Hospital Philadelphia-Camden-Wilmington, PA-NJ-DE-MD

Riddle Memorial Hospital

Riddle Memorial Hospital in Media, PA publishes cash prices for 406 common procedures listed here, from its own machine-readable price file updated Apr 1, 2026. Compared with other hospitals in the state, its outpatient cash prices are below the Pennsylvania median for 282 of 403 procedures and above it for 94. By typical cash price it ranks #39 of 108 Pennsylvania hospitals and #6 of 26 hospitals in the Philadelphia, PA area, cheapest first. Select a procedure to compare it with other hospitals nearby.

1068 West Baltimore Pike, Media, PA 19063 Collected Sep 23, 2026 Source price file Check a bill from this hospital (610) 566-9400

Acute care hospital Nonprofit hospital Emergency department CMS star rating 4 of 5 CCN 390222 · CMS hospital register NPI 1407856099

Financial assistance

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

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

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

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

Scans and imaging

Procedure	Cash price	List price	Insurers pay	vs Pennsylvania	Off list
Abdominal CT scan without and with contrast CPT 74170 Hc Ct Abdomen W/Wo Contrast	$1,886.80	$4,717.00	—	at median	60%
Abdominal CT scan without and with contrast inpatient CPT 74170 Hc Ct Abdomen W/Wo Contrast	$1,886.80	$4,717.00	—	—	60%
Abdominal X-ray, 2 views CPT 74019 Hc Xr Abdomen, 2 Views	$264.80	$662.00	—	19% below	60%
Abdominal X-ray, 2 views inpatient CPT 74019 Hc Xr Abdomen, 2 Views	$264.80	$662.00	—	—	60%
Ankle X-ray, complete, 3 or more views CPT 73610 Hc Xr Ankle Complete	$481.20	$1,203.00	—	32% above	60%
Ankle X-ray, complete, 3 or more views inpatient CPT 73610 Hc Xr Ankle Complete	$481.20	$1,203.00	—	—	60%
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 Hc Upr/L Xtremity Art 2 Levels	$504.00	$1,260.00	—	13% above	60%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 Hc Upr/L Xtremity Art 2 Levels	$504.00	$1,260.00	—	—	60%
Arm CT scan without contrast (shoulder to hand, any part) CPT 73200 Hc Ct Upper Extremity Wo Contrast	$2,148.80	$5,372.00	—	82% above	60%
Arm CT scan without contrast (shoulder to hand, any part) inpatient CPT 73200 Hc Ct Upper Extremity Wo Contrast	$2,148.80	$5,372.00	—	—	60%
Barium swallow (esophagus X-ray with contrast) CPT 74220 Hc Xr Esophagus	$334.00	$835.00	—	27% below	60%
Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 Hc Xr Esophagus	$334.00	$835.00	—	—	60%
Bone scan, whole body (nuclear medicine) CPT 78306 Hc Bone And/Or Joint Image Whole Bdy	$819.60	$2,049.00	—	33% below	60%
Bone scan, whole body (nuclear medicine) inpatient CPT 78306 Hc Bone And/Or Joint Image Whole Bdy	$819.60	$2,049.00	—	—	60%
Breast ultrasound, complete, one breast CPT 76641 Hc Us Breast Complete	$432.80	$1,082.00	—	21% below	60%
Breast ultrasound, complete, one breast inpatient CPT 76641 Hc Us Breast Complete	$432.80	$1,082.00	—	—	60%
Breast ultrasound, limited (one breast or one area) CPT 76642 Hc Us Breast Limited	$355.20	$888.00	—	23% below	60%
Breast ultrasound, limited (one breast or one area) inpatient CPT 76642 Hc Us Breast Limited	$355.20	$888.00	—	—	60%
CT angiography (CTA) of the abdomen and pelvis CPT 74174 Hc Cta Abdomen/Pelvis W/Wo Contrast	$1,431.20	$3,578.00	—	52% below	60%
CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174 Hc Cta Abdomen/Pelvis W/Wo Contrast	$1,431.20	$3,578.00	—	—	60%
CT angiography (CTA) of the head CPT 70496 Hc Ct Angio Head W/Wo Contrast	$1,366.00	$3,415.00	—	20% below	60%
CT angiography (CTA) of the head inpatient CPT 70496 Hc Ct Angio Head W/Wo Contrast	$1,366.00	$3,415.00	—	—	60%
CT angiography (CTA) of the neck CPT 70498 Hc Ct Angio Neck W/Wo Contrast	$1,148.00	$2,870.00	—	31% below	60%
CT angiography (CTA) of the neck inpatient CPT 70498 Hc Ct Angio Neck W/Wo Contrast	$1,148.00	$2,870.00	—	—	60%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 Hc Ct Angio Chest W/Wo Contrast	$1,413.60	$3,534.00	—	26% below	60%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 Hc Ct Angio Chest W/Wo Contrast	$1,413.60	$3,534.00	—	—	60%
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 Hc Cta Hrt/Cor Arteries/Graft W/3D Image	$822.00	$2,055.00	—	58% below	60%
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score inpatient CPT 75574 Hc Cta Hrt/Cor Arteries/Graft W/3D Image	$822.00	$2,055.00	—	—	60%
CT of the heart without contrast dye to measure coronary calcium CPT 75571 Hc Ct Heart Calcium Score	$181.60	$454.00	—	3% above	60%
CT of the heart without contrast dye to measure coronary calcium inpatient CPT 75571 Hc Ct Heart Calcium Score	$181.60	$454.00	—	—	60%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 Hc Ct Abdomen/Pelvis W/O Contrast	$1,430.80	$3,577.00	—	31% below	60%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 Hc Ct Abdomen/Pelvis W/O Contrast	$1,430.80	$3,577.00	—	—	60%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 Hc Ct Abdomen/Pelvis W/Contrast	$2,236.00	$5,590.00	—	25% below	60%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 Hc Ct Abdomen/Pelvis W/Contrast	$2,236.00	$5,590.00	—	—	60%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 Hc Ct Abdomen/Pelvis W/Wo Contrast	$2,526.40	$6,316.00	—	15% below	60%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 Hc Ct Abdomen/Pelvis W/Wo Contrast	$2,526.40	$6,316.00	—	—	60%
CT scan of the abdomen with contrast CPT 74160 Hc Ct Abdomen W Contrast	$1,654.80	$4,137.00	—	at median	60%
CT scan of the abdomen with contrast inpatient CPT 74160 Hc Ct Abdomen W Contrast	$1,654.80	$4,137.00	—	—	60%
CT scan of the abdomen without contrast CPT 74150 Hc Ct Abdomen Wo Contrast	$1,076.00	$2,690.00	—	5% below	60%
CT scan of the abdomen without contrast inpatient CPT 74150 Hc Ct Abdomen Wo Contrast	$1,076.00	$2,690.00	—	—	60%
CT scan of the face and sinuses, no contrast dye CPT 70486 Hc Ct Maxillofacial W/O Contrast	$937.20	$2,343.00	—	17% below	60%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 Hc Ct Maxillofacial W/O Contrast	$937.20	$2,343.00	—	—	60%
CT scan of the head or brain, no contrast dye CPT 70450 Hc Ct Head/Brain W/O Contrast	$606.00	$1,515.00	—	44% below	60%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 Hc Ct Head/Brain W/O Contrast	$606.00	$1,515.00	—	—	60%
CT scan of the head with contrast CPT 70460 Hc Ct Head/Brain W/Contrast	$854.00	$2,135.00	—	37% below	60%
CT scan of the head with contrast inpatient CPT 70460 Hc Ct Head/Brain W/Contrast	$854.00	$2,135.00	—	—	60%
CT scan of the head without and with contrast CPT 70470 Hc Ct Head/Brain W/Wo Contrast	$999.60	$2,499.00	—	40% below	60%
CT scan of the head without and with contrast inpatient CPT 70470 Hc Ct Head/Brain W/Wo Contrast	$999.60	$2,499.00	—	—	60%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 Hc Ct Lumbar Spine Wo Contrast	$900.00	$2,250.00	—	22% below	60%
CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 Hc Ct Lumbar Spine Wo Contrast	$900.00	$2,250.00	—	—	60%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 Hc Ct Cervical Spine Wo Contrast	$730.40	$1,826.00	—	38% below	60%
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 Hc Ct Cervical Spine Wo Contrast	$730.40	$1,826.00	—	—	60%
CT scan of the pelvis, with contrast dye CPT 72193 Hc Ct Pelvis W Contrast	$1,695.20	$4,238.00	—	at median	60%
CT scan of the pelvis, with contrast dye inpatient CPT 72193 Hc Ct Pelvis W Contrast	$1,695.20	$4,238.00	—	—	60%
Carotid artery ultrasound (duplex), both sides of the neck CPT 93880 Hc Carotid Ultrasound Doppler	$1,481.20	$3,703.00	—	83% above	60%
Carotid artery ultrasound (duplex), both sides of the neck inpatient CPT 93880 Hc Carotid Ultrasound Doppler	$1,481.20	$3,703.00	—	—	60%
Chest CT scan without and with contrast CPT 71270 Hc Ct Chest W/Wo Contrast	$1,576.80	$3,942.00	—	2% below	60%
Chest CT scan without and with contrast inpatient CPT 71270 Hc Ct Chest W/Wo Contrast	$1,576.80	$3,942.00	—	—	60%
Chest X-ray, 2 views CPT 71046 Hc Hc Xr Chest, 2 Views	$240.40	$601.00	—	25% below	60%
Chest X-ray, 2 views inpatient CPT 71046 Hc Hc Xr Chest, 2 Views	$240.40	$601.00	—	—	60%
Chest X-ray, single view CPT 71045 Hc Xr Chest, Single View	$156.00	$390.00	—	17% below	60%
Chest X-ray, single view inpatient CPT 71045 Hc Xr Chest, Single View	$156.00	$390.00	—	—	60%
Collarbone (clavicle) X-ray, complete CPT 73000 Hc Xr Clavicle	$228.00	$570.00	—	21% below	60%
Collarbone (clavicle) X-ray, complete inpatient CPT 73000 Hc Xr Clavicle	$228.00	$570.00	—	—	60%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 Hc Us Retroperitoneal Complete	$1,160.00	$2,900.00	—	60% above	60%
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 Hc Us Retroperitoneal Complete	$1,160.00	$2,900.00	—	—	60%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 Hc Dexa Bone Density Scan Axial Skeltn	$294.40	$736.00	—	8% above	60%
DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 Hc Dexa Bone Density Scan Axial Skeltn	$294.40	$736.00	—	—	60%
DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 Hc Dexa Bone Density Scan Periph Skeltn	$152.80	$382.00	—	16% below	60%
DEXA bone density scan of the wrist, heel or finger (peripheral) inpatient CPT 77081 Hc Dexa Bone Density Scan Periph Skeltn	$152.80	$382.00	—	—	60%
Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 Hc Us Pregnancy Detailed Sngl/1St	$698.40	$1,746.00	—	44% below	60%
Detailed fetal anatomy ultrasound, through the belly, one baby inpatient CPT 76811 Hc Us Pregnancy Detailed Sngl/1St	$698.40	$1,746.00	—	—	60%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 Hc Ct Chest W/O Contrast	$1,090.40	$2,726.00	—	1% below	60%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 Hc Ct Chest W/O Contrast	$1,090.40	$2,726.00	—	—	60%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 Hc Ct Chest W/Contrast	$1,314.00	$3,285.00	—	8% below	60%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 Hc Ct Chest W/Contrast	$1,314.00	$3,285.00	—	—	60%
Diagnostic mammogram, both breasts both sides CPT 77066 Dx Mammo Incl Cad Bi	$257.60	$644.00	—	—	60%
Diagnostic mammogram, both breasts inpatient both sides CPT 77066 Dx Mammo Incl Cad Bi	$257.60	$644.00	—	—	60%
Diagnostic mammogram, one breast CPT 77065 Hc Dx Mammo Incl Cad Uni	$252.40	$631.00	—	20% below	60%
Diagnostic mammogram, one breast inpatient CPT 77065 Hc Dx Mammo Incl Cad Uni	$252.40	$631.00	—	—	60%
Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 Hc Art Scan Le Bilateral	$1,197.60	$2,994.00	—	—	60%
Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 Hc Art Scan Le Bilateral	$1,197.60	$2,994.00	—	—	60%
Duplex ultrasound of the leg veins, both legs CPT 93970 Hc Doppler Study	$1,332.80	$3,332.00	—	53% above	60%
Duplex ultrasound of the leg veins, both legs inpatient CPT 93970 Hc Doppler Study	$1,332.80	$3,332.00	—	—	60%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 Hc Echo 2D Complete W/Dop/Col	$1,958.00	$4,895.00	—	4% above	60%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 Hc Echo 2D Complete W/Dop/Col	$1,958.00	$4,895.00	—	—	60%
Elbow X-ray, 2 views CPT 73070 Hc Xr Elbow Ap & Lateral	$385.60	$964.00	—	26% above	60%
Elbow X-ray, 2 views inpatient CPT 73070 Hc Xr Elbow Ap & Lateral	$385.60	$964.00	—	—	60%
Elbow X-ray, complete, 3 or more views CPT 73080 Hc Xr Elbow Complete	$224.40	$561.00	—	35% below	60%
Elbow X-ray, complete, 3 or more views inpatient CPT 73080 Hc Xr Elbow Complete	$224.40	$561.00	—	—	60%
Eye socket (orbit) CT scan without contrast CPT 70480 Hc Ct Orb/Ear/Fossa W/O Cntrst	$920.80	$2,302.00	—	15% below	60%
Eye socket (orbit) CT scan without contrast inpatient CPT 70480 Hc Ct Orb/Ear/Fossa W/O Cntrst	$920.80	$2,302.00	—	—	60%
Facial bones X-ray, complete, 3 or more views CPT 70150 Hc Xr Facial Bones Complete	$240.80	$602.00	—	41% below	60%
Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 Hc Xr Facial Bones Complete	$240.80	$602.00	—	—	60%
Forearm X-ray (radius and ulna), 2 views CPT 73090 Hc Xr Forearm	$216.00	$540.00	—	23% below	60%
Forearm X-ray (radius and ulna), 2 views inpatient CPT 73090 Hc Xr Forearm	$216.00	$540.00	—	—	60%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 Hc Hepatobiliary Image W/Gall Bldr	$724.40	$1,811.00	—	41% below	60%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 Hc Hepatobiliary Image W/Gall Bldr	$724.40	$1,811.00	—	—	60%
Hand X-ray, 2 views CPT 73120 Hc Xr Hand 2 Views	$192.00	$480.00	—	31% below	60%
Hand X-ray, 2 views inpatient CPT 73120 Hc Xr Hand 2 Views	$192.00	$480.00	—	—	60%
Heel bone (calcaneus) X-ray, 2 or more views CPT 73650 Hc Xr Heel/Calcaneus 2 Views	$216.00	$540.00	—	18% below	60%
Heel bone (calcaneus) X-ray, 2 or more views inpatient CPT 73650 Hc Xr Heel/Calcaneus 2 Views	$216.00	$540.00	—	—	60%
Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 Hc Sleep Study Unatt 4 Channels	$320.00	$800.00	—	47% below	60%
Home sleep apnea test, unattended, recording breathing and oxygen inpatient CPT 95806 Hc Sleep Study Unatt 4 Channels	$320.00	$800.00	—	—	60%
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 Hc N-Cpap Trial	$3,138.40	$7,846.00	—	at median	60%
In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 Hc N-Cpap Trial	$3,138.40	$7,846.00	—	—	60%
Knee X-ray, 3 views CPT 73562 Hc Xr Knee 3 Views	$261.20	$653.00	—	35% below	60%
Knee X-ray, 3 views inpatient CPT 73562 Hc Xr Knee 3 Views	$261.20	$653.00	—	—	60%
Knee X-ray, complete, 4 or more views CPT 73564 Hc Xr Knee 4 Views Or More	$580.00	$1,450.00	—	33% above	60%
Knee X-ray, complete, 4 or more views inpatient CPT 73564 Hc Xr Knee 4 Views Or More	$580.00	$1,450.00	—	—	60%
Leg CT scan without contrast (hip to foot, any part) CPT 73700 Hc Ct Lower Extremity Wo Contrast	$932.80	$2,332.00	—	12% below	60%
Leg CT scan without contrast (hip to foot, any part) inpatient CPT 73700 Hc Ct Lower Extremity Wo Contrast	$932.80	$2,332.00	—	—	60%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 Hc Us Abdomen Limited	$403.20	$1,008.00	—	33% below	60%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 Hc Us Abdomen Limited	$403.20	$1,008.00	—	—	60%
Limited ultrasound of an arm or leg (non-vascular) CPT 76882 Hc Us Extremity Non-Vasc Limited	$264.40	$661.00	—	33% below	60%
Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 Hc Us Extremity Non-Vasc Limited	$264.40	$661.00	—	—	60%
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 Hc Ct Lung Screening	$249.20	$623.00	—	37% below	60%
Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 Hc Ct Lung Screening	$249.20	$623.00	—	—	60%
Lower leg X-ray (tibia and fibula), 2 views CPT 73590 Hc Xr Tibia And Fibula 2 Views	$223.60	$559.00	—	33% below	60%
Lower leg X-ray (tibia and fibula), 2 views inpatient CPT 73590 Hc Xr Tibia And Fibula 2 Views	$223.60	$559.00	—	—	60%
MR angiography (MRA) of the head without contrast CPT 70544 Hc Mr Angio Head W/O Contrast	$1,770.40	$4,426.00	—	2% below	60%
