St. Joseph's Hospital of Buckhannon
St. Joseph's Hospital of Buckhannon in Buckhannon, WV publishes cash prices for 439 common procedures listed here, from its own machine-readable price file updated Jul 10, 2026. Compared with other hospitals in the state, its outpatient cash prices are below the West Virginia median for 250 of 438 procedures and above it for 159. By typical cash price it ranks #10 of 36 West Virginia hospitals, cheapest first. Select a procedure to compare it with other hospitals nearby.
1 Amalia Dr,Buckhannon,WV,26201 Collected Sep 23, 2026 Source price file Check a bill from this hospital (304) 472-2000
Critical access hospital (rural, 25 beds or fewer) Nonprofit hospital Emergency department CMS star rating 3 of 5 CCN 511321 · CMS hospital register NPI 1124005061
Financial assistance
Nonprofit hospital: it must offer free or discounted care to patients who qualify. How to apply
St. Joseph's Hospital of Buckhannon is a nonprofit hospital in the CMS register. Under section 501(r) of the federal tax code it must have a written Financial Assistance Policy with a free application, publish both on its website, and charge patients who qualify no more than the amounts generally billed to insured patients for emergency and other medically necessary care. Who qualifies depends on household income; the policy states the limits.
You can apply up to 240 days after the first bill. Before collection actions such as credit reporting or a lawsuit, the hospital must tell you about the policy and wait at least 120 days after that bill. Ask the billing office for the policy and the application before you pay, or search the hospital's website for “financial assistance”. Letters you can copy.
Source: IRS, section 501(r) requirements for nonprofit hospitals.
Scans and imaging
| Procedure | Cash price | List price | Insurers pay | vs West Virginia | Off list |
|---|---|---|---|---|---|
| Abdominal CT scan without and with contrast CPT 74170 CT SCAN OF ABDOMEN BEFORE AND AFTER CONTRAST | $1,681.50 | $3,363.00 | — | 36% above | 50% |
| Abdominal X-ray, 2 views CPT 74019 X-RAY OF ABDOMEN; 2 VIEWS | $224.00 | $448.00 | — | 2% above | 50% |
| Abdominal X-ray, 2 views CPT 74019 RADEX ABDOMEN 2 VIEWS | $241.00 | $482.00 | — | 10% above | 50% |
| Ankle X-ray, complete, 3 or more views CPT 73610 X-RAY EXAM OF ANKLE | $188.00 | $376.00 | — | 4% above | 50% |
| Ankle X-ray, complete, 3 or more views one side CPT 73610 X-RAY OF ANKLE; MINIMUM OF 3 VIEWS | $175.00 | $350.00 | — | 3% below | 50% |
| Ankle X-ray, complete, 3 or more views one side CPT 73610 X-RAY OF ANKLE; MINIMUM OF 3 VIEWS | $175.00 | $350.00 | — | 3% below | 50% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 UPR/L XTREMITY ART 2 LEVELS | $314.50 | $629.00 | — | 8% above | 50% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 ULTRASOUND STUDY OF ARM AND LEG ARTERIES | $769.00 | $1,538.00 | — | 165% above | 50% |
| Arm CT scan without contrast (shoulder to hand, any part) CPT 73200 CT UPPER EXTREMITY W/O DYE | $733.50 | $1,467.00 | — | 4% above | 50% |
| Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT SCAN OF ARM WITHOUT CONTRAST | $733.50 | $1,467.00 | — | 4% above | 50% |
| Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT SCAN OF ARM WITHOUT CONTRAST | $733.50 | $1,467.00 | — | 4% above | 50% |
| Barium swallow (esophagus X-ray with contrast) CPT 74220 SINGLE CONTRAST X-RAY OF ESOPHAGUS | $274.00 | $548.00 | — | 26% below | 50% |
| Barium swallow (esophagus X-ray with contrast) CPT 74220 X-RAY XM ESOPHAGUS 1CNTRST | $294.50 | $589.00 | — | 20% below | 50% |
| Bone scan, whole body (nuclear medicine) CPT 78306 NUCLEAR MEDICINE STUDY OF BONE AND/OR JOINT WHOLE BODY | $771.50 | $1,543.00 | — | 11% below | 50% |
| Breast ultrasound, limited (one breast or one area) CPT 76642 ULTRASOUND BREAST LIMITED | $230.50 | $461.00 | — | 12% below | 50% |
| Breast ultrasound, limited (one breast or one area) one side CPT 76642 LIMITED ULTRASOUND SCAN OF 1 BREAST | $214.50 | $429.00 | — | 19% below | 50% |
| Breast ultrasound, limited (one breast or one area) one side CPT 76642 LIMITED ULTRASOUND SCAN OF 1 BREAST | $214.50 | $429.00 | — | 19% below | 50% |
| CT angiography (CTA) of the abdomen and pelvis CPT 74174 CT SCAN OF BLOOD VESSELS OF ABDOMEN AND PELVIS WITH CONTRAST | $1,184.00 | $2,368.00 | — | 31% below | 50% |
| CT angiography (CTA) of the head CPT 70496 CT SCAN OF BLOOD VESSELS OF HEAD WITH CONTRAST | $1,080.00 | $2,160.00 | — | 11% below | 50% |
| CT angiography (CTA) of the neck CPT 70498 CT SCAN OF BLOOD VESSELS OF NECK WITH CONTRAST | $1,080.00 | $2,160.00 | — | 6% below | 50% |
| CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT SCAN OF BLOOD VESSELS OF CHEST WITH CONTRAST | $1,228.50 | $2,457.00 | — | 3% below | 50% |
| CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 CT ANGIO HRT W/3D IMAGE | $868.00 | $1,736.00 | — | 22% below | 50% |
| CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 CT SCAN OF BLOOD VESSELS AND GRAFTS OF HEART WITH CONTRAST | $1,205.50 | $2,411.00 | — | 9% above | 50% |
| CT of the heart without contrast dye to measure coronary calcium CPT 75571 CT SCAN OF HEART WITH EVALUATION OF BLOOD VESSEL CALCIUM | $99.00 | $198.00 | — | at median | 50% |
| CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT SCAN OF ABDOMEN AND PELVIS WITHOUT CONTRAST | $1,334.00 | $2,668.00 | — | 2% below | 50% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT SCAN OF ABDOMEN AND PELVIS WITH CONTRAST | $1,442.00 | $2,884.00 | — | 11% below | 50% |
| CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT SCAN OF ABDOMEN AND PELVIS BEFORE AND AFTER CONTRAST | $1,690.00 | $3,380.00 | — | 1% below | 50% |
| CT scan of the abdomen with contrast CPT 74160 CT SCAN OF ABDOMEN WITH CONTRAST | $1,408.50 | $2,817.00 | — | 33% above | 50% |
| CT scan of the abdomen without contrast CPT 74150 CT SCAN OF ABDOMEN WITHOUT CONTRAST | $1,270.00 | $2,540.00 | — | 72% above | 50% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 CT SCAN OF FACE WITHOUT CONTRAST | $698.50 | $1,397.00 | — | 1% above | 50% |
| CT scan of the head or brain, no contrast dye CPT 70450 CT SCAN HEAD OR BRAIN WITHOUT CONTRAST | $1,334.00 | $2,668.00 | — | 88% above | 50% |
| CT scan of the head with contrast CPT 70460 CT HEAD/BRAIN W/DYE | $1,442.00 | $2,884.00 | — | 41% above | 50% |
| CT scan of the head without and with contrast CPT 70470 CT SCAN OF HEAD OR BRAIN BEFORE AND AFTER CONTRAST | $1,690.00 | $3,380.00 | — | 45% above | 50% |
| CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT SCAN OF LOWER SPINE WITHOUT CONTRAST | $1,325.00 | $2,650.00 | — | 58% above | 50% |
| CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT SCAN OF UPPER SPINE WITHOUT CONTRAST | $1,325.00 | $2,650.00 | — | 62% above | 50% |
| CT scan of the pelvis, with contrast dye CPT 72193 CT SCAN OF PELVIS WITH CONTRAST | $1,408.50 | $2,817.00 | — | 48% above | 50% |
| Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 EXTRACRANIAL BILAT STUDY | $561.00 | $1,122.00 | — | — | 50% |
| Carotid artery ultrasound (duplex), both sides of the neck CPT 93880 ULTRASOUND OF BOTH SIDES OF HEAD AND NECK BLOOD FLOW | $781.50 | $1,563.00 | — | 36% above | 50% |
| Chest CT scan without and with contrast CPT 71270 CT SCAN OF CHEST BEFORE AND AFTER CONTRAST | $1,699.50 | $3,399.00 | — | 35% above | 50% |
| Chest X-ray, 2 views CPT 71046 X-RAY OF CHEST; 2 VIEWS | $203.50 | $407.00 | — | 8% above | 50% |
| Chest X-ray, 2 views CPT 71046 X-RAY EXAM CHEST 2 VIEWS | $219.00 | $438.00 | — | 16% above | 50% |
| Chest X-ray, single view CPT 71045 X-RAY OF CHEST; 1 VIEW | $158.50 | $317.00 | — | 10% below | 50% |
| Chest X-ray, single view CPT 71045 X-RAY EXAM CHEST 1 VIEW | $170.50 | $341.00 | — | 3% below | 50% |
| Collarbone (clavicle) X-ray, complete CPT 73000 X-RAY EXAM OF COLLAR BONE | $219.00 | $438.00 | — | 25% above | 50% |
| Collarbone (clavicle) X-ray, complete one side CPT 73000 X-RAY OF COLLAR BONE | $203.50 | $407.00 | — | 16% above | 50% |
| Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 COMPLETE ULTRASOUND SCAN BEHIND ABDOMINAL CAVITY | $475.50 | $951.00 | — | 8% above | 50% |
| Complete ultrasound of the back of the abdomen, such as both kidneys one side CPT 76770 COMPLETE ULTRASOUND SCAN BEHIND ABDOMINAL CAVITY | $475.50 | $951.00 | — | 8% above | 50% |
| DEXA bone density scan of the hip, pelvis or spine CPT 77080 DXA BONE DENSITY MEASUREMENT OF HIP; PELVIS; SPINE | $244.00 | $488.00 | — | 23% below | 50% |
| DEXA bone density scan of the hip, pelvis or spine CPT 77080 DXA BONE DENSITY AXIAL | $262.50 | $525.00 | — | 17% below | 50% |
| DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 DXA BONE DENSITY APPENDICULR | $222.50 | $445.00 | — | at median | 50% |
| Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 ULTRASOUND SCAN OF PREGNANT UTERUS WITH DETAILED FETAL ANATOMIC EXAMINATION; SINGLE OR FIRST FETUS | $439.00 | $878.00 | — | 7% below | 50% |
| Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 OB US DETAILED SNGL FETUS | $472.00 | $944.00 | — | at median | 50% |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT SCAN OF CHEST WITHOUT CONTRAST | $1,325.00 | $2,650.00 | — | 68% above | 50% |
| Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT SCAN OF CHEST WITH CONTRAST | $1,450.00 | $2,900.00 | — | 32% above | 50% |
| Diagnostic mammogram, both breasts both sides CPT 77066 DX MAMMO INCL CAD BI | $220.50 | $441.00 | — | — | 50% |
| Diagnostic mammogram, both breasts CPT 77066 DIAGNOSTIC MAMMOGRAPHY OF BOTH BREASTS | $205.00 | $410.00 | — | 33% below | 50% |
| Diagnostic mammogram, one breast CPT 77065 DX MAMMO INCL CAD UNI | $181.50 | $363.00 | — | 17% below | 50% |
| Diagnostic mammogram, one breast one side CPT 77065 DIAGNOSTIC MAMMOGRAPHY OF 1 BREAST | $169.00 | $338.00 | — | 23% below | 50% |
| Duplex ultrasound of the leg veins, both legs CPT 93970 ULTRASOUND STUDY OF ARM OR LEG VEINS WITH COMPRESSION AND MANEUVERS | $615.50 | $1,231.00 | — | 3% above | 50% |
| Duplex ultrasound of the leg veins, both legs CPT 93970 EXTREMITY STUDY | $617.50 | $1,235.00 | — | 4% above | 50% |
| Echocardiogram through the chest wall, complete, with Doppler CPT 93306 TTE W/DOPPLER COMPLETE | $1,023.00 | $2,046.00 | — | 11% below | 50% |
| Echocardiogram through the chest wall, complete, with Doppler CPT 93306 ULTRASOUND OF HEART WITH COLOR-DEPICTED BLOOD FLOW; RATE; DIRECTION AND VALVE FUNCTION | $1,852.00 | $3,704.00 | — | 60% above | 50% |
| Elbow X-ray, 2 views CPT 73070 X-RAY EXAM OF ELBOW | $136.00 | $272.00 | — | 29% below | 50% |
| Elbow X-ray, complete, 3 or more views CPT 73080 X-RAY EXAM OF ELBOW | $149.00 | $298.00 | — | 17% below | 50% |
| Elbow X-ray, complete, 3 or more views one side CPT 73080 X-RAY OF ELBOW; MINIMUM OF 3 VIEWS | $138.50 | $277.00 | — | 23% below | 50% |
| Elbow X-ray, complete, 3 or more views one side CPT 73080 X-RAY OF ELBOW; MINIMUM OF 3 VIEWS | $138.50 | $277.00 | — | 23% below | 50% |
| Eye socket (orbit) CT scan without contrast CPT 70480 CT SCAN OF CRANIAL CAVITY WITHOUT CONTRAST | $1,225.50 | $2,451.00 | — | 77% above | 50% |
| Facial bones X-ray, complete, 3 or more views CPT 70150 X-RAY EXAM OF FACIAL BONES | $179.50 | $359.00 | — | 24% below | 50% |
| Forearm X-ray (radius and ulna), 2 views CPT 73090 X-RAY EXAM OF FOREARM | $219.00 | $438.00 | — | 23% above | 50% |
| HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 NUCLEAR MEDICINE STUDY OF LIVER AND BILE DUCT SYSTEM | $603.00 | $1,206.00 | — | 29% below | 50% |
| Hand X-ray, 2 views CPT 73120 X-RAY EXAM OF HAND | $130.50 | $261.00 | — | 33% below | 50% |
| Heel bone (calcaneus) X-ray, 2 or more views CPT 73650 X-RAY EXAM OF HEEL | $165.50 | $331.00 | — | 4% below | 50% |
| Knee X-ray, 3 views CPT 73562 X-RAY EXAM OF KNEE 3 | $219.00 | $438.00 | — | 10% above | 50% |
| Knee X-ray, 3 views one side CPT 73562 X-RAY OF KNEE; 3 VIEWS | $203.50 | $407.00 | — | 2% above | 50% |
| Knee X-ray, 3 views one side CPT 73562 X-RAY OF KNEE; 3 VIEWS | $203.50 | $407.00 | — | 2% above | 50% |
| Knee X-ray, complete, 4 or more views CPT 73564 X-RAY EXAM KNEE 4 OR MORE | $188.00 | $376.00 | — | 30% below | 50% |
| Knee X-ray, complete, 4 or more views one side CPT 73564 X-RAY OF KNEE; 4 OR MORE VIEWS | $175.00 | $350.00 | — | 35% below | 50% |
| Knee X-ray, complete, 4 or more views one side CPT 73564 X-RAY OF KNEE; 4 OR MORE VIEWS | $175.00 | $350.00 | — | 35% below | 50% |
| Leg CT scan without contrast (hip to foot, any part) CPT 73700 CT LOWER EXTREMITY W/O DYE | $628.00 | $1,256.00 | — | 13% below | 50% |
| Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT SCAN OF LEG WITHOUT CONTRAST | $628.00 | $1,256.00 | — | 13% below | 50% |
| Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT SCAN OF LEG WITHOUT CONTRAST | $628.00 | $1,256.00 | — | 13% below | 50% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 LIMITED ULTRASOUND SCAN OF ABDOMEN | $430.50 | $861.00 | — | 7% above | 50% |
| Limited ultrasound of an arm or leg (non-vascular) CPT 76882 LIMITED ULTRASOUND SCAN OF JOINT OR OTHER EXTREMITY STRUCTURE LACKING BLOOD VESSELS | $296.00 | $592.00 | — | at median | 50% |
| Limited ultrasound of an arm or leg (non-vascular) CPT 76882 US LMTD JT/FCL EVL NVASC XTR | $318.00 | $636.00 | — | 7% above | 50% |
| Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 LIMITED ULTRASOUND SCAN OF JOINT OR OTHER EXTREMITY STRUCTURE LACKING BLOOD VESSELS | $296.00 | $592.00 | — | at median | 50% |
| Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 LIMITED ULTRASOUND SCAN OF JOINT OR OTHER EXTREMITY STRUCTURE LACKING BLOOD VESSELS | $296.00 | $592.00 | — | at median | 50% |
| Lower leg X-ray (tibia and fibula), 2 views CPT 73590 X-RAY EXAM OF LOWER LEG | $191.00 | $382.00 | — | 1% below | 50% |
| Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 X-RAY OF LOWER LEG; 2 VIEWS | $177.50 | $355.00 | — | 8% below | 50% |
| Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 X-RAY OF LOWER LEG; 2 VIEWS | $177.50 | $355.00 | — | 8% below | 50% |
| MR angiography (MRA) of the head without contrast CPT 70544 MR ANGIOGRAPHY HEAD W/O DYE | $1,516.00 | $3,032.00 | — | 8% above | 50% |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MRI JNT OF LWR EXTRE W/O DYE | $1,544.50 | $3,089.00 | — | 19% above | 50% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI SCAN OF LEG JOINT WITHOUT CONTRAST | $1,544.50 | $3,089.00 | — | 19% above | 50% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI SCAN OF LEG JOINT WITHOUT CONTRAST | $1,544.50 | $3,089.00 | — | 19% above | 50% |
| MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 MRI JOINT LWR EXTR W/O&W/DYE | $1,544.50 | $3,089.00 | — | 17% below | 50% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI SCAN OF LEG JOINT BEFORE AND AFTER CONTRAST | $1,544.50 | $3,089.00 | — | 17% below | 50% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI SCAN OF LEG JOINT BEFORE AND AFTER CONTRAST | $1,544.50 | $3,089.00 | — | 17% below | 50% |
| MRI of the abdomen without contrast CPT 74181 MRI SCAN OF ABDOMEN WITHOUT CONTRAST | $1,544.50 | $3,089.00 | — | 22% above | 50% |
| MRI of the abdomen, without and then with contrast dye CPT 74183 MRI SCAN OF ABDOMEN BEFORE AND AFTER CONTRAST | $2,415.50 | $4,831.00 | — | 24% above | 50% |
| MRI of the brain, no contrast dye CPT 70551 MRI SCAN OF BRAIN WITHOUT CONTRAST | $1,544.50 | $3,089.00 | — | 12% above | 50% |
| MRI of the brain, with and without contrast dye CPT 70553 MRI SCAN OF BRAIN BEFORE AND AFTER CONTRAST | $2,415.50 | $4,831.00 | — | 24% above | 50% |
| MRI of the lower back, no contrast dye CPT 72148 MRI SCAN OF LOWER SPINAL CANAL WITHOUT CONTRAST | $1,544.50 | $3,089.00 | — | 14% above | 50% |
| MRI of the lower back, without and then with contrast dye CPT 72158 MRI SCAN OF LOWER SPINAL CANAL BEFORE AND AFTER CONTRAST | $1,971.50 | $3,943.00 | — | 3% above | 50% |
| MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI SCAN OF MIDDLE SPINAL CANAL WITHOUT CONTRAST | $1,544.50 | $3,089.00 | — | 15% above | 50% |
| MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI SCAN OF UPPER SPINAL CANAL BEFORE AND AFTER CONTRAST | $2,415.50 | $4,831.00 | — | 28% above | 50% |
| MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI SCAN OF UPPER SPINAL CANAL WITHOUT CONTRAST | $1,544.50 | $3,089.00 | — | 6% above | 50% |
| MRI of the pelvis without and with contrast CPT 72197 MRI SCAN OF PELVIS BEFORE AND AFTER CONTRAST | $1,917.00 | $3,834.00 | — | 1% below | 50% |
| MRI of the pelvis, no contrast dye CPT 72195 MRI SCAN OF PELVIS WITHOUT CONTRAST | $1,544.50 | $3,089.00 | — | 14% above | 50% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 MRI JOINT UPR EXTREM W/O DYE | $1,544.50 | $3,089.00 | — | 15% above | 50% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI SCAN OF ARM JOINT WITHOUT CONTRAST | $1,544.50 | $3,089.00 | — | 15% above | 50% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI SCAN OF ARM JOINT WITHOUT CONTRAST | $1,544.50 | $3,089.00 | — | 15% above | 50% |
| Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 X-RAY EXAM NECK SPINE 4/5VWS | $260.50 | $521.00 | — | 6% below | 50% |
| Neck soft tissue CT scan with contrast CPT 70491 CT SCAN OF SOFT TISSUE OF NECK WITH CONTRAST | $902.00 | $1,804.00 | — | 17% below | 50% |
| Neck soft tissue CT scan without contrast CPT 70490 CT SCAN OF SOFT TISSUE OF NECK WITHOUT CONTRAST | $698.50 | $1,397.00 | — | 1% above | 50% |
| Neck soft tissue X-ray CPT 70360 X-RAY EXAM OF NECK | $133.50 | $267.00 | — | 27% below | 50% |
| Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 NUCLEAR MEDICINE STUDIES OF HEART MUSCLE AT REST AND WITH STRESS AND SPECT | $1,430.50 | $2,861.00 | — | 49% below | 50% |
| OCT scan of the retina (optical coherence tomography) CPT 92134 IMAGING OF RETINA | $182.00 | $364.00 | — | 30% above | 50% |
| OCT scan of the retina (optical coherence tomography) CPT 92134 CPTRZ OPH DX IMG PST SGM RTA | $195.50 | $391.00 | — | 40% above | 50% |
| PET/CT scan from the base of the skull to mid-thigh CPT 78815 PET IMAGE W/CT SKULL-THIGH | $1,826.00 | $3,652.00 | — | 46% below | 50% |
| Pelvic CT scan without contrast CPT 72192 CT SCAN OF PELVIS WITHOUT CONTRAST | $1,121.50 | $2,243.00 | — | 40% above | 50% |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 LIMITED ULTRASOUND SCAN OF PELVIS | $314.50 | $629.00 | — | 2% above | 50% |
| Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 COMPLETE ULTRASOUND SCAN OF PELVIS | $475.50 | $951.00 | — | 15% above | 50% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 ULTRASOUND SCAN OF PREGNANT UTERUS (14 WEEKS OR MORE); SINGLE OR FIRST FETUS | $372.00 | $744.00 | — | 12% below | 50% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 OB US >= 14 WKS SNGL FETUS | $400.00 | $800.00 | — | 6% below | 50% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 ULTRASOUND SCAN OF PREGNANT UTERUS (LESS THAN 14 WEEKS); SINGLE OR FIRST FETUS | $145.50 | $291.00 | — | 64% below | 50% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 OB US < 14 WKS SINGLE FETUS | $156.50 | $313.00 | — | 62% below | 50% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 OB US LIMITED FETUS(S) | $235.00 | $470.00 | — | 22% below | 50% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 LIMITED ULTRASOUND OF PREGNANT UTERUS | $280.00 | $560.00 | — | 8% below | 50% |
| Rib X-ray, one side, 2 views CPT 71100 X-RAY EXAM RIBS UNI 2 VIEWS | $141.00 | $282.00 | — | 27% below | 50% |
| Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 X-RAY OF RIBS ON SIDE OF BODY; MINIMUM OF 3 VIEWS | $199.50 | $399.00 | — | 14% below | 50% |
| Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 X-RAY EXAM UNILAT RIBS/CHEST | $214.50 | $429.00 | — | 7% below | 50% |
| Screening mammogram, both breasts both sides CPT 77067 SCR MAMMO BI INCL CAD | $100.00 | $200.00 | — | — | 50% |
| Screening mammogram, both breasts CPT 77067 SCREENING MAMMOGRAPHY | $186.50 | $373.00 | — | 35% below | 50% |
| Shoulder X-ray, complete, 2 or more views CPT 73030 X-RAY EXAM OF SHOULDER | $189.00 | $378.00 | — | 6% above | 50% |
| Shoulder X-ray, complete, 2 or more views one side CPT 73030 X-RAY OF SHOULDER; MINIMUM OF 2 VIEWS | $176.00 | $352.00 | — | 2% below | 50% |
| Shoulder X-ray, complete, 2 or more views one side CPT 73030 X-RAY OF SHOULDER; MINIMUM OF 2 VIEWS | $176.00 | $352.00 | — | 2% below | 50% |
| Sinus X-ray, complete, 3 or more views CPT 70220 X-RAY EXAM OF SINUSES | $235.50 | $471.00 | — | 7% above | 50% |
| Skull X-ray, fewer than 4 views CPT 70250 X-RAY EXAM OF SKULL | $171.50 | $343.00 | — | 15% below | 50% |
| Swallow study (modified barium swallow, video X-ray) CPT 74230 IMAGING FOR EVALUATION OF SWALLOWING FUNCTION | $370.50 | $741.00 | — | 7% below | 50% |
| Swallow study (modified barium swallow, video X-ray) CPT 74230 X-RAY XM SWLNG FUNCJ C+ | $398.50 | $797.00 | — | at median | 50% |
| Thigh bone (femur) X-ray, 2 or more views CPT 73552 X-RAY EXAM OF FEMUR 2/> | $202.00 | $404.00 | — | 7% above | 50% |
| Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 X-RAY OF THIGH BONE; MINIMUM 2 VIEWS | $188.00 | $376.00 | — | at median | 50% |
| Thoracic spine (mid back) CT scan without contrast CPT 72128 CT SCAN OF MIDDLE SPINE WITHOUT CONTRAST | $1,325.00 | $2,650.00 | — | 60% above | 50% |
| Toe X-ray, 2 or more views CPT 73660 X-RAY EXAM OF TOE(S) | $120.50 | $241.00 | — | 30% below | 50% |
| Transvaginal pelvic ultrasound CPT 76830 ULTRASOUND SCAN OF UTERUS; OVARIES; TUBES; CERVIX AND PELVIC AREA THROUGH VAGINA | $494.50 | $989.00 | — | 23% above | 50% |
| Transvaginal ultrasound during pregnancy CPT 76817 VAGINAL ULTRASOUND OF PREGNANT UTERUS | $222.50 | $445.00 | — | 23% below | 50% |
| Transvaginal ultrasound during pregnancy CPT 76817 TRANSVAGINAL US OBSTETRIC | $239.00 | $478.00 | — | 17% below | 50% |
| Ultrasound of the abdomen, complete CPT 76700 COMPLETE ULTRASOUND SCAN OF ABDOMEN | $302.00 | $604.00 | — | 31% below | 50% |
| Ultrasound of the abdomen, complete CPT 76700 US EXAM ABDOM COMPLETE | $324.50 | $649.00 | — | 26% below | 50% |
| Ultrasound of the scrotum and testicles CPT 76870 ULTRASOUND SCAN OF SCROTUM | $302.50 | $605.00 | — | 20% below | 50% |
| Ultrasound of the scrotum and testicles CPT 76870 US EXAM SCROTUM | $325.00 | $650.00 | — | 14% below | 50% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 ULTRASOUND SCAN OF HEAD AND NECK SOFT TISSUE | $280.50 | $561.00 | — | 24% below | 50% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US EXAM OF HEAD AND NECK | $301.50 | $603.00 | — | 18% below | 50% |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 X-RAY XM UPR GI TRC 1CNTRST | $375.00 | $750.00 | — | at median | 50% |
| Upper arm X-ray (humerus), 2 views CPT 73060 X-RAY EXAM OF HUMERUS | $191.00 | $382.00 | — | 6% above | 50% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 ULTRASOUND STUDY OF ONE ARM OR LEG VEINS WITH COMPRESSION AND MANEUVERS | $354.00 | $708.00 | — | 8% below | 50% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 EXTREMITY STUDY | $380.50 | $761.00 | — | 1% below | 50% |
| Wrist X-ray, 2 views CPT 73100 X-RAY EXAM OF WRIST | $148.50 | $297.00 | — | 7% below | 50% |
| Wrist X-ray, complete, 3 or more views CPT 73110 X-RAY EXAM OF WRIST | $164.00 | $328.00 | — | 7% below | 50% |
| Wrist X-ray, complete, 3 or more views one side CPT 73110 X-RAY OF WRIST; MINIMUM OF 3 VIEWS | $152.50 | $305.00 | — | 14% below | 50% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included CPT 73502 X-RAY EXAM HIP UNI 2-3 VIEWS | $115.00 | $230.00 | — | 39% below | 50% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 X-RAY OF HIP; 2-3 VIEWS | $107.00 | $214.00 | — | 43% below | 50% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 X-RAY OF HIP; 2-3 VIEWS | $107.00 | $214.00 | — | 43% below | 50% |
| X-ray of the abdomen, 1 view CPT 74018 X-RAY OF ABDOMEN; 1 VIEW | $153.50 | $307.00 | — | 17% below | 50% |
| X-ray of the abdomen, 1 view CPT 74018 RADEX ABDOMEN 1 VIEW | $165.00 | $330.00 | — | 10% below | 50% |
| X-ray of the ankle, 2 views CPT 73600 X-RAY EXAM OF ANKLE | $155.50 | $311.00 | — | 12% below | 50% |
| X-ray of the ankle, 2 views one side CPT 73600 X-RAY OF ANKLE; 2 VIEWS | $144.50 | $289.00 | — | 18% below | 50% |
| X-ray of the finger(s), 2 or more views CPT 73140 X-RAY EXAM OF FINGER(S) | $149.00 | $298.00 | — | 16% below | 50% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 X-RAY OF FINGER; MINIMUM OF 2 VIEWS | $138.50 | $277.00 | — | 22% below | 50% |
| X-ray of the foot, 2 views CPT 73620 X-RAY EXAM OF FOOT | $141.00 | $282.00 | — | 12% below | 50% |
| X-ray of the foot, 2 views one side CPT 73620 X-RAY OF FOOT; 2 VIEWS | $131.00 | $262.00 | — | 18% below | 50% |
| X-ray of the foot, complete, 3 or more views CPT 73630 X-RAY EXAM OF FOOT | $191.00 | $382.00 | — | 8% above | 50% |
| X-ray of the foot, complete, 3 or more views one side CPT 73630 X-RAY OF FOOT; MINIMUM OF 3 VIEWS | $177.50 | $355.00 | — | at median | 50% |
| X-ray of the foot, complete, 3 or more views one side CPT 73630 X-RAY OF FOOT; MINIMUM OF 3 VIEWS | $177.50 | $355.00 | — | at median | 50% |
| X-ray of the hand, 3 or more views CPT 73130 X-RAY EXAM OF HAND | $165.50 | $331.00 | — | 9% below | 50% |
| X-ray of the hand, 3 or more views one side CPT 73130 X-RAY OF HAND; MINIMUM OF 3 VIEWS | $154.00 | $308.00 | — | 15% below | 50% |
| X-ray of the hand, 3 or more views one side CPT 73130 X-RAY OF HAND; MINIMUM OF 3 VIEWS | $308.00 | $616.00 | — | 69% above | 50% |
| X-ray of the knee, 1 or 2 views CPT 73560 X-RAY EXAM OF KNEE 1 OR 2 | $171.50 | $343.00 | — | 5% below | 50% |
| X-ray of the knee, 1 or 2 views one side CPT 73560 X-RAY OF KNEE; 1-2 VIEWS | $159.50 | $319.00 | — | 12% below | 50% |
| X-ray of the knee, 1 or 2 views one side CPT 73560 X-RAY OF KNEE; 1-2 VIEWS | $159.50 | $319.00 | — | 12% below | 50% |
| X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 X-RAY OF LOWER AND SACRAL SPINE; 2-3 VIEWS | $242.50 | $485.00 | — | 12% above | 50% |
| X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 X-RAY EXAM L-S SPINE 2/3 VWS | $260.50 | $521.00 | — | 20% above | 50% |
| X-ray of the lower back, 4 or more views CPT 72110 X-RAY OF LOWER AND SACRAL SPINE; MINIMUM OF 4 VIEWS | $266.50 | $533.00 | — | 6% below | 50% |
| X-ray of the lower back, 4 or more views CPT 72110 X-RAY EXAM L-2 SPINE 4/>VWS | $286.50 | $573.00 | — | 1% above | 50% |
| X-ray of the nasal bones, 3 or more views CPT 70160 X-RAY EXAM OF NASAL BONES | $148.50 | $297.00 | — | 20% below | 50% |
