Hospital Lafayette, LA

Ochsner St. Martin Hospital

Listed in its price file as “St Martin Hospital INC”.

Ochsner St. Martin Hospital in Breaux Bridge, LA publishes cash prices for 364 common procedures listed here, from its own machine-readable price file (the file does not say when it was last updated). Compared with other hospitals in the state, its outpatient cash prices are below the Louisiana median for 272 of 360 procedures and above it for 79. By typical cash price it ranks #13 of 58 Louisiana hospitals and #4 of 7 hospitals in the Lafayette, LA area, cheapest first. Click a procedure to compare it with other hospitals nearby.

210 Champagne Blvd, Breaux Bridge, LA 70517-3700 Collected Sep 23, 2026 Source price file (337) 332-2178

Critical access hospital (rural, 25 beds or fewer) Emergency department CCN 191302 · CMS hospital register NPI 1437482817

Scans and imaging

Procedure	Cash price	List price	Insurers pay	vs Louisiana	Off list
Abdominal CT scan without and with contrast CPT 74170 HC CT ABDOMEN W/WO CONTRAST	$656.40	$2,188.00	$366.03–$1,991.08	36% below	70%
Abdominal CT scan without and with contrast inpatient CPT 74170 HC CT ABDOMEN W/WO CONTRAST	$656.40	$2,188.00	—	—	70%
Abdominal X-ray, 2 views CPT 74019 HC XRAY, ABDOMEN, 2 VIEWS	$79.80	$266.00	$53.58–$242.06	56% below	70%
Abdominal X-ray, 2 views inpatient CPT 74019 HC XRAY, ABDOMEN, 2 VIEWS	$79.80	$266.00	—	—	70%
Ankle X-ray, complete, 3 or more views CPT 73610 HC ANKLE COMP, MINIMUM 3 VIEWS	$64.20	$214.00	$47.08–$194.74	46% below	70%
Ankle X-ray, complete, 3 or more views inpatient CPT 73610 HC ANKLE COMP, MINIMUM 3 VIEWS	$64.20	$214.00	—	—	70%
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 HC ANKLE BRANCHIAL INDEX	$129.60	$432.00	$95.04–$417.19	24% below	70%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 HC ANKLE BRANCHIAL INDEX	$129.60	$432.00	—	—	70%
Arm CT scan without contrast (shoulder to hand, any part) CPT 73200 HC CT UPPER EXTREMITY WO CONTRAST	$491.40	$1,638.00	$223.39–$1,490.58	24% below	70%
Arm CT scan without contrast (shoulder to hand, any part) inpatient CPT 73200 HC CT UPPER EXTREMITY WO CONTRAST	$491.40	$1,638.00	—	—	70%
Barium swallow (esophagus X-ray with contrast) CPT 74220 HC XRAY, ESOPH, W/ SCOUT CHEST RADIOGRAPH/IMG, W/SNGL CONTRAST	$145.80	$486.00	$106.92–$442.26	32% below	70%
Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 HC XRAY, ESOPH, W/ SCOUT CHEST RADIOGRAPH/IMG, W/SNGL CONTRAST	$145.80	$486.00	—	—	70%
Bone scan, whole body (nuclear medicine) CPT 78306 HC BONE/JT IMAGING WHOLE BODY	$355.20	$1,184.00	$260.48–$1,077.44	35% below	70%
Bone scan, whole body (nuclear medicine) inpatient CPT 78306 HC BONE/JT IMAGING WHOLE BODY	$355.20	$1,184.00	—	—	70%
CT angiography (CTA) of the abdomen and pelvis CPT 74174 HC CTA ABD/PEL W/ AND W/O CONTRAS	$276.30	$921.00	$202.62–$1,149.27	69% below	70%
CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174 HC CTA ABD/PEL W/ AND W/O CONTRAS	$276.30	$921.00	—	—	70%
CT angiography (CTA) of the head CPT 70496 HC CTA HEAD CONTRAST	$703.20	$2,344.00	$366.03–$2,133.04	1% above	70%
CT angiography (CTA) of the head inpatient CPT 70496 HC CTA HEAD CONTRAST	$703.20	$2,344.00	—	—	70%
CT angiography (CTA) of the neck CPT 70498 HC CTA NECK CONTRAST	$703.20	$2,344.00	$366.03–$2,133.04	1% above	70%
CT angiography (CTA) of the neck inpatient CPT 70498 HC CTA NECK CONTRAST	$703.20	$2,344.00	—	—	70%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 HC CTA CHEST W/ NON CORONARY	$703.20	$2,344.00	$366.03–$2,133.04	20% below	70%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 HC CTA CHEST W/ NON CORONARY	$703.20	$2,344.00	—	—	70%
CT of the heart without contrast dye to measure coronary calcium CPT 75571 HC CT CARDIAC SCORING	$60.30	$201.00	$44.22–$182.91	24% below	70%
CT of the heart without contrast dye to measure coronary calcium inpatient CPT 75571 HC CT CARDIAC SCORING	$60.30	$201.00	—	—	70%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 HC CT ABD / PELVIS WO CONTRAST	$736.80	$2,456.00	$471.77–$2,234.96	35% below	70%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 HC CT ABD / PELVIS WO CONTRAST	$736.80	$2,456.00	—	—	70%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 HC CT ABD PELVIS WITH CONTRAST	$858.60	$2,862.00	$629.64–$2,604.42	35% below	70%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 HC CT ABD PELVIS WITH CONTRAST	$858.60	$2,862.00	—	—	70%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 HC CT ABD & PELVIS W & WO CONTRAST	$984.30	$3,281.00	$721.82–$2,985.71	32% below	70%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 HC CT ABD & PELVIS W & WO CONTRAST	$984.30	$3,281.00	—	—	70%
CT scan of the abdomen with contrast CPT 74160 HC CT ABD W CONTRAST	$574.20	$1,914.00	$366.03–$1,741.74	35% below	70%
CT scan of the abdomen with contrast inpatient CPT 74160 HC CT ABD W CONTRAST	$574.20	$1,914.00	—	—	70%
CT scan of the abdomen without contrast CPT 74150 HC CT ABDOMEN W/O CONTRAST	$491.40	$1,638.00	$223.39–$1,490.58	36% below	70%
CT scan of the abdomen without contrast inpatient CPT 74150 HC CT ABDOMEN W/O CONTRAST	$491.40	$1,638.00	—	—	70%
CT scan of the face and sinuses, no contrast dye CPT 70486 HC CT MAXILLOFACIAL W/O CONTRAST	$564.30	$1,881.00	$223.39–$1,711.71	15% below	70%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 HC CT MAXILLOFACIAL W/O CONTRAST	$564.30	$1,881.00	—	—	70%
CT scan of the head or brain, no contrast dye CPT 70450 HC CT HEAD W/O CONTRAST	$476.10	$1,587.00	$223.39–$1,444.17	27% below	70%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 HC CT HEAD W/O CONTRAST	$476.10	$1,587.00	—	—	70%
CT scan of the head with contrast CPT 70460 HC CT HEAD W/CONTRAST	$333.30	$1,111.00	$244.42–$1,011.01	54% below	70%
CT scan of the head with contrast inpatient CPT 70460 HC CT HEAD W/CONTRAST	$333.30	$1,111.00	—	—	70%
CT scan of the head without and with contrast CPT 70470 HC CT HEAD W/WO CONTRAST	$585.30	$1,951.00	$366.03–$1,775.41	36% below	70%
CT scan of the head without and with contrast inpatient CPT 70470 HC CT HEAD W/WO CONTRAST	$585.30	$1,951.00	—	—	70%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 HC CT LUMBAR SPINE W/O CONTRAST	$547.80	$1,826.00	$223.39–$1,661.66	28% below	70%
CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 HC CT LUMBAR SPINE W/O CONTRAST	$547.80	$1,826.00	—	—	70%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 HC CT CERVICAL SPINE W/O CONTRAST	$539.40	$1,798.00	$223.39–$1,636.18	27% below	70%
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 HC CT CERVICAL SPINE W/O CONTRAST	$539.40	$1,798.00	—	—	70%
CT scan of the pelvis, with contrast dye CPT 72193 HC CT PELVIS W CONTRAST	$570.60	$1,902.00	$366.03–$1,730.82	29% below	70%
CT scan of the pelvis, with contrast dye inpatient CPT 72193 HC CT PELVIS W CONTRAST	$570.60	$1,902.00	—	—	70%
Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 HC CAROTID DUPLEX SCAN, BILAT	$222.00	$740.00	$162.80–$673.40	—	70%
Carotid artery ultrasound (duplex), both sides of the neck inpatient both sides CPT 93880 HC CAROTID DUPLEX SCAN, BILAT	$222.00	$740.00	—	—	70%
Chest CT scan without and with contrast CPT 71270 HC CT SCAN, THORAX, DX, W/WO CONTRAST	$703.20	$2,344.00	$366.03–$2,133.04	33% below	70%
Chest CT scan without and with contrast inpatient CPT 71270 HC CT SCAN, THORAX, DX, W/WO CONTRAST	$703.20	$2,344.00	—	—	70%
Chest X-ray, 2 views CPT 71046 HC XRAY, CHEST, 2 VIEWS	$79.80	$266.00	$41.75–$242.06	39% below	70%
Chest X-ray, 2 views inpatient CPT 71046 HC XRAY, CHEST, 2 VIEWS	$79.80	$266.00	—	—	70%
Chest X-ray, single view CPT 71045 HC XRAY, CHEST, 1 VIEW	$65.10	$217.00	$30.72–$197.47	41% below	70%
Chest X-ray, single view inpatient CPT 71045 HC XRAY, CHEST, 1 VIEW	$65.10	$217.00	—	—	70%
Collarbone (clavicle) X-ray, complete CPT 73000 HC CLAVICLE	$63.30	$211.00	$40.17–$192.01	46% below	70%
Collarbone (clavicle) X-ray, complete inpatient CPT 73000 HC CLAVICLE	$63.30	$211.00	—	—	70%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 HC US RETROPERITONEAL COMPLETE	$199.80	$666.00	$146.52–$606.06	31% below	70%
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 HC US RETROPERITONEAL COMPLETE	$199.80	$666.00	—	—	70%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 HC DEXA BONE DENSITY SPINE/HIP	$139.80	$466.00	$102.52–$424.06	4% below	70%
DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 HC DEXA BONE DENSITY SPINE/HIP	$139.80	$466.00	—	—	70%
DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 HC DEXA BONE DENSITY APPEN SKEL	$85.20	$284.00	$37.79–$258.44	7% above	70%
DEXA bone density scan of the wrist, heel or finger (peripheral) inpatient CPT 77081 HC DEXA BONE DENSITY APPEN SKEL	$85.20	$284.00	—	—	70%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 HC CT SCAN, THORAX, DX, W/O CONTRAST	$508.20	$1,694.00	$223.39–$1,541.54	33% below	70%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 HC CT SCAN, THORAX, DX, W/O CONTRAST	$508.20	$1,694.00	—	—	70%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 HC CT SCAN, THORAX, DX, W/CONTRAST	$570.60	$1,902.00	$366.03–$1,730.82	33% below	70%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 HC CT SCAN, THORAX, DX, W/CONTRAST	$570.60	$1,902.00	—	—	70%
Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 HC DUPLEX LE ART/BPG, BILAT	$226.20	$754.00	$165.88–$686.14	—	70%
Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 HC DUPLEX LE ART/BPG, BILAT	$226.20	$754.00	—	—	70%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 HC US DUPLEX, UPPER OR LOWER EXT VENOUS,COMPLETE BILAT	$226.20	$754.00	$165.88–$686.14	—	70%
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 HC US DUPLEX, UPPER OR LOWER EXT VENOUS,COMPLETE BILAT	$226.20	$754.00	—	—	70%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 HC ECHO W/SPECT & COLOR DOPPLER	$308.10	$1,027.00	$225.94–$1,887.54	58% below	70%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 HC ECHO W/SPECT & COLOR DOPPLER	$308.10	$1,027.00	—	—	70%
Elbow X-ray, 2 views CPT 73070 HC ELBOW AP / LAT	$64.20	$214.00	$40.96–$194.74	45% below	70%
Elbow X-ray, 2 views inpatient CPT 73070 HC ELBOW AP / LAT	$64.20	$214.00	—	—	70%
Elbow X-ray, complete, 3 or more views CPT 73080 HC ELBOW MIN 3 VIEWS	$67.50	$225.00	$49.50–$204.75	48% below	70%
Elbow X-ray, complete, 3 or more views inpatient CPT 73080 HC ELBOW MIN 3 VIEWS	$67.50	$225.00	—	—	70%
Eye socket (orbit) CT scan without contrast CPT 70480 HC CT ORBIT,SELLA,EAR W/O CONTRA	$585.30	$1,951.00	$223.39–$1,775.41	4% below	70%
Eye socket (orbit) CT scan without contrast inpatient CPT 70480 HC CT ORBIT,SELLA,EAR W/O CONTRA	$585.30	$1,951.00	—	—	70%
Facial bones X-ray, complete, 3 or more views CPT 70150 HC FACIAL BONES COMP MIN 3VIEWS	$73.20	$244.00	$53.68–$223.39	53% below	70%
Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 HC FACIAL BONES COMP MIN 3VIEWS	$73.20	$244.00	—	—	70%
Forearm X-ray (radius and ulna), 2 views CPT 73090 HC FOREARM 2 VIEWS	$41.70	$139.00	$30.58–$165.85	63% below	70%
Forearm X-ray (radius and ulna), 2 views inpatient CPT 73090 HC FOREARM 2 VIEWS	$41.70	$139.00	—	—	70%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 HC HEPATOBIL IMG INC GALLBLADDER	$741.30	$2,471.00	$543.62–$2,248.61	30% above	70%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 HC HEPATOBIL IMG INC GALLBLADDER	$741.30	$2,471.00	—	—	70%
Hand X-ray, 2 views CPT 73120 HC HAND 2 VIEW	$64.20	$214.00	$39.39–$223.39	39% below	70%
Hand X-ray, 2 views inpatient CPT 73120 HC HAND 2 VIEW	$64.20	$214.00	—	—	70%
Heel bone (calcaneus) X-ray, 2 or more views CPT 73650 HC CALCANEUS	$64.20	$214.00	$39.39–$194.74	41% below	70%
Heel bone (calcaneus) X-ray, 2 or more views inpatient CPT 73650 HC CALCANEUS	$64.20	$214.00	—	—	70%
Knee X-ray, 3 views CPT 73562 HC KNEE MIN 3 VIEWS	$79.80	$266.00	$51.99–$242.06	41% below	70%
Knee X-ray, 3 views inpatient CPT 73562 HC KNEE MIN 3 VIEWS	$79.80	$266.00	—	—	70%
Knee X-ray, complete, 4 or more views CPT 73564 HC KNEE COMPLETE	$108.60	$362.00	$59.89–$329.42	29% below	70%
Knee X-ray, complete, 4 or more views inpatient CPT 73564 HC KNEE COMPLETE	$108.60	$362.00	—	—	70%
Leg CT scan without contrast (hip to foot, any part) CPT 73700 HC CT LOWER EXTREMITY WO CONTRAST	$491.40	$1,638.00	$223.39–$1,490.58	19% below	70%
Leg CT scan without contrast (hip to foot, any part) inpatient CPT 73700 HC CT LOWER EXTREMITY WO CONTRAST	$491.40	$1,638.00	—	—	70%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 HC US ABDOMEN LIMITED	$199.80	$666.00	$146.52–$606.06	24% below	70%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 HC US ABDOMEN LIMITED	$199.80	$666.00	—	—	70%
Limited ultrasound of an arm or leg (non-vascular) CPT 76882 HC US EXTREMITY OR AXILLA, TISSUE/MUSCLE/JOINT/NERVE, LTD	$162.60	$542.00	$23.61–$493.22	6% below	70%
Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 HC US EXTREMITY OR AXILLA, TISSUE/MUSCLE/JOINT/NERVE, LTD	$162.60	$542.00	—	—	70%
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 HC CT SCAN, THORAX, LOW DOSE LUNG CANCER SCRN, W/O CONTRAST	$135.90	$453.00	$99.66–$412.23	12% below	70%
Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 HC CT SCAN, THORAX, LOW DOSE LUNG CANCER SCRN, W/O CONTRAST	$135.90	$453.00	—	—	70%
Lower leg X-ray (tibia and fibula), 2 views CPT 73590 HC LEG AP/LAT (TIBIA/FIBULA)	$64.20	$214.00	$38.58–$194.74	45% below	70%
Lower leg X-ray (tibia and fibula), 2 views inpatient CPT 73590 HC LEG AP/LAT (TIBIA/FIBULA)	$64.20	$214.00	—	—	70%
MR angiography (MRA) of the head without contrast CPT 70544 HC MRA HEAD W/O CONTRAST	$840.90	$2,803.00	$471.77–$2,550.73	7% below	70%
MR angiography (MRA) of the head without contrast inpatient CPT 70544 HC MRA HEAD W/O CONTRAST	$840.90	$2,803.00	—	—	70%
MRI of knee or other lower-limb joint, no contrast dye CPT 73721 HC MRI LOW EXT JT W/O CONTR	$1,276.80	$4,256.00	$471.77–$3,872.96	18% above	70%
MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 HC MRI LOW EXT JT W/O CONTR	$1,276.80	$4,256.00	—	—	70%
MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 HC MRI LOW EXT JT W/WO CONT	$1,276.80	$4,256.00	$754.65–$3,872.96	at median	70%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 HC MRI LOW EXT JT W/WO CONT	$1,276.80	$4,256.00	—	—	70%
MRI of the abdomen without contrast CPT 74181 HC MRI ABDOMEN W/O CONTRAST	$801.30	$2,671.00	$471.77–$2,430.61	19% below	70%
MRI of the abdomen without contrast inpatient CPT 74181 HC MRI ABDOMEN W/O CONTRAST	$801.30	$2,671.00	—	—	70%
MRI of the abdomen, without and then with contrast dye CPT 74183 HC MRI ABDOMEN W/WO CONTRAST	$1,506.60	$5,022.00	$754.65–$4,570.02	13% above	70%
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 HC MRI ABDOMEN W/WO CONTRAST	$1,506.60	$5,022.00	—	—	70%
MRI of the brain, no contrast dye CPT 70551 HC MRI BRAIN W/O CONTRAST	$801.30	$2,671.00	$471.77–$2,430.61	29% below	70%
MRI of the brain, no contrast dye inpatient CPT 70551 HC MRI BRAIN W/O CONTRAST	$801.30	$2,671.00	—	—	70%
MRI of the brain, with and without contrast dye CPT 70553 HC MRI BRAIN W/WO CONTRAST	$1,506.60	$5,022.00	$754.65–$4,570.02	4% above	70%
MRI of the brain, with and without contrast dye inpatient CPT 70553 HC MRI BRAIN W/WO CONTRAST	$1,506.60	$5,022.00	—	—	70%
MRI of the lower back, no contrast dye CPT 72148 HC MRI SPINE LUMBAR WITHOUT CONTRAST	$801.30	$2,671.00	$471.77–$2,430.61	29% below	70%
MRI of the lower back, no contrast dye inpatient CPT 72148 HC MRI SPINE LUMBAR WITHOUT CONTRAST	$801.30	$2,671.00	—	—	70%
MRI of the lower back, without and then with contrast dye CPT 72158 HC MRI SPINE LUMBAR W/WO CONTRA	$1,794.30	$5,981.00	$754.65–$5,442.71	29% above	70%
MRI of the lower back, without and then with contrast dye inpatient CPT 72158 HC MRI SPINE LUMBAR W/WO CONTRA	$1,794.30	$5,981.00	—	—	70%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 HC MRI SPINE THORACIC W/O CONTRAS	$801.30	$2,671.00	$471.77–$2,430.61	28% below	70%
MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 HC MRI SPINE THORACIC W/O CONTRAS	$801.30	$2,671.00	—	—	70%
MRI of the neck (cervical spine) without and with contrast CPT 72156 HC MRI SPINE CERVICAL W/WO CONTR	$1,794.30	$5,981.00	$754.65–$5,442.71	12% above	70%
MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 HC MRI SPINE CERVICAL W/WO CONTR	$1,794.30	$5,981.00	—	—	70%
MRI of the neck (cervical spine), no contrast dye CPT 72141 HC MRI SPINE CERVICAL W/O CONTRAS	$801.30	$2,671.00	$471.77–$2,430.61	24% below	70%
MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 HC MRI SPINE CERVICAL W/O CONTRAS	$801.30	$2,671.00	—	—	70%
MRI of the pelvis without and with contrast CPT 72197 HC MRI PELVIS W & W/O CONTRAST	$940.50	$3,135.00	$689.70–$2,852.85	16% below	70%
MRI of the pelvis without and with contrast inpatient CPT 72197 HC MRI PELVIS W & W/O CONTRAST	$940.50	$3,135.00	—	—	70%
MRI of the pelvis, no contrast dye CPT 72195 HC MRI PELVIS W/O CONTRAST	$801.30	$2,671.00	$471.77–$2,430.61	8% below	70%
MRI of the pelvis, no contrast dye inpatient CPT 72195 HC MRI PELVIS W/O CONTRAST	$801.30	$2,671.00	—	—	70%
MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 HC MRI UP EXT JT W/O CONTRAS	$829.50	$2,765.00	$471.77–$2,516.15	15% below	70%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 HC MRI UP EXT JT W/O CONTRAS	$829.50	$2,765.00	—	—	70%
Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 HC SPINE CERVICAL MIN 4 OR 5 VIEWS	$111.00	$370.00	$74.87–$336.70	45% below	70%
Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 HC SPINE CERVICAL MIN 4 OR 5 VIEWS	$111.00	$370.00	—	—	70%
Neck soft tissue CT scan with contrast CPT 70491 HC CT SOFT TISSUE NECK W/CONTRAS	$499.80	$1,666.00	$366.03–$1,516.06	27% below	70%
Neck soft tissue CT scan with contrast inpatient CPT 70491 HC CT SOFT TISSUE NECK W/CONTRAS	$499.80	$1,666.00	—	—	70%
Neck soft tissue CT scan without contrast CPT 70490 HC CT SOFT TISSUE NECK W/O CONTR	$491.40	$1,638.00	$223.39–$1,490.58	27% below	70%
Neck soft tissue CT scan without contrast inpatient CPT 70490 HC CT SOFT TISSUE NECK W/O CONTR	$491.40	$1,638.00	—	—	70%
Neck soft tissue X-ray CPT 70360 HC NECK SOFT TISSUE	$64.20	$214.00	$38.58–$194.74	44% below	70%
Neck soft tissue X-ray inpatient CPT 70360 HC NECK SOFT TISSUE	$64.20	$214.00	—	—	70%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 HC MPI SPECT, MULTIPLE	$925.20	$3,084.00	$678.48–$2,806.44	21% below	70%
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 HC MPI SPECT, MULTIPLE	$925.20	$3,084.00	—	—	70%
Pelvic CT scan without contrast CPT 72192 HC CT PELVIS WO CONTRAST	$491.40	$1,638.00	$223.39–$1,490.58	29% below	70%
Pelvic CT scan without contrast inpatient CPT 72192 HC CT PELVIS WO CONTRAST	$491.40	$1,638.00	—	—	70%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 HC US PELVIC LIMITED NON-OB	$176.70	$589.00	$129.58–$535.99	at median	70%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 HC US PELVIC LIMITED NON-OB	$176.70	$589.00	—	—	70%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 HC US PELVIC COMPLETE NON-OB	$212.70	$709.00	$155.98–$645.19	24% below	70%
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 HC US PELVIC COMPLETE NON-OB	$212.70	$709.00	—	—	70%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 HC US, OB 14+WKS, TRANSABD, SINGLE GESTATION	$119.70	$399.00	$87.78–$363.09	54% below	70%
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 HC US, OB 14+WKS, TRANSABD, SINGLE GESTATION	$119.70	$399.00	—	—	70%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 HC US, OB <14WKS, TRANSABD, SINGLE GESTATION	$204.30	$681.00	$149.82–$619.71	13% below	70%
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 HC US, OB <14WKS, TRANSABD, SINGLE GESTATION	$204.30	$681.00	—	—	70%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 HC US OB LIMITED 1 OR MORE GESTA	$176.70	$589.00	$120.61–$535.99	2% above	70%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 HC US OB LIMITED 1 OR MORE GESTA	$176.70	$589.00	—	—	70%
Rib X-ray, one side, 2 views one side CPT 71100 HC RIBS UNILATERAL 2 VIEWS	$72.60	$242.00	$44.11–$220.22	46% below	70%
Rib X-ray, one side, 2 views inpatient one side CPT 71100 HC RIBS UNILATERAL 2 VIEWS	$72.60	$242.00	—	—	70%
Rib X-ray, one side, with a chest view, 3 or more views CPT 71101 HC RIBS W/PA CHEST	$94.80	$316.00	$52.78–$287.56	31% below	70%
Rib X-ray, one side, with a chest view, 3 or more views inpatient CPT 71101 HC RIBS W/PA CHEST	$94.80	$316.00	—	—	70%
Screening mammogram, both breasts both sides CPT 77067 HC MAMMO W/WO CAD, SCREENING, BILAT	$122.70	$409.00	$78.97–$372.19	—	70%
Screening mammogram, both breasts inpatient both sides CPT 77067 HC MAMMO W/WO CAD, SCREENING, BILAT	$122.70	$409.00	—	—	70%
Shoulder X-ray, complete, 2 or more views CPT 73030 HC SHOULDER ROUTINE	$72.60	$242.00	$41.75–$220.22	45% below	70%
Shoulder X-ray, complete, 2 or more views inpatient CPT 73030 HC SHOULDER ROUTINE	$72.60	$242.00	—	—	70%
Sinus X-ray, complete, 3 or more views CPT 70220 HC SINUSES, PARANASAL, COMP, MINIMUM 3 VIEWS	$84.00	$280.00	$54.37–$254.80	47% below	70%
Sinus X-ray, complete, 3 or more views inpatient CPT 70220 HC SINUSES, PARANASAL, COMP, MINIMUM 3 VIEWS	$84.00	$280.00	—	—	70%
Skull X-ray, fewer than 4 views CPT 70250 HC SKULL < 4VIEWS	$63.30	$211.00	$46.42–$223.39	53% below	70%
Skull X-ray, fewer than 4 views inpatient CPT 70250 HC SKULL < 4VIEWS	$63.30	$211.00	—	—	70%
Swallow study (modified barium swallow, video X-ray) CPT 74230 HC XRAY, SWALLOW FUNCT, CINE/VIDEO, W/ SCOUT NECK RADIOGRAPH/IMG, W/CONTRAST	$253.80	$846.00	$129.26–$769.86	5% above	70%
Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 HC XRAY, SWALLOW FUNCT, CINE/VIDEO, W/ SCOUT NECK RADIOGRAPH/IMG, W/CONTRAST	$253.80	$846.00	—	—	70%
Thigh bone (femur) X-ray, 2 or more views CPT 73552 HC X-RAY EXAM OF FEMUR 2/> VIEWS	$72.60	$242.00	$50.43–$220.22	37% below	70%
Thigh bone (femur) X-ray, 2 or more views inpatient CPT 73552 HC X-RAY EXAM OF FEMUR 2/> VIEWS	$72.60	$242.00	—	—	70%
Thoracic spine (mid back) CT scan without contrast CPT 72128 HC CT THORACIC SPINE W/O CONTRAST	$520.20	$1,734.00	$223.39–$1,577.94	31% below	70%
Thoracic spine (mid back) CT scan without contrast inpatient CPT 72128 HC CT THORACIC SPINE W/O CONTRAST	$520.20	$1,734.00	—	—	70%
Toe X-ray, 2 or more views CPT 73660 HC TOE OR TOES MIN 2VIEWS	$64.20	$214.00	$44.11–$194.74	42% below	70%
Toe X-ray, 2 or more views inpatient CPT 73660 HC TOE OR TOES MIN 2VIEWS	$64.20	$214.00	—	—	70%
Transvaginal pelvic ultrasound CPT 76830 HC US TRANSVAGINAL NON OB	$212.70	$709.00	$155.98–$645.19	1% above	70%
Transvaginal pelvic ultrasound inpatient CPT 76830 HC US TRANSVAGINAL NON OB	$212.70	$709.00	—	—	70%
Transvaginal ultrasound during pregnancy CPT 76817 HC US, OB, TRANSVAG APPROACH	$204.30	$681.00	$134.00–$619.71	14% above	70%
Transvaginal ultrasound during pregnancy inpatient CPT 76817 HC US, OB, TRANSVAG APPROACH	$204.30	$681.00	—	—	70%
Ultrasound of the abdomen, complete CPT 76700 HC US, ABD, B-SCAN, COMPLETE	$248.40	$828.00	$182.16–$753.48	18% below	70%
Ultrasound of the abdomen, complete inpatient CPT 76700 HC US, ABD, B-SCAN, COMPLETE	$248.40	$828.00	—	—	70%
Ultrasound of the scrotum and testicles CPT 76870 HC US SCROTUM & CONTENTS	$162.60	$542.00	$119.24–$493.22	23% below	70%
Ultrasound of the scrotum and testicles inpatient CPT 76870 HC US SCROTUM & CONTENTS	$162.60	$542.00	—	—	70%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 HC US SOFT TISS OF HEAD NECK THYR	$227.10	$757.00	$166.54–$688.87	10% below	70%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 HC US SOFT TISS OF HEAD NECK THYR	$227.10	$757.00	—	—	70%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 HC XRAY, UPPER GI TRACT, W/ SCOUT ABD RADIOGRAPH/IMG, W/SNGL CONTRAST	$153.30	$511.00	$112.42–$465.01	40% below	70%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 HC XRAY, UPPER GI TRACT, W/ SCOUT ABD RADIOGRAPH/IMG, W/SNGL CONTRAST	$153.30	$511.00	—	—	70%
Upper arm X-ray (humerus), 2 views CPT 73060 HC HUMERUS ROUTINE	$64.20	$214.00	$41.75–$194.74	45% below	70%
Upper arm X-ray (humerus), 2 views inpatient CPT 73060 HC HUMERUS ROUTINE	$64.20	$214.00	—	—	70%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 HC US DUPLEX, UPPER OR LOWER EXT VENOUS,UNILAT OR LTD	$140.70	$469.00	$103.18–$426.79	45% below	70%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 HC US DUPLEX, UPPER OR LOWER EXT VENOUS,UNILAT OR LTD	$140.70	$469.00	—	—	70%
Wrist X-ray, 2 views CPT 73100 HC WRIST 2 VIEW	$64.20	$214.00	$43.34–$194.74	41% below	70%
Wrist X-ray, 2 views inpatient CPT 73100 HC WRIST 2 VIEW	$64.20	$214.00	—	—	70%
Wrist X-ray, complete, 3 or more views CPT 73110 HC WRIST COMPLETE	$64.20	$214.00	$47.08–$194.74	44% below	70%
Wrist X-ray, complete, 3 or more views inpatient CPT 73110 HC WRIST COMPLETE	$64.20	$214.00	—	—	70%
X-ray of one hip, 2 or 3 views, with the pelvis when included CPT 73502 HC X-RAY EXAM HIP W/PELVIS UNI 2-3 VIEWS	$72.90	$243.00	$53.46–$221.13	42% below	70%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient CPT 73502 HC X-RAY EXAM HIP W/PELVIS UNI 2-3 VIEWS	$72.90	$243.00	—	—	70%
X-ray of the abdomen, 1 view CPT 74018 HC XRAY, ABDOMEN, 1 VIEW	$272.40	$908.00	$33.87–$826.28	113% above	70%
X-ray of the abdomen, 1 view inpatient CPT 74018 HC XRAY, ABDOMEN, 1 VIEW	$272.40	$908.00	—	—	70%
X-ray of the ankle, 2 views CPT 73600 HC ANKLE 2 VIEWS	$64.20	$214.00	$40.17–$194.74	41% below	70%
X-ray of the ankle, 2 views inpatient CPT 73600 HC ANKLE 2 VIEWS	$64.20	$214.00	—	—	70%
X-ray of the finger(s), 2 or more views CPT 73140 HC FINGER OR FINGERS MIN 2VIEWS	$64.20	$214.00	$47.08–$194.74	38% below	70%
X-ray of the finger(s), 2 or more views inpatient CPT 73140 HC FINGER OR FINGERS MIN 2VIEWS	$64.20	$214.00	—	—	70%
X-ray of the foot, 2 views CPT 73620 HC FOOT 2 VIEW	$64.20	$214.00	$38.58–$194.74	40% below	70%
X-ray of the foot, 2 views inpatient CPT 73620 HC FOOT 2 VIEW	$64.20	$214.00	—	—	70%
X-ray of the foot, complete, 3 or more views CPT 73630 HC FOOT COMP, MINIMUM 3 VIEWS	$64.20	$214.00	$46.48–$194.74	48% below	70%
X-ray of the foot, complete, 3 or more views inpatient CPT 73630 HC FOOT COMP, MINIMUM 3 VIEWS	$64.20	$214.00	—	—	70%
X-ray of the hand, 3 or more views CPT 73130 HC HAND COMPLETE	$64.20	$214.00	$46.48–$194.74	49% below	70%
X-ray of the hand, 3 or more views inpatient CPT 73130 HC HAND COMPLETE	$64.20	$214.00	—	—	70%
X-ray of the knee, 1 or 2 views CPT 73560 HC KNEE 1-2 VIEWS	$66.60	$222.00	$41.75–$202.02	41% below	70%
X-ray of the knee, 1 or 2 views inpatient CPT 73560 HC KNEE 1-2 VIEWS	$66.60	$222.00	—	—	70%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 HC SPINE LUMBAR 2 OR 3V	$84.00	$280.00	$57.50–$254.80	45% below	70%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 HC SPINE LUMBAR 2 OR 3V	$84.00	$280.00	—	—	70%
X-ray of the lower back, 4 or more views CPT 72110 HC SPINE LUMBAR COMP 5 VIEW	$111.00	$370.00	$78.81–$336.70	49% below	70%
X-ray of the lower back, 4 or more views inpatient CPT 72110 HC SPINE LUMBAR COMP 5 VIEW	$111.00	$370.00	—	—	70%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 HC SPINE THORACIC AP&LAT	$43.80	$146.00	$32.12–$223.39	72% below	70%
X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 HC SPINE THORACIC AP&LAT	$43.80	$146.00	—	—	70%
X-ray of the nasal bones, 3 or more views CPT 70160 HC NASAL BONES COMP, MINIMUM 3 VIEWS	$63.30	$211.00	$46.42–$192.01	46% below	70%
X-ray of the nasal bones, 3 or more views inpatient CPT 70160 HC NASAL BONES COMP, MINIMUM 3 VIEWS	$63.30	$211.00	—	—	70%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 HC SPINE CERVICAL, AP&LAT	$83.10	$277.00	$53.58–$252.07	42% below	70%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 HC SPINE CERVICAL, AP&LAT	$83.10	$277.00	—	—	70%
X-ray of the pelvis, 1 or 2 views CPT 72170 HC PELVIS 1 OR 2 VIEWS	$65.10	$217.00	$36.24–$223.39	51% below	70%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 HC PELVIS 1 OR 2 VIEWS	$65.10	$217.00	—	—	70%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 HC SACRUM & COCCYX MIN 2VIEWS	$64.20	$214.00	$41.75–$194.74	53% below	70%
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 HC SACRUM & COCCYX MIN 2VIEWS	$64.20	$214.00	—	—	70%

