Hospital

Harbor Beach Community Hospital

Harbor Beach Community Hospital in Harbor Beach, MI publishes cash prices for 300 common procedures listed here, from its own machine-readable price file updated May 1, 2026. Compared with other hospitals in the state, its outpatient cash prices are above the Michigan median for 174 of 298 procedures and below it for 122. By typical cash price it ranks #64 of 98 Michigan hospitals, cheapest first. Select a procedure to compare it with other hospitals nearby.

210 S FIRST STREET, HARBOR BEACH, MI, 484411236 Collected Sep 22, 2026 Source price file Check a bill from this hospital (517) 479-3201

Critical access hospital (rural, 25 beds or fewer) Nonprofit hospital Emergency department CCN 231313 · CMS hospital register NPI 1124089743

Financial assistance

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

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

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

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

Scans and imaging

Procedure	Cash price	List price	Insurers pay	vs Michigan	Off list
Abdominal CT scan without and with contrast CPT 74170 CT ABD W/WO CON	$1,853.25	$2,471.00	—	18% above	25%
Abdominal CT scan without and with contrast inpatient CPT 74170 CT ABD W/WO CON	$1,853.25	$2,471.00	—	—	25%
Abdominal X-ray, 2 views CPT 74019 XR ABD 2V FLAT/UPRIGHT	$182.25	$243.00	—	13% below	25%
Abdominal X-ray, 2 views inpatient CPT 74019 XR ABD 2V FLAT/UPRIGHT	$182.25	$243.00	—	—	25%
Ankle X-ray, complete, 3 or more views one side CPT 73610 XR ANKLE 3 VWS LT,Left side	$182.25	$243.00	—	15% below	25%
Ankle X-ray, complete, 3 or more views one side CPT 73610 XR ANKLE 3 VWS RT,Right side	$182.25	$243.00	—	15% below	25%
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 XR ANKLE 3 VWS RT,Right side	$182.25	$243.00	—	—	25%
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 XR ANKLE 3 VWS LT,Left side	$182.25	$243.00	—	—	25%
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 US ABI	$265.50	$354.00	—	17% below	25%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 US ABI	$265.50	$354.00	—	—	25%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT UPPEXT WO CON RT,Right side	$1,202.25	$1,603.00	—	20% above	25%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT UPPEXT WO CON LT,Left side	$1,202.25	$1,603.00	—	20% above	25%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT UPPEXT WO CON LT,Left side	$1,202.25	$1,603.00	—	—	25%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT UPPEXT WO CON RT,Right side	$1,202.25	$1,603.00	—	—	25%
Barium swallow (esophagus X-ray with contrast) CPT 74220 XR FLOURO ESOPHAGRAM (BA SWALLOW)	$207.00	$276.00	—	28% below	25%
Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 XR FLOURO ESOPHAGRAM (BA SWALLOW)	$207.00	$276.00	—	—	25%
Bone scan, whole body (nuclear medicine) CPT 78306 NM BONE SCAN WHOLE BODY	$1,193.25	$1,591.00	—	20% above	25%
Bone scan, whole body (nuclear medicine) inpatient CPT 78306 NM BONE SCAN WHOLE BODY	$1,193.25	$1,591.00	—	—	25%
Breast ultrasound, complete, one breast one side CPT 76641 US BREAST RT COMPLETE,Right side	$461.25	$615.00	—	48% above	25%
Breast ultrasound, complete, one breast one side CPT 76641 US BREAST LT COMPLETE,Left side	$461.25	$615.00	—	48% above	25%
Breast ultrasound, complete, one breast inpatient one side CPT 76641 US BREAST RT COMPLETE,Right side	$461.25	$615.00	—	—	25%
Breast ultrasound, complete, one breast inpatient one side CPT 76641 US BREAST LT COMPLETE,Left side	$461.25	$615.00	—	—	25%
Breast ultrasound, limited (one breast or one area) one side CPT 76642 US BREAST LT LIMITED,Left side	$324.00	$432.00	—	20% above	25%
Breast ultrasound, limited (one breast or one area) one side CPT 76642 US BREAST RT LIMITED,Right side	$324.00	$432.00	—	20% above	25%
Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 US BREAST RT LIMITED,Right side	$324.00	$432.00	—	—	25%
Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 US BREAST LT LIMITED,Left side	$324.00	$432.00	—	—	25%
CT angiography (CTA) of the abdomen and pelvis CPT 74174 CT CTA ABD/PELVIS	$1,518.75	$2,025.00	—	39% below	25%
CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174 CT CTA ABD/PELVIS	$1,518.75	$2,025.00	—	—	25%
CT angiography (CTA) of the head CPT 70496 CT CTA HEAD	$1,510.50	$2,014.00	—	3% below	25%
CT angiography (CTA) of the head inpatient CPT 70496 CT CTA HEAD	$1,510.50	$2,014.00	—	—	25%
CT angiography (CTA) of the neck CPT 70498 CT CTA NECK	$1,510.50	$2,014.00	—	at median	25%
CT angiography (CTA) of the neck inpatient CPT 70498 CT CTA NECK	$1,510.50	$2,014.00	—	—	25%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT CTA CHEST W/IV	$1,711.50	$2,282.00	—	2% above	25%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CT CTA CHEST W/IV	$1,711.50	$2,282.00	—	—	25%
CT of the heart without contrast dye to measure coronary calcium CPT 75571 CT CORON CALC SCORE	$347.25	$463.00	—	132% above	25%
CT of the heart without contrast dye to measure coronary calcium inpatient CPT 75571 CT CORON CALC SCORE	$347.25	$463.00	—	—	25%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT A/P WO CON	$2,163.75	$2,885.00	—	21% above	25%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT A/P RENAL STONE	$2,163.75	$2,885.00	—	21% above	25%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT A/P ORALCON ONLY	$2,163.75	$2,885.00	—	21% above	25%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT A/P WO CON	$2,163.75	$2,885.00	—	—	25%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT A/P ORALCON ONLY	$2,163.75	$2,885.00	—	—	25%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT A/P RENAL STONE	$2,163.75	$2,885.00	—	—	25%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT A/P IVCON ONLY	$2,868.00	$3,824.00	—	2% above	25%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT A/P IV/ORAL CON	$2,887.50	$3,850.00	—	2% above	25%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT A/P IVCON ONLY	$2,868.00	$3,824.00	—	—	25%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT A/P IV/ORAL CON	$2,887.50	$3,850.00	—	—	25%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT A/P W W/O CON	$3,572.25	$4,763.00	—	37% above	25%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT A/P W W/O CON	$3,572.25	$4,763.00	—	—	25%
CT scan of the abdomen with contrast CPT 74160 CT ABD WIV/ORAL CON	$1,525.50	$2,034.00	—	4% above	25%
CT scan of the abdomen with contrast CPT 74160 CT ABD WIV CON	$1,525.50	$2,034.00	—	4% above	25%
CT scan of the abdomen with contrast inpatient CPT 74160 CT ABD WIV/ORAL CON	$1,525.50	$2,034.00	—	—	25%
CT scan of the abdomen with contrast inpatient CPT 74160 CT ABD WIV CON	$1,525.50	$2,034.00	—	—	25%
CT scan of the abdomen without contrast CPT 74150 CT ABD WO CON	$1,390.50	$1,854.00	—	50% above	25%
CT scan of the abdomen without contrast CPT 74150 CT ABD W ORAL CON	$1,390.50	$1,854.00	—	50% above	25%
CT scan of the abdomen without contrast inpatient CPT 74150 CT ABD W ORAL CON	$1,390.50	$1,854.00	—	—	25%
CT scan of the abdomen without contrast inpatient CPT 74150 CT ABD WO CON	$1,390.50	$1,854.00	—	—	25%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT SINUS WO CON	$1,202.25	$1,603.00	—	18% above	25%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT FACE WO CON	$1,202.25	$1,603.00	—	18% above	25%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT FACE WO CON	$1,202.25	$1,603.00	—	—	25%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT SINUS WO CON	$1,202.25	$1,603.00	—	—	25%
CT scan of the head or brain, no contrast dye CPT 70450 CT HEAD WO CON	$1,331.25	$1,775.00	—	49% above	25%
CT scan of the head or brain, no contrast dye CPT 70450 CT HEAD W/O CONT	$1,331.25	$1,775.00	—	49% above	25%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT HEAD W/O CONT	$1,331.25	$1,775.00	—	—	25%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT HEAD WO CON	$1,331.25	$1,775.00	—	—	25%
CT scan of the head with contrast CPT 70460 CT HEAD W CON	$1,509.00	$2,012.00	—	22% above	25%
CT scan of the head with contrast inpatient CPT 70460 CT HEAD W CON	$1,509.00	$2,012.00	—	—	25%
CT scan of the head without and with contrast CPT 70470 CT HEAD W/WO CON	$1,609.50	$2,146.00	—	3% above	25%
CT scan of the head without and with contrast inpatient CPT 70470 CT HEAD W/WO CON	$1,609.50	$2,146.00	—	—	25%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT LUM SPINE WO CON	$1,202.25	$1,603.00	—	11% above	25%
CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 CT LUM SPINE WO CON	$1,202.25	$1,603.00	—	—	25%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT CERV SPINE WO CON	$1,349.25	$1,799.00	—	22% above	25%
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CT CERV SPINE WO CON	$1,349.25	$1,799.00	—	—	25%
CT scan of the pelvis, with contrast dye CPT 72193 CT PELVIS WIV CON	$1,882.50	$2,510.00	—	39% above	25%
CT scan of the pelvis, with contrast dye CPT 72193 CT PEL WIV/ORAL CON	$1,882.50	$2,510.00	—	39% above	25%
CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT PELVIS WIV CON	$1,882.50	$2,510.00	—	—	25%
CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT PEL WIV/ORAL CON	$1,882.50	$2,510.00	—	—	25%
Carotid artery ultrasound (duplex), both sides of the neck CPT 93880 US CAROTID DOPPLER	$839.25	$1,119.00	—	3% below	25%
Carotid artery ultrasound (duplex), both sides of the neck inpatient CPT 93880 US CAROTID DOPPLER	$839.25	$1,119.00	—	—	25%
Chest CT scan without and with contrast CPT 71270 CT CHEST W/WO CON	$1,985.25	$2,647.00	—	13% above	25%
Chest CT scan without and with contrast inpatient CPT 71270 CT CHEST W/WO CON	$1,985.25	$2,647.00	—	—	25%
Chest X-ray, 2 views CPT 71046 XR CHEST 2 VWS	$182.25	$243.00	—	2% above	25%
Chest X-ray, 2 views inpatient CPT 71046 XR CHEST 2 VWS	$182.25	$243.00	—	—	25%
Chest X-ray, single view CPT 71045 XR CHEST 1 VW	$153.75	$205.00	—	at median	25%
Chest X-ray, single view inpatient CPT 71045 XR CHEST 1 VW	$153.75	$205.00	—	—	25%
Collarbone (clavicle) X-ray, complete one side CPT 73000 XR CLAVICLE LT,Left side	$135.75	$181.00	—	22% below	25%
Collarbone (clavicle) X-ray, complete one side CPT 73000 XR CLAVICLE RT,Right side	$135.75	$181.00	—	22% below	25%
Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 XR CLAVICLE LT,Left side	$135.75	$181.00	—	—	25%
Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 XR CLAVICLE RT,Right side	$135.75	$181.00	—	—	25%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US RETROPERITON COMP	$825.00	$1,100.00	—	36% above	25%
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US RETROPERITON COMP	$825.00	$1,100.00	—	—	25%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 XR BONE DENSITY	$294.75	$393.00	—	5% below	25%
DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 XR BONE DENSITY	$294.75	$393.00	—	—	25%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT CHEST WO CON	$1,351.50	$1,802.00	—	35% above	25%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT CHEST WO CON REDUCED DOSE RADIATION	$1,351.50	$1,802.00	—	35% above	25%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT CHEST WO CON	$1,351.50	$1,802.00	—	—	25%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT CHEST WO CON REDUCED DOSE RADIATION	$1,351.50	$1,802.00	—	—	25%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT CHEST W CON	$1,882.50	$2,510.00	—	43% above	25%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT CHEST W CON	$1,882.50	$2,510.00	—	—	25%
Diagnostic mammogram, both breasts CPT 77066 MM MAMMO BIL DIAGNOSTIC 3D	$311.25	$415.00	—	at median	25%
Diagnostic mammogram, both breasts inpatient CPT 77066 MM MAMMO BIL DIAGNOSTIC 3D	$311.25	$415.00	—	—	25%
Diagnostic mammogram, one breast CPT 77065 MM MAMMO UNI DIAGNOSTIC 3D	$242.25	$323.00	—	22% below	25%
Diagnostic mammogram, one breast inpatient CPT 77065 MM MAMMO UNI DIAGNOSTIC 3D	$242.25	$323.00	—	—	25%
Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 US DUP LOW EXT ART BILAT	$504.75	$673.00	—	—	25%
Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 US DUP LOW EXT ART BILAT	$504.75	$673.00	—	—	25%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 US VEN DOPP UPP BILAT	$783.75	$1,045.00	—	—	25%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 US VEN DOPP LOW BILAT	$800.25	$1,067.00	—	—	25%
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 US VEN DOPP UPP BILAT	$783.75	$1,045.00	—	—	25%
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 US VEN DOPP LOW BILAT	$800.25	$1,067.00	—	—	25%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 US 2D ECHO COMP W/O CONTRAST	$1,489.50	$1,986.00	—	8% above	25%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 US 2D ECHO COMP W/O CONTRAST	$1,489.50	$1,986.00	—	—	25%
Elbow X-ray, 2 views one side CPT 73070 XR ELB AP&LAT LT,Left side	$152.25	$203.00	—	14% above	25%
Elbow X-ray, 2 views one side CPT 73070 XR ELB AP&LAT RT,Right side	$152.25	$203.00	—	14% above	25%
Elbow X-ray, 2 views inpatient one side CPT 73070 XR ELB AP&LAT LT,Left side	$152.25	$203.00	—	—	25%
Elbow X-ray, 2 views inpatient one side CPT 73070 XR ELB AP&LAT RT,Right side	$152.25	$203.00	—	—	25%
Elbow X-ray, complete, 3 or more views one side CPT 73080 XR ELB COMPL RT,Right side	$182.25	$243.00	—	4% below	25%
Elbow X-ray, complete, 3 or more views one side CPT 73080 XR ELB COMPL LT,Left side	$182.25	$243.00	—	4% below	25%
Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 XR ELB COMPL LT,Left side	$182.25	$243.00	—	—	25%
Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 XR ELB COMPL RT,Right side	$182.25	$243.00	—	—	25%
Eye socket (orbit) CT scan without contrast CPT 70480 CT IAC/SELL WO CON	$1,202.25	$1,603.00	—	18% above	25%
Eye socket (orbit) CT scan without contrast CPT 70480 CT ORBIT WO CON	$1,202.25	$1,603.00	—	18% above	25%
Eye socket (orbit) CT scan without contrast inpatient CPT 70480 CT ORBIT WO CON	$1,202.25	$1,603.00	—	—	25%
Eye socket (orbit) CT scan without contrast inpatient CPT 70480 CT IAC/SELL WO CON	$1,202.25	$1,603.00	—	—	25%
Facial bones X-ray, complete, 3 or more views CPT 70150 XR FAC BONES COMP	$204.00	$272.00	—	21% below	25%
Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 XR FAC BONES COMP	$204.00	$272.00	—	—	25%
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 XR FOREARM 2VWS LT,Left side	$182.25	$243.00	—	2% above	25%
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 XR FOREARM 2VWS RT,Right side	$182.25	$243.00	—	2% above	25%
Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 XR FOREARM 2VWS LT,Left side	$182.25	$243.00	—	—	25%
Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 XR FOREARM 2VWS RT,Right side	$182.25	$243.00	—	—	25%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 NM HIDA ONLY	$831.00	$1,108.00	—	11% below	25%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 NM HIDA ONLY	$831.00	$1,108.00	—	—	25%
Hand X-ray, 2 views one side CPT 73120 XR HAND 2VWS LT,Left side	$140.25	$187.00	—	4% below	25%
Hand X-ray, 2 views one side CPT 73120 XR HAND 2VWS RT,Right side	$140.25	$187.00	—	4% below	25%
Hand X-ray, 2 views inpatient one side CPT 73120 XR HAND 2VWS RT,Right side	$140.25	$187.00	—	—	25%
Hand X-ray, 2 views inpatient one side CPT 73120 XR HAND 2VWS LT,Left side	$140.25	$187.00	—	—	25%
Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 XR OSCALC 2VWS LT,Left side	$158.25	$211.00	—	3% above	25%
Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 XR OSCALC 2VWS RT,Right side	$158.25	$211.00	—	3% above	25%
Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 XR OSCALC 2VWS LT,Left side	$158.25	$211.00	—	—	25%
Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 XR OSCALC 2VWS RT,Right side	$158.25	$211.00	—	—	25%
Knee X-ray, 3 views one side CPT 73562 XR KNEE 3 VWS RT,Right side	$156.00	$208.00	—	19% below	25%
Knee X-ray, 3 views one side CPT 73562 XR KNEE 3 VWS LT,Left side	$156.00	$208.00	—	19% below	25%
Knee X-ray, 3 views inpatient one side CPT 73562 XR KNEE 3 VWS LT,Left side	$156.00	$208.00	—	—	25%
Knee X-ray, 3 views inpatient one side CPT 73562 XR KNEE 3 VWS RT,Right side	$156.00	$208.00	—	—	25%
Knee X-ray, complete, 4 or more views one side CPT 73564 XR KNEE 4-5 VW RT,Right side	$188.25	$251.00	—	12% below	25%
Knee X-ray, complete, 4 or more views one side CPT 73564 XR KNEE 4-5 VW LT,Left side	$188.25	$251.00	—	12% below	25%
Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 XR KNEE 4-5 VW RT,Right side	$188.25	$251.00	—	—	25%
Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 XR KNEE 4-5 VW LT,Left side	$188.25	$251.00	—	—	25%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT LOW EXT WO CON LT,Left side	$1,202.25	$1,603.00	—	10% above	25%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT LOW EXT WO CON RT,Right side	$1,202.25	$1,603.00	—	10% above	25%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT LOW EXT WO CON RT,Right side	$1,202.25	$1,603.00	—	—	25%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT LOW EXT WO CON LT,Left side	$1,202.25	$1,603.00	—	—	25%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US ABD LIMITED	$591.75	$789.00	—	27% above	25%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US PANCREAS	$612.00	$816.00	—	32% above	25%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US SPLEEN	$612.00	$816.00	—	32% above	25%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US ABD LIMITED	$591.75	$789.00	—	—	25%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US PANCREAS	$612.00	$816.00	—	—	25%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US SPLEEN	$612.00	$816.00	—	—	25%
Limited ultrasound of an arm or leg (non-vascular) CPT 76882 US EXT NON VASCULAR	$456.00	$608.00	—	26% above	25%
Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 US EXT NON VASCULAR	$456.00	$608.00	—	—	25%
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 CT CHEST LUNG CA SCREENING	$484.50	$646.00	—	39% above	25%
Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 CT CHEST LUNG CA SCREENING	$484.50	$646.00	—	—	25%
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 XR TIB/FIB 2VWS RT,Right side	$207.00	$276.00	—	12% above	25%
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 XR TIB/FIB 2VWS LT,Left side	$207.00	$276.00	—	12% above	25%
Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 XR TIB/FIB 2VWS RT,Right side	$207.00	$276.00	—	—	25%
Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 XR TIB/FIB 2VWS LT,Left side	$207.00	$276.00	—	—	25%
Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 XR CERV SP 4 or 5 VWS	$251.25	$335.00	—	12% below	25%
Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 XR CERV SP 4 or 5 VWS	$251.25	$335.00	—	—	25%
Neck soft tissue CT scan with contrast CPT 70491 CT S.T.NECK W CON	$1,597.50	$2,130.00	—	21% above	25%
Neck soft tissue CT scan with contrast inpatient CPT 70491 CT S.T.NECK W CON	$1,597.50	$2,130.00	—	—	25%
Neck soft tissue CT scan without contrast CPT 70490 CT S.T.NECK WO CON	$1,202.25	$1,603.00	—	18% above	25%
Neck soft tissue CT scan without contrast inpatient CPT 70490 CT S.T.NECK WO CON	$1,202.25	$1,603.00	—	—	25%
Neck soft tissue X-ray CPT 70360 XR NECK SOFT TISSUE	$153.75	$205.00	—	13% below	25%
Neck soft tissue X-ray inpatient CPT 70360 XR NECK SOFT TISSUE	$153.75	$205.00	—	—	25%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 NM MYOCARDIAL PERF SPECT MULTI	$2,431.50	$3,242.00	—	16% below	25%
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 NM MYOCARDIAL PERF SPECT MULTI	$2,431.50	$3,242.00	—	—	25%
Pelvic CT scan without contrast CPT 72192 CT PEL W ORAL CON	$1,331.25	$1,775.00	—	36% above	25%
Pelvic CT scan without contrast CPT 72192 CT PELVIS WO CON	$1,331.25	$1,775.00	—	36% above	25%
Pelvic CT scan without contrast inpatient CPT 72192 CT PEL W ORAL CON	$1,331.25	$1,775.00	—	—	25%
Pelvic CT scan without contrast inpatient CPT 72192 CT PELVIS WO CON	$1,331.25	$1,775.00	—	—	25%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US PELVIS, TA, LIMITED	$534.00	$712.00	—	59% above	25%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US PELVIS, TA, LIMITED	$534.00	$712.00	—	—	25%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US PELVIS TA COMP	$726.75	$969.00	—	30% above	25%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US COMP PREG DIAG	$750.75	$1,001.00	—	35% above	25%
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 US PELVIS TA COMP	$726.75	$969.00	—	—	25%
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 US COMP PREG DIAG	$750.75	$1,001.00	—	—	25%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US PREG UT TA 2ND TRI	$867.75	$1,157.00	—	54% above	25%
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US PREG UT TA 2ND TRI	$867.75	$1,157.00	—	—	25%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 US PREG UT TA 1ST TRI	$732.75	$977.00	—	32% above	25%
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 US PREG UT TA 1ST TRI	$732.75	$977.00	—	—	25%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US FETAL AGE & GRTH	$418.50	$558.00	—	30% above	25%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 US FETAL AGE & GRTH	$418.50	$558.00	—	—	25%
Rib X-ray, one side, 2 views one side CPT 71100 XR RIBS LT 2 VWS,Left side	$113.25	$151.00	—	43% below	25%
Rib X-ray, one side, 2 views one side CPT 71100 XR RIBS RT 2 VWS,Right side	$113.25	$151.00	—	43% below	25%
Rib X-ray, one side, 2 views inpatient one side CPT 71100 XR RIBS RT 2 VWS,Right side	$113.25	$151.00	—	—	25%
Rib X-ray, one side, 2 views inpatient one side CPT 71100 XR RIBS LT 2 VWS,Left side	$113.25	$151.00	—	—	25%
Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 XR RIBS RT W/CHEST,Right side	$187.50	$250.00	—	20% below	25%
Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 XR RIBS LT W/CHEST,Left side	$187.50	$250.00	—	20% below	25%
Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 XR RIBS LT W/CHEST,Left side	$187.50	$250.00	—	—	25%
Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 XR RIBS RT W/CHEST,Right side	$187.50	$250.00	—	—	25%
Screening mammogram, both breasts CPT 77067 MM MAMMO BIL SCREEN 3D	$254.25	$339.00	—	11% below	25%
Screening mammogram, both breasts inpatient CPT 77067 MM MAMMO BIL SCREEN 3D	$254.25	$339.00	—	—	25%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 XR SHOULDER 2-4 VW LT,Left side	$191.25	$255.00	—	5% below	25%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 XR SHOULDER 2-4 VW RT,Right side	$191.25	$255.00	—	5% below	25%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 XR SHOULDER 2-4 VW LT,Left side	$191.25	$255.00	—	—	25%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 XR SHOULDER 2-4 VW RT,Right side	$191.25	$255.00	—	—	25%
Sinus X-ray, complete, 3 or more views CPT 70220 XR SINUSES COMP	$248.25	$331.00	—	8% above	25%
Sinus X-ray, complete, 3 or more views inpatient CPT 70220 XR SINUSES COMP	$248.25	$331.00	—	—	25%
Skull X-ray, fewer than 4 views CPT 70250 XR SKULL PARTIAL	$139.50	$186.00	—	33% below	25%
Skull X-ray, fewer than 4 views inpatient CPT 70250 XR SKULL PARTIAL	$139.50	$186.00	—	—	25%
Swallow study (modified barium swallow, video X-ray) CPT 74230 XR FLOURO MODIFIED BARIUM SWALLOW	$189.75	$253.00	—	50% below	25%
Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 XR FLOURO MODIFIED BARIUM SWALLOW	$189.75	$253.00	—	—	25%
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 XR FEMUR 2VWS LT,Left side	$195.00	$260.00	—	9% below	25%
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 XR FEMUR 2VWS RT,Right side	$195.00	$260.00	—	9% below	25%
Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 XR FEMUR 2VWS RT,Right side	$195.00	$260.00	—	—	25%
Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 XR FEMUR 2VWS LT,Left side	$195.00	$260.00	—	—	25%
Thoracic spine (mid back) CT scan without contrast CPT 72128 CT T SPINE WO CON	$1,202.25	$1,603.00	—	18% above	25%
Thoracic spine (mid back) CT scan without contrast inpatient CPT 72128 CT T SPINE WO CON	$1,202.25	$1,603.00	—	—	25%
Toe X-ray, 2 or more views CPT 73660 XR TOE (S) MIN 3 VWS	$126.00	$168.00	—	at median	25%
Toe X-ray, 2 or more views inpatient CPT 73660 XR TOE (S) MIN 3 VWS	$126.00	$168.00	—	—	25%
Transvaginal pelvic ultrasound CPT 76830 US PELVIS TV	$614.25	$819.00	—	14% above	25%
Transvaginal pelvic ultrasound inpatient CPT 76830 US PELVIS TV	$614.25	$819.00	—	—	25%
Transvaginal ultrasound during pregnancy CPT 76817 US PREG UTERUS TV	$595.50	$794.00	—	37% above	25%
Transvaginal ultrasound during pregnancy inpatient CPT 76817 US PREG UTERUS TV	$595.50	$794.00	—	—	25%
Ultrasound of the abdomen, complete CPT 76700 US ABD COMPLETE	$791.25	$1,055.00	—	19% above	25%
Ultrasound of the abdomen, complete inpatient CPT 76700 US ABD COMPLETE	$791.25	$1,055.00	—	—	25%
Ultrasound of the scrotum and testicles CPT 76870 US SCROTAL W COLOR	$375.00	$500.00	—	29% below	25%
Ultrasound of the scrotum and testicles CPT 76870 US SCROTAL	$636.00	$848.00	—	21% above	25%
Ultrasound of the scrotum and testicles inpatient CPT 76870 US SCROTAL W COLOR	$375.00	$500.00	—	—	25%
Ultrasound of the scrotum and testicles inpatient CPT 76870 US SCROTAL	$636.00	$848.00	—	—	25%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US THYROID	$579.75	$773.00	—	21% above	25%
Ultrasound of the soft tissues of the head and neck, such as the thyroid one side CPT 76536 US S.T.FACE NECK RT	$533.25	$711.00	—	12% above	25%
Ultrasound of the soft tissues of the head and neck, such as the thyroid one side CPT 76536 US S.T. FACE NECK LT	$533.25	$711.00	—	12% above	25%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US THYROID	$579.75	$773.00	—	—	25%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient one side CPT 76536 US S.T.FACE NECK RT	$533.25	$711.00	—	—	25%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient one side CPT 76536 US S.T. FACE NECK LT	$533.25	$711.00	—	—	25%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 XR FLOURO UGI (UPPER GI)	$207.00	$276.00	—	49% below	25%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 XR FLOURO UGI (UPPER GI)	$207.00	$276.00	—	—	25%
Upper arm X-ray (humerus), 2 views one side CPT 73060 XR HUMERUS 2VWS RT,Right side	$182.25	$243.00	—	at median	25%
Upper arm X-ray (humerus), 2 views one side CPT 73060 XR HUMERUS 2VWS LT,Left side	$182.25	$243.00	—	at median	25%
Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 XR HUMERUS 2VWS RT,Right side	$182.25	$243.00	—	—	25%
Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 XR HUMERUS 2VWS LT,Left side	$182.25	$243.00	—	—	25%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US VEN DOPP UPP RT,Right side	$396.00	$528.00	—	25% below	25%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US VEN DOPP LOW RT,Right side	$396.00	$528.00	—	25% below	25%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US VEN DOPP LOW LT,Left side	$428.25	$571.00	—	19% below	25%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US VEN DOPP UPP LT,Left side	$428.25	$571.00	—	19% below	25%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US VEN DOPP UPP RT,Right side	$396.00	$528.00	—	—	25%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US VEN DOPP LOW RT,Right side	$396.00	$528.00	—	—	25%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US VEN DOPP LOW LT,Left side	$428.25	$571.00	—	—	25%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US VEN DOPP UPP LT,Left side	$428.25	$571.00	—	—	25%
Wrist X-ray, 2 views one side CPT 73100 XR WRIST AP&LAT LT,Left side	$152.25	$203.00	—	9% above	25%
Wrist X-ray, 2 views one side CPT 73100 XR WRIST AP&LAT RT,Right side	$152.25	$203.00	—	9% above	25%
Wrist X-ray, 2 views inpatient one side CPT 73100 XR WRIST AP&LAT RT,Right side	$152.25	$203.00	—	—	25%
Wrist X-ray, 2 views inpatient one side CPT 73100 XR WRIST AP&LAT LT,Left side	$152.25	$203.00	—	—	25%
Wrist X-ray, complete, 3 or more views one side CPT 73110 XR WRIST COMP RT,Right side	$182.25	$243.00	—	5% below	25%
Wrist X-ray, complete, 3 or more views one side CPT 73110 XR WRIST COMP LT,Left side	$182.25	$243.00	—	5% below	25%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 XR WRIST COMP LT,Left side	$182.25	$243.00	—	—	25%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 XR WRIST COMP RT,Right side	$182.25	$243.00	—	—	25%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR HIP COMP 2VWS RT,Right side	$207.75	$277.00	—	2% above	25%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR HIP/PELVIS 2-3 VW RT,Right side	$207.75	$277.00	—	2% above	25%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR HIP/PELVIS 2-3 VW LT,Left side	$207.75	$277.00	—	2% above	25%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR HIP COMP 2VWS LT,Left side	$207.75	$277.00	—	2% above	25%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 XR HIP COMP 2VWS RT,Right side	$207.75	$277.00	—	—	25%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 XR HIP/PELVIS 2-3 VW LT,Left side	$207.75	$277.00	—	—	25%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 XR HIP/PELVIS 2-3 VW RT,Right side	$207.75	$277.00	—	—	25%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 XR HIP COMP 2VWS LT,Left side	$207.75	$277.00	—	—	25%
X-ray of the abdomen, 1 view CPT 74018 XR ABD 1 VW	$116.25	$155.00	—	27% below	25%
X-ray of the abdomen, 1 view inpatient CPT 74018 XR ABD 1 VW	$116.25	$155.00	—	—	25%
X-ray of the ankle, 2 views one side CPT 73600 XR ANKLE 2 VWS LT,Left side	$152.25	$203.00	—	13% below	25%
X-ray of the ankle, 2 views one side CPT 73600 XR ANKLE 2 VWS RT,Right side	$152.25	$203.00	—	13% below	25%
X-ray of the ankle, 2 views inpatient one side CPT 73600 XR ANKLE 2 VWS LT,Left side	$152.25	$203.00	—	—	25%
X-ray of the ankle, 2 views inpatient one side CPT 73600 XR ANKLE 2 VWS RT,Right side	$152.25	$203.00	—	—	25%
X-ray of the finger(s), 2 or more views one side CPT 73140 XR FINGER RT 3VW,Right side	$124.50	$166.00	—	6% below	25%
X-ray of the finger(s), 2 or more views one side CPT 73140 XR FINGER LT 3VW,Left side	$124.50	$166.00	—	6% below	25%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR FINGER RT 3VW,Right side	$124.50	$166.00	—	—	25%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR FINGER LT 3VW,Left side	$124.50	$166.00	—	—	25%
X-ray of the foot, 2 views one side CPT 73620 XR FOOT 2 VWS RT,Right side	$162.75	$217.00	—	3% above	25%
X-ray of the foot, 2 views one side CPT 73620 XR FOOT 2 VWS LT,Left side	$162.75	$217.00	—	3% above	25%
X-ray of the foot, 2 views inpatient one side CPT 73620 XR FOOT 2 VWS LT,Left side	$162.75	$217.00	—	—	25%
X-ray of the foot, 2 views inpatient one side CPT 73620 XR FOOT 2 VWS RT,Right side	$162.75	$217.00	—	—	25%
X-ray of the foot, complete, 3 or more views one side CPT 73630 XR FOOT COMP LT,Left side	$182.25	$243.00	—	1% above	25%
X-ray of the foot, complete, 3 or more views one side CPT 73630 XR FOOT COMP RT,Right side	$182.25	$243.00	—	1% above	25%
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 XR FOOT COMP RT,Right side	$182.25	$243.00	—	—	25%
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 XR FOOT COMP LT,Left side	$182.25	$243.00	—	—	25%
X-ray of the hand, 3 or more views one side CPT 73130 XR HAND 3VWS LT,Left side	$175.50	$234.00	—	4% below	25%
X-ray of the hand, 3 or more views one side CPT 73130 XR HAND 3VWS RT,Right side	$175.50	$234.00	—	4% below	25%
X-ray of the hand, 3 or more views inpatient one side CPT 73130 XR HAND 3VWS RT,Right side	$175.50	$234.00	—	—	25%
X-ray of the hand, 3 or more views inpatient one side CPT 73130 XR HAND 3VWS LT,Left side	$175.50	$234.00	—	—	25%
X-ray of the knee, 1 or 2 views one side CPT 73560 XR KNEE 1-2 VWS LT,Left side	$105.00	$140.00	—	32% below	25%
X-ray of the knee, 1 or 2 views one side CPT 73560 XR KNEE 1-2 VWS RT,Right side	$105.00	$140.00	—	32% below	25%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 XR KNEE 1-2 VWS RT,Right side	$105.00	$140.00	—	—	25%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 XR KNEE 1-2 VWS LT,Left side	$105.00	$140.00	—	—	25%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 XR LS SP 2/3 VWS	$211.50	$282.00	—	1% below	25%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 XR LS SP 2/3 VWS	$211.50	$282.00	—	—	25%
X-ray of the lower back, 4 or more views CPT 72110 XR LS SP COMP MIN 4VWS	$312.75	$417.00	—	2% above	25%
X-ray of the lower back, 4 or more views inpatient CPT 72110 XR LS SP COMP MIN 4VWS	$312.75	$417.00	—	—	25%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 XR T SPINE AP&LAT	$261.00	$348.00	—	42% above	25%
X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 XR T SPINE AP&LAT	$261.00	$348.00	—	—	25%
X-ray of the nasal bones, 3 or more views CPT 70160 XR NASAL BONES 3 VWS	$142.50	$190.00	—	17% below	25%
X-ray of the nasal bones, 3 or more views inpatient CPT 70160 XR NASAL BONES 3 VWS	$142.50	$190.00	—	—	25%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 XR CERV SP 2 OR 3 VWS	$141.75	$189.00	—	39% below	25%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 XR CERV SP 2 OR 3 VWS	$141.75	$189.00	—	—	25%
X-ray of the pelvis, 1 or 2 views CPT 72170 XR PELVIS AP	$126.75	$169.00	—	23% below	25%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 XR PELVIS AP	$126.75	$169.00	—	—	25%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 XR SACR COCCYX 2VWS	$143.25	$191.00	—	17% below	25%
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 XR SACR COCCYX 2VWS	$143.25	$191.00	—	—	25%

