$46.15	$71.00	$19.74–$71.00	—	35%
Hepatitis C antibody blood test (screening) CPT 86803 IDM HEP C AB	$63.70	$98.00	$14.27–$26.72	at median	35%
Hepatitis C antibody blood test (screening) CPT 86803 HEP C AB	$63.70	$98.00	$14.27–$26.72	at median	35%
Hepatitis C antibody blood test (screening) CPT 86803 WHIIVF HEP C AB	$63.70	$98.00	$21.41–$42.99	at median	35%
Hepatitis C antibody blood test (screening) CPT 86803 *HEP C AB	$63.70	$98.00	$27.24–$98.00	at median	35%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 HEP C AB	$63.70	$98.00	$27.71–$98.00	—	35%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 WHIIVF HEP C AB	$63.70	$98.00	$27.24–$98.00	—	35%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 IDM HEP C AB	$63.70	$98.00	$27.24–$98.00	—	35%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 *HEP C AB	$63.70	$98.00	$27.24–$98.00	—	35%
Hepatitis C viral load (HCV RNA) test CPT 87522 QUANTIFICATION, HEPATITIS C VIRUS	$192.40	$296.00	$21.15–$129.06	at median	35%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 QUANTIFICATION, HEPATITIS C VIRUS	$192.40	$296.00	$83.71–$296.00	—	35%
Herpes blood test, HSV-1 antibody CPT 86695 HSV 1 IGM TITER REFLEX	$59.15	$91.00	$6.51–$39.73	at median	35%
Herpes blood test, HSV-1 antibody CPT 86695 %HSVG12 IGG 1	$59.15	$91.00	$25.73–$91.00	at median	35%
Herpes blood test, HSV-1 antibody CPT 86695 %HIVIFA HSV 1 IGM	$59.15	$91.00	$6.51–$39.73	at median	35%
Herpes blood test, HSV-1 antibody CPT 86695 %HSVIFA HSV 2 IGM	$59.15	$91.00	$6.51–$39.73	at median	35%
Herpes blood test, HSV-1 antibody CPT 86695 HERPES SIMPLEX TYPE I	$59.15	$91.00	$25.73–$91.00	at median	35%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 %HIVIFA HSV 1 IGM	$59.15	$91.00	$25.73–$91.00	—	35%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 HSV 1 IGM TITER REFLEX	$59.15	$91.00	$25.73–$91.00	—	35%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 %HSVIFA HSV 2 IGM	$59.15	$91.00	$25.73–$91.00	—	35%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 %HSVG12 IGG 1	$59.15	$91.00	$25.73–$91.00	—	35%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 HERPES SIMPLEX TYPE I	$59.15	$91.00	$25.73–$91.00	—	35%
Herpes blood test, HSV-2 antibody CPT 86696 %HSVG12 IGG 2	$87.10	$134.00	$37.90–$134.00	31% above	35%
Herpes blood test, HSV-2 antibody CPT 86696 *AB; HSV II	$87.10	$134.00	$9.56–$58.29	31% above	35%
Herpes blood test, HSV-2 antibody CPT 86696 %12IFA HERPES SIMP 2	$87.10	$134.00	$37.90–$134.00	31% above	35%
Herpes blood test, HSV-2 antibody CPT 86696 HSV 2 IGM TITER REFLEX	$87.10	$134.00	$9.56–$58.29	31% above	35%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 *AB; HSV II	$87.10	$134.00	$37.90–$134.00	—	35%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 %HSVG12 IGG 2	$87.10	$134.00	$37.90–$134.00	—	35%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HSV 2 IGM TITER REFLEX	$87.10	$134.00	$37.90–$134.00	—	35%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 %12IFA HERPES SIMP 2	$87.10	$134.00	$37.90–$134.00	—	35%
High-sensitivity CRP (hs-CRP) test CPT 86141 MCROHN C-REAC PROTEIN HS	$57.85	$89.00	$25.17–$89.00	14% below	35%
High-sensitivity CRP (hs-CRP) test CPT 86141 C-REACTIVE PROTEIN HIGH SENSE	$57.85	$89.00	$25.17–$89.00	14% below	35%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 C-REACTIVE PROTEIN HIGH SENSE	$57.85	$89.00	$25.17–$89.00	—	35%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 MCROHN C-REAC PROTEIN HS	$57.85	$89.00	$25.17–$89.00	—	35%
Homocysteine blood test CPT 83090 HOMOCYSTINE UR QNT	$80.60	$124.00	$8.33–$40.32	at median	35%
Homocysteine blood test CPT 83090 HOMOCYSTEINE ASSAY	$80.60	$124.00	$8.33–$40.32	at median	35%
Homocysteine blood test inpatient CPT 83090 HOMOCYSTINE UR QNT	$80.60	$124.00	$35.07–$124.00	—	35%
Homocysteine blood test inpatient CPT 83090 HOMOCYSTEINE ASSAY	$80.60	$124.00	$35.07–$124.00	—	35%
Insulin blood test CPT 83525 INSULIN ASSAY	$51.35	$79.00	$5.64–$25.73	at median	35%
Insulin blood test inpatient CPT 83525 INSULIN ASSAY	$51.35	$79.00	$22.34–$79.00	—	35%
Iron blood test (serum iron) CPT 83540 FE ASSAY	$29.25	$45.00	$6.47–$13.61	23% below	35%
Iron blood test (serum iron) CPT 83540 *FE ASSAY	$29.25	$45.00	$12.73–$45.00	23% below	35%
Iron blood test (serum iron) inpatient CPT 83540 FE ASSAY	$29.25	$45.00	$12.73–$45.00	—	35%
Iron blood test (serum iron) inpatient CPT 83540 *FE ASSAY	$29.25	$45.00	$12.73–$45.00	—	35%
Iron-binding capacity (TIBC) test CPT 83550 *FE BINDING CAPACITY	$39.00	$60.00	$16.97–$60.00	at median	35%
Iron-binding capacity (TIBC) test inpatient CPT 83550 *FE BINDING CAPACITY	$39.00	$60.00	$16.97–$60.00	—	35%
Kidney function blood test panel CPT 80069 RENAL FUNC PANL	$39.00	$60.00	$16.97–$60.00	46% below	35%
Kidney function blood test panel inpatient CPT 80069 RENAL FUNC PANL	$39.00	$60.00	$16.97–$60.00	—	35%
LH (luteinizing hormone) test CPT 83002 GONADOTROPIN LH	$83.20	$128.00	$24.59–$41.67	13% below	35%
LH (luteinizing hormone) test CPT 83002 LUTEINING HORMONE	$83.20	$128.00	$36.20–$128.00	13% below	35%
LH (luteinizing hormone) test CPT 83002 LH, PEDIATRIC	$83.20	$128.00	$36.20–$128.00	13% below	35%
LH (luteinizing hormone) test inpatient CPT 83002 LH, PEDIATRIC	$83.20	$128.00	$36.20–$128.00	—	35%
LH (luteinizing hormone) test inpatient CPT 83002 LUTEINING HORMONE	$83.20	$128.00	$36.20–$128.00	—	35%
LH (luteinizing hormone) test inpatient CPT 83002 GONADOTROPIN LH	$83.20	$128.00	$36.20–$128.00	—	35%
Lactate (lactic acid) blood test CPT 83605 ASSAY LACTIC ACID (POINT OF CARE LAB)	$52.00	$80.00	$11.57–$21.01	at median	35%
Lactate (lactic acid) blood test CPT 83605 LACTATE(LACTIC ACID)	$52.00	$80.00	$14.19–$26.04	at median	35%
Lactate (lactic acid) blood test CPT 83605 ASSAY LACTIC ACID	$52.00	$80.00	$22.62–$80.00	at median	35%
Lactate (lactic acid) blood test CPT 83605 LACTATE (LACTIC ACID)	$52.00	$80.00	$14.19–$26.04	at median	35%
Lactate (lactic acid) blood test CPT 83605 %GMAPS LACTATE	$52.00	$80.00	$22.62–$80.00	at median	35%
Lactate (lactic acid) blood test CPT 83605 ASSAY OF LACTIC ACID	$52.00	$80.00	$22.62–$80.00	at median	35%
Lactate (lactic acid) blood test inpatient CPT 83605 ASSAY OF LACTIC ACID	$52.00	$80.00	$22.62–$80.00	—	35%
Lactate (lactic acid) blood test inpatient CPT 83605 LACTATE(LACTIC ACID)	$52.00	$80.00	$22.62–$80.00	—	35%
Lactate (lactic acid) blood test inpatient CPT 83605 %GMAPS LACTATE	$52.00	$80.00	$22.62–$80.00	—	35%
Lactate (lactic acid) blood test inpatient CPT 83605 ASSAY LACTIC ACID (POINT OF CARE LAB)	$52.00	$80.00	$22.62–$80.00	—	35%
Lactate (lactic acid) blood test inpatient CPT 83605 LACTATE (LACTIC ACID)	$52.00	$80.00	$22.62–$80.00	—	35%
Lactate (lactic acid) blood test inpatient CPT 83605 ASSAY LACTIC ACID	$52.00	$80.00	$22.62–$80.00	—	35%
Lactate dehydrogenase (LDH) blood test CPT 83615 LAC (LD)(LDH)	$27.30	$42.00	$2.98–$16.28	at median	35%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 LAC (LD)(LDH)	$27.30	$42.00	$11.88–$42.00	—	35%
Lipase blood test (pancreas enzyme) CPT 83690 LIPASE ASSAY	$31.20	$48.00	$3.40–$18.57	46% below	35%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 LIPASE ASSAY	$31.20	$48.00	$13.57–$48.00	—	35%
Liver function blood test panel CPT 80076 HEP FUNC PANL	$36.40	$56.00	$15.84–$56.00	40% below	35%
Liver function blood test panel inpatient CPT 80076 HEP FUNC PANL	$36.40	$56.00	$15.84–$56.00	—	35%
Lyme disease antibody test CPT 86618 LYME IGG & IGM SERUM	$76.70	$118.00	$33.37–$118.00	at median	35%
Lyme disease antibody test CPT 86618 LYMRFX BORRELIA ANTIBODY	$76.70	$118.00	$8.41–$57.04	at median	35%
Lyme disease antibody test CPT 86618 LYME IGG CSF	$76.70	$118.00	$8.41–$57.04	at median	35%
Lyme disease antibody test CPT 86618 LYME REFLEX PNL, CSF	$76.70	$118.00	$8.41–$57.04	at median	35%
Lyme disease antibody test CPT 86618 BORELIA BURGDORFERI LYME	$76.70	$118.00	$8.41–$57.04	at median	35%
Lyme disease antibody test inpatient CPT 86618 BORELIA BURGDORFERI LYME	$76.70	$118.00	$33.37–$118.00	—	35%
Lyme disease antibody test inpatient CPT 86618 LYME REFLEX PNL, CSF	$76.70	$118.00	$33.37–$118.00	—	35%
Lyme disease antibody test inpatient CPT 86618 LYME IGG CSF	$76.70	$118.00	$33.37–$118.00	—	35%
Lyme disease antibody test inpatient CPT 86618 LYMRFX BORRELIA ANTIBODY	$76.70	$118.00	$33.37–$118.00	—	35%
Lyme disease antibody test inpatient CPT 86618 LYME IGG & IGM SERUM	$76.70	$118.00	$33.37–$118.00	—	35%
Magnesium blood test CPT 83735 MAG ASSAY	$29.90	$46.00	$3.31–$16.92	11% below	35%
Magnesium blood test CPT 83735 %STCATH MAGNESIUM	$29.90	$46.00	$13.01–$46.00	11% below	35%
Magnesium blood test CPT 83735 MAGNESIUM STOOL	$29.90	$46.00	$13.01–$46.00	11% below	35%
Magnesium blood test CPT 83735 MAGNESIUM RBC	$29.90	$46.00	$3.31–$16.92	11% below	35%
Magnesium blood test CPT 83735 STCATH ASSAY OF MAGNESIUM	$29.90	$46.00	$3.31–$16.92	11% below	35%
Magnesium blood test CPT 83735 SSAT24 MAGNESIUM, UR	$29.90	$46.00	$3.31–$16.92	11% below	35%
Magnesium blood test inpatient CPT 83735 %STCATH MAGNESIUM	$29.90	$46.00	$13.01–$46.00	—	35%
Magnesium blood test inpatient CPT 83735 STCATH ASSAY OF MAGNESIUM	$29.90	$46.00	$13.01–$46.00	—	35%
Magnesium blood test inpatient CPT 83735 SSAT24 MAGNESIUM, UR	$29.90	$46.00	$13.01–$46.00	—	35%
Magnesium blood test inpatient CPT 83735 MAGNESIUM STOOL	$29.90	$46.00	$13.01–$46.00	—	35%
Magnesium blood test inpatient CPT 83735 MAGNESIUM RBC	$29.90	$46.00	$13.01–$46.00	—	35%
Magnesium blood test inpatient CPT 83735 MAG ASSAY	$29.90	$46.00	$13.01–$46.00	—	35%
Measles (rubeola) antibody test CPT 86765 MEASLES-RUBEOLA IGG AB	$57.85	$89.00	$25.17–$89.00	1% above	35%
Measles (rubeola) antibody test CPT 86765 MEASLES-RUBEOLA IGM AB	$57.85	$89.00	$25.17–$89.00	1% above	35%
Measles (rubeola) antibody test inpatient CPT 86765 MEASLES-RUBEOLA IGM AB	$57.85	$89.00	$25.17–$89.00	—	35%
Measles (rubeola) antibody test inpatient CPT 86765 MEASLES-RUBEOLA IGG AB	$57.85	$89.00	$25.17–$89.00	—	35%
Mono test (heterophile antibody, Monospot) CPT 86308 HETRPHL AB SCRN	$23.40	$36.00	$10.18–$36.00	56% below	35%
Mono test (heterophile antibody, Monospot) CPT 86308 HTEROPHIL AB SCREEN	$23.40	$36.00	$10.18–$36.00	56% below	35%
Mono test (heterophile antibody, Monospot) CPT 86308 HETEROPHILE AB W RFLX	$23.40	$36.00	$5.18–$26.72	56% below	35%
Mono test (heterophile antibody, Monospot) CPT 86308 HTEROPHIL AB SCREEN (POINT OF CARE LAB)	$23.40	$36.00	$7.77–$22.80	56% below	35%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 HTEROPHIL AB SCREEN	$23.40	$36.00	$10.18–$36.00	—	35%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 HTEROPHIL AB SCREEN (POINT OF CARE LAB)	$23.40	$36.00	$10.18–$36.00	—	35%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 HETRPHL AB SCRN	$23.40	$36.00	$10.18–$36.00	—	35%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 HETEROPHILE AB W RFLX	$23.40	$36.00	$10.18–$36.00	—	35%
Mumps immunity blood test CPT 86735 MUMPS VIRUS AB IGM	$58.50	$90.00	$25.45–$90.00	at median	35%
Mumps immunity blood test CPT 86735 MUMPS IGG ANTIBODY	$58.50	$90.00	$25.45–$90.00	at median	35%
Mumps immunity blood test inpatient CPT 86735 MUMPS VIRUS AB IGM	$58.50	$90.00	$25.45–$90.00	—	35%
Mumps immunity blood test inpatient CPT 86735 MUMPS IGG ANTIBODY	$58.50	$90.00	$25.45–$90.00	—	35%
Obstetric blood test panel CPT 80055 OB PANEL	$214.50	$330.00	$23.61–$381.89	at median	35%
Obstetric blood test panel inpatient CPT 80055 OB PANEL	$214.50	$330.00	$93.32–$330.00	—	35%
PSA (prostate-specific antigen) blood test, free CPT 84154 %PHI PROST SPEC AG FREE	$82.55	$127.00	$35.92–$127.00	at median	35%
PSA (prostate-specific antigen) blood test, free CPT 84154 PSA FREE	$82.55	$127.00	$9.08–$41.39	at median	35%
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 %PHI PROST SPEC AG FREE	$82.55	$127.00	$35.92–$127.00	—	35%
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 PSA FREE	$82.55	$127.00	$35.92–$127.00	—	35%
PSA (prostate-specific antigen) blood test, total CPT 84153 %PHI PROST SPEC AG TOT	$82.55	$127.00	$35.92–$127.00	4% above	35%
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA SCREENING	$82.55	$127.00	$35.92–$127.00	4% above	35%
PSA (prostate-specific antigen) blood test, total CPT 84153 PHI PROST SPEC AG TOT	$82.55	$127.00	$35.92–$127.00	4% above	35%
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA DIAGNOSTIC	$82.55	$127.00	$10.42–$41.39	4% above	35%
PSA (prostate-specific antigen) blood test, total CPT 84153 BRWK PSA DIAGNOSTIC	$82.55	$127.00	$35.92–$127.00	4% above	35%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA SCREENING	$82.55	$127.00	$35.92–$127.00	—	35%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 BRWK PSA DIAGNOSTIC	$82.55	$127.00	$35.92–$127.00	—	35%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 %PHI PROST SPEC AG TOT	$82.55	$127.00	$35.92–$127.00	—	35%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA DIAGNOSTIC	$82.55	$127.00	$35.92–$127.00	—	35%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PHI PROST SPEC AG TOT	$82.55	$127.00	$35.92–$127.00	—	35%
Pap test (liquid-based, automated screening with review) CPT 88175 PAP WITH REFLEX HPV SCREEN-ARUP	$119.60	$184.00	$52.04–$184.00	23% above	35%
Pap test (liquid-based, automated screening with review) CPT 88175 CYTO IMAGER GYN TP DIAG	$119.60	$184.00	$39.92–$84.74	23% above	35%
Pap test (liquid-based, automated screening with review) CPT 88175 CYTO IMAGER GYN TP SCREEN	$119.60	$184.00	$15.29–$29.27	23% above	35%
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 PAP WITH REFLEX HPV SCREEN-ARUP	$119.60	$184.00	$52.04–$184.00	—	35%
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 CYTO IMAGER GYN TP SCREEN	$119.60	$184.00	$52.04–$184.00	—	35%
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 CYTO IMAGER GYN TP DIAG	$119.60	$184.00	$52.04–$184.00	—	35%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 PAP AND REFLEX HPV SCREEN- ARUP	$91.00	$140.00	$39.59–$140.00	at median	35%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 CYTOLOGY SUREPATH PAP	$91.00	$140.00	$39.59–$140.00	at median	35%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 PAP WITH REFLEX HPV SCREEN-ARUP	$91.00	$140.00	$30.39–$73.88	at median	35%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 CYTOLOGY GYN SC THIN PREP	$91.00	$140.00	$39.59–$140.00	at median	35%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 PAP SMR THN PRP	$91.00	$140.00	$39.59–$140.00	at median	35%
Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 CYTOLOGY SUREPATH PAP	$91.00	$140.00	$39.59–$140.00	—	35%
Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 PAP SMR THN PRP	$91.00	$140.00	$39.59–$140.00	—	35%
Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 CYTOLOGY GYN SC THIN PREP	$91.00	$140.00	$39.59–$140.00	—	35%
Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 PAP AND REFLEX HPV SCREEN- ARUP	$91.00	$140.00	$39.59–$140.00	—	35%
Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 PAP WITH REFLEX HPV SCREEN-ARUP	$91.00	$140.00	$39.59–$140.00	—	35%
Parathyroid hormone (PTH) blood test CPT 83970 PARATHYROID HORMONE ASSAY	$185.25	$285.00	$80.60–$285.00	31% above	35%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 PARATHYROID HORMONE ASSAY	$185.25	$285.00	$80.60–$285.00	—	35%
Partial thromboplastin time (PTT) clotting test CPT 85730 *PTT PLASMA/WHOLE BLOOD	$26.65	$41.00	$2.97–$18.11	29% below	35%
Partial thromboplastin time (PTT) clotting test CPT 85730 MANUAL HEME - PTT PLASMA/WHOLE BLOOD	$26.65	$41.00	$2.97–$18.11	29% below	35%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 MANUAL HEME - PTT PLASMA/WHOLE BLOOD	$26.65	$41.00	$11.59–$41.00	—	35%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 *PTT PLASMA/WHOLE BLOOD	$26.65	$41.00	$11.59–$41.00	—	35%
Phosphorus (phosphate) blood test CPT 84100 INORGANIC PHOSPHATE, SERUM (TRPHOS)	$21.45	$33.00	$4.74–$13.61	40% below	35%
Phosphorus (phosphate) blood test CPT 84100 %STCATH PHOSPOROUS	$21.45	$33.00	$2.34–$13.89	40% below	35%
Phosphorus (phosphate) blood test CPT 84100 PHOSPHOROUS ASSAY	$21.45	$33.00	$9.33–$33.00	40% below	35%
Phosphorus (phosphate) blood test inpatient CPT 84100 PHOSPHOROUS ASSAY	$21.45	$33.00	$9.33–$33.00	—	35%
Phosphorus (phosphate) blood test inpatient CPT 84100 %STCATH PHOSPOROUS	$21.45	$33.00	$9.33–$33.00	—	35%
Phosphorus (phosphate) blood test inpatient CPT 84100 INORGANIC PHOSPHATE, SERUM (TRPHOS)	$21.45	$33.00	$9.33–$33.00	—	35%