MR angiography (MRA) of the head without contrast inpatient CPT 70544 Hc Mr Angio Head W/O Contrast	$1,770.40	$4,426.00	—	—	60%
MRI of knee or other lower-limb joint, no contrast dye CPT 73721 Hc Mri Lower Ext Jt W/O Contrast	$1,642.40	$4,106.00	—	19% below	60%
MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 Hc Mri Lower Ext Jt W/O Contrast	$1,642.40	$4,106.00	—	—	60%
MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 Hc Mri Lower Ext Jt W/Wo Contrast	$6,506.00	$16,265.00	—	85% above	60%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 Hc Mri Lower Ext Jt W/Wo Contrast	$6,506.00	$16,265.00	—	—	60%
MRI of the abdomen without contrast CPT 74181 Hc Mri Abdomen W/O Contrst	$1,976.00	$4,940.00	—	at median	60%
MRI of the abdomen without contrast inpatient CPT 74181 Hc Mri Abdomen W/O Contrst	$1,976.00	$4,940.00	—	—	60%
MRI of the abdomen, without and then with contrast dye CPT 74183 Hc Mri Abdomen W/Wo Contrast	$3,659.60	$9,149.00	—	4% above	60%
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 Hc Mri Abdomen W/Wo Contrast	$3,659.60	$9,149.00	—	—	60%
MRI of the brain, no contrast dye CPT 70551 Hc Mri Brain W/O Contrast	$1,331.20	$3,328.00	—	27% below	60%
MRI of the brain, no contrast dye inpatient CPT 70551 Hc Mri Brain W/O Contrast	$1,331.20	$3,328.00	—	—	60%
MRI of the brain, with and without contrast dye CPT 70553 Hc Mri Brain W/Wo Contrast	$2,183.20	$5,458.00	—	25% below	60%
MRI of the brain, with and without contrast dye inpatient CPT 70553 Hc Mri Brain W/Wo Contrast	$2,183.20	$5,458.00	—	—	60%
MRI of the lower back, no contrast dye CPT 72148 Hc Mri Lumbar Spine W/O Contrst	$1,790.00	$4,475.00	—	at median	60%
MRI of the lower back, no contrast dye inpatient CPT 72148 Hc Mri Lumbar Spine W/O Contrst	$1,790.00	$4,475.00	—	—	60%
MRI of the lower back, without and then with contrast dye CPT 72158 Hc Mri Lumbar Spine W/Wo Contrast	$3,330.40	$8,326.00	—	2% above	60%
MRI of the lower back, without and then with contrast dye inpatient CPT 72158 Hc Mri Lumbar Spine W/Wo Contrast	$3,330.40	$8,326.00	—	—	60%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 Hc Mri Thoracic Spine W/O Contrst	$2,069.20	$5,173.00	—	at median	60%
MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 Hc Mri Thoracic Spine W/O Contrst	$2,069.20	$5,173.00	—	—	60%
MRI of the neck (cervical spine) without and with contrast CPT 72156 Hc Mri Cervical Spine W/Wo Contrast	$2,583.20	$6,458.00	—	11% below	60%
MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 Hc Mri Cervical Spine W/Wo Contrast	$2,583.20	$6,458.00	—	—	60%
MRI of the neck (cervical spine), no contrast dye CPT 72141 Hc Mri Cervical Spine W/O Contrst	$1,388.80	$3,472.00	—	21% below	60%
MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 Hc Mri Cervical Spine W/O Contrst	$1,388.80	$3,472.00	—	—	60%
MRI of the pelvis without and with contrast CPT 72197 Hc Mri Pelvis W/Wo Contrast	$3,535.20	$8,838.00	—	at median	60%
MRI of the pelvis without and with contrast inpatient CPT 72197 Hc Mri Pelvis W/Wo Contrast	$3,535.20	$8,838.00	—	—	60%
MRI of the pelvis, no contrast dye CPT 72195 Hc Mri Pelvis W/O Contrast	$1,908.80	$4,772.00	—	3% below	60%
MRI of the pelvis, no contrast dye inpatient CPT 72195 Hc Mri Pelvis W/O Contrast	$1,908.80	$4,772.00	—	—	60%
MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 Hc Mri Upper Ext Jt W/O Contrast	$4,412.40	$11,031.00	—	108% above	60%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 Hc Mri Upper Ext Jt W/O Contrast	$4,412.40	$11,031.00	—	—	60%
Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 Hc Xr Cervical Spine 4 Views	$390.00	$975.00	—	11% below	60%
Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 Hc Xr Cervical Spine 4 Views	$390.00	$975.00	—	—	60%
Neck soft tissue CT scan with contrast CPT 70491 Hc Ct Neck Soft Tissue W/Contrast	$1,114.00	$2,785.00	—	18% below	60%
Neck soft tissue CT scan with contrast inpatient CPT 70491 Hc Ct Neck Soft Tissue W/Contrast	$1,114.00	$2,785.00	—	—	60%
Neck soft tissue CT scan without contrast CPT 70490 Hc Ct Neck Soft Tissue W/O Contrst	$924.40	$2,311.00	—	15% below	60%
Neck soft tissue CT scan without contrast inpatient CPT 70490 Hc Ct Neck Soft Tissue W/O Contrst	$924.40	$2,311.00	—	—	60%
Neck soft tissue X-ray CPT 70360 Hc Xr Neck Soft Tissue	$240.00	$600.00	—	14% below	60%
Neck soft tissue X-ray inpatient CPT 70360 Hc Xr Neck Soft Tissue	$240.00	$600.00	—	—	60%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 Hc Myocardial Perfus Spect Mult Rest/Stres	$1,937.60	$4,844.00	—	51% below	60%
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 Hc Myocardial Perfus Spect Mult Rest/Stres	$1,937.60	$4,844.00	—	—	60%
OCT scan of the retina (optical coherence tomography) CPT 92134 Hc Oct Retina Exam	$396.00	$990.00	—	160% above	60%
OCT scan of the retina (optical coherence tomography) inpatient CPT 92134 Hc Oct Retina Exam	$396.00	$990.00	—	—	60%
PET/CT scan from the base of the skull to mid-thigh CPT 78815 Hc Pet W Ct Skull-Thigh Tumor Image	$4,235.60	$10,589.00	—	42% below	60%
PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 Hc Pet W Ct Skull-Thigh Tumor Image	$4,235.60	$10,589.00	—	—	60%
Pelvic CT scan without contrast CPT 72192 Hc Ct Pelvis Wo Contrast	$1,094.00	$2,735.00	—	at median	60%
Pelvic CT scan without contrast inpatient CPT 72192 Hc Ct Pelvis Wo Contrast	$1,094.00	$2,735.00	—	—	60%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 Hc Us Pelvis Non Ob Limited/Follow Up	$446.80	$1,117.00	—	at median	60%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 Hc Us Pelvis Non Ob Limited/Follow Up	$446.80	$1,117.00	—	—	60%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 Hc Us Pelvis Non Ob Complete	$446.80	$1,117.00	—	23% below	60%
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 Hc Us Pelvis Non Ob Complete	$446.80	$1,117.00	—	—	60%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 Hc Us Preg Uterus >= 14 Wk Transab Sgl/1St	$645.20	$1,613.00	—	5% above	60%
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 Hc Us Preg Uterus >= 14 Wk Transab Sgl/1St	$645.20	$1,613.00	—	—	60%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 Hc Us Preg Uterus < 14 Wk Transab Sgl/1St	$561.20	$1,403.00	—	at median	60%
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 Hc Us Preg Uterus < 14 Wk Transab Sgl/1St	$561.20	$1,403.00	—	—	60%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 Hc Us Pregnant Uterus Limited	$432.80	$1,082.00	—	19% below	60%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 Hc Us Pregnant Uterus Limited	$432.80	$1,082.00	—	—	60%
Rib X-ray, one side, 2 views one side CPT 71100 Hc Xr Ribs Unilateral	$179.60	$449.00	—	47% below	60%
Rib X-ray, one side, 2 views inpatient one side CPT 71100 Hc Xr Ribs Unilateral	$179.60	$449.00	—	—	60%
Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 Hc Xr Ribs Unilateral With Pa Chest	$206.80	$517.00	—	50% below	60%
Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 Hc Xr Ribs Unilateral With Pa Chest	$206.80	$517.00	—	—	60%
Screening mammogram, both breasts both sides CPT 77067 Sc Scr Mammo Bi Incl Cad	$272.40	$681.00	—	—	60%
Screening mammogram, both breasts inpatient both sides CPT 77067 Sc Scr Mammo Bi Incl Cad	$272.40	$681.00	—	—	60%
Shoulder X-ray, complete, 2 or more views CPT 73030 Hc Xr Shoulder Complete	$284.80	$712.00	—	16% below	60%
Shoulder X-ray, complete, 2 or more views inpatient CPT 73030 Hc Xr Shoulder Complete	$284.80	$712.00	—	—	60%
Sinus X-ray, complete, 3 or more views CPT 70220 Hc Xr Sinuses Complete	$177.20	$443.00	—	58% below	60%
Sinus X-ray, complete, 3 or more views inpatient CPT 70220 Hc Xr Sinuses Complete	$177.20	$443.00	—	—	60%
Skull X-ray, fewer than 4 views CPT 70250 Hc Xr Skull Survey Ap & Lateral	$234.00	$585.00	—	34% below	60%
Skull X-ray, fewer than 4 views inpatient CPT 70250 Hc Xr Skull Survey Ap & Lateral	$234.00	$585.00	—	—	60%
Sleep study in a lab (polysomnography) CPT 95810 Hc Psg Type Ii	$2,989.20	$7,473.00	—	14% below	60%
Sleep study in a lab (polysomnography) inpatient CPT 95810 Hc Psg Type Ii	$2,989.20	$7,473.00	—	—	60%
Stress echocardiogram, complete, including the stress test and supervision CPT 93351 Hc Stress Echo W/Cont Ekg Monitor	$738.00	$1,845.00	—	59% below	60%
Stress echocardiogram, complete, including the stress test and supervision inpatient CPT 93351 Hc Stress Echo W/Cont Ekg Monitor	$738.00	$1,845.00	—	—	60%
Swallow study (modified barium swallow, video X-ray) CPT 74230 Hc Swallowing Function Cine/Video	$350.40	$876.00	—	41% below	60%
Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 Hc Swallowing Function Cine/Video	$350.40	$876.00	—	—	60%
Thigh bone (femur) X-ray, 2 or more views CPT 73552 Hc Xr Femur Min 2 Views	$468.00	$1,170.00	—	17% above	60%
Thigh bone (femur) X-ray, 2 or more views inpatient CPT 73552 Hc Xr Femur Min 2 Views	$468.00	$1,170.00	—	—	60%
Thoracic spine (mid back) CT scan without contrast CPT 72128 Hc Ct Thoracic Spine Wo Contrast	$925.20	$2,313.00	—	21% below	60%
Thoracic spine (mid back) CT scan without contrast inpatient CPT 72128 Hc Ct Thoracic Spine Wo Contrast	$925.20	$2,313.00	—	—	60%
Toe X-ray, 2 or more views CPT 73660 Hc Xr Toe/Toes Min 2 Views	$382.40	$956.00	—	37% above	60%
Toe X-ray, 2 or more views inpatient CPT 73660 Hc Xr Toe/Toes Min 2 Views	$382.40	$956.00	—	—	60%
Transvaginal pelvic ultrasound CPT 76830 Hc Us Transvaginal Pelvis; Non Ob	$391.60	$979.00	—	30% below	60%
Transvaginal pelvic ultrasound inpatient CPT 76830 Hc Us Transvaginal Pelvis; Non Ob	$391.60	$979.00	—	—	60%
Transvaginal ultrasound during pregnancy CPT 76817 Hc Us Preg Uterus Transvaginal	$497.60	$1,244.00	—	10% below	60%
Transvaginal ultrasound during pregnancy inpatient CPT 76817 Hc Us Preg Uterus Transvaginal	$497.60	$1,244.00	—	—	60%
Ultrasound of the abdomen, complete CPT 76700 Hc Us Abdomen Complete	$540.00	$1,350.00	—	31% below	60%
Ultrasound of the abdomen, complete inpatient CPT 76700 Hc Us Abdomen Complete	$540.00	$1,350.00	—	—	60%
Ultrasound of the scrotum and testicles CPT 76870 Hc Us Scrotum	$406.40	$1,016.00	—	34% below	60%
Ultrasound of the scrotum and testicles inpatient CPT 76870 Hc Us Scrotum	$406.40	$1,016.00	—	—	60%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 Hc Us Soft Tissue Neck/Thyroid	$406.40	$1,016.00	—	29% below	60%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 Hc Us Soft Tissue Neck/Thyroid	$406.40	$1,016.00	—	—	60%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 Hc Upper Gi Without Kub	$409.60	$1,024.00	—	35% below	60%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 Hc Upper Gi Single-Contrast	$471.20	$1,178.00	—	25% below	60%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 Hc Upper Gi Without Kub	$409.60	$1,024.00	—	—	60%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 Hc Upper Gi Single-Contrast	$471.20	$1,178.00	—	—	60%
Upper arm X-ray (humerus), 2 views CPT 73060 Hc Xr Humerus Min 2 Views	$173.60	$434.00	—	37% below	60%
Upper arm X-ray (humerus), 2 views inpatient CPT 73060 Hc Xr Humerus Min 2 Views	$173.60	$434.00	—	—	60%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 Hc Duplex Scan Vein Le Unilat	$813.20	$2,033.00	—	27% above	60%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 Hc Duplex Scan Vein Le Unilat	$813.20	$2,033.00	—	—	60%
Wrist X-ray, 2 views CPT 73100 Hc Xr Wrist Ap Lateral Only	$213.20	$533.00	—	22% below	60%
Wrist X-ray, 2 views inpatient CPT 73100 Hc Xr Wrist Ap Lateral Only	$213.20	$533.00	—	—	60%
Wrist X-ray, complete, 3 or more views CPT 73110 Hc Xr Wrist Complete	$474.00	$1,185.00	—	47% above	60%
Wrist X-ray, complete, 3 or more views inpatient CPT 73110 Hc Xr Wrist Complete	$474.00	$1,185.00	—	—	60%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 Hc Hip Unilateral 2-3 Views	$206.00	$515.00	—	42% below	60%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 Hc Hip Unilateral 2-3 Views	$206.00	$515.00	—	—	60%
X-ray of the abdomen, 1 view CPT 74018 Hc Xr Abdomen, 1 View	$138.00	$345.00	—	51% below	60%
X-ray of the abdomen, 1 view inpatient CPT 74018 Hc Xr Abdomen, 1 View	$138.00	$345.00	—	—	60%
X-ray of the ankle, 2 views CPT 73600 Hc Xr Ankle 2 Views	$452.40	$1,131.00	—	34% above	60%
X-ray of the ankle, 2 views inpatient CPT 73600 Hc Xr Ankle 2 Views	$452.40	$1,131.00	—	—	60%
X-ray of the finger(s), 2 or more views CPT 73140 Hc Xr Fingers Min 2 Views	$168.00	$420.00	—	30% below	60%
X-ray of the finger(s), 2 or more views inpatient CPT 73140 Hc Xr Fingers Min 2 Views	$168.00	$420.00	—	—	60%
X-ray of the foot, 2 views CPT 73620 Hc Xr Foot 2 Views	$402.40	$1,006.00	—	24% above	60%
X-ray of the foot, 2 views inpatient CPT 73620 Hc Xr Foot 2 Views	$402.40	$1,006.00	—	—	60%
X-ray of the foot, complete, 3 or more views CPT 73630 Hc Xr Foot Complete	$452.40	$1,131.00	—	24% above	60%
X-ray of the foot, complete, 3 or more views inpatient CPT 73630 Hc Xr Foot Complete	$452.40	$1,131.00	—	—	60%
X-ray of the hand, 3 or more views CPT 73130 Hc Xr Hand Complete	$216.00	$540.00	—	27% below	60%
X-ray of the hand, 3 or more views inpatient CPT 73130 Hc Xr Hand Complete	$216.00	$540.00	—	—	60%
X-ray of the knee, 1 or 2 views CPT 73560 Hc Xr Knee 1-2 Views	$229.20	$573.00	—	19% below	60%
X-ray of the knee, 1 or 2 views inpatient CPT 73560 Hc Xr Knee 1-2 Views	$229.20	$573.00	—	—	60%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 Hc Xr Spine Lumbosacral 2-3 Views	$248.80	$622.00	—	32% below	60%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 Hc Xr Spine Lumbosacral 2-3 Views	$248.80	$622.00	—	—	60%
X-ray of the lower back, 4 or more views CPT 72110 Hc Xr Spine Lumbosacral Min 4 Views	$345.20	$863.00	—	24% below	60%
X-ray of the lower back, 4 or more views inpatient CPT 72110 Hc Xr Spine Lumbosacral Min 4 Views	$345.20	$863.00	—	—	60%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 Hc Xr Thoracic Spine Ap&Lateral Only	$360.40	$901.00	—	1% below	60%
X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 Hc Xr Thoracic Spine Ap&Lateral Only	$360.40	$901.00	—	—	60%
X-ray of the nasal bones, 3 or more views CPT 70160 Hc Xr Nasal Bones Complete	$258.00	$645.00	—	5% below	60%
X-ray of the nasal bones, 3 or more views inpatient CPT 70160 Hc Xr Nasal Bones Complete	$258.00	$645.00	—	—	60%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 Hc Xr Cervical Spine 2 Or 3 Views	$286.40	$716.00	—	14% below	60%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 Hc Xr Cervical Spine 2 Or 3 Views	$286.40	$716.00	—	—	60%
X-ray of the pelvis, 1 or 2 views CPT 72170 Hc Xr Pelvis 1-2 Views	$190.40	$476.00	—	35% below	60%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 Hc Xr Pelvis 1-2 Views	$190.40	$476.00	—	—	60%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 Hc Xr Sacrum And Coccyx Min 2 Views	$271.20	$678.00	—	19% below	60%
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 Hc Xr Sacrum And Coccyx Min 2 Views	$271.20	$678.00	—	—	60%