| X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 X-RAY EXAM NECK SPINE 2-3 VW | $194.00 | $388.00 | — | at median | 50% |
| X-ray of the pelvis, 1 or 2 views CPT 72170 X-RAY EXAM OF PELVIS | $189.00 | $378.00 | — | 4% below | 50% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 X-RAY OF SACRUM AND TAILBONE; MINIMUM OF 2 VIEWS | $162.00 | $324.00 | — | 9% below | 50% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 X-RAY EXAM SACRUM TAILBONE | $174.00 | $348.00 | — | 3% below | 50% |
Lab tests
| Procedure | Cash price | List price | Insurers pay | vs West Virginia | Off list |
|---|---|---|---|---|---|
| ACTH blood test CPT 82024 ADRENOCORTICOTROPIC HORMONE (ACTH) LEVEL | $62.50 | $125.00 | — | 67% below | 50% |
| ACTH blood test CPT 82024 ASSAY OF ACTH | $303.00 | $606.00 | — | 61% above | 50% |
| ALT (alanine aminotransferase) liver enzyme test CPT 84460 LIVER ENZYME (SGPT); LEVEL | $25.00 | $50.00 | — | 14% below | 50% |
| ALT (alanine aminotransferase) liver enzyme test CPT 84460 ALANINE AMINO (ALT) (SGPT) | $26.00 | $52.00 | — | 10% below | 50% |
| AST (aspartate aminotransferase) enzyme test CPT 84450 LIVER ENZYME (SGOT); LEVEL | $25.00 | $50.00 | — | 18% below | 50% |
| AST (aspartate aminotransferase) enzyme test CPT 84450 TRANSFERASE (AST) (SGOT) | $26.00 | $52.00 | — | 15% below | 50% |
| Acute hepatitis panel (hepatitis A, B and C) CPT 80074 ACUTE HEPATITIS PANEL | $221.00 | $442.00 | — | at median | 50% |
| Albumin blood test CPT 82040 ASSAY OF SERUM ALBUMIN | $7.00 | $14.00 | — | 61% below | 50% |
| Albumin blood test CPT 82040 ALBUMIN (PROTEIN) LEVEL | $25.00 | $50.00 | — | 39% above | 50% |
| Aldosterone blood test CPT 82088 ALDOSTERONE HORMONE LEVEL | $12.00 | $24.00 | — | 67% below | 50% |
| Aldosterone blood test CPT 82088 ASSAY OF ALDOSTERONE | $26.00 | $52.00 | — | 29% below | 50% |
| Alkaline phosphatase (ALP) blood test CPT 84075 ASSAY ALKALINE PHOSPHATASE | $18.00 | $36.00 | — | 13% below | 50% |
| Alkaline phosphatase (ALP) blood test CPT 84075 PHOSPHATASE (ENZYME) LEVEL; ALKALINE | $25.00 | $50.00 | — | 20% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 MEASUREMENT OF ANTIBODY (IGE) TO ALLERGIC SUBSTANCE; CRUDE ALLERGEN EXTRACT; EACH | $20.00 | $40.00 | — | 17% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLG SPEC IGE CRUDE XTRC EA | $39.50 | $79.00 | — | 130% above | 50% |
| Alpha-fetoprotein (AFP) blood test CPT 82105 ALPHA-FETOPROTEIN (AFP) LEVEL; SERUM | $72.50 | $145.00 | — | 5% below | 50% |
| Ammonia blood test CPT 82140 ASSAY OF AMMONIA | $28.50 | $57.00 | — | 38% below | 50% |
| Ammonia blood test CPT 82140 AMMONIA LEVEL | $34.50 | $69.00 | — | 25% below | 50% |
| Amylase blood test CPT 82150 AMYLASE (ENZYME) LEVEL | $22.50 | $45.00 | — | 42% below | 50% |
| Amylase blood test CPT 82150 ASSAY OF AMYLASE | $237.00 | $474.00 | — | 516% above | 50% |
| Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CCP ANTIBODY | $25.00 | $50.00 | — | 41% below | 50% |
| Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 MEASUREMENT OF ANTIBODY FOR RHEUMATOID ARTHRITIS ASSESSMENT | $71.50 | $143.00 | — | 69% above | 50% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 SCREENING TEST FOR AUTOIMMUNE DISORDER | $65.50 | $131.00 | — | 8% above | 50% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 ANTINUCLEAR ANTIBODIES | $67.50 | $135.00 | — | 11% above | 50% |
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 NATRIURETIC PEPTIDE (HEART AND BLOOD VESSEL PROTEIN) LEVEL | $103.50 | $207.00 | — | 14% below | 50% |
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 ASSAY OF NATRIURETIC PEPTIDE | $106.50 | $213.00 | — | 11% below | 50% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 BACTERIAL CULTURE; ANY OTHER SOURCE EXCEPT URINE; BLOOD OR STOOL; AEROBIC | $159.00 | $318.00 | — | 210% above | 50% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE OTHR SPECIMN AEROBIC | $164.00 | $328.00 | — | 220% above | 50% |
| Basic metabolic panel (blood test) CPT 80048 BLOOD TEST; BASIC GROUP OF BLOOD CHEMICALS (CALCIUM; TOTAL) | $39.00 | $78.00 | — | 28% below | 50% |
| Bilirubin blood test, total CPT 82247 BILIRUBIN LEVEL; TOTAL | $25.00 | $50.00 | — | 2% above | 50% |
| Bilirubin blood test, total CPT 82247 BILIRUBIN TOTAL | $26.00 | $52.00 | — | 6% above | 50% |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 TISSUE EXAM BY PATHOLOGIST | $101.00 | $202.00 | — | 7% below | 50% |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 PATHOLOGY EXAMINATION OF TISSUE USING A MICROSCOPE; INTERMEDIATE COMPLEXITY | $392.00 | $784.00 | — | 261% above | 50% |
| Blood culture for bacteria CPT 87040 BLOOD CULTURE FOR BACTERIA | $173.00 | $346.00 | — | 133% above | 50% |
| Blood culture for bacteria CPT 87040 BACTERIAL BLOOD CULTURE | $336.00 | $672.00 | — | 353% above | 50% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 INSERTION OF NEEDLE INTO VEIN FOR COLLECTION OF BLOOD SAMPLE | $8.50 | $17.00 | — | 19% below | 50% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 COLL VENOUS BLD VENIPUNCTURE | $9.00 | $18.00 | — | 14% below | 50% |
| Blood glucose (sugar) test CPT 82947 BLOOD GLUCOSE (SUGAR) LEVEL | $25.00 | $50.00 | — | 9% above | 50% |
| Blood glucose (sugar) test CPT 82947 ASSAY GLUCOSE BLOOD QUANT | $26.00 | $52.00 | — | 13% above | 50% |
| Blood lead test CPT 83655 LEAD LEVEL | $6.50 | $13.00 | — | 82% below | 50% |
| Blood lead test CPT 83655 ASSAY OF LEAD | $7.00 | $14.00 | — | 81% below | 50% |
| Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 GONADOTROPIN (REPRODUCTIVE HORMONE) ANALYSIS | $33.50 | $67.00 | — | 19% below | 50% |
| Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 CHORIONIC GONADOTROPIN ASSAY | $44.00 | $88.00 | — | 6% above | 50% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 BLOOD GROUP TYPING (ABO) | $14.40 | $28.80 | — | 65% below | 50% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 BLOOD TYPING SEROLOGIC ABO | $68.00 | $136.00 | — | 67% above | 50% |
| Blood urea nitrogen (BUN) test CPT 84520 UREA NITROGEN LEVEL TO ASSESS KIDNEY FUNCTION; QUANTITATIVE | $25.00 | $50.00 | — | 9% below | 50% |
| Blood urea nitrogen (BUN) test CPT 84520 ASSAY OF UREA NITROGEN | $26.00 | $52.00 | — | 5% below | 50% |
| C-peptide blood test CPT 84681 C-PEPTIDE (PROTEIN) LEVEL | $153.00 | $306.00 | — | 108% above | 50% |
| C-peptide blood test CPT 84681 ASSAY OF C-PEPTIDE | $157.50 | $315.00 | — | 114% above | 50% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C-REACTIVE PROTEIN | $20.50 | $41.00 | — | 33% below | 50% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 MEASUREMENT C-REACTIVE PROTEIN FOR DETECTION OF INFECTION OR INFLAMMATION | $24.00 | $48.00 | — | 21% below | 50% |
| C. difficile toxin gene test (stool PCR) CPT 87493 DETECTION TEST BY NUCLEIC ACID FOR CLOSTRIDIUM DIFFICILE; AMPLIFIED PROBE TECHNIQUE | $147.00 | $294.00 | — | 29% above | 50% |
| C. difficile toxin gene test (stool PCR) CPT 87493 C DIFF AMPLIFIED PROBE | $151.50 | $303.00 | — | 33% above | 50% |
| CA 19-9 blood test (tumor marker) CPT 86301 IMMUNOLOGIC ANALYSIS FOR DETECTION OF TUMOR ANTIGEN; QUANTITATIVE; CA 19-9 | $182.50 | $365.00 | — | 120% above | 50% |
| CA 19-9 blood test (tumor marker) CPT 86301 IMMUNOASSAY TUMOR CA 19-9 | $188.00 | $376.00 | — | 127% above | 50% |
| CA-125 blood test (ovarian cancer marker) CPT 86304 IMMUNOLOGIC ANALYSIS FOR DETECTION OF TUMOR ANTIGEN; QUANTITATIVE; CA 125 | $94.00 | $188.00 | — | 12% below | 50% |
| CA-125 blood test (ovarian cancer marker) CPT 86304 IMMUNOASSAY TUMOR CA 125 | $97.00 | $194.00 | — | 9% below | 50% |
| Calcium blood test, total CPT 82310 CALCIUM LEVEL; TOTAL | $18.50 | $37.00 | — | 27% below | 50% |
| Calcium blood test, total CPT 82310 ASSAY OF CALCIUM | $19.00 | $38.00 | — | 25% below | 50% |
| Carcinoembryonic antigen (CEA) test CPT 82378 CARCINOEMBRYONIC ANTIGEN (CEA) PROTEIN LEVEL | $134.00 | $268.00 | — | 29% above | 50% |
| Carcinoembryonic antigen (CEA) test CPT 82378 CARCINOEMBRYONIC ANTIGEN | $138.00 | $276.00 | — | 33% above | 50% |
| Chickenpox (varicella) immunity blood test CPT 86787 ANALYSIS FOR ANTIBODY TO VARICELLA-ZOSTER VIRUS (CHICKEN POX) | $14.50 | $29.00 | — | 62% below | 50% |
| Chickenpox (varicella) immunity blood test CPT 86787 VARICELLA-ZOSTER ANTIBODY | $15.00 | $30.00 | — | 61% below | 50% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLMYD TRACH DNA AMP PROBE | $76.00 | $152.00 | — | 34% above | 50% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 DETECTION TEST BY NUCLEIC ACID FOR CHLAMYDIA TRACHOMATIS; AMPLIFIED PROBE TECHNIQUE | $94.50 | $189.00 | — | 67% above | 50% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 BLOOD TEST; LIPIDS (CHOLESTEROL AND TRIGLYCERIDES) | $62.50 | $125.00 | — | at median | 50% |
| Complete blood count (CBC) with differential CPT 85025 COMPLETE BLOOD CELL COUNT (RED CELLS; WHITE BLOOD CELL; PLATELETS); AUTOMATED TEST AND AUTOMATED DIFFERENTIAL WHITE BLOOD CELL COUNT | $41.50 | $83.00 | — | at median | 50% |
| Complete blood count (CBC) with differential CPT 85025 COMPLETE CBC W/AUTO DIFF WBC | $42.50 | $85.00 | — | 2% above | 50% |
| Complete blood count (CBC), no differential CPT 85027 COMPLETE BLOOD CELL COUNT (RED CELLS; WHITE BLOOD CELL; PLATELETS); AUTOMATED TEST | $33.00 | $66.00 | — | 6% below | 50% |
| Complete blood count (CBC), no differential CPT 85027 COMPLETE CBC AUTOMATED | $34.00 | $68.00 | — | 3% below | 50% |
| Comprehensive metabolic panel (blood test) CPT 80053 BLOOD TEST; COMPREHENSIVE GROUP OF BLOOD CHEMICALS | $49.00 | $98.00 | — | at median | 50% |
| Cortisol blood test, total CPT 82533 TOTAL CORTISOL | $20.00 | $40.00 | — | 66% below | 50% |
| Cortisol blood test, total CPT 82533 CORTISOL (HORMONE) MEASUREMENT; TOTAL | $79.00 | $158.00 | — | 33% above | 50% |
| Creatine kinase (CK) blood test, total CPT 82550 CREATINE KINASE (CARDIAC ENZYME) LEVEL; TOTAL | $25.00 | $50.00 | — | 43% below | 50% |
| Creatine kinase (CK) blood test, total CPT 82550 ASSAY OF CK (CPK) | $26.00 | $52.00 | — | 40% below | 50% |
| Creatinine blood test CPT 82565 BLOOD CREATININE LEVEL | $25.00 | $50.00 | — | 15% below | 50% |
| Creatinine blood test CPT 82565 ASSAY OF CREATININE | $35.50 | $71.00 | — | 20% above | 50% |
| Cytomegalovirus (CMV) antibody test CPT 86644 CMV ANTIBODY | $63.00 | $126.00 | — | 25% above | 50% |
| Cytomegalovirus (CMV) antibody test CPT 86644 ANALYSIS FOR ANTIBODY TO CYTOMEGALOVIRUS (CMV) | $111.00 | $222.00 | — | 120% above | 50% |
| D-dimer blood test (blood clot marker) CPT 85379 COAGULATION FUNCTION MEASUREMENT; D-DIMER; QUANTITATIVE | $51.00 | $102.00 | — | 20% below | 50% |
| D-dimer blood test (blood clot marker) CPT 85379 FIBRIN DEGRADATION QUANT | $52.50 | $105.00 | — | 18% below | 50% |
| DHEA sulfate (DHEA-S) blood test CPT 82627 DEHYDROEPIANDROSTERONE (DHEA-S) HORMONE LEVEL | $87.50 | $175.00 | — | 6% below | 50% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 TESTING FOR PRESENCE OF DRUG; BY CHEMISTRY ANALYZERS | $364.50 | $729.00 | — | 1100% above | 50% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG TEST PRSMV CHEM ANLYZR | $375.50 | $751.00 | — | 1136% above | 50% |
| Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 BLOOD TEST PANEL FOR ELECTROLYTES (SODIUM POTASSIUM; CHLORIDE; CARBON DIOXIDE) | $32.50 | $65.00 | — | at median | 50% |
| Epstein-Barr virus (EBV) antibody test CPT 86665 ANALYSIS FOR ANTIBODY TO EPSTEIN-BARR VIRUS (MONONUCLEOSIS VIRUS); VIRAL CAPSID | $82.00 | $164.00 | — | 35% above | 50% |
| Epstein-Barr virus (EBV) antibody test CPT 86665 EPSTEIN-BARR CAPSID VCA | $207.50 | $415.00 | — | 242% above | 50% |
| Estradiol blood test CPT 82670 MEASUREMENT OF TOTAL ESTRADIOL (HORMONE) | $202.50 | $405.00 | — | 136% above | 50% |
| Estradiol blood test CPT 82670 ASSAY OF TOTAL ESTRADIOL | $208.50 | $417.00 | — | 143% above | 50% |
| FSH (follicle-stimulating hormone) test CPT 83001 GONADOTROPIN; FOLLICLE STIMULATING (REPRODUCTIVE HORMONE) LEVEL | $69.50 | $139.00 | — | 17% below | 50% |
| FSH (follicle-stimulating hormone) test CPT 83001 ASSAY OF GONADOTROPIN (FSH) | $71.50 | $143.00 | — | 15% below | 50% |
| Fecal calprotectin (stool inflammation test) CPT 83993 STOOL CALPROTECTIN (PROTEIN) LEVEL | $30.00 | $60.00 | — | 67% below | 50% |
| Ferritin blood test (iron stores) CPT 82728 FERRITIN (BLOOD PROTEIN) LEVEL | $67.00 | $134.00 | — | 5% below | 50% |
| Ferritin blood test (iron stores) CPT 82728 ASSAY OF FERRITIN | $69.00 | $138.00 | — | 2% below | 50% |
| Fibrinogen blood test CPT 85384 FIBRINOGEN (FACTOR 1) ACTIVITY MEASUREMENT | $83.50 | $167.00 | — | 63% above | 50% |
| Fibrinogen blood test CPT 85384 FIBRINOGEN ACTIVITY | $86.00 | $172.00 | — | 68% above | 50% |
| Folate (folic acid) blood test CPT 82746 FOLIC ACID LEVEL; SERUM | $68.00 | $136.00 | — | 4% below | 50% |
| Folate (folic acid) blood test CPT 82746 ASSAY OF FOLIC ACID SERUM | $70.00 | $140.00 | — | 1% below | 50% |
| Free T3 thyroid hormone test CPT 84481 THYROID HORMONE; T3 MEASUREMENT; FREE | $62.50 | $125.00 | — | 32% below | 50% |
| Free T3 thyroid hormone test CPT 84481 FREE ASSAY (FT-3) | $64.50 | $129.00 | — | 29% below | 50% |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 ASSAY OF FREE THYROXINE | $7.50 | $15.00 | — | 87% below | 50% |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 THYROXINE (THYROID CHEMICAL); FREE | $65.50 | $131.00 | — | 13% above | 50% |