Lab tests

Procedure	Cash price	List price	Insurers pay	vs Louisiana	Off list
ACTH blood test CPT 82024 HC ACTH	$118.20	$394.00	$38.62–$358.54	12% above	70%
ACTH blood test inpatient CPT 82024 HC ACTH	$118.20	$394.00	—	—	70%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 HC HCV FIBROSURE-ALT (SGPT)	$6.30	$21.00	$4.62–$19.11	67% below	70%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 HC ALT SGPT	$16.20	$54.00	$5.30–$49.14	16% below	70%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 HC HCV FIBROSURE-ALT (SGPT)	$6.30	$21.00	—	—	70%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 HC ALT SGPT	$16.20	$54.00	—	—	70%
AST (aspartate aminotransferase) enzyme test CPT 84450 *HC AST SGOT - RL	$16.20	$54.00	$5.18–$49.14	18% below	70%
AST (aspartate aminotransferase) enzyme test CPT 84450 HC AST SGOT	$16.20	$54.00	$5.18–$49.14	18% below	70%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 HC AST SGOT	$16.20	$54.00	—	—	70%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 *HC AST SGOT - RL	$16.20	$54.00	—	—	70%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 HC HEPATITIS PANEL, ACUTE	$68.10	$227.00	$47.63–$206.57	39% below	70%
Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 HC HEPATITIS PANEL, ACUTE	$68.10	$227.00	—	—	70%
Albumin blood test CPT 82040 HC ALBUMIN-SERUM	$4.80	$16.00	$3.52–$14.56	66% below	70%
Albumin blood test CPT 82040 *HC ALBUMIN-CSF	$4.80	$16.00	$3.52–$14.56	66% below	70%
Albumin blood test CPT 82040 HC ALBUMIN (RL)	$14.40	$48.00	$4.95–$43.68	2% above	70%
Albumin blood test CPT 82040 HC IGG INDEX-ALBUMIN SERUM	$14.40	$48.00	$4.95–$43.68	2% above	70%
Albumin blood test inpatient CPT 82040 HC ALBUMIN-SERUM	$4.80	$16.00	—	—	70%
Albumin blood test inpatient CPT 82040 *HC ALBUMIN-CSF	$4.80	$16.00	—	—	70%
Albumin blood test inpatient CPT 82040 HC IGG INDEX-ALBUMIN SERUM	$14.40	$48.00	—	—	70%
Albumin blood test inpatient CPT 82040 HC ALBUMIN (RL)	$14.40	$48.00	—	—	70%
Aldosterone blood test CPT 82088 HC ALDOSTERONE, LAV - RL	$88.20	$294.00	$40.75–$267.54	7% below	70%
Aldosterone blood test CPT 82088 HC ALDOSTERONE, URINE	$124.80	$416.00	$40.75–$378.56	31% above	70%
Aldosterone blood test CPT 82088 HC ALDOSTERONE, IVC - RL	$124.80	$416.00	$40.75–$378.56	31% above	70%
Aldosterone blood test CPT 82088 HC ALDOSTERONE, RAV - RL	$124.80	$416.00	$40.75–$378.56	31% above	70%
Aldosterone blood test CPT 82088 HC ALDOSTERONE- SERUM	$124.80	$416.00	$40.75–$378.56	31% above	70%
Aldosterone blood test inpatient CPT 82088 HC ALDOSTERONE, LAV - RL	$88.20	$294.00	—	—	70%
Aldosterone blood test inpatient CPT 82088 HC ALDOSTERONE- SERUM	$124.80	$416.00	—	—	70%
Aldosterone blood test inpatient CPT 82088 HC ALDOSTERONE, URINE	$124.80	$416.00	—	—	70%
Aldosterone blood test inpatient CPT 82088 HC ALDOSTERONE, IVC - RL	$124.80	$416.00	—	—	70%
Aldosterone blood test inpatient CPT 82088 HC ALDOSTERONE, RAV - RL	$124.80	$416.00	—	—	70%
Alkaline phosphatase (ALP) blood test CPT 84075 HC ALK PHOS, TOTAL	$15.30	$51.00	$5.18–$46.41	20% below	70%
Alkaline phosphatase (ALP) blood test CPT 84075 HC ALKALINE PHOSPHATASE	$15.30	$51.00	$5.18–$46.41	20% below	70%
Alkaline phosphatase (ALP) blood test CPT 84075 HC ALKALINE PHOSPHATASE, BONE SPE-RL	$15.30	$51.00	$5.18–$46.41	20% below	70%
Alkaline phosphatase (ALP) blood test inpatient CPT 84075 HC ALK PHOS, TOTAL	$15.30	$51.00	—	—	70%
Alkaline phosphatase (ALP) blood test inpatient CPT 84075 HC ALKALINE PHOSPHATASE, BONE SPE-RL	$15.30	$51.00	—	—	70%
Alkaline phosphatase (ALP) blood test inpatient CPT 84075 HC ALKALINE PHOSPHATASE	$15.30	$51.00	—	—	70%
Allergy blood test, specific IgE, per allergen CPT 86003 *HC ALLERGEN, ALMOND	$9.00	$30.00	$5.22–$27.30	8% below	70%
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN, MILK COMPONENTS-EACH	$9.00	$30.00	$5.22–$27.30	8% below	70%
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN, EGG COMPONENTS-EACH	$9.00	$30.00	$5.22–$27.30	8% below	70%
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN, PEANUT COMPONENTS-EACH	$9.00	$30.00	$5.22–$27.30	8% below	70%
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN CANDIDA ALBICANS IGE	$9.00	$30.00	$5.22–$27.30	8% below	70%
Allergy blood test, specific IgE, per allergen CPT 86003 HC RAST, SINGLE ALLERGEN, IGE, EACH	$22.50	$75.00	$5.22–$68.25	130% above	70%
Allergy blood test, specific IgE, per allergen CPT 86003 HC RAST, SINGLE ALLERGEN, IGE, EACH - RL	$22.50	$75.00	$5.22–$68.25	130% above	70%
Allergy blood test, specific IgE, per allergen CPT 86003 HC IGE, GLOVE LATEX EXT	$25.80	$86.00	$5.22–$78.26	164% above	70%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN CANDIDA ALBICANS IGE	$9.00	$30.00	—	—	70%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN, MILK COMPONENTS-EACH	$9.00	$30.00	—	—	70%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN, EGG COMPONENTS-EACH	$9.00	$30.00	—	—	70%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 *HC ALLERGEN, ALMOND	$9.00	$30.00	—	—	70%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN, PEANUT COMPONENTS-EACH	$9.00	$30.00	—	—	70%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC RAST, SINGLE ALLERGEN, IGE, EACH - RL	$22.50	$75.00	—	—	70%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC RAST, SINGLE ALLERGEN, IGE, EACH	$22.50	$75.00	—	—	70%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC IGE, GLOVE LATEX EXT	$25.80	$86.00	—	—	70%
Alpha-fetoprotein (AFP) blood test CPT 82105 HC AFP, MATERNAL SCREEN	$16.20	$54.00	$11.88–$49.14	67% below	70%
Alpha-fetoprotein (AFP) blood test CPT 82105 HC ALPHA FETOPROTEIN (TUMOR MARK)	$36.30	$121.00	$16.77–$110.11	26% below	70%
Alpha-fetoprotein (AFP) blood test CPT 82105 HC AFP, MATERNAL SEQ SCRN	$36.30	$121.00	$16.77–$110.11	26% below	70%
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 HC AFP, MATERNAL SCREEN	$16.20	$54.00	—	—	70%
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 HC AFP, MATERNAL SEQ SCRN	$36.30	$121.00	—	—	70%
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 HC ALPHA FETOPROTEIN (TUMOR MARK)	$36.30	$121.00	—	—	70%
Ammonia blood test CPT 82140 HC AMMONIA, BLOOD	$14.70	$49.00	$10.78–$44.59	70% below	70%
Ammonia blood test CPT 82140 HC SUPERSAT URINE, AMMONIUM	$27.90	$93.00	$14.57–$84.63	43% below	70%
Ammonia blood test CPT 82140 HC AMMONIA LEVEL ASSAY	$27.90	$93.00	$14.57–$84.63	43% below	70%
Ammonia blood test inpatient CPT 82140 HC AMMONIA, BLOOD	$14.70	$49.00	—	—	70%
Ammonia blood test inpatient CPT 82140 HC SUPERSAT URINE, AMMONIUM	$27.90	$93.00	—	—	70%
Ammonia blood test inpatient CPT 82140 HC AMMONIA LEVEL ASSAY	$27.90	$93.00	—	—	70%
Amylase blood test CPT 82150 HC AMYLASE	$6.00	$20.00	$4.40–$18.20	73% below	70%
Amylase blood test CPT 82150 HC POC AMYLASE	$6.00	$20.00	$4.40–$18.20	73% below	70%
Amylase blood test CPT 82150 *HC AMYLASE LEVEL, TOTAL	$7.80	$26.00	$5.72–$23.66	65% below	70%
Amylase blood test CPT 82150 HC AMYLASE ISOENZYMES, EACH	$24.60	$82.00	$6.48–$74.62	11% above	70%
Amylase blood test CPT 82150 HC AMYLASE BODY FLUID	$24.60	$82.00	$6.48–$74.62	11% above	70%
Amylase blood test CPT 82150 HC AMYLASE, BODY FLUID - RL	$24.60	$82.00	$6.48–$74.62	11% above	70%
Amylase blood test CPT 82150 *HC AMYLASE LEVEL, SALIVA	$24.60	$82.00	$6.48–$74.62	11% above	70%
Amylase blood test CPT 82150 HC AMYLASE, PANCREATIC FLUID	$24.60	$82.00	$6.48–$74.62	11% above	70%
Amylase blood test CPT 82150 HC AMYLASE, URINE	$24.60	$82.00	$6.48–$74.62	11% above	70%
Amylase blood test inpatient CPT 82150 HC POC AMYLASE	$6.00	$20.00	—	—	70%
Amylase blood test inpatient CPT 82150 HC AMYLASE	$6.00	$20.00	—	—	70%
Amylase blood test inpatient CPT 82150 *HC AMYLASE LEVEL, TOTAL	$7.80	$26.00	—	—	70%
Amylase blood test inpatient CPT 82150 HC AMYLASE, BODY FLUID - RL	$24.60	$82.00	—	—	70%
Amylase blood test inpatient CPT 82150 HC AMYLASE, PANCREATIC FLUID	$24.60	$82.00	—	—	70%
Amylase blood test inpatient CPT 82150 HC AMYLASE BODY FLUID	$24.60	$82.00	—	—	70%
Amylase blood test inpatient CPT 82150 HC AMYLASE ISOENZYMES, EACH	$24.60	$82.00	—	—	70%
Amylase blood test inpatient CPT 82150 HC AMYLASE, URINE	$24.60	$82.00	—	—	70%
Amylase blood test inpatient CPT 82150 *HC AMYLASE LEVEL, SALIVA	$24.60	$82.00	—	—	70%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 HC CCP ANTIBODIES	$55.80	$186.00	$12.95–$169.26	33% above	70%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 *HC CCP ANTIBODIES - RL	$55.80	$186.00	$12.95–$169.26	33% above	70%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 *HC CCP ANTIBODIES - RL	$55.80	$186.00	—	—	70%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 HC CCP ANTIBODIES	$55.80	$186.00	—	—	70%
Antinuclear antibody (ANA) blood test, screen CPT 86038 HC ANTI-NUCLEAR AB(ANA)	$24.90	$83.00	$12.09–$75.53	46% below	70%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 HC ANTI-NUCLEAR AB(ANA)	$24.90	$83.00	—	—	70%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 HC POC NATRIURETIC PEPTIDE ASSAY	$31.80	$106.00	$23.32–$96.46	51% below	70%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 HC NATRIURETIC PEPTIDE ASSAY	$51.00	$170.00	$37.40–$154.70	22% below	70%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 HC NT-PRO BNP, S	$51.00	$170.00	$37.40–$154.70	22% below	70%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 HC POC NATRIURETIC PEPTIDE ASSAY	$31.80	$106.00	—	—	70%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 HC NATRIURETIC PEPTIDE ASSAY	$51.00	$170.00	—	—	70%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 HC NT-PRO BNP, S	$51.00	$170.00	—	—	70%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HC CULTURE, WOUND	$16.20	$54.00	$8.62–$49.14	42% below	70%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 *HC CULTURE, GONORRHEA	$16.80	$56.00	$8.62–$50.96	40% below	70%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HC CULTURE THROAT	$16.80	$56.00	$8.62–$50.96	40% below	70%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HC BODY FLUID CULTURE	$16.80	$56.00	$8.62–$50.96	40% below	70%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 *HC CULTURE, EAR	$16.80	$56.00	$8.62–$50.96	40% below	70%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HC CULTURE, EYE	$16.80	$56.00	$8.62–$50.96	40% below	70%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HC SPINAL FLD CULTURE	$16.80	$56.00	$8.62–$50.96	40% below	70%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 *HC CULTURE, GENITAL	$16.80	$56.00	$8.62–$50.96	40% below	70%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HC RESPIRATORY CULTURE	$28.50	$95.00	$8.62–$86.45	1% above	70%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HC CULTURE BIOPSY/SURG SPC	$28.80	$96.00	$8.62–$87.36	2% above	70%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 HC CULTURE, WOUND	$16.20	$54.00	—	—	70%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 HC CULTURE, EYE	$16.80	$56.00	—	—	70%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 HC SPINAL FLD CULTURE	$16.80	$56.00	—	—	70%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 HC CULTURE THROAT	$16.80	$56.00	—	—	70%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 HC BODY FLUID CULTURE	$16.80	$56.00	—	—	70%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 *HC CULTURE, EAR	$16.80	$56.00	—	—	70%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 *HC CULTURE, GENITAL	$16.80	$56.00	—	—	70%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 *HC CULTURE, GONORRHEA	$16.80	$56.00	—	—	70%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 HC RESPIRATORY CULTURE	$28.50	$95.00	—	—	70%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 HC CULTURE BIOPSY/SURG SPC	$28.80	$96.00	—	—	70%
Basic metabolic panel (blood test) CPT 80048 HC BASIC METABOLIC PANEL(8 TESTS)	$20.40	$68.00	$8.46–$61.88	42% below	70%
Basic metabolic panel (blood test) inpatient CPT 80048 HC BASIC METABOLIC PANEL(8 TESTS)	$20.40	$68.00	—	—	70%
Bilirubin blood test, total CPT 82247 HC BILIRUBIN, TOTAL, BODY FLUID - RL	$18.90	$63.00	$4.73–$57.33	15% above	70%
Bilirubin blood test, total CPT 82247 HC BILIRUBIN, TOTAL	$18.90	$63.00	$4.73–$57.33	15% above	70%
Bilirubin blood test, total inpatient CPT 82247 HC BILIRUBIN, TOTAL, BODY FLUID - RL	$18.90	$63.00	—	—	70%
Bilirubin blood test, total inpatient CPT 82247 HC BILIRUBIN, TOTAL	$18.90	$63.00	—	—	70%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 HC LEVEL 4 GROSS & MICROSCOPIC, RB - RL	$60.30	$201.00	$44.22–$182.91	23% below	70%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 HC TISSUE, G & M, LEVEL IV	$65.40	$218.00	$47.96–$198.38	16% below	70%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 HC RENAL BIOPSY	$75.60	$252.00	$49.47–$229.32	3% below	70%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 HC LVL IV SURG PTH	$82.20	$274.00	$49.47–$249.34	5% above	70%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 HC LEVEL 4 GROSS & MICROSCOPIC, RB - RL	$60.30	$201.00	—	—	70%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 HC TISSUE, G & M, LEVEL IV	$65.40	$218.00	—	—	70%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 HC RENAL BIOPSY	$75.60	$252.00	—	—	70%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 HC LVL IV SURG PTH	$82.20	$274.00	—	—	70%
Blood culture for bacteria CPT 87040 HC BLOOD CULTURE	$25.80	$86.00	$10.32–$78.26	43% below	70%
Blood culture for bacteria inpatient CPT 87040 HC BLOOD CULTURE	$25.80	$86.00	—	—	70%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 HC REF LAB COURTESY VENIPUNCT COLLECT; QUEST	$2.40	$8.00	$1.76–$7.28	71% below	70%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 HC VENIPUNCTURE/BL COLL	$9.30	$31.00	$3.00–$28.21	13% above	70%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 HC REF LAB COURTESY VENIPUNCT COLLECT; QUEST	$2.40	$8.00	—	—	70%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 HC VENIPUNCTURE/BL COLL	$9.30	$31.00	—	—	70%
Blood glucose (sugar) test CPT 82947 *HC GLUCOSE, CAPILLARY	$3.60	$12.00	$2.64–$10.92	72% below	70%
Blood glucose (sugar) test CPT 82947 HC GLUCOSE, QUANTATIVE	$3.90	$13.00	$2.86–$11.83	70% below	70%
Blood glucose (sugar) test CPT 82947 HC GLUCOSE-ISTAT	$3.90	$13.00	$2.86–$11.83	70% below	70%
Blood glucose (sugar) test CPT 82947 *HC GLUCOSE TOLERANCE, 3H	$8.10	$27.00	$3.93–$24.57	38% below	70%
Blood glucose (sugar) test CPT 82947 HC GLUCOSE LEVEL FASTING SPEC	$8.10	$27.00	$3.93–$24.57	38% below	70%
Blood glucose (sugar) test CPT 82947 *HC GLUCOSE TOLERANCE, 6H	$8.10	$27.00	$3.93–$24.57	38% below	70%
Blood glucose (sugar) test CPT 82947 *HC GLUCOSE TOLERANCE, 5H	$8.10	$27.00	$3.93–$24.57	38% below	70%
Blood glucose (sugar) test CPT 82947 *HC GLUCOSE TOLERANCE, 1H	$8.10	$27.00	$3.93–$24.57	38% below	70%
Blood glucose (sugar) test CPT 82947 *HC GLUCOSE TOLERANCE, 2H	$8.10	$27.00	$3.93–$24.57	38% below	70%
Blood glucose (sugar) test CPT 82947 *HC GLUCOSE TOLERANCE, 4H	$8.10	$27.00	$3.93–$24.57	38% below	70%
Blood glucose (sugar) test CPT 82947 *HC GLUCOSE QUANT RANDOM LEVEL	$14.10	$47.00	$3.93–$42.77	8% above	70%
Blood glucose (sugar) test CPT 82947 HC GLUCOSE, QUANTATIVE, BODY FLUID	$14.10	$47.00	$3.93–$42.77	8% above	70%
Blood glucose (sugar) test CPT 82947 HC POC GLUCOSE	$21.60	$72.00	$3.93–$65.52	66% above	70%
Blood glucose (sugar) test inpatient CPT 82947 *HC GLUCOSE, CAPILLARY	$3.60	$12.00	—	—	70%
Blood glucose (sugar) test inpatient CPT 82947 HC GLUCOSE-ISTAT	$3.90	$13.00	—	—	70%
Blood glucose (sugar) test inpatient CPT 82947 HC GLUCOSE, QUANTATIVE	$3.90	$13.00	—	—	70%
Blood glucose (sugar) test inpatient CPT 82947 *HC GLUCOSE TOLERANCE, 5H	$8.10	$27.00	—	—	70%
Blood glucose (sugar) test inpatient CPT 82947 HC GLUCOSE LEVEL FASTING SPEC	$8.10	$27.00	—	—	70%
Blood glucose (sugar) test inpatient CPT 82947 *HC GLUCOSE TOLERANCE, 1H	$8.10	$27.00	—	—	70%
Blood glucose (sugar) test inpatient CPT 82947 *HC GLUCOSE TOLERANCE, 2H	$8.10	$27.00	—	—	70%
Blood glucose (sugar) test inpatient CPT 82947 *HC GLUCOSE TOLERANCE, 3H	$8.10	$27.00	—	—	70%
Blood glucose (sugar) test inpatient CPT 82947 *HC GLUCOSE TOLERANCE, 4H	$8.10	$27.00	—	—	70%
Blood glucose (sugar) test inpatient CPT 82947 *HC GLUCOSE TOLERANCE, 6H	$8.10	$27.00	—	—	70%
Blood glucose (sugar) test inpatient CPT 82947 *HC GLUCOSE QUANT RANDOM LEVEL	$14.10	$47.00	—	—	70%
Blood glucose (sugar) test inpatient CPT 82947 HC GLUCOSE, QUANTATIVE, BODY FLUID	$14.10	$47.00	—	—	70%
Blood glucose (sugar) test inpatient CPT 82947 HC POC GLUCOSE	$21.60	$72.00	—	—	70%
Blood lead test CPT 83655 *HC LEAD LEVEL ASSAY	$15.30	$51.00	$11.22–$46.41	43% below	70%