Potassium blood test CPT 84132 ELECTROLYTE K BLOOD	$21.45	$33.00	$9.33–$33.00	8% below	35%
Potassium blood test CPT 84132 POTASSIUM BLOOD (POINT OF CARE LAB)	$21.45	$33.00	$2.27–$12.39	8% below	35%
Potassium blood test CPT 84132 *POTASSIUM SERUM	$21.45	$33.00	$4.76–$13.61	8% below	35%
Potassium blood test CPT 84132 POTASSIUM	$21.45	$33.00	$9.33–$33.00	8% below	35%
Potassium blood test CPT 84132 POTASSIUM (POINT OF CARE LAB)	$21.45	$33.00	$2.27–$12.39	8% below	35%
Potassium blood test inpatient CPT 84132 POTASSIUM BLOOD (POINT OF CARE LAB)	$21.45	$33.00	$9.33–$33.00	—	35%
Potassium blood test inpatient CPT 84132 ELECTROLYTE K BLOOD	$21.45	$33.00	$9.33–$33.00	—	35%
Potassium blood test inpatient CPT 84132 *POTASSIUM SERUM	$21.45	$33.00	$9.33–$33.00	—	35%
Potassium blood test inpatient CPT 84132 POTASSIUM (POINT OF CARE LAB)	$21.45	$33.00	$9.33–$33.00	—	35%
Potassium blood test inpatient CPT 84132 POTASSIUM	$21.45	$33.00	$9.33–$33.00	—	35%
Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) CPT 81420 MATGEN FETAL CHRMOML ANEU	$3,404.05	$5,237.00	$645.00–$1,707.87	134% above	35%
Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) CPT 81420 MATERNIT21 PLUS	$3,404.05	$5,237.00	$645.00–$1,707.87	134% above	35%
Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) inpatient CPT 81420 MATGEN FETAL CHRMOML ANEU	$3,404.05	$5,237.00	$1,481.02–$5,237.00	—	35%
Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) inpatient CPT 81420 MATERNIT21 PLUS	$3,404.05	$5,237.00	$1,481.02–$5,237.00	—	35%
Progesterone blood test CPT 84144 PROGESTERONE	$93.60	$144.00	$40.72–$144.00	16% above	35%
Progesterone blood test CPT 84144 CAHSP ASSAY OF PROGESTERONE	$93.60	$144.00	$40.72–$144.00	16% above	35%
Progesterone blood test inpatient CPT 84144 PROGESTERONE	$93.60	$144.00	$40.72–$144.00	—	35%
Progesterone blood test inpatient CPT 84144 CAHSP ASSAY OF PROGESTERONE	$93.60	$144.00	$40.72–$144.00	—	35%
Prolactin blood test CPT 84146 *PROLACTIN ASSAY	$87.10	$134.00	$9.57–$43.61	at median	35%
Prolactin blood test CPT 84146 PROLACTIN	$87.10	$134.00	$37.90–$134.00	at median	35%
Prolactin blood test CPT 84146 PROLACTIN MACROADENOMA	$87.10	$134.00	$37.90–$134.00	at median	35%
Prolactin blood test inpatient CPT 84146 PROLACTIN MACROADENOMA	$87.10	$134.00	$37.90–$134.00	—	35%
Prolactin blood test inpatient CPT 84146 *PROLACTIN ASSAY	$87.10	$134.00	$37.90–$134.00	—	35%
Prolactin blood test inpatient CPT 84146 PROLACTIN	$87.10	$134.00	$37.90–$134.00	—	35%
Prothrombin time (PT/INR) clotting test CPT 85610 CLOTTING TEST (POINT OF CARE LAB)	$19.50	$30.00	$8.48–$30.00	19% below	35%
Prothrombin time (PT/INR) clotting test CPT 85610 *PRO TIME	$19.50	$30.00	$5.23–$12.92	19% below	35%
Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME AND INR (POINT OF CARE LAB)	$19.50	$30.00	$5.23–$12.92	19% below	35%
Prothrombin time (PT/INR) clotting test CPT 85610 PRO TIME (POINT OF CARE LAB)	$19.50	$30.00	$5.23–$12.92	19% below	35%
Prothrombin time (PT/INR) clotting test CPT 85610 MANUAL HEME - PRO TIME	$19.50	$30.00	$8.48–$30.00	19% below	35%
Prothrombin time (PT/INR) clotting test CPT 85610 CLOTTING TEST	$19.50	$30.00	$8.48–$30.00	19% below	35%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PRO TIME (POINT OF CARE LAB)	$19.50	$30.00	$8.48–$30.00	—	35%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 *PRO TIME	$19.50	$30.00	$8.48–$30.00	—	35%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 MANUAL HEME - PRO TIME	$19.50	$30.00	$8.48–$30.00	—	35%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 CLOTTING TEST	$19.50	$30.00	$8.48–$30.00	—	35%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTHROMBIN TIME AND INR (POINT OF CARE LAB)	$19.50	$30.00	$8.48–$30.00	—	35%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 CLOTTING TEST (POINT OF CARE LAB)	$19.50	$30.00	$8.48–$30.00	—	35%
Rapid flu test (influenza antigen) CPT 87804 *INFLUENZA A	$74.10	$114.00	$15.92–$54.55	13% above	35%
Rapid flu test (influenza antigen) CPT 87804 INFLUENZA OIA (POINT OF CARE LAB)	$74.10	$114.00	$32.24–$114.00	13% above	35%
Rapid flu test (influenza antigen) CPT 87804 RAPID FLU X2	$74.10	$114.00	$15.92–$54.55	13% above	35%
Rapid flu test (influenza antigen) inpatient CPT 87804 INFLUENZA OIA (POINT OF CARE LAB)	$74.10	$114.00	$32.24–$114.00	—	35%
Rapid flu test (influenza antigen) inpatient CPT 87804 RAPID FLU X2	$74.10	$114.00	$32.24–$114.00	—	35%
Rapid flu test (influenza antigen) inpatient CPT 87804 *INFLUENZA A	$74.10	$114.00	$32.24–$114.00	—	35%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 STREP ASSAY (POINT OF CARE LAB)	$74.10	$114.00	$32.24–$114.00	30% above	35%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 STREP A ASSAY W/OPTIC	$74.10	$114.00	$32.24–$114.00	30% above	35%
Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 STREP ASSAY (POINT OF CARE LAB)	$74.10	$114.00	$32.24–$114.00	—	35%
Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 STREP A ASSAY W/OPTIC	$74.10	$114.00	$32.24–$114.00	—	35%
Renin blood test CPT 84244 RENIN PLASMA	$98.80	$152.00	$10.86–$85.20	16% above	35%
Renin blood test inpatient CPT 84244 RENIN PLASMA	$98.80	$152.00	$42.99–$152.00	—	35%
Rh blood typing CPT 86901 WHIVF BLD TYPE RHD	$13.65	$21.00	$1.48–$22.96	63% below	35%
Rh blood typing CPT 86901 PAT BLOOD TYPING RH(D)	$13.65	$21.00	$5.94–$21.00	63% below	35%
Rh blood typing CPT 86901 *BLOOD TYPING RH(D)	$13.65	$21.00	$27.84–$39.30	63% below	35%
Rh blood typing CPT 86901 WKD D AG TYPING	$13.65	$21.00	$1.48–$22.96	63% below	35%
Rh blood typing inpatient CPT 86901 WKD D AG TYPING	$13.65	$21.00	$5.94–$21.00	—	35%
Rh blood typing inpatient CPT 86901 *BLOOD TYPING RH(D)	$13.65	$21.00	$5.94–$21.00	—	35%
Rh blood typing inpatient CPT 86901 PAT BLOOD TYPING RH(D)	$13.65	$21.00	$5.94–$21.00	—	35%
Rh blood typing inpatient CPT 86901 WHIVF BLD TYPE RHD	$13.65	$21.00	$5.94–$21.00	—	35%
Rheumatoid factor (RF) test CPT 86431 RHEUMATOID FACTOR QUANT	$25.35	$39.00	$2.80–$19.20	24% below	35%
Rheumatoid factor (RF) test CPT 86431 RHEUMATOID FACTOR TEST QUANT	$25.35	$39.00	$2.80–$19.20	24% below	35%
Rheumatoid factor (RF) test inpatient CPT 86431 RHEUMATOID FACTOR TEST QUANT	$25.35	$39.00	$11.03–$39.00	—	35%
Rheumatoid factor (RF) test inpatient CPT 86431 RHEUMATOID FACTOR QUANT	$25.35	$39.00	$11.03–$39.00	—	35%
Rubella antibody test (immunity check) CPT 86762 %TORCHM AB RUBELLA IGM	$64.35	$99.00	$7.11–$43.35	31% above	35%
Rubella antibody test (immunity check) CPT 86762 RUBELLA IGM IFA	$64.35	$99.00	$28.00–$99.00	31% above	35%
Rubella antibody test (immunity check) CPT 86762 RUBELLA IGG SEMI-QUANT	$64.35	$99.00	$28.00–$99.00	31% above	35%
Rubella antibody test (immunity check) CPT 86762 WHIIVF2 RUBELLA IGM IFA	$64.35	$99.00	$7.11–$43.35	31% above	35%
Rubella antibody test (immunity check) CPT 86762 WHIIVF2 RUBELLA IGG SEMI-QUANT	$64.35	$99.00	$7.11–$43.35	31% above	35%
Rubella antibody test (immunity check) CPT 86762 POMER4 RUBIGG	$64.35	$99.00	$28.00–$99.00	31% above	35%
Rubella antibody test (immunity check) CPT 86762 %TORC AB RUBELLA IGM	$64.35	$99.00	$28.00–$99.00	31% above	35%
Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA IGG SEMI-QUANT	$64.35	$99.00	$28.00–$99.00	—	35%
Rubella antibody test (immunity check) inpatient CPT 86762 WHIIVF2 RUBELLA IGG SEMI-QUANT	$64.35	$99.00	$28.00–$99.00	—	35%
Rubella antibody test (immunity check) inpatient CPT 86762 WHIIVF2 RUBELLA IGM IFA	$64.35	$99.00	$28.00–$99.00	—	35%
Rubella antibody test (immunity check) inpatient CPT 86762 POMER4 RUBIGG	$64.35	$99.00	$28.00–$99.00	—	35%
Rubella antibody test (immunity check) inpatient CPT 86762 %TORCHM AB RUBELLA IGM	$64.35	$99.00	$28.00–$99.00	—	35%
Rubella antibody test (immunity check) inpatient CPT 86762 %TORC AB RUBELLA IGM	$64.35	$99.00	$28.00–$99.00	—	35%
Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA IGM IFA	$64.35	$99.00	$28.00–$99.00	—	35%
Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 SEDIMENTATION RATE AUTO	$12.35	$19.00	$5.37–$19.00	67% below	35%
Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 SEDIMENTATION RATE AUTO	$12.35	$19.00	$5.37–$19.00	—	35%
Semen analysis: volume, sperm count, motility and morphology CPT 89320 CASA	$133.25	$205.00	$57.97–$205.00	at median	35%
Semen analysis: volume, sperm count, motility and morphology inpatient CPT 89320 CASA	$133.25	$205.00	$57.97–$205.00	—	35%
Sodium blood test CPT 84295 SODIUM	$21.45	$33.00	$9.33–$33.00	21% below	35%
Sodium blood test CPT 84295 *SODIUM BLOOD	$21.45	$33.00	$4.81–$13.61	21% below	35%
Sodium blood test CPT 84295 SODIUM BLOOD (POINT OF CARE LAB)	$21.45	$33.00	$2.38–$12.98	21% below	35%
Sodium blood test inpatient CPT 84295 SODIUM	$21.45	$33.00	$9.33–$33.00	—	35%
Sodium blood test inpatient CPT 84295 SODIUM BLOOD (POINT OF CARE LAB)	$21.45	$33.00	$9.33–$33.00	—	35%
Sodium blood test inpatient CPT 84295 *SODIUM BLOOD	$21.45	$33.00	$9.33–$33.00	—	35%
Stool ova and parasites exam CPT 87177 CONCENTRATION AND ID, OVA AND PARASITE	$39.65	$61.00	$4.40–$26.81	at median	35%
Stool ova and parasites exam inpatient CPT 87177 CONCENTRATION AND ID, OVA AND PARASITE	$39.65	$61.00	$17.25–$61.00	—	35%
Stool test for hidden blood (guaiac FOBT) CPT 82270 OCCULT BLOOD SCREEN	$19.50	$30.00	$8.48–$30.00	32% below	35%
Stool test for hidden blood (guaiac FOBT) CPT 82270 HEMOCULT FECES SCREEN (POINT OF CARE LAB)	$19.50	$30.00	$8.48–$30.00	32% below	35%
Stool test for hidden blood (guaiac FOBT) CPT 82270 OCCULT BLOOD FECES COLORECT	$19.50	$30.00	$8.48–$30.00	32% below	35%
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 HEMOCULT FECES SCREEN (POINT OF CARE LAB)	$19.50	$30.00	$8.48–$30.00	—	35%
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 OCCULT BLOOD FECES COLORECT	$19.50	$30.00	$8.48–$30.00	—	35%
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 OCCULT BLOOD SCREEN	$19.50	$30.00	$8.48–$30.00	—	35%
Stool test for hidden blood by immunoassay (FIT) CPT 82274 OCCULT BLD IA SCRN	$71.50	$110.00	$7.86–$48.98	34% above	35%
Stool test for hidden blood by immunoassay (FIT) CPT 82274 IMMUNOASSAY, FECAL OCCULT BLOOD	$71.50	$110.00	$7.86–$48.98	34% above	35%
Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 IMMUNOASSAY, FECAL OCCULT BLOOD	$71.50	$110.00	$31.11–$110.00	—	35%
Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 OCCULT BLD IA SCRN	$71.50	$110.00	$31.11–$110.00	—	35%
Syphilis antibody test (Treponema pallidum) CPT 86780 WHIIVF SYPHILIS	$59.15	$91.00	$19.86–$69.60	2% above	35%
Syphilis antibody test (Treponema pallidum) CPT 86780 WHIIVF SYPHILIS T PALLIDUM REFLEX	$59.15	$91.00	$19.86–$69.60	2% above	35%
Syphilis antibody test (Treponema pallidum) CPT 86780 SYPHILIS T PALLIDUM IGG	$59.15	$91.00	$25.73–$91.00	2% above	35%
Syphilis antibody test (Treponema pallidum) CPT 86780 TREPONEMA PALLIDUM	$59.15	$91.00	$25.73–$91.00	2% above	35%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 WHIIVF SYPHILIS	$59.15	$91.00	$25.73–$91.00	—	35%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 SYPHILIS T PALLIDUM IGG	$59.15	$91.00	$25.73–$91.00	—	35%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 TREPONEMA PALLIDUM	$59.15	$91.00	$25.73–$91.00	—	35%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 WHIIVF SYPHILIS T PALLIDUM REFLEX	$59.15	$91.00	$25.73–$91.00	—	35%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 WHIIVF SYPHILIS TEST	$18.85	$29.00	$2.11–$12.86	21% below	35%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 POMER4 RPR	$18.85	$29.00	$8.06–$29.00	21% below	35%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 VDRL/RPR QUAL	$18.85	$29.00	$4.27–$26.72	21% below	35%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 SYPHILIS TEST QUAL	$18.85	$29.00	$4.27–$26.72	21% below	35%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 SYPHILIS TEST QUAL	$18.85	$29.00	$8.06–$29.00	—	35%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 WHIIVF SYPHILIS TEST	$18.85	$29.00	$8.06–$29.00	—	35%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 POMER4 RPR	$18.85	$29.00	$8.06–$29.00	—	35%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 VDRL/RPR QUAL	$18.85	$29.00	$8.06–$29.00	—	35%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 QUANTIFERON-TB GOLD PLUS, BLOOD	$278.20	$428.00	$121.04–$428.00	138% above	35%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 TB GOLD PLUS	$278.20	$428.00	$121.04–$428.00	138% above	35%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 QUANTIFERON-TB GOLD PLUS, BLOOD	$278.20	$428.00	$121.04–$428.00	—	35%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 TB GOLD PLUS	$278.20	$428.00	$121.04–$428.00	—	35%
Testosterone blood test, total (not free testosterone) CPT 84403 HIRSUT TESTOSTERONE TOTAL	$115.70	$178.00	$12.75–$58.08	26% above	35%
Testosterone blood test, total (not free testosterone) CPT 84403 *TESTOSTERONE TOTAL ASSAY	$115.70	$178.00	$50.34–$178.00	26% above	35%
Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE, TOTAL, SERUM	$115.70	$178.00	$50.34–$178.00	26% above	35%
Testosterone blood test, total (not free testosterone) CPT 84403 FTTESM TESTOSTERONE	$115.70	$178.00	$12.75–$58.08	26% above	35%
Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE TOTAL ASSAY	$115.70	$178.00	$22.00–$28.39	26% above	35%
Testosterone blood test, total (not free testosterone) CPT 84403 CAHSP ASSAY OF TOTAL TESTOSTERONE	$115.70	$178.00	$50.34–$178.00	26% above	35%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 HIRSUT TESTOSTERONE TOTAL	$115.70	$178.00	$50.34–$178.00	—	35%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 FTTESM TESTOSTERONE	$115.70	$178.00	$50.34–$178.00	—	35%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE, TOTAL, SERUM	$115.70	$178.00	$50.34–$178.00	—	35%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 CAHSP ASSAY OF TOTAL TESTOSTERONE	$115.70	$178.00	$50.34–$178.00	—	35%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE TOTAL ASSAY	$115.70	$178.00	$50.34–$178.00	—	35%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 *TESTOSTERONE TOTAL ASSAY	$115.70	$178.00	$50.34–$178.00	—	35%
Thyroid peroxidase (TPO) antibody test CPT 86376 THYROID PEROXIDASE AB	$65.00	$100.00	$14.55–$26.72	at median	35%
Thyroid peroxidase (TPO) antibody test CPT 86376 MICROSOMAL ANTIBODIES EA	$65.00	$100.00	$7.18–$54.33	at median	35%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 MICROSOMAL ANTIBODIES EA	$65.00	$100.00	$28.28–$100.00	—	35%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 THYROID PEROXIDASE AB	$65.00	$100.00	$28.28–$100.00	—	35%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 %NEO TSH	$75.40	$116.00	$16.80–$25.48	at median	35%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 THYROID STIMULATING HORMONE (TSH)	$75.40	$116.00	$32.80–$116.00	at median	35%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 THYROID STIMULATING HORMONE (TSH)	$75.40	$116.00	$32.80–$116.00	—	35%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 %NEO TSH	$75.40	$116.00	$32.80–$116.00	—	35%
Total IgE blood test CPT 82785 *GAMMAGLOBULIN ASSAY IGE	$74.10	$114.00	$32.24–$114.00	20% above	35%
Total IgE blood test CPT 82785 ATOPIC GAMMAGLOB IGE	$74.10	$114.00	$32.24–$114.00	20% above	35%
Total IgE blood test CPT 82785 GAMMAGLOBULIN ASSAY IGE	$74.10	$114.00	$8.13–$55.15	20% above	35%
Total IgE blood test CPT 82785 ATLANTIC RESPIRATORY PANEL IGE TOTAL	$74.10	$114.00	$32.24–$114.00	20% above	35%
Total IgE blood test inpatient CPT 82785 *GAMMAGLOBULIN ASSAY IGE	$74.10	$114.00	$32.24–$114.00	—	35%
Total IgE blood test inpatient CPT 82785 ATOPIC GAMMAGLOB IGE	$74.10	$114.00	$32.24–$114.00	—	35%
Total IgE blood test inpatient CPT 82785 ATLANTIC RESPIRATORY PANEL IGE TOTAL	$74.10	$114.00	$32.24–$114.00	—	35%
Total IgE blood test inpatient CPT 82785 GAMMAGLOBULIN ASSAY IGE	$74.10	$114.00	$32.24–$114.00	—	35%
Total cholesterol blood test CPT 82465 %NASH CHOLESTEROL TOTAL	$19.50	$30.00	$4.35–$13.61	47% below	35%
Total cholesterol blood test CPT 82465 %GMAPS CHOLESTEROL TOTAL	$19.50	$30.00	$4.35–$13.61	47% below	35%
Total cholesterol blood test CPT 82465 CHOLESTEROL BLOOD TOTAL	$19.50	$30.00	$4.69–$11.73	47% below	35%
Total cholesterol blood test inpatient CPT 82465 %GMAPS CHOLESTEROL TOTAL	$19.50	$30.00	$8.48–$30.00	—	35%
Total cholesterol blood test inpatient CPT 82465 %NASH CHOLESTEROL TOTAL	$19.50	$30.00	$8.48–$30.00	—	35%