| Free testosterone test CPT 84402 ASSAY OF FREE TESTOSTERONE | $22.00 | $44.00 | — | 69% below | 50% |
| Free testosterone test CPT 84402 TESTOSTERONE (HORMONE) LEVEL; FREE | $77.50 | $155.00 | — | 10% above | 50% |
| Gamma-glutamyl transferase (GGT) blood test CPT 82977 GLUTAMYLTRANSFERASE (LIVER ENZYME) LEVEL | $25.00 | $50.00 | — | 28% below | 50% |
| Gamma-glutamyl transferase (GGT) blood test CPT 82977 ASSAY OF GGT | $26.00 | $52.00 | — | 25% below | 50% |
| General health panel: metabolic panel, blood count and TSH in one order CPT 80050 GENERAL HEALTH PANEL | $243.00 | $486.00 | — | 7% above | 50% |
| Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 BLOOD GLUCOSE (SUGAR) LEVEL AFTER RECEIVING DOSE OF GLUCOSE | $25.00 | $50.00 | — | 25% below | 50% |
| Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GLUCOSE TEST | $26.00 | $52.00 | — | 22% below | 50% |
| Glucose tolerance test, 3 samples CPT 82951 BLOOD GLUCOSE (SUGAR) TOLERANCE TEST; 3 SPECIMENS | $30.00 | $60.00 | — | 54% below | 50% |
| Glucose tolerance test, 3 samples CPT 82951 GLUCOSE TOLERANCE TEST (GTT) | $78.00 | $156.00 | — | 20% above | 50% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 N.GONORRHOEAE DNA AMP PROB | $76.00 | $152.00 | — | 25% above | 50% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 DETECTION TEST BY NUCLEIC ACID FOR NEISSERIA GONORRHOEAE (GONORRHOEAE BACTERIA); AMPLIFIED PROBE TECHNIQUE | $94.50 | $189.00 | — | 55% above | 50% |
| H. pylori stool antigen test CPT 87338 DETECTION TEST BY IMMUNOASSAY TECHNIQUE FOR HELICOBACTER PYLORI (GI TRACT BACTERIA) IN STOOL | $32.50 | $65.00 | — | 45% below | 50% |
| HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 DETECTION TEST BY NUCLEIC ACID FOR HIV-1 VIRUS; QUANTIFICATION | $135.50 | $271.00 | — | 46% below | 50% |
| HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV-1 QUANT&REVRSE TRNSCRPJ | $139.50 | $279.00 | — | 45% below | 50% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 DETECTION TEST BY IMMUNOASSAY TECHNIQUE FOR HIV-1 ANTIGEN AND HIV-1 AND HIV-2 ANTIBODIES | $68.00 | $136.00 | — | 7% above | 50% |
| HPV test for high-risk types, one combined (pooled) result CPT 87624 HPV HI-RISK TYP POOLED RSLT | $30.00 | $60.00 | — | 53% below | 50% |
| HPV test for high-risk types, one combined (pooled) result CPT 87624 DETECTION TEST BY NUCLEIC ACID FOR HUMAN PAPILLOMAVIRUS (HPV); HIGH-RISK TYPES | $42.00 | $84.00 | — | 34% below | 50% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HEMOGLOBIN GLYCOSYLATED A1C | $50.00 | $100.00 | — | at median | 50% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HEMOGLOBIN A1C LEVEL | $76.50 | $153.00 | — | 53% above | 50% |
| Hemoglobin blood test CPT 85018 BLOOD COUNT; HEMOGLOBIN | $20.00 | $40.00 | — | 43% above | 50% |
| Hemoglobin blood test CPT 85018 HEMOGLOBIN | $20.50 | $41.00 | — | 46% above | 50% |
| Hepatitis B core antibody test (total) CPT 86704 HEPATITIS B CORE ANTIBODY MEASUREMENT | $54.50 | $109.00 | — | 9% above | 50% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEPATITIS B SURFACE ANTIBODY MEASUREMENT | $108.50 | $217.00 | — | 128% above | 50% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEP B SURFACE ANTIBODY | $112.00 | $224.00 | — | 136% above | 50% |
| Hepatitis B surface antigen (HBsAg) test CPT 87340 DETECTION TEST BY IMMUNOASSAY TECHNIQUE FOR HEPATITIS B SURFACE ANTIGEN | $129.50 | $259.00 | — | 272% above | 50% |
| Hepatitis B surface antigen (HBsAg) test CPT 87340 HEPATITIS B SURFACE AG IA | $133.50 | $267.00 | — | 284% above | 50% |
| Hepatitis C antibody blood test (screening) CPT 86803 HEPATITIS C ANTIBODY MEASUREMENT | $68.50 | $137.00 | — | 17% above | 50% |
| Hepatitis C antibody blood test (screening) CPT 86803 HEPATITIS C AB TEST | $70.50 | $141.00 | — | 21% above | 50% |
| Hepatitis C viral load (HCV RNA) test CPT 87522 DETECTION TEST BY NUCLEIC ACID FOR HEPATITIS C VIRUS; QUANTIFICATION | $166.50 | $333.00 | — | 17% below | 50% |
| Hepatitis C viral load (HCV RNA) test CPT 87522 HEPATITIS C REVRS TRNSCRPJ | $336.50 | $673.00 | — | 69% above | 50% |
| Herpes blood test, HSV-1 antibody CPT 86695 ANALYSIS FOR ANTIBODY TO HERPES SIMPLEX VIRUS; TYPE 1 | $20.00 | $40.00 | — | 54% below | 50% |
| Herpes blood test, HSV-1 antibody CPT 86695 HERPES SIMPLEX TYPE 1 TEST | $25.00 | $50.00 | — | 43% below | 50% |
| Herpes blood test, HSV-2 antibody CPT 86696 ANALYSIS FOR ANTIBODY TO HERPES SIMPLEX VIRUS; TYPE 2 | $20.00 | $40.00 | — | 58% below | 50% |
| Herpes blood test, HSV-2 antibody CPT 86696 HERPES SIMPLEX TYPE 2 TEST | $25.00 | $50.00 | — | 48% below | 50% |
| High-sensitivity CRP (hs-CRP) test CPT 86141 MEASUREMENT C-REACTIVE PROTEIN FOR DETECTION OF INFECTION OR INFLAMMATION; HIGH SENSITIVITY | $62.00 | $124.00 | — | at median | 50% |
| High-sensitivity CRP (hs-CRP) test CPT 86141 C-REACTIVE PROTEIN HS | $64.00 | $128.00 | — | 4% above | 50% |
| Homocysteine blood test CPT 83090 HOMOCYSTEINE (AMINO ACID) LEVEL | $139.50 | $279.00 | — | 59% above | 50% |
| Homocysteine blood test CPT 83090 ASSAY OF HOMOCYSTEINE | $143.50 | $287.00 | — | 63% above | 50% |
| Insulin blood test CPT 83525 INSULIN MEASUREMENT; TOTAL | $97.50 | $195.00 | — | 76% above | 50% |
| Insulin blood test CPT 83525 ASSAY OF INSULIN | $100.50 | $201.00 | — | 81% above | 50% |
| Iron blood test (serum iron) CPT 83540 IRON LEVEL | $25.00 | $50.00 | — | 41% below | 50% |
| Iron blood test (serum iron) CPT 83540 ASSAY OF IRON | $26.00 | $52.00 | — | 39% below | 50% |
| Iron-binding capacity (TIBC) test CPT 83550 IRON BINDING TEST | $25.00 | $50.00 | — | 44% below | 50% |
| Kidney function blood test panel CPT 80069 KIDNEY FUNCTION BLOOD TEST PANEL | $40.00 | $80.00 | — | 7% below | 50% |
| LH (luteinizing hormone) test CPT 83002 ASSAY OF GONADOTROPIN (LH) | $101.00 | $202.00 | — | 20% above | 50% |
| LH (luteinizing hormone) test CPT 83002 GONADOTROPIN; LUTEINIZING (REPRODUCTIVE HORMONE) LEVEL | $207.00 | $414.00 | — | 146% above | 50% |
| Lactate (lactic acid) blood test CPT 83605 ASSAY OF LACTIC ACID | $50.00 | $100.00 | — | 12% below | 50% |
| Lactate (lactic acid) blood test CPT 83605 LACTIC ACID LEVEL | $97.00 | $194.00 | — | 71% above | 50% |
| Lactate dehydrogenase (LDH) blood test CPT 83615 LACTATE (LD) (LDH) ENZYME | $5.00 | $10.00 | — | 74% below | 50% |
| Lactate dehydrogenase (LDH) blood test CPT 83615 LACTATE DEHYDROGENASE (ENZYME) LEVEL | $19.50 | $39.00 | — | 2% above | 50% |
| Lipase blood test (pancreas enzyme) CPT 83690 LIPASE (FAT ENZYME) LEVEL | $25.00 | $50.00 | — | 38% below | 50% |
| Lipase blood test (pancreas enzyme) CPT 83690 ASSAY OF LIPASE | $27.00 | $54.00 | — | 33% below | 50% |
| Liver function blood test panel CPT 80076 LIVER FUNCTION BLOOD TEST PANEL | $38.00 | $76.00 | — | 20% below | 50% |
| Lyme disease antibody test CPT 86618 ANALYSIS FOR ANTIBODY BORRELIA BURGDORFERI (LYME DISEASE BACTERIA) | $27.50 | $55.00 | — | 13% below | 50% |
| Lyme disease antibody test CPT 86618 LYME DISEASE ANTIBODY | $53.00 | $106.00 | — | 68% above | 50% |
| Magnesium blood test CPT 83735 ASSAY OF MAGNESIUM | $13.50 | $27.00 | — | 31% below | 50% |
| Magnesium blood test CPT 83735 MAGNESIUM LEVEL | $21.50 | $43.00 | — | 10% above | 50% |
| Measles (rubeola) antibody test CPT 86765 ANALYSIS FOR ANTIBODY TO RUBEOLA (MEASLES VIRUS) | $9.00 | $18.00 | — | 77% below | 50% |
| Measles (rubeola) antibody test CPT 86765 RUBEOLA ANTIBODY | $13.50 | $27.00 | — | 66% below | 50% |
| Mono test (heterophile antibody, Monospot) CPT 86308 SCREENING TEST FOR MONONUCLEOSIS (MONO) | $21.50 | $43.00 | — | 39% below | 50% |
| Mono test (heterophile antibody, Monospot) CPT 86308 HETEROPHILE ANTIBODY SCREEN | $22.00 | $44.00 | — | 37% below | 50% |
| Mumps immunity blood test CPT 86735 MUMPS ANTIBODY | $10.50 | $21.00 | — | 76% below | 50% |
| Mumps immunity blood test CPT 86735 ANALYSIS FOR ANTIBODY TO MUMPS VIRUS | $29.50 | $59.00 | — | 34% below | 50% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 PSA (PROSTATE SPECIFIC ANTIGEN) MEASUREMENT; FREE | $51.00 | $102.00 | — | 15% below | 50% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 PSA (PROSTATE SPECIFIC ANTIGEN) MEASUREMENT; TOTAL | $7.50 | $15.00 | — | 88% below | 50% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 ASSAY OF PSA TOTAL | $65.00 | $130.00 | — | 3% above | 50% |
| Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 PAP TEST; MANUAL SCREENING | $74.00 | $148.00 | — | 48% above | 50% |
| Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 CYTOPATH C/V THIN LAYER | $75.00 | $150.00 | — | 50% above | 50% |
| Parathyroid hormone (PTH) blood test CPT 83970 PARATHORMONE (PARATHYROID HORMONE) LEVEL | $152.50 | $305.00 | — | at median | 50% |
| Parathyroid hormone (PTH) blood test CPT 83970 ASSAY OF PARATHORMONE | $156.00 | $312.00 | — | 3% above | 50% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 COAGULATION ASSESSMENT BLOOD TEST; PLASMA OR WHOLE BLOOD | $53.00 | $106.00 | — | 28% above | 50% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 THROMBOPLASTIN TIME PARTIAL | $54.50 | $109.00 | — | 31% above | 50% |
| Phosphorus (phosphate) blood test CPT 84100 PHOSPHATE LEVEL | $25.00 | $50.00 | — | 20% below | 50% |
| Phosphorus (phosphate) blood test CPT 84100 ASSAY OF PHOSPHORUS | $26.00 | $52.00 | — | 17% below | 50% |
| Potassium blood test CPT 84132 BLOOD POTASSIUM LEVEL | $25.00 | $50.00 | — | 7% below | 50% |
| Potassium blood test CPT 84132 ASSAY OF SERUM POTASSIUM | $26.00 | $52.00 | — | 4% below | 50% |
| Progesterone blood test CPT 84144 PROGESTERONE (REPRODUCTIVE HORMONE) LEVEL | $98.00 | $196.00 | — | 2% below | 50% |
| Progesterone blood test CPT 84144 ASSAY OF PROGESTERONE | $151.00 | $302.00 | — | 52% above | 50% |
| Prolactin blood test CPT 84146 ASSAY OF PROLACTIN | $34.00 | $68.00 | — | 47% below | 50% |
| Prolactin blood test CPT 84146 PROLACTIN (MILK PRODUCING HORMONE) LEVEL | $68.00 | $136.00 | — | 6% above | 50% |
| Prothrombin time (PT/INR) clotting test CPT 85610 BLOOD TEST; CLOTTING TIME | $27.00 | $54.00 | — | 6% below | 50% |
| Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME | $28.00 | $56.00 | — | 3% below | 50% |
| Rapid flu test (influenza antigen) CPT 87804 DETECTION TEST BY IMMUNOASSAY WITH DIRECT VISUAL OBSERVATION FOR INFLUENZA VIRUS | $29.00 | $58.00 | — | 38% below | 50% |
| Rapid flu test (influenza antigen) CPT 87804 INFLUENZA ASSAY W/OPTIC | $31.00 | $62.00 | — | 33% below | 50% |
| Rapid strep A antigen test from a throat swab, read visually CPT 87880 STREP A ASSAY W/OPTIC | $26.50 | $53.00 | — | 35% below | 50% |
| Rapid strep A antigen test from a throat swab, read visually CPT 87880 DETECTION TEST BY IMMUNOASSAY WITH DIRECT VISUAL OBSERVATION FOR STREPTOCOCCUS; GROUP A (STREP) | $43.00 | $86.00 | — | 6% above | 50% |
| Renin blood test CPT 84244 RENIN (KIDNEY ENZYME) LEVEL | $12.50 | $25.00 | — | 78% below | 50% |
| Rh blood typing CPT 86901 BLOOD TYPING SEROLOGIC RH(D) | $19.50 | $39.00 | — | 32% below | 50% |
| Rh blood typing CPT 86901 BLOOD TYPING FOR RH (D) ANTIGEN | $22.68 | $45.35 | — | 21% below | 50% |
| Rheumatoid factor (RF) test CPT 86431 RHEUMATOID FACTOR LEVEL | $87.00 | $174.00 | — | 143% above | 50% |
| Rheumatoid factor (RF) test CPT 86431 RHEUMATOID FACTOR QUANT | $89.50 | $179.00 | — | 150% above | 50% |
| Rubella antibody test (immunity check) CPT 86762 ANALYSIS FOR ANTIBODY TO RUBELLA (GERMAN MEASLES VIRUS) | $71.50 | $143.00 | — | 44% above | 50% |
| Rubella antibody test (immunity check) CPT 86762 RUBELLA ANTIBODY | $73.50 | $147.00 | — | 48% above | 50% |
| Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 RED BLOOD CELL SEDIMENTATION RATE; TO DETECT INFLAMMATION; AUTOMATED | $55.00 | $110.00 | — | 228% above | 50% |
| Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 RBC SED RATE AUTOMATED | $56.50 | $113.00 | — | 237% above | 50% |
| Sodium blood test CPT 84295 BLOOD SODIUM LEVEL | $25.00 | $50.00 | — | 4% below | 50% |
| Sodium blood test CPT 84295 ASSAY OF SERUM SODIUM | $27.50 | $55.00 | — | 6% above | 50% |
| Stool ova and parasites exam CPT 87177 OVA AND PARASITES SMEARS | $55.50 | $111.00 | — | 16% above | 50% |
| Stool ova and parasites exam CPT 87177 SMEAR FOR PARASITES | $60.00 | $120.00 | — | 25% above | 50% |
| Stool test for hidden blood (guaiac FOBT) CPT 82270 STOOL ANALYSIS FOR BLOOD TO SCREEN FOR COLON TUMORS | $3.00 | $6.00 | — | 81% below | 50% |
| Stool test for hidden blood (guaiac FOBT) CPT 82270 OCCULT BLOOD FECES | $13.00 | $26.00 | — | 19% below | 50% |
| Stool test for hidden blood by immunoassay (FIT) CPT 82274 STOOL ANALYSIS FOR BLOOD; BY FECAL HEMOGLOBIN DETERMINATION BY IMMUNOASSAY | $36.50 | $73.00 | — | at median | 50% |
| Stool test for hidden blood by immunoassay (FIT) CPT 82274 ASSAY TEST FOR BLOOD FECAL | $46.50 | $93.00 | — | 27% above | 50% |
| Syphilis antibody test (Treponema pallidum) CPT 86780 ANALYSIS FOR ANTIBODY; TREPONEMA PALLIDUM | $35.50 | $71.00 | — | 15% above | 50% |
| Syphilis antibody test (Treponema pallidum) CPT 86780 TREPONEMA PALLIDUM | $87.50 | $175.00 | — | 182% above | 50% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 SYPHILIS DETECTION TEST | $29.50 | $59.00 | — | 9% above | 50% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 SYPHILIS TEST NON-TREP QUAL | $44.50 | $89.00 | — | 65% above | 50% |
| TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 TUBERCULOSIS TEST; GAMMA INTERFERON | $120.50 | $241.00 | — | 36% below | 50% |
| TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 TB TEST CELL IMMUN MEASURE | $124.00 | $248.00 | — | 35% below | 50% |
| Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE (HORMONE) LEVEL; TOTAL | $39.00 | $78.00 | — | 56% below | 50% |
| Testosterone blood test, total (not free testosterone) CPT 84403 ASSAY OF TOTAL TESTOSTERONE | $48.50 | $97.00 | — | 45% below | 50% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 MICROSOMAL ANTIBODIES (AUTOANTIBODY) MEASUREMENT | $115.00 | $230.00 | — | 58% above | 50% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 MICROSOMAL ANTIBODY EACH | $173.00 | $346.00 | — | 138% above | 50% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 ASSAY THYROID STIM HORMONE | $22.00 | $44.00 | — | 66% below | 50% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 BLOOD TEST; THYROID STIMULATING HORMONE (TSH) | $74.50 | $149.00 | — | 15% above | 50% |
| Total IgE blood test CPT 82785 IGE (IMMUNE SYSTEM PROTEIN) LEVEL | $67.50 | $135.00 | — | 24% above | 50% |
| Total IgE blood test CPT 82785 ASSAY OF IGE | $69.50 | $139.00 | — | 28% above | 50% |
| Total cholesterol blood test CPT 82465 CHOLESTEROL LEVEL | $19.00 | $38.00 | — | 19% below | 50% |
| Total thyroxine (T4) blood test CPT 84436 THYROXINE (THYROID CHEMICAL); TOTAL | $67.00 | $134.00 | — | 47% above | 50% |
| Total thyroxine (T4) blood test CPT 84436 ASSAY OF TOTAL THYROXINE | $69.00 | $138.00 | — | 52% above | 50% |
| Total triiodothyronine (T3) blood test CPT 84480 THYROID HORMONE; T3 MEASUREMENT; TOTAL | $38.50 | $77.00 | — | 51% below | 50% |
| Total triiodothyronine (T3) blood test CPT 84480 ASSAY TRIIODOTHYRONINE (T3) | $50.50 | $101.00 | — | 36% below | 50% |
| Transferrin blood test CPT 84466 ASSAY OF TRANSFERRIN | $27.00 | $54.00 | — | 52% below | 50% |
| Transferrin blood test CPT 84466 TRANSFERRIN (IRON BINDING PROTEIN) LEVEL | $69.50 | $139.00 | — | 25% above | 50% |
| Trichomonas test (NAAT) CPT 87661 DETECTION TEST BY NUCLEIC ACID FOR TRICHOMONAS VAGINALIS (GENITAL PARASITE); AMPLIFIED PROBE TECHNIQUE | $140.50 | $281.00 | — | 82% above | 50% |
| Trichomonas test (NAAT) CPT 87661 TRICHOMONAS VAGINALIS AMPLIF | $158.50 | $317.00 | — | 105% above | 50% |
| Triglycerides blood test CPT 84478 TRIGLYCERIDES LEVEL | $24.50 | $49.00 | — | 16% below | 50% |
| Triglycerides blood test CPT 84478 ASSAY OF TRIGLYCERIDES | $51.00 | $102.00 | — | 74% above | 50% |
| Troponin test, quantitative CPT 84484 TROPONIN (PROTEIN) ANALYSIS; QUANTITATIVE | $38.00 | $76.00 | — | 49% below | 50% |
| Troponin test, quantitative CPT 84484 ASSAY OF TROPONIN QUANT | $39.00 | $78.00 | — | 48% below | 50% |
| Uric acid blood test CPT 84550 URIC ACID LEVEL; BLOOD | $25.00 | $50.00 | — | 24% below | 50% |
| Uric acid blood test CPT 84550 ASSAY OF BLOOD/URIC ACID | $26.00 | $52.00 | — | 21% below | 50% |
| Urinalysis with microscope exam, automated CPT 81001 MANUAL URINALYSIS TEST WITH EXAMINATION USING MICROSCOPE; AUTOMATED | $27.50 | $55.00 | — | 8% below | 50% |
| Urinalysis without microscope exam, automated CPT 81003 URINALYSIS AUTO W/O SCOPE | $19.00 | $38.00 | — | 23% above | 50% |
| Urinalysis without microscope exam, automated CPT 81003 AUTOMATED URINALYSIS TEST | $27.50 | $55.00 | — | 77% above | 50% |
| Urinalysis without microscope exam, manual CPT 81002 URINALYSIS; MANUAL TEST | $9.00 | $18.00 | — | 28% below | 50% |
| Urinalysis without microscope exam, manual CPT 81002 URINALYSIS NONAUTO W/O SCOPE | $15.00 | $30.00 | — | 20% above | 50% |
| Urine culture for bacteria, with colony count CPT 87086 BACTERIAL COLONY COUNT; URINE | $69.50 | $139.00 | — | 19% above | 50% |
| Urine culture for bacteria, with colony count CPT 87086 URINE CULTURE/COLONY COUNT | $71.50 | $143.00 | — | 22% above | 50% |
| Urine microalbumin (albumin) test CPT 82043 UR ALBUMIN QUANTITATIVE | $14.00 | $28.00 | — | 58% below | 50% |
| Urine microalbumin (albumin) test CPT 82043 URINE MICROALBUMIN (PROTEIN) LEVEL | $27.50 | $55.00 | — | 17% below | 50% |
| Urine pregnancy test, read by color change CPT 81025 URINE PREGNANCY TEST | $15.00 | $30.00 | — | 33% below | 50% |
| Vitamin B12 (cobalamin) blood test CPT 82607 CYANOCOBALAMIN (VITAMIN B-12) LEVEL | $74.00 | $148.00 | — | 8% below | 50% |
| Vitamin B12 (cobalamin) blood test CPT 82607 VITAMIN B-12 | $75.50 | $151.00 | — | 7% below | 50% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D-3 LEVEL | $12.00 | $24.00 | — | 86% below | 50% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D 25 HYDROXY | $71.50 | $143.00 | — | 17% below | 50% |
| Vitamin D, 1,25-dihydroxy blood test CPT 82652 DIHYDROXYVITAMIN D; 1; 25 LEVEL | $14.00 | $28.00 | — | 82% below | 50% |
| Zinc blood test CPT 84630 ZINC LEVEL | $6.00 | $12.00 | — | 85% below | 50% |
| Zinc blood test CPT 84630 ASSAY OF ZINC | $10.00 | $20.00 | — | 74% below | 50% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 GONADOTROPIN; CHORIONIC (REPRODUCTIVE HORMONE) LEVEL | $90.50 | $181.00 | — | 23% above | 50% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 CHORIONIC GONADOTROPIN TEST | $93.00 | $186.00 | — | 27% above | 50% |
Surgery and procedures
| Procedure | Cash price | List price | Insurers pay | vs West Virginia | Off list |
|---|---|---|---|---|---|
| Appendectomy, open surgery CPT 44950 REMOVAL OF APPENDIX | $9,919.00 | $19,838.00 | — | 216% above | 50% |
| Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 TREATMENT OF ANKLE FRACTURE | $236.50 | $473.00 | — | 22% below | 50% |
| Broken ankle (outer ankle bone) treatment without surgery or setting one side CPT 27786 CLOSED TREATMENT OF BROKEN OUTSIDE LOWER LEG BONE AT ANKLE | $221.00 | $442.00 | — | 27% below | 50% |
| Broken ankle (outer ankle bone) treatment without surgery or setting one side CPT 27786 CLOSED TREATMENT OF BROKEN OUTSIDE LOWER LEG BONE AT ANKLE | $221.00 | $442.00 | — | 27% below | 50% |
| Broken foot (metatarsal) treatment without surgery or setting CPT 28470 TREAT METATARSAL FRACTURE | $236.50 | $473.00 | — | at median | 50% |
| Broken foot (metatarsal) treatment without surgery or setting one side CPT 28470 CLOSED TREATMENT OF BROKEN BONE IN FOREFOOT OR MIDFOOT | $221.00 | $442.00 | — | 7% below | 50% |
| Broken foot (metatarsal) treatment without surgery or setting one side CPT 28470 CLOSED TREATMENT OF BROKEN BONE IN FOREFOOT OR MIDFOOT | $221.00 | $442.00 | — | 7% below | 50% |
| Bunion correction with a bone cut near the head of the first metatarsal one side CPT 28296 CORRECTION OF BUNION WITH ALIGNMENT CORRECTION OF MIDFOOT BONE TOWARD TOE AREA | $4,224.00 | $8,448.00 | — | 18% below | 50% |
| Bunion correction with removal of part of the big toe joint one side CPT 28292 CORRECTION OF BUNION | $2,053.34 | $4,106.67 | — | 45% below | 50% |
| Bunion correction with removal of part of the big toe joint one side CPT 28292 CORRECTION OF BUNION | $4,186.00 | $8,372.00 | — | 11% above | 50% |
| Cardioversion, elective (restoring heart rhythm) CPT 92960 EXTERNAL SHOCK TO HEART TO REGULATE HEART BEAT | $835.50 | $1,671.00 | — | 21% below | 50% |
| Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION ELECTRIC EXT | $898.00 | $1,796.00 | — | 16% below | 50% |
| Cataract surgery with lens implant one side CPT 66984 REMOVAL OF CATARACT WITH INSERTION OF PROSTHETIC LENS | $2,184.00 | $4,368.00 | — | 21% below | 50% |
| Cataract surgery with lens implant one side CPT 66984 REMOVAL OF CATARACT WITH INSERTION OF PROSTHETIC LENS | $2,457.00 | $4,914.00 | — | 11% below | 50% |
| Cervical biopsy CPT 57500 BIOPSY OF CERVIX OR REMOVAL OF GROWTH | $995.00 | $1,990.00 | — | 9% below | 50% |
| Cervical biopsy CPT 57500 BIOPSY OF CERVIX | $1,045.00 | $2,090.00 | — | 4% below | 50% |
| Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 REMOVAL OF FORESKIN USING CLAMP OR DEVICE | $613.50 | $1,227.00 | — | 74% below | 50% |
| Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 CIRCUMCISION W/REGIONL BLOCK | $2,002.50 | $4,005.00 | — | 17% below | 50% |
| Circumcision, surgical, older than a newborn CPT 54160 REMOVAL OF FORESKIN (28 DAYS OR YOUNGER) | $613.50 | $1,227.00 | — | 23% below | 50% |
| Circumcision, surgical, older than a newborn CPT 54160 CIRCUMCISION NEONATE | $668.00 | $1,336.00 | — | 17% below | 50% |
| Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 CLOSED TREATMENT OF BROKEN FOREARM (RADIUS) BONE AT THE WRIST AREA ON THE THUMB SIDE OF THE WRIST WITHOUT MANIPULATION | $485.00 | $970.00 | — | 53% above | 50% |
| Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 CLTX DST RDL FX/EPHYS SEP WO | $509.50 | $1,019.00 | — | 60% above | 50% |
| Closed treatment of a wrist (distal radius) fracture, no resetting one side CPT 25600 CLOSED TREATMENT OF BROKEN FOREARM (RADIUS) BONE AT THE WRIST AREA ON THE THUMB SIDE OF THE WRIST WITHOUT MANIPULATION | $485.00 | $970.00 | — | 53% above | 50% |
| Closed treatment of a wrist (distal radius) fracture, no resetting one side CPT 25600 CLOSED TREATMENT OF BROKEN FOREARM (RADIUS) BONE AT THE WRIST AREA ON THE THUMB SIDE OF THE WRIST WITHOUT MANIPULATION | $485.00 | $970.00 | — | 53% above | 50% |
| Colonoscopy with polyp removal CPT 45385 REMOVAL OF POLYPS OR GROWTHS OF LARGE BOWEL USING AN ENDOSCOPE WITH MECHANICAL SNARE | $840.50 | $1,681.00 | — | 42% below | 50% |
| Colonoscopy with tissue sample CPT 45380 BIOPSY OF LARGE BOWEL USING A FLEXIBLE ENDOSCOPE | $1,722.00 | $3,444.00 | — | 7% above | 50% |
| Colonoscopy, diagnostic CPT 45378 DIAGNOSTIC EXAM OF LARGE BOWEL USING A FLEXIBLE ENDOSCOPE | $683.33 | $1,366.66 | — | 46% below | 50% |
| Colposcopy with LEEP (loop electrosurgical excision) CPT 57460 BX OF CERVIX W/SCOPE LEEP | $3,130.00 | $6,260.00 | — | 7% below | 50% |
| Colposcopy with cervical biopsy and scraping of the cervical canal CPT 57454 BIOPSY AND SCRAPING OF CERVIX USING AN ENDOSCOPE | $243.50 | $487.00 | — | 26% below | 50% |
| Colposcopy with cervical biopsy and scraping of the cervical canal CPT 57454 BX/CURETT OF CERVIX W/SCOPE | $292.00 | $584.00 | — | 12% below | 50% |
| Complex cataract surgery with lens implant one side CPT 66982 COMPLEX REMOVAL OF CATARACT WITH INSERTION OF PROSTHETIC LENS | $2,002.00 | $4,004.00 | — | 35% below | 50% |
| Complex cataract surgery with lens implant one side CPT 66982 COMPLEX REMOVAL OF CATARACT WITH INSERTION OF PROSTHETIC LENS | $2,275.00 | $4,550.00 | — | 26% below | 50% |
| Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 CYSTOURETHROSCOPY | $571.00 | $1,142.00 | — | 31% below | 50% |
| D&C (dilation and curettage), not related to pregnancy CPT 58120 DILATION AND SCRAPING OF UTERUS | $4,082.00 | $8,164.00 | — | 8% above | 50% |
| Earwax removal by irrigation (rinsing), one ear CPT 69209 REMOVE IMPACTED EAR WAX UNI | $56.50 | $113.00 | — | 33% below | 50% |
| Earwax removal by irrigation (rinsing), one ear one side CPT 69209 REMOVAL OF IMPACTED EAR WAX BY WASHING | $52.50 | $105.00 | — | 38% below | 50% |
| Earwax removal by irrigation (rinsing), one ear one side CPT 69209 REMOVAL OF IMPACTED EAR WAX BY WASHING | $52.50 | $105.00 | — | 38% below | 50% |
| Earwax removal with instruments, one ear CPT 69210 REMOVE IMPACTED EAR WAX UNI | $56.50 | $113.00 | — | 20% below | 50% |
| Earwax removal with instruments, one ear CPT 69210 REMOVAL OF IMPACTED EAR WAX | $85.00 | $170.00 | — | 20% above | 50% |
| Earwax removal with instruments, one ear one side CPT 69210 REMOVAL OF IMPACTED EAR WAX | $36.50 | $73.00 | — | 48% below | 50% |
| Earwax removal with instruments, one ear one side CPT 69210 REMOVAL OF IMPACTED EAR WAX | $36.50 | $73.00 | — | 48% below | 50% |
| Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 BIOPSY OF UTERUS LINING | $201.00 | $402.00 | — | at median | 50% |
| Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 BIOPSY OF LINING OF UTERUS | $1,491.50 | $2,983.00 | — | 640% above | 50% |
| Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 INJECTION OF SUBSTANCE INTO MIDDLE OR UPPER SPINE CANAL USING IMAGING GUIDANCE | $1,394.00 | $2,788.00 | — | 39% above | 50% |
| Epidural steroid injection, neck or mid back, with imaging guidance one side CPT 62321 INJECTION OF SUBSTANCE INTO MIDDLE OR UPPER SPINE CANAL USING IMAGING GUIDANCE | $738.00 | $1,476.00 | — | 26% below | 50% |
| Epidural steroid injection, neck or mid back, with imaging guidance one side CPT 62321 INJECTION OF SUBSTANCE INTO MIDDLE OR UPPER SPINE CANAL USING IMAGING GUIDANCE | $1,312.00 | $2,624.00 | — | 31% above | 50% |
| Eye injection into the vitreous (intravitreal injection) CPT 67028 INJECTION OF DRUG INTO EYE | $421.50 | $843.00 | — | 11% below | 50% |
| Eye injection into the vitreous (intravitreal injection) CPT 67028 INJECTION EYE DRUG | $442.50 | $885.00 | — | 6% below | 50% |
| Eye injection into the vitreous (intravitreal injection) one side CPT 67028 INJECTION OF DRUG INTO EYE | $421.50 | $843.00 | — | 11% below | 50% |
| Eye injection into the vitreous (intravitreal injection) one side CPT 67028 INJECTION OF DRUG INTO EYE | $421.50 | $843.00 | — | 11% below | 50% |