Lab tests

Procedure	Cash price	List price	Insurers pay	vs Pennsylvania	Off list
ACTH blood test CPT 82024 Hc Acth	$88.00	$220.00	—	60% below	60%
ACTH blood test inpatient CPT 82024 Hc Acth	$88.00	$220.00	—	—	60%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 Hc Sgpt (Alt)	$13.20	$33.00	—	64% below	60%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 Hc Alt Nafld	$15.20	$38.00	—	58% below	60%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 Hc Sgpt (Alt)	$13.20	$33.00	—	—	60%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 Hc Alt Nafld	$15.20	$38.00	—	—	60%
AST (aspartate aminotransferase) enzyme test CPT 84450 Hc Sgot (Ast)	$13.20	$33.00	—	64% below	60%
AST (aspartate aminotransferase) enzyme test CPT 84450 Hc Ast Nafld	$15.20	$38.00	—	58% below	60%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 Hc Sgot (Ast)	$13.20	$33.00	—	—	60%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 Hc Ast Nafld	$15.20	$38.00	—	—	60%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 Hc Acute Hepatitis Panel	$308.80	$772.00	—	at median	60%
Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 Hc Acute Hepatitis Panel	$308.80	$772.00	—	—	60%
Albumin blood test CPT 82040 Hc Iggsr Albumin 300	$15.20	$38.00	—	52% below	60%
Albumin blood test CPT 82040 Hc Albumin Serum	$15.20	$38.00	—	52% below	60%
Albumin blood test CPT 82040 Hc Mspan Albumin	$15.20	$38.00	—	52% below	60%
Albumin blood test CPT 82040 Hc Albumin Nafld	$15.20	$38.00	—	52% below	60%
Albumin blood test inpatient CPT 82040 Hc Albumin Serum	$15.20	$38.00	—	—	60%
Albumin blood test inpatient CPT 82040 Hc Iggsr Albumin 300	$15.20	$38.00	—	—	60%
Albumin blood test inpatient CPT 82040 Hc Mspan Albumin	$15.20	$38.00	—	—	60%
Albumin blood test inpatient CPT 82040 Hc Albumin Nafld	$15.20	$38.00	—	—	60%
Aldosterone blood test CPT 82088 Hc Aldosterone Serm	$84.40	$211.00	—	60% below	60%
Aldosterone blood test CPT 82088 Hc Aldosterone Ur	$84.40	$211.00	—	60% below	60%
Aldosterone blood test inpatient CPT 82088 Hc Aldosterone Serm	$84.40	$211.00	—	—	60%
Aldosterone blood test inpatient CPT 82088 Hc Aldosterone Ur	$84.40	$211.00	—	—	60%
Alkaline phosphatase (ALP) blood test CPT 84075 Hc Alk Phosphatase	$14.40	$36.00	—	60% below	60%
Alkaline phosphatase (ALP) blood test CPT 84075 Hc Alkpi Alk P'tase	$14.40	$36.00	—	60% below	60%
Alkaline phosphatase (ALP) blood test inpatient CPT 84075 Hc Alkpi Alk P'tase	$14.40	$36.00	—	—	60%
Alkaline phosphatase (ALP) blood test inpatient CPT 84075 Hc Alk Phosphatase	$14.40	$36.00	—	—	60%
Allergy blood test, specific IgE, per allergen CPT 86003 Hc Ige Allergen Each	$18.40	$46.00	—	43% below	60%
Allergy blood test, specific IgE, per allergen CPT 86003 Hc Allergy Specific Ige	$21.60	$54.00	—	33% below	60%
Allergy blood test, specific IgE, per allergen CPT 86003 Hc Immunocap Specific Ige Test	$21.60	$54.00	—	33% below	60%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Hc Ige Allergen Each	$18.40	$46.00	—	—	60%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Hc Immunocap Specific Ige Test	$21.60	$54.00	—	—	60%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Hc Allergy Specific Ige	$21.60	$54.00	—	—	60%
Alpha-fetoprotein (AFP) blood test CPT 82105 Hc Afp	$102.40	$256.00	—	7% below	60%
Alpha-fetoprotein (AFP) blood test CPT 82105 Hc Afp Tumor Marker	$102.40	$256.00	—	7% below	60%
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 Hc Afp	$102.40	$256.00	—	—	60%
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 Hc Afp Tumor Marker	$102.40	$256.00	—	—	60%
Ammonia blood test CPT 82140 Hc Stnrdq Ammonia	$40.40	$101.00	—	56% below	60%
Ammonia blood test CPT 82140 Hc Ammonia	$40.40	$101.00	—	56% below	60%
Ammonia blood test inpatient CPT 82140 Hc Ammonia	$40.40	$101.00	—	—	60%
Ammonia blood test inpatient CPT 82140 Hc Stnrdq Ammonia	$40.40	$101.00	—	—	60%
Amylase blood test CPT 82150 Hc Amyi-Amylase Isoenzymes	$38.00	$95.00	—	13% below	60%
Amylase blood test CPT 82150 Hc Redpath Amylase	$41.60	$104.00	—	5% below	60%
Amylase blood test CPT 82150 Hc Amylase	$41.60	$104.00	—	5% below	60%
Amylase blood test inpatient CPT 82150 Hc Amyi-Amylase Isoenzymes	$38.00	$95.00	—	—	60%
Amylase blood test inpatient CPT 82150 Hc Amylase	$41.60	$104.00	—	—	60%
Amylase blood test inpatient CPT 82150 Hc Redpath Amylase	$41.60	$104.00	—	—	60%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 Hc Cyclic Citrulintd Peptde A	$33.60	$84.00	—	61% below	60%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 Hc Cyclic Citrulintd Peptde A	$33.60	$84.00	—	—	60%
Antinuclear antibody (ANA) blood test, screen CPT 86038 Hc Ana	$74.40	$186.00	—	at median	60%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 Hc Ana	$74.40	$186.00	—	—	60%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 Hc Cardio Iq Probnp, N-Terminal	$85.20	$213.00	—	57% below	60%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 Hc B-Natriuretic Peptide	$85.20	$213.00	—	57% below	60%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 Hc Cardio Iq Probnp, N-Terminal	$85.20	$213.00	—	—	60%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 Hc B-Natriuretic Peptide	$85.20	$213.00	—	—	60%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Hc Cath Tip Culture	$117.20	$293.00	—	125% above	60%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Hc Wound Culture	$117.20	$293.00	—	125% above	60%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Hc Tissue Culture	$117.20	$293.00	—	125% above	60%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Hc Sputum Culture	$117.20	$293.00	—	125% above	60%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Hc Upper Resp Cult	$117.20	$293.00	—	125% above	60%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Hc Routine Culture	$117.20	$293.00	—	125% above	60%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Hc Genital Culture	$117.20	$293.00	—	125% above	60%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Hc Eye Culture	$117.20	$293.00	—	125% above	60%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Hc Ear Culture	$117.20	$293.00	—	125% above	60%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Hc Csf Culture	$117.20	$293.00	—	125% above	60%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Hc Fluid Culture	$117.20	$293.00	—	125% above	60%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Hc Fluid Culture	$117.20	$293.00	—	—	60%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Hc Cath Tip Culture	$117.20	$293.00	—	—	60%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Hc Wound Culture	$117.20	$293.00	—	—	60%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Hc Routine Culture	$117.20	$293.00	—	—	60%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Hc Tissue Culture	$117.20	$293.00	—	—	60%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Hc Csf Culture	$117.20	$293.00	—	—	60%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Hc Sputum Culture	$117.20	$293.00	—	—	60%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Hc Upper Resp Cult	$117.20	$293.00	—	—	60%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Hc Genital Culture	$117.20	$293.00	—	—	60%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Hc Eye Culture	$117.20	$293.00	—	—	60%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Hc Ear Culture	$117.20	$293.00	—	—	60%
Basic metabolic panel (blood test) CPT 80048 Hc Bmp With Total Calcium	$101.60	$254.00	—	31% above	60%
Basic metabolic panel (blood test) inpatient CPT 80048 Hc Bmp With Total Calcium	$101.60	$254.00	—	—	60%
Bilirubin blood test, total CPT 82247 Hc Bilirubin Total	$14.40	$36.00	—	55% below	60%
Bilirubin blood test, total inpatient CPT 82247 Hc Bilirubin Total	$14.40	$36.00	—	—	60%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 Hc Cell Block	$75.20	$188.00	—	58% below	60%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 Hc Surg Path Lvl Iv	$112.00	$280.00	—	37% below	60%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 Hc Path Level 4 Prostate	$112.00	$280.00	—	37% below	60%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 Hc Surgical Path Level 4 Tju	$888.00	$2,220.00	—	401% above	60%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 Hc Cell Block	$75.20	$188.00	—	—	60%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 Hc Surg Path Lvl Iv	$112.00	$280.00	—	—	60%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 Hc Path Level 4 Prostate	$112.00	$280.00	—	—	60%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 Hc Surgical Path Level 4 Tju	$888.00	$2,220.00	—	—	60%
Blood culture for bacteria CPT 87040 Hc Blood Culture	$84.80	$212.00	—	at median	60%
Blood culture for bacteria inpatient CPT 87040 Hc Blood Culture	$84.80	$212.00	—	—	60%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 Hc Collect Blood By Venipunture	$14.40	$36.00	—	4% below	60%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 Hc Venipuncture Collection	$14.40	$36.00	—	4% below	60%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 Hc Collect Blood By Venipunture	$14.40	$36.00	—	—	60%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 Hc Venipuncture Collection	$14.40	$36.00	—	—	60%
Blood glucose (sugar) test CPT 82947 Hc Glucose (Il Syn) Quan	$14.40	$36.00	—	44% below	60%
Blood glucose (sugar) test CPT 82947 Hc Glucose Nafld	$15.20	$38.00	—	41% below	60%
Blood glucose (sugar) test inpatient CPT 82947 Hc Glucose (Il Syn) Quan	$14.40	$36.00	—	—	60%
Blood glucose (sugar) test inpatient CPT 82947 Hc Glucose Nafld	$15.20	$38.00	—	—	60%
Blood lead test CPT 83655 Hc Lead Urine	$85.20	$213.00	—	9% above	60%
Blood lead test CPT 83655 Hc Hmsu-Lead (Urine)	$93.60	$234.00	—	20% above	60%
Blood lead test CPT 83655 Hc Hmsb-Lead (Blood)	$93.60	$234.00	—	20% above	60%
Blood lead test CPT 83655 Hc Lead	$93.60	$234.00	—	20% above	60%
Blood lead test inpatient CPT 83655 Hc Lead Urine	$85.20	$213.00	—	—	60%
Blood lead test inpatient CPT 83655 Hc Hmsb-Lead (Blood)	$93.60	$234.00	—	—	60%
Blood lead test inpatient CPT 83655 Hc Hmsu-Lead (Urine)	$93.60	$234.00	—	—	60%
Blood lead test inpatient CPT 83655 Hc Lead	$93.60	$234.00	—	—	60%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 Hc Beta Hcg Qual	$40.40	$101.00	—	19% below	60%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 Hc Beta Hcg Qual	$40.40	$101.00	—	—	60%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 Hc Arc Abo Type	$21.20	$53.00	—	84% below	60%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 Hc Blood Type Abo	$21.20	$53.00	—	84% below	60%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 Hc Arc Abo Type	$21.20	$53.00	—	—	60%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 Hc Blood Type Abo	$21.20	$53.00	—	—	60%
Blood urea nitrogen (BUN) test CPT 84520 Hc Bun Quan	$14.00	$35.00	—	48% below	60%
Blood urea nitrogen (BUN) test inpatient CPT 84520 Hc Bun Quan	$14.00	$35.00	—	—	60%
C-peptide blood test CPT 84681 Hc C-Peptide	$38.00	$95.00	—	65% below	60%
C-peptide blood test inpatient CPT 84681 Hc C-Peptide	$38.00	$95.00	—	—	60%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 Hc C-Reactive Protein(Crp)	$30.40	$76.00	—	15% below	60%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 Hc C-Reactive Protein(Crp)	$30.40	$76.00	—	—	60%
C. difficile toxin gene test (stool PCR) CPT 87493 Hc C.Diff Tox Gene,Amplifd Pr	$88.00	$220.00	—	58% below	60%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 Hc C.Diff Tox Gene,Amplifd Pr	$88.00	$220.00	—	—	60%
CA 19-9 blood test (tumor marker) CPT 86301 Hc Ca 19-9 Immunoassay Quant	$62.40	$156.00	—	53% below	60%
CA 19-9 blood test (tumor marker) inpatient CPT 86301 Hc Ca 19-9 Immunoassay Quant	$62.40	$156.00	—	—	60%
CA-125 blood test (ovarian cancer marker) CPT 86304 Hc Ca 125 Antigen	$126.40	$316.00	—	4% below	60%
CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 Hc Ca 125 Antigen	$126.40	$316.00	—	—	60%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 Hc Sars-Cov-2, Pcr (Covid-19)	$63.20	$158.00	—	31% below	60%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 Hc Covid-19 Sendout_3	$63.20	$158.00	—	31% below	60%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 Hc Covid-19 Sendout_3	$63.20	$158.00	—	—	60%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 Hc Sars-Cov-2, Pcr (Covid-19)	$63.20	$158.00	—	—	60%
Calcium blood test, total CPT 82310 Hc Calcium Total	$15.20	$38.00	—	55% below	60%
Calcium blood test, total inpatient CPT 82310 Hc Calcium Total	$15.20	$38.00	—	—	60%
Carcinoembryonic antigen (CEA) test CPT 82378 Hc Cea	$103.60	$259.00	—	13% below	60%
Carcinoembryonic antigen (CEA) test CPT 82378 Hc Redpath Cea	$103.60	$259.00	—	13% below	60%
Carcinoembryonic antigen (CEA) test inpatient CPT 82378 Hc Redpath Cea	$103.60	$259.00	—	—	60%
Carcinoembryonic antigen (CEA) test inpatient CPT 82378 Hc Cea	$103.60	$259.00	—	—	60%
Chickenpox (varicella) immunity blood test CPT 86787 Hc Var Zoster Ab Igm	$113.60	$284.00	—	34% above	60%
Chickenpox (varicella) immunity blood test CPT 86787 Hc Varicella Ab (Igg)	$113.60	$284.00	—	34% above	60%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 Hc Varicella Ab (Igg)	$113.60	$284.00	—	—	60%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 Hc Var Zoster Ab Igm	$113.60	$284.00	—	—	60%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Hc Chlamydia,Rna,Tma Rectal	$19.20	$48.00	—	90% below	60%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Hc Chlamyia Rna Tma Throat	$22.00	$55.00	—	89% below	60%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Hc Ss Ct/Ng Trach: Chlamydia Trach,Amp Probe	$45.60	$114.00	—	77% below	60%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Hc Hc Chlamydia/Gc,Rna,Tma Throat	$76.00	$190.00	—	61% below	60%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Hc Hc Chlamydia/Gc,Rna,Tma Rectal	$76.00	$190.00	—	61% below	60%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Hc Cgrnaq Chlamydia Trach	$101.60	$254.00	—	48% below	60%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Hc Chlamydia;Amp Probe	$101.60	$254.00	—	48% below	60%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Hc Ss Chlamydia Trach, Rna Amp Probe	$120.00	$300.00	—	39% below	60%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 Hc Chlamydia,Rna,Tma Rectal	$19.20	$48.00	—	—	60%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 Hc Chlamyia Rna Tma Throat	$22.00	$55.00	—	—	60%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 Hc Ss Ct/Ng Trach: Chlamydia Trach,Amp Probe	$45.60	$114.00	—	—	60%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 Hc Hc Chlamydia/Gc,Rna,Tma Rectal	$76.00	$190.00	—	—	60%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 Hc Hc Chlamydia/Gc,Rna,Tma Throat	$76.00	$190.00	—	—	60%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 Hc Chlamydia;Amp Probe	$101.60	$254.00	—	—	60%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 Hc Cgrnaq Chlamydia Trach	$101.60	$254.00	—	—	60%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 Hc Ss Chlamydia Trach, Rna Amp Probe	$120.00	$300.00	—	—	60%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Hc Lipid Panel So	$103.20	$258.00	—	16% above	60%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Hc Lipid Panel	$103.20	$258.00	—	16% above	60%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 Hc Lipid Panel So	$103.20	$258.00	—	—	60%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 Hc Lipid Panel	$103.20	$258.00	—	—	60%
Complete blood count (CBC) with differential CPT 85025 Hc Cbc Auto W/Auto Diff	$40.40	$101.00	—	21% below	60%
Complete blood count (CBC) with differential inpatient CPT 85025 Hc Cbc Auto W/Auto Diff	$40.40	$101.00	—	—	60%
Complete blood count (CBC), no differential CPT 85027 Hc Cbc Auto W/O Diff	$35.20	$88.00	—	19% below	60%
Complete blood count (CBC), no differential inpatient CPT 85027 Hc Cbc Auto W/O Diff	$35.20	$88.00	—	—	60%
Comprehensive metabolic panel (blood test) CPT 80053 Hc Comp Metab Panel	$172.00	$430.00	—	94% above	60%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 Hc Comp Metab Panel	$172.00	$430.00	—	—	60%
Cortisol blood test, total CPT 82533 Hc Cortisol Total	$95.60	$239.00	—	7% below	60%
Cortisol blood test, total inpatient CPT 82533 Hc Cortisol Total	$95.60	$239.00	—	—	60%
Creatine kinase (CK) blood test, total CPT 82550 Hc Cpk	$48.80	$122.00	—	8% above	60%
Creatine kinase (CK) blood test, total inpatient CPT 82550 Hc Cpk	$48.80	$122.00	—	—	60%
Creatinine blood test CPT 82565 Hc Creatinine Serum	$14.00	$35.00	—	59% below	60%
Creatinine blood test CPT 82565 Hc Creatinine,Serum	$26.80	$67.00	—	21% below	60%
Creatinine blood test inpatient CPT 82565 Hc Creatinine Serum	$14.00	$35.00	—	—	60%