Total cholesterol blood test inpatient CPT 82465 CHOLESTEROL BLOOD TOTAL	$19.50	$30.00	$8.48–$30.00	—	35%
Total thyroxine (T4) blood test CPT 84436 *THYROXINE TOTAL ASSAY	$30.55	$47.00	$13.29–$47.00	27% below	35%
Total thyroxine (T4) blood test CPT 84436 THYROXINE TOTAL ASSAY	$30.55	$47.00	$3.39–$21.15	27% below	35%
Total thyroxine (T4) blood test inpatient CPT 84436 THYROXINE TOTAL ASSAY	$30.55	$47.00	$13.29–$47.00	—	35%
Total thyroxine (T4) blood test inpatient CPT 84436 *THYROXINE TOTAL ASSAY	$30.55	$47.00	$13.29–$47.00	—	35%
Total triiodothyronine (T3) blood test CPT 84480 TRIIODOTHYRONINE TOTAL(TT-3)	$63.70	$98.00	$7.00–$31.91	6% above	35%
Total triiodothyronine (T3) blood test inpatient CPT 84480 TRIIODOTHYRONINE TOTAL(TT-3)	$63.70	$98.00	$27.71–$98.00	—	35%
Transferrin blood test CPT 84466 TRANSFERRIN	$57.20	$88.00	$24.89–$88.00	23% below	35%
Transferrin blood test inpatient CPT 84466 TRANSFERRIN	$57.20	$88.00	$24.89–$88.00	—	35%
Trichomonas test (NAAT) CPT 87661 T VAGINALIS UR MALES	$157.30	$242.00	$33.62–$38.93	82% above	35%
Trichomonas test (NAAT) CPT 87661 TRICHOMONAS VAG AMP	$157.30	$242.00	$19.15–$105.71	82% above	35%
Trichomonas test (NAAT) CPT 87661 TRICHOMONAS VAGINALIS AMPLIF	$157.30	$242.00	$19.15–$105.71	82% above	35%
Trichomonas test (NAAT) inpatient CPT 87661 TRICHOMONAS VAGINALIS AMPLIF	$157.30	$242.00	$68.44–$242.00	—	35%
Trichomonas test (NAAT) inpatient CPT 87661 TRICHOMONAS VAG AMP	$157.30	$242.00	$68.44–$242.00	—	35%
Trichomonas test (NAAT) inpatient CPT 87661 T VAGINALIS UR MALES	$157.30	$242.00	$68.44–$242.00	—	35%
Triglycerides blood test CPT 84478 TRIGLYCERIDES BF W REFLEX TO CHYLOMICRON ELECTROPH	$26.00	$40.00	$11.31–$40.00	25% below	35%
Triglycerides blood test CPT 84478 %VAP TRIGLYCERIDES	$26.00	$40.00	$5.74–$13.61	25% below	35%
Triglycerides blood test CPT 84478 TRIGLYCERIDES ASSAY	$26.00	$40.00	$7.63–$15.49	25% below	35%
Triglycerides blood test CPT 84478 %NASH TRIGLYCERIDES	$26.00	$40.00	$7.63–$15.49	25% below	35%
Triglycerides blood test inpatient CPT 84478 %NASH TRIGLYCERIDES	$26.00	$40.00	$11.31–$40.00	—	35%
Triglycerides blood test inpatient CPT 84478 TRIGLYCERIDES BF W REFLEX TO CHYLOMICRON ELECTROPH	$26.00	$40.00	$11.31–$40.00	—	35%
Triglycerides blood test inpatient CPT 84478 TRIGLYCERIDES ASSAY	$26.00	$40.00	$11.31–$40.00	—	35%
Triglycerides blood test inpatient CPT 84478 %VAP TRIGLYCERIDES	$26.00	$40.00	$11.31–$40.00	—	35%
Troponin test, quantitative CPT 84484 TROPONIN T	$55.90	$86.00	$24.32–$86.00	33% below	35%
Troponin test, quantitative CPT 84484 TROPONIN I	$55.90	$86.00	$24.32–$86.00	33% below	35%
Troponin test, quantitative inpatient CPT 84484 TROPONIN T	$55.90	$86.00	$24.32–$86.00	—	35%
Troponin test, quantitative inpatient CPT 84484 TROPONIN I	$55.90	$86.00	$24.32–$86.00	—	35%
Uric acid blood test CPT 84550 %GMAPS URIC ACID BLD	$20.15	$31.00	$6.00–$19.33	43% below	35%
Uric acid blood test CPT 84550 URIC ACID BLOOD ASSAY	$20.15	$31.00	$6.00–$19.33	43% below	35%
Uric acid blood test CPT 84550 URIC ACID BLOOD	$20.15	$31.00	$6.00–$19.33	43% below	35%
Uric acid blood test inpatient CPT 84550 %GMAPS URIC ACID BLD	$20.15	$31.00	$8.77–$31.00	—	35%
Uric acid blood test inpatient CPT 84550 URIC ACID BLOOD	$20.15	$31.00	$8.77–$31.00	—	35%
Uric acid blood test inpatient CPT 84550 URIC ACID BLOOD ASSAY	$20.15	$31.00	$8.77–$31.00	—	35%
Urinalysis with microscope exam, automated CPT 81001 URINALYSIS AUTO W SCPE	$14.30	$22.00	$3.17–$7.38	47% below	35%
Urinalysis with microscope exam, automated CPT 81001 URINALYSIS WITH MICRO (POINT OF CARE LAB)	$14.30	$22.00	$6.22–$22.00	47% below	35%
Urinalysis with microscope exam, automated inpatient CPT 81001 URINALYSIS AUTO W SCPE	$14.30	$22.00	$6.22–$22.00	—	35%
Urinalysis with microscope exam, automated inpatient CPT 81001 URINALYSIS WITH MICRO (POINT OF CARE LAB)	$14.30	$22.00	$6.22–$22.00	—	35%
Urinalysis with microscope exam, manual CPT 81000 URINALYSIS NONAUTO W SCPE (POINT OF CARE LAB)	$18.20	$28.00	$4.02–$7.38	at median	35%
Urinalysis with microscope exam, manual inpatient CPT 81000 URINALYSIS NONAUTO W SCPE (POINT OF CARE LAB)	$18.20	$28.00	$7.92–$28.00	—	35%
Urinalysis without microscope exam, automated CPT 81003 URINALYSIS AUTO WO SCPE (POINT OF CARE LAB)	$10.40	$16.00	$2.25–$7.38	56% below	35%
Urinalysis without microscope exam, automated CPT 81003 URINALYSIS ONLY	$10.40	$16.00	$3.38–$17.31	56% below	35%
Urinalysis without microscope exam, automated CPT 81003 URINALYSIS AUTO WO SCPE	$10.40	$16.00	$2.25–$7.38	56% below	35%
Urinalysis without microscope exam, automated CPT 81003 URINALYSIS (POINT OF CARE LAB)	$10.40	$16.00	$3.38–$17.31	56% below	35%
Urinalysis without microscope exam, automated inpatient CPT 81003 URINALYSIS AUTO WO SCPE (POINT OF CARE LAB)	$10.40	$16.00	$4.52–$16.00	—	35%
Urinalysis without microscope exam, automated inpatient CPT 81003 URINALYSIS (POINT OF CARE LAB)	$10.40	$16.00	$4.52–$16.00	—	35%
Urinalysis without microscope exam, automated inpatient CPT 81003 URINALYSIS AUTO WO SCPE	$10.40	$16.00	$4.52–$16.00	—	35%
Urinalysis without microscope exam, automated inpatient CPT 81003 URINALYSIS ONLY	$10.40	$16.00	$4.52–$16.00	—	35%
Urinalysis without microscope exam, manual CPT 81002 N-AUTOM URINALYS WO MICRO (POINT OF CARE LAB)	$15.60	$24.00	$3.48–$7.38	4% below	35%
Urinalysis without microscope exam, manual CPT 81002 UA NON-AUTO W/O MICRO (POINT OF CARE LAB)	$15.60	$24.00	$3.48–$7.38	4% below	35%
Urinalysis without microscope exam, manual inpatient CPT 81002 N-AUTOM URINALYS WO MICRO (POINT OF CARE LAB)	$15.60	$24.00	$6.79–$24.00	—	35%
Urinalysis without microscope exam, manual inpatient CPT 81002 UA NON-AUTO W/O MICRO (POINT OF CARE LAB)	$15.60	$24.00	$6.79–$24.00	—	35%
Urine culture for bacteria, with colony count CPT 87086 CULT/COLONY COUNT QUANT URINE	$36.40	$56.00	$15.84–$56.00	36% below	35%
Urine culture for bacteria, with colony count CPT 87086 CULTURE, BACTERIAL, URINE, QUANTITATIVE	$36.40	$56.00	$15.84–$56.00	36% below	35%
Urine culture for bacteria, with colony count inpatient CPT 87086 CULTURE, BACTERIAL, URINE, QUANTITATIVE	$36.40	$56.00	$15.84–$56.00	—	35%
Urine culture for bacteria, with colony count inpatient CPT 87086 CULT/COLONY COUNT QUANT URINE	$36.40	$56.00	$15.84–$56.00	—	35%
Urine microalbumin (albumin) test CPT 82043 *MICROALBUMIN URINE QUANT	$26.00	$40.00	$5.78–$7.38	49% below	35%
Urine microalbumin (albumin) test inpatient CPT 82043 *MICROALBUMIN URINE QUANT	$26.00	$40.00	$11.31–$40.00	—	35%
Urine pregnancy test, read by color change CPT 81025 HCG QUAL FLUID/URINE	$38.35	$59.00	$16.69–$59.00	21% below	35%
Urine pregnancy test, read by color change CPT 81025 PREGNANCY TEST URINE (POINT OF CARE LAB)	$38.35	$59.00	$16.69–$59.00	21% below	35%
Urine pregnancy test, read by color change CPT 81025 HCG URINE (POINT OF CARE LAB)	$38.35	$59.00	$8.39–$25.94	21% below	35%
Urine pregnancy test, read by color change inpatient CPT 81025 HCG URINE (POINT OF CARE LAB)	$38.35	$59.00	$16.69–$59.00	—	35%
Urine pregnancy test, read by color change inpatient CPT 81025 PREGNANCY TEST URINE (POINT OF CARE LAB)	$38.35	$59.00	$16.69–$59.00	—	35%
Urine pregnancy test, read by color change inpatient CPT 81025 HCG QUAL FLUID/URINE	$38.35	$59.00	$16.69–$59.00	—	35%
Vitamin B12 (cobalamin) blood test CPT 82607 VIT B-12	$67.60	$104.00	$15.08–$25.48	9% below	35%
Vitamin B12 (cobalamin) blood test CPT 82607 VITAMIN B12 BLOOD	$67.60	$104.00	$29.41–$104.00	9% below	35%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 VITAMIN B12 BLOOD	$67.60	$104.00	$29.41–$104.00	—	35%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 VIT B-12	$67.60	$104.00	$29.41–$104.00	—	35%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 D2D3 25-OH VITAMIN	$132.60	$204.00	$20.86–$32.56	41% above	35%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D 25 HYDROXY	$132.60	$204.00	$57.69–$204.00	41% above	35%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 VITAMIN D 25 HYDROXY	$132.60	$204.00	$57.69–$204.00	—	35%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 D2D3 25-OH VITAMIN	$132.60	$204.00	$57.69–$204.00	—	35%
Vitamin D, 1,25-dihydroxy blood test CPT 82652 VIT D 1 25 DIHYDROXY	$172.90	$266.00	$75.22–$266.00	12% above	35%
Vitamin D, 1,25-dihydroxy blood test inpatient CPT 82652 VIT D 1 25 DIHYDROXY	$172.90	$266.00	$75.22–$266.00	—	35%
Zinc blood test CPT 84630 ZINC BLOOD	$51.35	$79.00	$22.34–$79.00	at median	35%
Zinc blood test CPT 84630 ZINC WHOL BLOOD	$51.35	$79.00	$5.62–$87.67	at median	35%
Zinc blood test CPT 84630 ZINC, UR QNT	$51.35	$79.00	$5.62–$87.67	at median	35%
Zinc blood test CPT 84630 ZINC, URINE QUANTITATIVE	$51.35	$79.00	$11.39–$18.77	at median	35%
Zinc blood test inpatient CPT 84630 ZINC, URINE QUANTITATIVE	$51.35	$79.00	$22.34–$79.00	—	35%
Zinc blood test inpatient CPT 84630 ZINC, UR QNT	$51.35	$79.00	$22.34–$79.00	—	35%
Zinc blood test inpatient CPT 84630 ZINC WHOL BLOOD	$51.35	$79.00	$22.34–$79.00	—	35%
Zinc blood test inpatient CPT 84630 ZINC BLOOD	$51.35	$79.00	$22.34–$79.00	—	35%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HCG QUANT SERUM	$67.60	$104.00	$29.41–$104.00	at median	35%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 %SEQ2 HCG QUANT	$67.60	$104.00	$29.41–$104.00	at median	35%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 %1ST TRI HCG QUANT	$67.60	$104.00	$29.41–$104.00	at median	35%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 BETA HCG QUANT TUMOR MARKER	$67.60	$104.00	$15.05–$25.48	at median	35%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 %FIRSCN HCG QUANT	$67.60	$104.00	$7.44–$46.39	at median	35%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 BETA-HCG QNT TM CSF	$67.60	$104.00	$29.41–$104.00	at median	35%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 %SEQ1 HCG	$67.60	$104.00	$29.41–$104.00	at median	35%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 BETA HCG QUANT SERUM	$67.60	$104.00	$29.41–$104.00	at median	35%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 %SEQ1 HCG	$67.60	$104.00	$29.41–$104.00	—	35%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HCG QUANT SERUM	$67.60	$104.00	$29.41–$104.00	—	35%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 %FIRSCN HCG QUANT	$67.60	$104.00	$29.41–$104.00	—	35%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 %1ST TRI HCG QUANT	$67.60	$104.00	$29.41–$104.00	—	35%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 %SEQ2 HCG QUANT	$67.60	$104.00	$29.41–$104.00	—	35%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 BETA HCG QUANT TUMOR MARKER	$67.60	$104.00	$29.41–$104.00	—	35%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 BETA-HCG QNT TM CSF	$67.60	$104.00	$29.41–$104.00	—	35%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 BETA HCG QUANT SERUM	$67.60	$104.00	$29.41–$104.00	—	35%

Surgery and procedures

Procedure	Cash price	List price	Insurers pay	vs Ohio	Off list
Balloon dilation of the maxillary sinus opening, one side CPT 31295 NASAL/SINUS NDSC SURG W/DILATION MAXILLARY SINUS	$20,697.95	$31,843.00	$8,852.35–$31,843.00	5% above	35%
Balloon dilation of the maxillary sinus opening, one side inpatient CPT 31295 NASAL/SINUS NDSC SURG W/DILATION MAXILLARY SINUS	$20,697.95	$31,843.00	$8,852.35–$31,843.00	—	35%
Botox injections for chronic migraine CPT 64615 CHEMODERVATE FACIAL/TRIGEM/CERV MUSC MIGRAINE	$1,324.05	$2,037.00	$566.29–$2,037.00	139% above	35%
Botox injections for chronic migraine inpatient CPT 64615 CHEMODERVATE FACIAL/TRIGEM/CERV MUSC MIGRAINE	$1,324.05	$2,037.00	$566.29–$2,037.00	—	35%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion CPT 19081 BX BREAST W/DEVICE 1ST LESION STEREOTACTIC GUID	$7,267.00	$11,180.00	$187.90–$6,112.00	81% above	35%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion CPT 19081 MAM STEREO BREAST BX FIRST LES	$7,267.00	$11,180.00	$3,108.04–$11,180.00	81% above	35%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion inpatient CPT 19081 MAM STEREO BREAST BX FIRST LES	$7,267.00	$11,180.00	$3,108.04–$11,180.00	—	35%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion inpatient CPT 19081 BX BREAST W/DEVICE 1ST LESION STEREOTACTIC GUID	$7,267.00	$11,180.00	$3,108.04–$11,180.00	—	35%
Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 CLTX DSTL FIBULAR FX LAT MALLS W/O MANJ	$716.95	$1,103.00	$204.59–$4,392.00	90% above	35%
Broken ankle (outer ankle bone) treatment without surgery or setting inpatient CPT 27786 CLTX DSTL FIBULAR FX LAT MALLS W/O MANJ	$716.95	$1,103.00	$306.63–$1,103.00	—	35%
Broken foot (metatarsal) treatment without surgery or setting CPT 28470 CLOSED TX METATARSAL FRACTURE W/O MANIPULATION	$716.95	$1,103.00	$204.59–$4,392.00	97% above	35%
Broken foot (metatarsal) treatment without surgery or setting inpatient CPT 28470 CLOSED TX METATARSAL FRACTURE W/O MANIPULATION	$716.95	$1,103.00	$306.63–$1,103.00	—	35%
Cardiac catheterization with coronary angiogram CPT 93458 CATH PLMT L HRT & ARTS W/NJX & ANGIO IMG S&I	$12,021.10	$18,494.00	$1,290.31–$10,201.00	at median	35%
Cardiac catheterization with coronary angiogram inpatient CPT 93458 CATH PLMT L HRT & ARTS W/NJX & ANGIO IMG S&I	$12,021.10	$18,494.00	$5,141.33–$18,494.00	—	35%
Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION ELECTIVE ARRHYTHMIA EXTERNAL	$2,445.95	$3,763.00	$1,046.11–$3,763.00	19% above	35%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 CARDIOVERSION ELECTIVE ARRHYTHMIA EXTERNAL	$2,445.95	$3,763.00	$1,046.11–$3,763.00	—	35%
Carpal tunnel release, open surgery CPT 64721 NEUROPLASTY &/TRANSPOS MEDIAN NRV CARPAL TUNNE	$8,758.10	$13,474.00	$3,745.77–$13,474.00	6% above	35%
Carpal tunnel release, open surgery inpatient CPT 64721 NEUROPLASTY &/TRANSPOS MEDIAN NRV CARPAL TUNNE	$8,758.10	$13,474.00	$3,745.77–$13,474.00	—	35%
Catheter ablation for atrial fibrillation CPT 93656 COMPRE EP EVAL ABLTJ ATR FIB PULM VEIN ISOLATION	$45,258.20	$69,628.00	$19,356.58–$69,628.00	33% above	35%
Catheter ablation for atrial fibrillation inpatient CPT 93656 COMPRE EP EVAL ABLTJ ATR FIB PULM VEIN ISOLATION	$45,258.20	$69,628.00	$19,356.58–$69,628.00	—	35%
Cervical biopsy CPT 57500 BIOPSY CERVIX SINGLE/MULT/EXCISION OF LESION SPX	$2,603.25	$4,005.00	$1,113.39–$4,005.00	49% above	35%
Cervical biopsy inpatient CPT 57500 BIOPSY CERVIX SINGLE/MULT/EXCISION OF LESION SPX	$2,603.25	$4,005.00	$1,113.39–$4,005.00	—	35%
Circumcision by surgical excision, older than 28 days (children and adults) CPT 54161 CIRCUMCISION AGE >28 DAYS	$6,124.95	$9,423.00	$232.66–$5,265.00	at median	35%
Circumcision by surgical excision, older than 28 days (children and adults) inpatient CPT 54161 CIRCUMCISION AGE >28 DAYS	$6,124.95	$9,423.00	$2,619.59–$9,423.00	—	35%
Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 CIRCUMCISION W/CLAMP/OTH DEV W/BLOCK	$6,124.95	$9,423.00	$2,619.59–$9,423.00	246% above	35%
Circumcision with a clamp or device and a numbing nerve block, usually newborns inpatient CPT 54150 CIRCUMCISION W/CLAMP/OTH DEV W/BLOCK	$6,124.95	$9,423.00	$2,619.59–$9,423.00	—	35%
Circumcision, surgical, older than a newborn CPT 54160 CIRCUMCISION NEONATE	$1,995.50	$3,070.00	$853.46–$3,070.00	at median	35%
Circumcision, surgical, older than a newborn inpatient CPT 54160 CIRCUMCISION NEONATE	$1,995.50	$3,070.00	$853.46–$3,070.00	—	35%
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 CLTX DSTL RADIAL FX/EPIPHYSL SEP W/O MANJ	$716.95	$1,103.00	$204.59–$3,443.00	75% above	35%
Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 CLTX DSTL RADIAL FX/EPIPHYSL SEP W/O MANJ	$716.95	$1,103.00	$306.63–$1,103.00	—	35%
Colonoscopy with endoscopic ultrasound CPT 45391 COLSC FLX W/NDSC US XM RCTM ET AL LMTD&ADJ STRUX	$3,525.60	$5,424.00	$298.08–$6,112.00	13% above	35%
Colonoscopy with endoscopic ultrasound inpatient CPT 45391 COLSC FLX W/NDSC US XM RCTM ET AL LMTD&ADJ STRUX	$3,525.60	$5,424.00	$1,507.87–$5,424.00	—	35%
Colonoscopy with polyp removal CPT 45385 COLSC FLX W/RMVL OF TUMOR POLYP LESION SNARE TQ	$3,525.60	$5,424.00	$294.02–$6,112.00	6% above	35%
Colonoscopy with polyp removal inpatient CPT 45385 COLSC FLX W/RMVL OF TUMOR POLYP LESION SNARE TQ	$3,525.60	$5,424.00	$1,507.87–$5,424.00	—	35%
Colonoscopy with tissue sample CPT 45380 COLONOSCOPY W/BIOPSY SINGLE/MULTIPLE	$3,525.60	$5,424.00	$232.45–$6,112.00	6% above	35%
