Alice Hyde Medical Center
Alice Hyde Medical Center in Malone, NY publishes cash prices for 60 common procedures listed here, from its own machine-readable price file updated Apr 28, 2026. Click a procedure to compare it with other hospitals nearby.
133 Park Street, Malone, NY 12953 Collected Sep 23, 2026 Source price file
Scans and imaging
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 HC - CT ABDOMEN & PELVIS W/CONTRAST MATERIAL | $5,273.00 | $5,273.00 | — |
| CT scan of the head or brain, no contrast dye CPT 70450 HC - CT HEAD/BRAIN W/O CONTRAST MATERIAL | $2,195.00 | $2,195.00 | — |
| CT scan of the pelvis, with contrast dye CPT 72193 HC - CT PELVIS W/CONTRAST MATERIAL | $2,368.00 | $2,368.00 | — |
| Diagnostic mammogram, both breasts both sides CPT 77066 HC - DIAGNOSTIC MAMMOGRAPHY COMPUTER-AIDED DETCJ BI | $675.00 | $675.00 | — |
| Diagnostic mammogram, one breast CPT 77065 HC - DIAGNOSTIC MAMMOGRAPHY COMPUTER-AIDED DETCJ UNI | $551.00 | $551.00 | — |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 CHG MRI ANY JT LOWER EXTREM W/O CONTRAST MATRL | $1,438.00 | $1,438.00 | — |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 HC - MRI ANY JT LOWER EXTREM W/O CONTRAST MATRL | $3,795.00 | $3,795.00 | — |
| MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 CHG MRI ANY JT LOWER EXTREM W/O CONTRAST MATRL | $1,438.00 | $1,438.00 | — |
| MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 CHG MRI ANY JT LOWER EXTREM W/O & W/CONTRAST MATRL | $1,881.00 | $1,881.00 | — |
| MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 HC - MRI ANY JT LOWER EXTREM W/O & W/CONTRAST MATRL | $4,053.00 | $4,053.00 | — |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 CHG MRI ANY JT LOWER EXTREM W/O & W/CONTRAST MATRL | $1,881.00 | $1,881.00 | — |
| MRI of the brain, no contrast dye CPT 70551 HC - MRI QUICK BRAIN BRAIN STEM W/O CONTRAST MATERIAL | $324.00 | $324.00 | — |
| MRI of the brain, no contrast dye CPT 70551 HC - MRI BRAIN BRAIN STEM W/O CONTRAST MATERIAL | $4,113.00 | $4,113.00 | — |
| MRI of the brain, with and without contrast dye CPT 70553 CHG MRI BRAIN BRAIN STEM W/O W/CONTRAST MATERIAL | $2,086.00 | $2,086.00 | — |
| MRI of the brain, with and without contrast dye CPT 70553 HC - MRI BRAIN BRAIN STEM W/O W/CONTRAST MATERIAL | $5,596.00 | $5,596.00 | — |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 CHG MRI BRAIN BRAIN STEM W/O W/CONTRAST MATERIAL | $2,086.00 | $2,086.00 | — |
| MRI of the lower back, no contrast dye CPT 72148 HC - MRI SPINAL CANAL LUMBAR W/O CONTRAST MATERIAL | $3,913.00 | $3,913.00 | — |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 CHG US PREG UTERUS AFTER 1ST TRIMEST 1/1ST GESTATION | $486.00 | $486.00 | — |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 HC - US PREG UTERUS AFTER 1ST TRIMEST 1/1ST GESTATION | $506.00 | $506.00 | — |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 CHG US PREG UTERUS AFTER 1ST TRIMEST 1/1ST GESTATION | $486.00 | $486.00 | — |
| Screening mammogram, both breasts both sides CPT 77067 HC - SCREENING MAMMOGRAPHY BI 2-VIEW BREAST INC CAD | $592.00 | $592.00 | — |
| Sleep study in a lab (polysomnography) CPT 95810 PR POLYSOM 6/>YRS SLEEP 4/> ADDL PARAM ATTND | $2,821.00 | $2,821.00 | — |
| Sleep study in a lab (polysomnography) CPT 95810 HC - POLYSOM 6/>YRS SLEEP 4/> ADDL PARAM ATTND | $4,081.00 | $4,081.00 | — |