Blood lead test CPT 83655 HC LEAD, BLOOD	$27.90	$93.00	$12.11–$84.63	3% above	70%
Blood lead test CPT 83655 HC LEAD, URINE	$27.90	$93.00	$12.11–$84.63	3% above	70%
Blood lead test inpatient CPT 83655 *HC LEAD LEVEL ASSAY	$15.30	$51.00	—	—	70%
Blood lead test inpatient CPT 83655 HC LEAD, BLOOD	$27.90	$93.00	—	—	70%
Blood lead test inpatient CPT 83655 HC LEAD, URINE	$27.90	$93.00	—	—	70%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 HC HCG, QUALITATIVE BLOOD OR UR	$20.40	$68.00	$7.52–$61.88	31% below	70%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 HC HCG, QUALITATIVE BLOOD OR UR	$20.40	$68.00	—	—	70%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 HC BB REF ABO TYPE	$9.30	$31.00	$2.99–$28.21	79% below	70%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 HC C-BLOOD TYPING, ABO	$45.00	$150.00	$2.99–$136.50	2% above	70%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 HC BB REF ABO TYPE	$9.30	$31.00	—	—	70%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 HC C-BLOOD TYPING, ABO	$45.00	$150.00	—	—	70%
Blood urea nitrogen (BUN) test CPT 84520 HC ASSAY UREA NITROGEN, QUAN	$4.50	$15.00	$3.30–$13.65	73% below	70%
Blood urea nitrogen (BUN) test CPT 84520 HC UREA NITROGEN, BLOOD	$14.70	$49.00	$3.95–$44.59	12% below	70%
Blood urea nitrogen (BUN) test CPT 84520 *HC UREA NITROGEN, URINE, 24H	$14.70	$49.00	$3.95–$44.59	12% below	70%
Blood urea nitrogen (BUN) test inpatient CPT 84520 HC ASSAY UREA NITROGEN, QUAN	$4.50	$15.00	—	—	70%
Blood urea nitrogen (BUN) test inpatient CPT 84520 HC UREA NITROGEN, BLOOD	$14.70	$49.00	—	—	70%
Blood urea nitrogen (BUN) test inpatient CPT 84520 *HC UREA NITROGEN, URINE, 24H	$14.70	$49.00	—	—	70%
C-peptide blood test CPT 84681 HC C PEPTIDE	$19.80	$66.00	$14.52–$60.06	61% below	70%
C-peptide blood test CPT 84681 *HC C PEPTIDE, URINE, 24H	$50.40	$168.00	$20.81–$152.88	2% below	70%
C-peptide blood test CPT 84681 HC C PEPTIDE, SERUM - RL	$50.40	$168.00	$20.81–$152.88	2% below	70%
C-peptide blood test inpatient CPT 84681 HC C PEPTIDE	$19.80	$66.00	—	—	70%
C-peptide blood test inpatient CPT 84681 HC C PEPTIDE, SERUM - RL	$50.40	$168.00	—	—	70%
C-peptide blood test inpatient CPT 84681 *HC C PEPTIDE, URINE, 24H	$50.40	$168.00	—	—	70%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 *HC CRP, BLOOD	$23.70	$79.00	$5.18–$71.89	2% above	70%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 HC C-REACTIVE PROTEIN	$24.60	$82.00	$5.18–$74.62	6% above	70%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 *HC CRP, BLOOD	$23.70	$79.00	—	—	70%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 HC C-REACTIVE PROTEIN	$24.60	$82.00	—	—	70%
C. difficile toxin gene test (stool PCR) CPT 87493 HC C. DIFFICILE TOXIN BY PCR	$45.60	$152.00	$33.44–$138.32	28% below	70%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 HC C. DIFFICILE TOXIN BY PCR	$45.60	$152.00	—	—	70%
CA 19-9 blood test (tumor marker) CPT 86301 HC CA 19-9	$39.30	$131.00	$20.81–$119.21	18% below	70%
CA 19-9 blood test (tumor marker) inpatient CPT 86301 HC CA 19-9	$39.30	$131.00	—	—	70%
CA-125 blood test (ovarian cancer marker) CPT 86304 HC CANCER AG 125 (CA 125)-RL	$38.10	$127.00	$20.81–$115.57	27% below	70%
CA-125 blood test (ovarian cancer marker) CPT 86304 HC CA 125 (CANCER ANTIGEN 125)	$38.10	$127.00	$20.81–$115.57	27% below	70%
CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 HC CANCER AG 125 (CA 125)-RL	$38.10	$127.00	—	—	70%
CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 HC CA 125 (CANCER ANTIGEN 125)	$38.10	$127.00	—	—	70%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 HC SARS-COV-2 COVID-19 AMPLIFIED PROBE	$92.70	$309.00	$38.48–$281.19	30% above	70%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 HC SARS-COV-2 COVID-19 AMPLIFIED PROBE	$92.70	$309.00	—	—	70%
Calcium blood test, total CPT 82310 HC CALCIUM ISTAT	$17.70	$59.00	$5.16–$53.69	11% below	70%
Calcium blood test, total CPT 82310 HC CALCIUM SERUM	$17.70	$59.00	$5.16–$53.69	11% below	70%
Calcium blood test, total inpatient CPT 82310 HC CALCIUM SERUM	$17.70	$59.00	—	—	70%
Calcium blood test, total inpatient CPT 82310 HC CALCIUM ISTAT	$17.70	$59.00	—	—	70%
Carcinoembryonic antigen (CEA) test CPT 82378 HC CEA, FLUID	$33.00	$110.00	$18.96–$100.10	44% below	70%
Carcinoembryonic antigen (CEA) test CPT 82378 HC CEA	$33.00	$110.00	$18.96–$100.10	44% below	70%
Carcinoembryonic antigen (CEA) test inpatient CPT 82378 HC CEA	$33.00	$110.00	—	—	70%
Carcinoembryonic antigen (CEA) test inpatient CPT 82378 HC CEA, FLUID	$33.00	$110.00	—	—	70%
Chickenpox (varicella) immunity blood test CPT 86787 HC VZV AB (IGG), IFA, CSF	$12.90	$43.00	$9.46–$39.13	65% below	70%
Chickenpox (varicella) immunity blood test CPT 86787 HC VARICELLA ZOSTER AB-IGG	$25.50	$85.00	$12.88–$77.35	30% below	70%
Chickenpox (varicella) immunity blood test CPT 86787 HC VARICELLA ZOSTER AB-IGM	$25.50	$85.00	$12.88–$77.35	30% below	70%
Chickenpox (varicella) immunity blood test CPT 86787 HC VARICELLA AB	$25.50	$85.00	$12.88–$77.35	30% below	70%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 HC VZV AB (IGG), IFA, CSF	$12.90	$43.00	—	—	70%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 HC VARICELLA ZOSTER AB-IGG	$25.50	$85.00	—	—	70%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 HC VARICELLA ZOSTER AB-IGM	$25.50	$85.00	—	—	70%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 HC VARICELLA AB	$25.50	$85.00	—	—	70%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 HC CHLAMYDIA TRACHOMATIS RNA, TMA	$30.60	$102.00	$22.44–$92.82	47% below	70%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 HC CHLAMYDIA T BY AMPLIFIED PROBE	$42.30	$141.00	$31.02–$128.31	26% below	70%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 HC CHLAMYDIA TRACHOMATIS TMA	$42.30	$141.00	$31.02–$128.31	26% below	70%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 HC C. TRACH, MISC, AMPLIFIED RNA	$42.30	$141.00	$31.02–$128.31	26% below	70%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 HC CHLAMYDIA TRACHOMATIS RNA, TMA	$30.60	$102.00	—	—	70%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 HC CHLAMYDIA TRACHOMATIS TMA	$42.30	$141.00	—	—	70%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 HC CHLAMYDIA T BY AMPLIFIED PROBE	$42.30	$141.00	—	—	70%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 HC C. TRACH, MISC, AMPLIFIED RNA	$42.30	$141.00	—	—	70%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 HC LIPID PROFILE	$39.30	$131.00	$13.39–$119.21	22% below	70%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 HC LIPID PROFILE	$39.30	$131.00	—	—	70%
Complete blood count (CBC) with differential CPT 85025 HC COMPL CBC W/PLT W/AUTOM DIFF	$20.40	$68.00	$7.77–$61.88	22% below	70%
Complete blood count (CBC) with differential inpatient CPT 85025 HC COMPL CBC W/PLT W/AUTOM DIFF	$20.40	$68.00	—	—	70%
Complete blood count (CBC), no differential CPT 85027 HC HEMATOLOGY PROFILE	$6.00	$20.00	$4.40–$18.20	78% below	70%
Complete blood count (CBC), no differential CPT 85027 HC CBC WITHOUT DIFF	$15.00	$50.00	$6.47–$45.50	46% below	70%
Complete blood count (CBC), no differential inpatient CPT 85027 HC HEMATOLOGY PROFILE	$6.00	$20.00	—	—	70%
Complete blood count (CBC), no differential inpatient CPT 85027 HC CBC WITHOUT DIFF	$15.00	$50.00	—	—	70%
Comprehensive metabolic panel (blood test) CPT 80053 HC COMPREHENSIVE METABOLIC PAN 14	$27.00	$90.00	$10.56–$81.90	64% below	70%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 HC COMPREHENSIVE METABOLIC PAN 14	$27.00	$90.00	—	—	70%
Cortisol blood test, total CPT 82533 HC CORTISOL, LCMS	$19.20	$64.00	$14.08–$58.24	49% below	70%
Cortisol blood test, total CPT 82533 HC CORTISOL, SALIVA	$29.70	$99.00	$16.30–$90.09	21% below	70%
Cortisol blood test, total CPT 82533 HC CORTISOL	$36.30	$121.00	$16.30–$110.11	4% below	70%
Cortisol blood test, total inpatient CPT 82533 HC CORTISOL, LCMS	$19.20	$64.00	—	—	70%
Cortisol blood test, total inpatient CPT 82533 HC CORTISOL, SALIVA	$29.70	$99.00	—	—	70%
Cortisol blood test, total inpatient CPT 82533 HC CORTISOL	$36.30	$121.00	—	—	70%
Creatine kinase (CK) blood test, total CPT 82550 HC CREATINE KINASE CK TOTAL	$6.90	$23.00	$5.06–$20.93	69% below	70%
Creatine kinase (CK) blood test, total CPT 82550 HC CREATINE KINASE (CK), CPK, TOTAL	$18.90	$63.00	$6.51–$57.33	15% below	70%
Creatine kinase (CK) blood test, total inpatient CPT 82550 HC CREATINE KINASE CK TOTAL	$6.90	$23.00	—	—	70%
Creatine kinase (CK) blood test, total inpatient CPT 82550 HC CREATINE KINASE (CK), CPK, TOTAL	$18.90	$63.00	—	—	70%
Creatinine blood test CPT 82565 HC CREATININE-BLOOD	$6.00	$20.00	$4.40–$18.20	64% below	70%
Creatinine blood test CPT 82565 HC CREATININE	$24.30	$81.00	$5.12–$73.71	46% above	70%
Creatinine blood test inpatient CPT 82565 HC CREATININE-BLOOD	$6.00	$20.00	—	—	70%
Creatinine blood test inpatient CPT 82565 HC CREATININE	$24.30	$81.00	—	—	70%
Cytomegalovirus (CMV) antibody test CPT 86644 HC CMV SCREEN	$13.50	$45.00	$9.90–$40.95	66% below	70%
Cytomegalovirus (CMV) antibody test CPT 86644 HC CMV AB (TOTAL)	$33.90	$113.00	$14.39–$102.83	14% below	70%
Cytomegalovirus (CMV) antibody test CPT 86644 HC CYTOMEGALOVIRUS IGG	$33.90	$113.00	$14.39–$102.83	14% below	70%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 HC CMV SCREEN	$13.50	$45.00	—	—	70%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 HC CMV AB (TOTAL)	$33.90	$113.00	—	—	70%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 HC CYTOMEGALOVIRUS IGG	$33.90	$113.00	—	—	70%
D-dimer blood test (blood clot marker) CPT 85379 HC D-DIMER, QUANT	$42.90	$143.00	$10.18–$130.13	15% below	70%
D-dimer blood test (blood clot marker) inpatient CPT 85379 HC D-DIMER, QUANT	$42.90	$143.00	—	—	70%
DHEA sulfate (DHEA-S) blood test CPT 82627 HC DHEA-S	$53.70	$179.00	$22.23–$162.89	5% below	70%
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 HC DHEA-S	$53.70	$179.00	—	—	70%
Drug screen by lab instrument (any number of drug classes) CPT 80307 *HC DRUG SCREEN IMMUNOASSAY, EACH SUBSQ	$15.60	$52.00	$11.44–$346.79	53% below	70%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC DRUG SCREEN QUAL, EACH	$18.60	$62.00	$13.64–$346.79	44% below	70%
Drug screen by lab instrument (any number of drug classes) CPT 80307 *HC DRUG SCREEN, PRESUMP, TRICYCLIC ANTIDEPRESSANTS	$20.40	$68.00	$14.96–$346.79	38% below	70%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC DRUG SCREEN,PRESUMP, ANY CLASS, BY INSTRMNT CHEM ANALY, AMPHETAMINES,URINE	$20.40	$68.00	$14.96–$346.79	38% below	70%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC CHAIN OF CUSTODY, URINE DRUG SCREEN	$20.40	$68.00	$14.96–$346.79	38% below	70%
Drug screen by lab instrument (any number of drug classes) CPT 80307 *HC DRUG SCREEN, PRESUMP, BENZODIAZEPINE	$20.40	$68.00	$14.96–$346.79	38% below	70%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC GAMMA-HYDROXYBUTYRIC ACID	$24.60	$82.00	$18.04–$346.79	25% below	70%
Drug screen by lab instrument (any number of drug classes) CPT 80307 *HC COMPREHENSIVE GASTRIC DRUG SCREEN	$24.60	$82.00	$18.04–$346.79	25% below	70%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC DRUG ABUSE SCREEN, URINE	$24.60	$82.00	$18.04–$346.79	25% below	70%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC KETAMINE AND METABOLITE SCREEN, PLASMA - RL	$38.40	$128.00	$28.16–$346.79	16% above	70%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC DRUG ABUSE SCREEN, ANY	$82.80	$276.00	$60.72–$346.79	151% above	70%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC DRUG SCRN, MECONIUM STOOL ,CANNABIS (THC)	$114.60	$382.00	$62.14–$347.62	247% above	70%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC BUPRENORPHINE SCREEN	$114.60	$382.00	$62.14–$347.62	247% above	70%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC MECONIUM DRUG SCREEN PANEL	$114.60	$382.00	$62.14–$347.62	247% above	70%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC PAIN CLINIC DRUG SCREEN, U - RL	$124.50	$415.00	$62.14–$377.65	277% above	70%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC COMPLIANCE DRUG SCREEN, URINE	$124.50	$415.00	$62.14–$377.65	277% above	70%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC DRUG ABUSE PANEL, MECONIUM - SCREEN	$124.50	$415.00	$62.14–$377.65	277% above	70%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC BUPRENORPHINE ANALYSIS, URINE - RL	$135.30	$451.00	$62.14–$410.41	310% above	70%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC DRUG SCREEN, PRESC/OTC, UR	$135.30	$451.00	$62.14–$410.41	310% above	70%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC DRUG SCREEN, PRESC/OTC, SERUM	$135.30	$451.00	$62.14–$410.41	310% above	70%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC ETHYL GLUCURONIDE SCREEN	$135.30	$451.00	$62.14–$410.41	310% above	70%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 *HC DRUG SCREEN IMMUNOASSAY, EACH SUBSQ	$15.60	$52.00	—	—	70%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC DRUG SCREEN QUAL, EACH	$18.60	$62.00	—	—	70%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC CHAIN OF CUSTODY, URINE DRUG SCREEN	$20.40	$68.00	—	—	70%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC DRUG SCREEN,PRESUMP, ANY CLASS, BY INSTRMNT CHEM ANALY, AMPHETAMINES,URINE	$20.40	$68.00	—	—	70%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 *HC DRUG SCREEN, PRESUMP, BENZODIAZEPINE	$20.40	$68.00	—	—	70%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 *HC DRUG SCREEN, PRESUMP, TRICYCLIC ANTIDEPRESSANTS	$20.40	$68.00	—	—	70%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC DRUG ABUSE SCREEN, URINE	$24.60	$82.00	—	—	70%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 *HC COMPREHENSIVE GASTRIC DRUG SCREEN	$24.60	$82.00	—	—	70%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC GAMMA-HYDROXYBUTYRIC ACID	$24.60	$82.00	—	—	70%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC KETAMINE AND METABOLITE SCREEN, PLASMA - RL	$38.40	$128.00	—	—	70%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC DRUG ABUSE SCREEN, ANY	$82.80	$276.00	—	—	70%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC MECONIUM DRUG SCREEN PANEL	$114.60	$382.00	—	—	70%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC DRUG SCRN, MECONIUM STOOL ,CANNABIS (THC)	$114.60	$382.00	—	—	70%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC BUPRENORPHINE SCREEN	$114.60	$382.00	—	—	70%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC COMPLIANCE DRUG SCREEN, URINE	$124.50	$415.00	—	—	70%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC DRUG ABUSE PANEL, MECONIUM - SCREEN	$124.50	$415.00	—	—	70%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC PAIN CLINIC DRUG SCREEN, U - RL	$124.50	$415.00	—	—	70%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC DRUG SCREEN, PRESC/OTC, UR	$135.30	$451.00	—	—	70%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC ETHYL GLUCURONIDE SCREEN	$135.30	$451.00	—	—	70%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC DRUG SCREEN, PRESC/OTC, SERUM	$135.30	$451.00	—	—	70%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC BUPRENORPHINE ANALYSIS, URINE - RL	$135.30	$451.00	—	—	70%
Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 HC ELECTROLYTE PANEL	$43.50	$145.00	$7.01–$131.95	19% above	70%
Electrolyte panel (sodium, potassium, chloride, CO2) inpatient CPT 80051 HC ELECTROLYTE PANEL	$43.50	$145.00	—	—	70%
Epstein-Barr virus (EBV) antibody test CPT 86665 HC EB VIRUS, VCA IGG	$16.80	$56.00	$12.32–$50.96	67% below	70%
Epstein-Barr virus (EBV) antibody test CPT 86665 HC EB VIRUS, VCA IGM	$16.80	$56.00	$12.32–$50.96	67% below	70%
Epstein-Barr virus (EBV) antibody test CPT 86665 HC EBV IGG	$16.80	$56.00	$12.32–$50.96	67% below	70%
Epstein-Barr virus (EBV) antibody test CPT 86665 HC EBV-IGM	$19.50	$65.00	$14.30–$59.15	62% below	70%
Epstein-Barr virus (EBV) antibody test CPT 86665 HC EPSTEIN-BARR ANTIBODY,V CAPSID	$55.80	$186.00	$18.14–$169.26	10% above	70%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 HC EB VIRUS, VCA IGM	$16.80	$56.00	—	—	70%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 HC EB VIRUS, VCA IGG	$16.80	$56.00	—	—	70%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 HC EBV IGG	$16.80	$56.00	—	—	70%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 HC EBV-IGM	$19.50	$65.00	—	—	70%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 HC EPSTEIN-BARR ANTIBODY,V CAPSID	$55.80	$186.00	—	—	70%
Estradiol blood test CPT 82670 *HC ESTRADIOL, LCMS, ENDO-SCI	$53.70	$179.00	$27.94–$162.89	6% below	70%