Colonoscopy with tissue sample inpatient CPT 45380 COLONOSCOPY W/BIOPSY SINGLE/MULTIPLE	$3,525.60	$5,424.00	$1,507.87–$5,424.00	—	35%
Colonoscopy, diagnostic CPT 45378 COLONOSCOPY FLX DX W/COLLJ SPEC WHEN PFRMD	$2,726.10	$4,194.00	$214.53–$6,112.00	at median	35%
Colonoscopy, diagnostic inpatient CPT 45378 COLONOSCOPY FLX DX W/COLLJ SPEC WHEN PFRMD	$2,726.10	$4,194.00	$1,165.93–$4,194.00	—	35%
Colposcopy with LEEP (loop electrosurgical excision) CPT 57460 COLPOSCOPY CERVIX VAG LOOP ELTRD BX CERVIX	$9,506.90	$14,626.00	$4,066.03–$14,626.00	145% above	35%
Colposcopy with LEEP (loop electrosurgical excision) inpatient CPT 57460 COLPOSCOPY CERVIX VAG LOOP ELTRD BX CERVIX	$9,506.90	$14,626.00	$4,066.03–$14,626.00	—	35%
Colposcopy with cervical biopsy and scraping of the cervical canal CPT 57454 COLPOSCOPY CERVIX BX CERVIX & ENDOCRV CURRETAGE	$909.35	$1,399.00	$388.92–$1,399.00	at median	35%
Colposcopy with cervical biopsy and scraping of the cervical canal inpatient CPT 57454 COLPOSCOPY CERVIX BX CERVIX & ENDOCRV CURRETAGE	$909.35	$1,399.00	$388.92–$1,399.00	—	35%
Coronary stent placement, one artery CPT 92928 PRQ CARDIAC STENT W/ANGIO 1 VSL	$27,482.65	$42,281.00	$596.27–$12,013.86	113% above	35%
Coronary stent placement, one artery inpatient CPT 92928 PRQ CARDIAC STENT W/ANGIO 1 VSL	$27,482.65	$42,281.00	$11,754.12–$42,281.00	—	35%
Cystoscopy with ureteral stent placement CPT 52332 CYSTO W/INSERT URETERAL STENT	$10,312.25	$15,865.00	$182.47–$6,987.00	4% above	35%
Cystoscopy with ureteral stent placement inpatient CPT 52332 CYSTO W/INSERT URETERAL STENT	$10,312.25	$15,865.00	$4,410.47–$15,865.00	—	35%
Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 CYSTOURETHROSCOPY	$1,995.50	$3,070.00	$93.98–$4,392.00	at median	35%
Cystoscopy, diagnostic look inside the bladder and urethra inpatient CPT 52000 CYSTOURETHROSCOPY	$1,995.50	$3,070.00	$853.46–$3,070.00	—	35%
D&C (dilation and curettage), not related to pregnancy CPT 58120 DILATION & CURETTAGE DX&/THER NONOBSTETRIC	$9,506.90	$14,626.00	$263.09–$5,265.00	37% above	35%
D&C (dilation and curettage), not related to pregnancy inpatient CPT 58120 DILATION & CURETTAGE DX&/THER NONOBSTETRIC	$9,506.90	$14,626.00	$4,066.03–$14,626.00	—	35%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 DESTRUCTION PREMALIGNANT LESION 1ST	$387.40	$596.00	$165.69–$596.00	91% above	35%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 DESTRUCTION PREMALIGNANT LESION 1ST	$387.40	$596.00	$165.69–$596.00	—	35%
Ear tube placement (tympanostomy) under general anesthesia, one ear CPT 69436 TYMPANOSTOMY GENERAL ANESTHESIA	$3,851.25	$5,925.00	$178.34–$7,813.00	10% below	35%
Ear tube placement (tympanostomy) under general anesthesia, one ear inpatient CPT 69436 TYMPANOSTOMY GENERAL ANESTHESIA	$3,851.25	$5,925.00	$1,647.15–$5,925.00	—	35%
Ear tube placement (tympanostomy) with local anesthesia, one ear CPT 69433 TYMPANOSTOMY LOCAL/TOPICAL ANESTHESIA	$1,324.05	$2,037.00	$107.64–$7,431.00	at median	35%
Ear tube placement (tympanostomy) with local anesthesia, one ear inpatient CPT 69433 TYMPANOSTOMY LOCAL/TOPICAL ANESTHESIA	$1,324.05	$2,037.00	$566.29–$2,037.00	—	35%
Earwax removal by irrigation (rinsing), one ear one side CPT 69209 REMOVAL IMPACTED CERUMEN IRRIGATION/LVG UNILAT	$154.70	$238.00	$66.16–$238.00	at median	35%
Earwax removal by irrigation (rinsing), one ear inpatient one side CPT 69209 REMOVAL IMPACTED CERUMEN IRRIGATION/LVG UNILAT	$154.70	$238.00	$66.16–$238.00	—	35%
Earwax removal with instruments, one ear one side CPT 69210 REMOVAL IMPACTED CERUMEN INSTRUMENTATION UNILAT	$154.70	$238.00	$36.18–$3,443.00	at median	35%
Earwax removal with instruments, one ear inpatient one side CPT 69210 REMOVAL IMPACTED CERUMEN INSTRUMENTATION UNILAT	$154.70	$238.00	$66.16–$238.00	—	35%
Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 ENDOMETRIAL BX W/WO ENDOCERVIX BX W/O DILAT SPX	$601.25	$925.00	$257.15–$925.00	57% above	35%
Endometrial biopsy (uterine lining sample) without dilating the cervix inpatient CPT 58100 ENDOMETRIAL BX W/WO ENDOCERVIX BX W/O DILAT SPX	$601.25	$925.00	$257.15–$925.00	—	35%
Endoscopic sinus surgery: opening the maxillary (cheek) sinus CPT 31256 NASAL/SINUS ENDOSCOPY W/MAXILLARY ANTROSTOMY	$11,024.00	$16,960.00	$4,714.88–$16,960.00	5% above	35%
Endoscopic sinus surgery: opening the maxillary (cheek) sinus inpatient CPT 31256 NASAL/SINUS ENDOSCOPY W/MAXILLARY ANTROSTOMY	$11,024.00	$16,960.00	$4,714.88–$16,960.00	—	35%
Endoscopic sinus surgery: opening the maxillary sinus with removal of tissue CPT 31267 NSL/SINUS NDSC MAX ANTROST W/RMVL TISS MAX SINUS	$20,697.95	$31,843.00	$8,852.35–$31,843.00	5% below	35%
Endoscopic sinus surgery: opening the maxillary sinus with removal of tissue inpatient CPT 31267 NSL/SINUS NDSC MAX ANTROST W/RMVL TISS MAX SINUS	$20,697.95	$31,843.00	$8,852.35–$31,843.00	—	35%
Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 NJX DX/THER SBST INTRLMNR CRV/THRC W/IMG GDN	$3,105.70	$4,778.00	$126.25–$4,628.00	39% above	35%
Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 NJX DX/THER SBST INTRLMNR CRV/THRC W/IMG GDN	$3,105.70	$4,778.00	$1,328.28–$4,778.00	—	35%
Eye injection into the vitreous (intravitreal injection) CPT 67028 INTRAVITREAL NJX PHARMACOLOGIC AGT SPX	$991.90	$1,526.00	$424.23–$1,526.00	152% above	35%
Eye injection into the vitreous (intravitreal injection) inpatient CPT 67028 INTRAVITREAL NJX PHARMACOLOGIC AGT SPX	$991.90	$1,526.00	$424.23–$1,526.00	—	35%
Facet joint injection, lower back, one level, with imaging guidance CPT 64493 NJX DX/THER AGT PVRT FACET JT LMBR/SAC 1 LEVEL	$3,992.95	$6,143.00	$105.90–$4,628.00	83% above	35%
Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 NJX DX/THER AGT PVRT FACET JT LMBR/SAC 1 LEVEL	$3,992.95	$6,143.00	$1,707.75–$6,143.00	—	35%
Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 SIGMOIDOSCOPY FLX DX W/COLLJ SPEC BR/WA IF PFRMD	$2,726.10	$4,194.00	$1,165.93–$4,194.00	6% above	35%
Flexible sigmoidoscopy, diagnostic (lower colon only) inpatient CPT 45330 SIGMOIDOSCOPY FLX DX W/COLLJ SPEC BR/WA IF PFRMD	$2,726.10	$4,194.00	$1,165.93–$4,194.00	—	35%
Hammertoe correction surgery CPT 28285 CORRECTION HAMMERTOE	$9,701.25	$14,925.00	$4,149.15–$14,925.00	at median	35%
Hammertoe correction surgery inpatient CPT 28285 CORRECTION HAMMERTOE	$9,701.25	$14,925.00	$4,149.15–$14,925.00	—	35%
Hemorrhoid banding (rubber band ligation) CPT 46221 HEMORRHOIDECTOMY INTERNAL RUBBER BAND LIGATIONS	$2,726.10	$4,194.00	$236.61–$4,628.00	43% above	35%
Hemorrhoid banding (rubber band ligation) inpatient CPT 46221 HEMORRHOIDECTOMY INTERNAL RUBBER BAND LIGATIONS	$2,726.10	$4,194.00	$1,165.93–$4,194.00	—	35%
Hemorrhoidectomy (internal and external), one area CPT 46255 HEMORRHOIDECTOMY NTRNL & XTRNL 1 COLUMN/GROUP	$8,199.75	$12,615.00	$428.20–$7,813.00	12% below	35%
Hemorrhoidectomy (internal and external), one area inpatient CPT 46255 HEMORRHOIDECTOMY NTRNL & XTRNL 1 COLUMN/GROUP	$8,199.75	$12,615.00	$3,506.97–$12,615.00	—	35%
Hysterectomy through an abdominal incision (total) CPT 58150 TOTAL ABDOMINAL HYSTERECT W/WO RMVL TUBE OVARY	$3,001.70	$4,618.00	$1,180.59–$10,201.00	at median	35%
Hysterectomy through an abdominal incision (total) inpatient CPT 58150 TOTAL ABDOMINAL HYSTERECT W/WO RMVL TUBE OVARY	$3,001.70	$4,618.00	$1,006.72–$4,618.00	—	35%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 CATH & SALINE/CONTRAST SONOHYSTER/HYSTEROSALPI	$540.15	$831.00	$65.58–$4,628.00	42% above	35%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes inpatient CPT 58340 CATH & SALINE/CONTRAST SONOHYSTER/HYSTEROSALPI	$540.15	$831.00	$181.16–$831.00	—	35%
Hysteroscopy with endometrial ablation CPT 58563 HYSTEROSCOPY ENDOMETRIAL ABLATION	$14,760.20	$22,708.00	$281.17–$33,436.00	28% above	35%
Hysteroscopy with endometrial ablation inpatient CPT 58563 HYSTEROSCOPY ENDOMETRIAL ABLATION	$14,760.20	$22,708.00	$6,312.82–$22,708.00	—	35%
Hysteroscopy with uterine lining sampling and/or polyp removal CPT 58558 HYSTEROSCOPY BX ENDOMETRIUM&/POLYPC W/WO D&C	$9,506.90	$14,626.00	$264.47–$7,813.00	at median	35%
Hysteroscopy with uterine lining sampling and/or polyp removal inpatient CPT 58558 HYSTEROSCOPY BX ENDOMETRIUM&/POLYPC W/WO D&C	$9,506.90	$14,626.00	$4,066.03–$14,626.00	—	35%
IUD insertion (the device itself billed separately) CPT 58300 INSERTION INTRAUTERINE DEVICE IUD	$326.30	$502.00	$68.60–$12,500.00	35% below	35%
IUD insertion (the device itself billed separately) inpatient CPT 58300 INSERTION INTRAUTERINE DEVICE IUD	$326.30	$502.00	$109.44–$502.00	—	35%
Incision and drainage of a simple or single skin abscess CPT 10060 INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE	$387.40	$596.00	$127.84–$3,443.00	at median	35%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE	$387.40	$596.00	$165.69–$596.00	—	35%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 INJECTION 1 TENDON SHEATH/LIGAMENT APONEUROSIS	$882.70	$1,358.00	$44.63–$4,628.00	160% above	35%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 INJECTION 1 TENDON SHEATH/LIGAMENT APONEUROSIS	$882.70	$1,358.00	$377.52–$1,358.00	—	35%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/O US	$882.70	$1,358.00	$51.29–$4,628.00	27% above	35%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/O US	$882.70	$1,358.00	$377.52–$1,358.00	—	35%
Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 INSERTION DRUG DELIVERY IMPLANT	$251.55	$387.00	$70.86–$12,500.00	33% below	35%
Insertion of a drug-delivery implant, such as the arm birth control implant inpatient CPT 11981 INSERTION DRUG DELIVERY IMPLANT	$251.55	$387.00	$107.59–$387.00	—	35%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ARTHROCENTESIS ASPIR&/INJ INTERM JT/BURS W/O US	$882.70	$1,358.00	$42.37–$4,628.00	43% above	35%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 ARTHROCENTESIS ASPIR&/INJ INTERM JT/BURS W/O US	$882.70	$1,358.00	$377.52–$1,358.00	—	35%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 ARTHROCENTESIS ASPIR&/INJ SMALL JT/BURSA W/O US	$882.70	$1,358.00	$41.36–$4,628.00	79% above	35%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 ARTHROCENTESIS ASPIR&/INJ SMALL JT/BURSA W/O US	$882.70	$1,358.00	$377.52–$1,358.00	—	35%
Laser treatment of clouding after cataract surgery (YAG) CPT 66821 POST-CATARACT LASER SURGERY	$1,640.60	$2,524.00	$701.67–$2,524.00	16% above	35%
Laser treatment of clouding after cataract surgery (YAG) inpatient CPT 66821 POST-CATARACT LASER SURGERY	$1,640.60	$2,524.00	$701.67–$2,524.00	—	35%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 REPAIR INTERMEDIATE S/A/T/E 2.5 CM/<	$779.35	$1,199.00	$166.32–$3,443.00	46% above	35%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 REPAIR INTERMEDIATE S/A/T/E 2.5 CM/<	$779.35	$1,199.00	$333.32–$1,199.00	—	35%
Left heart catheterization, diagnostic CPT 93452 L HRT CATH W/NJX L VENTRICULOGRAPHY IMG S&I	$12,021.10	$18,494.00	$5,141.33–$18,494.00	29% above	35%
Left heart catheterization, diagnostic inpatient CPT 93452 L HRT CATH W/NJX L VENTRICULOGRAPHY IMG S&I	$12,021.10	$18,494.00	$5,141.33–$18,494.00	—	35%
Lower-back epidural injection, with imaging guidance CPT 62323 NJX DX/THER SBST INTRLMNR LMBR/SAC W/IMG GDN	$3,105.70	$4,778.00	$117.63–$4,628.00	53% above	35%
Lower-back epidural injection, with imaging guidance inpatient CPT 62323 NJX DX/THER SBST INTRLMNR LMBR/SAC W/IMG GDN	$3,105.70	$4,778.00	$1,328.28–$4,778.00	—	35%
Lower-back epidural injection, without imaging guidance CPT 62322 NJX DX/THER SBST INTRLMNR LMBR/SAC W/O IMG GDN	$3,992.95	$6,143.00	$98.33–$4,628.00	146% above	35%
Lower-back epidural injection, without imaging guidance inpatient CPT 62322 NJX DX/THER SBST INTRLMNR LMBR/SAC W/O IMG GDN	$3,992.95	$6,143.00	$1,707.75–$6,143.00	—	35%
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 NJX AA&/STRD TFRML EPI LUMBAR/SACRAL 1 LEVEL	$3,992.95	$6,143.00	$129.97–$4,628.00	93% above	35%
Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 NJX AA&/STRD TFRML EPI LUMBAR/SACRAL 1 LEVEL	$3,992.95	$6,143.00	$1,707.75–$6,143.00	—	35%
Miscarriage treatment with D&C, first trimester CPT 59820 TX MISSED ABORTION FIRST TRIMESTER SURGICAL	$8,266.70	$12,718.00	$433.87–$13,821.00	17% above	35%
Miscarriage treatment with D&C, first trimester inpatient CPT 59820 TX MISSED ABORTION FIRST TRIMESTER SURGICAL	$8,266.70	$12,718.00	$3,535.60–$12,718.00	—	35%
Mohs surgery for skin cancer, first stage, head, neck, hands, feet or genitals CPT 17311 MOHS MICROGRAPHIC H/N/H/F/G 1ST STAGE 5 BLOCKS	$1,193.40	$1,836.00	$241.52–$4,337.00	1% below	35%
Mohs surgery for skin cancer, first stage, head, neck, hands, feet or genitals inpatient CPT 17311 MOHS MICROGRAPHIC H/N/H/F/G 1ST STAGE 5 BLOCKS	$1,193.40	$1,836.00	$510.41–$1,836.00	—	35%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 EXC B9 LESION MRGN XCP SK TG T/A/L 0.5 CM/<	$1,372.15	$2,111.00	$97.21–$3,443.00	2% above	35%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 EXC B9 LESION MRGN XCP SK TG T/A/L 0.5 CM/<	$1,372.15	$2,111.00	$586.86–$2,111.00	—	35%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 EXC B9 LESION MRGN XCP SK TG F/E/E/N/L/M 0.5CM/<	$1,372.15	$2,111.00	$586.86–$2,111.00	at median	35%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 EXC B9 LESION MRGN XCP SK TG F/E/E/N/L/M 0.5CM/<	$1,372.15	$2,111.00	$586.86–$2,111.00	—	35%
Nail removal (partial or complete), one nail CPT 11730 AVULSION NAIL PLATE PARTIAL/COMPLETE SIMPLE 1	$387.40	$596.00	$165.69–$596.00	22% above	35%
Nail removal (partial or complete), one nail inpatient CPT 11730 AVULSION NAIL PLATE PARTIAL/COMPLETE SIMPLE 1	$387.40	$596.00	$165.69–$596.00	—	35%
Occipital nerve block (injection for headaches) CPT 64405 INJECTION AA&/STRD GREATER OCCIPITAL NERVE	$1,324.05	$2,037.00	$58.85–$4,628.00	68% above	35%
Occipital nerve block (injection for headaches) inpatient CPT 64405 INJECTION AA&/STRD GREATER OCCIPITAL NERVE	$1,324.05	$2,037.00	$566.29–$2,037.00	—	35%
Pacemaker implant (dual chamber) CPT 33208 INS NEW/RPLCMT PRM PM W/TRANSV ELTRD ATRIAL&VENT	$16,670.55	$25,647.00	$572.82–$12,235.00	7% above	35%
Pacemaker implant (dual chamber) inpatient CPT 33208 INS NEW/RPLCMT PRM PM W/TRANSV ELTRD ATRIAL&VENT	$16,670.55	$25,647.00	$7,129.87–$25,647.00	—	35%
Paracentesis with imaging guidance CPT 49083 ABDOM PARACENTESIS DX/THER W/IMAGING GUIDANCE	$2,803.45	$4,313.00	$123.62–$6,112.00	61% above	35%
Paracentesis with imaging guidance inpatient CPT 49083 ABDOM PARACENTESIS DX/THER W/IMAGING GUIDANCE	$2,803.45	$4,313.00	$1,199.01–$4,313.00	—	35%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 EXCISION NAIL MATRIX PERMANENT REMOVAL	$779.35	$1,199.00	$120.28–$3,443.00	at median	35%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 EXCISION NAIL MATRIX PERMANENT REMOVAL	$779.35	$1,199.00	$333.32–$1,199.00	—	35%
Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 DSTR NROLYTC AGNT PARVERTEB FCT SNGL LMBR/SACRAL	$8,758.10	$13,474.00	$226.36–$8,326.00	163% above	35%
Radiofrequency ablation of facet joint nerves, lower back, one level inpatient CPT 64635 DSTR NROLYTC AGNT PARVERTEB FCT SNGL LMBR/SACRAL	$8,758.10	$13,474.00	$3,745.77–$13,474.00	—	35%
Removal of a breast lump, open surgery CPT 19120 EXC CYST/ABERRANT BREAST TISSUE OPEN 1/> LESION	$7,467.20	$11,488.00	$493.27–$7,813.00	68% above	35%
Removal of a breast lump, open surgery inpatient CPT 19120 EXC CYST/ABERRANT BREAST TISSUE OPEN 1/> LESION	$7,467.20	$11,488.00	$3,193.66–$11,488.00	—	35%
Removal of a foreign object under the skin, simple CPT 10120 INCISION & REMOVAL FOREIGN BODY SUBQ TISS SIMPLE	$779.35	$1,199.00	$129.95–$12,500.00	16% above	35%
Removal of a foreign object under the skin, simple inpatient CPT 10120 INCISION & REMOVAL FOREIGN BODY SUBQ TISS SIMPLE	$779.35	$1,199.00	$333.32–$1,199.00	—	35%
Screening colonoscopy for a person at average risk (Medicare code) HCPCS G0121 COLOSCPY, SCRN; NOT HI RISK	$2,370.55	$3,647.00	$214.72–$5,265.00	9% below	35%
Screening colonoscopy for a person at average risk (Medicare code) inpatient HCPCS G0121 COLOSCPY, SCRN; NOT HI RISK	$2,370.55	$3,647.00	$1,013.87–$3,647.00	—	35%
Screening colonoscopy, high risk of colorectal cancer (Medicare code) HCPCS G0105 COLON, SCRN HIGH RISK	$2,370.55	$3,647.00	$214.53–$5,265.00	9% below	35%
Screening colonoscopy, high risk of colorectal cancer (Medicare code) inpatient HCPCS G0105 COLON, SCRN HIGH RISK	$2,370.55	$3,647.00	$1,013.87–$3,647.00	—	35%