Creatinine blood test inpatient CPT 82565 Hc Creatinine,Serum	$26.80	$67.00	—	—	60%
Cytomegalovirus (CMV) antibody test CPT 86644 Hc Rc-Dir Don Cmv Tst Per Un	$54.00	$135.00	—	38% below	60%
Cytomegalovirus (CMV) antibody test CPT 86644 Hc Cmv Ab Igg	$66.00	$165.00	—	24% below	60%
Cytomegalovirus (CMV) antibody test CPT 86644 Hc Arc-Cmv Neg (Per Unit)	$66.00	$165.00	—	24% below	60%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 Hc Rc-Dir Don Cmv Tst Per Un	$54.00	$135.00	—	—	60%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 Hc Arc-Cmv Neg (Per Unit)	$66.00	$165.00	—	—	60%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 Hc Cmv Ab Igg	$66.00	$165.00	—	—	60%
D-dimer blood test (blood clot marker) CPT 85379 Hc D-Dimer	$59.60	$149.00	—	13% below	60%
D-dimer blood test (blood clot marker) inpatient CPT 85379 Hc D-Dimer	$59.60	$149.00	—	—	60%
DHEA sulfate (DHEA-S) blood test CPT 82627 Hc Dhea-S	$105.60	$264.00	—	21% below	60%
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 Hc Dhea-S	$105.60	$264.00	—	—	60%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Hc Drug Monitor, Barbituates W/Conf, Urine	$30.80	$77.00	—	83% below	60%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Hc Drug Monitor, Oxycodone W/Conf, Urine	$30.80	$77.00	—	83% below	60%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Hc Drug Monitor, Marijuana Metab W/Conf, Urine	$30.80	$77.00	—	83% below	60%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Hc Drug Monitor, Opiods W/Conf, Urine	$30.80	$77.00	—	83% below	60%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Hc Drug Monitor, Benzo W/Conf, Urine	$30.80	$77.00	—	83% below	60%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Hc Drug Monitor, Amphetamines W/Conf, Urine	$30.80	$77.00	—	83% below	60%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Hc Drug Monitor, Alcohol Metad W/Conf, Urine	$30.80	$77.00	—	83% below	60%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Hc Drug Monitor, Buprenorphine/Naloxone, W/Conf, Urine	$30.80	$77.00	—	83% below	60%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Hc Drug Screen, Serum Or Blood	$40.80	$102.00	—	78% below	60%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Hc Carisoprodol Screen (U) W/Conf. ---Prsmv, Pr Date	$42.40	$106.00	—	77% below	60%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Hc Diurq Chromatog,Mult Analy	$66.00	$165.00	—	64% below	60%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Hc Tricyclic Drug Screen	$71.20	$178.00	—	61% below	60%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Hc Buprenophrine	$86.80	$217.00	—	52% below	60%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Hc Drug Screen Fentanyl, Urine	$105.60	$264.00	—	42% below	60%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Hc Drug Screen Urine	$108.00	$270.00	—	41% below	60%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Hc Drug Monitoring Panel 1	$113.60	$284.00	—	38% below	60%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Hc Meconium Drug Screen	$123.60	$309.00	—	32% below	60%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Hc Methadone 300	$176.40	$441.00	—	3% below	60%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Hc Oxycodone 300	$176.40	$441.00	—	3% below	60%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Hc Methaqualone	$176.40	$441.00	—	3% below	60%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Hc Drug Monitor, Opiods W/Conf, Urine	$30.80	$77.00	—	—	60%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Hc Drug Monitor, Alcohol Metad W/Conf, Urine	$30.80	$77.00	—	—	60%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Hc Drug Monitor, Benzo W/Conf, Urine	$30.80	$77.00	—	—	60%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Hc Drug Monitor, Buprenorphine/Naloxone, W/Conf, Urine	$30.80	$77.00	—	—	60%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Hc Drug Monitor, Barbituates W/Conf, Urine	$30.80	$77.00	—	—	60%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Hc Drug Monitor, Marijuana Metab W/Conf, Urine	$30.80	$77.00	—	—	60%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Hc Drug Monitor, Amphetamines W/Conf, Urine	$30.80	$77.00	—	—	60%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Hc Drug Monitor, Oxycodone W/Conf, Urine	$30.80	$77.00	—	—	60%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Hc Drug Screen, Serum Or Blood	$40.80	$102.00	—	—	60%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Hc Carisoprodol Screen (U) W/Conf. ---Prsmv, Pr Date	$42.40	$106.00	—	—	60%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Hc Diurq Chromatog,Mult Analy	$66.00	$165.00	—	—	60%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Hc Tricyclic Drug Screen	$71.20	$178.00	—	—	60%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Hc Buprenophrine	$86.80	$217.00	—	—	60%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Hc Drug Screen Fentanyl, Urine	$105.60	$264.00	—	—	60%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Hc Drug Screen Urine	$108.00	$270.00	—	—	60%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Hc Drug Monitoring Panel 1	$113.60	$284.00	—	—	60%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Hc Meconium Drug Screen	$123.60	$309.00	—	—	60%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Hc Methadone 300	$176.40	$441.00	—	—	60%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Hc Methaqualone	$176.40	$441.00	—	—	60%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Hc Oxycodone 300	$176.40	$441.00	—	—	60%
Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 Hc Electrolyte Panel	$50.80	$127.00	—	4% below	60%
Electrolyte panel (sodium, potassium, chloride, CO2) inpatient CPT 80051 Hc Electrolyte Panel	$50.80	$127.00	—	—	60%
Epstein-Barr virus (EBV) antibody test CPT 86665 Hc Ebve Eb Vca Igm	$101.60	$254.00	—	11% below	60%
Epstein-Barr virus (EBV) antibody test CPT 86665 Hc Ebve Eb Vca Igg	$101.60	$254.00	—	11% below	60%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 Hc Ebve Eb Vca Igg	$101.60	$254.00	—	—	60%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 Hc Ebve Eb Vca Igm	$101.60	$254.00	—	—	60%
Estradiol blood test CPT 82670 Hc Estusq Estradiol	$22.40	$56.00	—	87% below	60%
Estradiol blood test CPT 82670 Hc Estrfq Estradiol	$49.60	$124.00	—	70% below	60%
Estradiol blood test CPT 82670 Hc Estradiol	$150.00	$375.00	—	10% below	60%
Estradiol blood test inpatient CPT 82670 Hc Estusq Estradiol	$22.40	$56.00	—	—	60%
Estradiol blood test inpatient CPT 82670 Hc Estrfq Estradiol	$49.60	$124.00	—	—	60%
Estradiol blood test inpatient CPT 82670 Hc Estradiol	$150.00	$375.00	—	—	60%
FSH (follicle-stimulating hormone) test CPT 83001 Hc Fsh	$107.60	$269.00	—	10% below	60%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 Hc Fsh	$107.60	$269.00	—	—	60%
Fecal calprotectin (stool inflammation test) CPT 83993 Hc Calprotectin, Stool	$49.20	$123.00	—	62% below	60%
Fecal calprotectin (stool inflammation test) inpatient CPT 83993 Hc Calprotectin, Stool	$49.20	$123.00	—	—	60%
Ferritin blood test (iron stores) CPT 82728 Hc Ferritin	$80.00	$200.00	—	8% below	60%
Ferritin blood test (iron stores) inpatient CPT 82728 Hc Ferritin	$80.00	$200.00	—	—	60%
Fibrinogen blood test CPT 85384 Hc Fibrinogen Activated	$48.80	$122.00	—	26% below	60%
Fibrinogen blood test CPT 85384 Hc Teg,Fibrinogen;Activity	$48.80	$122.00	—	26% below	60%
Fibrinogen blood test CPT 85384 Hc Fibrinogen	$48.80	$122.00	—	26% below	60%
Fibrinogen blood test inpatient CPT 85384 Hc Fibrinogen Activated	$48.80	$122.00	—	—	60%
Fibrinogen blood test inpatient CPT 85384 Hc Fibrinogen	$48.80	$122.00	—	—	60%
Fibrinogen blood test inpatient CPT 85384 Hc Teg,Fibrinogen;Activity	$48.80	$122.00	—	—	60%
Folate (folic acid) blood test CPT 82746 Hc Folate (Fol Acid)	$86.80	$217.00	—	at median	60%
Folate (folic acid) blood test inpatient CPT 82746 Hc Folate (Fol Acid)	$86.80	$217.00	—	—	60%
Free T3 thyroid hormone test CPT 84481 Hc Free T3	$100.40	$251.00	—	6% below	60%
Free T3 thyroid hormone test inpatient CPT 84481 Hc Free T3	$100.40	$251.00	—	—	60%
Free T4 (free thyroxine) thyroid blood test CPT 84439 Hc T4 Free/Direct Dial	$78.00	$195.00	—	30% above	60%
Free T4 (free thyroxine) thyroid blood test CPT 84439 Hc Free T4-Thyroxine	$78.00	$195.00	—	30% above	60%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 Hc T4 Free/Direct Dial	$78.00	$195.00	—	—	60%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 Hc Free T4-Thyroxine	$78.00	$195.00	—	—	60%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 Hc Ggt	$41.60	$104.00	—	13% below	60%
Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 Hc Ggt	$41.60	$104.00	—	—	60%
General health panel: metabolic panel, blood count and TSH in one order CPT 80050 Hc General Health Panel	$94.00	$235.00	—	50% below	60%
General health panel: metabolic panel, blood count and TSH in one order inpatient CPT 80050 Hc General Health Panel	$94.00	$235.00	—	—	60%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 Hc Glucose Post Dose	$26.40	$66.00	—	29% below	60%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 Hc Glucose Post Dose	$26.40	$66.00	—	—	60%
Glucose tolerance test, 3 samples CPT 82951 Hc Tol Test = 3 Spec	$78.40	$196.00	—	3% below	60%
Glucose tolerance test, 3 samples inpatient CPT 82951 Hc Tol Test = 3 Spec	$78.40	$196.00	—	—	60%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 Hc N.Gon,Rna, Tma Throat	$22.00	$55.00	—	88% below	60%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 Hc Ss N.Gonorrhoeae, Amp Probe	$45.60	$114.00	—	75% below	60%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 Hc Hc Gonorrhoeae/Gc,Rna,Tma Rectal	$76.00	$190.00	—	59% below	60%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 Hc Hc Gonorrhoeae/Gc,Rna,Tma Throat	$76.00	$190.00	—	59% below	60%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 Hc Gonorrhoeae;Amp Probe	$101.60	$254.00	—	45% below	60%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 Hc Cgrnaq Gonorrhoeae	$101.60	$254.00	—	45% below	60%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 Hc Ss N.Gonorrhoeae,Amp,Dna	$120.00	$300.00	—	35% below	60%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 Hc N.Gon,Rna, Tma Rectal	$260.40	$651.00	—	42% above	60%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 Hc N.Gon,Rna, Tma Throat	$22.00	$55.00	—	—	60%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 Hc Ss N.Gonorrhoeae, Amp Probe	$45.60	$114.00	—	—	60%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 Hc Hc Gonorrhoeae/Gc,Rna,Tma Rectal	$76.00	$190.00	—	—	60%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 Hc Hc Gonorrhoeae/Gc,Rna,Tma Throat	$76.00	$190.00	—	—	60%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 Hc Cgrnaq Gonorrhoeae	$101.60	$254.00	—	—	60%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 Hc Gonorrhoeae;Amp Probe	$101.60	$254.00	—	—	60%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 Hc Ss N.Gonorrhoeae,Amp,Dna	$120.00	$300.00	—	—	60%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 Hc N.Gon,Rna, Tma Rectal	$260.40	$651.00	—	—	60%
H. pylori stool antigen test CPT 87338 Hc Helicobacter Pylori Ag	$70.80	$177.00	—	27% below	60%
H. pylori stool antigen test inpatient CPT 87338 Hc Helicobacter Pylori Ag	$70.80	$177.00	—	—	60%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 Hc Hiv-1 Rna Pcr Ul Trasens	$157.60	$394.00	—	68% below	60%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 Hc Hiv-1 Rna Pcr Quant	$190.00	$475.00	—	62% below	60%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 Hc Hiv-1 Rna Pcr Ul Trasens	$157.60	$394.00	—	—	60%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 Hc Hiv-1 Rna Pcr Quant	$190.00	$475.00	—	—	60%
HIV-1 and HIV-2 antibody test CPT 86703 Hc Rapid Hiv 1/2 Antibody	$95.20	$238.00	—	8% below	60%
HIV-1 and HIV-2 antibody test inpatient CPT 86703 Hc Rapid Hiv 1/2 Antibody	$95.20	$238.00	—	—	60%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 Hc Hiv 1&2 Ab Screen	$49.20	$123.00	—	65% below	60%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 Hc Hiv 1&2 Ab Screen	$49.20	$123.00	—	—	60%
HPV test for high-risk types, one combined (pooled) result CPT 87624 Hc Hpv Hybrid Captr 2 Dna Tst	$116.00	$290.00	—	44% below	60%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 Hc Hpv Hybrid Captr 2 Dna Tst	$116.00	$290.00	—	—	60%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 Hc Hemoglobin A1C W/ Eag, Glycosylated	$12.40	$31.00	—	76% below	60%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 Hc Hemoglb; Glycosylated A1C	$69.20	$173.00	—	36% above	60%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 Hc Hemoglobin A1C W/ Eag, Glycosylated	$12.40	$31.00	—	—	60%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 Hc Hemoglb; Glycosylated A1C	$69.20	$173.00	—	—	60%
Hemoglobin blood test CPT 85018 Hc Hemoglobin	$19.20	$48.00	—	12% above	60%
Hemoglobin blood test inpatient CPT 85018 Hc Hemoglobin	$19.20	$48.00	—	—	60%
Hepatitis B core antibody test (total) CPT 86704 Hc Hep B Core Ab	$96.00	$240.00	—	14% above	60%
Hepatitis B core antibody test (total) inpatient CPT 86704 Hc Hep B Core Ab	$96.00	$240.00	—	—	60%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 Hc Hep B Surface Ab	$83.20	$208.00	—	14% above	60%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 Hc Hep B Surface Ab	$83.20	$208.00	—	—	60%
Hepatitis B surface antigen (HBsAg) test CPT 87340 Hc Hep B Surface Ag	$69.60	$174.00	—	at median	60%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 Hc Hep B Surface Ag	$69.60	$174.00	—	—	60%
Hepatitis C antibody blood test (screening) CPT 86803 Hc Hep C Antibody	$95.60	$239.00	—	4% below	60%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 Hc Hep C Antibody	$95.60	$239.00	—	—	60%
Hepatitis C viral load (HCV RNA) test CPT 87522 Hc Hcv Rna Pcr Quant Amp Pr	$82.80	$207.00	—	71% below	60%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 Hc Hcv Rna Pcr Quant Amp Pr	$82.80	$207.00	—	—	60%
Herpes blood test, HSV-1 antibody CPT 86695 Hc Hsv 1/2 Igg Specific Antibodies: Hsv Type 1	$15.20	$38.00	—	81% below	60%
Herpes blood test, HSV-1 antibody CPT 86695 Hc Hsvg/Hgcsf Herpes 1	$73.20	$183.00	—	8% below	60%
Herpes blood test, HSV-1 antibody CPT 86695 Hc Hsv 1 Igm	$73.20	$183.00	—	8% below	60%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 Hc Hsv 1/2 Igg Specific Antibodies: Hsv Type 1	$15.20	$38.00	—	—	60%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 Hc Hsv 1 Igm	$73.20	$183.00	—	—	60%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 Hc Hsvg/Hgcsf Herpes 1	$73.20	$183.00	—	—	60%
Herpes blood test, HSV-2 antibody CPT 86696 Hc Antibody Hsv Type 2	$15.20	$38.00	—	86% below	60%
Herpes blood test, HSV-2 antibody CPT 86696 Hc Herpes Simplex Igg Type 2	$17.60	$44.00	—	84% below	60%
Herpes blood test, HSV-2 antibody CPT 86696 Hc Hsv 2 Igm	$54.00	$135.00	—	50% below	60%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 Hc Antibody Hsv Type 2	$15.20	$38.00	—	—	60%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 Hc Herpes Simplex Igg Type 2	$17.60	$44.00	—	—	60%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 Hc Hsv 2 Igm	$54.00	$135.00	—	—	60%
High-sensitivity CRP (hs-CRP) test CPT 86141 Hc Cardio Iq Hs-Crp	$27.60	$69.00	—	65% below	60%
High-sensitivity CRP (hs-CRP) test CPT 86141 Hc Crp, High Sensitive	$33.60	$84.00	—	57% below	60%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 Hc Cardio Iq Hs-Crp	$27.60	$69.00	—	—	60%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 Hc Crp, High Sensitive	$33.60	$84.00	—	—	60%
Homocysteine blood test CPT 83090 Hc Homocystine	$59.60	$149.00	—	50% below	60%
Homocysteine blood test inpatient CPT 83090 Hc Homocystine	$59.60	$149.00	—	—	60%
Insulin blood test CPT 83525 Hc Insulin	$38.00	$95.00	—	48% below	60%
Insulin blood test inpatient CPT 83525 Hc Insulin	$38.00	$95.00	—	—	60%
Iron blood test (serum iron) CPT 83540 Hc Iron	$54.40	$136.00	—	19% above	60%
Iron blood test (serum iron) inpatient CPT 83540 Hc Iron	$54.40	$136.00	—	—	60%
Iron-binding capacity (TIBC) test CPT 83550 Hc Iron Binding	$49.20	$123.00	—	18% below	60%
Iron-binding capacity (TIBC) test inpatient CPT 83550 Hc Iron Binding	$49.20	$123.00	—	—	60%
Kidney function blood test panel CPT 80069 Hc Renal Panel	$68.40	$171.00	—	at median	60%
Kidney function blood test panel inpatient CPT 80069 Hc Renal Panel	$68.40	$171.00	—	—	60%
LH (luteinizing hormone) test CPT 83002 Hc Lh Leut Hormone	$102.40	$256.00	—	14% below	60%
LH (luteinizing hormone) test inpatient CPT 83002 Hc Lh Leut Hormone	$102.40	$256.00	—	—	60%
Lactate (lactic acid) blood test CPT 83605 Hc Lactate	$76.80	$192.00	—	at median	60%
Lactate (lactic acid) blood test inpatient CPT 83605 Hc Lactate	$76.80	$192.00	—	—	60%