Estradiol blood test CPT 82670 *HC ESTRADIOL, FEMALE ADULT PREMENOPAUSAL	$53.70	$179.00	$27.94–$162.89	6% below	70%
Estradiol blood test CPT 82670 HC ESTRADIOL	$53.70	$179.00	$27.94–$162.89	6% below	70%
Estradiol blood test CPT 82670 *HC ESTRADIOL, MALE CHILD OR POST MENOPAUSAL FEMALE	$53.70	$179.00	$27.94–$162.89	6% below	70%
Estradiol blood test inpatient CPT 82670 *HC ESTRADIOL, LCMS, ENDO-SCI	$53.70	$179.00	—	—	70%
Estradiol blood test inpatient CPT 82670 *HC ESTRADIOL, MALE CHILD OR POST MENOPAUSAL FEMALE	$53.70	$179.00	—	—	70%
Estradiol blood test inpatient CPT 82670 HC ESTRADIOL	$53.70	$179.00	—	—	70%
Estradiol blood test inpatient CPT 82670 *HC ESTRADIOL, FEMALE ADULT PREMENOPAUSAL	$53.70	$179.00	—	—	70%
FSH (follicle-stimulating hormone) test CPT 83001 HC FSH	$31.50	$105.00	$18.58–$95.55	43% below	70%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 HC FSH	$31.50	$105.00	—	—	70%
Fecal calprotectin (stool inflammation test) CPT 83993 HC CALPROTECTIN, FECAL	$19.50	$65.00	$14.30–$59.15	79% below	70%
Fecal calprotectin (stool inflammation test) inpatient CPT 83993 HC CALPROTECTIN, FECAL	$19.50	$65.00	—	—	70%
Ferritin blood test (iron stores) CPT 82728 HC FERRITIN - RL	$25.80	$86.00	$13.63–$78.26	44% below	70%
Ferritin blood test (iron stores) CPT 82728 HC FERRITIN	$25.80	$86.00	$13.63–$78.26	44% below	70%
Ferritin blood test (iron stores) inpatient CPT 82728 HC FERRITIN	$25.80	$86.00	—	—	70%
Ferritin blood test (iron stores) inpatient CPT 82728 HC FERRITIN - RL	$25.80	$86.00	—	—	70%
Fibrinogen blood test CPT 85384 HC FIBRINOGEN	$29.10	$97.00	$9.72–$88.27	6% below	70%
Fibrinogen blood test CPT 85384 HC CITRATED FUNCTIONAL FIBRINOGEN FLEV	$31.80	$106.00	$9.72–$96.46	2% above	70%
Fibrinogen blood test CPT 85384 HC CITRATED FUNCTIONAL FIBRINOGEN MA	$31.80	$106.00	$9.72–$96.46	2% above	70%
Fibrinogen blood test inpatient CPT 85384 HC FIBRINOGEN	$29.10	$97.00	—	—	70%
Fibrinogen blood test inpatient CPT 85384 HC CITRATED FUNCTIONAL FIBRINOGEN MA	$31.80	$106.00	—	—	70%
Fibrinogen blood test inpatient CPT 85384 HC CITRATED FUNCTIONAL FIBRINOGEN FLEV	$31.80	$106.00	—	—	70%
Folate (folic acid) blood test CPT 82746 HC FOLIC ACID	$29.10	$97.00	$14.70–$88.27	23% below	70%
Folate (folic acid) blood test inpatient CPT 82746 HC FOLIC ACID	$29.10	$97.00	—	—	70%
Free T3 thyroid hormone test CPT 84481 HC T3,FREE	$42.90	$143.00	$13.43–$130.13	13% below	70%
Free T3 thyroid hormone test inpatient CPT 84481 HC T3,FREE	$42.90	$143.00	—	—	70%
Free T4 (free thyroxine) thyroid blood test CPT 84439 HC T4, FREE	$9.30	$31.00	$6.82–$28.21	73% below	70%
Free T4 (free thyroxine) thyroid blood test CPT 84439 HC T4, FREE BY DIALYSIS	$32.40	$108.00	$9.02–$98.28	7% below	70%
Free T4 (free thyroxine) thyroid blood test CPT 84439 HC THYROXINE FREE	$39.00	$130.00	$9.02–$118.30	12% above	70%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 HC T4, FREE	$9.30	$31.00	—	—	70%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 HC T4, FREE BY DIALYSIS	$32.40	$108.00	—	—	70%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 HC THYROXINE FREE	$39.00	$130.00	—	—	70%
Free testosterone test CPT 84402 HC TESTOSTERONE, FREE BY DIALYSIS	$23.10	$77.00	$16.94–$70.07	62% below	70%
Free testosterone test CPT 84402 HC TESTOSTERONE, FREE	$36.30	$121.00	$25.47–$110.11	40% below	70%
Free testosterone test CPT 84402 HC TESTOSTERONE, FREE, FEMALES OR CHILDREN	$99.00	$330.00	$25.47–$300.30	64% above	70%
Free testosterone test CPT 84402 HC TESTOSTERONE, FREE, MALES	$99.00	$330.00	$25.47–$300.30	64% above	70%
Free testosterone test inpatient CPT 84402 HC TESTOSTERONE, FREE BY DIALYSIS	$23.10	$77.00	—	—	70%
Free testosterone test inpatient CPT 84402 HC TESTOSTERONE, FREE	$36.30	$121.00	—	—	70%
Free testosterone test inpatient CPT 84402 HC TESTOSTERONE, FREE, FEMALES OR CHILDREN	$99.00	$330.00	—	—	70%
Free testosterone test inpatient CPT 84402 HC TESTOSTERONE, FREE, MALES	$99.00	$330.00	—	—	70%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 HC HCV FIBROSURE-GGT	$8.10	$27.00	$5.94–$24.57	67% below	70%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 HC GAMMA GT	$17.70	$59.00	$7.20–$53.69	28% below	70%
Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 HC HCV FIBROSURE-GGT	$8.10	$27.00	—	—	70%
Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 HC GAMMA GT	$17.70	$59.00	—	—	70%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 HC GLUCOSE POST DOSE	$16.80	$56.00	$4.75–$50.96	5% above	70%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 *HC GLUCOSE 2HR POST DOSE	$23.40	$78.00	$4.75–$70.98	46% above	70%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 HC GLUCOSE POST DOSE	$16.80	$56.00	—	—	70%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 *HC GLUCOSE 2HR POST DOSE	$23.40	$78.00	—	—	70%
Glucose tolerance test, 3 samples CPT 82951 HC GLUCOSE TOLERANCE 3 SPECIMENS	$12.30	$41.00	$9.02–$37.31	73% below	70%
Glucose tolerance test, 3 samples CPT 82951 HC GLUCOSE TOLERANCE 2 HRS	$33.90	$113.00	$12.87–$102.83	25% below	70%
Glucose tolerance test, 3 samples CPT 82951 HC GLUCOSE TOLERANCE 3H	$33.90	$113.00	$12.87–$102.83	25% below	70%
Glucose tolerance test, 3 samples inpatient CPT 82951 HC GLUCOSE TOLERANCE 3 SPECIMENS	$12.30	$41.00	—	—	70%
Glucose tolerance test, 3 samples inpatient CPT 82951 HC GLUCOSE TOLERANCE 2 HRS	$33.90	$113.00	—	—	70%
Glucose tolerance test, 3 samples inpatient CPT 82951 HC GLUCOSE TOLERANCE 3H	$33.90	$113.00	—	—	70%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 HC NEISSERIA GONORRHOEAE TMA	$42.30	$141.00	$31.02–$128.31	26% below	70%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 HC N. GONORR, MISC, AMPLIFIED RNA	$63.90	$213.00	$35.09–$193.83	12% above	70%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 HC GC BY AMPLIFIED PROBE	$63.90	$213.00	$35.09–$193.83	12% above	70%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 HC NEISSERIA GONORRHOEAE TMA	$42.30	$141.00	—	—	70%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 HC N. GONORR, MISC, AMPLIFIED RNA	$63.90	$213.00	—	—	70%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 HC GC BY AMPLIFIED PROBE	$63.90	$213.00	—	—	70%
H. pylori antibody blood test CPT 86677 HC HELICOBACTER PYLORI IGG	$45.60	$152.00	$15.82–$138.32	1% below	70%
H. pylori antibody blood test CPT 86677 HC HELICOBACTER PYLORI AB, EACH	$45.60	$152.00	$15.82–$138.32	1% below	70%
H. pylori antibody blood test inpatient CPT 86677 HC HELICOBACTER PYLORI IGG	$45.60	$152.00	—	—	70%
H. pylori antibody blood test inpatient CPT 86677 HC HELICOBACTER PYLORI AB, EACH	$45.60	$152.00	—	—	70%
H. pylori stool antigen test CPT 87338 HC HELICOBACTER PYLORI AG STOOL	$61.80	$206.00	$6.31–$187.46	1% above	70%
H. pylori stool antigen test inpatient CPT 87338 HC HELICOBACTER PYLORI AG STOOL	$61.80	$206.00	—	—	70%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HC HIV-1 QUANT BY NAAT	$74.10	$247.00	$54.34–$224.77	57% below	70%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HC HIV-1 RNA ULT QUANT BY PCR	$105.30	$351.00	$77.22–$319.41	39% below	70%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HC HIV-1 RNA DETECT/QUANT	$150.00	$500.00	$85.10–$455.00	13% below	70%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HC HIV-1 QUANT BY NAAT	$74.10	$247.00	—	—	70%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HC HIV-1 RNA ULT QUANT BY PCR	$105.30	$351.00	—	—	70%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HC HIV-1 RNA DETECT/QUANT	$150.00	$500.00	—	—	70%
HIV-1 and HIV-2 antibody test CPT 86703 HC HIV 1/2 AB, DONOR EVAL (BLOOD CENTER)	$9.90	$33.00	$7.26–$30.03	71% below	70%
HIV-1 and HIV-2 antibody test CPT 86703 HC RAPID HIV-1/2 AB	$25.80	$86.00	$13.71–$78.26	25% below	70%
HIV-1 and HIV-2 antibody test CPT 86703 HC HIV1 & HIV2, SGL ASSAY	$25.80	$86.00	$13.71–$78.26	25% below	70%
HIV-1 and HIV-2 antibody test inpatient CPT 86703 HC HIV 1/2 AB, DONOR EVAL (BLOOD CENTER)	$9.90	$33.00	—	—	70%
HIV-1 and HIV-2 antibody test inpatient CPT 86703 HC HIV1 & HIV2, SGL ASSAY	$25.80	$86.00	—	—	70%
HIV-1 and HIV-2 antibody test inpatient CPT 86703 HC RAPID HIV-1/2 AB	$25.80	$86.00	—	—	70%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HC HIV-1 AG W/ HIV1 AB & HIV2 AB	$25.80	$86.00	$18.92–$78.26	45% below	70%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HC HIV-1 AG W/ HIV1 AB & HIV2 AB	$25.80	$86.00	—	—	70%
HPV test for high-risk types, one combined (pooled) result CPT 87624 HC HPV,HIGH RISK TYPES, POOLED RESULT	$33.30	$111.00	$24.42–$101.01	34% below	70%
HPV test for high-risk types, one combined (pooled) result CPT 87624 *HC HPV DNA HIGH RISK	$41.70	$139.00	$30.58–$126.49	18% below	70%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HC HPV,HIGH RISK TYPES, POOLED RESULT	$33.30	$111.00	—	—	70%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 *HC HPV DNA HIGH RISK	$41.70	$139.00	—	—	70%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HC GLYCOSYLATED HB	$9.00	$30.00	$6.60–$27.30	75% below	70%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HC HEMOGLOBIN A1C - RL	$18.00	$60.00	$9.71–$54.60	49% below	70%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HC GLYCOSYLATED HB	$9.00	$30.00	—	—	70%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HC HEMOGLOBIN A1C - RL	$18.00	$60.00	—	—	70%
Hemoglobin blood test CPT 85018 HC HEMOGLOBIN	$8.10	$27.00	$2.37–$24.57	22% below	70%
Hemoglobin blood test inpatient CPT 85018 HC HEMOGLOBIN	$8.10	$27.00	—	—	70%
Hepatitis B core antibody test (total) CPT 86704 HC HEPATITIS B CORE AB, DONOR EVAL (BLOOD CENTER)	$11.40	$38.00	$8.36–$34.58	60% below	70%
Hepatitis B core antibody test (total) CPT 86704 HC HBCAB	$11.40	$38.00	$8.36–$34.58	60% below	70%
Hepatitis B core antibody test (total) CPT 86704 HC HEP B CORE AB,IGG/IGM DIFF	$12.90	$43.00	$9.46–$39.13	55% below	70%
Hepatitis B core antibody test (total) CPT 86704 HC HEPATITIS B CORE, TOTAL	$13.80	$46.00	$10.12–$41.86	51% below	70%
Hepatitis B core antibody test (total) inpatient CPT 86704 HC HBCAB	$11.40	$38.00	—	—	70%
Hepatitis B core antibody test (total) inpatient CPT 86704 HC HEPATITIS B CORE AB, DONOR EVAL (BLOOD CENTER)	$11.40	$38.00	—	—	70%
Hepatitis B core antibody test (total) inpatient CPT 86704 HC HEP B CORE AB,IGG/IGM DIFF	$12.90	$43.00	—	—	70%
Hepatitis B core antibody test (total) inpatient CPT 86704 HC HEPATITIS B CORE, TOTAL	$13.80	$46.00	—	—	70%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HC HEPATITIS B SURFACE AB TITER	$12.60	$42.00	$9.24–$38.22	58% below	70%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HC HBSAB	$12.60	$42.00	$9.24–$38.22	58% below	70%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HC HBSAB	$12.60	$42.00	—	—	70%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HC HEPATITIS B SURFACE AB TITER	$12.60	$42.00	—	—	70%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HC HBSAG	$24.30	$81.00	$10.33–$73.71	32% below	70%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HC HEPATITIS B SURFACE AG, DONOR EVAL (BLOOD CENTER)	$24.30	$81.00	$10.33–$73.71	32% below	70%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HC HEPATITIS B SURFACE AG, DONOR EVAL (BLOOD CENTER)	$24.30	$81.00	—	—	70%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HC HBSAG	$24.30	$81.00	—	—	70%
Hepatitis C antibody blood test (screening) CPT 86803 *HC C-AB, HEP-C	$16.20	$54.00	$11.88–$49.14	64% below	70%
Hepatitis C antibody blood test (screening) CPT 86803 HC HEPATITIS C ANTIBODY, DONOR EVAL (BLOOD CENTER)	$46.20	$154.00	$14.27–$140.14	3% above	70%
Hepatitis C antibody blood test (screening) CPT 86803 HC HCV-AB	$46.20	$154.00	$14.27–$140.14	3% above	70%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 *HC C-AB, HEP-C	$16.20	$54.00	—	—	70%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 HC HCV-AB	$46.20	$154.00	—	—	70%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 HC HEPATITIS C ANTIBODY, DONOR EVAL (BLOOD CENTER)	$46.20	$154.00	—	—	70%
Hepatitis C viral load (HCV RNA) test CPT 87522 HC HCV RNA ULTRAQUANT BY PCR	$41.10	$137.00	$30.14–$124.67	63% below	70%
Hepatitis C viral load (HCV RNA) test CPT 87522 HC HCV QUANTITATIVE BY NAAT	$51.60	$172.00	$37.84–$156.52	53% below	70%
Hepatitis C viral load (HCV RNA) test CPT 87522 HC HCV QUANTITATION BY PCR	$138.60	$462.00	$42.84–$420.42	26% above	70%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HC HCV RNA ULTRAQUANT BY PCR	$41.10	$137.00	—	—	70%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HC HCV QUANTITATIVE BY NAAT	$51.60	$172.00	—	—	70%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HC HCV QUANTITATION BY PCR	$138.60	$462.00	—	—	70%
Herpes blood test, HSV-1 antibody CPT 86695 HC HSV1 GLYCOPROTEIN G-SPECIFIC AB	$11.40	$38.00	$8.36–$34.58	55% below	70%
Herpes blood test, HSV-1 antibody CPT 86695 HC HSV1 IGM	$11.70	$39.00	$8.58–$35.49	54% below	70%
Herpes blood test, HSV-1 antibody CPT 86695 HC HSV1 IGG TYPE SPECIFIC AB	$14.10	$47.00	$10.34–$42.77	44% below	70%
Herpes blood test, HSV-1 antibody CPT 86695 HC HSV 1 IGG INDEX, CSF	$29.10	$97.00	$13.19–$88.27	15% above	70%
Herpes blood test, HSV-1 antibody CPT 86695 *HC ENCEPH - HSV I AB	$43.20	$144.00	$13.19–$131.04	71% above	70%
Herpes blood test, HSV-1 antibody CPT 86695 HC HSV1 IGG	$43.20	$144.00	$13.19–$131.04	71% above	70%
Herpes blood test, HSV-1 antibody CPT 86695 HC HSV1 IGG AB	$43.20	$144.00	$13.19–$131.04	71% above	70%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 HC HSV1 GLYCOPROTEIN G-SPECIFIC AB	$11.40	$38.00	—	—	70%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 HC HSV1 IGM	$11.70	$39.00	—	—	70%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 HC HSV1 IGG TYPE SPECIFIC AB	$14.10	$47.00	—	—	70%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 HC HSV 1 IGG INDEX, CSF	$29.10	$97.00	—	—	70%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 HC HSV1 IGG AB	$43.20	$144.00	—	—	70%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 HC HSV1 IGG	$43.20	$144.00	—	—	70%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 *HC ENCEPH - HSV I AB	$43.20	$144.00	—	—	70%
Herpes blood test, HSV-2 antibody CPT 86696 HC HSV2 IGM	$17.70	$59.00	$12.98–$53.69	59% below	70%
Herpes blood test, HSV-2 antibody CPT 86696 HC HSV2 IGG TYPE SPECIFIC AB	$21.00	$70.00	$15.40–$63.70	51% below	70%
Herpes blood test, HSV-2 antibody CPT 86696 HC HSV2 GLYCOPROTEIN G-SPECIFIC AB	$22.20	$74.00	$16.28–$67.34	49% below	70%
Herpes blood test, HSV-2 antibody CPT 86696 HC HSV TYPE 2 IGG, CSF	$29.10	$97.00	$19.35–$88.27	33% below	70%
Herpes blood test, HSV-2 antibody CPT 86696 HC HSV2 IGG AB	$56.40	$188.00	$19.35–$171.08	31% above	70%
Herpes blood test, HSV-2 antibody CPT 86696 HC HSV2 IGG	$56.40	$188.00	$19.35–$171.08	31% above	70%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HC HSV2 IGM	$17.70	$59.00	—	—	70%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HC HSV2 IGG TYPE SPECIFIC AB	$21.00	$70.00	—	—	70%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HC HSV2 GLYCOPROTEIN G-SPECIFIC AB	$22.20	$74.00	—	—	70%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HC HSV TYPE 2 IGG, CSF	$29.10	$97.00	—	—	70%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HC HSV2 IGG	$56.40	$188.00	—	—	70%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HC HSV2 IGG AB	$56.40	$188.00	—	—	70%
High-sensitivity CRP (hs-CRP) test CPT 86141 HC C-REACTIVE PROTEIN, HIGH SENS	$16.20	$54.00	$11.88–$49.14	62% below	70%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 HC C-REACTIVE PROTEIN, HIGH SENS	$16.20	$54.00	—	—	70%
Homocysteine blood test CPT 83090 HC HOMOCYSTINES, PLASMA	$63.30	$211.00	$17.92–$192.01	11% above	70%
Homocysteine blood test inpatient CPT 83090 HC HOMOCYSTINES, PLASMA	$63.30	$211.00	—	—	70%
Insulin blood test CPT 83525 HC INSULIN	$13.20	$44.00	$9.68–$40.04	54% below	70%
Insulin blood test CPT 83525 HC INSULIN AND C-PEPTIDE	$40.20	$134.00	$11.43–$121.94	41% above	70%
Insulin blood test inpatient CPT 83525 HC INSULIN	$13.20	$44.00	—	—	70%
Insulin blood test inpatient CPT 83525 HC INSULIN AND C-PEPTIDE	$40.20	$134.00	—	—	70%
Iron blood test (serum iron) CPT 83540 HC IRON, LIVER TISSUE - RL	$21.60	$72.00	$6.47–$65.52	1% below	70%
Iron blood test (serum iron) CPT 83540 HC IRON, URINE	$21.60	$72.00	$6.47–$65.52	1% below	70%
Iron blood test (serum iron) inpatient CPT 83540 HC IRON, URINE	$21.60	$72.00	—	—	70%
Iron blood test (serum iron) inpatient CPT 83540 HC IRON, LIVER TISSUE - RL	$21.60	$72.00	—	—	70%