Septoplasty to straighten the nasal septum CPT 30520 SEPTOPLASTY/SUBMUCOUS RESECJ W/WO CARTILAGE GRF	$9,696.70	$14,918.00	$777.99–$10,789.00	53% below	35%
Septoplasty to straighten the nasal septum inpatient CPT 30520 SEPTOPLASTY/SUBMUCOUS RESECJ W/WO CARTILAGE GRF	$9,696.70	$14,918.00	$4,147.20–$14,918.00	—	35%
Shock-wave lithotripsy to break up kidney stones (from outside the body) CPT 50590 LITHOTRIPSY XTRCORP SHOCK WAVE	$10,312.25	$15,865.00	$672.27–$25,635.00	3% above	35%
Shock-wave lithotripsy to break up kidney stones (from outside the body) inpatient CPT 50590 LITHOTRIPSY XTRCORP SHOCK WAVE	$10,312.25	$15,865.00	$4,410.47–$15,865.00	—	35%
Short arm cast (elbow to hand) CPT 29075 APPLICATION CAST ELBOW FINGER SHORT ARM	$794.30	$1,222.00	$72.22–$2,453.00	164% above	35%
Short arm cast (elbow to hand) inpatient CPT 29075 APPLICATION CAST ELBOW FINGER SHORT ARM	$794.30	$1,222.00	$339.72–$1,222.00	—	35%
Short arm splint (forearm and hand) CPT 29125 APPLICATION SHORT ARM SPLINT FOREARM-HAND STATIC	$385.45	$593.00	$164.85–$593.00	33% above	35%
Short arm splint (forearm and hand) inpatient CPT 29125 APPLICATION SHORT ARM SPLINT FOREARM-HAND STATIC	$385.45	$593.00	$164.85–$593.00	—	35%
Short leg cast (below the knee) CPT 29405 APPLICATION SHORT LEG CAST BELOW KNEE-TOE	$794.30	$1,222.00	$339.72–$1,222.00	109% above	35%
Short leg cast (below the knee) inpatient CPT 29405 APPLICATION SHORT LEG CAST BELOW KNEE-TOE	$794.30	$1,222.00	$339.72–$1,222.00	—	35%
Short leg splint (calf to foot) CPT 29515 APPLICATION SHORT LEG SPLINT CALF FOOT	$471.90	$726.00	$201.83–$726.00	60% above	35%
Short leg splint (calf to foot) inpatient CPT 29515 APPLICATION SHORT LEG SPLINT CALF FOOT	$471.90	$726.00	$201.83–$726.00	—	35%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 SIMPLE REPAIR SCALP/NECK/AX/GENIT/TRUNK 2.5CM/<	$387.40	$596.00	$165.69–$596.00	17% above	35%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 SIMPLE REPAIR SCALP/NECK/AX/GENIT/TRUNK 2.5CM/<	$387.40	$596.00	$165.69–$596.00	—	35%
Skin biopsy, punch, one lesion CPT 11104 PUNCH BIOPSY SKIN SINGLE LESION	$779.35	$1,199.00	$50.78–$12,500.00	75% above	35%
Skin biopsy, punch, one lesion inpatient CPT 11104 PUNCH BIOPSY SKIN SINGLE LESION	$779.35	$1,199.00	$333.32–$1,199.00	—	35%
Skin cancer removal (excision), body, arms or legs, up to 0.5 cm CPT 11600 EXCISION MAL LESION TRUNK/ARM/LEG 0.5 CM/<	$1,372.15	$2,111.00	$586.86–$2,111.00	at median	35%
Skin cancer removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11600 EXCISION MAL LESION TRUNK/ARM/LEG 0.5 CM/<	$1,372.15	$2,111.00	$586.86–$2,111.00	—	35%
Skin tag removal, up to 15 tags CPT 11200 REMOVAL SKN TAGS MLT FIBRQ TAGS ANY AREA UPW/15	$387.40	$596.00	$88.41–$12,500.00	32% above	35%
Skin tag removal, up to 15 tags inpatient CPT 11200 REMOVAL SKN TAGS MLT FIBRQ TAGS ANY AREA UPW/15	$387.40	$596.00	$165.69–$596.00	—	35%
Spinal tap (lumbar puncture), diagnostic CPT 62270 DIAGNOSTIC LUMBAR SPINAL PUNCTURE	$3,105.70	$4,778.00	$74.92–$4,628.00	190% above	35%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 DIAGNOSTIC LUMBAR SPINAL PUNCTURE	$3,105.70	$4,778.00	$1,328.28–$4,778.00	—	35%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 SMPL REPAIR SCALP/NECK/AX/GENIT/TRUNK 2.6-7.5CM	$387.40	$596.00	$165.69–$596.00	10% above	35%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 SMPL REPAIR SCALP/NECK/AX/GENIT/TRUNK 2.6-7.5CM	$387.40	$596.00	$165.69–$596.00	—	35%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 SIMPLE REPAIR F/E/E/N/L/M 2.5CM/<	$387.40	$596.00	$165.69–$596.00	22% above	35%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 SIMPLE REPAIR F/E/E/N/L/M 2.5CM/<	$387.40	$596.00	$165.69–$596.00	—	35%
Tangential (shave-style) skin biopsy, one lesion CPT 11102 TANGENTIAL BIOPSY SKIN SINGLE LESION	$387.40	$596.00	$40.28–$12,500.00	28% above	35%
Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 TANGENTIAL BIOPSY SKIN SINGLE LESION	$387.40	$596.00	$165.69–$596.00	—	35%
Thoracentesis with imaging guidance CPT 32555 THORACENTESIS NEEDLE/CATH PLEURA W/IMAGING	$1,848.60	$2,844.00	$128.29–$4,628.00	6% above	35%
Thoracentesis with imaging guidance inpatient CPT 32555 THORACENTESIS NEEDLE/CATH PLEURA W/IMAGING	$1,848.60	$2,844.00	$790.63–$2,844.00	—	35%
Trigger finger release surgery CPT 26055 TENDON SHEATH INCISION	$4,785.30	$7,362.00	$363.54–$5,265.00	46% above	35%
Trigger finger release surgery inpatient CPT 26055 TENDON SHEATH INCISION	$4,785.30	$7,362.00	$2,046.64–$7,362.00	—	35%
Trigger point injections, 1 or 2 muscles CPT 20552 INJECTION SINGLE/MLT TRIGGER POINT 1/2 MUSCLES	$882.70	$1,358.00	$46.16–$4,628.00	26% above	35%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 INJECTION SINGLE/MLT TRIGGER POINT 1/2 MUSCLES	$882.70	$1,358.00	$377.52–$1,358.00	—	35%
Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 BX BREAST W/DEVICE 1ST LESION ULTRASOUND GUID	$7,267.00	$11,180.00	$177.13–$6,112.00	118% above	35%
Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient CPT 19083 BX BREAST W/DEVICE 1ST LESION ULTRASOUND GUID	$7,267.00	$11,180.00	$3,108.04–$11,180.00	—	35%
Upper endoscopy (EGD) with balloon widening of the esophagus CPT 43249 EGD BALLOON DILATION ESOPHAGUS <30 MM DIAM	$5,671.90	$8,726.00	$2,425.83–$8,726.00	62% above	35%
Upper endoscopy (EGD) with balloon widening of the esophagus inpatient CPT 43249 EGD BALLOON DILATION ESOPHAGUS <30 MM DIAM	$5,671.90	$8,726.00	$2,425.83–$8,726.00	—	35%
Upper endoscopy (EGD) with biopsy CPT 43239 EGD TRANSORAL BIOPSY SINGLE/MULTIPLE	$2,803.45	$4,313.00	$160.83–$5,265.00	at median	35%
Upper endoscopy (EGD) with biopsy inpatient CPT 43239 EGD TRANSORAL BIOPSY SINGLE/MULTIPLE	$2,803.45	$4,313.00	$1,199.01–$4,313.00	—	35%
Upper endoscopy (EGD) with injection into the lining CPT 43236 ESOPHAGOGASTRODUODENOSCOPY SUBMUCOSAL INJECTION	$2,803.45	$4,313.00	$160.83–$6,112.00	at median	35%
Upper endoscopy (EGD) with injection into the lining inpatient CPT 43236 ESOPHAGOGASTRODUODENOSCOPY SUBMUCOSAL INJECTION	$2,803.45	$4,313.00	$1,199.01–$4,313.00	—	35%
Upper endoscopy (EGD) with polyp removal by snare CPT 43251 EGD REMOVAL TUMOR POLYP/OTHER LESION SNARE TECH	$5,671.90	$8,726.00	$2,425.83–$8,726.00	75% above	35%
Upper endoscopy (EGD) with polyp removal by snare inpatient CPT 43251 EGD REMOVAL TUMOR POLYP/OTHER LESION SNARE TECH	$5,671.90	$8,726.00	$2,425.83–$8,726.00	—	35%
Upper endoscopy (EGD) with widening of the esophagus over a guide wire CPT 43248 EGD INSERT GUIDE WIRE DILATOR PASSAGE ESOPHAGUS	$2,803.45	$4,313.00	$1,199.01–$4,313.00	at median	35%
Upper endoscopy (EGD) with widening of the esophagus over a guide wire inpatient CPT 43248 EGD INSERT GUIDE WIRE DILATOR PASSAGE ESOPHAGUS	$2,803.45	$4,313.00	$1,199.01–$4,313.00	—	35%
Upper endoscopy (EGD), diagnostic CPT 43235 ESOPHAGOGASTRODUODENOSCOPY TRANSORAL DIAGNOSTIC	$2,803.45	$4,313.00	$143.26–$4,392.00	8% above	35%
Upper endoscopy (EGD), diagnostic inpatient CPT 43235 ESOPHAGOGASTRODUODENOSCOPY TRANSORAL DIAGNOSTIC	$2,803.45	$4,313.00	$1,199.01–$4,313.00	—	35%
Upper endoscopy with drainage of a pseudocyst through the stomach wall CPT 43240 EGD TRANSORAL TRANSMURAL DRAINAGE PSEUDOCYST	$17,798.95	$27,383.00	$7,612.47–$27,383.00	290% above	35%
Upper endoscopy with drainage of a pseudocyst through the stomach wall inpatient CPT 43240 EGD TRANSORAL TRANSMURAL DRAINAGE PSEUDOCYST	$17,798.95	$27,383.00	$7,612.47–$27,383.00	—	35%
Ureteroscopy with laser stone breaking and stent placement CPT 52356 CYSTO/URETERO W/LITHOTRIPSY &INDWELL STENT INSRT	$15,200.25	$23,385.00	$484.62–$13,821.00	at median	35%
Ureteroscopy with laser stone breaking and stent placement inpatient CPT 52356 CYSTO/URETERO W/LITHOTRIPSY &INDWELL STENT INSRT	$15,200.25	$23,385.00	$6,501.03–$23,385.00	—	35%
Vasectomy, one or both sides, including follow-up semen testing both sides CPT 55250 VASECTOMY UNI/BI SPX W/POSTOP SEMEN EXAMS	$6,124.95	$9,423.00	$2,619.59–$9,423.00	—	35%
Vasectomy, one or both sides, including follow-up semen testing inpatient both sides CPT 55250 VASECTOMY UNI/BI SPX W/POSTOP SEMEN EXAMS	$6,124.95	$9,423.00	$2,619.59–$9,423.00	—	35%
Vein ablation, radiofrequency, first vein CPT 36475 ENDOVEN ABLTJ INCMPTNT VEIN XTR RF 1ST VEIN	$11,763.70	$18,098.00	$317.89–$33,436.00	80% above	35%
Vein ablation, radiofrequency, first vein inpatient CPT 36475 ENDOVEN ABLTJ INCMPTNT VEIN XTR RF 1ST VEIN	$11,763.70	$18,098.00	$5,031.24–$18,098.00	—	35%
Wart removal, up to 14 warts CPT 17110 DESTRUCTION BENIGN LESIONS UP TO 14	$387.40	$596.00	$80.41–$12,500.00	23% above	35%
Wart removal, up to 14 warts inpatient CPT 17110 DESTRUCTION BENIGN LESIONS UP TO 14	$387.40	$596.00	$165.69–$596.00	—	35%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBRIDEMENT SUBCUTANEOUS TISSUE 20 SQ CM/<	$779.35	$1,199.00	$71.41–$5,265.00	at median	35%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DEBRIDEMENT SUBCUTANEOUS TISSUE 20 SQ CM/<	$779.35	$1,199.00	$333.32–$1,199.00	—	35%

Doctor visits and therapy

Procedure	Cash price	List price	Insurers pay	vs Ohio	Off list
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION BLOOD OR BLOOD COMPONENT - PACU	$1,634.10	$2,514.00	$698.89–$2,514.00	47% above	35%
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION BLOOD/BLOOD COMPONENTS	$1,634.10	$2,514.00	$698.89–$2,514.00	47% above	35%
Blood transfusion (giving blood or blood components) CPT 36430 TXFUS BLOOD/BLOOD COMPONENT	$1,634.10	$2,514.00	$698.89–$2,514.00	47% above	35%
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION BLOOD OR BLOOD COMPONENTS	$1,634.10	$2,514.00	$698.89–$2,514.00	47% above	35%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 TRANSFUSION BLOOD OR BLOOD COMPONENT - PACU	$1,634.10	$2,514.00	$698.89–$2,514.00	—	35%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 TXFUS BLOOD/BLOOD COMPONENT	$1,634.10	$2,514.00	$698.89–$2,514.00	—	35%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 TRANSFUSION BLOOD OR BLOOD COMPONENTS	$1,634.10	$2,514.00	$698.89–$2,514.00	—	35%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 TRANSFUSION BLOOD/BLOOD COMPONENTS	$1,634.10	$2,514.00	$698.89–$2,514.00	—	35%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 PRESSURIZED/NONPRESSURIZED INHALATION TREATMENT	$608.40	$936.00	$260.21–$936.00	247% above	35%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 DAILY PRESSURIZED/NONPRESSURIZED INHALATION TREATMENT	$1,885.65	$2,901.00	$10.99–$227.89	974% above	35%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 PRESSURIZED/NONPRESSURIZED INHALATION TREATMENT	$608.40	$936.00	$260.21–$936.00	—	35%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 DAILY PRESSURIZED/NONPRESSURIZED INHALATION TREATMENT	$1,885.65	$2,901.00	$806.48–$2,901.00	—	35%
Chemotherapy IV infusion, first hour CPT 96413 CHEMOTX ADMN IV NFS TQ UP 1 HR 1/1ST SBST/DRUG	$1,487.85	$2,289.00	$636.34–$2,289.00	94% above	35%
Chemotherapy IV infusion, first hour inpatient CPT 96413 CHEMOTX ADMN IV NFS TQ UP 1 HR 1/1ST SBST/DRUG	$1,487.85	$2,289.00	$636.34–$2,289.00	—	35%
Comprehensive eye exam by an eye doctor, new patient CPT 92004 OPHTH MEDICAL XM&EVAL COMPRE NEW PT 1/> VST	$385.45	$593.00	$68.73–$138.55	50% above	35%
Comprehensive eye exam by an eye doctor, new patient inpatient CPT 92004 OPHTH MEDICAL XM&EVAL COMPRE NEW PT 1/> VST	$385.45	$593.00	$164.85–$593.00	—	35%
Comprehensive eye exam, returning patient CPT 92014 OPHTH MEDICAL XM&EVAL COMPRHNSV ESTAB PT 1/>	$385.45	$593.00	$68.73–$138.55	67% above	35%
Comprehensive eye exam, returning patient inpatient CPT 92014 OPHTH MEDICAL XM&EVAL COMPRHNSV ESTAB PT 1/>	$385.45	$593.00	$164.85–$593.00	—	35%
Comprehensive hearing test: tone and speech audiometry, both ears CPT 92557 AUDIOMETRY EVAL & SPEECH RECOG	$406.90	$626.00	$35.94–$156.65	55% above	35%
Comprehensive hearing test: tone and speech audiometry, both ears CPT 92557 COMPRE AUDIOMETRY THRESHOLD EVAL SP RECOGNIJ	$406.90	$626.00	$174.03–$626.00	55% above	35%
Comprehensive hearing test: tone and speech audiometry, both ears inpatient CPT 92557 AUDIOMETRY EVAL & SPEECH RECOG	$406.90	$626.00	$174.03–$626.00	—	35%
Comprehensive hearing test: tone and speech audiometry, both ears inpatient CPT 92557 COMPRE AUDIOMETRY THRESHOLD EVAL SP RECOGNIJ	$406.90	$626.00	$174.03–$626.00	—	35%
Critical care, first 30 to 74 minutes CPT 99291 CRITICAL CARE ILL/INJURED PATIENT INIT 30-74 MIN	$3,779.10	$5,814.00	$68.73–$3,005.00	29% above	35%
Critical care, first 30 to 74 minutes inpatient CPT 99291 CRITICAL CARE ILL/INJURED PATIENT INIT 30-74 MIN	$3,779.10	$5,814.00	$1,616.29–$5,232.60	—	35%
EEG (brain wave test), awake and drowsy, routine CPT 95816 ELECTROENCEPHALOGRAM W/REC AWAKE&DROWSY	$1,396.85	$2,149.00	$204.28–$581.60	46% above	35%
EEG (brain wave test), awake and drowsy, routine inpatient CPT 95816 ELECTROENCEPHALOGRAM W/REC AWAKE&DROWSY	$1,396.85	$2,149.00	$597.42–$2,149.00	—	35%
Electrocardiogram (ECG/EKG) with interpretation CPT 93000 ECG ROUTINE ECG W/LEAST 12 LDS W/I&R	$269.75	$415.00	$90.47–$415.00	7% above	35%
Electrocardiogram (ECG/EKG) with interpretation inpatient CPT 93000 ECG ROUTINE ECG W/LEAST 12 LDS W/I&R	$269.75	$415.00	$90.47–$415.00	—	35%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 ECG ROUTINE ECG W/LEAST 12 LDS TRCG ONLY W/O I&R	$222.30	$342.00	$8.64–$61.39	20% above	35%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 ECG ROUTINE ECG W/LEAST 12 LDS TRCG ONLY W/O I&R	$222.30	$342.00	$95.08–$342.00	—	35%
Electroconvulsive therapy (ECT), one session CPT 90870 ELECTROCONVULSIVE THERAPY	$1,034.80	$1,592.00	$139.72–$893.68	24% below	35%
Electroconvulsive therapy (ECT), one session inpatient CPT 90870 ELECTROCONVULSIVE THERAPY	$1,034.80	$1,592.00	$450.22–$1,592.00	—	35%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 EMERGENCY DEPARTMENT VISIT MAY NOT REQ PHYS/QHP	$395.20	$608.00	$14.86–$1,713.00	27% above	35%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 EMERGENCY DEPARTMENT VISIT MAY NOT REQ PHYS/QHP	$395.20	$608.00	$171.94–$547.20	—	35%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 EMERGENCY DEPARTMENT VISIT STRAIGHTFORWARD MDM	$710.45	$1,093.00	$54.67–$1,713.00	39% above	35%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 EMERGENCY DEPARTMENT VISIT STRAIGHTFORWARD MDM	$710.45	$1,093.00	$309.10–$983.70	—	35%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 EMERGENCY DEPARTMENT VISIT LOW MDM	$1,242.15	$1,911.00	$68.73–$3,196.00	47% above	35%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 EMERGENCY DEPARTMENT VISIT LOW MDM	$1,242.15	$1,911.00	$540.43–$1,719.90	—	35%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 EMERGENCY DEPARTMENT VISIT MODERATE MDM	$1,909.70	$2,938.00	$68.73–$3,196.00	44% above	35%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 EMERGENCY DEPARTMENT VISIT MODERATE MDM	$1,909.70	$2,938.00	$830.87–$2,644.20	—	35%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 EMERGENCY DEPARTMENT VISIT HIGH MDM	$2,749.50	$4,230.00	$68.73–$3,517.00	58% above	35%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 EMERGENCY DEPARTMENT VISIT HIGH MDM	$2,749.50	$4,230.00	$1,196.24–$3,807.00	—	35%
Exercise stress test, tracing only, the hospital charge CPT 93017 CV STRS TST XERS&/OR RX CONT ECG TRCG ONLY	$1,164.15	$1,791.00	$52.52–$311.77	30% above	35%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 CV STRS TST XERS&/OR RX CONT ECG TRCG ONLY	$1,164.15	$1,791.00	$497.90–$1,791.00	—	35%
Eye exam, returning patient, intermediate CPT 92012 OPHTH MEDICAL XM&EVAL INTERMEDIATE ESTAB PT	$385.45	$593.00	$56.96–$138.55	26% above	35%
Eye exam, returning patient, intermediate inpatient CPT 92012 OPHTH MEDICAL XM&EVAL INTERMEDIATE ESTAB PT	$385.45	$593.00	$164.85–$593.00	—	35%
Family therapy with the patient, 50 minutes CPT 90847 FAMILY PSYCHOTHERAPY W/PATIENT PRESENT 50 MINS	$313.30	$482.00	$134.00–$482.00	5% above	35%
Family therapy with the patient, 50 minutes CPT 90847 FAM THERAPY W PATIENT DTOX	$313.30	$482.00	$138.32–$184.72	5% above	35%
Family therapy with the patient, 50 minutes inpatient CPT 90847 FAM THERAPY W PATIENT DTOX	$313.30	$482.00	$136.31–$482.00	—	35%
Family therapy with the patient, 50 minutes inpatient CPT 90847 FAMILY PSYCHOTHERAPY W/PATIENT PRESENT 50 MINS	$313.30	$482.00	$134.00–$482.00	—	35%