Lactate dehydrogenase (LDH) blood test CPT 83615 Hc Ldh, Pericardial Fluid	$11.60	$29.00	—	68% below	60%
Lactate dehydrogenase (LDH) blood test CPT 83615 Hc Ldh Quest	$32.00	$80.00	—	13% below	60%
Lactate dehydrogenase (LDH) blood test CPT 83615 Hc Ldh	$32.00	$80.00	—	13% below	60%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 Hc Ldh, Pericardial Fluid	$11.60	$29.00	—	—	60%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 Hc Ldh	$32.00	$80.00	—	—	60%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 Hc Ldh Quest	$32.00	$80.00	—	—	60%
Lipase blood test (pancreas enzyme) CPT 83690 Hc Lipase	$40.80	$102.00	—	13% below	60%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 Hc Lipase	$40.80	$102.00	—	—	60%
Liver function blood test panel CPT 80076 Hc Hepatic Function Panel	$91.60	$229.00	—	17% above	60%
Liver function blood test panel inpatient CPT 80076 Hc Hepatic Function Panel	$91.60	$229.00	—	—	60%
Lyme disease antibody test CPT 86618 Hc Lyme Ab (Igm)	$83.60	$209.00	—	12% below	60%
Lyme disease antibody test CPT 86618 Hc Lyme Ab (Capture)	$83.60	$209.00	—	12% below	60%
Lyme disease antibody test CPT 86618 Hc Lyme Ab Igg & Igm	$92.00	$230.00	—	3% below	60%
Lyme disease antibody test inpatient CPT 86618 Hc Lyme Ab (Capture)	$83.60	$209.00	—	—	60%
Lyme disease antibody test inpatient CPT 86618 Hc Lyme Ab (Igm)	$83.60	$209.00	—	—	60%
Lyme disease antibody test inpatient CPT 86618 Hc Lyme Ab Igg & Igm	$92.00	$230.00	—	—	60%
Magnesium blood test CPT 83735 Hc Lax Magnesium	$34.00	$85.00	—	18% below	60%
Magnesium blood test CPT 83735 Hc Magnesium	$37.60	$94.00	—	10% below	60%
Magnesium blood test CPT 83735 Hc Magnesium, Rbc	$37.60	$94.00	—	10% below	60%
Magnesium blood test CPT 83735 Hc Stnrdq Magnesium 300	$37.60	$94.00	—	10% below	60%
Magnesium blood test inpatient CPT 83735 Hc Lax Magnesium	$34.00	$85.00	—	—	60%
Magnesium blood test inpatient CPT 83735 Hc Magnesium, Rbc	$37.60	$94.00	—	—	60%
Magnesium blood test inpatient CPT 83735 Hc Stnrdq Magnesium 300	$37.60	$94.00	—	—	60%
Magnesium blood test inpatient CPT 83735 Hc Magnesium	$37.60	$94.00	—	—	60%
Measles (rubeola) antibody test CPT 86765 Hc Rubeola Ab Igg	$140.40	$351.00	—	74% above	60%
Measles (rubeola) antibody test CPT 86765 Hc Rubeola Ab Igm	$140.40	$351.00	—	74% above	60%
Measles (rubeola) antibody test inpatient CPT 86765 Hc Rubeola Ab Igm	$140.40	$351.00	—	—	60%
Measles (rubeola) antibody test inpatient CPT 86765 Hc Rubeola Ab Igg	$140.40	$351.00	—	—	60%
Mono test (heterophile antibody, Monospot) CPT 86308 Hc Heterophile Ab	$38.80	$97.00	—	4% above	60%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 Hc Heterophile Ab	$38.80	$97.00	—	—	60%
Mumps immunity blood test CPT 86735 Hc Mumps Virus Igm	$33.60	$84.00	—	59% below	60%
Mumps immunity blood test CPT 86735 Hc Mumps Igg Antibody	$33.60	$84.00	—	59% below	60%
Mumps immunity blood test inpatient CPT 86735 Hc Mumps Virus Igm	$33.60	$84.00	—	—	60%
Mumps immunity blood test inpatient CPT 86735 Hc Mumps Igg Antibody	$33.60	$84.00	—	—	60%
Obstetric blood test panel CPT 80055 Hc Obsteric Panel	$51.60	$129.00	—	83% below	60%
Obstetric blood test panel inpatient CPT 80055 Hc Obsteric Panel	$51.60	$129.00	—	—	60%
PSA (prostate-specific antigen) blood test, free CPT 84154 Hc Free Psa Battery (Free Psa 300	$56.80	$142.00	—	50% below	60%
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 Hc Free Psa Battery (Free Psa 300	$56.80	$142.00	—	—	60%
PSA (prostate-specific antigen) blood test, total CPT 84153 Hc Psa Post Prostatectomy	$89.20	$223.00	—	19% below	60%
PSA (prostate-specific antigen) blood test, total CPT 84153 Hc Psa Total	$89.20	$223.00	—	19% below	60%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 Hc Psa Post Prostatectomy	$89.20	$223.00	—	—	60%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 Hc Psa Total	$89.20	$223.00	—	—	60%
Pap test (liquid-based, automated screening with review) CPT 88175 Hc Cytopthlgy,Cervical Or Vag	$76.00	$190.00	—	7% below	60%
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 Hc Cytopthlgy,Cervical Or Vag	$76.00	$190.00	—	—	60%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 Hc Thin Prep Diagnostic	$50.80	$127.00	—	17% below	60%
Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 Hc Thin Prep Diagnostic	$50.80	$127.00	—	—	60%
Parathyroid hormone (PTH) blood test CPT 83970 Hc Parathormone	$203.60	$509.00	—	7% below	60%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 Hc Parathormone	$203.60	$509.00	—	—	60%
Partial thromboplastin time (PTT) clotting test CPT 85730 Hc Von Wilie,Ptt Plasm/Whol	$45.60	$114.00	—	10% above	60%
Partial thromboplastin time (PTT) clotting test CPT 85730 Hc Ptt	$45.60	$114.00	—	10% above	60%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 Hc Ptt	$45.60	$114.00	—	—	60%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 Hc Von Wilie,Ptt Plasm/Whol	$45.60	$114.00	—	—	60%
Phosphorus (phosphate) blood test CPT 84100 Hc Lax Phosphate	$19.60	$49.00	—	40% below	60%
Phosphorus (phosphate) blood test CPT 84100 Hc Phosphorous-Inorg	$22.00	$55.00	—	32% below	60%
Phosphorus (phosphate) blood test inpatient CPT 84100 Hc Lax Phosphate	$19.60	$49.00	—	—	60%
Phosphorus (phosphate) blood test inpatient CPT 84100 Hc Phosphorous-Inorg	$22.00	$55.00	—	—	60%
Potassium blood test CPT 84132 Hc Potassium Serum	$15.20	$38.00	—	52% below	60%
Potassium blood test inpatient CPT 84132 Hc Potassium Serum	$15.20	$38.00	—	—	60%
Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) CPT 81420 Hc Qnatal Advanced Fetal Chromosomal Aneuploidy Genomic Seq Analys	$1,440.80	$3,602.00	—	38% below	60%
Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) CPT 81420 Hc Qnatal, Non Invasive Prenatal	$1,469.20	$3,673.00	—	37% below	60%
Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) inpatient CPT 81420 Hc Qnatal Advanced Fetal Chromosomal Aneuploidy Genomic Seq Analys	$1,440.80	$3,602.00	—	—	60%
Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) inpatient CPT 81420 Hc Qnatal, Non Invasive Prenatal	$1,469.20	$3,673.00	—	—	60%
Progesterone blood test CPT 84144 Hc Progesterone	$116.80	$292.00	—	15% below	60%
Progesterone blood test inpatient CPT 84144 Hc Progesterone	$116.80	$292.00	—	—	60%
Prolactin blood test CPT 84146 Hc Prolactin	$106.00	$265.00	—	15% below	60%
Prolactin blood test inpatient CPT 84146 Hc Prolactin	$106.00	$265.00	—	—	60%
Prothrombin time (PT/INR) clotting test CPT 85610 Hc Prothrombin Time	$22.40	$56.00	—	21% below	60%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 Hc Prothrombin Time	$22.40	$56.00	—	—	60%
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 Hc Drug Test Prsmv Qualdir Optical Obs Per Day	$23.20	$58.00	—	58% below	60%
Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 Hc Drug Test Prsmv Qualdir Optical Obs Per Day	$23.20	$58.00	—	—	60%
Rapid flu test (influenza antigen) CPT 87804 Hc Influenza Assay W/Optic	$19.20	$48.00	—	65% below	60%
Rapid flu test (influenza antigen) inpatient CPT 87804 Hc Influenza Assay W/Optic	$19.20	$48.00	—	—	60%
Renin blood test CPT 84244 Hc Renin Activity	$64.00	$160.00	—	56% below	60%
Renin blood test inpatient CPT 84244 Hc Renin Activity	$64.00	$160.00	—	—	60%
Rh blood typing CPT 86901 Hc Du Antigen	$18.00	$45.00	—	68% below	60%
Rh blood typing CPT 86901 Hc Arc Rh Type	$19.20	$48.00	—	66% below	60%
Rh blood typing CPT 86901 Hc Blood Type Rh (D)	$19.20	$48.00	—	66% below	60%
Rh blood typing inpatient CPT 86901 Hc Du Antigen	$18.00	$45.00	—	—	60%
Rh blood typing inpatient CPT 86901 Hc Blood Type Rh (D)	$19.20	$48.00	—	—	60%
Rh blood typing inpatient CPT 86901 Hc Arc Rh Type	$19.20	$48.00	—	—	60%
Rheumatoid factor (RF) test CPT 86431 Hc Rheum Factor Quant	$39.20	$98.00	—	at median	60%
Rheumatoid factor (RF) test inpatient CPT 86431 Hc Rheum Factor Quant	$39.20	$98.00	—	—	60%
Rubella antibody test (immunity check) CPT 86762 Hc Rubella Igm Ab	$84.40	$211.00	—	at median	60%
Rubella antibody test (immunity check) CPT 86762 Hc Rubella Ab Igg	$84.40	$211.00	—	at median	60%
Rubella antibody test (immunity check) inpatient CPT 86762 Hc Rubella Ab Igg	$84.40	$211.00	—	—	60%
Rubella antibody test (immunity check) inpatient CPT 86762 Hc Rubella Igm Ab	$84.40	$211.00	—	—	60%
Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 Hc Sed Rate	$22.40	$56.00	—	4% above	60%
Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 Hc Sed Rate	$22.40	$56.00	—	—	60%
Sodium blood test CPT 84295 Hc Sodium Serum	$15.20	$38.00	—	53% below	60%
Sodium blood test inpatient CPT 84295 Hc Sodium Serum	$15.20	$38.00	—	—	60%
Stool ova and parasites exam CPT 87177 Hc Ova And Parasites	$76.40	$191.00	—	30% above	60%
Stool ova and parasites exam inpatient CPT 87177 Hc Ova And Parasites	$76.40	$191.00	—	—	60%
Stool test for hidden blood (guaiac FOBT) CPT 82270 Hc Occult Bld Stool	$22.40	$56.00	—	10% above	60%
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 Hc Occult Bld Stool	$22.40	$56.00	—	—	60%
Stool test for hidden blood by immunoassay (FIT) CPT 82274 Hc Fit Fecal Occult Blood Diag	$39.20	$98.00	—	9% above	60%
Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 Hc Fit Fecal Occult Blood Diag	$39.20	$98.00	—	—	60%
Syphilis antibody test (Treponema pallidum) CPT 86780 Hc Syphilis	$15.20	$38.00	—	80% below	60%
Syphilis antibody test (Treponema pallidum) CPT 86780 Hc Treponema Pallidum Antibody, Particle Agglutination	$44.00	$110.00	—	41% below	60%
Syphilis antibody test (Treponema pallidum) CPT 86780 Hc Fluor Treponem Ab	$82.00	$205.00	—	10% above	60%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 Hc Syphilis	$15.20	$38.00	—	—	60%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 Hc Treponema Pallidum Antibody, Particle Agglutination	$44.00	$110.00	—	—	60%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 Hc Fluor Treponem Ab	$82.00	$205.00	—	—	60%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 Hc Rpr	$27.20	$68.00	—	3% below	60%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 Hc Rpr	$27.20	$68.00	—	—	60%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 Hc Tb Test Quanti Feron-Gold	$134.40	$336.00	—	57% below	60%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 Hc Tb Test Quanti Feron-Gold	$134.40	$336.00	—	—	60%
Testosterone blood test, total (not free testosterone) CPT 84403 Hc Btest Testost Tot	$165.60	$414.00	—	2% above	60%
Testosterone blood test, total (not free testosterone) CPT 84403 Hc Testosterone	$165.60	$414.00	—	2% above	60%
Testosterone blood test, total (not free testosterone) CPT 84403 Hc Testosterone; Total	$165.60	$414.00	—	2% above	60%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 Hc Testosterone	$165.60	$414.00	—	—	60%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 Hc Btest Testost Tot	$165.60	$414.00	—	—	60%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 Hc Testosterone; Total	$165.60	$414.00	—	—	60%
Thyroid peroxidase (TPO) antibody test CPT 86376 Hc Lkm-1 Ab Igg	$98.80	$247.00	—	31% above	60%
Thyroid peroxidase (TPO) antibody test CPT 86376 Hc Antimicrosomal Ab	$98.80	$247.00	—	31% above	60%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 Hc Lkm-1 Ab Igg	$98.80	$247.00	—	—	60%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 Hc Antimicrosomal Ab	$98.80	$247.00	—	—	60%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 Hc Tsh	$86.80	$217.00	—	13% below	60%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 Hc Tsh	$86.80	$217.00	—	—	60%
Total IgE blood test CPT 82785 Hc Gammaglobulin Ige	$88.80	$222.00	—	14% below	60%
Total IgE blood test inpatient CPT 82785 Hc Gammaglobulin Ige	$88.80	$222.00	—	—	60%
Total cholesterol blood test CPT 82465 Hc Cholesterol	$30.00	$75.00	—	1% below	60%
Total cholesterol blood test inpatient CPT 82465 Hc Cholesterol	$30.00	$75.00	—	—	60%
Total thyroxine (T4) blood test CPT 84436 Hc Total T4-Thyroxine	$42.00	$105.00	—	7% below	60%
Total thyroxine (T4) blood test inpatient CPT 84436 Hc Total T4-Thyroxine	$42.00	$105.00	—	—	60%
Total triiodothyronine (T3) blood test CPT 84480 Hc T3 Total	$108.40	$271.00	—	12% above	60%
Total triiodothyronine (T3) blood test inpatient CPT 84480 Hc T3 Total	$108.40	$271.00	—	—	60%
Transferrin blood test CPT 84466 Hc Transferrin	$110.00	$275.00	—	28% above	60%
Transferrin blood test inpatient CPT 84466 Hc Transferrin	$110.00	$275.00	—	—	60%
Trichomonas test (NAAT) CPT 87661 Hc Trichomonas Vaginalis Amp Probe	$42.00	$105.00	—	77% below	60%
Trichomonas test (NAAT) CPT 87661 Hc Trichomonas Vaginalis Amp	$74.40	$186.00	—	60% below	60%
Trichomonas test (NAAT) CPT 87661 Hc Ss V/V Plus: Trichomonas, Amp Probe	$120.00	$300.00	—	35% below	60%
Trichomonas test (NAAT) CPT 87661 Hc Trichomonas Vaginalis Amp,Dna	$154.40	$386.00	—	16% below	60%
Trichomonas test (NAAT) CPT 87661 Hc Trichomonas Vaginalis Amplif	$201.20	$503.00	—	9% above	60%
Trichomonas test (NAAT) inpatient CPT 87661 Hc Trichomonas Vaginalis Amp Probe	$42.00	$105.00	—	—	60%
Trichomonas test (NAAT) inpatient CPT 87661 Hc Trichomonas Vaginalis Amp	$74.40	$186.00	—	—	60%
Trichomonas test (NAAT) inpatient CPT 87661 Hc Ss V/V Plus: Trichomonas, Amp Probe	$120.00	$300.00	—	—	60%
Trichomonas test (NAAT) inpatient CPT 87661 Hc Trichomonas Vaginalis Amp,Dna	$154.40	$386.00	—	—	60%
Trichomonas test (NAAT) inpatient CPT 87661 Hc Trichomonas Vaginalis Amplif	$201.20	$503.00	—	—	60%
Triglycerides blood test CPT 84478 Hc Triglycerides	$46.40	$116.00	—	17% above	60%
Triglycerides blood test inpatient CPT 84478 Hc Triglycerides	$46.40	$116.00	—	—	60%
Troponin test, quantitative CPT 84484 Hc Troponin Quant	$76.80	$192.00	—	7% below	60%
Troponin test, quantitative inpatient CPT 84484 Hc Troponin Quant	$76.80	$192.00	—	—	60%
Uric acid blood test CPT 84550 Hc Uric Acid Serum	$24.80	$62.00	—	22% below	60%
Uric acid blood test inpatient CPT 84550 Hc Uric Acid Serum	$24.80	$62.00	—	—	60%
Urinalysis with microscope exam, automated CPT 81001 Hc Urinalysis Auto W/Micro	$28.00	$70.00	—	15% below	60%
Urinalysis with microscope exam, automated inpatient CPT 81001 Hc Urinalysis Auto W/Micro	$28.00	$70.00	—	—	60%
Urinalysis without microscope exam, automated CPT 81003 Hc Urinalysis Auto W/O Micro	$34.40	$86.00	—	93% above	60%
Urinalysis without microscope exam, automated CPT 81003 Hc Urinalysis Auto W/O Micro Poc	$34.40	$86.00	—	93% above	60%
Urinalysis without microscope exam, automated inpatient CPT 81003 Hc Urinalysis Auto W/O Micro Poc	$34.40	$86.00	—	—	60%
Urinalysis without microscope exam, automated inpatient CPT 81003 Hc Urinalysis Auto W/O Micro	$34.40	$86.00	—	—	60%
Urine culture for bacteria, with colony count CPT 87086 Hc Urine Culture	$60.00	$150.00	—	6% above	60%
Urine culture for bacteria, with colony count inpatient CPT 87086 Hc Urine Culture	$60.00	$150.00	—	—	60%
Urine microalbumin (albumin) test CPT 82043 Hc Microalbumin,Urine Quant 300	$26.40	$66.00	—	33% below	60%
Urine microalbumin (albumin) test inpatient CPT 82043 Hc Microalbumin,Urine Quant 300	$26.40	$66.00	—	—	60%
Urine pregnancy test, read by color change CPT 81025 Hc Urine Hcg Poc	$24.40	$61.00	—	34% below	60%
Urine pregnancy test, read by color change CPT 81025 Hc Urine Hcg Qual	$24.40	$61.00	—	34% below	60%
Urine pregnancy test, read by color change inpatient CPT 81025 Hc Urine Hcg Qual	$24.40	$61.00	—	—	60%
Urine pregnancy test, read by color change inpatient CPT 81025 Hc Urine Hcg Poc	$24.40	$61.00	—	—	60%
Vitamin B12 (cobalamin) blood test CPT 82607 Hc Vitamin B12	$86.80	$217.00	—	8% below	60%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 Hc Vitamin B12	$86.80	$217.00	—	—	60%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 Hc Vitamin D, 25-Hydroxy	$64.80	$162.00	—	57% below	60%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 Hc Vitamin D, 25-Hydroxy	$64.80	$162.00	—	—	60%
Vitamin D, 1,25-dihydroxy blood test CPT 82652 Hc Vitamin D 1 25 Dihyd	$93.60	$234.00	—	61% below	60%
Vitamin D, 1,25-dihydroxy blood test inpatient CPT 82652 Hc Vitamin D 1 25 Dihyd	$93.60	$234.00	—	—	60%
Zinc blood test CPT 84630 Hc Zinc Urine	$52.40	$131.00	—	27% below	60%
Zinc blood test CPT 84630 Hc Zinc	$64.00	$160.00	—	11% below	60%
Zinc blood test inpatient CPT 84630 Hc Zinc Urine	$52.40	$131.00	—	—	60%
Zinc blood test inpatient CPT 84630 Hc Zinc	$64.00	$160.00	—	—	60%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 Hc Prenatal Screens Hcg, Quant	$19.60	$49.00	—	78% below	60%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 Hc Beta Hcg Quant	$86.80	$217.00	—	3% below	60%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 Hc Prenatal Screens Hcg, Quant	$19.60	$49.00	—	—	60%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 Hc Beta Hcg Quant	$86.80	$217.00	—	—	60%