Lab tests

Procedure	Cash price	List price	Insurers pay	vs Michigan	Off list
ACTH blood test CPT 82024 ADRENOCORTICOTROPIC HORMONE (ACTH)	$290.25	$387.00	—	210% above	25%
ACTH blood test inpatient CPT 82024 ADRENOCORTICOTROPIC HORMONE (ACTH)	$290.25	$387.00	—	—	25%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 ALT/SGPT	$43.50	$58.00	—	81% above	25%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 ALT/SGPT	$43.50	$58.00	—	—	25%
AST (aspartate aminotransferase) enzyme test CPT 84450 AST/SGOT	$43.50	$58.00	—	98% above	25%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 AST/SGOT	$43.50	$58.00	—	—	25%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 HEPATITIS ACUTE PANEL W/REFLEX	$347.25	$463.00	—	104% above	25%
Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 HEPATITIS ACUTE PANEL W/REFLEX	$347.25	$463.00	—	—	25%
Albumin blood test CPT 82040 ALBUMIN SERUM	$43.50	$58.00	—	118% above	25%
Albumin blood test inpatient CPT 82040 ALBUMIN SERUM	$43.50	$58.00	—	—	25%
Aldosterone blood test CPT 82088 ALDOSTERONE URINE	$112.50	$150.00	—	105% above	25%
Aldosterone blood test CPT 82088 ALDOSTERONE SERUM	$295.50	$394.00	—	437% above	25%
Aldosterone blood test inpatient CPT 82088 ALDOSTERONE URINE	$112.50	$150.00	—	—	25%
Aldosterone blood test inpatient CPT 82088 ALDOSTERONE SERUM	$295.50	$394.00	—	—	25%
Alkaline phosphatase (ALP) blood test CPT 84075 ALK PHOSP	$45.00	$60.00	—	114% above	25%
Alkaline phosphatase (ALP) blood test inpatient CPT 84075 ALK PHOSP	$45.00	$60.00	—	—	25%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN ALTERNARIA ALTERNATA IgE	$6.00	$8.00	—	6% below	25%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN CLADOSPORIUM HERBARUM IgE	$6.00	$8.00	—	6% below	25%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN WHITE FACED HORNET VENOM IgE	$11.25	$15.00	—	77% above	25%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN YELLOW JACKET VENOM IgE	$11.25	$15.00	—	77% above	25%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN WASP VENOM IgE	$11.25	$15.00	—	77% above	25%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN HONEYBEE VENOM IgE	$11.25	$15.00	—	77% above	25%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN COCKLEBUR IGE	$12.00	$16.00	—	88% above	25%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN WILLOW IGE	$12.00	$16.00	—	88% above	25%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN PECAN TREE IGE	$12.00	$16.00	—	88% above	25%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN GOLDENROD IGE	$12.00	$16.00	—	88% above	25%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN GIANT RAGWEED IGE	$12.00	$16.00	—	88% above	25%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN HOUSE DUST H-S IGE	$12.00	$16.00	—	88% above	25%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN MEADOW FESCUE IgE	$12.00	$16.00	—	88% above	25%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN SHEEP SORREL IGE	$12.00	$16.00	—	88% above	25%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN BEECH IGE	$12.00	$16.00	—	88% above	25%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN CRANBERRY IGE	$12.75	$17.00	—	100% above	25%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN LAMB IgE	$12.75	$17.00	—	100% above	25%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN AVOCADO IGE	$12.75	$17.00	—	100% above	25%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN KIWI FRUIT IGE	$12.75	$17.00	—	100% above	25%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN BUCKWHEAT IGE	$12.75	$17.00	—	100% above	25%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN SYCAMORE IgE	$12.75	$17.00	—	100% above	25%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN COCONUT IGE	$13.50	$18.00	—	112% above	25%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN CASHEW IGE	$13.50	$18.00	—	112% above	25%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN BRAZIL NUT IGE	$13.50	$18.00	—	112% above	25%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN ALMOND IGE	$13.50	$18.00	—	112% above	25%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN SWEET CHESTNUT IGE	$13.50	$18.00	—	112% above	25%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN MACADAMIA NUT IGE	$13.50	$18.00	—	112% above	25%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN HAZELNUT FOOD IGE	$13.50	$18.00	—	112% above	25%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN OYSTER IgE	$13.50	$18.00	—	112% above	25%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN PINE NUT IGE	$13.50	$18.00	—	112% above	25%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN PISTACHIO IGE	$13.50	$18.00	—	112% above	25%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN PECAN FOOD IGE	$13.50	$18.00	—	112% above	25%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN WHEAT IgE	$14.25	$19.00	—	124% above	25%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN CLAM IgE	$14.25	$19.00	—	124% above	25%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN SCALLOP IgE	$14.25	$19.00	—	124% above	25%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN PUMPKIN IgE	$16.50	$22.00	—	159% above	25%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN BEEF IgE	$18.75	$25.00	—	194% above	25%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN MOLD ALTERNARIA IGE	$18.75	$25.00	—	194% above	25%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN SARDINE IgE	$19.50	$26.00	—	206% above	25%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN CUCUMBER IGE	$19.50	$26.00	—	206% above	25%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN SESAME SEED IGE	$19.50	$26.00	—	206% above	25%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN ELM TREE IGE	$21.75	$29.00	—	241% above	25%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN DOG DANDER IGE	$21.75	$29.00	—	241% above	25%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN CAT EPI & DANDER IGE	$21.75	$29.00	—	241% above	25%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN A FUMIGATUS IGE	$21.75	$29.00	—	241% above	25%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN COMMON (SHORT) RAGWEED IGE	$21.75	$29.00	—	241% above	25%
Allergy blood test, specific IgE, per allergen CPT 86003 ALL MAPLE LEAF SYCAMORE LON PLANE IGE	$21.75	$29.00	—	241% above	25%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN BOX ELDER/MAPLE TREE IGE	$21.75	$29.00	—	241% above	25%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN OLIVE TREE IGE	$21.75	$29.00	—	241% above	25%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN PINEAPPLE IGE	$21.75	$29.00	—	241% above	25%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN GMN COCKROACH IGE	$21.75	$29.00	—	241% above	25%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN BERMUDA GRASS IGE	$21.75	$29.00	—	241% above	25%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN CHICKEN IGE	$21.75	$29.00	—	241% above	25%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN WHITE OAK IGE	$21.75	$29.00	—	241% above	25%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN MOLD A. TENUIS IGE	$21.75	$29.00	—	241% above	25%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN D PTERONYSSINUS IGE	$21.75	$29.00	—	241% above	25%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN D FARINAE IGE	$21.75	$29.00	—	241% above	25%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN RYE IGE	$21.75	$29.00	—	241% above	25%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN WHEY IGE	$21.75	$29.00	—	241% above	25%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN COW HAIR & DANDER IGE	$21.75	$29.00	—	241% above	25%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN POTATO IgE	$21.75	$29.00	—	241% above	25%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN PORK MEAT IgE	$21.75	$29.00	—	241% above	25%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN EGG YOLK IgE	$21.75	$29.00	—	241% above	25%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN BANANA IgE	$21.75	$29.00	—	241% above	25%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN APPLE IgE	$21.75	$29.00	—	241% above	25%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN C HER/HOR IGE (MISC)	$21.75	$29.00	—	241% above	25%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN FEATHER MIX IGE	$21.75	$29.00	—	241% above	25%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN TOMATO IgE	$21.75	$29.00	—	241% above	25%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN SOYBEAN IgE	$21.75	$29.00	—	241% above	25%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN MILK IgE	$21.75	$29.00	—	241% above	25%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN EGG WHITE IgE	$21.75	$29.00	—	241% above	25%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN CORN MAIZE IgE	$21.75	$29.00	—	241% above	25%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN HORSE HAIR & DANDER IGE	$21.75	$29.00	—	241% above	25%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN PENICILLIUM NOTATUM IGE	$21.75	$29.00	—	241% above	25%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN PEANUT IgE	$21.75	$29.00	—	241% above	25%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN WESTERN RAGWEED IGE	$21.75	$29.00	—	241% above	25%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN SAGEBRUSH/WORMWOOD IGE	$21.75	$29.00	—	241% above	25%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN RUSSIAN THISTLE IGE	$21.75	$29.00	—	241% above	25%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN OAK TREE IgE	$21.75	$29.00	—	241% above	25%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN PIGWEED IGE	$21.75	$29.00	—	241% above	25%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN FALSE RAGWEED IGE	$21.75	$29.00	—	241% above	25%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN HOUSE DUST GREER IGE	$21.75	$29.00	—	241% above	25%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN TIMOTHY GRASS IGE	$21.75	$29.00	—	241% above	25%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN JUNE GRASS IGE	$21.75	$29.00	—	241% above	25%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN STRAWBERRY IGE	$21.75	$29.00	—	241% above	25%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN CARROT IGE	$21.75	$29.00	—	241% above	25%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN ROUGH MARSHELDER IGE	$21.75	$29.00	—	241% above	25%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN GLUTEN IGE	$21.75	$29.00	—	241% above	25%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN REDTOP BENTGRASS IGE	$21.75	$29.00	—	241% above	25%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN ORANGE IGE	$21.75	$29.00	—	241% above	25%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN WALNUT IgE	$21.75	$29.00	—	241% above	25%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN WHITE ASH TREE IGE	$21.75	$29.00	—	241% above	25%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN AURE PULLOLANS	$21.75	$29.00	—	241% above	25%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN C ALBICANS IGE	$21.75	$29.00	—	241% above	25%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN EPI PURPURASCENS IGE	$21.75	$29.00	—	241% above	25%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN JOHNSON GRASS IGE	$21.75	$29.00	—	241% above	25%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN PLANTAIN (ENGLISH) IGE	$21.75	$29.00	—	241% above	25%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN RHIZOPUS NIGRICANS IGE	$21.75	$29.00	—	241% above	25%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN MUCOR RACEMOSOS IGE	$21.75	$29.00	—	241% above	25%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN HELMINTHOSPORIUM IGE	$21.75	$29.00	—	241% above	25%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN AM COCKROACH IgE	$21.75	$29.00	—	241% above	25%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN LAMBS QUARTER IGE	$21.75	$29.00	—	241% above	25%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN MAPLE LEAF IGE	$21.75	$29.00	—	241% above	25%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN COTTONWOOD TREE IGE	$21.75	$29.00	—	241% above	25%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN ORCHARD GRASS IGE	$21.75	$29.00	—	241% above	25%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN SILVER BIRCH IGE	$21.75	$29.00	—	241% above	25%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN TUNA IGE	$21.75	$29.00	—	241% above	25%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN CRAB IGE	$21.75	$29.00	—	241% above	25%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN LOBSTER IGE	$21.75	$29.00	—	241% above	25%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN COD IGE	$21.75	$29.00	—	241% above	25%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN SHRIMP IGE	$21.75	$29.00	—	241% above	25%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN PERCH IGE	$21.75	$29.00	—	241% above	25%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN BLACK WALNUT FOOD IgE	$24.75	$33.00	—	289% above	25%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN RED MAPLE IgE	$37.50	$50.00	—	489% above	25%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN ALPHA-LACTALBUMIN IGE	$43.50	$58.00	—	583% above	25%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN CASEIN IGE	$43.50	$58.00	—	583% above	25%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN A. TENUIS (IgE)	$43.50	$58.00	—	583% above	25%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN BETA-LACTOGLOBULIN IGE	$43.50	$58.00	—	583% above	25%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN OAT IGE	$45.00	$60.00	—	606% above	25%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN CHOCOLATE IGE	$50.25	$67.00	—	689% above	25%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN RICE IGE	$50.25	$67.00	—	689% above	25%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN SALMON IGE	$50.25	$67.00	—	689% above	25%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN COFFEE IGE	$50.25	$67.00	—	689% above	25%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN BEEF IGE	$50.25	$67.00	—	689% above	25%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN BAKER'S YEAST IGE	$50.25	$67.00	—	689% above	25%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN YELLOW FACED HORNET VENOM IgE	$55.50	$74.00	—	771% above	25%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN ZUCCHINI IGE	$69.00	$92.00	—	983% above	25%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN PEANUT COMPONENTS IGE	$426.00	$568.00	—	6588% above	25%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGENS PANEL FOOD COMP IgE (63)	$474.75	$633.00	—	7353% above	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN CLADOSPORIUM HERBARUM IgE	$6.00	$8.00	—	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN ALTERNARIA ALTERNATA IgE	$6.00	$8.00	—	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN WASP VENOM IgE	$11.25	$15.00	—	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN WHITE FACED HORNET VENOM IgE	$11.25	$15.00	—	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN YELLOW JACKET VENOM IgE	$11.25	$15.00	—	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN HONEYBEE VENOM IgE	$11.25	$15.00	—	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN COCKLEBUR IGE	$12.00	$16.00	—	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN SHEEP SORREL IGE	$12.00	$16.00	—	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN HOUSE DUST H-S IGE	$12.00	$16.00	—	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN MEADOW FESCUE IgE	$12.00	$16.00	—	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN GIANT RAGWEED IGE	$12.00	$16.00	—	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN GOLDENROD IGE	$12.00	$16.00	—	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN PECAN TREE IGE	$12.00	$16.00	—	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN WILLOW IGE	$12.00	$16.00	—	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN BEECH IGE	$12.00	$16.00	—	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN KIWI FRUIT IGE	$12.75	$17.00	—	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN AVOCADO IGE	$12.75	$17.00	—	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN SYCAMORE IgE	$12.75	$17.00	—	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN LAMB IgE	$12.75	$17.00	—	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN CRANBERRY IGE	$12.75	$17.00	—	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN BUCKWHEAT IGE	$12.75	$17.00	—	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN MACADAMIA NUT IGE	$13.50	$18.00	—	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN HAZELNUT FOOD IGE	$13.50	$18.00	—	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN COCONUT IGE	$13.50	$18.00	—	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN CASHEW IGE	$13.50	$18.00	—	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN ALMOND IGE	$13.50	$18.00	—	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN BRAZIL NUT IGE	$13.50	$18.00	—	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN OYSTER IgE	$13.50	$18.00	—	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN SWEET CHESTNUT IGE	$13.50	$18.00	—	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN PISTACHIO IGE	$13.50	$18.00	—	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN PINE NUT IGE	$13.50	$18.00	—	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN PECAN FOOD IGE	$13.50	$18.00	—	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN WHEAT IgE	$14.25	$19.00	—	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN CLAM IgE	$14.25	$19.00	—	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN SCALLOP IgE	$14.25	$19.00	—	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN PUMPKIN IgE	$16.50	$22.00	—	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN MOLD ALTERNARIA IGE	$18.75	$25.00	—	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN BEEF IgE	$18.75	$25.00	—	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN CUCUMBER IGE	$19.50	$26.00	—	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN SESAME SEED IGE	$19.50	$26.00	—	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN SARDINE IgE	$19.50	$26.00	—	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN SILVER BIRCH IGE	$21.75	$29.00	—	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN STRAWBERRY IGE	$21.75	$29.00	—	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN ROUGH MARSHELDER IGE	$21.75	$29.00	—	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN REDTOP BENTGRASS IGE	$21.75	$29.00	—	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN ORCHARD GRASS IGE	$21.75	$29.00	—	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN WHITE OAK IGE	$21.75	$29.00	—	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN MOLD A. TENUIS IGE	$21.75	$29.00	—	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN D PTERONYSSINUS IGE	$21.75	$29.00	—	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN D FARINAE IGE	$21.75	$29.00	—	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN C HER/HOR IGE (MISC)	$21.75	$29.00	—	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN GMN COCKROACH IGE	$21.75	$29.00	—	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN ELM TREE IGE	$21.75	$29.00	—	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN DOG DANDER IGE	$21.75	$29.00	—	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN PEANUT IgE	$21.75	$29.00	—	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN CORN MAIZE IgE	$21.75	$29.00	—	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN EGG WHITE IgE	$21.75	$29.00	—	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN MILK IgE	$21.75	$29.00	—	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN SOYBEAN IgE	$21.75	$29.00	—	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN TOMATO IgE	$21.75	$29.00	—	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN APPLE IgE	$21.75	$29.00	—	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN BANANA IgE	$21.75	$29.00	—	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN EGG YOLK IgE	$21.75	$29.00	—	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN PORK MEAT IgE	$21.75	$29.00	—	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN POTATO IgE	$21.75	$29.00	—	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN CHICKEN IGE	$21.75	$29.00	—	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN PERCH IGE	$21.75	$29.00	—	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN SHRIMP IGE	$21.75	$29.00	—	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN COD IGE	$21.75	$29.00	—	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN LOBSTER IGE	$21.75	$29.00	—	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN CRAB IGE	$21.75	$29.00	—	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN TUNA IGE	$21.75	$29.00	—	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN COTTONWOOD TREE IGE	$21.75	$29.00	—	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN MAPLE LEAF IGE	$21.75	$29.00	—	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN LAMBS QUARTER IGE	$21.75	$29.00	—	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN AM COCKROACH IgE	$21.75	$29.00	—	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN HELMINTHOSPORIUM IGE	$21.75	$29.00	—	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN MUCOR RACEMOSOS IGE	$21.75	$29.00	—	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN RHIZOPUS NIGRICANS IGE	$21.75	$29.00	—	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN PLANTAIN (ENGLISH) IGE	$21.75	$29.00	—	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN JOHNSON GRASS IGE	$21.75	$29.00	—	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN EPI PURPURASCENS IGE	$21.75	$29.00	—	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN C ALBICANS IGE	$21.75	$29.00	—	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN AURE PULLOLANS	$21.75	$29.00	—	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN WHITE ASH TREE IGE	$21.75	$29.00	—	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN WALNUT IgE	$21.75	$29.00	—	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN OAK TREE IgE	$21.75	$29.00	—	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN CARROT IGE	$21.75	$29.00	—	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN GLUTEN IGE	$21.75	$29.00	—	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN ORANGE IGE	$21.75	$29.00	—	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN PINEAPPLE IGE	$21.75	$29.00	—	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN RYE IGE	$21.75	$29.00	—	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN WHEY IGE	$21.75	$29.00	—	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN COW HAIR & DANDER IGE	$21.75	$29.00	—	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN FEATHER MIX IGE	$21.75	$29.00	—	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN HORSE HAIR & DANDER IGE	$21.75	$29.00	—	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN PENICILLIUM NOTATUM IGE	$21.75	$29.00	—	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN BERMUDA GRASS IGE	$21.75	$29.00	—	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN JUNE GRASS IGE	$21.75	$29.00	—	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN TIMOTHY GRASS IGE	$21.75	$29.00	—	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN HOUSE DUST GREER IGE	$21.75	$29.00	—	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN FALSE RAGWEED IGE	$21.75	$29.00	—	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN PIGWEED IGE	$21.75	$29.00	—	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN RUSSIAN THISTLE IGE	$21.75	$29.00	—	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN SAGEBRUSH/WORMWOOD IGE	$21.75	$29.00	—	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN WESTERN RAGWEED IGE	$21.75	$29.00	—	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN OLIVE TREE IGE	$21.75	$29.00	—	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALL MAPLE LEAF SYCAMORE LON PLANE IGE	$21.75	$29.00	—	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN A FUMIGATUS IGE	$21.75	$29.00	—	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN BOX ELDER/MAPLE TREE IGE	$21.75	$29.00	—	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN CAT EPI & DANDER IGE	$21.75	$29.00	—	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN COMMON (SHORT) RAGWEED IGE	$21.75	$29.00	—	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN BLACK WALNUT FOOD IgE	$24.75	$33.00	—	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN RED MAPLE IgE	$37.50	$50.00	—	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN A. TENUIS (IgE)	$43.50	$58.00	—	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN CASEIN IGE	$43.50	$58.00	—	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN BETA-LACTOGLOBULIN IGE	$43.50	$58.00	—	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN ALPHA-LACTALBUMIN IGE	$43.50	$58.00	—	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN OAT IGE	$45.00	$60.00	—	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN CHOCOLATE IGE	$50.25	$67.00	—	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN COFFEE IGE	$50.25	$67.00	—	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN SALMON IGE	$50.25	$67.00	—	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN BEEF IGE	$50.25	$67.00	—	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN BAKER'S YEAST IGE	$50.25	$67.00	—	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN RICE IGE	$50.25	$67.00	—	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN YELLOW FACED HORNET VENOM IgE	$55.50	$74.00	—	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN ZUCCHINI IGE	$69.00	$92.00	—	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN PEANUT COMPONENTS IGE	$426.00	$568.00	—	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGENS PANEL FOOD COMP IgE (63)	$474.75	$633.00	—	—	25%
Ammonia blood test CPT 82140 AMMONIA	$108.75	$145.00	—	67% above	25%
Ammonia blood test inpatient CPT 82140 AMMONIA	$108.75	$145.00	—	—	25%
Amylase blood test CPT 82150 AMYLASE SERUM	$55.50	$74.00	—	158% above	25%
Amylase blood test CPT 82150 AMYLASE URINE	$55.50	$74.00	—	158% above	25%
Amylase blood test inpatient CPT 82150 AMYLASE SERUM	$55.50	$74.00	—	—	25%
Amylase blood test inpatient CPT 82150 AMYLASE URINE	$55.50	$74.00	—	—	25%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CYCLIC CITRULLINATED PEPTIDE IGG	$127.50	$170.00	—	129% above	25%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 CYCLIC CITRULLINATED PEPTIDE IGG	$127.50	$170.00	—	—	25%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA SCREEN	$70.50	$94.00	—	26% above	25%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANTI-CENTROMERE AB	$78.75	$105.00	—	41% above	25%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA SCREEN W/REFLEX TO TITER	$90.75	$121.00	—	62% above	25%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA SCREEN	$70.50	$94.00	—	—	25%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANTI-CENTROMERE AB	$78.75	$105.00	—	—	25%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA SCREEN W/REFLEX TO TITER	$90.75	$121.00	—	—	25%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 NT-proBNP	$89.25	$119.00	—	14% above	25%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 BNP,QUANT	$166.50	$222.00	—	112% above	25%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 BNP(SEND OUT)	$303.00	$404.00	—	286% above	25%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 NT-proBNP	$89.25	$119.00	—	—	25%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 BNP,QUANT	$166.50	$222.00	—	—	25%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 BNP(SEND OUT)	$303.00	$404.00	—	—	25%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE CATHETER TIP	$55.50	$74.00	—	5% above	25%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE GENITAL	$68.25	$91.00	—	29% above	25%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE EYE	$68.25	$91.00	—	29% above	25%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE THROAT	$68.25	$91.00	—	29% above	25%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE AEROBIC	$68.25	$91.00	—	29% above	25%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE NOSE	$68.25	$91.00	—	29% above	25%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE SPUTUM (RESPIRATORY)	$68.25	$91.00	—	29% above	25%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE CSF	$80.25	$107.00	—	51% above	25%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE CATHETER TIP	$55.50	$74.00	—	—	25%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE EYE	$68.25	$91.00	—	—	25%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE SPUTUM (RESPIRATORY)	$68.25	$91.00	—	—	25%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE AEROBIC	$68.25	$91.00	—	—	25%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE NOSE	$68.25	$91.00	—	—	25%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE THROAT	$68.25	$91.00	—	—	25%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE GENITAL	$68.25	$91.00	—	—	25%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE CSF	$80.25	$107.00	—	—	25%
Basic metabolic panel (blood test) CPT 80048 BASIC METABOLIC PANEL	$92.25	$123.00	—	71% above	25%
Basic metabolic panel (blood test) inpatient CPT 80048 BASIC METABOLIC PANEL	$92.25	$123.00	—	—	25%
Bilirubin blood test, total CPT 82247 BILIRUBIN TOTAL	$45.00	$60.00	—	98% above	25%
Bilirubin blood test, total inpatient CPT 82247 BILIRUBIN TOTAL	$45.00	$60.00	—	—	25%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 SURG PATH LEVEL IV G & M	$184.50	$246.00	—	69% above	25%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 SURG PATH LEVEL IV G & M	$184.50	$246.00	—	—	25%
Blood culture for bacteria CPT 87040 CULTURE BLOOD	$80.25	$107.00	—	27% above	25%