| Facet joint injection, lower back, one level, with imaging guidance CPT 64493 INJECTION OF LOWER OR SACRAL SPINE FACET JOINT USING IMAGING GUIDANCE; SINGLE LEVEL | $676.00 | $1,352.00 | — | 34% below | 50% |
| Facet joint injection, lower back, one level, with imaging guidance one side CPT 64493 INJECTION OF LOWER OR SACRAL SPINE FACET JOINT USING IMAGING GUIDANCE; SINGLE LEVEL | $394.34 | $788.67 | — | 61% below | 50% |
| Facet joint injection, lower back, one level, with imaging guidance one side CPT 64493 INJECTION OF LOWER OR SACRAL SPINE FACET JOINT USING IMAGING GUIDANCE; SINGLE LEVEL | $507.00 | $1,014.00 | — | 50% below | 50% |
| First repair of a front abdominal hernia (such as umbilical) 3 to 10 cm CPT 49593 REPAIR OF ANTERIOR ABDOMINAL HERNIA(S) (IE; EPIGASTRIC; INCISIONAL; VENTRAL; UMBILICAL; SPIGELIAN); ANY APPROACH (IE; OPEN; LAPAROSCOPIC; ROBOTIC); INITIAL; INCLUDING IMPLANTATION OF MESH OR OTHER PROSTHESIS WHEN PERFORMED; TOTAL LENGTH OF DEFECT(S); 3 CM TO 10 CM; REDUCIBLE | $7,098.00 | $14,196.00 | — | 15% below | 50% |
| First repair of a front abdominal hernia larger than 10 cm CPT 49595 REPAIR OF ANTERIOR ABDOMINAL HERNIA(S) (IE; EPIGASTRIC; INCISIONAL; VENTRAL; UMBILICAL; SPIGELIAN); ANY APPROACH (IE; OPEN; LAPAROSCOPIC; ROBOTIC); INITIAL; INCLUDING IMPLANTATION OF MESH OR OTHER PROSTHESIS WHEN PERFORMED; TOTAL LENGTH OF DEFECT(S); GREATER THAN 10 CM; REDUCIBLE | $12,695.63 | $25,391.25 | — | 36% below | 50% |
| First repair of a small front abdominal hernia (e.g. umbilical), under 3 cm CPT 49591 REPAIR OF ANTERIOR ABDOMINAL HERNIA(S) (IE; EPIGASTRIC; INCISIONAL; VENTRAL; UMBILICAL; SPIGELIAN); ANY APPROACH (IE; OPEN; LAPAROSCOPIC; ROBOTIC); INITIAL; INCLUDING IMPLANTATION OF MESH OR OTHER PROSTHESIS WHEN PERFORMED; TOTAL LENGTH OF DEFECT(S); LESS THAN 3 CM; REDUCIBLE | $3,080.00 | $6,160.00 | — | 47% below | 50% |
| Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 DIAGNOSTIC EXAM OF LOWER PORTION OF LARGE BOWEL USING A FLEXIBLE ENDOSCOPE | $498.67 | $997.33 | — | 42% below | 50% |
| Gallbladder removal, laparoscopic CPT 47562 REMOVAL OF GALLBLADDER USING AN ENDOSCOPE | $10,842.00 | $21,684.00 | — | 12% above | 50% |
| Gallbladder removal, laparoscopic, with X-ray of the bile ducts during surgery CPT 47563 REMOVAL OF GALLBLADDER WITH X-RAY STUDY OF BILE DUCTS USING AN ENDOSCOPE | $7,503.00 | $15,006.00 | — | 7% below | 50% |
| Hammertoe correction surgery one side CPT 28285 CORRECTION OF TOE JOINT DEFORMITY | $2,184.00 | $4,368.00 | — | 35% below | 50% |
| Hemorrhoid banding (rubber band ligation) CPT 46221 REMOVAL OF EXTERNAL HEMORRHOIDS BY RUBBER BANDING | $418.67 | $837.33 | — | 65% below | 50% |
| Hysterectomy through an abdominal incision (total) CPT 58150 REMOVAL OF UTERUS AND CERVIX THROUGH ABDOMEN | $17,952.00 | $35,904.00 | — | 151% above | 50% |
| Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 INSERTION OF TUBE AND INTRODUCTION OF CONTRAST FOR X-RAY OF UTERUS AND FALLOPIAN TUBES | $267.00 | $534.00 | — | 4% below | 50% |
| Hysteroscopy with endometrial ablation CPT 58563 EXAM OF UTERUS WITH DESTRUCTION OF LINING OF UTERUS USING AN ENDOSCOPE | $2,170.67 | $4,341.34 | — | 55% below | 50% |
| Hysteroscopy with uterine lining sampling and/or polyp removal CPT 58558 BIOPSY OF LINING OF UTERUS AND/OR REMOVAL OF POLYP USING AN ENDOSCOPE | $3,517.50 | $7,035.00 | — | 16% below | 50% |
| Hysteroscopy with uterine lining sampling and/or polyp removal CPT 58558 HYSTEROSCOPY BIOPSY | $3,693.50 | $7,387.00 | — | 12% below | 50% |
| IUD insertion (the device itself billed separately) CPT 58300 INSERTION OF IUD FOR PREGNANCY PREVENTION | $178.50 | $357.00 | — | 9% above | 50% |
| Incision and drainage of a simple or single skin abscess CPT 10060 SIMPLE OR SINGLE DRAINAGE OF SKIN ABSCESS | $241.00 | $482.00 | — | 3% above | 50% |
| Incision and drainage of a simple or single skin abscess CPT 10060 I&D ABSCESS SIMPLE/SINGLE | $259.00 | $518.00 | — | 10% above | 50% |
| Inguinal (groin) hernia repair, age 5 or older one side CPT 49505 REPAIR OF GROIN HERNIA (5 YEARS OR OLDER) | $5,481.00 | $10,962.00 | — | 10% above | 50% |
| Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 INJECTION INTO TENDON OR LIGAMENT | $276.50 | $553.00 | — | 17% below | 50% |
| Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 INJ TENDON SHEATH/LIGAMENT | $297.00 | $594.00 | — | 11% below | 50% |
| Injection into a tendon sheath or ligament (for example trigger finger) one side CPT 20550 INJECTION INTO TENDON OR LIGAMENT | $276.50 | $553.00 | — | 17% below | 50% |
| Injection into a tendon sheath or ligament (for example trigger finger) one side CPT 20550 INJECTION INTO TENDON OR LIGAMENT | $276.50 | $553.00 | — | 17% below | 50% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ASPIRATION AND/OR INJECTION OF FLUID FROM LARGE JOINT | $276.50 | $553.00 | — | 20% below | 50% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 DRAIN/INJ JOINT/BURSA W/O US | $297.00 | $594.00 | — | 14% below | 50% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 ASPIRATION AND/OR INJECTION OF FLUID FROM LARGE JOINT | $276.50 | $553.00 | — | 20% below | 50% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 ASPIRATION AND/OR INJECTION OF FLUID FROM LARGE JOINT | $1,014.00 | $2,028.00 | — | 195% above | 50% |
| Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 INSERTION OF DRUG DELIVERY IMPLANT INTO TISSUE | $170.00 | $340.00 | — | 3% above | 50% |
| Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 INSERTION DRUG DLVR IMPLANT | $178.50 | $357.00 | — | 8% above | 50% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ASPIRATION AND/OR INJECTION OF FLUID FROM MEDIUM JOINT | $264.50 | $529.00 | — | 23% below | 50% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 DRAIN/INJ JOINT/BURSA W/O US | $294.00 | $588.00 | — | 14% below | 50% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) one side CPT 20605 ASPIRATION AND/OR INJECTION OF FLUID FROM MEDIUM JOINT | $264.50 | $529.00 | — | 23% below | 50% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) one side CPT 20605 ASPIRATION AND/OR INJECTION OF FLUID FROM MEDIUM JOINT | $264.50 | $529.00 | — | 23% below | 50% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 ASPIRATION AND/OR INJECTION OF FLUID FROM SMALL JOINT | $264.50 | $529.00 | — | 24% below | 50% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 DRAIN/INJ JOINT/BURSA W/O US | $294.00 | $588.00 | — | 16% below | 50% |
| Joint injection or drainage, small joint (fingers, toes) one side CPT 20600 ASPIRATION AND/OR INJECTION OF FLUID FROM SMALL JOINT | $264.50 | $529.00 | — | 24% below | 50% |
| Joint injection or drainage, small joint (fingers, toes) one side CPT 20600 ASPIRATION AND/OR INJECTION OF FLUID FROM SMALL JOINT | $264.50 | $529.00 | — | 24% below | 50% |
| Laparoscopic appendectomy (appendix removal through small cuts) CPT 44970 REMOVAL OF APPENDIX USING AN ENDOSCOPE | $5,490.00 | $10,980.00 | — | 25% below | 50% |
| Laparoscopic hysterectomy (uterus 250 g or less) CPT 58570 REMOVAL OF UTERUS THROUGH ABDOMEN USING AN ENDOSCOPE; 250.0 G OR LESS | $7,098.00 | $14,196.00 | — | 50% below | 50% |
| Laparoscopic hysterectomy, uterus 250 g or less, with tubes and/or ovaries CPT 58571 REMOVAL OF UTERUS; TUBES; AND/OR OVARIES THROUGH ABDOMEN USING AN ENDOSCOPE; 250.0 G OR LESS | $15,097.50 | $30,195.00 | — | 2% below | 50% |
| Laparoscopic inguinal (groin) hernia repair, first repair on that side one side CPT 49650 REPAIR OF GROIN HERNIA USING AN ENDOSCOPE | $6,862.50 | $13,725.00 | — | 25% below | 50% |
| Laparoscopic inguinal (groin) hernia repair, first repair on that side one side CPT 49650 REPAIR OF GROIN HERNIA USING AN ENDOSCOPE | $7,411.50 | $14,823.00 | — | 19% below | 50% |
| Laparoscopic inguinal (groin) hernia repair, recurrent hernia one side CPT 49651 REPAIR OF RECURRENT GROIN HERNIA USING AN ENDOSCOPE | $6,496.50 | $12,993.00 | — | 42% below | 50% |
| Laparoscopic inguinal (groin) hernia repair, recurrent hernia one side CPT 49651 REPAIR OF RECURRENT GROIN HERNIA USING AN ENDOSCOPE | $7,228.50 | $14,457.00 | — | 36% below | 50% |
| Laparoscopic removal of fallopian tubes and/or ovaries CPT 58661 REMOVAL OF OVARIES AND/OR TUBES USING AN ENDOSCOPE | $9,058.50 | $18,117.00 | — | 73% above | 50% |
| Laser treatment of clouding after cataract surgery (YAG) CPT 66821 AFTER CATARACT LASER SURGERY | $760.50 | $1,521.00 | — | 3% above | 50% |
| Laser treatment of clouding after cataract surgery (YAG) one side CPT 66821 REMOVAL OF RECURRING CATARACT IN LENS CAPSULE USING A LASER | $724.50 | $1,449.00 | — | 2% below | 50% |
| Laser treatment of clouding after cataract surgery (YAG) one side CPT 66821 REMOVAL OF RECURRING CATARACT IN LENS CAPSULE USING A LASER | $724.50 | $1,449.00 | — | 2% below | 50% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 INTERMEDIATE REPAIR OF WOUND OF SCALP; UNDERARMS; TRUNK; ARMS; OR LEGS; 2.5 CM OR LESS | $1,422.67 | $2,845.33 | — | 235% above | 50% |
| Lower-back epidural injection, with imaging guidance CPT 62323 INJECTION OF SUBSTANCE INTO LOWER SPINE CANAL USING IMAGING GUIDANCE | $785.00 | $1,570.00 | — | 29% below | 50% |
| Lower-back epidural injection, with imaging guidance CPT 62323 NJX INTERLAMINAR LMBR/SAC | $1,022.50 | $2,045.00 | — | 8% below | 50% |
| Lower-back epidural injection, with imaging guidance one side CPT 62323 INJECTION OF SUBSTANCE INTO LOWER SPINE CANAL USING IMAGING GUIDANCE | $628.00 | $1,256.00 | — | 43% below | 50% |
| Lower-back epidural injection, with imaging guidance one side CPT 62323 INJECTION OF SUBSTANCE INTO LOWER SPINE CANAL USING IMAGING GUIDANCE | $1,025.34 | $2,050.67 | — | 8% below | 50% |
| Lower-back epidural injection, without imaging guidance CPT 62322 NJX INTERLAMINAR LMBR/SAC | $854.50 | $1,709.00 | — | 26% below | 50% |
| Lower-back nerve root steroid injection, with imaging guidance one side CPT 64483 INJECTION OF ANESTHETIC AND/OR STEROID DRUG INTO SACRAL SPINE NERVE ROOT USING IMAGING GUIDANCE; SINGLE LEVEL | $957.67 | $1,915.34 | — | 30% below | 50% |
| Lower-back nerve root steroid injection, with imaging guidance one side CPT 64483 INJECTION OF ANESTHETIC AND/OR STEROID DRUG INTO SACRAL SPINE NERVE ROOT USING IMAGING GUIDANCE; SINGLE LEVEL | $1,352.00 | $2,704.00 | — | 1% below | 50% |
| Lumbar discectomy or laminotomy to free a nerve root, one level CPT 63030 LOW BACK DISK SURGERY | $4,937.00 | $9,874.00 | — | 14% below | 50% |
| Lumpectomy (partial mastectomy) one side CPT 19301 PARTIAL REMOVAL OF BREAST | $6,072.00 | $12,144.00 | — | 37% above | 50% |
| Mastectomy (total removal of the breast) one side CPT 19303 SIMPLE COMPLETE REMOVAL OF BREAST | $1,345.88 | $2,691.75 | — | 66% below | 50% |
| Mastectomy (total removal of the breast) one side CPT 19303 SIMPLE COMPLETE REMOVAL OF BREAST | $4,316.51 | $8,633.02 | — | 9% above | 50% |
| Miscarriage treatment with D&C, first trimester CPT 59820 TREATMENT OF MISCARRIAGE DURING FIRST TRIMESTER | $1,884.00 | $3,768.00 | — | 50% below | 50% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 REMOVAL OF NONCANCER SKIN GROWTH OF BODY; ARMS; OR LEGS; 0.5 CM OR LESS | $660.00 | $1,320.00 | — | at median | 50% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 EXC TR-EXT B9+MARG 0.5 CM< | $693.00 | $1,386.00 | — | 5% above | 50% |
| Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 EXC FACE-MM B9+MARG 0.5 CM/< | $693.00 | $1,386.00 | — | 1% above | 50% |
| Nail removal (partial or complete), one nail CPT 11730 REMOVAL OF NAIL PLATE | $192.00 | $384.00 | — | 28% below | 50% |
| Paracentesis with imaging guidance CPT 49083 DRAINAGE OF FLUID FROM ABDOMINAL CAVITY USING IMAGING GUIDANCE | $510.00 | $1,020.00 | — | 64% below | 50% |
| Paracentesis with imaging guidance CPT 49083 ABD PARACENTESIS W/IMAGING | $1,170.50 | $2,341.00 | — | 18% below | 50% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 PERMANENT REMOVAL FINGERNAIL OR TOENAIL | $374.50 | $749.00 | — | 20% below | 50% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 REMOVAL OF NAIL BED | $402.50 | $805.00 | — | 14% below | 50% |
| Radiofrequency ablation of facet joint nerves, lower back, one level one side CPT 64635 DESTRUCTION OF LOWER OR SACRAL SPINAL FACET JOINT NERVES USING IMAGING GUIDANCE; SINGLE FACET JOINT | $2,112.50 | $4,225.00 | — | 4% below | 50% |
| Radiofrequency ablation of facet joint nerves, lower back, one level one side CPT 64635 DESTRUCTION OF LOWER OR SACRAL SPINAL FACET JOINT NERVES USING IMAGING GUIDANCE; SINGLE FACET JOINT | $2,281.50 | $4,563.00 | — | 4% above | 50% |
| Removal of a breast lump, open surgery CPT 19120 REMOVAL OF BREAST LESION | $4,838.50 | $9,677.00 | — | 12% above | 50% |
| Removal of a breast lump, open surgery one side CPT 19120 REMOVAL OF GROWTH AND TISSUE OF BREAST; DUCT; OR NIPPLE | $2,983.00 | $5,966.00 | — | 31% below | 50% |
| Removal of a breast lump, open surgery one side CPT 19120 REMOVAL OF GROWTH AND TISSUE OF BREAST; DUCT; OR NIPPLE | $4,840.00 | $9,680.00 | — | 12% above | 50% |
| Removal of a foreign object under the skin, simple CPT 10120 INC&RMVL FB SUBQ TISS SMPL | $490.00 | $980.00 | — | 26% above | 50% |
| Removal of a foreign object under the skin, simple CPT 10120 REMOVAL OF FOREIGN BODY FROM TISSUE; ACCESSED BENEATH THE SKIN; SIMPLE | $1,408.00 | $2,816.00 | — | 261% above | 50% |