Surgery and procedures

Procedure	Cash price	List price	Insurers pay	vs Pennsylvania	Off list
Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 Hc Distal Fibular Fx W/O Manip	$622.40	$1,556.00	—	6% below	60%
Broken ankle (outer ankle bone) treatment without surgery or setting inpatient CPT 27786 Hc Distal Fibular Fx W/O Manip	$622.40	$1,556.00	—	—	60%
Broken foot (metatarsal) treatment without surgery or setting CPT 28470 Hc Metatarsal Fx W/O Manip	$502.00	$1,255.00	—	4% below	60%
Broken foot (metatarsal) treatment without surgery or setting inpatient CPT 28470 Hc Metatarsal Fx W/O Manip	$502.00	$1,255.00	—	—	60%
Cardiac catheterization with coronary angiogram CPT 93458 Hc Lhc With Coro Angio	$8,075.20	$20,188.00	—	8% below	60%
Cardiac catheterization with coronary angiogram inpatient CPT 93458 Hc Lhc With Coro Angio	$8,075.20	$20,188.00	—	—	60%
Cardioversion, elective (restoring heart rhythm) CPT 92960 Hc Cardioversion Elective-Conv	$1,121.60	$2,804.00	—	23% below	60%
Cardioversion, elective (restoring heart rhythm) CPT 92960 Hc Cardioversion	$1,121.60	$2,804.00	—	23% below	60%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 Hc Cardioversion	$1,121.60	$2,804.00	—	—	60%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 Hc Cardioversion Elective-Conv	$1,121.60	$2,804.00	—	—	60%
Catheter ablation for atrial fibrillation CPT 93656 Hc Tx Atrial Fib Pulm Vein Iso	$15,019.20	$37,548.00	—	52% below	60%
Catheter ablation for atrial fibrillation CPT 93656 Hc Amaze Afib Ablation	$15,019.20	$37,548.00	—	52% below	60%
Catheter ablation for atrial fibrillation inpatient CPT 93656 Hc Tx Atrial Fib Pulm Vein Iso	$15,019.20	$37,548.00	—	—	60%
Catheter ablation for atrial fibrillation inpatient CPT 93656 Hc Amaze Afib Ablation	$15,019.20	$37,548.00	—	—	60%
Cervical biopsy CPT 57500 Hc Bx/Exc Cervix Lesion	$1,464.00	$3,660.00	—	42% below	60%
Cervical biopsy inpatient CPT 57500 Hc Bx/Exc Cervix Lesion	$1,464.00	$3,660.00	—	—	60%
Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 Hc Circumcision	$945.60	$2,364.00	—	22% below	60%
Circumcision with a clamp or device and a numbing nerve block, usually newborns inpatient CPT 54150 Hc Circumcision	$945.60	$2,364.00	—	—	60%
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 Hc Clos Rx Dist Rad Fx;W/O Manip	$505.60	$1,264.00	—	24% below	60%
Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 Hc Clos Rx Dist Rad Fx;W/O Manip	$505.60	$1,264.00	—	—	60%
Colonoscopy with endoscopic ultrasound CPT 45391 Hc Colonoscopy W/Endoscope Us	$992.80	$2,482.00	—	57% below	60%
Colonoscopy with endoscopic ultrasound inpatient CPT 45391 Hc Colonoscopy W/Endoscope Us	$992.80	$2,482.00	—	—	60%
Colonoscopy with tissue sample CPT 45380 Hc Colonoscopy W/Biopsy Single/Multiple	$992.80	$2,482.00	—	55% below	60%
Colonoscopy with tissue sample CPT 45380 Hc Colonoscopy W/ Bx	$1,570.40	$3,926.00	—	29% below	60%
Colonoscopy with tissue sample CPT 45380 Hc Colonscopy Biopsy	$1,680.00	$4,200.00	—	24% below	60%
Colonoscopy with tissue sample inpatient CPT 45380 Hc Colonoscopy W/Biopsy Single/Multiple	$992.80	$2,482.00	—	—	60%
Colonoscopy with tissue sample inpatient CPT 45380 Hc Colonoscopy W/ Bx	$1,570.40	$3,926.00	—	—	60%
Colonoscopy with tissue sample inpatient CPT 45380 Hc Colonscopy Biopsy	$1,680.00	$4,200.00	—	—	60%
Colonoscopy, diagnostic CPT 45378 Hc Colonos;Flx;Diag;W/Wo Spc	$1,239.60	$3,099.00	—	17% below	60%
Colonoscopy, diagnostic inpatient CPT 45378 Hc Colonos;Flx;Diag;W/Wo Spc	$1,239.60	$3,099.00	—	—	60%
Colposcopy with cervical biopsy and scraping of the cervical canal CPT 57454 Hc Colposcopy + Biop	$215.60	$539.00	—	56% below	60%
Colposcopy with cervical biopsy and scraping of the cervical canal inpatient CPT 57454 Hc Colposcopy + Biop	$215.60	$539.00	—	—	60%
Coronary stent placement, one artery CPT 92928 Hc Coro Stent W/Angio 1 Vsl	$7,808.80	$19,522.00	—	61% below	60%
Coronary stent placement, one artery inpatient CPT 92928 Hc Coro Stent W/Angio 1 Vsl	$7,808.80	$19,522.00	—	—	60%
Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 Hc Cystourethroscopy	$216.80	$542.00	—	87% below	60%
Cystoscopy, diagnostic look inside the bladder and urethra inpatient CPT 52000 Hc Cystourethroscopy	$216.80	$542.00	—	—	60%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 Hc Destruct Premalg Lesion,One	$74.00	$185.00	—	83% below	60%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 Hc Dist Benign/Premalg Les 1	$78.00	$195.00	—	82% below	60%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 Hc Destruct Premalg Lesion,One	$74.00	$185.00	—	—	60%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 Hc Dist Benign/Premalg Les 1	$78.00	$195.00	—	—	60%
Earwax removal by irrigation (rinsing), one ear CPT 69209 Hc Remove Impacted Ear Wax Uni	$184.40	$461.00	—	32% above	60%
Earwax removal by irrigation (rinsing), one ear one side CPT 69209 Hc Removal Impacted Cerumen Irrigation/Lvg Unilat	$22.00	$55.00	—	84% below	60%
Earwax removal by irrigation (rinsing), one ear one side CPT 69209 Hc Remove Impacted Cerumen Unilat	$184.40	$461.00	—	32% above	60%
Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 Hc Remove Impacted Ear Wax Uni	$184.40	$461.00	—	—	60%
Earwax removal by irrigation (rinsing), one ear inpatient one side CPT 69209 Hc Removal Impacted Cerumen Irrigation/Lvg Unilat	$22.00	$55.00	—	—	60%
Earwax removal by irrigation (rinsing), one ear inpatient one side CPT 69209 Hc Remove Impacted Cerumen Unilat	$184.40	$461.00	—	—	60%
Earwax removal with instruments, one ear CPT 69210 Hc Remove Impacted Ear Wax Uni	$368.40	$921.00	—	175% above	60%
Earwax removal with instruments, one ear CPT 69210 Hc Removal Impact Cerumen Ear	$368.40	$921.00	—	175% above	60%
Earwax removal with instruments, one ear one side CPT 69210 Hc Removal Impacted Cerumen Instrumentation Unilat	$22.00	$55.00	—	84% below	60%
Earwax removal with instruments, one ear inpatient CPT 69210 Hc Removal Impact Cerumen Ear	$368.40	$921.00	—	—	60%
Earwax removal with instruments, one ear inpatient CPT 69210 Hc Remove Impacted Ear Wax Uni	$368.40	$921.00	—	—	60%
Earwax removal with instruments, one ear inpatient one side CPT 69210 Hc Removal Impacted Cerumen Instrumentation Unilat	$22.00	$55.00	—	—	60%
Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 Hc Endometrl Samplng	$237.20	$593.00	—	40% below	60%
Endometrial biopsy (uterine lining sample) without dilating the cervix inpatient CPT 58100 Hc Endometrl Samplng	$237.20	$593.00	—	—	60%
Eye injection into the vitreous (intravitreal injection) CPT 67028 Hc Injection Of Eye Drug	$225.20	$563.00	—	56% below	60%
Eye injection into the vitreous (intravitreal injection) inpatient CPT 67028 Hc Injection Of Eye Drug	$225.20	$563.00	—	—	60%
Facet joint injection, lower back, one level, with imaging guidance CPT 64493 Hc Inj Anes/Roids Lmb/Scr Sgl	$638.00	$1,595.00	—	56% below	60%
Facet joint injection, lower back, one level, with imaging guidance CPT 64493 Hc Inj Paravert Facet Joint	$937.20	$2,343.00	—	35% below	60%
Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 Hc Inj Anes/Roids Lmb/Scr Sgl	$638.00	$1,595.00	—	—	60%
Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 Hc Inj Paravert Facet Joint	$937.20	$2,343.00	—	—	60%
Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 Hc Sigmoidscpy W/Wo Br/Wash	$454.40	$1,136.00	—	61% below	60%
Flexible sigmoidoscopy, diagnostic (lower colon only) inpatient CPT 45330 Hc Sigmoidscpy W/Wo Br/Wash	$454.40	$1,136.00	—	—	60%
Hemorrhoid banding (rubber band ligation) CPT 46221 Hc Ligation Of Hemorrhoid(S)	$332.80	$832.00	—	81% below	60%
Hemorrhoid banding (rubber band ligation) inpatient CPT 46221 Hc Ligation Of Hemorrhoid(S)	$332.80	$832.00	—	—	60%
Hysteroscopy with uterine lining sampling and/or polyp removal CPT 58558 Hc Hysteroscopy Biopsy	$1,034.00	$2,585.00	—	80% below	60%
Hysteroscopy with uterine lining sampling and/or polyp removal inpatient CPT 58558 Hc Hysteroscopy Biopsy	$1,034.00	$2,585.00	—	—	60%
IUD insertion (the device itself billed separately) CPT 58300 Hc Insertion Iud	$62.00	$155.00	—	80% below	60%
IUD insertion (the device itself billed separately) inpatient CPT 58300 Hc Insertion Iud	$62.00	$155.00	—	—	60%
Incision and drainage of a simple or single skin abscess CPT 10060 Hc I&D Abscess Simple/Single	$366.40	$916.00	—	28% below	60%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 Hc I&D Abscess Simple/Single	$366.40	$916.00	—	—	60%
Inguinal (groin) hernia repair, age 5 or older CPT 49505 Hc Rpr Init Ing Hernia >5 Yr	$3,158.40	$7,896.00	—	45% below	60%
Inguinal (groin) hernia repair, age 5 or older inpatient CPT 49505 Hc Rpr Init Ing Hernia >5 Yr	$3,158.40	$7,896.00	—	—	60%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 Hc Inj Tnd Sth/Lig/Trgb Pt/Cys	$297.60	$744.00	—	48% below	60%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 Hc Inj Tendon Sheath/Ligament 510	$378.00	$945.00	—	34% below	60%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 Hc Inj Tnd Sth/Lig/Trgb Pt/Cys	$297.60	$744.00	—	—	60%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 Hc Inj Tendon Sheath/Ligament 510	$378.00	$945.00	—	—	60%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 Hc Arthrocentesis Aspir&/Inj Major Jt/Bursa W/O Us	$456.00	$1,140.00	—	3% below	60%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 Hc Arthrocent Mjr Jt/Bur/Gan	$500.80	$1,252.00	—	7% above	60%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 Hc Arthrocent Asp/Inj Jt Major	$500.80	$1,252.00	—	7% above	60%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 Hc Arthrocentesis Aspir&/Inj Major Jt/Bursa W/O Us	$456.00	$1,140.00	—	—	60%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 Hc Arthrocent Mjr Jt/Bur/Gan	$500.80	$1,252.00	—	—	60%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 Hc Arthrocent Asp/Inj Jt Major	$500.80	$1,252.00	—	—	60%
Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 Hc Insj Non-Biodegradable Drug Delivery Implant	$218.40	$546.00	—	14% below	60%
Insertion of a drug-delivery implant, such as the arm birth control implant inpatient CPT 11981 Hc Insj Non-Biodegradable Drug Delivery Implant	$218.40	$546.00	—	—	60%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 Hc Arthrocentesis Aspir&/Inj Interm Jt/Burs W/O Us	$335.20	$838.00	—	5% below	60%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 Hc Drain/Inject Joint/Bursa	$335.20	$838.00	—	5% below	60%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 Hc Arthrocent Int Jt/Burs/Gan	$405.20	$1,013.00	—	15% above	60%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 Hc Arthrocentesis Aspir&/Inj Interm Jt/Burs W/O Us	$335.20	$838.00	—	—	60%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 Hc Drain/Inject Joint/Bursa	$335.20	$838.00	—	—	60%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 Hc Arthrocent Int Jt/Burs/Gan	$405.20	$1,013.00	—	—	60%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 Hc Arthrocentesis - Aspir&/Inj Small Jt/Bursa W/O Us	$325.20	$813.00	—	21% below	60%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 Hc Arthrocent Sm Jt/Bursa/Gan	$350.40	$876.00	—	15% below	60%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 Hc Drain/Inject Sm Jnt/Bursa 510	$350.40	$876.00	—	15% below	60%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 Hc Arthrocentesis - Aspir&/Inj Small Jt/Bursa W/O Us	$325.20	$813.00	—	—	60%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 Hc Drain/Inject Sm Jnt/Bursa 510	$350.40	$876.00	—	—	60%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 Hc Arthrocent Sm Jt/Bursa/Gan	$350.40	$876.00	—	—	60%
Laser treatment of clouding after cataract surgery (YAG) CPT 66821 Hc After Cataract Laser Surg	$1,164.00	$2,910.00	—	25% above	60%
Laser treatment of clouding after cataract surgery (YAG) inpatient CPT 66821 Hc After Cataract Laser Surg	$1,164.00	$2,910.00	—	—	60%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 Hc Inter Rpr S/A/T/E <2.5Cm	$483.20	$1,208.00	—	18% below	60%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 Hc Rep Intermed 2.5Cm Or Less	$483.20	$1,208.00	—	18% below	60%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 Hc Rep Intermed 2.5Cm Or Less	$483.20	$1,208.00	—	—	60%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 Hc Inter Rpr S/A/T/E <2.5Cm	$483.20	$1,208.00	—	—	60%
Left heart catheterization, diagnostic CPT 93452 Hc Lhc Only	$5,228.00	$13,070.00	—	20% below	60%
Left heart catheterization, diagnostic inpatient CPT 93452 Hc Lhc Only	$5,228.00	$13,070.00	—	—	60%
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 Hc Inj Transforaminal Epidural	$1,234.40	$3,086.00	—	36% below	60%
Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 Hc Inj Transforaminal Epidural	$1,234.40	$3,086.00	—	—	60%
Miscarriage treatment with D&C, first trimester CPT 59820 Hc Surg Tx Missed Abortion	$1,566.80	$3,917.00	—	71% below	60%
Miscarriage treatment with D&C, first trimester inpatient CPT 59820 Hc Surg Tx Missed Abortion	$1,566.80	$3,917.00	—	—	60%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 Hc Exc Benign Trunk .5Cm Or Less	$458.80	$1,147.00	—	66% below	60%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 Hc Exc Benign Les T/A/L <0.5Cm	$562.00	$1,405.00	—	58% below	60%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 Hc Exc Benign Trunk .5Cm Or Less	$458.80	$1,147.00	—	—	60%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 Hc Exc Benign Les T/A/L <0.5Cm	$562.00	$1,405.00	—	—	60%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 Hc Excision Lesion Benign Face/Ear/Lip <0.5Cm	$302.40	$756.00	—	83% below	60%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 Hc Excision Lesion Benign Face/Ear/Lip <0.5Cm	$302.40	$756.00	—	—	60%
Nail removal (partial or complete), one nail CPT 11730 Hc Avulsion Nail Plate Single	$152.00	$380.00	—	68% below	60%
Nail removal (partial or complete), one nail CPT 11730 Hc Avulsion Of Nail Plate 510	$168.40	$421.00	—	64% below	60%
Nail removal (partial or complete), one nail inpatient CPT 11730 Hc Avulsion Nail Plate Single	$152.00	$380.00	—	—	60%
Nail removal (partial or complete), one nail inpatient CPT 11730 Hc Avulsion Of Nail Plate 510	$168.40	$421.00	—	—	60%
Occipital nerve block (injection for headaches) CPT 64405 Hc Inj Anes Great Occip Nerve	$228.40	$571.00	—	60% below	60%
Occipital nerve block (injection for headaches) inpatient CPT 64405 Hc Inj Anes Great Occip Nerve	$228.40	$571.00	—	—	60%
Pacemaker implant (dual chamber) CPT 33208 Hc Insrt/Rpl Pace Gen W/Atrl Vnt Lead	$5,716.40	$14,291.00	—	55% below	60%
Pacemaker implant (dual chamber) inpatient CPT 33208 Hc Insrt/Rpl Pace Gen W/Atrl Vnt Lead	$5,716.40	$14,291.00	—	—	60%
Paracentesis with imaging guidance CPT 49083 Hc Abd Parcntesis W/Image	$1,736.80	$4,342.00	—	3% above	60%
Paracentesis with imaging guidance inpatient CPT 49083 Hc Abd Parcntesis W/Image	$1,736.80	$4,342.00	—	—	60%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 Hc Excision Of Nail And Matrix	$479.60	$1,199.00	—	42% below	60%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 Hc Exicis Nail/Matrix Perm Rm	$872.00	$2,180.00	—	5% above	60%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 Hc Excision Of Nail And Matrix	$479.60	$1,199.00	—	—	60%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 Hc Exicis Nail/Matrix Perm Rm	$872.00	$2,180.00	—	—	60%
Removal of a foreign object under the skin, simple CPT 10120 Hc Incs & Rem Fb Subq Simple	$863.60	$2,159.00	—	59% above	60%
Removal of a foreign object under the skin, simple CPT 10120 Hc Remove Foreign B.,Sq,Simple	$863.60	$2,159.00	—	59% above	60%
Removal of a foreign object under the skin, simple inpatient CPT 10120 Hc Incs & Rem Fb Subq Simple	$863.60	$2,159.00	—	—	60%
Removal of a foreign object under the skin, simple inpatient CPT 10120 Hc Remove Foreign B.,Sq,Simple	$863.60	$2,159.00	—	—	60%
Shock-wave lithotripsy to break up kidney stones (from outside the body) CPT 50590 Hc Lithotripsy	$6,655.20	$16,638.00	—	at median	60%
Shock-wave lithotripsy to break up kidney stones (from outside the body) inpatient CPT 50590 Hc Lithotripsy	$6,655.20	$16,638.00	—	—	60%
Short arm cast (elbow to hand) CPT 29075 Hc App Plast Fig 8 Elbw To Fin	$245.60	$614.00	—	41% below	60%
Short arm cast (elbow to hand) inpatient CPT 29075 Hc App Plast Fig 8 Elbw To Fin	$245.60	$614.00	—	—	60%
Short arm splint (forearm and hand) CPT 29125 Hc Appl Short Arm Splint Stat	$300.00	$750.00	—	5% below	60%
Short arm splint (forearm and hand) inpatient CPT 29125 Hc Appl Short Arm Splint Stat	$300.00	$750.00	—	—	60%
Short leg cast (below the knee) CPT 29405 Hc Application Cast Leg Short 510	$340.00	$850.00	—	35% below	60%
Short leg cast (below the knee) CPT 29405 Hc Apply Short Leg Cast	$340.00	$850.00	—	35% below	60%
Short leg cast (below the knee) inpatient CPT 29405 Hc Application Cast Leg Short 510	$340.00	$850.00	—	—	60%
Short leg cast (below the knee) inpatient CPT 29405 Hc Apply Short Leg Cast	$340.00	$850.00	—	—	60%
Short leg splint (calf to foot) CPT 29515 Hc Application Short Leg Splint	$249.20	$623.00	—	46% below	60%
Short leg splint (calf to foot) CPT 29515 Hc Appl Short Leg Splint	$299.20	$748.00	—	35% below	60%
Short leg splint (calf to foot) inpatient CPT 29515 Hc Application Short Leg Splint	$249.20	$623.00	—	—	60%
Short leg splint (calf to foot) inpatient CPT 29515 Hc Appl Short Leg Splint	$299.20	$748.00	—	—	60%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 Hc Simp Rpr S/N/A/G/T/E <2.5Cm	$504.80	$1,262.00	—	2% below	60%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 Hc Rep Simple 2.5Cm Or Less	$504.80	$1,262.00	—	2% below	60%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 Hc Rep Simple 2.5Cm Or Less	$504.80	$1,262.00	—	—	60%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 Hc Simp Rpr S/N/A/G/T/E <2.5Cm	$504.80	$1,262.00	—	—	60%
Skin biopsy, punch, one lesion CPT 11104 Hc Punch Bx Skin Single Lesion	$286.40	$716.00	—	56% below	60%
Skin biopsy, punch, one lesion inpatient CPT 11104 Hc Punch Bx Skin Single Lesion	$286.40	$716.00	—	—	60%
Skin cancer removal (excision), body, arms or legs, up to 0.5 cm CPT 11600 Hc Exc Malig Trunk .5Cm Or Less	$458.80	$1,147.00	—	56% below	60%
Skin cancer removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11600 Hc Exc Malig Trunk .5Cm Or Less	$458.80	$1,147.00	—	—	60%
Skin tag removal, up to 15 tags CPT 11200 Hc Remove Skin Tags Up To 15	$378.00	$945.00	—	37% below	60%
Skin tag removal, up to 15 tags inpatient CPT 11200 Hc Remove Skin Tags Up To 15	$378.00	$945.00	—	—	60%
Spinal tap (lumbar puncture), diagnostic CPT 62270 Hc Spinal Fluid Tap Diagnostic	$892.80	$2,232.00	—	27% below	60%
Spinal tap (lumbar puncture), diagnostic CPT 62270 Hc Spinal Punct Lumbar Diag	$892.80	$2,232.00	—	27% below	60%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 Hc Spinal Punct Lumbar Diag	$892.80	$2,232.00	—	—	60%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 Hc Spinal Fluid Tap Diagnostic	$892.80	$2,232.00	—	—	60%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 Hc Rep Simple 2.6Cm To 7.5Cm	$665.60	$1,664.00	—	26% above	60%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 Hc Simp Rpr S/N/A/G/T/E 2.6-7.5Cm	$665.60	$1,664.00	—	26% above	60%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 Hc Rep Simple 2.6Cm To 7.5Cm	$665.60	$1,664.00	—	—	60%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 Hc Simp Rpr S/N/A/G/T/E 2.6-7.5Cm	$665.60	$1,664.00	—	—	60%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 Hc Rpr Lac Smp Face <2.5 Cm	$509.60	$1,274.00	—	at median	60%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 Hc Simp Rpr F/E/E/N/L/Mm<2.5Cm	$509.60	$1,274.00	—	at median	60%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 Hc Rpr Lac Smp Face <2.5 Cm	$509.60	$1,274.00	—	—	60%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 Hc Simp Rpr F/E/E/N/L/Mm<2.5Cm	$509.60	$1,274.00	—	—	60%
Tangential (shave-style) skin biopsy, one lesion CPT 11102 Hc Tangntl Bx Skin Single Les	$286.40	$716.00	—	49% below	60%
Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 Hc Tangntl Bx Skin Single Les	$286.40	$716.00	—	—	60%
Thoracentesis with imaging guidance CPT 32555 Hc Thoracent For Asp W Guidance	$456.80	$1,142.00	—	69% below	60%
Thoracentesis with imaging guidance CPT 32555 Hc Thoracent For Asp W Guide	$479.60	$1,199.00	—	67% below	60%
Thoracentesis with imaging guidance inpatient CPT 32555 Hc Thoracent For Asp W Guidance	$456.80	$1,142.00	—	—	60%
Thoracentesis with imaging guidance inpatient CPT 32555 Hc Thoracent For Asp W Guide	$479.60	$1,199.00	—	—	60%
Trigger point injections, 1 or 2 muscles CPT 20552 Hc Inj Trig Pnt(S)1-2 Musc(S)	$246.80	$617.00	—	54% below	60%
Trigger point injections, 1 or 2 muscles CPT 20552 Hc Inj Trigger Point 1/2 Muscl	$365.60	$914.00	—	32% below	60%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 Hc Inj Trig Pnt(S)1-2 Musc(S)	$246.80	$617.00	—	—	60%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 Hc Inj Trigger Point 1/2 Muscl	$365.60	$914.00	—	—	60%
Upper endoscopy (EGD) with balloon widening of the esophagus CPT 43249 Hc Egd Balloon <30Mm	$1,442.40	$3,606.00	—	58% below	60%
Upper endoscopy (EGD) with balloon widening of the esophagus inpatient CPT 43249 Hc Egd Balloon <30Mm	$1,442.40	$3,606.00	—	—	60%
Upper endoscopy (EGD) with biopsy CPT 43239 Hc Egd;Bx,Single/Multiple	$1,125.60	$2,814.00	—	48% below	60%
Upper endoscopy (EGD) with biopsy CPT 43239 Hc Egd Biopsy	$1,807.60	$4,519.00	—	17% below	60%
Upper endoscopy (EGD) with biopsy inpatient CPT 43239 Hc Egd;Bx,Single/Multiple	$1,125.60	$2,814.00	—	—	60%
Upper endoscopy (EGD) with biopsy inpatient CPT 43239 Hc Egd Biopsy	$1,807.60	$4,519.00	—	—	60%
Upper endoscopy (EGD) with injection into the lining CPT 43236 Hc Injection Of Esophagus, Stomach, And/Or Upper Small Bowel Using A Flexib	$541.60	$1,354.00	—	79% below	60%
Upper endoscopy (EGD) with injection into the lining inpatient CPT 43236 Hc Injection Of Esophagus, Stomach, And/Or Upper Small Bowel Using A Flexib	$541.60	$1,354.00	—	—	60%
Upper endoscopy (EGD) with widening of the esophagus over a guide wire CPT 43248 Hc Egd Ins Gwire W Dilation	$838.40	$2,096.00	—	66% below	60%
Upper endoscopy (EGD) with widening of the esophagus over a guide wire inpatient CPT 43248 Hc Egd Ins Gwire W Dilation	$838.40	$2,096.00	—	—	60%
Upper endoscopy (EGD), diagnostic CPT 43235 Hc Egd Diagnostic Brush Wash	$504.40	$1,261.00	—	73% below	60%
Upper endoscopy (EGD), diagnostic inpatient CPT 43235 Hc Egd Diagnostic Brush Wash	$504.40	$1,261.00	—	—	60%
Wart removal, up to 14 warts CPT 17110 Hc Destruct Benign Lesion 1-14	$755.20	$1,888.00	—	35% above	60%
Wart removal, up to 14 warts CPT 17110 Hc Er Dest Benign Lesn <15	$872.00	$2,180.00	—	56% above	60%
Wart removal, up to 14 warts inpatient CPT 17110 Hc Destruct Benign Lesion 1-14	$755.20	$1,888.00	—	—	60%
Wart removal, up to 14 warts inpatient CPT 17110 Hc Er Dest Benign Lesn <15	$872.00	$2,180.00	—	—	60%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 Hc Debrd Subc T 1St 20Sq Cm Or <	$674.00	$1,685.00	—	37% below	60%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 Hc Debr Skin/Subq 1St 20Sqcm	$748.00	$1,870.00	—	31% below	60%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 Hc Debridement Of Pocket	$828.80	$2,072.00	—	23% below	60%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 Hc Debrd Subc T 1St 20Sq Cm Or <	$674.00	$1,685.00	—	—	60%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 Hc Debr Skin/Subq 1St 20Sqcm	$748.00	$1,870.00	—	—	60%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 Hc Debridement Of Pocket	$828.80	$2,072.00	—	—	60%