Blood culture for bacteria inpatient CPT 87040 CULTURE BLOOD	$80.25	$107.00	—	—	25%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 .BLOOD DRAWING FEE	$4.50	$6.00	—	65% below	25%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 .KIT COLLECT/PROCESS	$44.25	$59.00	—	244% above	25%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 .BLOOD DRAWING FEE	$4.50	$6.00	—	—	25%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 .KIT COLLECT/PROCESS	$44.25	$59.00	—	—	25%
Blood glucose (sugar) test CPT 82947 GLUCOSE	$36.00	$48.00	—	50% above	25%
Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE	$36.00	$48.00	—	—	25%
Blood lead test CPT 83655 LEAD BLOOD	$19.50	$26.00	—	155% above	25%
Blood lead test CPT 83655 LEAD URINE	$48.00	$64.00	—	527% above	25%
Blood lead test inpatient CPT 83655 LEAD BLOOD	$19.50	$26.00	—	—	25%
Blood lead test inpatient CPT 83655 LEAD URINE	$48.00	$64.00	—	—	25%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 .BB ABO TYPING	$36.75	$49.00	—	76% above	25%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 BB ABO TYPE (SO)	$42.00	$56.00	—	101% above	25%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 .BB ABO TYPING	$36.75	$49.00	—	—	25%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 BB ABO TYPE (SO)	$42.00	$56.00	—	—	25%
Blood urea nitrogen (BUN) test CPT 84520 BUN	$38.25	$51.00	—	113% above	25%
Blood urea nitrogen (BUN) test inpatient CPT 84520 BUN	$38.25	$51.00	—	—	25%
C-peptide blood test CPT 84681 C-PEPTIDE	$155.25	$207.00	—	120% above	25%
C-peptide blood test inpatient CPT 84681 C-PEPTIDE	$155.25	$207.00	—	—	25%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 CRP (NC)	$50.25	$67.00	—	48% above	25%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 CRP (NC)	$50.25	$67.00	—	—	25%
C. difficile toxin gene test (stool PCR) CPT 87493 C DIFF STOOL TOXIN (PCR)	$87.75	$117.00	—	24% below	25%
C. difficile toxin gene test (stool PCR) CPT 87493 C. DIFFICILE TOXIN BY PCR	$94.50	$126.00	—	19% below	25%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 C DIFF STOOL TOXIN (PCR)	$87.75	$117.00	—	—	25%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 C. DIFFICILE TOXIN BY PCR	$94.50	$126.00	—	—	25%
CA 19-9 blood test (tumor marker) CPT 86301 CA 19-9	$226.50	$302.00	—	142% above	25%
CA 19-9 blood test (tumor marker) inpatient CPT 86301 CA 19-9	$226.50	$302.00	—	—	25%
CA-125 blood test (ovarian cancer marker) CPT 86304 CA 125	$155.25	$207.00	—	54% above	25%
CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 CA 125	$155.25	$207.00	—	—	25%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 SARS-COV-2 QUAL (COVID-19)	$116.25	$155.00	—	8% above	25%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 SARS-COV-2 PCR (COVID-19)	$131.25	$175.00	—	21% above	25%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 SARS-COV-2 QUAL (COVID-19)	$116.25	$155.00	—	—	25%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 SARS-COV-2 PCR (COVID-19)	$131.25	$175.00	—	—	25%
Calcium blood test, total CPT 82310 CALCIUM	$41.25	$55.00	—	103% above	25%
Calcium blood test, total inpatient CPT 82310 CALCIUM	$41.25	$55.00	—	—	25%
Carcinoembryonic antigen (CEA) test CPT 82378 CEA	$141.75	$189.00	—	71% above	25%
Carcinoembryonic antigen (CEA) test inpatient CPT 82378 CEA	$141.75	$189.00	—	—	25%
Chickenpox (varicella) immunity blood test CPT 86787 VARICELLA ZOSTER AB IGG	$137.25	$183.00	—	241% above	25%
Chickenpox (varicella) immunity blood test CPT 86787 VARICELLA ZOSTER AB IGM	$137.25	$183.00	—	241% above	25%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 VARICELLA ZOSTER AB IGG	$137.25	$183.00	—	—	25%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 VARICELLA ZOSTER AB IGM	$137.25	$183.00	—	—	25%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 C TRACHOMATIS (URINE)	$60.00	$80.00	—	19% below	25%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA TRACHOMATIS PCR	$72.75	$97.00	—	2% below	25%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA DNA	$92.25	$123.00	—	25% above	25%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 C TRACHOMATIS (URINE)	$60.00	$80.00	—	—	25%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMYDIA TRACHOMATIS PCR	$72.75	$97.00	—	—	25%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMYDIA DNA	$92.25	$123.00	—	—	25%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PANEL	$127.50	$170.00	—	150% above	25%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PANEL	$127.50	$170.00	—	—	25%
Complete blood count (CBC) with differential CPT 85025 .CBC W/ AUTO DIFF	$63.00	$84.00	—	54% above	25%
Complete blood count (CBC) with differential CPT 85025 CBC W/ AUTO DIFFERENTIAL	$63.00	$84.00	—	54% above	25%
Complete blood count (CBC) with differential inpatient CPT 85025 CBC W/ AUTO DIFFERENTIAL	$63.00	$84.00	—	—	25%
Complete blood count (CBC) with differential inpatient CPT 85025 .CBC W/ AUTO DIFF	$63.00	$84.00	—	—	25%
Complete blood count (CBC), no differential CPT 85027 .CBC	$57.00	$76.00	—	97% above	25%
Complete blood count (CBC), no differential inpatient CPT 85027 .CBC	$57.00	$76.00	—	—	25%
Comprehensive metabolic panel (blood test) CPT 80053 COMPREHENSIVE METABOLIC PANEL	$162.00	$216.00	—	116% above	25%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 COMPREHENSIVE METABOLIC PANEL	$162.00	$216.00	—	—	25%
Cortisol blood test, total CPT 82533 CORTISOL RANDOM	$44.25	$59.00	—	30% above	25%
Cortisol blood test, total CPT 82533 CORTISOL AM	$44.25	$59.00	—	30% above	25%
Cortisol blood test, total CPT 82533 CORTISOL SALIVA	$69.75	$93.00	—	105% above	25%
Cortisol blood test, total CPT 82533 CORTISOL PM	$107.25	$143.00	—	215% above	25%
Cortisol blood test, total inpatient CPT 82533 CORTISOL AM	$44.25	$59.00	—	—	25%
Cortisol blood test, total inpatient CPT 82533 CORTISOL RANDOM	$44.25	$59.00	—	—	25%
Cortisol blood test, total inpatient CPT 82533 CORTISOL SALIVA	$69.75	$93.00	—	—	25%
Cortisol blood test, total inpatient CPT 82533 CORTISOL PM	$107.25	$143.00	—	—	25%
Creatine kinase (CK) blood test, total CPT 82550 CPK TOTAL	$60.00	$80.00	—	100% above	25%
Creatine kinase (CK) blood test, total inpatient CPT 82550 CPK TOTAL	$60.00	$80.00	—	—	25%
Creatinine blood test CPT 82565 CREATININE SERUM	$42.00	$56.00	—	73% above	25%
Creatinine blood test inpatient CPT 82565 CREATININE SERUM	$42.00	$56.00	—	—	25%
Cytomegalovirus (CMV) antibody test CPT 86644 CMV AB, IGG	$137.25	$183.00	—	215% above	25%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 CMV AB, IGG	$137.25	$183.00	—	—	25%
D-dimer blood test (blood clot marker) CPT 85379 D-DIMER,QUANT	$66.00	$88.00	—	53% above	25%
D-dimer blood test (blood clot marker) CPT 85379 D DIMER QUANTATIVE (SO)	$137.25	$183.00	—	219% above	25%
D-dimer blood test (blood clot marker) inpatient CPT 85379 D-DIMER,QUANT	$66.00	$88.00	—	—	25%
D-dimer blood test (blood clot marker) inpatient CPT 85379 D DIMER QUANTATIVE (SO)	$137.25	$183.00	—	—	25%
Drug screen by lab instrument (any number of drug classes) CPT 80307 ALCOHOL ETHYL URINE	$72.00	$96.00	—	24% above	25%
Drug screen by lab instrument (any number of drug classes) CPT 80307 FENTANYL SCREEN URINE	$76.50	$102.00	—	31% above	25%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG SCREEN URINE	$92.25	$123.00	—	58% above	25%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG CONFIRMATION EACH PROC	$99.00	$132.00	—	70% above	25%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG SCREEN COMPREHENSIVE (SERUM)	$141.00	$188.00	—	142% above	25%
Drug screen by lab instrument (any number of drug classes) CPT 80307 BUPRENORPHINE SCREEN W/REFLEX URINE	$191.25	$255.00	—	228% above	25%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 ALCOHOL ETHYL URINE	$72.00	$96.00	—	—	25%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 FENTANYL SCREEN URINE	$76.50	$102.00	—	—	25%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG SCREEN URINE	$92.25	$123.00	—	—	25%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG CONFIRMATION EACH PROC	$99.00	$132.00	—	—	25%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG SCREEN COMPREHENSIVE (SERUM)	$141.00	$188.00	—	—	25%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 BUPRENORPHINE SCREEN W/REFLEX URINE	$191.25	$255.00	—	—	25%
Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 ELECTROLYTES	$87.75	$117.00	—	174% above	25%
Electrolyte panel (sodium, potassium, chloride, CO2) inpatient CPT 80051 ELECTROLYTES	$87.75	$117.00	—	—	25%
Epstein-Barr virus (EBV) antibody test CPT 86665 EPSTEIN BARR VIRAL CAPSID IgG	$22.50	$30.00	—	65% below	25%
Epstein-Barr virus (EBV) antibody test CPT 86665 EPSTEIN BARR VIRAL CAPSID IGM	$26.25	$35.00	—	59% below	25%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 EPSTEIN BARR VIRAL CAPSID IgG	$22.50	$30.00	—	—	25%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 EPSTEIN BARR VIRAL CAPSID IGM	$26.25	$35.00	—	—	25%
Estradiol blood test CPT 82670 ESTRADIOL	$247.50	$330.00	—	216% above	25%
Estradiol blood test inpatient CPT 82670 ESTRADIOL	$247.50	$330.00	—	—	25%
FSH (follicle-stimulating hormone) test CPT 83001 FSH	$142.50	$190.00	—	79% above	25%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 FSH	$142.50	$190.00	—	—	25%
Fecal calprotectin (stool inflammation test) CPT 83993 CALPROTECTIN	$188.25	$251.00	—	197% above	25%
Fecal calprotectin (stool inflammation test) inpatient CPT 83993 CALPROTECTIN	$188.25	$251.00	—	—	25%
Ferritin blood test (iron stores) CPT 82728 FERRITIN	$92.25	$123.00	—	54% above	25%
Ferritin blood test (iron stores) inpatient CPT 82728 FERRITIN	$92.25	$123.00	—	—	25%
Fibrinogen blood test CPT 85384 FIBRINOGEN	$63.00	$84.00	—	117% above	25%
Fibrinogen blood test inpatient CPT 85384 FIBRINOGEN	$63.00	$84.00	—	—	25%
Folate (folic acid) blood test CPT 82746 FOLATE SERUM	$69.00	$92.00	—	12% below	25%
Folate (folic acid) blood test inpatient CPT 82746 FOLATE SERUM	$69.00	$92.00	—	—	25%
Free T3 thyroid hormone test CPT 84481 T3 FREE	$147.75	$197.00	—	121% above	25%
Free T3 thyroid hormone test inpatient CPT 84481 T3 FREE	$147.75	$197.00	—	—	25%
Free T4 (free thyroxine) thyroid blood test CPT 84439 THYROXINE FREE T4 (SO)	$90.00	$120.00	—	190% above	25%
Free T4 (free thyroxine) thyroid blood test CPT 84439 T4 FREE	$91.50	$122.00	—	195% above	25%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 THYROXINE FREE T4 (SO)	$90.00	$120.00	—	—	25%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 T4 FREE	$91.50	$122.00	—	—	25%
Free testosterone test CPT 84402 TESTOSTERONE FREE	$190.50	$254.00	—	419% above	25%
Free testosterone test inpatient CPT 84402 TESTOSTERONE FREE	$190.50	$254.00	—	—	25%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 GGTP	$55.50	$74.00	—	81% above	25%
Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 GGTP	$55.50	$74.00	—	—	25%
General health panel: metabolic panel, blood count and TSH in one order CPT 80050 GHP (GENERAL HEALTH PANEL)	$347.25	$463.00	—	93% above	25%
General health panel: metabolic panel, blood count and TSH in one order inpatient CPT 80050 GHP (GENERAL HEALTH PANEL)	$347.25	$463.00	—	—	25%
Glucose tolerance test, 3 samples CPT 82951 GLUCOSE TOLERANCE 1H	$98.25	$131.00	—	71% above	25%
Glucose tolerance test, 3 samples CPT 82951 GLUCOSE TOLERANCE 2H	$99.00	$132.00	—	73% above	25%
Glucose tolerance test, 3 samples CPT 82951 GLUCOSE TOLERANCE 3H	$112.50	$150.00	—	96% above	25%
Glucose tolerance test, 3 samples CPT 82951 GLUCOSE TOLERANCE 5H	$138.00	$184.00	—	141% above	25%
Glucose tolerance test, 3 samples inpatient CPT 82951 GLUCOSE TOLERANCE 1H	$98.25	$131.00	—	—	25%
Glucose tolerance test, 3 samples inpatient CPT 82951 GLUCOSE TOLERANCE 2H	$99.00	$132.00	—	—	25%
Glucose tolerance test, 3 samples inpatient CPT 82951 GLUCOSE TOLERANCE 3H	$112.50	$150.00	—	—	25%
Glucose tolerance test, 3 samples inpatient CPT 82951 GLUCOSE TOLERANCE 5H	$138.00	$184.00	—	—	25%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 GONORRHOEAE (GC) PCR	$60.00	$80.00	—	37% below	25%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 N GONORRHOEAE DNA	$92.25	$123.00	—	3% below	25%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 GONORRHOEAE (GC) PCR	$60.00	$80.00	—	—	25%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 N GONORRHOEAE DNA	$92.25	$123.00	—	—	25%
H. pylori antibody blood test CPT 86677 HELICOBACTER PYLORI AB IgG	$188.25	$251.00	—	218% above	25%
H. pylori antibody blood test inpatient CPT 86677 HELICOBACTER PYLORI AB IgG	$188.25	$251.00	—	—	25%
H. pylori stool antigen test CPT 87338 HELICOBACTER PYLORI AG, STOOL	$341.25	$455.00	—	439% above	25%
H. pylori stool antigen test inpatient CPT 87338 HELICOBACTER PYLORI AG, STOOL	$341.25	$455.00	—	—	25%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV 1 RNA QUANT ULTRA (RT-PCR)	$174.00	$232.00	—	5% below	25%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HIV 1 RNA QUANT ULTRA (RT-PCR)	$174.00	$232.00	—	—	25%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV 1/HIV 2 CONFIRMATION TEST LAB ONLY	$28.50	$38.00	—	42% below	25%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HIV 1/HIV 2 CONFIRMATION TEST LAB ONLY	$28.50	$38.00	—	—	25%
HPV test for high-risk types, one combined (pooled) result CPT 87624 HPV W / GENOTYPE	$280.50	$374.00	—	279% above	25%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HPV W / GENOTYPE	$280.50	$374.00	—	—	25%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HEMOGLOBIN A1C	$56.25	$75.00	—	39% above	25%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HEMOGLOBIN A1C	$56.25	$75.00	—	—	25%
Hemoglobin blood test CPT 85018 HEMOGLOBIN	$27.75	$37.00	—	73% above	25%
Hemoglobin blood test inpatient CPT 85018 HEMOGLOBIN	$27.75	$37.00	—	—	25%
Hepatitis B core antibody test (total) CPT 86704 HEPATITIS B CORE AB TOTAL, IgM & IgG	$175.50	$234.00	—	297% above	25%
Hepatitis B core antibody test (total) inpatient CPT 86704 HEPATITIS B CORE AB TOTAL, IgM & IgG	$175.50	$234.00	—	—	25%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEPATITIS B SURF AB QUAL/QUANT	$80.25	$107.00	—	91% above	25%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HEPATITIS B SURF AB QUAL/QUANT	$80.25	$107.00	—	—	25%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HEPATITIS B SURF AG W/CONFIRMATION	$77.25	$103.00	—	67% above	25%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HEPATITIS B SURF AG W/CONFIRMATION	$77.25	$103.00	—	—	25%
Hepatitis C antibody blood test (screening) CPT 86803 HEPATITIS C AB	$167.25	$223.00	—	248% above	25%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 HEPATITIS C AB	$167.25	$223.00	—	—	25%
Hepatitis C viral load (HCV RNA) test CPT 87522 HCV RNA QUANT W/ REFLEX TO GENOTYPE	$95.25	$127.00	—	28% below	25%
Hepatitis C viral load (HCV RNA) test CPT 87522 HCV RNA QUANT PCR	$95.25	$127.00	—	28% below	25%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HCV RNA QUANT W/ REFLEX TO GENOTYPE	$95.25	$127.00	—	—	25%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HCV RNA QUANT PCR	$95.25	$127.00	—	—	25%