| Removal of one lobe of the thyroid (lobectomy) one side CPT 60220 REMOVAL OF THYROID LOBE ON SIDE OF NECK | $8,888.00 | $17,776.00 | — | 13% above | 50% |
| Removal of one lobe of the thyroid (lobectomy) one side CPT 60220 REMOVAL OF THYROID LOBE ON SIDE OF NECK | $9,922.50 | $19,845.00 | — | 26% above | 50% |
| Screening colonoscopy for a person at average risk (Medicare code) HCPCS G0121 COLORECTAL CANCER SCREENING; COLONOSCOPY ON INDIVIDUAL NOT MEETING CRITERIA FOR HIGH RISK | $2,132.00 | $4,264.00 | — | 42% above | 50% |
| Screening colonoscopy, high risk of colorectal cancer (Medicare code) HCPCS G0105 COLORECTAL CANCER SCREENING; COLONOSCOPY ON INDIVIDUAL AT HIGH RISK | $2,378.00 | $4,756.00 | — | 72% above | 50% |
| Short arm cast (elbow to hand) CPT 29075 APPLICATION OF ELBOW TO FINGER CAST | $249.00 | $498.00 | — | 14% below | 50% |
| Short arm cast (elbow to hand) CPT 29075 APPLICATION OF FOREARM CAST | $268.00 | $536.00 | — | 7% below | 50% |
| Short arm cast (elbow to hand) one side CPT 29075 APPLICATION OF ELBOW TO FINGER CAST | $249.00 | $498.00 | — | 14% below | 50% |
| Short arm cast (elbow to hand) one side CPT 29075 APPLICATION OF ELBOW TO FINGER CAST | $249.00 | $498.00 | — | 14% below | 50% |
| Short arm splint (forearm and hand) CPT 29125 APPLY FOREARM SPLINT | $127.50 | $255.00 | — | 31% below | 50% |
| Short arm splint (forearm and hand) one side CPT 29125 APPLICATION OF NONMOVEABLE FOREARM TO HAND SPLINT | $99.00 | $198.00 | — | 46% below | 50% |
| Short arm splint (forearm and hand) one side CPT 29125 APPLICATION OF NONMOVEABLE FOREARM TO HAND SPLINT | $99.00 | $198.00 | — | 46% below | 50% |
| Short leg cast (below the knee) CPT 29405 APPLICATION OF SHORT LEG CAST | $144.50 | $289.00 | — | 55% below | 50% |
| Short leg cast (below the knee) CPT 29405 APPLY SHORT LEG CAST | $268.00 | $536.00 | — | 16% below | 50% |
| Short leg cast (below the knee) one side CPT 29405 APPLICATION OF SHORT LEG CAST | $144.50 | $289.00 | — | 55% below | 50% |
| Short leg cast (below the knee) one side CPT 29405 APPLICATION OF SHORT LEG CAST | $144.50 | $289.00 | — | 55% below | 50% |
| Short leg splint (calf to foot) CPT 29515 APPLICATION LOWER LEG SPLINT | $155.50 | $311.00 | — | 33% below | 50% |
| Short leg splint (calf to foot) one side CPT 29515 APPLICATION OF SHORT LEG SPLINT FROM CALF TO FOOT | $122.00 | $244.00 | — | 47% below | 50% |
| Short leg splint (calf to foot) one side CPT 29515 APPLICATION OF SHORT LEG SPLINT FROM CALF TO FOOT | $122.00 | $244.00 | — | 47% below | 50% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 SIMPLE REPAIR OF SURFACE WOUND OF SCALP; NECK; UNDERARMS; TRUNK; ARMS; OR LEGS; 2.5 CM OR LESS | $225.50 | $451.00 | — | 20% below | 50% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 RPR S/N/AX/GEN/TRNK 2.5CM/< | $242.50 | $485.00 | — | 14% below | 50% |
| Skin biopsy, punch, one lesion CPT 11104 PUNCH BX SKIN SINGLE LESION | $389.50 | $779.00 | — | 1% above | 50% |
| Skin biopsy, punch, one lesion CPT 11104 PUNCH BIOPSY; FIRST SKIN GROWTH | $590.00 | $1,180.00 | — | 54% above | 50% |
| Skin tag removal, up to 15 tags CPT 11200 REMOVAL OF SKIN TAG; 1-15 SKIN TAGS | $186.50 | $373.00 | — | 5% below | 50% |
| Skin tag removal, up to 15 tags CPT 11200 RMVL SKIN TAGS UP TO&INC 15 | $196.00 | $392.00 | — | at median | 50% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 REMOVAL OF CEREBROSPINAL FLUID WITH LOWER BACK SPINAL TAP FOR DIAGNOSTIC TEST | $1,307.50 | $2,615.00 | — | 30% above | 50% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 SIMPLE REPAIR OF SURFACE WOUND OF SCALP; NECK; UNDERARMS; TRUNK; ARMS; OR LEGS; 2.6-7.5 CM | $225.50 | $451.00 | — | 13% below | 50% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 RPR S/N/AX/GEN/TRNK2.6-7.5CM | $242.50 | $485.00 | — | 6% below | 50% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 SIMPLE REPAIR OF SURFACE WOUND OF FACE; EARS; EYELIDS; NOSE; LIPS; OR MOUTH; 2.5 CM OR LESS | $288.50 | $577.00 | — | at median | 50% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 RPR F/E/E/N/L/M 2.5 CM/< | $310.00 | $620.00 | — | 7% above | 50% |
| Tangential (shave-style) skin biopsy, one lesion CPT 11102 BIOPSY OF RELATED SKIN GROWTH; FIRST GROWTH | $288.50 | $577.00 | — | 17% below | 50% |
| Tangential (shave-style) skin biopsy, one lesion CPT 11102 TANGNTL BX SKIN SINGLE LES | $389.50 | $779.00 | — | 12% above | 50% |
| Thoracentesis with imaging guidance CPT 32555 ASPIRATE PLEURA W/ IMAGING | $822.00 | $1,644.00 | — | 34% below | 50% |
| Thoracentesis with imaging guidance CPT 32555 ASPIRATION OF FLUID FROM CHEST CAVITY USING IMAGING GUIDANCE | $3,116.00 | $6,232.00 | — | 149% above | 50% |
| Tonsil removal (tonsillectomy) only, age 12 or older CPT 42826 REMOVAL OF TONSILS (12 YEARS OR OLDER) | $3,520.00 | $7,040.00 | — | 12% below | 50% |
| Total thyroid removal (thyroidectomy) CPT 60240 REMOVAL OF THYROID | $8,624.00 | $17,248.00 | — | at median | 50% |
| Trigger point injections, 1 or 2 muscles CPT 20552 INJ TRIGGER POINT 1/2 MUSCL | $294.00 | $588.00 | — | at median | 50% |
| Trigger point injections, 1 or 2 muscles CPT 20552 INJECTION OF TRIGGER POINTS; 1-2 MUSCLES | $392.50 | $785.00 | — | 34% above | 50% |
| Trigger point injections, 1 or 2 muscles one side CPT 20552 INJECTION OF TRIGGER POINTS; 1-2 MUSCLES | $471.00 | $942.00 | — | 60% above | 50% |
| Trigger point injections, 1 or 2 muscles one side CPT 20552 INJECTION OF TRIGGER POINTS; 1-2 MUSCLES | $1,145.50 | $2,291.00 | — | 290% above | 50% |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 BIOPSY OF BREAST AND PLACEMENT OF LOCATING DEVICE USING ULTRASOUND; FIRST GROWTH | $849.00 | $1,698.00 | — | 64% below | 50% |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 BX BREAST 1ST LESION US IMAG | $1,582.00 | $3,164.00 | — | 33% below | 50% |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion one side CPT 19083 BIOPSY OF BREAST AND PLACEMENT OF LOCATING DEVICE USING ULTRASOUND; FIRST GROWTH | $849.00 | $1,698.00 | — | 64% below | 50% |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion one side CPT 19083 BIOPSY OF BREAST AND PLACEMENT OF LOCATING DEVICE USING ULTRASOUND; FIRST GROWTH | $1,408.00 | $2,816.00 | — | 41% below | 50% |
| Upper endoscopy (EGD) with balloon widening of the esophagus CPT 43249 BALLOON DILATION OF ESOPHAGUS; STOMACH; AND/OR UPPER SMALL BOWEL USING A FLEXIBLE ENDOSCOPE; LESS THAN 3.0 CM | $1,884.00 | $3,768.00 | — | 20% above | 50% |
| Upper endoscopy (EGD) with biopsy CPT 43239 BIOPSY OF ESOPHAGUS; STOMACH; AND/OR UPPER SMALL BOWEL USING A FLEXIBLE ENDOSCOPE | $929.34 | $1,858.67 | — | 14% below | 50% |
| Upper endoscopy (EGD) with polyp removal by snare CPT 43251 REMOVAL OF POLYPS OR GROWTHS OF ESOPHAGUS; STOMACH; AND/OR UPPER SMALL BOWEL USING AN ENDOSCOPE WITH MECHANICAL SNARE | $3,034.00 | $6,068.00 | — | 109% above | 50% |
| Upper endoscopy (EGD), diagnostic CPT 43235 DIAGNOSTIC EXAM OF ESOPHAGUS; STOMACH; AND/OR UPPER SMALL BOWEL USING A FLEXIBLE ENDOSCOPE | $792.67 | $1,585.33 | — | 4% below | 50% |
| Wart removal, up to 14 warts CPT 17110 DESTRUCTION OF SKIN GROWTH; 1-14 GROWTHS | $179.00 | $358.00 | — | 13% below | 50% |
| Wart removal, up to 14 warts CPT 17110 DESTRUCT B9 LESION 1-14 | $192.50 | $385.00 | — | 7% below | 50% |
| Wart removal, up to 14 warts one side CPT 17110 DESTRUCTION OF SKIN GROWTH; 1-14 GROWTHS | $192.50 | $385.00 | — | 7% below | 50% |
| Wart removal, up to 14 warts one side CPT 17110 DESTRUCTION OF SKIN GROWTH; 1-14 GROWTHS | $192.50 | $385.00 | — | 7% below | 50% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 REMOVAL OF SKIN AND TISSUE; 20.0 SQ CM OR LESS | $209.00 | $418.00 | — | 45% below | 50% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DBRDMT SUBQ TIS 1ST 20SQCM/< | $389.50 | $779.00 | — | 3% above | 50% |
| Wound debridement, skin and tissue under it, first 20 sq cm one side CPT 11042 REMOVAL OF SKIN AND TISSUE; 20.0 SQ CM OR LESS | $209.00 | $418.00 | — | 45% below | 50% |
| Wound debridement, skin and tissue under it, first 20 sq cm one side CPT 11042 REMOVAL OF SKIN AND TISSUE; 20.0 SQ CM OR LESS | $389.50 | $779.00 | — | 3% above | 50% |
Doctor visits and therapy
| Procedure | Cash price | List price | Insurers pay | vs West Virginia | Off list |
|---|---|---|---|---|---|
| Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION OF BLOOD OR BLOOD PRODUCTS | $331.00 | $662.00 | — | 48% below | 50% |
| Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION BLD/BLD COMPNT | $422.50 | $845.00 | — | 34% below | 50% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 AIRWAY INHALATION TREATMENT | $140.00 | $280.00 | $2,323.28–$12,172.00 | — | 50% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 INHALATION TREATMENT FOR AIRWAY OBSTRUCTION OR SPUTUM PRODUCTION | $575.00 | $1,150.00 | $2,323.28–$12,172.00 | — | 50% |
| Chemotherapy IV infusion, first hour CPT 96413 ADMINISTRATION OF CHEMOTHERAPY INTO VEIN; 1 HOUR OR LESS | $195.50 | $391.00 | — | 68% below | 50% |
| Chemotherapy IV infusion, first hour CPT 96413 CHEMO IV INFUSION 1 HR | $422.00 | $844.00 | — | 31% below | 50% |
| Comprehensive hearing test: tone and speech audiometry, both ears CPT 92557 COMPREHENSIVE HEARING AND SPEECH RECOGNITION TEST | $80.50 | $161.00 | — | 41% below | 50% |
| Comprehensive hearing test: tone and speech audiometry, both ears CPT 92557 COMPREHENSIVE HEARING TEST | $86.50 | $173.00 | — | 37% below | 50% |
| Critical care, first 30 to 74 minutes CPT 99291 CRITICAL CARE FIRST HOUR | $651.00 | $1,302.00 | — | 48% below | 50% |
| Electrocardiogram (ECG/EKG) with interpretation CPT 93000 ELECTROCARDIOGRAM COMPLETE | $145.50 | $291.00 | — | 3% below | 50% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 ROUTINE ELECTROCARDIOGRAM (ECG) USING AT LEAST 12 LEADS WITH TRACING | $107.50 | $215.00 | — | 11% below | 50% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 ELECTROCARDIOGRAM TRACING | $115.50 | $231.00 | — | 4% below | 50% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 EMERGENCY DEPARTMENT VISIT FOR PROBLEM OF MILD SEVERITY | $103.00 | $206.00 | — | 35% below | 50% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 EMR DPT VST MAYX REQ PHY/QHP | $110.50 | $221.00 | — | 30% below | 50% |
| Emergency room visit, level 2 of 5, straightforward problem CPT 99282 EMERGENCY DEPARTMENT VISIT FOR PROBLEM OF MILD TO MODERATE SEVERITY | $159.00 | $318.00 | — | 37% below | 50% |
| Emergency room visit, level 2 of 5, straightforward problem CPT 99282 EMERGENCY DEPT VISIT SF MDM | $171.00 | $342.00 | — | 32% below | 50% |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 EMERGENCY DEPARTMENT VISIT FOR PROBLEM OF MODERATE SEVERITY | $318.00 | $636.00 | — | 21% below | 50% |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 EMERGENCY DEPT VISIT LOW MDM | $342.00 | $684.00 | — | 15% below | 50% |
| Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 EMERGENCY DEPARTMENT VISIT FOR PROBLEM OF HIGH SEVERITY | $397.50 | $795.00 | — | 42% below | 50% |
| Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 EMERGENCY DEPT VISIT MOD MDM | $427.50 | $855.00 | — | 38% below | 50% |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 EMERGENCY DEPARTMENT VISIT FOR LIFE THREATENING OR FUNCTIONING SEVERITY | $457.00 | $914.00 | — | 52% below | 50% |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 EMERGENCY DEPT VISIT HI MDM | $491.50 | $983.00 | — | 48% below | 50% |
| Exercise stress test, tracing only, the hospital charge CPT 93017 EXERCISE OR DRUG-INDUCED HEART STRESS TEST WITH ELECTROCARDIOGRAM (ECG) | $711.50 | $1,423.00 | — | 11% above | 50% |
| Family therapy with the patient, 50 minutes CPT 90847 FAMILY PSYTX W/PT 50 MIN | $170.00 | $340.00 | — | 11% below | 50% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 INFUSION INTO A VEIN FOR HYDRATION; 31-60 MINUTES | $160.00 | $320.00 | $320.00 | 29% below | 50% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 HYDRATION IV INFUSION INIT | $203.50 | $407.00 | $336.96 | 10% below | 50% |
| IV infusion of a medicine, first hour CPT 96365 INFUSION INTO A VEIN FOR THERAPY; PREVENTION; OR DIAGNOSIS; 1 HOUR OR LESS | $164.00 | $328.00 | — | 34% below | 50% |
| IV infusion of a medicine, first hour CPT 96365 THER/PROPH/DIAG IV INF INIT | $203.50 | $407.00 | — | 18% below | 50% |
| IV push of a medicine, first drug CPT 96374 INJECTION OF DRUG OR SUBSTANCE INTO VEIN | $140.50 | $281.00 | — | 31% below | 50% |
| IV push of a medicine, first drug CPT 96374 THER/PROPH/DIAG INJ IV PUSH | $203.50 | $407.00 | — | at median | 50% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJECTION OF DRUG OR SUBSTANCE UNDER SKIN OR INTO MUSCLE | $36.00 | $72.00 | — | 50% below | 50% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 THER/PROPH/DIAG INJ SC/IM | $69.00 | $138.00 | — | 3% below | 50% |
| Neuromuscular re-education, 15 minutes CPT 97112 NEUROMUSCULAR REEDUCATION | $94.50 | $189.00 | — | 22% above | 50% |