Iron-binding capacity (TIBC) test CPT 83550 HC IRON BINDING CAPACITY	$27.00	$90.00	$8.74–$81.90	16% below	70%
Iron-binding capacity (TIBC) test inpatient CPT 83550 HC IRON BINDING CAPACITY	$27.00	$90.00	—	—	70%
Kidney function blood test panel CPT 80069 HC RENAL FUNCTION PANEL	$43.50	$145.00	$8.68–$131.95	13% below	70%
Kidney function blood test panel inpatient CPT 80069 HC RENAL FUNCTION PANEL	$43.50	$145.00	—	—	70%
LH (luteinizing hormone) test CPT 83002 HC LH	$21.60	$72.00	$15.84–$65.52	60% below	70%
LH (luteinizing hormone) test CPT 83002 *HC LUTEINIZING HORMONE - RL	$33.00	$110.00	$18.52–$100.10	39% below	70%
LH (luteinizing hormone) test inpatient CPT 83002 HC LH	$21.60	$72.00	—	—	70%
LH (luteinizing hormone) test inpatient CPT 83002 *HC LUTEINIZING HORMONE - RL	$33.00	$110.00	—	—	70%
Lactate (lactic acid) blood test CPT 83605 HC ORG ACID LACTIC ACID, URINE	$9.60	$32.00	$7.04–$29.12	66% below	70%
Lactate (lactic acid) blood test CPT 83605 HC D-LACTATE, PLASMA	$11.10	$37.00	$8.14–$33.67	60% below	70%
Lactate (lactic acid) blood test CPT 83605 HC LACTIC ACID, CSF	$36.00	$120.00	$11.57–$109.20	29% above	70%
Lactate (lactic acid) blood test CPT 83605 HC LACTIC ACID	$36.00	$120.00	$11.57–$109.20	29% above	70%
Lactate (lactic acid) blood test CPT 83605 HC LACTATE	$36.00	$120.00	$11.57–$109.20	29% above	70%
Lactate (lactic acid) blood test inpatient CPT 83605 HC ORG ACID LACTIC ACID, URINE	$9.60	$32.00	—	—	70%
Lactate (lactic acid) blood test inpatient CPT 83605 HC D-LACTATE, PLASMA	$11.10	$37.00	—	—	70%
Lactate (lactic acid) blood test inpatient CPT 83605 HC LACTATE	$36.00	$120.00	—	—	70%
Lactate (lactic acid) blood test inpatient CPT 83605 HC LACTIC ACID	$36.00	$120.00	—	—	70%
Lactate (lactic acid) blood test inpatient CPT 83605 HC LACTIC ACID, CSF	$36.00	$120.00	—	—	70%
Lactate dehydrogenase (LDH) blood test CPT 83615 *HC LDH, TOTAL	$7.20	$24.00	$5.28–$21.84	65% below	70%
Lactate dehydrogenase (LDH) blood test CPT 83615 HC LACTATE DEHYDROGENASE TOTAL, BODY FLUID - RL	$18.90	$63.00	$6.04–$57.33	7% below	70%
Lactate dehydrogenase (LDH) blood test CPT 83615 HC LACTATE DEHYDROGENASE TOTAL, BLOOD	$18.90	$63.00	$6.04–$57.33	7% below	70%
Lactate dehydrogenase (LDH) blood test CPT 83615 HC LDH-BLOOD OR BODY FLUID	$18.90	$63.00	$6.04–$57.33	7% below	70%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 *HC LDH, TOTAL	$7.20	$24.00	—	—	70%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 HC LDH-BLOOD OR BODY FLUID	$18.90	$63.00	—	—	70%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 HC LACTATE DEHYDROGENASE TOTAL, BODY FLUID - RL	$18.90	$63.00	—	—	70%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 HC LACTATE DEHYDROGENASE TOTAL, BLOOD	$18.90	$63.00	—	—	70%
Lipase blood test (pancreas enzyme) CPT 83690 *HC LIPASE, BODY FLUID	$8.10	$27.00	$5.94–$24.57	68% below	70%
Lipase blood test (pancreas enzyme) CPT 83690 HC LIPASE, BODY FLUID - RL	$20.40	$68.00	$6.89–$61.88	19% below	70%
Lipase blood test (pancreas enzyme) CPT 83690 HC LIPASE	$20.40	$68.00	$6.89–$61.88	19% below	70%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 *HC LIPASE, BODY FLUID	$8.10	$27.00	—	—	70%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 HC LIPASE	$20.40	$68.00	—	—	70%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 HC LIPASE, BODY FLUID - RL	$20.40	$68.00	—	—	70%
Liver function blood test panel CPT 80076 HC HEPATIC FUNCTION PANEL,7 TESTS	$39.30	$131.00	$8.17–$119.21	22% below	70%
Liver function blood test panel inpatient CPT 80076 HC HEPATIC FUNCTION PANEL,7 TESTS	$39.30	$131.00	—	—	70%
Lyme disease antibody test CPT 86618 *HC LYME AB INDX IGG/IGM	$19.80	$66.00	$14.52–$60.06	61% below	70%
Lyme disease antibody test CPT 86618 HC IGG INDEX, LYME AB, CSF - RL	$19.80	$66.00	$14.52–$60.06	61% below	70%
Lyme disease antibody test CPT 86618 HC IGG INDEX, LYME AB, SERUM - RL	$19.80	$66.00	$14.52–$60.06	61% below	70%
Lyme disease antibody test CPT 86618 HC LYME DISEASE ANTIBODIES	$39.00	$130.00	$17.03–$118.30	23% below	70%
Lyme disease antibody test inpatient CPT 86618 *HC LYME AB INDX IGG/IGM	$19.80	$66.00	—	—	70%
Lyme disease antibody test inpatient CPT 86618 HC IGG INDEX, LYME AB, CSF - RL	$19.80	$66.00	—	—	70%
Lyme disease antibody test inpatient CPT 86618 HC IGG INDEX, LYME AB, SERUM - RL	$19.80	$66.00	—	—	70%
Lyme disease antibody test inpatient CPT 86618 HC LYME DISEASE ANTIBODIES	$39.00	$130.00	—	—	70%
Magnesium blood test CPT 83735 HC MAGNESIUM	$6.00	$20.00	$4.40–$18.20	72% below	70%
Magnesium blood test CPT 83735 HC CATHARTIC LAXATIVE PROF - MAGNESIUM, FECES	$6.60	$22.00	$4.84–$20.02	69% below	70%
Magnesium blood test CPT 83735 HC MAGNESIUM, RBC	$7.80	$26.00	$5.72–$23.66	64% below	70%
Magnesium blood test CPT 83735 HC MAGNESIUM, URINE	$14.40	$48.00	$6.70–$43.68	33% below	70%
Magnesium blood test CPT 83735 HC MAGNESIUM LEVEL ASSAY	$14.40	$48.00	$6.70–$43.68	33% below	70%
Magnesium blood test CPT 83735 HC MAGNESIUM, FECES	$27.00	$90.00	$6.70–$81.90	26% above	70%
Magnesium blood test CPT 83735 HC SUPERSAT URINE, MAGNESIUM	$27.00	$90.00	$6.70–$81.90	26% above	70%
Magnesium blood test inpatient CPT 83735 HC MAGNESIUM	$6.00	$20.00	—	—	70%
Magnesium blood test inpatient CPT 83735 HC CATHARTIC LAXATIVE PROF - MAGNESIUM, FECES	$6.60	$22.00	—	—	70%
Magnesium blood test inpatient CPT 83735 HC MAGNESIUM, RBC	$7.80	$26.00	—	—	70%
Magnesium blood test inpatient CPT 83735 HC MAGNESIUM, URINE	$14.40	$48.00	—	—	70%
Magnesium blood test inpatient CPT 83735 HC MAGNESIUM LEVEL ASSAY	$14.40	$48.00	—	—	70%
Magnesium blood test inpatient CPT 83735 HC MAGNESIUM, FECES	$27.00	$90.00	—	—	70%
Magnesium blood test inpatient CPT 83735 HC SUPERSAT URINE, MAGNESIUM	$27.00	$90.00	—	—	70%
Measles (rubeola) antibody test CPT 86765 HC RUBEOLA IGG	$12.60	$42.00	$9.24–$38.22	57% below	70%
Measles (rubeola) antibody test CPT 86765 HC MEASLES (RUBEOLA) IGM BY IFA, CSF	$14.70	$49.00	$10.78–$44.59	49% below	70%
Measles (rubeola) antibody test CPT 86765 HC RUBEOLA IGG - RL	$40.50	$135.00	$12.88–$122.85	39% above	70%
Measles (rubeola) antibody test CPT 86765 *HC RUBEOLA ANTIBODY	$40.50	$135.00	$12.88–$122.85	39% above	70%
Measles (rubeola) antibody test CPT 86765 HC RUBEOLA IGM	$40.50	$135.00	$12.88–$122.85	39% above	70%
Measles (rubeola) antibody test CPT 86765 HC MEASLES (RUBEOLA) IGG BY IFA, CSF	$40.50	$135.00	$12.88–$122.85	39% above	70%
Measles (rubeola) antibody test inpatient CPT 86765 HC RUBEOLA IGG	$12.60	$42.00	—	—	70%
Measles (rubeola) antibody test inpatient CPT 86765 HC MEASLES (RUBEOLA) IGM BY IFA, CSF	$14.70	$49.00	—	—	70%
Measles (rubeola) antibody test inpatient CPT 86765 *HC RUBEOLA ANTIBODY	$40.50	$135.00	—	—	70%
Measles (rubeola) antibody test inpatient CPT 86765 HC MEASLES (RUBEOLA) IGG BY IFA, CSF	$40.50	$135.00	—	—	70%
Measles (rubeola) antibody test inpatient CPT 86765 HC RUBEOLA IGG - RL	$40.50	$135.00	—	—	70%
Measles (rubeola) antibody test inpatient CPT 86765 HC RUBEOLA IGM	$40.50	$135.00	—	—	70%
Mono test (heterophile antibody, Monospot) CPT 86308 HC MONOSPOT	$34.80	$116.00	$5.18–$105.56	44% above	70%
Mono test (heterophile antibody, Monospot) CPT 86308 HC HETEROPHILE ANTIBODY SCREEN	$38.10	$127.00	$5.18–$115.57	58% above	70%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 HC MONOSPOT	$34.80	$116.00	—	—	70%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 HC HETEROPHILE ANTIBODY SCREEN	$38.10	$127.00	—	—	70%
Mumps immunity blood test CPT 86735 HC MUMPS AB, IGG	$12.00	$40.00	$8.80–$36.40	59% below	70%
Mumps immunity blood test CPT 86735 HC MUMPS ANTIBODIES IGM (EIA)	$15.60	$52.00	$11.44–$47.32	47% below	70%
Mumps immunity blood test CPT 86735 HC MUMPS AB IGM, CSF	$15.60	$52.00	$11.44–$47.32	47% below	70%
Mumps immunity blood test CPT 86735 *HC MUMPS ANTIBODY	$66.60	$222.00	$13.05–$202.02	125% above	70%
Mumps immunity blood test CPT 86735 HC MUMPS AB IGG, CSF	$66.60	$222.00	$13.05–$202.02	125% above	70%
Mumps immunity blood test CPT 86735 *HC MUMPS IGG - RL	$66.60	$222.00	$13.05–$202.02	125% above	70%
Mumps immunity blood test inpatient CPT 86735 HC MUMPS AB, IGG	$12.00	$40.00	—	—	70%
Mumps immunity blood test inpatient CPT 86735 HC MUMPS ANTIBODIES IGM (EIA)	$15.60	$52.00	—	—	70%
Mumps immunity blood test inpatient CPT 86735 HC MUMPS AB IGM, CSF	$15.60	$52.00	—	—	70%
Mumps immunity blood test inpatient CPT 86735 *HC MUMPS ANTIBODY	$66.60	$222.00	—	—	70%
Mumps immunity blood test inpatient CPT 86735 HC MUMPS AB IGG, CSF	$66.60	$222.00	—	—	70%
Mumps immunity blood test inpatient CPT 86735 *HC MUMPS IGG - RL	$66.60	$222.00	—	—	70%
Obstetric blood test panel CPT 80055 HC OBSTETRIC PANEL	$27.00	$90.00	$19.80–$103.61	64% below	70%
Obstetric blood test panel inpatient CPT 80055 HC OBSTETRIC PANEL	$27.00	$90.00	—	—	70%
PSA (prostate-specific antigen) blood test, free CPT 84154 HC PSA, PROSTATE HEALTH INDEX (PHI), FREE	$19.20	$64.00	$14.08–$58.24	61% below	70%
PSA (prostate-specific antigen) blood test, free CPT 84154 HC PSA, FREE	$53.10	$177.00	$18.39–$161.07	9% above	70%
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 HC PSA, PROSTATE HEALTH INDEX (PHI), FREE	$19.20	$64.00	—	—	70%
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 HC PSA, FREE	$53.10	$177.00	—	—	70%
PSA (prostate-specific antigen) blood test, total CPT 84153 HC PSA, TOTAL-REF LAB ONLY	$16.20	$54.00	$11.88–$49.14	63% below	70%
PSA (prostate-specific antigen) blood test, total CPT 84153 HC PSA, DIAGNOSTIC	$21.30	$71.00	$15.62–$64.61	52% below	70%
PSA (prostate-specific antigen) blood test, total CPT 84153 HC PSA, SCREENING	$31.50	$105.00	$18.39–$95.55	29% below	70%
PSA (prostate-specific antigen) blood test, total CPT 84153 HC PROSTATE HEALTH INDEX (PHI)	$38.10	$127.00	$18.39–$115.57	14% below	70%
PSA (prostate-specific antigen) blood test, total CPT 84153 HC PSA, TOTAL	$38.10	$127.00	$18.39–$115.57	14% below	70%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 HC PSA, TOTAL-REF LAB ONLY	$16.20	$54.00	—	—	70%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 HC PSA, DIAGNOSTIC	$21.30	$71.00	—	—	70%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 HC PSA, SCREENING	$31.50	$105.00	—	—	70%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 HC PROSTATE HEALTH INDEX (PHI)	$38.10	$127.00	—	—	70%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 HC PSA, TOTAL	$38.10	$127.00	—	—	70%
Pap test (liquid-based, automated screening with review) CPT 88175 HC PAP SMEAR, THIN PREP IMAGER SC	$18.60	$62.00	$13.64–$56.42	57% below	70%
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 HC PAP SMEAR, THIN PREP IMAGER SC	$18.60	$62.00	—	—	70%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 HC PAP SMEAR, THIN PREP DIAGNOSTIC	$15.90	$53.00	$11.66–$48.23	43% below	70%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 HC PAP SMEAR, THIN PREP SCREENING	$21.30	$71.00	$15.62–$64.61	23% below	70%
Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 HC PAP SMEAR, THIN PREP DIAGNOSTIC	$15.90	$53.00	—	—	70%
Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 HC PAP SMEAR, THIN PREP SCREENING	$21.30	$71.00	—	—	70%
Parathyroid hormone (PTH) blood test CPT 83970 HC PTH, INTRAOPERATIVE	$45.30	$151.00	$33.22–$137.41	50% below	70%
Parathyroid hormone (PTH) blood test CPT 83970 HC PARATHYROID HORMONE, FNA	$47.40	$158.00	$34.76–$143.78	48% below	70%
Parathyroid hormone (PTH) blood test CPT 83970 HC PTH, INTACT	$55.80	$186.00	$40.92–$169.26	39% below	70%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 HC PTH, INTRAOPERATIVE	$45.30	$151.00	—	—	70%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 HC PARATHYROID HORMONE, FNA	$47.40	$158.00	—	—	70%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 HC PTH, INTACT	$55.80	$186.00	—	—	70%
Partial thromboplastin time (PTT) clotting test CPT 85730 HC LUPUS PTT - RL	$6.00	$20.00	$4.40–$18.20	71% below	70%
Partial thromboplastin time (PTT) clotting test CPT 85730 HC PARTIAL THROMBOPLASTIN TIME	$7.20	$24.00	$5.28–$21.84	65% below	70%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 HC LUPUS PTT - RL	$6.00	$20.00	—	—	70%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 HC PARTIAL THROMBOPLASTIN TIME	$7.20	$24.00	—	—	70%
Phosphorus (phosphate) blood test CPT 84100 HC CATHARTIC LAXATIVE PROF - PHOSPHORUS, FECES	$5.10	$17.00	$3.74–$15.47	70% below	70%
Phosphorus (phosphate) blood test CPT 84100 HC PHOSPHORUS	$15.60	$52.00	$4.74–$47.32	7% below	70%
Phosphorus (phosphate) blood test CPT 84100 HC PHOSPHORUS, FECES	$15.60	$52.00	$4.74–$47.32	7% below	70%
Phosphorus (phosphate) blood test inpatient CPT 84100 HC CATHARTIC LAXATIVE PROF - PHOSPHORUS, FECES	$5.10	$17.00	—	—	70%
Phosphorus (phosphate) blood test inpatient CPT 84100 HC PHOSPHORUS, FECES	$15.60	$52.00	—	—	70%
Phosphorus (phosphate) blood test inpatient CPT 84100 HC PHOSPHORUS	$15.60	$52.00	—	—	70%
Potassium blood test CPT 84132 HC POTASSIUM	$4.50	$15.00	$3.30–$13.65	74% below	70%
Potassium blood test CPT 84132 *HC POC POTASSIUM	$15.30	$51.00	$4.76–$46.41	13% below	70%
Potassium blood test inpatient CPT 84132 HC POTASSIUM	$4.50	$15.00	—	—	70%
Potassium blood test inpatient CPT 84132 *HC POC POTASSIUM	$15.30	$51.00	—	—	70%
Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) CPT 81420 HC FETAL CHROMOSOMAL ANEUPLOIDY	$483.30	$1,611.00	$354.42–$3,321.39	15% above	70%
Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) inpatient CPT 81420 HC FETAL CHROMOSOMAL ANEUPLOIDY	$483.30	$1,611.00	—	—	70%
Progesterone blood test CPT 84144 HC PROGESTERONE	$35.10	$117.00	$20.86–$106.47	36% below	70%
Progesterone blood test inpatient CPT 84144 HC PROGESTERONE	$35.10	$117.00	—	—	70%
Prolactin blood test CPT 84146 HC MACROPROLACTIN-UNPRECIP PROLAC	$22.20	$74.00	$16.28–$67.34	65% below	70%
Prolactin blood test CPT 84146 HC MACROPROLACTIN-TOTAL PROLACT	$22.20	$74.00	$16.28–$67.34	65% below	70%
Prolactin blood test CPT 84146 HC PROLACTIN	$36.30	$121.00	$19.38–$110.11	43% below	70%
Prolactin blood test inpatient CPT 84146 HC MACROPROLACTIN-TOTAL PROLACT	$22.20	$74.00	—	—	70%
Prolactin blood test inpatient CPT 84146 HC MACROPROLACTIN-UNPRECIP PROLAC	$22.20	$74.00	—	—	70%
Prolactin blood test inpatient CPT 84146 HC PROLACTIN	$36.30	$121.00	—	—	70%
Prothrombin time (PT/INR) clotting test CPT 85610 HC LUPUS PT - RL	$3.60	$12.00	$2.64–$10.92	75% below	70%
Prothrombin time (PT/INR) clotting test CPT 85610 HC PROTHROMBIN TIME - RL	$4.80	$16.00	$3.52–$14.56	67% below	70%
Prothrombin time (PT/INR) clotting test CPT 85610 HC POC PT/INR	$13.50	$45.00	$4.29–$40.95	7% below	70%
Prothrombin time (PT/INR) clotting test CPT 85610 HC PROTHROMBIN TIME	$18.30	$61.00	$4.29–$55.51	26% above	70%
Prothrombin time (PT/INR) clotting test CPT 85610 HC PROTHROMBIN TIME/INR	$18.90	$63.00	$4.29–$57.33	31% above	70%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 HC LUPUS PT - RL	$3.60	$12.00	—	—	70%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 HC PROTHROMBIN TIME - RL	$4.80	$16.00	—	—	70%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 HC POC PT/INR	$13.50	$45.00	—	—	70%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 HC PROTHROMBIN TIME	$18.30	$61.00	—	—	70%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 HC PROTHROMBIN TIME/INR	$18.90	$63.00	—	—	70%
Rapid flu test (influenza antigen) CPT 87804 HC POC INFLUENZA A & B VIRUS TESTING	$10.80	$36.00	$7.92–$32.76	52% below	70%
Rapid flu test (influenza antigen) CPT 87804 HC INFLUENZA A & B VIRUS TESTING	$24.90	$83.00	$16.32–$75.53	10% above	70%
Rapid flu test (influenza antigen) inpatient CPT 87804 HC POC INFLUENZA A & B VIRUS TESTING	$10.80	$36.00	—	—	70%
Rapid flu test (influenza antigen) inpatient CPT 87804 HC INFLUENZA A & B VIRUS TESTING	$24.90	$83.00	—	—	70%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 HC THROAT SCREEN	$11.70	$39.00	$8.58–$35.49	47% below	70%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 HC POC STREP A SCREEN	$13.50	$45.00	$9.90–$40.95	39% below	70%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 PR STREP A ASSAY W/OPTIC	$17.10	$57.00	$12.54–$51.87	23% below	70%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 HC STREP A SCREEN	$17.10	$57.00	$12.54–$51.87	23% below	70%
Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 HC THROAT SCREEN	$11.70	$39.00	—	—	70%
Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 HC POC STREP A SCREEN	$13.50	$45.00	—	—	70%
Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 HC STREP A SCREEN	$17.10	$57.00	—	—	70%
Renin blood test CPT 84244 HC RENIN ACTIVITY	$44.10	$147.00	$21.99–$133.77	26% below	70%