Herpes blood test, HSV-1 antibody CPT 86695 HERPES SIMPLEX I	$15.75	$21.00	—	62% below	25%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 HERPES SIMPLEX I	$15.75	$21.00	—	—	25%
Herpes blood test, HSV-2 antibody CPT 86696 HERPES SIMPLEX II	$22.50	$30.00	—	56% below	25%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HERPES SIMPLEX II	$22.50	$30.00	—	—	25%
High-sensitivity CRP (hs-CRP) test CPT 86141 CRP (CARDIO) HS	$99.00	$132.00	—	72% above	25%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 CRP (CARDIO) HS	$99.00	$132.00	—	—	25%
Homocysteine blood test CPT 83090 HOMOCYSTEINE(CARDIO)	$126.75	$169.00	—	65% above	25%
Homocysteine blood test CPT 83090 HOMOCYSTEINE	$198.00	$264.00	—	158% above	25%
Homocysteine blood test inpatient CPT 83090 HOMOCYSTEINE(CARDIO)	$126.75	$169.00	—	—	25%
Homocysteine blood test inpatient CPT 83090 HOMOCYSTEINE	$198.00	$264.00	—	—	25%
Insulin blood test CPT 83525 INSULIN SERUM	$63.75	$85.00	—	74% above	25%
Insulin blood test inpatient CPT 83525 INSULIN SERUM	$63.75	$85.00	—	—	25%
Iron blood test (serum iron) CPT 83540 IRON	$55.50	$74.00	—	90% above	25%
Iron blood test (serum iron) inpatient CPT 83540 IRON	$55.50	$74.00	—	—	25%
Iron-binding capacity (TIBC) test CPT 83550 TIBC	$41.25	$55.00	—	4% above	25%
Iron-binding capacity (TIBC) test inpatient CPT 83550 TIBC	$41.25	$55.00	—	—	25%
Kidney function blood test panel CPT 80069 RENAL PROFILE	$143.25	$191.00	—	132% above	25%
Kidney function blood test panel inpatient CPT 80069 RENAL PROFILE	$143.25	$191.00	—	—	25%
LH (luteinizing hormone) test CPT 83002 LUTEINIZING HORMONE(LH)	$142.50	$190.00	—	87% above	25%
LH (luteinizing hormone) test inpatient CPT 83002 LUTEINIZING HORMONE(LH)	$142.50	$190.00	—	—	25%
Lactate (lactic acid) blood test CPT 83605 LACTIC ACID	$45.75	$61.00	—	2% above	25%
Lactate (lactic acid) blood test CPT 83605 LACTIC ACID (SO)	$99.00	$132.00	—	120% above	25%
Lactate (lactic acid) blood test inpatient CPT 83605 LACTIC ACID	$45.75	$61.00	—	—	25%
Lactate (lactic acid) blood test inpatient CPT 83605 LACTIC ACID (SO)	$99.00	$132.00	—	—	25%
Lactate dehydrogenase (LDH) blood test CPT 83615 LDH	$55.50	$74.00	—	131% above	25%
Lactate dehydrogenase (LDH) blood test CPT 83615 LDH FLUID	$55.50	$74.00	—	131% above	25%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 LDH	$55.50	$74.00	—	—	25%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 LDH FLUID	$55.50	$74.00	—	—	25%
Lipase blood test (pancreas enzyme) CPT 83690 LIPASE	$57.00	$76.00	—	84% above	25%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 LIPASE	$57.00	$76.00	—	—	25%
Liver function blood test panel CPT 80076 HEPATIC FUNCTION	$132.75	$177.00	—	183% above	25%
Liver function blood test panel inpatient CPT 80076 HEPATIC FUNCTION	$132.75	$177.00	—	—	25%
Lyme disease antibody test CPT 86618 LYME DISEASE AB TOTAL BY ELISA(MISC)	$54.75	$73.00	—	111% above	25%
Lyme disease antibody test inpatient CPT 86618 LYME DISEASE AB TOTAL BY ELISA(MISC)	$54.75	$73.00	—	—	25%
Magnesium blood test CPT 83735 MAGNESIUM	$49.50	$66.00	—	148% above	25%
Magnesium blood test CPT 83735 MAGNESIUM, RBC	$49.50	$66.00	—	148% above	25%
Magnesium blood test CPT 83735 MAGNESIUM 24 HR URINE	$49.50	$66.00	—	148% above	25%
Magnesium blood test inpatient CPT 83735 MAGNESIUM, RBC	$49.50	$66.00	—	—	25%
Magnesium blood test inpatient CPT 83735 MAGNESIUM	$49.50	$66.00	—	—	25%
Magnesium blood test inpatient CPT 83735 MAGNESIUM 24 HR URINE	$49.50	$66.00	—	—	25%
Measles (rubeola) antibody test CPT 86765 MEASLES (RUBEOLA) AB IgG	$49.50	$66.00	—	101% above	25%
Measles (rubeola) antibody test inpatient CPT 86765 MEASLES (RUBEOLA) AB IgG	$49.50	$66.00	—	—	25%
Mono test (heterophile antibody, Monospot) CPT 86308 MONONUCLEOSIS TEST	$40.50	$54.00	—	at median	25%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 MONONUCLEOSIS TEST	$40.50	$54.00	—	—	25%
Mumps immunity blood test CPT 86735 MUMPS VIRUS AB IgG	$63.00	$84.00	—	151% above	25%
Mumps immunity blood test CPT 86735 MUMPS VIRUS AB IgM	$130.50	$174.00	—	420% above	25%
Mumps immunity blood test CPT 86735 MUMPS AB PANEL	$171.00	$228.00	—	581% above	25%
Mumps immunity blood test inpatient CPT 86735 MUMPS VIRUS AB IgG	$63.00	$84.00	—	—	25%
Mumps immunity blood test inpatient CPT 86735 MUMPS VIRUS AB IgM	$130.50	$174.00	—	—	25%
Mumps immunity blood test inpatient CPT 86735 MUMPS AB PANEL	$171.00	$228.00	—	—	25%
PSA (prostate-specific antigen) blood test, free CPT 84154 PSA TOTAL & FREE (SO)	$139.50	$186.00	—	143% above	25%
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 PSA TOTAL & FREE (SO)	$139.50	$186.00	—	—	25%
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA TOTAL DIAGNOSTIC	$99.00	$132.00	—	93% above	25%
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA TOTAL DIAG (SO)	$99.00	$132.00	—	93% above	25%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA TOTAL DIAG (SO)	$99.00	$132.00	—	—	25%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA TOTAL DIAGNOSTIC	$99.00	$132.00	—	—	25%
Parathyroid hormone (PTH) blood test CPT 83970 PTH INTACT	$150.75	$201.00	—	12% above	25%
Parathyroid hormone (PTH) blood test CPT 83970 PTH MID-REGION	$299.25	$399.00	—	122% above	25%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 PTH INTACT	$150.75	$201.00	—	—	25%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 PTH MID-REGION	$299.25	$399.00	—	—	25%
Partial thromboplastin time (PTT) clotting test CPT 85730 ACTIVATED PTT	$55.50	$74.00	—	79% above	25%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 ACTIVATED PTT	$55.50	$74.00	—	—	25%
Phosphorus (phosphate) blood test CPT 84100 PHOSPHORUS	$41.25	$55.00	—	96% above	25%
Phosphorus (phosphate) blood test inpatient CPT 84100 PHOSPHORUS	$41.25	$55.00	—	—	25%
Potassium blood test CPT 84132 POTASSIUM	$41.25	$55.00	—	73% above	25%
Potassium blood test CPT 84132 POTASSIUM, RBC	$103.50	$138.00	—	333% above	25%
Potassium blood test inpatient CPT 84132 POTASSIUM	$41.25	$55.00	—	—	25%
Potassium blood test inpatient CPT 84132 POTASSIUM, RBC	$103.50	$138.00	—	—	25%
Progesterone blood test CPT 84144 PROGESTERONE	$155.25	$207.00	—	144% above	25%
Progesterone blood test inpatient CPT 84144 PROGESTERONE	$155.25	$207.00	—	—	25%
Prolactin blood test CPT 84146 PROLACTIN	$152.25	$203.00	—	107% above	25%
Prolactin blood test inpatient CPT 84146 PROLACTIN	$152.25	$203.00	—	—	25%
Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN/INR	$45.00	$60.00	—	131% above	25%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTHROMBIN/INR	$45.00	$60.00	—	—	25%
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 DRUG SCREEN URINE (CONTRACT)	$52.50	$70.00	—	40% above	25%
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 URINE DRUG SCREEN	$87.75	$117.00	—	133% above	25%
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 DRUG SCREEN SINGLE	$99.00	$132.00	—	163% above	25%
Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 DRUG SCREEN URINE (CONTRACT)	$52.50	$70.00	—	—	25%
Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 URINE DRUG SCREEN	$87.75	$117.00	—	—	25%
Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 DRUG SCREEN SINGLE	$99.00	$132.00	—	—	25%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 STREP SCREEN	$27.00	$36.00	—	50% below	25%
Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 STREP SCREEN	$27.00	$36.00	—	—	25%
Renin blood test CPT 84244 DIRECT RENIN	$130.50	$174.00	—	213% above	25%
Renin blood test inpatient CPT 84244 DIRECT RENIN	$130.50	$174.00	—	—	25%
Rubella antibody test (immunity check) CPT 86762 RUBELLA QUAL/QUANT IgG (LAB12620)	$18.75	$25.00	—	63% below	25%
Rubella antibody test (immunity check) CPT 86762 RUBELLA AB (IMM STATUS)	$98.25	$131.00	—	93% above	25%
Rubella antibody test (immunity check) CPT 86762 RUBELLA TITER	$102.75	$137.00	—	101% above	25%
Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA QUAL/QUANT IgG (LAB12620)	$18.75	$25.00	—	—	25%
Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA AB (IMM STATUS)	$98.25	$131.00	—	—	25%
Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA TITER	$102.75	$137.00	—	—	25%
Sodium blood test CPT 84295 SODIUM SERUM	$41.25	$55.00	—	98% above	25%
Sodium blood test inpatient CPT 84295 SODIUM SERUM	$41.25	$55.00	—	—	25%
Stool test for hidden blood (guaiac FOBT) CPT 82270 OCCULT BLOOD SCREEN	$27.75	$37.00	—	58% above	25%
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 OCCULT BLOOD SCREEN	$27.75	$37.00	—	—	25%
Syphilis antibody test (Treponema pallidum) CPT 86780 T PALLIDUM (FTA-ABS) IgG BY IFA (MISC)	$66.00	$88.00	—	41% above	25%
Syphilis antibody test (Treponema pallidum) CPT 86780 SYPHILIS AB	$77.25	$103.00	—	65% above	25%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 T PALLIDUM (FTA-ABS) IgG BY IFA (MISC)	$66.00	$88.00	—	—	25%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 SYPHILIS AB	$77.25	$103.00	—	—	25%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 RPR	$31.50	$42.00	—	83% above	25%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 RPR	$31.50	$42.00	—	—	25%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 QUANTIFERON, TB GOLD	$103.50	$138.00	—	18% below	25%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 QUANTIFERON, TB GOLD	$103.50	$138.00	—	—	25%
Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE TOTAL	$138.00	$184.00	—	287% above	25%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE TOTAL	$138.00	$184.00	—	—	25%
Thyroid peroxidase (TPO) antibody test CPT 86376 THYROPEROXIDASE AB	$103.50	$138.00	—	124% above	25%
Thyroid peroxidase (TPO) antibody test CPT 86376 ANTI LIVER KIDNEY MICROSOME AB	$124.50	$166.00	—	170% above	25%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 THYROPEROXIDASE AB	$103.50	$138.00	—	—	25%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 ANTI LIVER KIDNEY MICROSOME AB	$124.50	$166.00	—	—	25%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH	$120.75	$161.00	—	88% above	25%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH W/ REFLEX TO T4 FREE	$120.75	$161.00	—	88% above	25%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH	$120.75	$161.00	—	—	25%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH W/ REFLEX TO T4 FREE	$120.75	$161.00	—	—	25%
Total IgE blood test CPT 82785 ALLERGEN SPECIFIC IGE	$21.75	$29.00	—	51% below	25%
Total IgE blood test CPT 82785 IMMUNOGLOBULIN E	$97.50	$130.00	—	120% above	25%
Total IgE blood test inpatient CPT 82785 ALLERGEN SPECIFIC IGE	$21.75	$29.00	—	—	25%
Total IgE blood test inpatient CPT 82785 IMMUNOGLOBULIN E	$97.50	$130.00	—	—	25%
Total cholesterol blood test CPT 82465 CHOLESTEROL	$43.50	$58.00	—	118% above	25%
Total cholesterol blood test inpatient CPT 82465 CHOLESTEROL	$43.50	$58.00	—	—	25%
Total thyroxine (T4) blood test CPT 84436 T4 TOTAL (THYROXINE)	$50.25	$67.00	—	64% above	25%
Total thyroxine (T4) blood test inpatient CPT 84436 T4 TOTAL (THYROXINE)	$50.25	$67.00	—	—	25%
Total triiodothyronine (T3) blood test CPT 84480 T3 TOTAL	$84.00	$112.00	—	82% above	25%
Total triiodothyronine (T3) blood test inpatient CPT 84480 T3 TOTAL	$84.00	$112.00	—	—	25%
Transferrin blood test CPT 84466 TRANSFERRIN	$102.75	$137.00	—	80% above	25%
Transferrin blood test inpatient CPT 84466 TRANSFERRIN	$102.75	$137.00	—	—	25%
Trichomonas test (NAAT) CPT 87661 TRICHOMONAS VAGINALIS PCR	$141.00	$188.00	—	92% above	25%
Trichomonas test (NAAT) inpatient CPT 87661 TRICHOMONAS VAGINALIS PCR	$141.00	$188.00	—	—	25%
Triglycerides blood test CPT 84478 TRIGLYCERIDES	$43.50	$58.00	—	126% above	25%
Triglycerides blood test inpatient CPT 84478 TRIGLYCERIDES	$43.50	$58.00	—	—	25%
Troponin test, quantitative CPT 84484 TROPONIN I HIGH SENSITIVITY	$126.00	$168.00	—	196% above	25%
Troponin test, quantitative inpatient CPT 84484 TROPONIN I HIGH SENSITIVITY	$126.00	$168.00	—	—	25%
Uric acid blood test CPT 84550 URIC ACID BLOOD	$41.25	$55.00	—	83% above	25%
Uric acid blood test inpatient CPT 84550 URIC ACID BLOOD	$41.25	$55.00	—	—	25%
Urinalysis with microscope exam, manual CPT 81000 URINALYSIS COMPLETE W/REFLEX TO CULTURE	$27.75	$37.00	—	85% above	25%
Urinalysis with microscope exam, manual inpatient CPT 81000 URINALYSIS COMPLETE W/REFLEX TO CULTURE	$27.75	$37.00	—	—	25%
Urinalysis without microscope exam, automated CPT 81003 PH URINE(SO)	$6.75	$9.00	—	48% below	25%
Urinalysis without microscope exam, automated inpatient CPT 81003 PH URINE(SO)	$6.75	$9.00	—	—	25%
Urinalysis without microscope exam, manual CPT 81002 URINALYSIS W/REFLEX TO MICRO AND CULTURE	$13.50	$18.00	—	11% below	25%
Urinalysis without microscope exam, manual CPT 81002 URINALYSIS DIPSTICK	$13.50	$18.00	—	11% below	25%
Urinalysis without microscope exam, manual inpatient CPT 81002 URINALYSIS DIPSTICK	$13.50	$18.00	—	—	25%
Urinalysis without microscope exam, manual inpatient CPT 81002 URINALYSIS W/REFLEX TO MICRO AND CULTURE	$13.50	$18.00	—	—	25%
Urine microalbumin (albumin) test CPT 82043 MICROALBUMIN URINE	$34.50	$46.00	—	33% above	25%
Urine microalbumin (albumin) test CPT 82043 MICROALBUMIN URINE 24 HR	$37.50	$50.00	—	44% above	25%
Urine microalbumin (albumin) test inpatient CPT 82043 MICROALBUMIN URINE	$34.50	$46.00	—	—	25%
Urine microalbumin (albumin) test inpatient CPT 82043 MICROALBUMIN URINE 24 HR	$37.50	$50.00	—	—	25%
Urine pregnancy test, read by color change CPT 81025 HCG QUAL SERUM	$36.75	$49.00	—	60% above	25%
Urine pregnancy test, read by color change CPT 81025 PREGNANCY TEST URINE QUAL (HCG)	$36.75	$49.00	—	60% above	25%
Urine pregnancy test, read by color change inpatient CPT 81025 HCG QUAL SERUM	$36.75	$49.00	—	—	25%
Urine pregnancy test, read by color change inpatient CPT 81025 PREGNANCY TEST URINE QUAL (HCG)	$36.75	$49.00	—	—	25%
Vitamin B12 (cobalamin) blood test CPT 82607 VITAMIN B12	$77.25	$103.00	—	30% above	25%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 VITAMIN B12	$77.25	$103.00	—	—	25%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 25 HYDROXYVITAMIN D2 AND D3	$27.75	$37.00	—	69% below	25%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 CALCIFEDIOL(25-OH VIT D-3)	$118.50	$158.00	—	34% above	25%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 25 HYDROXYVITAMIN D2 AND D3	$27.75	$37.00	—	—	25%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 CALCIFEDIOL(25-OH VIT D-3)	$118.50	$158.00	—	—	25%
Vitamin D, 1,25-dihydroxy blood test CPT 82652 VIT D,1,25-DIHYDROXY	$36.00	$48.00	—	54% below	25%
Vitamin D, 1,25-dihydroxy blood test inpatient CPT 82652 VIT D,1,25-DIHYDROXY	$36.00	$48.00	—	—	25%
Zinc blood test CPT 84630 ZINC RBC WHOLE BLOOD	$33.75	$45.00	—	42% above	25%
Zinc blood test CPT 84630 ZINC	$139.50	$186.00	—	486% above	25%
Zinc blood test inpatient CPT 84630 ZINC RBC WHOLE BLOOD	$33.75	$45.00	—	—	25%
Zinc blood test inpatient CPT 84630 ZINC	$139.50	$186.00	—	—	25%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 BHCG QUANTITATIVE	$116.25	$155.00	—	138% above	25%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 BHCG QUANTITATIVE	$116.25	$155.00	—	—	25%