Family therapy without the patient, 50 minutes CPT 90846 FAMILY PSYCHOTHERAPY W/O PATIENT PRESENT 50 MINS	$313.30	$482.00	$134.00–$482.00	1% above	35%
Family therapy without the patient, 50 minutes inpatient CPT 90846 FAMILY PSYCHOTHERAPY W/O PATIENT PRESENT 50 MINS	$313.30	$482.00	$134.00–$482.00	—	35%
Group psychotherapy session CPT 90853 VIRTUAL VISIT GROUP THERAPY	$180.70	$278.00	$77.28–$278.00	6% above	35%
Group psychotherapy session CPT 90853 GROUP THERAPY	$180.70	$278.00	$33.67–$152.57	6% above	35%
Group psychotherapy session CPT 90853 VIRTUAL VISIT MH IOP GROUP THERAPY	$180.70	$278.00	$77.28–$278.00	6% above	35%
Group psychotherapy session inpatient CPT 90853 VIRTUAL VISIT GROUP THERAPY	$180.70	$278.00	$77.28–$278.00	—	35%
Group psychotherapy session inpatient CPT 90853 VIRTUAL VISIT MH IOP GROUP THERAPY	$180.70	$278.00	$77.28–$278.00	—	35%
Group psychotherapy session inpatient CPT 90853 GROUP THERAPY	$180.70	$278.00	$77.28–$278.00	—	35%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV HYDRATE INIT 31-60MIN	$945.10	$1,454.00	$404.21–$1,454.00	126% above	35%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV HYDRATE INIT 31-60MIN	$945.10	$1,454.00	$404.21–$1,454.00	—	35%
IV infusion of a medicine, first hour CPT 96365 THERAPEUTIC IV INFUSION 1ST HR	$945.10	$1,454.00	$84.89–$321.40	118% above	35%
IV infusion of a medicine, first hour CPT 96365 IV INF INIT UP TO 1 HR	$945.10	$1,454.00	$404.21–$1,454.00	118% above	35%
IV infusion of a medicine, first hour inpatient CPT 96365 THERAPEUTIC IV INFUSION 1ST HR	$945.10	$1,454.00	$404.21–$1,454.00	—	35%
IV infusion of a medicine, first hour inpatient CPT 96365 IV INF INIT UP TO 1 HR	$945.10	$1,454.00	$404.21–$1,454.00	—	35%
IV push of a medicine, first drug CPT 96374 INJECTION IV PUSH INIT	$945.10	$1,454.00	$45.54–$221.36	268% above	35%
IV push of a medicine, first drug CPT 96374 INJ IVPUSH INIT DRUG	$945.10	$1,454.00	$404.21–$1,454.00	268% above	35%
IV push of a medicine, first drug inpatient CPT 96374 INJECTION IV PUSH INIT	$945.10	$1,454.00	$404.21–$1,454.00	—	35%
IV push of a medicine, first drug inpatient CPT 96374 INJ IVPUSH INIT DRUG	$945.10	$1,454.00	$404.21–$1,454.00	—	35%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJ SQ/IM	$319.15	$491.00	$136.50–$491.00	126% above	35%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 THERAPEUTIC PROPHYLACTIC/DX INJECTION SUBQ/IM	$319.15	$491.00	$136.50–$491.00	126% above	35%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 IM/SC INJECTION (MONTHLY)	$319.15	$491.00	$18.05–$74.93	126% above	35%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 IM/SC INJECTION (MONTHLY)	$319.15	$491.00	$136.50–$491.00	—	35%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INJ SQ/IM	$319.15	$491.00	$136.50–$491.00	—	35%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 THERAPEUTIC PROPHYLACTIC/DX INJECTION SUBQ/IM	$319.15	$491.00	$136.50–$491.00	—	35%
Mental health diagnostic evaluation (intake), without medical services CPT 90791 PSYCHIATRIC DIAGNOSTIC EVALUATION	$313.30	$482.00	$134.00–$482.00	at median	35%
Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 PSYCHIATRIC DIAGNOSTIC EVALUATION	$313.30	$482.00	$134.00–$482.00	—	35%
Nerve conduction study, 7 or 8 nerve studies CPT 95910 NERVE CONDUCTION STUDIES 7-8 STUDIES	$1,396.85	$2,149.00	$222.17–$453.61	1% above	35%
Nerve conduction study, 7 or 8 nerve studies inpatient CPT 95910 NERVE CONDUCTION STUDIES 7-8 STUDIES	$1,396.85	$2,149.00	$597.42–$2,149.00	—	35%
Neuromuscular re-education, 15 minutes CPT 97112 THER PX 1/> AREAS EACH 15 MIN NEUROMUSC REEDUCA	$169.65	$261.00	$72.56–$261.00	55% above	35%
Neuromuscular re-education, 15 minutes CPT 97112 NEURMSCL THERAPY 15MIN	$169.65	$261.00	$72.56–$261.00	55% above	35%
Neuromuscular re-education, 15 minutes CPT 97112 VV NEUROMUSCULAR EDUCATION OT (97112)	$169.65	$261.00	$72.56–$261.00	55% above	35%
Neuromuscular re-education, 15 minutes CPT 97112 VV NEUROMUSCULAR EDUCATION PT (97112)	$169.65	$261.00	$41.24–$98.52	55% above	35%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 VV NEUROMUSCULAR EDUCATION OT (97112)	$169.65	$261.00	$72.56–$261.00	—	35%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 VV NEUROMUSCULAR EDUCATION PT (97112)	$169.65	$261.00	$72.56–$261.00	—	35%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 THER PX 1/> AREAS EACH 15 MIN NEUROMUSC REEDUCA	$169.65	$261.00	$72.56–$261.00	—	35%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 NEURMSCL THERAPY 15MIN	$169.65	$261.00	$72.56–$261.00	—	35%
New patient office visit, about 30 minutes CPT 99203 OFFICE/OUTPATIENT NEW LOW MDM 30-44 MINUTES	$90.35	$139.00	$68.73–$105.76	18% below	35%
New patient office visit, about 30 minutes inpatient CPT 99203 OFFICE/OUTPATIENT NEW LOW MDM 30-44 MINUTES	$90.35	$139.00	$30.30–$139.00	—	35%
New patient office visit, about 45 minutes CPT 99204 OFFICE/OUTPATIENT NEW MODERATE MDM 45-59 MINUTES	$113.10	$174.00	$0.01	7% below	35%
New patient office visit, about 45 minutes inpatient CPT 99204 OFFICE/OUTPATIENT NEW MODERATE MDM 45-59 MINUTES	$113.10	$174.00	$37.93–$174.00	—	35%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 VIRTUAL INITIAL NUTRITION THERAPY, EA. 15M	$137.80	$212.00	$58.94–$212.00	113% above	35%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 MEDICAL NUTRITION ASSMT&IVNTJ INDIV EACH 15 MI	$137.80	$212.00	$35.63–$96.37	113% above	35%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 NUTRITION THERAPY, INITIAL 15 MIN	$137.80	$212.00	$58.94–$212.00	113% above	35%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 MEDICAL NUTRITION ASSMT&IVNTJ INDIV EACH 15 MI	$137.80	$212.00	$58.94–$212.00	—	35%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 NUTRITION THERAPY, INITIAL 15 MIN	$137.80	$212.00	$58.94–$212.00	—	35%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 VIRTUAL INITIAL NUTRITION THERAPY, EA. 15M	$137.80	$212.00	$58.94–$212.00	—	35%
Occupational therapy evaluation, low complexity CPT 97165 VV EVALUATION LOW COMPLEXITY (97165)	$438.10	$674.00	$187.37–$674.00	68% above	35%
Occupational therapy evaluation, low complexity CPT 97165 OT EVAL - LOW	$438.10	$674.00	$187.37–$674.00	68% above	35%
Occupational therapy evaluation, low complexity inpatient CPT 97165 VV EVALUATION LOW COMPLEXITY (97165)	$438.10	$674.00	$187.37–$674.00	—	35%
Occupational therapy evaluation, low complexity inpatient CPT 97165 OT EVAL - LOW	$438.10	$674.00	$187.37–$674.00	—	35%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 VV EVALUATION HIGH COMPLEXITY (97163)	$393.25	$605.00	$93.19–$139.07	31% above	35%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PT EVAL - HIGH	$393.25	$605.00	$93.19–$139.07	31% above	35%
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 PT EVAL - HIGH	$393.25	$605.00	$168.19–$605.00	—	35%
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 VV EVALUATION HIGH COMPLEXITY (97163)	$393.25	$605.00	$168.19–$605.00	—	35%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PHYSICAL THERAPY EVALUATION LOW COMPLEX 20 MINS	$393.25	$605.00	$168.19–$605.00	51% above	35%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PT EVAL - LOW	$393.25	$605.00	$93.19–$139.07	51% above	35%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 VV EVALUATION LOW COMPLEXITY (97161)	$393.25	$605.00	$93.19–$139.07	51% above	35%
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 PT EVAL - LOW	$393.25	$605.00	$168.19–$605.00	—	35%
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 VV EVALUATION LOW COMPLEXITY (97161)	$393.25	$605.00	$168.19–$605.00	—	35%
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 PHYSICAL THERAPY EVALUATION LOW COMPLEX 20 MINS	$393.25	$605.00	$168.19–$605.00	—	35%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 VV EVALUATION MODERATE COMPLEXITY (97162)	$393.25	$605.00	$93.19–$139.07	42% above	35%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PT EVAL - MOD	$393.25	$605.00	$93.19–$139.07	42% above	35%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 PT EVAL - MOD	$393.25	$605.00	$168.19–$605.00	—	35%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 VV EVALUATION MODERATE COMPLEXITY (97162)	$393.25	$605.00	$168.19–$605.00	—	35%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MANUAL THERAPY 15MIN GP	$156.65	$241.00	$67.00–$241.00	41% above	35%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MANUAL THERAPY 15MIN	$156.65	$241.00	$67.00–$241.00	41% above	35%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MANUAL THERAPY TQS 1/> REGIONS EACH 15 MINUTES	$156.65	$241.00	$67.00–$241.00	41% above	35%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 MANUAL THERAPY 15MIN	$156.65	$241.00	$67.00–$241.00	—	35%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 MANUAL THERAPY TQS 1/> REGIONS EACH 15 MINUTES	$156.65	$241.00	$67.00–$241.00	—	35%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 MANUAL THERAPY 15MIN GP	$156.65	$241.00	$67.00–$241.00	—	35%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERA EXER 15MIN	$167.70	$258.00	$71.72–$258.00	42% above	35%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERA EXER 1	$167.70	$258.00	$71.72–$258.00	42% above	35%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 VV THERAPEUTIC EXERCISE OT (97110)	$167.70	$258.00	$71.72–$258.00	42% above	35%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 OT THERAPEUT PROC/EXER 15 MIN	$167.70	$258.00	$71.72–$258.00	42% above	35%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERA EXER 15MIN GO	$167.70	$258.00	$71.72–$258.00	42% above	35%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERAPEUTIC EXERCISES EA 15MIN	$167.70	$258.00	$37.06–$98.52	42% above	35%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERA EXER EA 15 MINS	$167.70	$258.00	$37.06–$98.52	42% above	35%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 VV THERAPEUTIC EXERCISE PT (97110)	$167.70	$258.00	$37.06–$98.52	42% above	35%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 PT THERAPEUT PROC/EXER, 15 MIN	$167.70	$258.00	$71.72–$258.00	42% above	35%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 VV THERAPEUTIC EXERCISE PT (97110)	$167.70	$258.00	$71.72–$258.00	—	35%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THERA EXER 15MIN	$167.70	$258.00	$71.72–$258.00	—	35%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 PT THERAPEUT PROC/EXER, 15 MIN	$167.70	$258.00	$71.72–$258.00	—	35%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THERA EXER 15MIN GO	$167.70	$258.00	$71.72–$258.00	—	35%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THERA EXER 1	$167.70	$258.00	$71.72–$258.00	—	35%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THERAPEUTIC EXERCISES EA 15MIN	$167.70	$258.00	$71.72–$258.00	—	35%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THERA EXER EA 15 MINS	$167.70	$258.00	$71.72–$258.00	—	35%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 VV THERAPEUTIC EXERCISE OT (97110)	$167.70	$258.00	$71.72–$258.00	—	35%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 OT THERAPEUT PROC/EXER 15 MIN	$167.70	$258.00	$71.72–$258.00	—	35%
Preventive checkup, new patient aged 18–39 CPT 99385 INITIAL PREVENTIVE MEDICINE NEW PT AGE 18-39YRS	$119.60	$184.00	$0.01	at median	35%
Preventive checkup, new patient aged 18–39 inpatient CPT 99385 INITIAL PREVENTIVE MEDICINE NEW PT AGE 18-39YRS	$119.60	$184.00	$40.11–$184.00	—	35%
Preventive checkup, new patient aged 40–64 CPT 99386 INITIAL PREVENTIVE MEDICINE NEW PATIENT 40-64YRS	$165.10	$254.00	$0.01	13% above	35%
Preventive checkup, new patient aged 40–64 inpatient CPT 99386 INITIAL PREVENTIVE MEDICINE NEW PATIENT 40-64YRS	$165.10	$254.00	$55.37–$254.00	—	35%
Preventive checkup, new patient aged 65 or older CPT 99387 INITIAL PREVENTIVE MEDICINE NEW PATIENT 65YRS&>	$189.15	$291.00	$0.01	21% above	35%
Preventive checkup, new patient aged 65 or older inpatient CPT 99387 INITIAL PREVENTIVE MEDICINE NEW PATIENT 65YRS&>	$189.15	$291.00	$63.44–$291.00	—	35%
Preventive checkup, returning patient aged 18–39 CPT 99395 PERIODIC PREVENTIVE MED EST PATIENT 18-39 YRS	$203.45	$313.00	$0.01	62% above	35%
Preventive checkup, returning patient aged 18–39 inpatient CPT 99395 PERIODIC PREVENTIVE MED EST PATIENT 18-39 YRS	$203.45	$313.00	$68.23–$313.00	—	35%
Preventive checkup, returning patient aged 40–64 CPT 99396 PERIODIC PREVENTIVE MED EST PATIENT 40-64YRS	$149.50	$230.00	$50.14–$230.00	19% above	35%
Preventive checkup, returning patient aged 40–64 inpatient CPT 99396 PERIODIC PREVENTIVE MED EST PATIENT 40-64YRS	$149.50	$230.00	$50.14–$230.00	—	35%
Preventive checkup, returning patient aged 65 or older CPT 99397 PERIODIC PREVENTIVE MED EST PATIENT 65YRS& OLDER	$157.95	$243.00	$52.97–$243.00	22% above	35%
Preventive checkup, returning patient aged 65 or older inpatient CPT 99397 PERIODIC PREVENTIVE MED EST PATIENT 65YRS& OLDER	$157.95	$243.00	$52.97–$243.00	—	35%
Psychiatric evaluation with medical services CPT 90792 PSYCHIATRIC DIAGNOSTIC EVAL W/MEDICAL SERVICES	$313.30	$482.00	$134.00–$482.00	11% below	35%
Psychiatric evaluation with medical services inpatient CPT 90792 PSYCHIATRIC DIAGNOSTIC EVAL W/MEDICAL SERVICES	$313.30	$482.00	$134.00–$482.00	—	35%
Psychological testing evaluation by a psychologist or physician, first hour CPT 96130 PSYCHOLOGICAL TST EVAL SVC PHYS/QHP FIRST HOUR	$607.10	$934.00	$141.65–$311.77	43% above	35%
Psychological testing evaluation by a psychologist or physician, first hour inpatient CPT 96130 PSYCHOLOGICAL TST EVAL SVC PHYS/QHP FIRST HOUR	$607.10	$934.00	$259.65–$934.00	—	35%
Psychotherapy for crisis, first 60 minutes CPT 90839 VIRTUAL PSYCHOTHERAPY FOR CRISIS INITIAL 60 MINUTES	$313.30	$482.00	$118.97–$189.52	at median	35%
Psychotherapy for crisis, first 60 minutes CPT 90839 PSYCHOTHERAPY FOR CRISIS INITIAL 60 MINUTES	$313.30	$482.00	$134.00–$482.00	at median	35%
Psychotherapy for crisis, first 60 minutes inpatient CPT 90839 VIRTUAL PSYCHOTHERAPY FOR CRISIS INITIAL 60 MINUTES	$313.30	$482.00	$134.00–$482.00	—	35%
Psychotherapy for crisis, first 60 minutes inpatient CPT 90839 PSYCHOTHERAPY FOR CRISIS INITIAL 60 MINUTES	$313.30	$482.00	$134.00–$482.00	—	35%
Psychotherapy session, 30 minutes CPT 90832 PSYCHOTHERAPY W/PATIENT 30 MINUTES	$313.30	$482.00	$134.00–$482.00	66% above	35%
Psychotherapy session, 30 minutes inpatient CPT 90832 PSYCHOTHERAPY W/PATIENT 30 MINUTES	$313.30	$482.00	$134.00–$482.00	—	35%
Psychotherapy session, 45 minutes CPT 90834 PSYCHOTHERAPY W/PATIENT 45 MINUTES	$313.30	$482.00	$134.00–$482.00	17% above	35%
Psychotherapy session, 45 minutes inpatient CPT 90834 PSYCHOTHERAPY W/PATIENT 45 MINUTES	$313.30	$482.00	$134.00–$482.00	—	35%
Psychotherapy session, 60 minutes CPT 90837 PSYCHOTHERAPY W/PATIENT 60 MINUTES	$313.30	$482.00	$134.00–$482.00	at median	35%
Psychotherapy session, 60 minutes inpatient CPT 90837 PSYCHOTHERAPY W/PATIENT 60 MINUTES	$313.30	$482.00	$134.00–$482.00	—	35%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 TOBACCO USE CESSATION INTERMEDIATE 3-10 MINUTES	$57.85	$89.00	$24.74–$89.00	32% above	35%
Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 TOBACCO USE CESSATION INTERMEDIATE 3-10 MINUTES	$57.85	$89.00	$24.74–$89.00	—	35%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 OFFICE/OUTPATIENT ESTABLISHED HIGH MDM 40-54 MIN	$156.00	$240.00	$0.01	7% below	35%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 OFFICE/OUTPATIENT ESTABLISHED HIGH MDM 40-54 MIN	$156.00	$240.00	$52.32–$240.00	—	35%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 OFFICE/OUTPATIENT ESTABLISHED LOW MDM 20-29 MIN	$97.50	$150.00	$0.01	16% below	35%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 OFFICE/OUTPATIENT ESTABLISHED LOW MDM 20-29 MIN	$97.50	$150.00	$32.70–$150.00	—	35%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 OFFICE/OUTPATIENT ESTABLISHED MOD MDM 30-39 MIN	$121.55	$187.00	$0.01	11% below	35%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 OFFICE/OUTPATIENT ESTABLISHED MOD MDM 30-39 MIN	$121.55	$187.00	$40.77–$187.00	—	35%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 OFFICE/OUTPATIENT ESTABLISHED SF MDM 10-19 MIN	$97.50	$150.00	$0.01	3% below	35%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 OFFICE/OUTPATIENT ESTABLISHED SF MDM 10-19 MIN	$97.50	$150.00	$32.70–$150.00	—	35%