Renin blood test CPT 84244 HC RENIN ACTIVITY, PLASMA -RL	$66.60	$222.00	$21.99–$202.02	12% above	70%
Renin blood test inpatient CPT 84244 HC RENIN ACTIVITY	$44.10	$147.00	—	—	70%
Renin blood test inpatient CPT 84244 HC RENIN ACTIVITY, PLASMA -RL	$66.60	$222.00	—	—	70%
Rh blood typing CPT 86901 HC BB REF RH TYPE	$6.30	$21.00	$2.99–$19.11	71% below	70%
Rh blood typing CPT 86901 HC C-BLOOD RH TYPE	$8.40	$28.00	$2.99–$25.48	61% below	70%
Rh blood typing inpatient CPT 86901 HC BB REF RH TYPE	$6.30	$21.00	—	—	70%
Rh blood typing inpatient CPT 86901 HC C-BLOOD RH TYPE	$8.40	$28.00	—	—	70%
Rheumatoid factor (RF) test CPT 86431 HC RHEUMATOID FACTOR, QUANT	$22.50	$75.00	$5.67–$68.25	4% below	70%
Rheumatoid factor (RF) test inpatient CPT 86431 HC RHEUMATOID FACTOR, QUANT	$22.50	$75.00	—	—	70%
Rubella antibody test (immunity check) CPT 86762 HC RUBELLA ANTIBODY, IGG	$16.20	$54.00	$11.88–$49.14	51% below	70%
Rubella antibody test (immunity check) CPT 86762 HC RUBELLA QUANTITATIVE	$16.20	$54.00	$11.88–$49.14	51% below	70%
Rubella antibody test (immunity check) CPT 86762 HC RUBELLA IGM	$40.20	$134.00	$14.39–$121.94	21% above	70%
Rubella antibody test (immunity check) CPT 86762 HC RUBELLA IGG	$55.20	$184.00	$14.39–$167.44	66% above	70%
Rubella antibody test (immunity check) inpatient CPT 86762 HC RUBELLA ANTIBODY, IGG	$16.20	$54.00	—	—	70%
Rubella antibody test (immunity check) inpatient CPT 86762 HC RUBELLA QUANTITATIVE	$16.20	$54.00	—	—	70%
Rubella antibody test (immunity check) inpatient CPT 86762 HC RUBELLA IGM	$40.20	$134.00	—	—	70%
Rubella antibody test (immunity check) inpatient CPT 86762 HC RUBELLA IGG	$55.20	$184.00	—	—	70%
Semen analysis: volume, sperm count, motility and morphology CPT 89320 HC SEMEN ANALYSIS	$21.00	$70.00	$12.31–$63.70	42% below	70%
Semen analysis: volume, sperm count, motility and morphology inpatient CPT 89320 HC SEMEN ANALYSIS	$21.00	$70.00	—	—	70%
Sodium blood test CPT 84295 HC SODIUM, BLOOD	$4.50	$15.00	$3.30–$13.65	74% below	70%
Sodium blood test CPT 84295 *HC POC SODIUM, BLOOD	$16.80	$56.00	$4.81–$50.96	2% below	70%
Sodium blood test CPT 84295 HC SODIUM	$16.80	$56.00	$4.81–$50.96	2% below	70%
Sodium blood test inpatient CPT 84295 HC SODIUM, BLOOD	$4.50	$15.00	—	—	70%
Sodium blood test inpatient CPT 84295 *HC POC SODIUM, BLOOD	$16.80	$56.00	—	—	70%
Sodium blood test inpatient CPT 84295 HC SODIUM	$16.80	$56.00	—	—	70%
Stool ova and parasites exam CPT 87177 HC EXAM PARA, URINE/B.F.	$27.90	$93.00	$8.90–$84.63	7% below	70%
Stool ova and parasites exam inpatient CPT 87177 HC EXAM PARA, URINE/B.F.	$27.90	$93.00	—	—	70%
Stool test for hidden blood (guaiac FOBT) CPT 82270 HC OCCULT BLOOD SCREEN	$26.10	$87.00	$4.38–$79.17	93% above	70%
Stool test for hidden blood (guaiac FOBT) CPT 82270 HC POC OCCULT BLOOD SCREEN	$26.10	$87.00	$4.38–$79.17	93% above	70%
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 HC POC OCCULT BLOOD SCREEN	$26.10	$87.00	—	—	70%
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 HC OCCULT BLOOD SCREEN	$26.10	$87.00	—	—	70%
Stool test for hidden blood by immunoassay (FIT) CPT 82274 HC FECAL IMMUNOASSAY OCCULT BLOOD - RL	$18.60	$62.00	$13.64–$56.42	27% below	70%
Stool test for hidden blood by immunoassay (FIT) CPT 82274 HC FECAL IMMUNOASSAY OCCULT BLOOD	$33.60	$112.00	$15.92–$101.92	32% above	70%
Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 HC FECAL IMMUNOASSAY OCCULT BLOOD - RL	$18.60	$62.00	—	—	70%
Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 HC FECAL IMMUNOASSAY OCCULT BLOOD	$33.60	$112.00	—	—	70%
Syphilis antibody test (Treponema pallidum) CPT 86780 HC SYPHILIS AB, TP-PA	$11.70	$39.00	$8.58–$35.49	54% below	70%
Syphilis antibody test (Treponema pallidum) CPT 86780 HC FTA-ABS CSF	$11.70	$39.00	$8.58–$35.49	54% below	70%
Syphilis antibody test (Treponema pallidum) CPT 86780 HC FTA-ABS	$12.30	$41.00	$9.02–$37.31	52% below	70%
Syphilis antibody test (Treponema pallidum) CPT 86780 HC SYPHILIS TOTAL ABS	$12.60	$42.00	$9.24–$38.22	51% below	70%
Syphilis antibody test (Treponema pallidum) CPT 86780 HC TREPONEMA PALLIDUM ANTIBODIES	$23.70	$79.00	$13.24–$71.89	8% below	70%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 HC SYPHILIS AB, TP-PA	$11.70	$39.00	—	—	70%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 HC FTA-ABS CSF	$11.70	$39.00	—	—	70%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 HC FTA-ABS	$12.30	$41.00	—	—	70%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 HC SYPHILIS TOTAL ABS	$12.60	$42.00	—	—	70%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 HC TREPONEMA PALLIDUM ANTIBODIES	$23.70	$79.00	—	—	70%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 HC RAPID PLASMA REAGIN	$14.70	$49.00	$4.27–$44.59	2% above	70%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 HC VDRL (CSF ONLY)	$15.00	$50.00	$4.27–$45.50	4% above	70%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 HC RAPID PLASMA REAGIN	$14.70	$49.00	—	—	70%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 HC VDRL (CSF ONLY)	$15.00	$50.00	—	—	70%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 HC QUANTIFERON GOLD TB TEST	$57.00	$190.00	$41.80–$172.90	52% below	70%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 HC QUANTIFERON GOLD TB TEST	$57.00	$190.00	—	—	70%
Testosterone blood test, total (not free testosterone) CPT 84403 HC TESTOSTERONE, FEMALES OR CHILDREN	$23.70	$79.00	$17.38–$71.89	60% below	70%
Testosterone blood test, total (not free testosterone) CPT 84403 HC TESTOSTERONE, TOTAL LC/MS/MS	$29.70	$99.00	$21.78–$90.09	49% below	70%
Testosterone blood test, total (not free testosterone) CPT 84403 *HC TESTOSTERONE, FREE, FEMALES OR CHILDREN -RL	$36.30	$121.00	$25.81–$110.11	38% below	70%
Testosterone blood test, total (not free testosterone) CPT 84403 HC TESTOSTERONE TOTAL	$36.30	$121.00	$25.81–$110.11	38% below	70%
Testosterone blood test, total (not free testosterone) CPT 84403 HC TESTOSTERONE, TOTAL	$36.30	$121.00	$25.81–$110.11	38% below	70%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 HC TESTOSTERONE, FEMALES OR CHILDREN	$23.70	$79.00	—	—	70%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 HC TESTOSTERONE, TOTAL LC/MS/MS	$29.70	$99.00	—	—	70%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 *HC TESTOSTERONE, FREE, FEMALES OR CHILDREN -RL	$36.30	$121.00	—	—	70%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 HC TESTOSTERONE TOTAL	$36.30	$121.00	—	—	70%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 HC TESTOSTERONE, TOTAL	$36.30	$121.00	—	—	70%
Thyroid peroxidase (TPO) antibody test CPT 86376 HC ANTI-LIVER-KIDNEY MICROSOME AB	$41.70	$139.00	$14.55–$126.49	16% above	70%
Thyroid peroxidase (TPO) antibody test CPT 86376 HC THYROPEROXIDASE (TPO) ABS	$43.20	$144.00	$14.55–$131.04	20% above	70%
Thyroid peroxidase (TPO) antibody test CPT 86376 HC CU INDEX-MICROSOMAL AB, EACH	$55.20	$184.00	$14.55–$167.44	53% above	70%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 HC ANTI-LIVER-KIDNEY MICROSOME AB	$41.70	$139.00	—	—	70%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 HC THYROPEROXIDASE (TPO) ABS	$43.20	$144.00	—	—	70%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 HC CU INDEX-MICROSOMAL AB, EACH	$55.20	$184.00	—	—	70%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 HC TSH - SENSITIVE, SERUM - RL	$28.80	$96.00	$16.80–$87.36	30% below	70%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 HC TSH	$28.80	$96.00	$16.80–$87.36	30% below	70%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 HC CU INDEX-TSH ASSAY	$28.80	$96.00	$16.80–$87.36	30% below	70%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 *HC THYROID FUNCTION TEST REFLEX PANEL	$63.90	$213.00	$16.80–$193.83	55% above	70%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 HC CU INDEX-TSH ASSAY	$28.80	$96.00	—	—	70%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 HC TSH - SENSITIVE, SERUM - RL	$28.80	$96.00	—	—	70%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 HC TSH	$28.80	$96.00	—	—	70%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 *HC THYROID FUNCTION TEST REFLEX PANEL	$63.90	$213.00	—	—	70%
Total IgE blood test CPT 82785 HC IGE-IMMUNOGLOBULIN	$15.60	$52.00	$11.44–$47.32	59% below	70%
Total IgE blood test CPT 82785 *HC IMMUNOGLOBULIN E	$33.90	$113.00	$16.46–$102.83	11% below	70%
Total IgE blood test inpatient CPT 82785 HC IGE-IMMUNOGLOBULIN	$15.60	$52.00	—	—	70%
Total IgE blood test inpatient CPT 82785 *HC IMMUNOGLOBULIN E	$33.90	$113.00	—	—	70%
Total cholesterol blood test CPT 82465 HC NMR CHOLESTEROL ASSAY	$15.00	$50.00	$4.35–$45.50	at median	70%
Total cholesterol blood test CPT 82465 HC CHOLESTEROL	$15.00	$50.00	$4.35–$45.50	at median	70%
Total cholesterol blood test inpatient CPT 82465 HC NMR CHOLESTEROL ASSAY	$15.00	$50.00	—	—	70%
Total cholesterol blood test inpatient CPT 82465 HC CHOLESTEROL	$15.00	$50.00	—	—	70%
Total thyroxine (T4) blood test CPT 84436 HC T4, TOTAL	$5.40	$18.00	$3.96–$16.38	77% below	70%
Total thyroxine (T4) blood test CPT 84436 HC THYROXINE TOTAL	$15.00	$50.00	$6.58–$45.50	36% below	70%
Total thyroxine (T4) blood test CPT 84436 *HC THYROXINE TOTAL (SEND OUT)	$15.00	$50.00	$6.58–$45.50	36% below	70%
Total thyroxine (T4) blood test inpatient CPT 84436 HC T4, TOTAL	$5.40	$18.00	—	—	70%
Total thyroxine (T4) blood test inpatient CPT 84436 *HC THYROXINE TOTAL (SEND OUT)	$15.00	$50.00	—	—	70%
Total thyroxine (T4) blood test inpatient CPT 84436 HC THYROXINE TOTAL	$15.00	$50.00	—	—	70%
Total triiodothyronine (T3) blood test CPT 84480 HC T3 TOTAT	$33.30	$111.00	$8.73–$101.01	30% below	70%
Total triiodothyronine (T3) blood test inpatient CPT 84480 HC T3 TOTAT	$33.30	$111.00	—	—	70%
Transferrin blood test CPT 84466 HC TRANSFERRIN	$38.70	$129.00	$12.76–$117.39	at median	70%
Transferrin blood test inpatient CPT 84466 HC TRANSFERRIN	$38.70	$129.00	—	—	70%
Trichomonas test (NAAT) CPT 87661 HC VAG SCRN-TRICHOMONAS VAG BY AMP PROBE	$30.00	$100.00	$22.00–$91.00	39% below	70%
Trichomonas test (NAAT) CPT 87661 HC TRICHOMONAS VAGINALIS, RNA, QUAL, URINE	$31.20	$104.00	$22.88–$94.64	36% below	70%
Trichomonas test (NAAT) inpatient CPT 87661 HC VAG SCRN-TRICHOMONAS VAG BY AMP PROBE	$30.00	$100.00	—	—	70%
Trichomonas test (NAAT) inpatient CPT 87661 HC TRICHOMONAS VAGINALIS, RNA, QUAL, URINE	$31.20	$104.00	—	—	70%
Triglycerides blood test CPT 84478 HC TRIGLYCERIDES, FLUID - RL	$16.20	$54.00	$5.74–$49.14	32% below	70%
Triglycerides blood test CPT 84478 HC TRIGLYCERIDES, BODY FLUID	$16.20	$54.00	$5.74–$49.14	32% below	70%
Triglycerides blood test CPT 84478 HC TRIGLYCERIDES	$16.20	$54.00	$5.74–$49.14	32% below	70%
Triglycerides blood test inpatient CPT 84478 HC TRIGLYCERIDES, FLUID - RL	$16.20	$54.00	—	—	70%
Triglycerides blood test inpatient CPT 84478 HC TRIGLYCERIDES, BODY FLUID	$16.20	$54.00	—	—	70%
Triglycerides blood test inpatient CPT 84478 HC TRIGLYCERIDES	$16.20	$54.00	—	—	70%
Troponin test, quantitative CPT 84484 HC POC TROPONIN I	$18.00	$60.00	$12.47–$54.60	52% below	70%
Troponin test, quantitative CPT 84484 *HC POC TROPONIN	$29.10	$97.00	$12.47–$88.27	23% below	70%
Troponin test, quantitative CPT 84484 HC TROPONIN I	$29.10	$97.00	$12.47–$88.27	23% below	70%
Troponin test, quantitative inpatient CPT 84484 HC POC TROPONIN I	$18.00	$60.00	—	—	70%
Troponin test, quantitative inpatient CPT 84484 HC TROPONIN I	$29.10	$97.00	—	—	70%
Troponin test, quantitative inpatient CPT 84484 *HC POC TROPONIN	$29.10	$97.00	—	—	70%
Uric acid blood test CPT 84550 HC URIC ACID	$14.40	$48.00	$4.52–$43.68	18% below	70%
Uric acid blood test inpatient CPT 84550 HC URIC ACID	$14.40	$48.00	—	—	70%
Urinalysis with microscope exam, automated CPT 81001 HC URINALYSIS, AUTO W/MICRO	$14.10	$47.00	$3.17–$42.77	44% below	70%
Urinalysis with microscope exam, automated CPT 81001 PR URINALYSIS, AUTO, W/SCOPE	$23.40	$78.00	$1.40–$27.30	6% below	70%
Urinalysis with microscope exam, automated inpatient CPT 81001 HC URINALYSIS, AUTO W/MICRO	$14.10	$47.00	—	—	70%
Urinalysis with microscope exam, manual CPT 81000 HC URINALYSIS, NON-AUTO W/MICRO	$14.10	$47.00	$4.02–$42.77	115% above	70%
Urinalysis with microscope exam, manual inpatient CPT 81000 HC URINALYSIS, NON-AUTO W/MICRO	$14.10	$47.00	—	—	70%
Urinalysis without microscope exam, automated CPT 81003 HC URINE W/O MICRO, AUTO	$3.00	$10.00	$2.20–$9.10	66% below	70%
Urinalysis without microscope exam, automated inpatient CPT 81003 HC URINE W/O MICRO, AUTO	$3.00	$10.00	—	—	70%
Urinalysis without microscope exam, manual CPT 81002 *HC URINE SINGLE ITEM	$3.30	$11.00	$2.42–$10.01	52% below	70%
Urinalysis without microscope exam, manual CPT 81002 PR URINALYSIS NONAUTO W/O SCOPEPR URINALYSIS NONAUTO W/O SCOPE	$4.50	$15.00	$1.56–$22.00	35% below	70%
Urinalysis without microscope exam, manual CPT 81002 PR URINALYSIS NONAUTO W/O SCOPE	$5.10	$17.00	$3.48–$15.47	26% below	70%
Urinalysis without microscope exam, manual inpatient CPT 81002 *HC URINE SINGLE ITEM	$3.30	$11.00	—	—	70%
Urine culture for bacteria, with colony count CPT 87086 HC CULTURE, URINE COLONY COUNT	$11.10	$37.00	$8.07–$33.67	70% below	70%
Urine culture for bacteria, with colony count inpatient CPT 87086 HC CULTURE, URINE COLONY COUNT	$11.10	$37.00	—	—	70%
Urine microalbumin (albumin) test CPT 82043 HC MICROALB URINE, RANDOM	$9.60	$32.00	$5.78–$29.12	45% below	70%
Urine microalbumin (albumin) test CPT 82043 HC MICROALBUMIN URINE QUANT	$33.90	$113.00	$5.78–$102.83	95% above	70%
Urine microalbumin (albumin) test CPT 82043 *HC MICROALBUMIN, 24 HOUR URINE	$33.90	$113.00	$5.78–$102.83	95% above	70%
Urine microalbumin (albumin) test inpatient CPT 82043 HC MICROALB URINE, RANDOM	$9.60	$32.00	—	—	70%
Urine microalbumin (albumin) test inpatient CPT 82043 HC MICROALBUMIN URINE QUANT	$33.90	$113.00	—	—	70%
Urine microalbumin (albumin) test inpatient CPT 82043 *HC MICROALBUMIN, 24 HOUR URINE	$33.90	$113.00	—	—	70%
Urine pregnancy test, read by color change CPT 81025 HC PREGNANCY TEST, URINE	$21.00	$70.00	$8.61–$63.70	at median	70%
Urine pregnancy test, read by color change inpatient CPT 81025 HC PREGNANCY TEST, URINE	$21.00	$70.00	—	—	70%
Vitamin B12 (cobalamin) blood test CPT 82607 HC VITAMIN B 12	$15.30	$51.00	$11.22–$46.41	61% below	70%
Vitamin B12 (cobalamin) blood test CPT 82607 HC PERNICIOUS ANEMIA CASCADE, VIT B-12	$20.40	$68.00	$14.96–$61.88	49% below	70%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 HC VITAMIN B 12	$15.30	$51.00	—	—	70%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 HC PERNICIOUS ANEMIA CASCADE, VIT B-12	$20.40	$68.00	—	—	70%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 HC VITAMIN D, 25 HYDROXY	$70.50	$235.00	$29.60–$213.85	8% below	70%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 HC 25-HYDROXYVITAMIN D2 AND D3	$70.50	$235.00	$29.60–$213.85	8% below	70%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 HC 25-HYDROXYVITAMIN D2 AND D3	$70.50	$235.00	—	—	70%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 HC VITAMIN D, 25 HYDROXY	$70.50	$235.00	—	—	70%
Vitamin D, 1,25-dihydroxy blood test CPT 82652 HC VITAMIN D, 1-25 DIHYRDOXY	$68.10	$227.00	$38.50–$206.57	24% below	70%
Vitamin D, 1,25-dihydroxy blood test inpatient CPT 82652 HC VITAMIN D, 1-25 DIHYRDOXY	$68.10	$227.00	—	—	70%
Zinc blood test CPT 84630 HC ZINC, URINE	$28.50	$95.00	$11.39–$86.45	9% below	70%
Zinc blood test CPT 84630 HC ZINC, SERUM - RL	$28.50	$95.00	$11.39–$86.45	9% below	70%
Zinc blood test CPT 84630 HC ZINC QUANTITATIVE	$28.50	$95.00	$11.39–$86.45	9% below	70%
Zinc blood test CPT 84630 HC ZINC RBC	$28.50	$95.00	$11.39–$86.45	9% below	70%
Zinc blood test inpatient CPT 84630 HC ZINC, SERUM - RL	$28.50	$95.00	—	—	70%
Zinc blood test inpatient CPT 84630 HC ZINC, URINE	$28.50	$95.00	—	—	70%
Zinc blood test inpatient CPT 84630 HC ZINC RBC	$28.50	$95.00	—	—	70%
Zinc blood test inpatient CPT 84630 HC ZINC QUANTITATIVE	$28.50	$95.00	—	—	70%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HC HCG BETA SUBUNIT, CSF	$15.60	$52.00	$11.44–$47.32	68% below	70%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HC BETA-HCG QUANTITATIVE (TUMOR MARKER)	$19.80	$66.00	$14.52–$60.06	59% below	70%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HC HCG QUANTITATIVE	$51.30	$171.00	$15.05–$155.61	5% above	70%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HC HCG BETA SUBUNIT, CSF	$15.60	$52.00	—	—	70%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HC BETA-HCG QUANTITATIVE (TUMOR MARKER)	$19.80	$66.00	—	—	70%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HC HCG QUANTITATIVE	$51.30	$171.00	—	—	70%