Doctor visits and therapy

Procedure	Cash price	List price	Insurers pay	vs Pennsylvania	Off list
Blood transfusion (giving blood or blood components) CPT 36430 Hc Blood Product Transfusion	$748.00	$1,870.00	—	21% below	60%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Hc Blood Product Transfusion	$748.00	$1,870.00	—	—	60%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Hc Airway Inhalation Treatment	$149.60	$374.00	—	33% below	60%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Hc Press/Nonpress Inhalation Treatment	$164.40	$411.00	—	26% below	60%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Hc Airway Inhalation Treatment	$149.60	$374.00	—	—	60%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Hc Press/Nonpress Inhalation Treatment	$164.40	$411.00	—	—	60%
Chemotherapy IV infusion, first hour CPT 96413 Hc Chemo, Iv Infusion, 1 Hr	$651.20	$1,628.00	—	10% below	60%
Chemotherapy IV infusion, first hour inpatient CPT 96413 Hc Chemo, Iv Infusion, 1 Hr	$651.20	$1,628.00	—	—	60%
Comprehensive eye exam by an eye doctor, new patient CPT 92004 Hc Compreh Eye Exam New Pt	$152.80	$382.00	—	at median	60%
Comprehensive eye exam by an eye doctor, new patient inpatient CPT 92004 Hc Compreh Eye Exam New Pt	$152.80	$382.00	—	—	60%
Comprehensive eye exam, returning patient CPT 92014 Hc Compreh Eye Exam Estab Pt	$122.40	$306.00	—	at median	60%
Comprehensive eye exam, returning patient inpatient CPT 92014 Hc Compreh Eye Exam Estab Pt	$122.40	$306.00	—	—	60%
Comprehensive hearing test: tone and speech audiometry, both ears CPT 92557 Hc Comprhensive Hearing Test	$360.00	$900.00	—	at median	60%
Comprehensive hearing test: tone and speech audiometry, both ears inpatient CPT 92557 Hc Comprhensive Hearing Test	$360.00	$900.00	—	—	60%
Critical care, first 30 to 74 minutes CPT 99291 Hc Critical Care First Hour	$1,876.80	$4,692.00	—	at median	60%
Critical care, first 30 to 74 minutes inpatient CPT 99291 Hc Critical Care First Hour	$1,876.80	$4,692.00	—	—	60%
EEG (brain wave test), awake and drowsy, routine CPT 95816 Hc Eeg Awake & Drowsy	$814.00	$2,035.00	—	7% above	60%
EEG (brain wave test), awake and drowsy, routine inpatient CPT 95816 Hc Eeg Awake & Drowsy	$814.00	$2,035.00	—	—	60%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 Hc Ekg 12 Lead Tracing Only	$261.20	$653.00	—	50% above	60%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 Hc Ekg 12 Lead Tracing Only	$261.20	$653.00	—	—	60%
Electroconvulsive therapy (ECT), one session CPT 90870 Hc Electroconvulsive Therapy	$1,262.40	$3,156.00	—	at median	60%
Electroconvulsive therapy (ECT), one session inpatient CPT 90870 Hc Electroconvulsive Therapy	$1,262.40	$3,156.00	—	—	60%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 Hc Ed E&M Self Limited/Minor	$400.00	$1,000.00	—	32% above	60%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 Hc Ed E&M Self Limited/Minor	$400.00	$1,000.00	—	—	60%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 Hc Ed E&M Low Moderate Sever	$480.00	$1,200.00	—	at median	60%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 Hc Ed E&M Low Moderate Sever	$480.00	$1,200.00	—	—	60%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 Hc Ed E&M Moderate Severity	$674.00	$1,685.00	—	9% below	60%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 Hc Ed E&M Moderate Severity	$674.00	$1,685.00	—	—	60%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 Hc Ed E&M High Severity Urg Ev	$944.00	$2,360.00	—	23% below	60%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 Hc Ed E&M High Severity Urg Ev	$944.00	$2,360.00	—	—	60%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 Hc Ed E&M High Sever Immed Sig	$1,324.80	$3,312.00	—	17% below	60%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 Hc Ed E&M High Sever Immed Sig	$1,324.80	$3,312.00	—	—	60%
Exercise stress test, tracing only, the hospital charge CPT 93017 Hc Cardiac Stress Test Tracing Only	$992.80	$2,482.00	—	5% above	60%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 Hc Cardiac Stress Test Tracing Only	$992.80	$2,482.00	—	—	60%
Eye exam, returning patient, intermediate CPT 92012 Hc Intermed Eye Exam Estab Pt	$80.80	$202.00	—	at median	60%
Eye exam, returning patient, intermediate inpatient CPT 92012 Hc Intermed Eye Exam Estab Pt	$80.80	$202.00	—	—	60%
Family therapy with the patient, 50 minutes CPT 90847 Hc Fam Psych W/Pt Present	$88.00	$220.00	—	71% below	60%
Family therapy with the patient, 50 minutes inpatient CPT 90847 Hc Fam Psych W/Pt Present	$88.00	$220.00	—	—	60%
Family therapy without the patient, 50 minutes CPT 90846 Hc Fam Psych W/O Pt Present	$88.00	$220.00	—	51% below	60%
Family therapy without the patient, 50 minutes inpatient CPT 90846 Hc Fam Psych W/O Pt Present	$88.00	$220.00	—	—	60%
Group psychotherapy session CPT 90853 Hc Group Psychotherapy Non-Php Medicare	$55.60	$139.00	—	61% below	60%
Group psychotherapy session CPT 90853 Hc Day Tx Group Therapy Per 1 Hr	$243.60	$609.00	—	70% above	60%
Group psychotherapy session inpatient CPT 90853 Hc Group Psychotherapy Non-Php Medicare	$55.60	$139.00	—	—	60%
Group psychotherapy session inpatient CPT 90853 Hc Day Tx Group Therapy Per 1 Hr	$243.60	$609.00	—	—	60%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 Hc Hydration Iv Infusion - Init	$282.80	$707.00	—	35% below	60%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 Hc Hydration;Init 30Min To 1Hr	$282.80	$707.00	—	35% below	60%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 Hc Hydration;Init 30Min To 1Hr	$282.80	$707.00	—	—	60%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 Hc Hydration Iv Infusion - Init	$282.80	$707.00	—	—	60%
IV infusion of a medicine, first hour CPT 96365 Hc Ther/Proph/Diag Iv Inf, Init	$435.60	$1,089.00	—	3% below	60%
IV infusion of a medicine, first hour CPT 96365 Hc Th/Proph/Dg Iv Inf;Init Hr	$435.60	$1,089.00	—	3% below	60%
IV infusion of a medicine, first hour inpatient CPT 96365 Hc Th/Proph/Dg Iv Inf;Init Hr	$435.60	$1,089.00	—	—	60%
IV infusion of a medicine, first hour inpatient CPT 96365 Hc Ther/Proph/Diag Iv Inf, Init	$435.60	$1,089.00	—	—	60%
IV push of a medicine, first drug CPT 96374 Hc Ther/Proph/Diag Inj, Iv Push	$146.40	$366.00	—	55% below	60%
IV push of a medicine, first drug CPT 96374 Hc Ther/Proph/Dx Inj Iv Push	$146.40	$366.00	—	55% below	60%
IV push of a medicine, first drug inpatient CPT 96374 Hc Ther/Proph/Dx Inj Iv Push	$146.40	$366.00	—	—	60%
IV push of a medicine, first drug inpatient CPT 96374 Hc Ther/Proph/Diag Inj, Iv Push	$146.40	$366.00	—	—	60%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 Hc Therapeutic Injection,Sc Or Im	$146.40	$366.00	—	19% above	60%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 Hc Ther/Prophy/Dx Inj;Sc Im	$146.40	$366.00	—	19% above	60%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 Hc Therapeutic Injection,Sc Or Im	$146.40	$366.00	—	—	60%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 Hc Ther/Prophy/Dx Inj;Sc Im	$146.40	$366.00	—	—	60%
Mental health diagnostic evaluation (intake), without medical services CPT 90791 Hc Psychiatric Diagnostic Eval	$170.40	$426.00	—	36% below	60%
Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 Hc Psychiatric Diagnostic Eval	$170.40	$426.00	—	—	60%
Nerve conduction study, 7 or 8 nerve studies CPT 95910 Hc Nerve Cond Studies 7-8	$689.20	$1,723.00	—	53% below	60%
Nerve conduction study, 7 or 8 nerve studies inpatient CPT 95910 Hc Nerve Cond Studies 7-8	$689.20	$1,723.00	—	—	60%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 Hc Nutrition Tx Init'l;Indiv;15Mn (Telehealth)	$43.60	$109.00	—	13% below	60%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 Hc Nutrition Tx Init'l;Indiv;15Mn	$43.60	$109.00	—	13% below	60%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 Hc Nutrition Tx Init'l;Indiv;15Mn	$43.60	$109.00	—	—	60%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 Hc Nutrition Tx Init'l;Indiv;15Mn (Telehealth)	$43.60	$109.00	—	—	60%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 Hc Pt Eval High Comp 45Min	$201.20	$503.00	—	41% below	60%
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 Hc Pt Eval High Comp 45Min	$201.20	$503.00	—	—	60%
Preventive checkup, new patient aged 18–39 CPT 99385 Hc Preventive New 18-39	$120.00	$300.00	—	18% below	60%
Preventive checkup, new patient aged 18–39 inpatient CPT 99385 Hc Preventive New 18-39	$120.00	$300.00	—	—	60%
Preventive checkup, new patient aged 40–64 CPT 99386 Hc Preventive New 40-64	$120.00	$300.00	—	22% below	60%
Preventive checkup, new patient aged 40–64 inpatient CPT 99386 Hc Preventive New 40-64	$120.00	$300.00	—	—	60%
Preventive checkup, returning patient aged 18–39 CPT 99395 Hc Preventive Established 18-39	$64.00	$160.00	—	51% below	60%
Preventive checkup, returning patient aged 18–39 inpatient CPT 99395 Hc Preventive Established 18-39	$64.00	$160.00	—	—	60%
Preventive checkup, returning patient aged 40–64 CPT 99396 Hc Preventive Established 40-64	$64.00	$160.00	—	59% below	60%
Preventive checkup, returning patient aged 40–64 inpatient CPT 99396 Hc Preventive Established 40-64	$64.00	$160.00	—	—	60%
Psychiatric evaluation with medical services CPT 90792 Hc Psych Diag Eval W/Medl Service	$192.40	$481.00	—	41% below	60%
Psychiatric evaluation with medical services inpatient CPT 90792 Hc Psych Diag Eval W/Medl Service	$192.40	$481.00	—	—	60%
Psychotherapy for crisis, first 60 minutes CPT 90839 Hc Psychotherapy For Crisis Initial 60 Mins	$106.00	$265.00	—	41% below	60%
Psychotherapy for crisis, first 60 minutes inpatient CPT 90839 Hc Psychotherapy For Crisis Initial 60 Mins	$106.00	$265.00	—	—	60%
Psychotherapy session, 30 minutes CPT 90832 Hc Psych 30 Min Pat And/Or Family	$74.40	$186.00	—	70% below	60%
Psychotherapy session, 30 minutes inpatient CPT 90832 Hc Psych 30 Min Pat And/Or Family	$74.40	$186.00	—	—	60%
Psychotherapy session, 45 minutes CPT 90834 Hc Psych 45 Min Pat And/Or Family	$99.60	$249.00	—	61% below	60%
Psychotherapy session, 45 minutes inpatient CPT 90834 Hc Psych 45 Min Pat And/Or Family	$99.60	$249.00	—	—	60%
Psychotherapy session, 60 minutes CPT 90837 Hc Psych 60 Min Pat And/Or Family	$148.80	$372.00	—	51% below	60%
Psychotherapy session, 60 minutes inpatient CPT 90837 Hc Psych 60 Min Pat And/Or Family	$148.80	$372.00	—	—	60%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 Hc Smoke Cessation Edu 3-10Min	$28.40	$71.00	—	38% below	60%
Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 Hc Smoke Cessation Edu 3-10Min	$28.40	$71.00	—	—	60%
Spirometry (breathing test) CPT 94010 Hc D Spirometry	$403.20	$1,008.00	—	34% above	60%
Spirometry (breathing test) inpatient CPT 94010 Hc D Spirometry	$403.20	$1,008.00	—	—	60%
Spirometry before and after a bronchodilator CPT 94060 Hc D Spirometry Pre/Post	$944.40	$2,361.00	—	45% above	60%
Spirometry before and after a bronchodilator inpatient CPT 94060 Hc D Spirometry Pre/Post	$944.40	$2,361.00	—	—	60%
TMS (transcranial magnetic stimulation), first session with mapping CPT 90867 Hc Tms Treatment Planning	$394.80	$987.00	—	at median	60%
TMS (transcranial magnetic stimulation), first session with mapping inpatient CPT 90867 Hc Tms Treatment Planning	$394.80	$987.00	—	—	60%
Therapeutic activities (functional training), 15 minutes CPT 97530 Hc Day Tx Therapeutic Activity	$72.80	$182.00	—	43% below	60%
Therapeutic activities (functional training), 15 minutes CPT 97530 Hc Ip Rec Therapeutic Act Ea 15 Min	$80.40	$201.00	—	37% below	60%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 Hc Day Tx Therapeutic Activity	$72.80	$182.00	—	—	60%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 Hc Ip Rec Therapeutic Act Ea 15 Min	$80.40	$201.00	—	—	60%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 Hc Phlebotomy, Therapeutic	$177.20	$443.00	—	23% below	60%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 Hc Phlebotomy, Therapeutic	$177.20	$443.00	—	—	60%
Visual field test, extended CPT 92083 Hc Auto Perimeter	$509.20	$1,273.00	—	83% above	60%
Visual field test, extended inpatient CPT 92083 Hc Auto Perimeter	$509.20	$1,273.00	—	—	60%