Specialist consultation, moderate complexity or 40+ minutes CPT 99244 OFFICE/OP CONSLTJ NEW/EST PT MOD MDM 40 MINUTES	$95.55	$147.00	$32.05–$147.00	28% below	35%
Specialist consultation, moderate complexity or 40+ minutes inpatient CPT 99244 OFFICE/OP CONSLTJ NEW/EST PT MOD MDM 40 MINUTES	$95.55	$147.00	$32.05–$147.00	—	35%
Speech and language evaluation CPT 92523 EVAL SPEECH SOUND LANG COMPREH	$651.30	$1,002.00	$278.56–$1,002.00	91% above	35%
Speech and language evaluation CPT 92523 VV SPEECH SOUND LANGUAGE COMPREHENSIVE EVAL (92523)	$651.30	$1,002.00	$278.56–$1,002.00	91% above	35%
Speech and language evaluation CPT 92523 EVAL SPEECH SOUND PRODUCT LANGUAGE COMPREHENSION	$651.30	$1,002.00	$278.56–$1,002.00	91% above	35%
Speech and language evaluation inpatient CPT 92523 EVAL SPEECH SOUND PRODUCT LANGUAGE COMPREHENSION	$651.30	$1,002.00	$278.56–$1,002.00	—	35%
Speech and language evaluation inpatient CPT 92523 VV SPEECH SOUND LANGUAGE COMPREHENSIVE EVAL (92523)	$651.30	$1,002.00	$278.56–$1,002.00	—	35%
Speech and language evaluation inpatient CPT 92523 EVAL SPEECH SOUND LANG COMPREH	$651.30	$1,002.00	$278.56–$1,002.00	—	35%
Speech therapy session, individual CPT 92507 SPEECH/HEARING THERAPY INDIV	$307.45	$473.00	$131.49–$473.00	40% above	35%
Speech therapy session, individual CPT 92507 VV SPEECH THERAPY (92507)	$307.45	$473.00	$131.49–$473.00	40% above	35%
Speech therapy session, individual CPT 92507 TX SPEECH LANG VOICE COMMJ &/AUDITORY PROC IND	$307.45	$473.00	$131.49–$473.00	40% above	35%
Speech therapy session, individual inpatient CPT 92507 VV SPEECH THERAPY (92507)	$307.45	$473.00	$131.49–$473.00	—	35%
Speech therapy session, individual inpatient CPT 92507 SPEECH/HEARING THERAPY INDIV	$307.45	$473.00	$131.49–$473.00	—	35%
Speech therapy session, individual inpatient CPT 92507 TX SPEECH LANG VOICE COMMJ &/AUDITORY PROC IND	$307.45	$473.00	$131.49–$473.00	—	35%
Spirometry (breathing test) CPT 94010 SPMTRY W/VC EXPIRATORY FLO W/WO MXML VOL VNTJ	$468.00	$720.00	$36.09–$224.71	51% above	35%
Spirometry (breathing test) inpatient CPT 94010 SPMTRY W/VC EXPIRATORY FLO W/WO MXML VOL VNTJ	$468.00	$720.00	$200.16–$720.00	—	35%
Spirometry before and after a bronchodilator CPT 94060 BRNCDILAT RSPSE SPMTRY PRE&POST-BRNCDILAT ADMN	$930.80	$1,432.00	$51.99–$388.34	63% above	35%
Spirometry before and after a bronchodilator inpatient CPT 94060 BRNCDILAT RSPSE SPMTRY PRE&POST-BRNCDILAT ADMN	$930.80	$1,432.00	$398.10–$1,432.00	—	35%
TMS (transcranial magnetic stimulation), first session with mapping CPT 90867 TCRANIAL MAGN STIM TX PLAN	$607.10	$934.00	$259.65–$934.00	36% above	35%
TMS (transcranial magnetic stimulation), first session with mapping inpatient CPT 90867 TCRANIAL MAGN STIM TX PLAN	$607.10	$934.00	$259.65–$934.00	—	35%
Therapeutic activities (functional training), 15 minutes CPT 97530 THERA ACTIVITY DIR 15MIN	$178.10	$274.00	$76.17–$274.00	46% above	35%
Therapeutic activities (functional training), 15 minutes CPT 97530 VV THERAPEUTIC ACTIVITY OT (97530)	$178.10	$274.00	$76.17–$274.00	46% above	35%
Therapeutic activities (functional training), 15 minutes CPT 97530 THERA FUNC ACTIVITIES 15M	$178.10	$274.00	$76.17–$274.00	46% above	35%
Therapeutic activities (functional training), 15 minutes CPT 97530 VV THERAPEUTIC ACTIVITIES (97530)	$178.10	$274.00	$44.62–$98.52	46% above	35%
Therapeutic activities (functional training), 15 minutes CPT 97530 THERAPEUT ACTVITY DIRECT PT CONTACT EACH 15 MIN	$178.10	$274.00	$76.17–$274.00	46% above	35%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 THERA FUNC ACTIVITIES 15M	$178.10	$274.00	$76.17–$274.00	—	35%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 THERAPEUT ACTVITY DIRECT PT CONTACT EACH 15 MIN	$178.10	$274.00	$76.17–$274.00	—	35%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 THERA ACTIVITY DIR 15MIN	$178.10	$274.00	$76.17–$274.00	—	35%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 VV THERAPEUTIC ACTIVITIES (97530)	$178.10	$274.00	$76.17–$274.00	—	35%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 VV THERAPEUTIC ACTIVITY OT (97530)	$178.10	$274.00	$76.17–$274.00	—	35%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 PHLEBOTOMY	$577.85	$889.00	$247.14–$889.00	144% above	35%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 THERAPEUTIC PHLEBOTOMY	$577.85	$889.00	$247.14–$889.00	144% above	35%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 PHLEBOTOMY THERAPEUTIC SEPARATE PROCEDURE	$577.85	$889.00	$247.14–$889.00	144% above	35%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 PHLEBOTOMY	$577.85	$889.00	$247.14–$889.00	—	35%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 PHLEBOTOMY THERAPEUTIC SEPARATE PROCEDURE	$577.85	$889.00	$247.14–$889.00	—	35%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 THERAPEUTIC PHLEBOTOMY	$577.85	$889.00	$247.14–$889.00	—	35%
Visual field test, extended both sides CPT 92083 VISUAL FIELD XM UNI/BI W/INTERP EXTENDED EXAM	$385.45	$593.00	$48.64–$138.46	—	35%
Visual field test, extended inpatient both sides CPT 92083 VISUAL FIELD XM UNI/BI W/INTERP EXTENDED EXAM	$385.45	$593.00	$164.85–$593.00	—	35%

Vaccines

Procedure	Cash price	List price	Insurers pay	vs Ohio	Off list
COVID-19 vaccine (Pfizer-BioNTech), age 12 and older CPT 91320 SARSCOV2 VACC 30MCG/0.3ML TRIS-SUCROSE IM USE	$346.26	$532.70	$116.13–$532.70	4% above	35%
COVID-19 vaccine (Pfizer-BioNTech), age 12 and older CPT 91320 SARSCOV2 VACC 30MCG/0.3ML TRIS-SUCROSE IM USE	$346.26	$532.70	$116.13–$532.70	4% above	35%
COVID-19 vaccine (Pfizer-BioNTech), age 12 and older inpatient CPT 91320 SARSCOV2 VACC 30MCG/0.3ML TRIS-SUCROSE IM USE	$346.26	$532.70	$116.13–$532.70	—	35%
COVID-19 vaccine (Pfizer-BioNTech), age 12 and older inpatient CPT 91320 SARSCOV2 VACC 30MCG/0.3ML TRIS-SUCROSE IM USE	$346.26	$532.70	$116.13–$532.70	—	35%
Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 VARICELLA VIRUS VACCINE LIVE	$427.05	$657.00	$143.23–$657.00	15% above	35%
Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 VARICELLA VIRUS VACCINE LIVE	$427.05	$657.00	$143.23–$657.00	15% above	35%
Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 VARICELLA VIRUS VACCINE LIVE	$427.05	$657.00	$143.23–$657.00	—	35%
Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 VARICELLA VIRUS VACCINE LIVE	$427.05	$657.00	$143.23–$657.00	—	35%
DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) CPT 90696 DTAP-IPV VACC 4-6 YR IM	$136.50	$210.00	$45.78–$210.00	6% above	35%
DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) CPT 90696 DTAP-IPV VACC 4-6 YR IM	$136.50	$210.00	$45.78–$210.00	6% above	35%
DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) inpatient CPT 90696 DTAP-IPV VACC 4-6 YR IM	$136.50	$210.00	$45.78–$210.00	—	35%
DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) inpatient CPT 90696 DTAP-IPV VACC 4-6 YR IM	$136.50	$210.00	$45.78–$210.00	—	35%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 DTAP IMMUNIZATION	$66.30	$102.00	$22.24–$102.00	2% above	35%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 DTAP 5 PERTUSSIS ANTIGENS VACC < 7 YR IM DAPTACEL LATEX FREE	$66.30	$102.00	$22.24–$102.00	2% above	35%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 DTAP 5 PERTUSSIS ANTIGENS VACC < 7 YR IM DAPTACEL LATEX FREE	$66.30	$102.00	$22.24–$102.00	2% above	35%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 DTAP IMMUNIZATION	$66.30	$102.00	$22.24–$102.00	2% above	35%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 inpatient CPT 90700 DTAP 5 PERTUSSIS ANTIGENS VACC < 7 YR IM DAPTACEL LATEX FREE	$66.30	$102.00	$22.24–$102.00	—	35%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 inpatient CPT 90700 DTAP 5 PERTUSSIS ANTIGENS VACC < 7 YR IM DAPTACEL LATEX FREE	$66.30	$102.00	$22.24–$102.00	—	35%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 inpatient CPT 90700 DTAP IMMUNIZATION	$66.30	$102.00	$22.24–$102.00	—	35%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 inpatient CPT 90700 DTAP IMMUNIZATION	$66.30	$102.00	$22.24–$102.00	—	35%
DTaP, hepatitis B and polio combination vaccine (Pediarix) CPT 90723 PEDIARIX	$202.80	$312.00	$68.02–$312.00	4% above	35%
DTaP, hepatitis B and polio combination vaccine (Pediarix) CPT 90723 PEDIARIX	$202.80	$312.00	$68.02–$312.00	4% above	35%
DTaP, hepatitis B and polio combination vaccine (Pediarix) inpatient CPT 90723 PEDIARIX	$202.80	$312.00	$68.02–$312.00	—	35%
DTaP, hepatitis B and polio combination vaccine (Pediarix) inpatient CPT 90723 PEDIARIX	$202.80	$312.00	$68.02–$312.00	—	35%
DTaP, polio and Hib combination vaccine (Pentacel) CPT 90698 DTAP-HIB-IP VACCINE, IM	$240.50	$370.00	$80.66–$370.00	51% above	35%
DTaP, polio and Hib combination vaccine (Pentacel) CPT 90698 DTAP-HIB-IP VACCINE, IM	$240.50	$370.00	$80.66–$370.00	51% above	35%
DTaP, polio and Hib combination vaccine (Pentacel) inpatient CPT 90698 DTAP-HIB-IP VACCINE, IM	$240.50	$370.00	$80.66–$370.00	—	35%
DTaP, polio and Hib combination vaccine (Pentacel) inpatient CPT 90698 DTAP-HIB-IP VACCINE, IM	$240.50	$370.00	$80.66–$370.00	—	35%
DTaP, polio, Hib and hepatitis B combination vaccine (Vaxelis) CPT 90697 DTAP-IPV-HIB-HEPB VACCINE IM	$341.93	$526.05	$114.68–$526.05	at median	35%
DTaP, polio, Hib and hepatitis B combination vaccine (Vaxelis) CPT 90697 DTAP-IPV-HIB-HEPB VACCINE IM	$341.93	$526.05	$114.68–$526.05	at median	35%
DTaP, polio, Hib and hepatitis B combination vaccine (Vaxelis) inpatient CPT 90697 DTAP-IPV-HIB-HEPB VACCINE IM	$341.93	$526.05	$114.68–$526.05	—	35%
DTaP, polio, Hib and hepatitis B combination vaccine (Vaxelis) inpatient CPT 90697 DTAP-IPV-HIB-HEPB VACCINE IM	$341.93	$526.05	$114.68–$526.05	—	35%
Flu shot, recombinant, egg-free (Flublok) CPT 90673 FLUBLOK TRIVALENT	$184.99	$284.60	$62.04–$284.60	at median	35%
Flu shot, recombinant, egg-free (Flublok) CPT 90673 FLUBLOK TRIVALENT	$184.99	$284.60	$62.04–$284.60	at median	35%
Flu shot, recombinant, egg-free (Flublok) inpatient CPT 90673 FLUBLOK TRIVALENT	$184.99	$284.60	$62.04–$284.60	—	35%
Flu shot, recombinant, egg-free (Flublok) inpatient CPT 90673 FLUBLOK TRIVALENT	$184.99	$284.60	$62.04–$284.60	—	35%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 FLU VACCINE NO PRESERV 0.25 ML	$48.56	$74.70	$16.28–$74.70	6% above	35%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 INFLUENZA VACCINE	$48.56	$74.70	$16.28–$74.70	6% above	35%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 INFLUENZA VACCINE	$48.56	$74.70	$16.28–$74.70	6% above	35%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 FLU VACCINE NO PRESERV 0.25 ML	$48.56	$74.70	$16.28–$74.70	6% above	35%
Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 FLU VACCINE NO PRESERV 0.25 ML	$48.56	$74.70	$16.28–$74.70	—	35%
Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 INFLUENZA VACCINE	$48.56	$74.70	$16.28–$74.70	—	35%
Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 FLU VACCINE NO PRESERV 0.25 ML	$48.56	$74.70	$16.28–$74.70	—	35%
Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 INFLUENZA VACCINE	$48.56	$74.70	$16.28–$74.70	—	35%
HPV vaccine, 9-valent (Gardasil 9) CPT 90651 HPV VIRUS VACCINE 9 VAL IM	$718.90	$1,106.00	$241.11–$1,106.00	39% above	35%
HPV vaccine, 9-valent (Gardasil 9) CPT 90651 HPV VIRUS VACCINE 9 VAL IM	$718.90	$1,106.00	$241.11–$1,106.00	39% above	35%
HPV vaccine, 9-valent (Gardasil 9) inpatient CPT 90651 HPV VIRUS VACCINE 9 VAL IM	$718.90	$1,106.00	$241.11–$1,106.00	—	35%
HPV vaccine, 9-valent (Gardasil 9) inpatient CPT 90651 HPV VIRUS VACCINE 9 VAL IM	$718.90	$1,106.00	$241.11–$1,106.00	—	35%
Hepatitis A and B combination vaccine, adult (Twinrix) CPT 90636 IM ADULT HEPA-HEPB	$306.80	$472.00	$102.90–$472.00	at median	35%
Hepatitis A and B combination vaccine, adult (Twinrix) CPT 90636 IM ADULT HEPA-HEPB	$306.80	$472.00	$102.90–$472.00	at median	35%
Hepatitis A and B combination vaccine, adult (Twinrix) inpatient CPT 90636 IM ADULT HEPA-HEPB	$306.80	$472.00	$102.90–$472.00	—	35%
Hepatitis A and B combination vaccine, adult (Twinrix) inpatient CPT 90636 IM ADULT HEPA-HEPB	$306.80	$472.00	$102.90–$472.00	—	35%
Hepatitis A vaccine, adult dose CPT 90632 HEP A/ADULT	$200.20	$308.00	$67.14–$308.00	3% above	35%
Hepatitis A vaccine, adult dose CPT 90632 HEP A/ADULT	$200.20	$308.00	$67.14–$308.00	3% above	35%
Hepatitis A vaccine, adult dose inpatient CPT 90632 HEP A/ADULT	$200.20	$308.00	$67.14–$308.00	—	35%
Hepatitis A vaccine, adult dose inpatient CPT 90632 HEP A/ADULT	$200.20	$308.00	$67.14–$308.00	—	35%
Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 HEP A/PEDIATRIC ADOLESEN	$89.70	$138.00	$30.08–$138.00	at median	35%
Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 HEP A/PEDIATRIC ADOLESEN	$89.70	$138.00	$30.08–$138.00	at median	35%
Hepatitis A vaccine, child and teen dose (2-dose schedule) inpatient CPT 90633 HEP A/PEDIATRIC ADOLESEN	$89.70	$138.00	$30.08–$138.00	—	35%
Hepatitis A vaccine, child and teen dose (2-dose schedule) inpatient CPT 90633 HEP A/PEDIATRIC ADOLESEN	$89.70	$138.00	$30.08–$138.00	—	35%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 IMMUNIZATION HEPATITIS	$167.70	$258.00	$56.24–$258.00	8% above	35%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 IMMUNIZATION HEPATITIS	$167.70	$258.00	$56.24–$258.00	8% above	35%
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 IMMUNIZATION HEPATITIS	$167.70	$258.00	$56.24–$258.00	—	35%
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 IMMUNIZATION HEPATITIS	$167.70	$258.00	$56.24–$258.00	—	35%
Hepatitis B vaccine, adult, 2-dose schedule (Heplisav-B) CPT 90739 HEPB VACC 2 DOSE ADULT IM	$365.30	$562.00	$122.52–$562.00	67% above	35%
Hepatitis B vaccine, adult, 2-dose schedule (Heplisav-B) CPT 90739 HEPB VACC 2 DOSE ADULT IM	$365.30	$562.00	$122.52–$562.00	67% above	35%
Hepatitis B vaccine, adult, 2-dose schedule (Heplisav-B) inpatient CPT 90739 HEPB VACC 2 DOSE ADULT IM	$365.30	$562.00	$122.52–$562.00	—	35%
Hepatitis B vaccine, adult, 2-dose schedule (Heplisav-B) inpatient CPT 90739 HEPB VACC 2 DOSE ADULT IM	$365.30	$562.00	$122.52–$562.00	—	35%
Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 HEP B/PEDIATRIC/ADOLESCEN	$67.60	$104.00	$22.67–$104.00	13% above	35%
Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 HEP B/PEDIATRIC/ADOLESCEN	$67.60	$104.00	$22.67–$104.00	13% above	35%
Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 HEP B/PEDIATRIC/ADOLESCEN	$67.60	$104.00	$22.67–$104.00	—	35%
Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 HEP B/PEDIATRIC/ADOLESCEN	$67.60	$104.00	$22.67–$104.00	—	35%
Hib vaccine (Haemophilus influenzae type b), 3-dose schedule (PedvaxHIB) CPT 90647 IM 3 DOSE HIB, PRP-OMP	$70.20	$108.00	$23.54–$108.00	at median	35%
Hib vaccine (Haemophilus influenzae type b), 3-dose schedule (PedvaxHIB) CPT 90647 IM 3 DOSE HIB, PRP-OMP	$70.20	$108.00	$23.54–$108.00	at median	35%
Hib vaccine (Haemophilus influenzae type b), 3-dose schedule (PedvaxHIB) inpatient CPT 90647 IM 3 DOSE HIB, PRP-OMP	$70.20	$108.00	$23.54–$108.00	—	35%
Hib vaccine (Haemophilus influenzae type b), 3-dose schedule (PedvaxHIB) inpatient CPT 90647 IM 3 DOSE HIB, PRP-OMP	$70.20	$108.00	$23.54–$108.00	—	35%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) CPT 90648 HIB, PRP-T	$30.55	$47.00	$10.25–$47.00	at median	35%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) CPT 90648 HIB, PRP-T	$30.55	$47.00	$10.25–$47.00	at median	35%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) inpatient CPT 90648 HIB, PRP-T	$30.55	$47.00	$10.25–$47.00	—	35%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) inpatient CPT 90648 HIB, PRP-T	$30.55	$47.00	$10.25–$47.00	—	35%
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 FLU VACC PRSV FREE INC ANTIG	$132.15	$203.30	$44.32–$203.30	28% above	35%
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 FLU VACC PRSV FREE INC ANTIG	$132.15	$203.30	$44.32–$203.30	28% above	35%
High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 FLU VACC PRSV FREE INC ANTIG	$132.15	$203.30	$44.32–$203.30	—	35%
High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 FLU VACC PRSV FREE INC ANTIG	$132.15	$203.30	$44.32–$203.30	—	35%
Japanese encephalitis vaccine (Ixiaro), 2-dose schedule CPT 90738 JAPANESE ENCEPHALITIS VACC IM	$673.40	$1,036.00	$225.85–$1,036.00	51% below	35%
Japanese encephalitis vaccine (Ixiaro), 2-dose schedule CPT 90738 JAPANESE ENCEPHALITIS VACC IM	$673.40	$1,036.00	$225.85–$1,036.00	51% below	35%