| New patient office visit, about 30 minutes CPT 99203 NEW PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 30-44 MINUTES | $23.00 | $46.00 | — | 72% below | 50% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 NEW PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 15-29 MINUTES | $23.00 | $46.00 | — | 66% below | 50% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 OFFICE O/P NEW SF 15 MIN | $25.00 | $50.00 | — | 64% below | 50% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 MEDICAL NUTRITION INDIV IN | $116.50 | $233.00 | — | 143% above | 50% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 THERAPY PROCEDURE FOR NUTRITION MANAGEMENT; EACH 15 MINUTES | $146.00 | $292.00 | — | 204% above | 50% |
| Occupational therapy evaluation, low complexity CPT 97165 OT EVAL LOW COMPLEX 30 MIN | $110.50 | $221.00 | — | 40% below | 50% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PT EVAL HIGH COMPLEX 45 MIN | $141.00 | $282.00 | — | 33% below | 50% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PT EVAL LOW COMPLEX 20 MIN | $100.00 | $200.00 | — | 46% below | 50% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PT EVAL MOD COMPLEX 30 MIN | $118.50 | $237.00 | — | 43% below | 50% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MANUAL THERAPY 1/> REGIONS | $98.50 | $197.00 | — | 48% above | 50% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERAPEUTIC EXERCISES | $94.50 | $189.00 | — | 34% above | 50% |
| Preventive checkup, new patient aged 18–39 CPT 99385 INITIAL NEW PATIENT PREVENTIVE MEDICINE EVALUATION (18-39 YEARS) | $83.00 | $166.00 | — | 1% above | 50% |
| Preventive checkup, new patient aged 40–64 CPT 99386 INITIAL NEW PATIENT PREVENTIVE MEDICINE EVALUATION (40-64 YEARS) | $96.00 | $192.00 | — | 7% above | 50% |
| Preventive checkup, new patient aged 65 or older CPT 99387 INIT PM E/M NEW PAT 65+ YRS | $118.00 | $236.00 | — | 7% above | 50% |
| Preventive checkup, returning patient aged 18–39 CPT 99395 ESTABLISHED PATIENT PERIODIC PREVENTIVE MEDICINE EXAMINATION (18-39 YEARS) | $68.00 | $136.00 | — | 3% above | 50% |
| Preventive checkup, returning patient aged 40–64 CPT 99396 ESTABLISHED PATIENT PERIODIC PREVENTIVE MEDICINE EXAMINATION (40-64 YEARS) | $74.50 | $149.00 | — | at median | 50% |
| Preventive checkup, returning patient aged 65 or older CPT 99397 ESTABLISHED PATIENT PERIODIC PREVENTIVE MEDICINE EXAMINATION (65 YEAR OLD OR OLDER) | $83.00 | $166.00 | — | 23% above | 50% |
| Quit-smoking counseling, 3 to 10 minutes CPT 99406 SMOKING AND TOBACCO USE INTENSIVE COUNSELING; 4-10 MINUTES | $38.00 | $76.00 | — | 4% above | 50% |
| Quit-smoking counseling, 3 to 10 minutes CPT 99406 BEHAV CHNG SMOKING 3-10 MIN | $41.00 | $82.00 | — | 12% above | 50% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 ESTABLISHED PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 40-54 MINUTES | $79.00 | $158.00 | — | 7% below | 50% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 ESTABLISHED PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 20-29 MINUTES | $23.00 | $46.00 | — | 71% below | 50% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 ESTABLISHED PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 30-39 MINUTES | $23.00 | $46.00 | — | 76% below | 50% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 ESTABLISHED PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 10-19 MINUTES | $23.00 | $46.00 | — | 64% below | 50% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 OFFICE O/P EST SF 10 MIN | $25.00 | $50.00 | — | 61% below | 50% |
| Specialist consultation, low complexity or 30+ minutes CPT 99243 OFF/OP CNSLTJ NEW/EST LOW 30 | $105.00 | $210.00 | — | 7% below | 50% |
| Specialist consultation, moderate complexity or 40+ minutes CPT 99244 OFFICE CONSULTATION; TYPICALLY 1 HOUR | $82.50 | $165.00 | — | 17% below | 50% |
| Specialist consultation, moderate complexity or 40+ minutes CPT 99244 OFF/OP CNSLTJ NEW/EST MOD 40 | $88.50 | $177.00 | — | 11% below | 50% |
| Speech and language evaluation CPT 92523 SPEECH SOUND LANG COMPREHEN | $162.00 | $324.00 | — | 42% below | 50% |
| Speech therapy session, individual CPT 92507 TX SP LANG VOICE COMM INDIV | $126.00 | $252.00 | — | 18% below | 50% |
| Spirometry (breathing test) CPT 94010 BREATHING CAPACITY TEST | $207.00 | $414.00 | — | at median | 50% |
| Spirometry (breathing test) CPT 94010 TEST TO MEASURE EXPIRATORY AIRFLOW AND VOLUME | $300.50 | $601.00 | — | 45% above | 50% |
| Spirometry before and after a bronchodilator CPT 94060 TEST TO MEASURE EXPIRATORY AIRFLOW AND VOLUME CHANGES BEFORE AND AFTER MEDICATION ADMINISTRATION | $325.50 | $651.00 | — | 16% below | 50% |
| Spirometry before and after a bronchodilator CPT 94060 EVALUATION OF WHEEZING | $357.50 | $715.00 | — | 8% below | 50% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 THERAPEUTIC ACTIVITIES | $90.00 | $180.00 | — | 18% above | 50% |
| Therapeutic phlebotomy (removing blood as treatment) CPT 99195 DRAWING OF BLOOD FOR A MEDICAL PROBLEM | $146.50 | $293.00 | — | 3% below | 50% |
| Therapeutic phlebotomy (removing blood as treatment) CPT 99195 PHLEBOTOMY | $157.50 | $315.00 | — | 5% above | 50% |
Vaccines
| Procedure | Cash price | List price | Insurers pay | vs West Virginia | Off list |
|---|---|---|---|---|---|
| Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older CPT 90653 INFLUENZA VACCINE; INACTIVATED | $86.67 | $173.34 | — | 19% above | 50% |
| Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older CPT 90653 Fluad 2024-2025 Formula | $87.00 | $174.00 | — | 19% above | 50% |
| Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older CPT 90653 Fluad 2025-2026 Formula | $87.00 | $174.00 | — | 19% above | 50% |
| Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older CPT 90653 IIV ADJUVANT VACCINE IM | $109.50 | $219.00 | — | 50% above | 50% |
| COVID-19 vaccine (Moderna), age 12 and older CPT 91322 SARSCOV2 VAC 50 MCG/0.5ML IM | $186.00 | $372.00 | $240.77 | 20% above | 50% |
| COVID-19 vaccine (Pfizer-BioNTech), age 12 and older CPT 91320 SARSCV2 VAC 30MCG TRS-SUC IM | $150.50 | $301.00 | $216.32 | at median | 50% |
| Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 VAR VACCINE LIVE SUBQ | $274.00 | $548.00 | $344.92 | 38% above | 50% |
| DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) CPT 90696 DTAP-IPV VACCINE 4-6 YRS IM | $86.00 | $172.00 | $172.00 | 31% above | 50% |
| DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 DTAP VACCINE < 7 YRS IM | $41.00 | $82.00 | $56.96 | 30% above | 50% |
| DTaP, hepatitis B and polio combination vaccine (Pediarix) CPT 90723 Pediarix PFS | $91.51 | $183.01 | $183.01 | at median | 50% |
| DTaP, hepatitis B and polio combination vaccine (Pediarix) CPT 90723 DTAP-HEP B-IPV VACCINE IM | $94.50 | $189.00 | $187.79 | 3% above | 50% |
| DTaP, polio and Hib combination vaccine (Pentacel) CPT 90698 DTAP-IPV/HIB VACCINE IM | $159.00 | $318.00 | $217.26 | 50% above | 50% |
| Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 FluLaval 2025-2026 Formula | $21.00 | $42.00 | $21.07 | 8% above | 50% |
| Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 IIV3 VACC NO PRSV 0.5 ML IM | $29.00 | $58.00 | $21.07 | 49% above | 50% |
| HPV vaccine, 9-valent (Gardasil 9) CPT 90651 Gardasil 9 PFS | $411.50 | $823.00 | $569.07 | 30% above | 50% |
| HPV vaccine, 9-valent (Gardasil 9) CPT 90651 9VHPV VACCINE 2/3 DOSE IM | $435.50 | $871.00 | $569.07 | 37% above | 50% |
| Hepatitis A and B combination vaccine, adult (Twinrix) CPT 90636 HEP A/HEP B VACC ADULT IM | $143.00 | $286.00 | $213.39 | at median | 50% |
| Hepatitis A vaccine, adult dose CPT 90632 HEPA VACCINE ADULT IM | $97.50 | $195.00 | $115.93 | at median | 50% |
| Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 HEPA VACC PED/ADOL 2 DOSE IM | $41.50 | $83.00 | $68.72 | 15% above | 50% |
| Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 Engerix-B Adult PFS | $66.50 | $133.00 | $116.13 | at median | 50% |
| Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 HEPB VACCINE 3 DOSE ADULT IM | $69.50 | $139.00 | $116.13 | 5% above | 50% |
| Hepatitis B vaccine, adult, 2-dose schedule (Heplisav-B) CPT 90739 HEPB VACC 2/4 DOSE ADULT IM | $190.00 | $380.00 | $264.46 | 50% above | 50% |
| Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 HEPB VACC 3 DOSE PED/ADOL IM | $33.00 | $66.00 | $50.77 | 3% above | 50% |
| Hib vaccine (Haemophilus influenzae type b), 3-dose schedule (PedvaxHIB) CPT 90647 HIB PRP-OMP VACC 3 DOSE IM | $41.50 | $83.00 | $58.58 | 48% above | 50% |
| Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) CPT 90648 ActHIB | $17.57 | $35.14 | $25.21 | 3% above | 50% |
| Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) CPT 90648 HIB PRP-T VACCINE 4 DOSE IM | $18.50 | $37.00 | $25.21 | 9% above | 50% |
| High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 IIV NO PRSV INCREASED AG IM | $119.00 | $238.00 | $121.11 | 49% above | 50% |
| Japanese encephalitis vaccine (Ixiaro), 2-dose schedule CPT 90738 INACTIVATED JE VACC IM | $531.50 | $1,063.00 | $504.42 | 50% above | 50% |
| MMR vaccine (measles, mumps and rubella), live CPT 90707 M-M-R II | $121.52 | $243.04 | $182.39 | 4% above | 50% |
| MMR vaccine (measles, mumps and rubella), live CPT 90707 MMR VACCINE SC | $129.00 | $258.00 | $182.39 | 10% above | 50% |
| MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) CPT 90710 MMRV VACCINE SC | $404.00 | $808.00 | $218.94 | 34% above | 50% |
| Meningococcal ACWY (MenACWY) vaccine CPT 90734 MENACWYD/MENACWYCRM VACC IM | $156.50 | $313.00 | $299.95 | at median | 50% |
| Meningococcal ACWY vaccine (MenQuadfi) CPT 90619 MENACWY-TT VACCINE IM | $220.50 | $441.00 | $330.38 | 27% above | 50% |
| Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 MENB-4C VACCINE IM | $229.00 | $458.00 | $411.10 | at median | 50% |
| Meningococcal B vaccine (Trumenba) CPT 90621 MENB-FHBP VACC 2/3 DOSE IM | $254.50 | $509.00 | $376.46 | 50% above | 50% |
| Nasal spray flu vaccine, live (FluMist) CPT 90660 LAIV3 VACCINE INTRANASAL | $36.50 | $73.00 | $27.56 | 49% above | 50% |
| Pneumonia vaccine, 15-valent conjugate (Vaxneuvance) CPT 90671 PCV15 VACCINE IM | $272.50 | $545.00 | $418.37 | 50% above | 50% |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 PCV20 VACCINE IM | $363.50 | $727.00 | $476.29 | at median | 50% |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 Pneumovax 23 PFS | $156.51 | $313.01 | $220.23 | 43% above | 50% |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PPSV23 VACC 2 YRS+ SUBQ/IM | $158.00 | $316.00 | $220.23 | 44% above | 50% |
| Polio vaccine, inactivated (IPV) CPT 90713 POLIOVIRUS IPV SC/IM | $61.50 | $123.00 | $84.18 | 50% above | 50% |
| RSV antibody shot for infants and toddlers, larger dose (1 mL, 100 mg) CPT 90381 RSV MONOC ANTB SEASN 1 ML IM | $789.00 | $1,578.00 | $980.10 | at median | 50% |
| RSV antibody shot for infants, seasonal dose (0.5 mL) CPT 90380 RSV MONOC ANTB SEASN .5ML IM | $789.00 | $1,578.00 | $1,578.00 | at median | 50% |
| RSV vaccine (Abrysvo), one dose for older adults or during pregnancy CPT 90678 RESPIRATORY SYNCYTIAL VIRUS VACCINE; PREF; SUBUNIT; BIVALENT; FOR INTRAMUSCULAR USE | $358.00 | $716.00 | $584.10 | 32% above | 50% |
| RSV vaccine (Abrysvo), one dose for older adults or during pregnancy CPT 90678 RSV VACC PREF BIVALENT IM | $406.00 | $812.00 | $584.10 | 50% above | 50% |
| RSV vaccine with adjuvant (Arexvy), one dose for older adults CPT 90679 RSV VACC PREF RECOMB ADJT IM | $342.00 | $684.00 | $554.40 | 50% above | 50% |
| Rabies vaccine, one dose CPT 90675 RabAvert | $489.48 | $978.96 | $535.82 | at median | 50% |
| Rabies vaccine, one dose CPT 90675 RABIES VACCINE IM | $569.00 | $1,138.00 | $535.82 | 16% above | 50% |
| Rabies vaccine, one dose CPT 90675 RABIES VACCINE FOR INJECTION INTO MUSCLE | $609.00 | $1,218.00 | $535.82 | 24% above | 50% |
| Rotavirus vaccine, oral, 2-dose schedule (Rotarix) CPT 90681 RV1 VACC 2 DOSE LIVE ORAL | $154.50 | $309.00 | $182.97 | 3% above | 50% |
| Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) CPT 90680 RV5 VACC 3 DOSE LIVE ORAL | $126.50 | $253.00 | $189.75 | 29% above | 50% |
| Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 HZV VACC RECOMBINANT IM | $261.50 | $523.00 | — | 23% above | 50% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TD VACC NO PRESV 7 YRS+ IM | $58.50 | $117.00 | $50.06 | 14% above | 50% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 DIPHTHERIA; TETANUS; AND ACELLULAR PERTUSSIS VACCINE (7 YEARS OR OLDER) | $51.34 | $102.68 | $63.21 | at median | 50% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 Boostrix PFS | $66.50 | $133.00 | $63.21 | 30% above | 50% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 TDAP VACCINE 7 YRS/> IM | $68.00 | $136.00 | $63.21 | 32% above | 50% |
| Typhoid vaccine, injectable (Vi polysaccharide) CPT 90691 TYPHOID VACCINE IM | $212.50 | $425.00 | $180.23 | 50% above | 50% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 ADMINISTRATION OF VACCINE | $36.00 | $72.00 | — | 17% below | 50% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMIN | $69.00 | $138.00 | — | 59% above | 50% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 ADMINISTRATION OF VACCINE; EACH ADDITIONAL VACCINE | $24.50 | $49.00 | — | at median | 50% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMUNIZATION ADMIN EACH ADD | $26.50 | $53.00 | — | 8% above | 50% |
| Yellow fever vaccine, live CPT 90717 YELLOW FEVER VACCINE SUBQ | $308.50 | $617.00 | $263.36 | 50% above | 50% |