Surgery and procedures

Procedure	Cash price	List price	Insurers pay	vs Michigan	Off list
Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION	$303.00	$404.00	—	69% below	25%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 CARDIOVERSION	$303.00	$404.00	—	—	25%
Earwax removal by irrigation (rinsing), one ear CPT 69209 REMOVAL CERUMEN IRRIGATION LAVAGE	$24.00	$32.00	—	76% below	25%
Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 REMOVAL CERUMEN IRRIGATION LAVAGE	$24.00	$32.00	—	—	25%
Earwax removal with instruments, one ear CPT 69210 REMOVAL CERUMEN REQUIRES INSTRUMENT	$72.00	$96.00	—	23% below	25%
Earwax removal with instruments, one ear inpatient CPT 69210 REMOVAL CERUMEN REQUIRES INSTRUMENT	$72.00	$96.00	—	—	25%
Incision and drainage of a simple or single skin abscess CPT 10060 I & D ABSCESS SIMPLE	$140.25	$187.00	—	49% below	25%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 I & D ABSCESS SIMPLE	$140.25	$187.00	—	—	25%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 INJECTION SINGLE TENDON SHEATH OR LIG	$63.75	$85.00	—	84% below	25%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 INJECTION SINGLE TENDON SHEATH OR LIG	$63.75	$85.00	—	—	25%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ARTHROCENTESIS MAJ JOINT OR BURSA	$66.00	$88.00	—	84% below	25%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ARTHROCENTESIS MAJ JOINT OR BURSA	$66.00	$88.00	—	—	25%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ARTHROCENTESIS ASPIR INT JOINT OR BURSA	$53.25	$71.00	—	84% below	25%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 ARTHROCENTESIS ASPIR INT JOINT OR BURSA	$53.25	$71.00	—	—	25%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 SUTURE 2.5CM OR LESS	$145.50	$194.00	—	61% below	25%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 SUTURE 2.5CM OR LESS	$145.50	$194.00	—	—	25%
Nail removal (partial or complete), one nail CPT 11730 AVULSION NAIL PARTIAL/COMPLETE	$89.25	$119.00	—	56% below	25%
Nail removal (partial or complete), one nail inpatient CPT 11730 AVULSION NAIL PARTIAL/COMPLETE	$89.25	$119.00	—	—	25%
Occipital nerve block (injection for headaches) CPT 64405 NERVE BLOCK OCCIPITAL NERVE	$108.75	$145.00	—	79% below	25%
Occipital nerve block (injection for headaches) inpatient CPT 64405 NERVE BLOCK OCCIPITAL NERVE	$108.75	$145.00	—	—	25%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 EXCISION NAIL AND MATRIX	$126.75	$169.00	—	76% below	25%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 EXCISION NAIL AND MATRIX	$126.75	$169.00	—	—	25%
Removal of a foreign object under the skin, simple CPT 10120 INCISION AND REMOVAL OF FOREIGN BODY	$105.75	$141.00	—	71% below	25%
Removal of a foreign object under the skin, simple inpatient CPT 10120 INCISION AND REMOVAL OF FOREIGN BODY	$105.75	$141.00	—	—	25%
Short arm cast (elbow to hand) CPT 29075 CAST SHORT ARM	$75.00	$100.00	—	70% below	25%
Short arm cast (elbow to hand) inpatient CPT 29075 CAST SHORT ARM	$75.00	$100.00	—	—	25%
Short arm splint (forearm and hand) CPT 29125 APPLICATION OF SHORT ARM SPLINT STATIC	$75.00	$100.00	—	60% below	25%
Short arm splint (forearm and hand) inpatient CPT 29125 APPLICATION OF SHORT ARM SPLINT STATIC	$75.00	$100.00	—	—	25%
Short leg cast (below the knee) CPT 29405 SHORT LEG BELOW KNEE CAST	$87.00	$116.00	—	68% below	25%
Short leg cast (below the knee) inpatient CPT 29405 SHORT LEG BELOW KNEE CAST	$87.00	$116.00	—	—	25%
Short leg splint (calf to foot) CPT 29515 APPLICATION OF SHORT LEG SPLINT	$75.00	$100.00	—	53% below	25%
Short leg splint (calf to foot) inpatient CPT 29515 APPLICATION OF SHORT LEG SPLINT	$75.00	$100.00	—	—	25%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 SIMPLE 2.5 CM OR LESS	$48.00	$64.00	—	77% below	25%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 SIMPLE 2.5 CM OR LESS	$48.00	$64.00	—	—	25%
Spinal tap (lumbar puncture), diagnostic CPT 62270 SPINAL PUNCTURE, LUMBAR DIAGNOSTIC	$199.50	$266.00	—	77% below	25%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 SPINAL PUNCTURE, LUMBAR DIAGNOSTIC	$199.50	$266.00	—	—	25%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 SUTURE 2.6CM TO 7.5CM	$101.25	$135.00	—	58% below	25%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 SUTURE 2.6CM TO 7.5CM	$101.25	$135.00	—	—	25%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 SUTURE 2.5CM OR LESS	$83.25	$111.00	—	65% below	25%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 SUTURE 2.5CM OR LESS	$83.25	$111.00	—	—	25%
Trigger finger release surgery CPT 26055 TENDON SHEATH INC TRIGGER FINGER	$310.50	$414.00	—	83% below	25%
Trigger finger release surgery inpatient CPT 26055 TENDON SHEATH INC TRIGGER FINGER	$310.50	$414.00	—	—	25%
Trigger point injections, 1 or 2 muscles CPT 20552 TRIGGER POINT INJECTION	$54.00	$72.00	—	85% below	25%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 TRIGGER POINT INJECTION	$54.00	$72.00	—	—	25%