Vaccines

Procedure	Cash price	List price	Insurers pay	vs Pennsylvania	Off list
COVID-19 vaccine (Moderna), age 12 and older CPT 91322 COVID VAC 2023-24 (12 YR UP)(ANDUSOMERAN)(PF) 50 MCG/0.5 ML INJECTION WRAPPER [502482]	$358.40	$896.00	—	80% above	60%
COVID-19 vaccine (Moderna), age 12 and older inpatient CPT 91322 COVID VAC 2023-24 (12 YR UP)(ANDUSOMERAN)(PF) 50 MCG/0.5 ML INJECTION WRAPPER [502482]	$358.40	$896.00	—	—	60%
Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 VARICELLA VIRUS VACCINE LIVE (PF) 1,350 UNIT/0.5 ML SUBCUTANEOUS SUSP [113088]	$456.40	$1,141.00	—	122% above	60%
Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 VARICELLA VIRUS VACCINE LIVE (PF) 1,350 UNIT/0.5 ML SUBCUTANEOUS SUSP [113088]	$456.40	$1,141.00	—	—	60%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 DIPH,PERTUS(ACEL),TET PED(PF) 25 LF UNIT-58 MCG-10 LF/0.5ML IM SYRINGE [19451]	$101.60	$254.00	—	197% above	60%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 inpatient CPT 90700 DIPH,PERTUS(ACEL),TET PED(PF) 25 LF UNIT-58 MCG-10 LF/0.5ML IM SYRINGE [19451]	$101.60	$254.00	—	—	60%
DTaP, hepatitis B and polio combination vaccine (Pediarix) CPT 90723 HEP B-DP(A)T-POLIO VACC (PF) 10 MCG-25LF-25 MCG-10LF/0.5 ML IM SYRINGE [34550]	$270.00	$675.00	—	225% above	60%
DTaP, hepatitis B and polio combination vaccine (Pediarix) inpatient CPT 90723 HEP B-DP(A)T-POLIO VACC (PF) 10 MCG-25LF-25 MCG-10LF/0.5 ML IM SYRINGE [34550]	$270.00	$675.00	—	—	60%
DTaP, polio and Hib combination vaccine (Pentacel) CPT 90698 DTAP-POLIO-HIB CONJ-TET(PF) 15 LF-48MCG-5 LF-62 DU-10MCG/ 0.5ML IM KIT [180470]	$373.20	$933.00	—	350% above	60%
DTaP, polio and Hib combination vaccine (Pentacel) inpatient CPT 90698 DTAP-POLIO-HIB CONJ-TET(PF) 15 LF-48MCG-5 LF-62 DU-10MCG/ 0.5ML IM KIT [180470]	$373.20	$933.00	—	—	60%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 FLU VACCINE TS 2024-25(6MOS UP)(PF) 45 MCG(15MCG X3)/0.5 ML IM SYRINGE [193666]	$80.00	$200.00	—	20% above	60%
Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 FLU VACCINE TS 2024-25(6MOS UP)(PF) 45 MCG(15MCG X3)/0.5 ML IM SYRINGE [193666]	$80.00	$200.00	—	—	60%
HPV vaccine, 9-valent (Gardasil 9) CPT 90651 HUMAN PAPILLOMAVIRUS VACCINE,9-VALENT (PF) 0.5 ML IM SUSPENSION [127765]	$668.40	$1,671.00	—	164% above	60%
HPV vaccine, 9-valent (Gardasil 9) CPT 90651 HUMAN PAPILLOMAVIRUS VACCINE,9-VALENT(PF) 0.5 ML INTRAMUSCULAR SYRINGE [127764]	$743.60	$1,859.00	—	193% above	60%
HPV vaccine, 9-valent (Gardasil 9) inpatient CPT 90651 HUMAN PAPILLOMAVIRUS VACCINE,9-VALENT (PF) 0.5 ML IM SUSPENSION [127765]	$668.40	$1,671.00	—	—	60%
HPV vaccine, 9-valent (Gardasil 9) inpatient CPT 90651 HUMAN PAPILLOMAVIRUS VACCINE,9-VALENT(PF) 0.5 ML INTRAMUSCULAR SYRINGE [127764]	$743.60	$1,859.00	—	—	60%
Hepatitis A and B combination vaccine, adult (Twinrix) CPT 90636 HEPATITIS A AND B VIRUS VACCINE(PF)720 ELISA UNIT-20 MCG/ML IM SYRINGE [127255]	$356.00	$890.00	—	296% above	60%
Hepatitis A and B combination vaccine, adult (Twinrix) inpatient CPT 90636 HEPATITIS A AND B VIRUS VACCINE(PF)720 ELISA UNIT-20 MCG/ML IM SYRINGE [127255]	$356.00	$890.00	—	—	60%
Hepatitis A vaccine, adult dose CPT 90632 HEPATITIS A VACCINE (PF) 1,440 ELISA UNIT/ML INTRAMUSCULAR SYRINGE [127052]	$264.00	$660.00	—	196% above	60%
Hepatitis A vaccine, adult dose inpatient CPT 90632 HEPATITIS A VACCINE (PF) 1,440 ELISA UNIT/ML INTRAMUSCULAR SYRINGE [127052]	$264.00	$660.00	—	—	60%
Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 HEPATITIS A VIRUS VACCINE (PF) 720 ELISA UNIT/0.5 ML IM SYRINGE [91033]	$136.00	$340.00	—	83% above	60%
Hepatitis A vaccine, child and teen dose (2-dose schedule) inpatient CPT 90633 HEPATITIS A VIRUS VACCINE (PF) 720 ELISA UNIT/0.5 ML IM SYRINGE [91033]	$136.00	$340.00	—	—	60%
Hepatitis B vaccine, adult, 2-dose schedule (Heplisav-B) CPT 90739 HEPATITIS B VACCINE 20 MCG/0.5 ML-ADJUVANT CPG 1018 (PF) IM SYRINGE [175535]	$393.60	$984.00	—	126% above	60%
Hepatitis B vaccine, adult, 2-dose schedule (Heplisav-B) inpatient CPT 90739 HEPATITIS B VACCINE 20 MCG/0.5 ML-ADJUVANT CPG 1018 (PF) IM SYRINGE [175535]	$393.60	$984.00	—	—	60%
Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 HEPATITIS B VIRUS VACCINE RECOMB (PF) 10 MCG/0.5 ML IM SYRINGE [126911]	$87.20	$218.00	—	84% above	60%
Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 HEPATITIS B VIRUS VACCINE RECOMB (PF) 10 MCG/0.5 ML IM SYRINGE [126911]	$87.20	$218.00	—	—	60%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) CPT 90648 HAEMOPHILUS B POLYSACCHARID CONJ-TETANUS TOX(PF) (HIBERIX) 10 MCG/0.5 ML IM SOLN [11931]	$45.60	$114.00	—	46% above	60%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) CPT 90648 HAEMOPHILUS B POLYSACCHARID CONJ-TETANUS TOX(PF) (PENTACEL) 10 MCG/0.5 ML IM SOLN [502140]	$1,200.80	$3,002.00	—	3738% above	60%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) inpatient CPT 90648 HAEMOPHILUS B POLYSACCHARID CONJ-TETANUS TOX(PF) (HIBERIX) 10 MCG/0.5 ML IM SOLN [11931]	$45.60	$114.00	—	—	60%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) inpatient CPT 90648 HAEMOPHILUS B POLYSACCHARID CONJ-TETANUS TOX(PF) (PENTACEL) 10 MCG/0.5 ML IM SOLN [502140]	$1,200.80	$3,002.00	—	—	60%
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 FLU VACCINE TS2024-25(65YR UP)(PF)180 MCG/0.5 ML INTRAMUSCULAR SYRINGE [193667]	$258.80	$647.00	—	196% above	60%
High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 FLU VACCINE TS2024-25(65YR UP)(PF)180 MCG/0.5 ML INTRAMUSCULAR SYRINGE [193667]	$258.80	$647.00	—	—	60%
MMR vaccine (measles, mumps and rubella), live CPT 90707 MEASLES,MUMPS,RUBELLA VACCINE LIVE(PF)1,000-12,500TCID50/0.5 ML SUBCUT [10512]	$32.80	$82.00	—	50% below	60%
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 MEASLES,MUMPS,RUBELLA VACCINE LIVE(PF)1,000-12,500TCID50/0.5 ML SUBCUT [10512]	$32.80	$82.00	—	—	60%
Meningococcal ACWY (MenACWY) vaccine CPT 90734 MENINGOCO C,Y,W-135 VACC 1 OF 2(PF) 5 MCG X3/0.5 ML(FINAL) IM SOLUTION [133330]	$402.40	$1,006.00	—	330% above	60%
Meningococcal ACWY (MenACWY) vaccine CPT 90734 MENINGOC VAC A,C,Y,W-135 DIP(PF) 10 MCG-5 MCG/0.5 ML IM KIT (2 VIALS) [129531]	$448.40	$1,121.00	—	379% above	60%
Meningococcal ACWY (MenACWY) vaccine CPT 90734 MENINGOCOCCAL A CONJ VACC 2 OF 2(PF) 10 MCG/0.5 ML (FINAL) IM SOLUTION [101034]	$448.40	$1,121.00	—	379% above	60%
Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 MENINGOCO C,Y,W-135 VACC 1 OF 2(PF) 5 MCG X3/0.5 ML(FINAL) IM SOLUTION [133330]	$402.40	$1,006.00	—	—	60%
Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 MENINGOCOCCAL A CONJ VACC 2 OF 2(PF) 10 MCG/0.5 ML (FINAL) IM SOLUTION [101034]	$448.40	$1,121.00	—	—	60%
Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 MENINGOC VAC A,C,Y,W-135 DIP(PF) 10 MCG-5 MCG/0.5 ML IM KIT (2 VIALS) [129531]	$448.40	$1,121.00	—	—	60%
Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 MENINGOCOCCAL B VAC,4-CMP 50 MCG-50 MCG-50 MCG-25 MCG/0.5ML IM SYRINGE [127348]	$584.80	$1,462.00	—	205% above	60%
Meningococcal B vaccine (Bexsero), 2-dose schedule inpatient CPT 90620 MENINGOCOCCAL B VAC,4-CMP 50 MCG-50 MCG-50 MCG-25 MCG/0.5ML IM SYRINGE [127348]	$584.80	$1,462.00	—	—	60%
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) CPT 90670 PNEUMOCOCCAL 13-VAL CONJ VACCINE-DIP CRM (PF) 0.5 ML IM SYRINGE [103895]	$606.00	$1,515.00	—	321% above	60%
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) inpatient CPT 90670 PNEUMOCOCCAL 13-VAL CONJ VACCINE-DIP CRM (PF) 0.5 ML IM SYRINGE [103895]	$606.00	$1,515.00	—	—	60%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 PNEUMOCOCCAL 20-VALENT CONJ VACCINE-DIP CRM (PF) 0.5 ML IM SYRINGE [183326]	$812.40	$2,031.00	—	152% above	60%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 PNEUMOCOCCAL 20-VALENT CONJ VACCINE-DIP CRM (PF) 0.5 ML IM SYRINGE [183326]	$812.40	$2,031.00	—	—	60%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PNEUMOCOCCAL 23 POLYVALENT VACCINE 25 MCG/0.5 ML INJECTION SOLUTION [11037]	$354.00	$885.00	—	176% above	60%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 PNEUMOCOCCAL 23 POLYVALENT VACCINE 25 MCG/0.5 ML INJECTION SOLUTION [11037]	$354.00	$885.00	—	—	60%
Polio vaccine, inactivated (IPV) CPT 90713 POLIOVIRUS VACCINE 40 UNIT-8 UNIT-32 UNIT/0.5 ML INJECTION SUSPENSION [108127]	$1,270.00	$3,175.00	—	2015% above	60%
Polio vaccine, inactivated (IPV) inpatient CPT 90713 POLIOVIRUS VACCINE 40 UNIT-8 UNIT-32 UNIT/0.5 ML INJECTION SUSPENSION [108127]	$1,270.00	$3,175.00	—	—	60%
RSV antibody shot for infants, seasonal dose (0.5 mL) CPT 90380 NIRSEVIMAB-ALIP 50 MG/0.5 ML INTRAMUSCULAR SYRINGE [190421]	$808.00	$2,020.00	—	10% below	60%
RSV antibody shot for infants, seasonal dose (0.5 mL) inpatient CPT 90380 NIRSEVIMAB-ALIP 50 MG/0.5 ML INTRAMUSCULAR SYRINGE [190421]	$808.00	$2,020.00	—	—	60%
RSV vaccine with adjuvant (Arexvy), one dose for older adults CPT 90679 RSVPREF3 ANTIGEN-AS01E ADJUVANT(PF) 120 MCG/0.5 ML IM SUSPENSION, KIT [189521]	$914.00	$2,285.00	—	108% above	60%
RSV vaccine with adjuvant (Arexvy), one dose for older adults CPT 90679 RESPIRATORY SYNCYTIAL VIRUS VACCINE, ANTIGEN (2 OF 2) 120 MCG IM SUSP [189520]	$914.00	$2,285.00	—	108% above	60%
RSV vaccine with adjuvant (Arexvy), one dose for older adults inpatient CPT 90679 RSVPREF3 ANTIGEN-AS01E ADJUVANT(PF) 120 MCG/0.5 ML IM SUSPENSION, KIT [189521]	$914.00	$2,285.00	—	—	60%
RSV vaccine with adjuvant (Arexvy), one dose for older adults inpatient CPT 90679 RESPIRATORY SYNCYTIAL VIRUS VACCINE, ANTIGEN (2 OF 2) 120 MCG IM SUSP [189520]	$914.00	$2,285.00	—	—	60%
Rabies vaccine, one dose CPT 90675 RABIES VACCINE, PURIFIED CHICKEN EMBRYO CELL (PF) 2.5 UNIT IM SUSP [22120]	$815.60	$2,039.00	—	36% above	60%
Rabies vaccine, one dose inpatient CPT 90675 RABIES VACCINE, PURIFIED CHICKEN EMBRYO CELL (PF) 2.5 UNIT IM SUSP [22120]	$815.60	$2,039.00	—	—	60%
Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) CPT 90680 ROTAVIRUS VACCINE LIVE, PENTAVALENT 2 ML ORAL SOLUTION [122171]	$338.00	$845.00	—	307% above	60%
Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) inpatient CPT 90680 ROTAVIRUS VACCINE LIVE, PENTAVALENT 2 ML ORAL SOLUTION [122171]	$338.00	$845.00	—	—	60%
Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 VARICELLA-ZOSTER GLYCOP E VACCINE (VIAL 2 OF 2) 50 MCG IM SUSPENSION [172803]	$494.80	$1,237.00	—	87% above	60%
Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 VARICELLA-ZOSTER GLYCOE VACC-AS01B ADJ(PF) 50 MCG/0.5 ML IM SUSP, KIT [172801]	$494.80	$1,237.00	—	87% above	60%
Shingles vaccine (Shingrix), recombinant, one dose inpatient CPT 90750 VARICELLA-ZOSTER GLYCOE VACC-AS01B ADJ(PF) 50 MCG/0.5 ML IM SUSP, KIT [172801]	$494.80	$1,237.00	—	—	60%
Shingles vaccine (Shingrix), recombinant, one dose inpatient CPT 90750 VARICELLA-ZOSTER GLYCOP E VACCINE (VIAL 2 OF 2) 50 MCG IM SUSPENSION [172803]	$494.80	$1,237.00	—	—	60%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TETANUS-DIPHTHERIA TOXOIDS INTRAMUSCULAR (WRAPPER) [40837504]	$95.60	$239.00	—	71% above	60%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TETANUS AND DIPHTHERIA TOX (PF) 5 LF UNIT-2 LF UNIT/0.5 ML IM SUSP [128440]	$131.60	$329.00	—	136% above	60%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 TETANUS-DIPHTHERIA TOXOIDS INTRAMUSCULAR (WRAPPER) [40837504]	$95.60	$239.00	—	—	60%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 TETANUS AND DIPHTHERIA TOX (PF) 5 LF UNIT-2 LF UNIT/0.5 ML IM SUSP [128440]	$131.60	$329.00	—	—	60%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 TETANUS,DIPTH,PERTUSS(ACELL) 5 LF UNIT-2.5 LF UNIT-8 MCG/0.5 ML (WRAPPER) [408125415]	$151.20	$378.00	—	170% above	60%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 TETANUS,DIPTH,PERTUSS(ACELL) 5 LF UNIT-2.5 LF UNIT-8 MCG/0.5 ML (WRAPPER) [408125415]	$151.20	$378.00	—	—	60%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Hc Admin Vaccine 1St Vaccine	$64.00	$160.00	—	at median	60%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Hc Admin Vaccine 1St Vaccine	$64.00	$160.00	—	—	60%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Hc Admin Vaccine Ea Addl Vaccine	$31.60	$79.00	—	18% above	60%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 Hc Admin Vaccine Ea Addl Vaccine	$31.60	$79.00	—	—	60%

Dental

Procedure	Cash price	List price	Insurers pay	vs Pennsylvania	Off list
Simple extraction of a tooth or exposed root that is above the gum CDT D7140 Hc Extraction Erupted Tooth/Exr	$798.40	$1,996.00	—	58% below	60%
Simple extraction of a tooth or exposed root that is above the gum inpatient CDT D7140 Hc Extraction Erupted Tooth/Exr	$798.40	$1,996.00	—	—	60%

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://www.mainlinehealth.org/-/media/files/pdf/basic-content/patient-services/patient-billing/price-transparency/2026/23-1529076_riddle-memorial-hospital_standardcharges.csv