Surgery and procedures

Procedure	Cash price	List price	Insurers pay	vs Louisiana	Off list
Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 HC CL TX DST FIB FX WO MAN	$123.30	$411.00	$90.42–$556.34	41% below	70%
Broken ankle (outer ankle bone) treatment without surgery or setting inpatient CPT 27786 HC CL TX DST FIB FX WO MAN	$123.30	$411.00	—	—	70%
Cardiac catheterization with coronary angiogram CPT 93458 HC LHRT ARTERY/VENTRICLE ANGIO	$4,890.90	$16,303.00	$2,807.00–$14,835.73	4% above	70%
Cardiac catheterization with coronary angiogram inpatient CPT 93458 HC LHRT ARTERY/VENTRICLE ANGIO	$4,890.90	$16,303.00	—	—	70%
Cardioversion, elective (restoring heart rhythm) CPT 92960 HC CARDIOVERSION	$585.00	$1,950.00	$429.00–$1,778.68	8% above	70%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 HC CARDIOVERSION	$585.00	$1,950.00	—	—	70%
Carpal tunnel release, open surgery CPT 64721 CARPAL TUNNEL SURGERY	$2,029.34	$6,764.48	$468.30–$2,811.02	14% above	70%
Cataract surgery with lens implant CPT 66984 CATARACT SURG W/IOL 1 STAGE	$3,264.81	$10,882.68	$864.15–$3,554.50	56% above	70%
Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 HC CIRCUMCISION CLAMP/OTHER DEVICE, NONSURG (ANY AGE)	$735.90	$2,453.00	$468.30–$6,651.06	8% below	70%
Circumcision with a clamp or device and a numbing nerve block, usually newborns inpatient CPT 54150 HC CIRCUMCISION CLAMP/OTHER DEVICE, NONSURG (ANY AGE)	$735.90	$2,453.00	—	—	70%
Circumcision, surgical, older than a newborn CPT 54160 HC CIRCUMCISION - SURGICAL NO CLAMP/DEVICE, 0-28 DAYS ONLY (NEONATE)	$735.90	$2,453.00	$468.30–$6,651.06	7% above	70%
Circumcision, surgical, older than a newborn inpatient CPT 54160 HC CIRCUMCISION - SURGICAL NO CLAMP/DEVICE, 0-28 DAYS ONLY (NEONATE)	$735.90	$2,453.00	—	—	70%
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 HC CL TX OF DIST RAD FX/ES, WO MA	$216.00	$720.00	$158.40–$1,112.67	7% below	70%
Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 HC CL TX OF DIST RAD FX/ES, WO MA	$216.00	$720.00	—	—	70%
Colonoscopy with polyp removal CPT 45385 HC COLON W/REMOVAL BY SNARE TECH	$543.60	$1,812.00	$398.64–$1,648.92	36% below	70%
Colonoscopy with polyp removal inpatient CPT 45385 HC COLON W/REMOVAL BY SNARE TECH	$543.60	$1,812.00	—	—	70%
Colonoscopy with tissue sample CPT 45380 HC COLON W/BX SGL OR MLT-BITE/CLD	$543.60	$1,812.00	$398.64–$1,648.92	37% below	70%
Colonoscopy with tissue sample inpatient CPT 45380 HC COLON W/BX SGL OR MLT-BITE/CLD	$543.60	$1,812.00	—	—	70%
Colonoscopy, diagnostic CPT 45378 HC COLON DX (INCL BRUSH/WASH)	$543.60	$1,812.00	$398.64–$1,648.92	27% below	70%
Colonoscopy, diagnostic inpatient CPT 45378 HC COLON DX (INCL BRUSH/WASH)	$543.60	$1,812.00	—	—	70%
Complex cataract surgery with lens implant CPT 66982 CATARACT SURGERY COMPLEX	$3,720.17	$12,400.56	$864.15–$3,554.50	11% below	70%
Earwax removal by irrigation (rinsing), one ear one side CPT 69209 HC REMOVAL IMPACTED CERUMEN USING IRRAGATION/LAVAGE, UNILATERAL	$108.90	$363.00	$79.86–$330.33	55% above	70%
Earwax removal by irrigation (rinsing), one ear inpatient one side CPT 69209 HC REMOVAL IMPACTED CERUMEN USING IRRAGATION/LAVAGE, UNILATERAL	$108.90	$363.00	—	—	70%
Earwax removal with instruments, one ear one side CPT 69210 HC REMOVAL IMPACTED CERUMEN REQUIRING INSTRUMENTATION, UNILATERAL	$61.20	$204.00	$44.88–$210.00	5% below	70%
Earwax removal with instruments, one ear inpatient one side CPT 69210 HC REMOVAL IMPACTED CERUMEN REQUIRING INSTRUMENTATION, UNILATERAL	$61.20	$204.00	—	—	70%
Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 HC INJ CERV/THORAC,W/GUIDANCE	$1,364.40	$4,548.00	$349.65–$4,138.68	78% above	70%
Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 HC INJ CERV/THORAC,W/GUIDANCE	$1,364.40	$4,548.00	—	—	70%
Eye injection into the vitreous (intravitreal injection) CPT 67028 HC INTRAVITREAL INJ OF PHARM AGEN	$542.70	$1,809.00	$210.00–$1,646.19	81% above	70%
Eye injection into the vitreous (intravitreal injection) inpatient CPT 67028 HC INTRAVITREAL INJ OF PHARM AGEN	$542.70	$1,809.00	—	—	70%
Facet joint injection, lower back, one level, with imaging guidance CPT 64493 HC MBB/INJ FACET LUM/SAC 1ST LEVEL	$550.80	$1,836.00	$403.92–$1,670.76	8% above	70%
Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 HC MBB/INJ FACET LUM/SAC 1ST LEVEL	$550.80	$1,836.00	—	—	70%
Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 HC FLEXIBLE SIGMOIDOSCOPY DX	$151.80	$506.00	$111.32–$568.00	66% below	70%
Flexible sigmoidoscopy, diagnostic (lower colon only) inpatient CPT 45330 HC FLEXIBLE SIGMOIDOSCOPY DX	$151.80	$506.00	—	—	70%
Hemorrhoid banding (rubber band ligation) CPT 46221 HC HEMORRHOID LIGATION	$459.90	$1,533.00	$337.26–$1,395.03	at median	70%
Hemorrhoid banding (rubber band ligation) inpatient CPT 46221 HC HEMORRHOID LIGATION	$459.90	$1,533.00	—	—	70%
IUD insertion (the device itself billed separately) CPT 58300 HC INSERTION OF INTRAUTERINE DEVICE (IUD)	$302.40	$1,008.00	$210.00–$917.28	58% above	70%
IUD insertion (the device itself billed separately) inpatient CPT 58300 HC INSERTION OF INTRAUTERINE DEVICE (IUD)	$302.40	$1,008.00	—	—	70%
Incision and drainage of a simple or single skin abscess CPT 10060 HC INCISION & DRAINAGE SINGLE	$217.80	$726.00	$159.72–$660.66	12% above	70%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 HC INCISION & DRAINAGE SINGLE	$217.80	$726.00	—	—	70%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 HC ARTHROCENTESIS MAJOR JOINT	$120.30	$401.00	$88.22–$364.91	52% below	70%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 HC ARTHROCENTESIS MAJOR JOINT	$120.30	$401.00	—	—	70%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 HC ARTHOCENTESIS, INTERMEDIATE JOINT/BURSA	$120.30	$401.00	$88.22–$364.91	43% below	70%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 HC ARTHOCENTESIS, INTERMEDIATE JOINT/BURSA	$120.30	$401.00	—	—	70%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 HC ARTHOCENTESIS, SMALL JOINT	$354.60	$1,182.00	$126.46–$1,075.62	55% above	70%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 HC ARTHOCENTESIS, SMALL JOINT	$354.60	$1,182.00	—	—	70%
Knee arthroscopy with meniscus trim CPT 29881 KNEE ARTHROSCOPY/SURGERY	$3,507.25	$11,690.83	$661.50–$4,414.62	at median	70%
Knee arthroscopy with removal of both torn meniscus parts CPT 29880 KNEE ARTHROSCOPY/SURGERY	$3,614.73	$12,049.09	$661.50–$4,414.62	2% below	70%
Knee arthroscopy with smoothing of damaged cartilage (chondroplasty) CPT 29877 KNEE ARTHROSCOPY/SURGERY	$3,329.03	$11,096.76	$661.50–$4,414.62	2% below	70%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 HC INT REP S/A/T/EX 2.5CM/<	$138.90	$463.00	$101.86–$1,366.81	58% below	70%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 HC INT REP S/A/T/EX 2.5CM/<	$138.90	$463.00	—	—	70%
Lower-back epidural injection, with imaging guidance CPT 62323 HC INJ LUMBAR/SACRAL, W/IMAGING GUIDANCE	$1,364.40	$4,548.00	$349.65–$4,138.68	76% above	70%
Lower-back epidural injection, with imaging guidance inpatient CPT 62323 HC INJ LUMBAR/SACRAL, W/IMAGING GUIDANCE	$1,364.40	$4,548.00	—	—	70%
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 HC EPIDURAL INJ, ANES/STEROID, TRANSFORAMINAL, LUMB/SACR, SNGL LEVL	$550.80	$1,836.00	$403.92–$1,670.76	21% above	70%
Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 HC EPIDURAL INJ, ANES/STEROID, TRANSFORAMINAL, LUMB/SACR, SNGL LEVL	$550.80	$1,836.00	—	—	70%
Nail removal (partial or complete), one nail CPT 11730 HC AVULSION NAIL PLATE SINGLE	$141.90	$473.00	$104.06–$430.43	5% above	70%
Nail removal (partial or complete), one nail inpatient CPT 11730 HC AVULSION NAIL PLATE SINGLE	$141.90	$473.00	—	—	70%
Occipital nerve block (injection for headaches) CPT 64405 HC NERVE BLOCK INJ, ANES/STEROID, OCCIPITAL	$220.20	$734.00	$145.02–$667.94	15% below	70%
Occipital nerve block (injection for headaches) inpatient CPT 64405 HC NERVE BLOCK INJ, ANES/STEROID, OCCIPITAL	$220.20	$734.00	—	—	70%
Pacemaker implant (dual chamber) CPT 33208 HC INS/RPL PERM PACER A&V	$8,926.50	$29,755.00	$6,546.10–$27,077.05	14% below	70%
Pacemaker implant (dual chamber) inpatient CPT 33208 HC INS/RPL PERM PACER A&V	$8,926.50	$29,755.00	—	—	70%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 HC EXCISION INGROWN TOENAIL	$548.70	$1,829.00	$210.00–$1,664.39	54% above	70%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 HC EXCISION INGROWN TOENAIL	$548.70	$1,829.00	—	—	70%
Prostate biopsy CPT 55700 HC PROSTATE NEEDLE BIOPSY	$1,508.70	$5,029.00	$468.30–$4,576.39	98% above	70%
Prostate biopsy inpatient CPT 55700 HC PROSTATE NEEDLE BIOPSY	$1,508.70	$5,029.00	—	—	70%
Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 HC R/F FACET NERVE - LUM/SAC	$950.40	$3,168.00	$696.96–$2,882.88	6% below	70%
Radiofrequency ablation of facet joint nerves, lower back, one level inpatient CPT 64635 HC R/F FACET NERVE - LUM/SAC	$950.40	$3,168.00	—	—	70%
Removal of a foreign object under the skin, simple CPT 10120 HC REMO F/B SUBQ SIMPLE	$114.00	$380.00	$83.60–$1,225.89	51% below	70%
Removal of a foreign object under the skin, simple inpatient CPT 10120 HC REMO F/B SUBQ SIMPLE	$114.00	$380.00	—	—	70%
Screening colonoscopy for a person at average risk (Medicare code) HCPCS G0121 HC COLONOSCOPY - AVERAGE RISK	$767.10	$2,557.00	$468.30–$2,326.87	22% above	70%
Screening colonoscopy for a person at average risk (Medicare code) inpatient HCPCS G0121 HC COLONOSCOPY - AVERAGE RISK	$767.10	$2,557.00	—	—	70%
Screening colonoscopy, high risk of colorectal cancer (Medicare code) HCPCS G0105 HC COLONOSCOPY - HIGH RISK	$767.10	$2,557.00	$468.30–$2,326.87	26% above	70%
Screening colonoscopy, high risk of colorectal cancer (Medicare code) inpatient HCPCS G0105 HC COLONOSCOPY - HIGH RISK	$767.10	$2,557.00	—	—	70%
Short arm cast (elbow to hand) CPT 29075 HC APPLICATION, CAST, SHORT ARM	$54.90	$183.00	$40.26–$1,027.99	68% below	70%
Short arm cast (elbow to hand) inpatient CPT 29075 HC APPLICATION, CAST, SHORT ARM	$54.90	$183.00	—	—	70%
Short arm splint (forearm and hand) CPT 29125 HC OT APPL SPLINT SHRT ARM STATIC	$54.90	$183.00	$40.26–$513.82	55% below	70%
Short arm splint (forearm and hand) CPT 29125 HC APPLICATION, SPLINT, SHORT ARM, STATIC	$54.90	$183.00	$40.26–$513.82	55% below	70%
Short arm splint (forearm and hand) inpatient CPT 29125 HC APPLICATION, SPLINT, SHORT ARM, STATIC	$54.90	$183.00	—	—	70%
Short arm splint (forearm and hand) inpatient CPT 29125 HC OT APPL SPLINT SHRT ARM STATIC	$54.90	$183.00	—	—	70%
Short leg cast (below the knee) CPT 29405 HC APPLICATION, CAST, SHORT LEG	$54.90	$183.00	$40.26–$1,027.99	70% below	70%
Short leg cast (below the knee) inpatient CPT 29405 HC APPLICATION, CAST, SHORT LEG	$54.90	$183.00	—	—	70%
Short leg splint (calf to foot) CPT 29515 HC APPLICATION, SPLINT, LOWER LEG	$162.00	$540.00	$118.80–$513.82	14% above	70%
Short leg splint (calf to foot) inpatient CPT 29515 HC APPLICATION, SPLINT, LOWER LEG	$162.00	$540.00	—	—	70%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 HC SIM REP S/N/A/G/TR/E <2.5CM	$138.90	$463.00	$101.86–$466.06	26% below	70%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 HC SIM REP S/N/A/G/TR/E <2.5CM	$138.90	$463.00	—	—	70%
Skin biopsy, punch, one lesion CPT 11104 HC PUNCH BIOPSY, SKIN, SINGLE LESION	$392.70	$1,309.00	$210.00–$1,191.19	45% above	70%
Skin biopsy, punch, one lesion inpatient CPT 11104 HC PUNCH BIOPSY, SKIN, SINGLE LESION	$392.70	$1,309.00	—	—	70%
Spinal tap (lumbar puncture), diagnostic CPT 62270 HC SPINAL PUNCTURE, LUMBAR, DX	$322.20	$1,074.00	$236.28–$977.34	24% below	70%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 HC SPINAL PUNCTURE, LUMBAR, DX	$322.20	$1,074.00	—	—	70%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 HC SIM REP S/N/A/G/T/E 2.6-7.5C	$153.00	$510.00	$112.20–$466.06	17% below	70%
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 SIM REP S/N/A/G/T/E 2.6-7.5C	$153.00	$510.00	—	—	70%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 HC SIM REP F/E/N/L/MM <2.5CM	$138.90	$463.00	$101.86–$468.30	24% below	70%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 HC SIM REP F/E/N/L/MM <2.5CM	$138.90	$463.00	—	—	70%
Thoracentesis with imaging guidance CPT 32555 HC THORACENTESIS W/IMAGING	$739.80	$2,466.00	$349.65–$2,244.06	14% above	70%
Thoracentesis with imaging guidance inpatient CPT 32555 HC THORACENTESIS W/IMAGING	$739.80	$2,466.00	—	—	70%
Trigger finger release surgery CPT 26055 INCISE FINGER TENDON SHEATH	$1,632.80	$5,442.66	$468.30–$5,058.59	2% above	70%
Trigger point injections, 1 or 2 muscles CPT 20552 HC INJ SING/MULT TRIG 1 OR 2 MUS	$132.00	$440.00	$96.80–$400.40	at median	70%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 HC INJ SING/MULT TRIG 1 OR 2 MUS	$132.00	$440.00	—	—	70%
Upper endoscopy (EGD) with balloon widening of the esophagus CPT 43249 HC EGD W/DILATION BALLOON <30MM	$734.70	$2,449.00	$468.30–$2,228.59	14% below	70%
Upper endoscopy (EGD) with balloon widening of the esophagus inpatient CPT 43249 HC EGD W/DILATION BALLOON <30MM	$734.70	$2,449.00	—	—	70%
Upper endoscopy (EGD) with biopsy CPT 43239 HC EGD W/BX SGL OR MULT (BITE/COL	$490.50	$1,635.00	$359.70–$1,487.85	34% below	70%
Upper endoscopy (EGD) with biopsy inpatient CPT 43239 HC EGD W/BX SGL OR MULT (BITE/COL	$490.50	$1,635.00	—	—	70%
Upper endoscopy (EGD) with injection into the lining CPT 43236 HC EGD W/SUBMUC INJECT(S)	$396.30	$1,321.00	$290.62–$1,258.06	31% below	70%
Upper endoscopy (EGD) with injection into the lining inpatient CPT 43236 HC EGD W/SUBMUC INJECT(S)	$396.30	$1,321.00	—	—	70%
Upper endoscopy (EGD) with polyp removal by snare CPT 43251 HC EGD W/REMOVAL BY SNARE TECH	$593.40	$1,978.00	$435.16–$1,883.99	28% below	70%
Upper endoscopy (EGD) with polyp removal by snare inpatient CPT 43251 HC EGD W/REMOVAL BY SNARE TECH	$593.40	$1,978.00	—	—	70%
Upper endoscopy (EGD) with widening of the esophagus over a guide wire CPT 43248 HC EGD W/DILAT OVER GUIDE WIRE	$490.50	$1,635.00	$359.70–$1,487.85	26% below	70%
Upper endoscopy (EGD) with widening of the esophagus over a guide wire inpatient CPT 43248 HC EGD W/DILAT OVER GUIDE WIRE	$490.50	$1,635.00	—	—	70%
Upper endoscopy (EGD), diagnostic CPT 43235 HC EGD DX (INCL BRUSH/WASH)	$490.50	$1,635.00	$349.65–$1,487.85	39% below	70%
Upper endoscopy (EGD), diagnostic inpatient CPT 43235 HC EGD DX (INCL BRUSH/WASH)	$490.50	$1,635.00	—	—	70%
Wrist fracture surgery (plate and screws), distal radius CPT 25607 TREAT FX RAD EXTRA-ARTICUL	$4,120.59	$13,735.31	$752.85–$19,115.34	46% below	70%