Doctor visits and therapy

Procedure	Cash price	List price	Insurers pay	vs Michigan	Off list
Blood transfusion (giving blood or blood components) CPT 36430 BB BLOOD TRANSFUSION FEE	$476.25	$635.00	—	37% below	25%
Blood transfusion (giving blood or blood components) CPT 36430 BB BLOOD TRANSFUSION ROOM CHARGE	$948.75	$1,265.00	—	26% above	25%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BB BLOOD TRANSFUSION FEE	$476.25	$635.00	—	—	25%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BB BLOOD TRANSFUSION ROOM CHARGE	$948.75	$1,265.00	—	—	25%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 UPDRAFT INITIAL TREATMENT	$30.75	$41.00	—	82% below	25%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 IPPB INITIAL TREATMENT	$30.75	$41.00	—	82% below	25%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 IPPB INITIAL TREATMENT	$30.75	$41.00	—	—	25%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 UPDRAFT INITIAL TREATMENT	$30.75	$41.00	—	—	25%
Critical care, first 30 to 74 minutes CPT 99291 ER CRITICAL CARE	$1,194.75	$1,593.00	—	39% below	25%
Critical care, first 30 to 74 minutes inpatient CPT 99291 ER CRITICAL CARE	$1,194.75	$1,593.00	—	—	25%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG	$91.50	$122.00	—	30% below	25%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG	$91.50	$122.00	—	—	25%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 MINOR ER	$170.25	$227.00	—	9% below	25%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 MINOR ER	$170.25	$227.00	—	—	25%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 ER LOW TO MODERATE	$237.00	$316.00	—	30% below	25%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 ER LOW TO MODERATE	$237.00	$316.00	—	—	25%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 ER MODERATE SEVERITY	$355.50	$474.00	—	44% below	25%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 ER MODERATE SEVERITY	$355.50	$474.00	—	—	25%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 ER HIGH NO IMMEDIATE THREAT	$512.25	$683.00	—	51% below	25%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 ER HIGH NO IMMEDIATE THREAT	$512.25	$683.00	—	—	25%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 ER HIGH IMMEDIATE THREAT	$825.00	$1,100.00	—	51% below	25%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 ER HIGH IMMEDIATE THREAT	$825.00	$1,100.00	—	—	25%
Exercise stress test, tracing only, the hospital charge CPT 93017 ST STRESS TEST	$459.00	$612.00	—	37% below	25%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 ST STRESS TEST	$459.00	$612.00	—	—	25%
Family therapy with the patient, 50 minutes CPT 90847 FAMILY PSYCHOTHERAPY WITH PT	$253.50	$338.00	—	92% above	25%
Family therapy with the patient, 50 minutes inpatient CPT 90847 FAMILY PSYCHOTHERAPY WITH PT	$253.50	$338.00	—	—	25%
Family therapy without the patient, 50 minutes CPT 90846 FAMILY PSYCHOTHERAPY W/O PT	$253.50	$338.00	—	72% above	25%
Family therapy without the patient, 50 minutes inpatient CPT 90846 FAMILY PSYCHOTHERAPY W/O PT	$253.50	$338.00	—	—	25%
Group psychotherapy session CPT 90853 GROUP PSYCHOTHERAPY 1 SESSION	$165.75	$221.00	—	184% above	25%
Group psychotherapy session CPT 90853 GROUP PSYCHOTHERAPY 3 SESSIONS	$482.25	$643.00	—	725% above	25%
Group psychotherapy session inpatient CPT 90853 GROUP PSYCHOTHERAPY 1 SESSION	$165.75	$221.00	—	—	25%
Group psychotherapy session inpatient CPT 90853 GROUP PSYCHOTHERAPY 3 SESSIONS	$482.25	$643.00	—	—	25%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV INFUSION/HYDRATION INITIAL HOUR ER	$127.50	$170.00	—	51% below	25%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV INFUSION/HYDRATION INITIAL HOUR	$127.50	$170.00	—	51% below	25%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV INFUSION/HYDRATION INITIAL HOUR ER	$127.50	$170.00	—	—	25%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV INFUSION/HYDRATION INITIAL HOUR	$127.50	$170.00	—	—	25%
IV infusion of a medicine, first hour CPT 96365 IVPB THERAPY 1ST HOUR	$241.50	$322.00	—	20% below	25%
IV infusion of a medicine, first hour CPT 96365 IVPB THERAPY 1ST HOUR ER	$241.50	$322.00	—	20% below	25%
IV infusion of a medicine, first hour inpatient CPT 96365 IVPB THERAPY 1ST HOUR ER	$241.50	$322.00	—	—	25%
IV infusion of a medicine, first hour inpatient CPT 96365 IVPB THERAPY 1ST HOUR	$241.50	$322.00	—	—	25%
IV push of a medicine, first drug CPT 96374 INJECTION IV PUSH INITIAL	$76.50	$102.00	—	60% below	25%
IV push of a medicine, first drug CPT 96374 INJECTION IV PUSH INITIAL ER	$76.50	$102.00	—	60% below	25%
IV push of a medicine, first drug inpatient CPT 96374 INJECTION IV PUSH INITIAL	$76.50	$102.00	—	—	25%
IV push of a medicine, first drug inpatient CPT 96374 INJECTION IV PUSH INITIAL ER	$76.50	$102.00	—	—	25%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJECTION EMERGENCY ROOM	$60.00	$80.00	—	34% below	25%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJECTION SUBQ/IM	$60.00	$80.00	—	34% below	25%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INJECTION EMERGENCY ROOM	$60.00	$80.00	—	—	25%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INJECTION SUBQ/IM	$60.00	$80.00	—	—	25%
Mental health diagnostic evaluation (intake), without medical services CPT 90791 PSYCHIATRIC DIAGNOSTIC EVALUATION	$285.00	$380.00	—	27% above	25%
Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 PSYCHIATRIC DIAGNOSTIC EVALUATION	$285.00	$380.00	—	—	25%
Neuromuscular re-education, 15 minutes CPT 97112 PT NEUROMUSCULAR RE-ED UNIT	$101.25	$135.00	—	7% above	25%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 PT NEUROMUSCULAR RE-ED UNIT	$101.25	$135.00	—	—	25%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 MEDICAL NUTRITIONAL THERAPY 1ON1-15MIN	$34.50	$46.00	—	25% below	25%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 MEDICAL NUTRITIONAL THERAPY 1ON1-15MIN	$34.50	$46.00	—	—	25%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 OT THERAP EXER UNIT	$87.75	$117.00	—	6% below	25%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 OT THERAP EXER UNIT	$87.75	$117.00	—	—	25%
Psychotherapy session, 30 minutes CPT 90832 INDIVIDUAL PSYCHOTHERAPY 16-37	$209.25	$279.00	—	9% above	25%
Psychotherapy session, 30 minutes inpatient CPT 90832 INDIVIDUAL PSYCHOTHERAPY 16-37	$209.25	$279.00	—	—	25%
Psychotherapy session, 45 minutes CPT 90834 INDIVIDUAL PSYCHOTHERAPY 38-52	$228.75	$305.00	—	7% above	25%
Psychotherapy session, 45 minutes inpatient CPT 90834 INDIVIDUAL PSYCHOTHERAPY 38-52	$228.75	$305.00	—	—	25%
Psychotherapy session, 60 minutes CPT 90837 INDIVIDUAL PSYCHOTHERAPY 53-67	$253.50	$338.00	—	10% above	25%
Psychotherapy session, 60 minutes inpatient CPT 90837 INDIVIDUAL PSYCHOTHERAPY 53-67	$253.50	$338.00	—	—	25%
Spirometry before and after a bronchodilator CPT 94060 PFT BRONCHODILATOR(COMPLETE)	$312.00	$416.00	—	21% below	25%
Spirometry before and after a bronchodilator inpatient CPT 94060 PFT BRONCHODILATOR(COMPLETE)	$312.00	$416.00	—	—	25%
Therapeutic activities (functional training), 15 minutes CPT 97530 OT THERAPEUTIC ACT UNIT	$75.00	$100.00	—	7% below	25%
Therapeutic activities (functional training), 15 minutes CPT 97530 PT THERAPEUTIC ACT UNIT	$75.00	$100.00	—	7% below	25%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 PT THERAPEUTIC ACT UNIT	$75.00	$100.00	—	—	25%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 OT THERAPEUTIC ACT UNIT	$75.00	$100.00	—	—	25%

Vaccines

Procedure	Cash price	List price	Insurers pay	vs Michigan	Off list
Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older CPT 90653 INFLUENZA VAC 65+ (FLUAD) ADJU 2526 PFS	$73.50	$98.00	—	17% below	25%
Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older inpatient CPT 90653 INFLUENZA VAC 65+ (FLUAD) ADJU 2526 PFS	$73.50	$98.00	—	—	25%
COVID-19 vaccine (Moderna), age 12 and older CPT 91322 COVID-19 mRNA LNP-S PF 2024/0.5ML DOSE	$112.50	$150.00	—	60% below	25%
COVID-19 vaccine (Moderna), age 12 and older inpatient CPT 91322 COVID-19 mRNA LNP-S PF 2024/0.5ML DOSE	$112.50	$150.00	—	—	25%
Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 VARIVAX VACC 10 W/DIL (CLINIC)	$204.00	$272.00	—	1% above	25%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 INFANRIX 10X0.5ML	$25.50	$34.00	—	34% below	25%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 inpatient CPT 90700 INFANRIX 10X0.5ML	$25.50	$34.00	—	—	25%
Hepatitis A vaccine, adult dose CPT 90632 HEP A VACCINE INJ PFS 50U/ML 1ML (ST)	$81.00	$108.00	—	31% below	25%
Hepatitis A vaccine, adult dose inpatient CPT 90632 HEP A VACCINE INJ PFS 50U/ML 1ML (ST)	$81.00	$108.00	—	—	25%
Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 HAVRIX 720ELU 10X0.5ML	$33.00	$44.00	—	56% below	25%
Hepatitis A vaccine, child and teen dose (2-dose schedule) inpatient CPT 90633 HAVRIX 720ELU 10X0.5ML	$33.00	$44.00	—	—	25%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 HEP B VACCINE INJ SDV 20MCG(ST) 1ML	$52.50	$70.00	—	38% below	25%
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 HEP B VACCINE INJ SDV 20MCG(ST) 1ML	$52.50	$70.00	—	—	25%
Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 ENGERIX-B 10MCG/0.5ML 10X0.5ML (PEDS)	$22.50	$30.00	—	31% below	25%
Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 ENGERIX-B 10MCG/0.5ML 10X0.5ML (PEDS)	$22.50	$30.00	—	—	25%
Hib vaccine (Haemophilus influenzae type b), 3-dose schedule (PedvaxHIB) CPT 90647 HIBERIX PR 10 10X0.5ML	$14.25	$19.00	—	71% below	25%
Hib vaccine (Haemophilus influenzae type b), 3-dose schedule (PedvaxHIB) CPT 90647 PEDVAXHIB 7.5MCG 10X0.5ML	$32.25	$43.00	—	34% below	25%
Hib vaccine (Haemophilus influenzae type b), 3-dose schedule (PedvaxHIB) inpatient CPT 90647 HIBERIX PR 10 10X0.5ML	$14.25	$19.00	—	—	25%
Hib vaccine (Haemophilus influenzae type b), 3-dose schedule (PedvaxHIB) inpatient CPT 90647 PEDVAXHIB 7.5MCG 10X0.5ML	$32.25	$43.00	—	—	25%
Meningococcal ACWY vaccine (MenQuadfi) CPT 90619 MENINGOCOCCAL ACWY 135	$180.75	$241.00	—	23% below	25%
Meningococcal ACWY vaccine (MenQuadfi) inpatient CPT 90619 MENINGOCOCCAL ACWY 135	$180.75	$241.00	—	—	25%
Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 BEXSERO 10X0.5ML	$185.25	$247.00	—	43% below	25%
Meningococcal B vaccine (Bexsero), 2-dose schedule inpatient CPT 90620 BEXSERO 10X0.5ML	$185.25	$247.00	—	—	25%
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) CPT 90670 PNEUMOCOCCAL 13 VAL CONJ.10X0.5ML	$223.50	$298.00	—	17% below	25%
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) inpatient CPT 90670 PNEUMOCOCCAL 13 VAL CONJ.10X0.5ML	$223.50	$298.00	—	—	25%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 PNEUMOCOCCAL 20 VAL CONJ.1X0.5ML (LTCU)	$282.00	$376.00	—	26% below	25%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 PNEUMOCOCCAL 20 VAL CONJ.10X0.5ML (ST)	$311.25	$415.00	—	18% below	25%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 PNEUMOCOCCAL 20 VAL CONJ.1X0.5ML (LTCU)	$282.00	$376.00	—	—	25%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 PNEUMOCOCCAL 20 VAL CONJ.10X0.5ML (ST)	$311.25	$415.00	—	—	25%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PNEUMOCOCCAL 23 INJ 25MCG 10X0.5ML	$128.25	$171.00	—	19% below	25%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 PNEUMOCOCCAL 23 INJ 25MCG 10X0.5ML	$128.25	$171.00	—	—	25%
Polio vaccine, inactivated (IPV) CPT 90713 IPOL 5ML 10DOSE	$45.00	$60.00	—	27% below	25%
Polio vaccine, inactivated (IPV) inpatient CPT 90713 IPOL 5ML 10DOSE	$45.00	$60.00	—	—	25%
RSV antibody shot for infants and toddlers, larger dose (1 mL, 100 mg) CPT 90381 RSV NIRSEVIMAB (BEYFORTUS) 1ML	$595.50	$794.00	—	20% below	25%
RSV antibody shot for infants and toddlers, larger dose (1 mL, 100 mg) inpatient CPT 90381 RSV NIRSEVIMAB (BEYFORTUS) 1ML	$595.50	$794.00	—	—	25%
RSV antibody shot for infants, seasonal dose (0.5 mL) CPT 90380 RSV NIRSEVIMAB (BEYFORTUS) 0.5ML	$595.50	$794.00	—	20% below	25%
RSV antibody shot for infants, seasonal dose (0.5 mL) inpatient CPT 90380 RSV NIRSEVIMAB (BEYFORTUS) 0.5ML	$595.50	$794.00	—	—	25%
Rabies vaccine, one dose CPT 90675 RABIES VACC (RABAVERT) CHICK-EMB (ST)	$433.50	$578.00	—	16% below	25%
Rabies vaccine, one dose CPT 90675 RABIES VACC (IMOVAX) HUMAN-DIP	$607.50	$810.00	—	18% above	25%
Rabies vaccine, one dose inpatient CPT 90675 RABIES VACC (RABAVERT) CHICK-EMB (ST)	$433.50	$578.00	—	—	25%
Rabies vaccine, one dose inpatient CPT 90675 RABIES VACC (IMOVAX) HUMAN-DIP	$607.50	$810.00	—	—	25%
Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 SHINGRIX 50MCG/0.5ML PFS	$309.75	$413.00	—	59% above	25%
Shingles vaccine (Shingrix), recombinant, one dose inpatient CPT 90750 SHINGRIX 50MCG/0.5ML PFS	$309.75	$413.00	—	—	25%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TETANUS/DIPTHERIA TOXOID PFS(ST) 0.5ML	$44.25	$59.00	—	18% below	25%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 KINRIX SYR 10X0.5ML	$54.75	$73.00	—	1% above	25%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 TETANUS/DIPTHERIA TOXOID PFS(ST) 0.5ML	$44.25	$59.00	—	—	25%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 KINRIX SYR 10X0.5ML	$54.75	$73.00	—	—	25%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 Tdap 1 DOSE syringe	$40.50	$54.00	—	44% below	25%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 Tdap 1 DOSE (ST)	$43.50	$58.00	—	40% below	25%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 Tdap 1 DOSE syringe	$40.50	$54.00	—	—	25%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 Tdap 1 DOSE (ST)	$43.50	$58.00	—	—	25%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 INJ IMMUNIZATION TD TDAP ER	$29.25	$39.00	—	27% above	25%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 PREVENTIVE VACCINATION INFLUENZA	$30.75	$41.00	—	34% above	25%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 INJ IMMUNIZATION PNEUMONIA ER	$30.75	$41.00	—	34% above	25%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 INJ IMMUNIZATION INFLUENZA ER	$30.75	$41.00	—	34% above	25%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 PREVENTIVE VACCINATION	$30.75	$41.00	—	34% above	25%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 INJ IMMUNIZATION TD TDAP ER	$29.25	$39.00	—	—	25%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 INJ IMMUNIZATION INFLUENZA ER	$30.75	$41.00	—	—	25%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 PREVENTIVE VACCINATION	$30.75	$41.00	—	—	25%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 PREVENTIVE VACCINATION INFLUENZA	$30.75	$41.00	—	—	25%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 INJ IMMUNIZATION PNEUMONIA ER	$30.75	$41.00	—	—	25%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 PREVENTIVE VACCINATION 2 OR MORE	$17.25	$23.00	—	13% below	25%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 PREVENTIVE VACCINATION 2 OR MORE	$17.25	$23.00	—	—	25%

Procedure The service, with its billing code (CPT or HCPCS) and, in small type, the line exactly as the hospital wrote it in its price file. More

Cash price The hospital's own price for a patient paying without insurance (“discounted cash” in its price file). Hospitals must publish it under federal law, 45 CFR 180.50. Call to confirm it before booking. More

List price The hospital's full chargemaster price (“gross charge”) before any discount. Almost nobody pays it; the gap to the cash price shows what the self-pay discount is worth. More

Insurers pay The lowest and highest rates this hospital has agreed with insurance plans for the same item, from its price file. If the cash price is below what your plan pays and you have not met your deductible, paying cash can cost you less. More

Against the state median This hospital's cash price compared with the median cash price of hospitals in the state for the same code. Shown when at least three hospitals in the state price it.

Off list How much lower the cash price is than the list price.

No cash discount This line's cash price equals the hospital's full list price. Many hospitals still reduce bills for uninsured patients: ask the billing office for its self-pay discount in writing. More

At or below Medicare This cash price is at or below what Medicare pays a hospital for the same service, which is unusually low. It is what the hospital's file says; confirm it and what it includes before booking. More

Check the item The description in the hospital file looks like a supply or device (a catheter, a brace, an implant), not this procedure. The hospital may have filed it under the wrong code: ask before relying on this price.

Source file: https://d9491de2-de27-403f-9f84-988deccd465b.usrfiles.com/ugd/d9491d_352b3562f30240d99a266756126d6bed.csv