Japanese encephalitis vaccine (Ixiaro), 2-dose schedule inpatient CPT 90738 JAPANESE ENCEPHALITIS VACC IM	$673.40	$1,036.00	$225.85–$1,036.00	—	35%
Japanese encephalitis vaccine (Ixiaro), 2-dose schedule inpatient CPT 90738 JAPANESE ENCEPHALITIS VACC IM	$673.40	$1,036.00	$225.85–$1,036.00	—	35%
MMR vaccine (measles, mumps and rubella), live CPT 90707 MUMPS RUBELLA MEA	$218.40	$336.00	$73.25–$336.00	5% above	35%
MMR vaccine (measles, mumps and rubella), live CPT 90707 MUMPS RUBELLA MEA	$218.40	$336.00	$73.25–$336.00	5% above	35%
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 MUMPS RUBELLA MEA	$218.40	$336.00	$73.25–$336.00	—	35%
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 MUMPS RUBELLA MEA	$218.40	$336.00	$73.25–$336.00	—	35%
MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) CPT 90710 MMRV VACCINE	$644.80	$992.00	$216.26–$992.00	26% above	35%
MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) CPT 90710 MMRV VACCINE	$644.80	$992.00	$216.26–$992.00	26% above	35%
MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) inpatient CPT 90710 MMRV VACCINE	$644.80	$992.00	$216.26–$992.00	—	35%
MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) inpatient CPT 90710 MMRV VACCINE	$644.80	$992.00	$216.26–$992.00	—	35%
Meningococcal ACWY (MenACWY) vaccine CPT 90734 MENINGOCOCCAL VACCINE, IM	$367.25	$565.00	$123.17–$565.00	16% above	35%
Meningococcal ACWY (MenACWY) vaccine CPT 90734 MENINGOCOCCAL VACCINE, IM	$367.25	$565.00	$123.17–$565.00	16% above	35%
Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 MENINGOCOCCAL VACCINE, IM	$367.25	$565.00	$123.17–$565.00	—	35%
Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 MENINGOCOCCAL VACCINE, IM	$367.25	$565.00	$123.17–$565.00	—	35%
Meningococcal ACWY vaccine (MenQuadfi) CPT 90619 MENINGOCOCCAL VACCINE, QUADRIVALENT (MENQUADFI)	$401.05	$617.00	$134.51–$617.00	at median	35%
Meningococcal ACWY vaccine (MenQuadfi) CPT 90619 MENINGOCOCCAL VACCINE, QUADRIVALENT (MENQUADFI)	$401.05	$617.00	$134.51–$617.00	at median	35%
Meningococcal ACWY vaccine (MenQuadfi) inpatient CPT 90619 MENINGOCOCCAL VACCINE, QUADRIVALENT (MENQUADFI)	$401.05	$617.00	$134.51–$617.00	—	35%
Meningococcal ACWY vaccine (MenQuadfi) inpatient CPT 90619 MENINGOCOCCAL VACCINE, QUADRIVALENT (MENQUADFI)	$401.05	$617.00	$134.51–$617.00	—	35%
Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 MENB RP W/OMV VACCINE IM	$553.80	$852.00	$185.74–$852.00	at median	35%
Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 MENB RP W/OMV VACCINE IM	$553.80	$852.00	$185.74–$852.00	at median	35%
Meningococcal B vaccine (Bexsero), 2-dose schedule inpatient CPT 90620 MENB RP W/OMV VACCINE IM	$553.80	$852.00	$185.74–$852.00	—	35%
Meningococcal B vaccine (Bexsero), 2-dose schedule inpatient CPT 90620 MENB RP W/OMV VACCINE IM	$553.80	$852.00	$185.74–$852.00	—	35%
Meningococcal B vaccine (Trumenba) CPT 90621 MENB RLP VACCINE IM	$392.60	$604.00	$131.67–$604.00	at median	35%
Meningococcal B vaccine (Trumenba) CPT 90621 MENB RLP VACCINE IM	$392.60	$604.00	$131.67–$604.00	at median	35%
Meningococcal B vaccine (Trumenba) inpatient CPT 90621 MENB RLP VACCINE IM	$392.60	$604.00	$131.67–$604.00	—	35%
Meningococcal B vaccine (Trumenba) inpatient CPT 90621 MENB RLP VACCINE IM	$392.60	$604.00	$131.67–$604.00	—	35%
Mpox and smallpox vaccine (Jynneos), 2-dose schedule CPT 90611 JYNNEOS VACCINE (MPOX) 0.5 ML	$510.71	$785.70	$188.57–$785.70	at median	35%
Mpox and smallpox vaccine (Jynneos), 2-dose schedule CPT 90611 JYNNEOS VACCINE (MPOX) 0.5 ML	$510.71	$785.70	$188.57–$785.70	at median	35%
Mpox and smallpox vaccine (Jynneos), 2-dose schedule inpatient CPT 90611 JYNNEOS VACCINE (MPOX) 0.5 ML	$510.71	$785.70	$188.57–$785.70	—	35%
Mpox and smallpox vaccine (Jynneos), 2-dose schedule inpatient CPT 90611 JYNNEOS VACCINE (MPOX) 0.5 ML	$510.71	$785.70	$188.57–$785.70	—	35%
Nasal spray flu vaccine, live (FluMist) CPT 90660 FLUMIST VACC NSPR 0.2ML	$40.89	$62.90	$13.71–$62.90	3% above	35%
Nasal spray flu vaccine, live (FluMist) CPT 90660 FLUMIST VACC NSPR 0.2ML	$40.89	$62.90	$13.71–$62.90	3% above	35%
Nasal spray flu vaccine, live (FluMist) inpatient CPT 90660 FLUMIST VACC NSPR 0.2ML	$40.89	$62.90	$13.71–$62.90	—	35%
Nasal spray flu vaccine, live (FluMist) inpatient CPT 90660 FLUMIST VACC NSPR 0.2ML	$40.89	$62.90	$13.71–$62.90	—	35%
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) CPT 90670 PREVNAR13 PNEUMOCOCCAL VACC IM	$529.10	$814.00	$177.45–$814.00	21% above	35%
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) CPT 90670 PREVNAR13 PNEUMOCOCCAL VACC IM	$529.10	$814.00	$177.45–$814.00	21% above	35%
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) inpatient CPT 90670 PREVNAR13 PNEUMOCOCCAL VACC IM	$529.10	$814.00	$177.45–$814.00	—	35%
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) inpatient CPT 90670 PREVNAR13 PNEUMOCOCCAL VACC IM	$529.10	$814.00	$177.45–$814.00	—	35%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 PNEUMOCOCCAL 20-VALENT CONJUGATE VACCINE CODE 90677	$661.70	$1,018.00	$221.92–$1,018.00	at median	35%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 PNEUMOCOCCAL 20-VALENT CONJUGATE VACCINE CODE 90677	$661.70	$1,018.00	$221.92–$1,018.00	at median	35%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 PNEUMOCOCCAL 20-VALENT CONJUGATE VACCINE CODE 90677	$661.70	$1,018.00	$221.92–$1,018.00	—	35%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 PNEUMOCOCCAL 20-VALENT CONJUGATE VACCINE CODE 90677	$661.70	$1,018.00	$221.92–$1,018.00	—	35%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PNEUMOCOCCAL VACCINE 23V	$274.95	$423.00	$92.21–$423.00	at median	35%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PNEUMOCOCCAL VACCINE 23V	$274.95	$423.00	$92.21–$423.00	at median	35%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 PNEUMOCOCCAL VACCINE 23V	$274.95	$423.00	$92.21–$423.00	—	35%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 PNEUMOCOCCAL VACCINE 23V	$274.95	$423.00	$92.21–$423.00	—	35%
Polio vaccine, inactivated (IPV) CPT 90713 INACTIVE POLIO VACCINE	$98.15	$151.00	$32.92–$151.00	54% above	35%
Polio vaccine, inactivated (IPV) CPT 90713 INACTIVE POLIO VACCINE	$98.15	$151.00	$32.92–$151.00	54% above	35%
Polio vaccine, inactivated (IPV) inpatient CPT 90713 INACTIVE POLIO VACCINE	$98.15	$151.00	$32.92–$151.00	—	35%
Polio vaccine, inactivated (IPV) inpatient CPT 90713 INACTIVE POLIO VACCINE	$98.15	$151.00	$32.92–$151.00	—	35%
RSV antibody shot for infants and toddlers, larger dose (1 mL, 100 mg) CPT 90381 RSV MONOCLONAL ANTB SEASONAL DOSE 1 ML IM USE	$1,352.00	$2,080.00	$453.44–$2,080.00	30% above	35%
RSV antibody shot for infants and toddlers, larger dose (1 mL, 100 mg) CPT 90381 RSV MONOCLONAL ANTB SEASONAL DOSE 1 ML IM USE	$1,352.00	$2,080.00	$453.44–$2,080.00	30% above	35%
RSV antibody shot for infants and toddlers, larger dose (1 mL, 100 mg) inpatient CPT 90381 RSV MONOCLONAL ANTB SEASONAL DOSE 1 ML IM USE	$1,352.00	$2,080.00	$453.44–$2,080.00	—	35%
RSV antibody shot for infants and toddlers, larger dose (1 mL, 100 mg) inpatient CPT 90381 RSV MONOCLONAL ANTB SEASONAL DOSE 1 ML IM USE	$1,352.00	$2,080.00	$453.44–$2,080.00	—	35%
RSV antibody shot for infants, seasonal dose (0.5 mL) CPT 90380 RSV MONOCLONAL ANTB SEASONAL DOSE 0.5ML IM USE	$1,352.00	$2,080.00	$453.44–$2,080.00	at median	35%
RSV antibody shot for infants, seasonal dose (0.5 mL) CPT 90380 RSV MONOCLONAL ANTB SEASONAL DOSE 0.5ML IM USE	$1,352.00	$2,080.00	$453.44–$2,080.00	at median	35%
RSV antibody shot for infants, seasonal dose (0.5 mL) inpatient CPT 90380 RSV MONOCLONAL ANTB SEASONAL DOSE 0.5ML IM USE	$1,352.00	$2,080.00	$453.44–$2,080.00	—	35%
RSV antibody shot for infants, seasonal dose (0.5 mL) inpatient CPT 90380 RSV MONOCLONAL ANTB SEASONAL DOSE 0.5ML IM USE	$1,352.00	$2,080.00	$453.44–$2,080.00	—	35%
RSV vaccine (Abrysvo), one dose for older adults or during pregnancy CPT 90678 RSV VACCINE, BIVALENT (ABRYSVO)	$718.90	$1,106.00	$241.11–$1,106.00	at median	35%
RSV vaccine (Abrysvo), one dose for older adults or during pregnancy CPT 90678 RSV VACCINE, BIVALENT (ABRYSVO)	$718.90	$1,106.00	$241.11–$1,106.00	at median	35%
RSV vaccine (Abrysvo), one dose for older adults or during pregnancy inpatient CPT 90678 RSV VACCINE, BIVALENT (ABRYSVO)	$718.90	$1,106.00	$241.11–$1,106.00	—	35%
RSV vaccine (Abrysvo), one dose for older adults or during pregnancy inpatient CPT 90678 RSV VACCINE, BIVALENT (ABRYSVO)	$718.90	$1,106.00	$241.11–$1,106.00	—	35%
RSV vaccine with adjuvant (Arexvy), one dose for older adults CPT 90679 RSV VACCINE, ADJUVANTED (AREXVY)	$235.95	$363.00	$79.13–$363.00	33% below	35%
RSV vaccine with adjuvant (Arexvy), one dose for older adults CPT 90679 RSV VACCINE, ADJUVANTED (AREXVY)	$235.95	$363.00	$79.13–$363.00	33% below	35%
RSV vaccine with adjuvant (Arexvy), one dose for older adults inpatient CPT 90679 RSV VACCINE, ADJUVANTED (AREXVY)	$235.95	$363.00	$79.13–$363.00	—	35%
RSV vaccine with adjuvant (Arexvy), one dose for older adults inpatient CPT 90679 RSV VACCINE, ADJUVANTED (AREXVY)	$235.95	$363.00	$79.13–$363.00	—	35%
Rabies vaccine, one dose CPT 90675 RABIES VACCINE, IM	$969.15	$1,491.00	$357.84–$1,491.00	2% above	35%
Rabies vaccine, one dose CPT 90675 RABIES VACCINE, IM	$969.15	$1,491.00	$357.84–$1,491.00	2% above	35%
Rabies vaccine, one dose inpatient CPT 90675 RABIES VACCINE, IM	$969.15	$1,491.00	$357.84–$1,491.00	—	35%
Rabies vaccine, one dose inpatient CPT 90675 RABIES VACCINE, IM	$969.15	$1,491.00	$357.84–$1,491.00	—	35%
Rotavirus vaccine, oral, 2-dose schedule (Rotarix) CPT 90681 ROTAVIRUS VAC 2 DOSE ORAL	$261.30	$402.00	$87.64–$402.00	at median	35%
Rotavirus vaccine, oral, 2-dose schedule (Rotarix) CPT 90681 ROTAVIRUS VAC 2 DOSE ORAL	$261.30	$402.00	$87.64–$402.00	at median	35%
Rotavirus vaccine, oral, 2-dose schedule (Rotarix) inpatient CPT 90681 ROTAVIRUS VAC 2 DOSE ORAL	$261.30	$402.00	$87.64–$402.00	—	35%
Rotavirus vaccine, oral, 2-dose schedule (Rotarix) inpatient CPT 90681 ROTAVIRUS VAC 2 DOSE ORAL	$261.30	$402.00	$87.64–$402.00	—	35%
Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) CPT 90680 ROTOVIRUS VAC ORAL USE	$200.85	$309.00	$67.36–$309.00	48% above	35%
Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) CPT 90680 ROTOVIRUS VAC ORAL USE	$200.85	$309.00	$67.36–$309.00	48% above	35%
Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) inpatient CPT 90680 ROTOVIRUS VAC ORAL USE	$200.85	$309.00	$67.36–$309.00	—	35%
Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) inpatient CPT 90680 ROTOVIRUS VAC ORAL USE	$200.85	$309.00	$67.36–$309.00	—	35%
Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 HZV VACC RECOMBINANT IM NJX	$505.05	$777.00	$169.39–$777.00	at median	35%
Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 HZV VACC RECOMBINANT IM NJX	$505.05	$777.00	$169.39–$777.00	at median	35%
Shingles vaccine (Shingrix), recombinant, one dose inpatient CPT 90750 HZV VACC RECOMBINANT IM NJX	$505.05	$777.00	$169.39–$777.00	—	35%
Shingles vaccine (Shingrix), recombinant, one dose inpatient CPT 90750 HZV VACC RECOMBINANT IM NJX	$505.05	$777.00	$169.39–$777.00	—	35%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TD VACCINE NO PRSRV >= 7 IM	$91.65	$141.00	$30.74–$141.00	2% above	35%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TD VACCINE NO PRSRV >= 7 IM	$91.65	$141.00	$30.74–$141.00	2% above	35%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 TD VACCINE NO PRSRV >= 7 IM	$91.65	$141.00	$30.74–$141.00	—	35%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 TD VACCINE NO PRSRV >= 7 IM	$91.65	$141.00	$30.74–$141.00	—	35%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 TDAP VACCINE >7 IM	$110.50	$170.00	$37.06–$170.00	at median	35%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 TDAP VACCINE >7 IM	$110.50	$170.00	$37.06–$170.00	at median	35%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 TDAP VACCINE >7 IM	$110.50	$170.00	$37.06–$170.00	—	35%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 TDAP VACCINE >7 IM	$110.50	$170.00	$37.06–$170.00	—	35%
Typhoid vaccine, injectable (Vi polysaccharide) CPT 90691 TYPHOID VI 25MCG/0.5ML SYG	$286.65	$441.00	$96.14–$441.00	at median	35%
Typhoid vaccine, injectable (Vi polysaccharide) CPT 90691 TYPHOID VI 25MCG/0.5ML SYG	$286.65	$441.00	$96.14–$441.00	at median	35%
Typhoid vaccine, injectable (Vi polysaccharide) inpatient CPT 90691 TYPHOID VI 25MCG/0.5ML SYG	$286.65	$441.00	$96.14–$441.00	—	35%
Typhoid vaccine, injectable (Vi polysaccharide) inpatient CPT 90691 TYPHOID VI 25MCG/0.5ML SYG	$286.65	$441.00	$96.14–$441.00	—	35%
Typhoid vaccine, oral capsules (Vivotif) CPT 90690 TYPHOID VACC CAP EC	$74.75	$115.00	$25.07–$115.00	51% above	35%
Typhoid vaccine, oral capsules (Vivotif) CPT 90690 TYPHOID VACC CAP EC	$74.75	$115.00	$25.07–$115.00	51% above	35%
Typhoid vaccine, oral capsules (Vivotif) inpatient CPT 90690 TYPHOID VACC CAP EC	$74.75	$115.00	$25.07–$115.00	—	35%
Typhoid vaccine, oral capsules (Vivotif) inpatient CPT 90690 TYPHOID VACC CAP EC	$74.75	$115.00	$25.07–$115.00	—	35%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 RSV VACCINE PREF SUBUNIT BIVALENT FOR IM USE	$21.45	$33.00	$17.08–$74.93	47% below	35%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 ADMIN VACCINE PNEUMONIA	$139.10	$214.00	$59.49–$214.00	242% above	35%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZ INJ-HEP B VACC ONLY	$139.10	$214.00	$59.49–$214.00	242% above	35%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 ADMIN VACCINE SNGL	$139.10	$214.00	$59.49–$214.00	242% above	35%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 ADMIN VACCINE FLU	$139.10	$214.00	$59.49–$214.00	242% above	35%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 RSV VACCINE PREF SUBUNIT BIVALENT FOR IM USE	$21.45	$33.00	$9.17–$33.00	—	35%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZ INJ-HEP B VACC ONLY	$139.10	$214.00	$59.49–$214.00	—	35%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 ADMIN VACCINE SNGL	$139.10	$214.00	$59.49–$214.00	—	35%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 ADMIN VACCINE FLU	$139.10	$214.00	$59.49–$214.00	—	35%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 ADMIN VACCINE PNEUMONIA	$139.10	$214.00	$59.49–$214.00	—	35%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 ADMIN VACCINE EA ADD	$41.60	$64.00	$13.95–$64.00	20% above	35%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 ADMIN VAC EA ADD CHILD	$41.60	$64.00	$17.08–$21.15	20% above	35%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 ADMIN VAC EA ADD CHILD	$41.60	$64.00	$13.95–$64.00	—	35%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 ADMIN VACCINE EA ADD	$41.60	$64.00	$13.95–$64.00	—	35%
Yellow fever vaccine, live CPT 90717 YELLOW FEVER VACCINE, SQ LIVE	$421.20	$648.00	$141.26–$648.00	at median	35%
Yellow fever vaccine, live CPT 90717 YELLOW FEVER VACCINE, SQ LIVE	$421.20	$648.00	$141.26–$648.00	at median	35%
Yellow fever vaccine, live inpatient CPT 90717 YELLOW FEVER VACCINE, SQ LIVE	$421.20	$648.00	$141.26–$648.00	—	35%
Yellow fever vaccine, live inpatient CPT 90717 YELLOW FEVER VACCINE, SQ LIVE	$421.20	$648.00	$141.26–$648.00	—	35%

Dental

Procedure	Cash price	List price	Insurers pay	vs Ohio	Off list
Dental implant, surgical placement CDT D6010 SURGICAL PLACEMENT OF IMPLANT BODY; ENDOSTEAL IMPLANT	$1,300.00	$2,000.00	$436.00–$2,000.00	—	35%
Dental implant, surgical placement inpatient CDT D6010 SURGICAL PLACEMENT OF IMPLANT BODY; ENDOSTEAL IMPLANT	$1,300.00	$2,000.00	$436.00–$2,000.00	—	35%
Removal of an impacted tooth fully covered by bone, often a wisdom tooth CDT D7240 IMPCT TOOTH REMOV COMP BONY TECH	$1,300.00	$2,000.00	$556.00–$2,000.00	—	35%
Removal of an impacted tooth fully covered by bone, often a wisdom tooth inpatient CDT D7240 IMPCT TOOTH REMOV COMP BONY TECH	$1,300.00	$2,000.00	$556.00–$2,000.00	—	35%
Simple extraction of a tooth or exposed root that is above the gum CDT D7140 EXTRACTION, ERUPTED TOOTH OR EXPOSED ROOT	$1,300.00	$2,000.00	$556.00–$2,000.00	at median	35%
Simple extraction of a tooth or exposed root that is above the gum inpatient CDT D7140 EXTRACTION, ERUPTED TOOTH OR EXPOSED ROOT	$1,300.00	$2,000.00	$556.00–$2,000.00	—	35%

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://clevelandclinic.pt.panaceainc.com/MRFDownload/clevelandclinic/clevelandclinic