Doctor visits and therapy

Procedure	Cash price	List price	Insurers pay	vs Louisiana	Off list
Blood transfusion (giving blood or blood components) CPT 36430 HC BLD PRODUCT TRANSFUSION/ADMIN (ONE PER DAY)	$259.50	$865.00	$190.30–$1,177.94	45% below	70%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 HC BLD PRODUCT TRANSFUSION/ADMIN (ONE PER DAY)	$259.50	$865.00	—	—	70%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HC IPPB (INTERMITTENT POS PRESSURE BREATHING) TX	$20.10	$67.00	$14.74–$260.00	77% below	70%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HC AEROSOL /IPPB/MDI TREATMENT	$21.60	$72.00	$15.84–$260.00	75% below	70%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HC AEROSOL TREATMENT	$21.90	$73.00	$16.06–$260.00	75% below	70%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HC INTRAPULMONARY PERCUSSIVE VENTILATION THERAPY	$25.20	$84.00	$18.48–$260.00	71% below	70%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HC MDI (METERED DOSE INHALER) TREATMENT	$25.20	$84.00	$18.48–$260.00	71% below	70%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HC IPPB (INTERMITTENT POS PRESSURE BREATHING) TX	$20.10	$67.00	—	—	70%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HC AEROSOL /IPPB/MDI TREATMENT	$21.60	$72.00	—	—	70%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HC AEROSOL TREATMENT	$21.90	$73.00	—	—	70%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HC MDI (METERED DOSE INHALER) TREATMENT	$25.20	$84.00	—	—	70%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HC INTRAPULMONARY PERCUSSIVE VENTILATION THERAPY	$25.20	$84.00	—	—	70%
Chemotherapy IV infusion, first hour CPT 96413 HC CHEMO ADMIN-INFUSION,UP TO 1HR	$308.70	$1,029.00	$226.38–$936.39	1% above	70%
Chemotherapy IV infusion, first hour inpatient CPT 96413 HC CHEMO ADMIN-INFUSION,UP TO 1HR	$308.70	$1,029.00	—	—	70%
Critical care, first 30 to 74 minutes CPT 99291 HC CRITICAL CARE (30-74 MINUTES)	$405.00	$1,350.00	$297.00–$3,165.00	46% below	70%
Critical care, first 30 to 74 minutes inpatient CPT 99291 HC CRITICAL CARE (30-74 MINUTES)	$405.00	$1,350.00	—	—	70%
EEG (brain wave test), awake and drowsy, routine CPT 95816 HC EEG: AWAKE & DROWSY	$202.50	$675.00	$148.50–$614.25	34% below	70%
EEG (brain wave test), awake and drowsy, routine inpatient CPT 95816 HC EEG: AWAKE & DROWSY	$202.50	$675.00	—	—	70%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 HC EKG	$33.00	$110.00	$24.20–$127.00	60% below	70%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 HC EKG	$33.00	$110.00	—	—	70%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 HC EMER ROOM LEVEL I	$34.50	$115.00	$25.30–$350.00	63% below	70%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 HC EMER ROOM LEVEL I	$34.50	$115.00	—	—	70%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 HC EMER ROOM LEVEL II	$75.60	$252.00	$55.44–$350.00	53% below	70%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 HC EMER ROOM LEVEL II	$75.60	$252.00	—	—	70%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 HC EMER ROOM LEVEL III	$99.90	$333.00	$73.26–$565.25	60% below	70%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 HC EMER ROOM LEVEL III	$99.90	$333.00	—	—	70%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 HC EMER ROOM LEVEL IV	$125.70	$419.00	$92.18–$983.57	69% below	70%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 HC EMER ROOM LEVEL IV	$125.70	$419.00	—	—	70%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 HC EMER ROOM LEVEL V	$151.50	$505.00	$111.10–$1,636.00	71% below	70%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 HC EMER ROOM LEVEL V	$151.50	$505.00	—	—	70%
Exercise stress test, tracing only, the hospital charge CPT 93017 HC CARDIAC STRESS TEST W/WO PHARM	$93.90	$313.00	$68.86–$646.64	72% below	70%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 HC CARDIAC STRESS TEST W/WO PHARM	$93.90	$313.00	—	—	70%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 HC IV INFUSION - HYDRATION, INITIAL, 31 MIN - 1 HOUR	$81.30	$271.00	$59.62–$246.61	45% below	70%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 HC IV INFUSION - HYDRATION, INITIAL, 31 MIN - 1 HOUR	$81.30	$271.00	—	—	70%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 HC SQ/IM INJECTION	$67.80	$226.00	$43.91–$205.66	28% above	70%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 HC SQ/IM INJECTION	$67.80	$226.00	—	—	70%
Neuromuscular re-education, 15 minutes CPT 97112 HC OT NEUROMUSCULAR RE-ED EA 15 MINS	$38.70	$129.00	$28.38–$158.00	at median	70%
Neuromuscular re-education, 15 minutes CPT 97112 HC PT NEUROMUSCULAR RE-ED EA 15 MINS	$38.70	$129.00	$28.38–$158.00	at median	70%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 HC OT NEUROMUSCULAR RE-ED EA 15 MINS	$38.70	$129.00	—	—	70%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 HC PT NEUROMUSCULAR RE-ED EA 15 MINS	$38.70	$129.00	—	—	70%
New patient office visit, about 30 minutes CPT 99203 HC OFFICE/OUTPT VISIT, NEW, LEVL III, 30-44 MIN	$103.50	$345.00	$38.00–$313.95	45% above	70%
New patient office visit, about 30 minutes inpatient CPT 99203 HC OFFICE/OUTPT VISIT, NEW, LEVL III, 30-44 MIN	$103.50	$345.00	—	—	70%
New patient office visit, about 45 minutes CPT 99204 HC OFFICE/OUTPT VISIT, NEW, LEVL IV, 45-59 MIN	$108.90	$363.00	$57.00–$383.61	38% above	70%
New patient office visit, about 45 minutes inpatient CPT 99204 HC OFFICE/OUTPT VISIT, NEW, LEVL IV, 45-59 MIN	$108.90	$363.00	—	—	70%
New patient office visit, about 60 minutes CPT 99205 HC OFFICE/OUTPT VISIT, NEW, LEVL V, 60-74 MIN	$114.60	$382.00	$57.00–$383.61	18% above	70%
New patient office visit, about 60 minutes inpatient CPT 99205 HC OFFICE/OUTPT VISIT, NEW, LEVL V, 60-74 MIN	$114.60	$382.00	—	—	70%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 HC OFFICE/OUTPT VISIT, NEW, LEVL II, 15-29 MIN	$98.40	$328.00	$33.00–$298.48	79% above	70%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 HC OFFICE/OUTPT VISIT, NEW, LEVL II, 15-29 MIN	$98.40	$328.00	—	—	70%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 HC MED NUTRTN TH INIT 15 MIN	$44.10	$147.00	$32.34–$155.00	48% above	70%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 HC MED NUTRTN TH INIT 15 MIN	$44.10	$147.00	—	—	70%
Occupational therapy evaluation, low complexity CPT 97165 HC OT EVAL LOW COMPLEXITY 30 MINS	$93.60	$312.00	$57.26–$283.92	18% below	70%
Occupational therapy evaluation, low complexity inpatient CPT 97165 HC OT EVAL LOW COMPLEXITY 30 MINS	$93.60	$312.00	—	—	70%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 HC PT EVAL HIGH COMPLEXITY 45 MINS	$125.10	$417.00	$58.94–$379.47	2% below	70%
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 HC PT EVAL HIGH COMPLEXITY 45 MINS	$125.10	$417.00	—	—	70%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 HC PT EVAL LOW COMPLEXITY 20 MINS	$97.80	$326.00	$58.94–$296.66	11% below	70%
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 HC PT EVAL LOW COMPLEXITY 20 MINS	$97.80	$326.00	—	—	70%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 HC PT EVAL, MOD COMPLEXITY 30 MINS	$108.90	$363.00	$58.94–$330.33	7% below	70%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 HC PT EVAL, MOD COMPLEXITY 30 MINS	$108.90	$363.00	—	—	70%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 HC OT MANUAL THERAPY TECHNIQUE EA 15 MINS	$38.70	$129.00	$28.38–$158.00	at median	70%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 HC PT MANUAL THERAPY TECHNIQUE EA 15 MINS	$38.70	$129.00	$28.38–$158.00	at median	70%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 HC OT MANUAL THERAPY TECHNIQUE EA 15 MINS	$38.70	$129.00	—	—	70%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 HC PT MANUAL THERAPY TECHNIQUE EA 15 MINS	$38.70	$129.00	—	—	70%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HC OT THERAPEUTIC EX EA 15MIN	$33.90	$113.00	$11.00–$158.00	11% below	70%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HC PT THERAPEUTIC EX EA 15MIN	$33.90	$113.00	$11.00–$158.00	11% below	70%
Physical therapy, therapeutic exercise (15-minute unit) one side CPT 97110 HC THERAPEUTIC EX, EA 15 MIN-RT	$33.90	$113.00	$24.86–$260.00	11% below	70%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 HC PT THERAPEUTIC EX EA 15MIN	$33.90	$113.00	—	—	70%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 HC OT THERAPEUTIC EX EA 15MIN	$33.90	$113.00	—	—	70%
Physical therapy, therapeutic exercise (15-minute unit) inpatient one side CPT 97110 HC THERAPEUTIC EX, EA 15 MIN-RT	$33.90	$113.00	—	—	70%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 HC OFFICE/OUTPT VISIT, EST, LEVL V, 40-54 MIN	$114.90	$383.00	$57.00–$383.61	67% above	70%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 HC OFFICE/OUTPT VISIT, EST, LEVL V, 40-54 MIN	$114.90	$383.00	—	—	70%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 HC OFFICE/OUTPT VISIT, EST, LEVL III, 20-29 MIN	$103.80	$346.00	$38.00–$314.86	86% above	70%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 HC OFFICE/OUTPT VISIT, EST, LEVL III, 20-29 MIN	$103.80	$346.00	—	—	70%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 HC OFFICE/OUTPT VISIT, EST, LEVL IV, 30-39 MIN	$109.20	$364.00	$57.00–$383.61	71% above	70%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 HC OFFICE/OUTPT VISIT, EST, LEVL IV, 30-39 MIN	$109.20	$364.00	—	—	70%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 HC OFFICE/OUTPT VISIT, EST, LEVL II, 10-19 MIN	$98.70	$329.00	$33.00–$299.39	100% above	70%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 HC OFFICE/OUTPT VISIT, EST, LEVL II, 10-19 MIN	$98.70	$329.00	—	—	70%
Speech and language evaluation CPT 92523 HC EVAL OF SPEECH SOUND PROD W/ COMPH & EXPRESSION	$149.10	$497.00	$109.34–$510.51	20% below	70%
Speech and language evaluation inpatient CPT 92523 HC EVAL OF SPEECH SOUND PROD W/ COMPH & EXPRESSION	$149.10	$497.00	—	—	70%
Speech therapy session, individual CPT 92507 HC SPEECH/LANG TX/INDIVIDUAL	$89.70	$299.00	$33.00–$373.98	6% above	70%
Speech therapy session, individual inpatient CPT 92507 HC SPEECH/LANG TX/INDIVIDUAL	$89.70	$299.00	—	—	70%
Spirometry (breathing test) CPT 94010 HC SPIROMETRY	$39.30	$131.00	$28.82–$249.16	69% below	70%
Spirometry (breathing test) inpatient CPT 94010 HC SPIROMETRY	$39.30	$131.00	—	—	70%
Spirometry before and after a bronchodilator CPT 94060 HC EVAL BRONCHODILATION RESPONSE, PRE/POST ADMIN	$195.60	$652.00	$143.44–$593.32	10% below	70%
Spirometry before and after a bronchodilator inpatient CPT 94060 HC EVAL BRONCHODILATION RESPONSE, PRE/POST ADMIN	$195.60	$652.00	—	—	70%
Therapeutic activities (functional training), 15 minutes CPT 97530 HC PT THER ACTIVITIES, ONE ON ONE EA 15 MINS	$38.70	$129.00	$8.80–$158.00	4% below	70%
Therapeutic activities (functional training), 15 minutes CPT 97530 HC OT THER ACTIVITIES, ONE ON ONE EA 15 MINS	$38.70	$129.00	$8.80–$158.00	4% below	70%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 HC OT THER ACTIVITIES, ONE ON ONE EA 15 MINS	$38.70	$129.00	—	—	70%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 HC PT THER ACTIVITIES, ONE ON ONE EA 15 MINS	$38.70	$129.00	—	—	70%

Vaccines

Procedure	Cash price	List price	Insurers pay	vs Louisiana	Off list
Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older CPT 90653 FLU VAC TS 65UP-ADJMF59C(PF) 45 MCG/0.5 ML IM (UMBRELLA CVX 168)	$266.63	$888.78	$83.49–$808.79	147% above	70%
Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older inpatient CPT 90653 FLU VAC TS 65UP-ADJMF59C(PF) 45 MCG/0.5 ML IM (UMBRELLA CVX 168)	$266.63	$888.78	—	—	70%
DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) CPT 90696 DIPH,PERTUS(ACEL),TET,POL 25 LF-58 MCG-10 LF/0.5 ML IM (UMBRELLA)	$213.27	$710.89	$69.07–$646.91	205% above	70%
DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) inpatient CPT 90696 DIPH,PERTUS(ACEL),TET,POL 25 LF-58 MCG-10 LF/0.5 ML IM (UMBRELLA)	$213.27	$710.89	—	—	70%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 DIPH,PERTUS(ACEL),TET PED (PF) 25-58-10 LF-MCG-LF/0.5ML IM SYRG	$97.48	$324.92	$32.40–$295.68	197% above	70%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 inpatient CPT 90700 DIPH,PERTUS(ACEL),TET PED (PF) 25-58-10 LF-MCG-LF/0.5ML IM SYRG	$97.48	$324.92	—	—	70%
DTaP, hepatitis B and polio combination vaccine (Pediarix) CPT 90723 HEP B-DP(A)T-POLIO VAC (PF) 10 MCG-25LF-25 MCG-10LF/0.5 ML IM SYRG	$152.63	$508.78	$110.97–$462.99	42% above	70%
DTaP, hepatitis B and polio combination vaccine (Pediarix) inpatient CPT 90723 HEP B-DP(A)T-POLIO VAC (PF) 10 MCG-25LF-25 MCG-10LF/0.5 ML IM SYRG	$152.63	$508.78	—	—	70%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 FLU VAC TS 6MOS UP(PF) 45 MCG/0.5 ML IM (UMBRELLA CVX 140)	$69.70	$232.32	$22.35–$211.41	125% above	70%
Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 FLU VAC TS 6MOS UP(PF) 45 MCG/0.5 ML IM (UMBRELLA CVX 140)	$69.70	$232.32	—	—	70%
HPV vaccine, 9-valent (Gardasil 9) CPT 90651 HUMAN PAPILLOMAV VAC,9-VAL(PF) 0.5 ML IM SYRG (UIR)	$497.12	$1,657.05	$350.53–$1,507.92	89% above	70%
HPV vaccine, 9-valent (Gardasil 9) CPT 90651 HUMAN PAPILLOMAV VAC,9-VAL(PF) 0.5 ML IM (UMBRELLA)	$497.12	$1,657.05	$350.53–$1,507.92	89% above	70%
HPV vaccine, 9-valent (Gardasil 9) inpatient CPT 90651 HUMAN PAPILLOMAV VAC,9-VAL(PF) 0.5 ML IM (UMBRELLA)	$497.12	$1,657.05	—	—	70%
HPV vaccine, 9-valent (Gardasil 9) inpatient CPT 90651 HUMAN PAPILLOMAV VAC,9-VAL(PF) 0.5 ML IM SYRG (UIR)	$497.12	$1,657.05	—	—	70%
Hepatitis A vaccine, adult dose CPT 90632 HEPATITIS A VIRUS VACCINE (PF) 1,440 ELISA UNIT/ML IM SYRG	$301.53	$1,005.10	$77.53–$914.64	243% above	70%
Hepatitis A vaccine, adult dose inpatient CPT 90632 HEPATITIS A VIRUS VACCINE (PF) 1,440 ELISA UNIT/ML IM SYRG	$301.53	$1,005.10	—	—	70%
Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 HEPATITIS B VIRUS VACC.REC(PF) 10 MCG/0.5 ML IM UMBRELLA	$101.61	$338.71	$31.67–$308.23	157% above	70%
Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 HEPATITIS B VIRUS VACC.REC(PF) 10 MCG/0.5 ML IM UMBRELLA	$101.61	$338.71	—	—	70%
MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) CPT 90710 MEASLES,MUMPS,RUBELLA VACC(PF) 1,000-12,500 TCID50/0.5 ML SUBQ SOLR	$150.58	$501.94	$110.43–$456.77	at median	70%
MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) inpatient CPT 90710 MEASLES,MUMPS,RUBELLA VACC(PF) 1,000-12,500 TCID50/0.5 ML SUBQ SOLR	$150.58	$501.94	—	—	70%
Meningococcal ACWY (MenACWY) vaccine CPT 90734 MENING VAC A,C,Y,W135 DIP (PF) 10-5 MCG/0.5 ML IM KIT (2 MO - 55 YO)	$253.70	$845.65	$179.24–$769.54	54% above	70%
Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 MENING VAC A,C,Y,W135 DIP (PF) 10-5 MCG/0.5 ML IM KIT (2 MO - 55 YO)	$253.70	$845.65	—	—	70%
Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 MENINGOCOCCAL B VACCINE,4-COMP 50-50-50-25 MCG/0.5 ML IM SYRG	$361.25	$1,204.18	$254.93–$1,095.80	68% above	70%
Meningococcal B vaccine (Bexsero), 2-dose schedule inpatient CPT 90620 MENINGOCOCCAL B VACCINE,4-COMP 50-50-50-25 MCG/0.5 ML IM SYRG	$361.25	$1,204.18	—	—	70%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 PNEUMOC 20-VAL CONJ-DIP CR(PF) 0.5 ML IM SYRG	$435.80	$1,452.66	$315.92–$1,321.92	30% above	70%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 PNEUMOC 20-VAL CONJ-DIP CR(PF) 0.5 ML IM SYRG	$435.80	$1,452.66	—	—	70%
Rabies vaccine, one dose CPT 90675 RABIES VACCINE, PCEC (PF) 2.5 UNITS IM SUSR	$670.54	$2,235.12	$347.45–$2,033.96	7% below	70%
Rabies vaccine, one dose CPT 90675 RABIES VACC,HUMAN DIPLOID (PF) 2.5 UNITS IM SOLR	$702.77	$2,342.58	$347.45–$2,131.75	3% below	70%
Rabies vaccine, one dose inpatient CPT 90675 RABIES VACCINE, PCEC (PF) 2.5 UNITS IM SUSR	$670.54	$2,235.12	—	—	70%
Rabies vaccine, one dose inpatient CPT 90675 RABIES VACC,HUMAN DIPLOID (PF) 2.5 UNITS IM SOLR	$702.77	$2,342.58	—	—	70%
Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) CPT 90680 ROTAVIRUS VACCINE LIVE, PENTA 2 ML ORAL SOLN	$158.87	$529.57	$112.51–$481.91	67% above	70%
Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) inpatient CPT 90680 ROTAVIRUS VACCINE LIVE, PENTA 2 ML ORAL SOLN	$158.87	$529.57	—	—	70%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 DIPHTH,PERTUS(ACELL),TETANUS 2.5-8-5 LF-MCG-LF/0.5ML IM (UMBRELLA)	$165.76	$552.54	$42.37–$502.81	144% above	70%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 DIPH, PERTUSS(ACEL), TET VAC(PF) (ADULT) (ADACEL) 0.5 ML (UMBRELLA)	$167.37	$557.90	$42.37–$507.69	147% above	70%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 DIPHTH,PERTUS(ACELL),TETANUS 2.5-8-5 LF-MCG-LF/0.5ML IM (UMBRELLA)	$165.76	$552.54	—	—	70%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 DIPH, PERTUSS(ACEL), TET VAC(PF) (ADULT) (ADACEL) 0.5 ML (UMBRELLA)	$167.37	$557.90	—	—	70%

Source file: https://ochsner-craft.s3.amazonaws.com/core/264626264_st-martin-hospital-inc-_standardcharges.csv.csv