| Sleep study in a lab (polysomnography) inpatient CPT 95810 PR POLYSOM 6/>YRS SLEEP 4/> ADDL PARAM ATTND | $2,821.00 | $2,821.00 | — |
| Transvaginal pelvic ultrasound CPT 76830 HC - US TRANSVAGINAL | $985.00 | $985.00 | — |
| Ultrasound of the abdomen, complete CPT 76700 HC - US ABDOMINAL REAL TIME W/IMAGE DOCUMENTATION | $973.00 | $973.00 | — |
| X-ray of the lower back, 4 or more views CPT 72110 HC - RADEX SPINE LUMBOSACRAL MINIMUM 4 VIEWS | $652.00 | $652.00 | — |
Lab tests
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Basic metabolic panel (blood test) CPT 80048 HC - BASIC METABOLIC PANEL CALCIUM TOTAL | $151.00 | $151.00 | — |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 CHG LIPID PANEL | $18.00 | $18.00 | — |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 HC - LIPOEL LIPID PANEL | $275.00 | $275.00 | — |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 HC - LIPID PROFILE | $282.00 | $282.00 | — |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 CHG LIPID PANEL | $18.00 | $18.00 | — |
| Complete blood count (CBC) with differential CPT 85025 CHG BLOOD COUNT COMPLETE AUTO&AUTO DIFRNTL WBC | $21.00 | $21.00 | — |
| Complete blood count (CBC) with differential CPT 85025 HC - AUTOMATED DIFFERENTIAL ADD | $120.00 | $120.00 | — |
| Complete blood count (CBC) with differential CPT 85025 HC - BLOOD COUNT COMPLETE AUTO&AUTO DIFRNTL WBC | $120.00 | $120.00 | — |
| Complete blood count (CBC) with differential inpatient CPT 85025 CHG BLOOD COUNT COMPLETE AUTO&AUTO DIFRNTL WBC | $21.00 | $21.00 | — |
| Complete blood count (CBC), no differential CPT 85027 HC - HEMAGRAM | $91.00 | $91.00 | — |
| Comprehensive metabolic panel (blood test) CPT 80053 HC - COMPREHENSIVE METABOLIC PANEL | $238.00 | $238.00 | — |
| Kidney function blood test panel CPT 80069 HC - RENAL FUNCTION PANEL | $167.00 | $167.00 | — |
| Liver function blood test panel CPT 80076 HC - HEPATIC FUNCTION PANEL | $221.00 | $221.00 | — |
| PSA (prostate-specific antigen) blood test, free CPT 84154 HC - PSA FREE MAYO | $26.00 | $26.00 | — |
| PSA (prostate-specific antigen) blood test, free CPT 84154 HC - FREE PSA, PHI | $60.00 | $60.00 | — |
| PSA (prostate-specific antigen) blood test, total CPT 84153 HC - PSA TOTAL MAYO | $23.00 | $23.00 | — |
| PSA (prostate-specific antigen) blood test, total CPT 84153 HC - PROSTATE SPECIFIC AG, PHI | $49.00 | $49.00 | — |
| PSA (prostate-specific antigen) blood test, total CPT 84153 HC - ASSAY OF PROSTATE SPECIFIC ANTIGEN TOTAL | $86.00 | $86.00 | — |
| PSA (prostate-specific antigen) blood test, total CPT 84153 HC - DIAGNOSTIC PROSTATIC SPEC AG | $86.00 | $86.00 | — |
| PSA (prostate-specific antigen) blood test, total CPT 84153 HC - PROSTATIC SPEC AG SCREEN | $86.00 | $86.00 | — |
| Partial thromboplastin time (PTT) clotting test CPT 85730 HC - THROMBOPLASTIN TIME PARTIAL PLASMA/WHOLE BLOOD | $90.00 | $90.00 | — |
| Prothrombin time (PT/INR) clotting test CPT 85610 CHG PROTHROMBIN TIME | $31.00 | $31.00 | — |
| Prothrombin time (PT/INR) clotting test CPT 85610 HC - INR FINGERSTICK (LAB PERFORMED) | $68.00 | $68.00 | — |
| Prothrombin time (PT/INR) clotting test CPT 85610 HC - PROTIME, LUPUS CASCADE REFLEX | $68.00 | $68.00 | — |
| Prothrombin time (PT/INR) clotting test CPT 85610 HC - PROTHROMBIN TIME | $68.00 | $68.00 | — |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 CHG PROTHROMBIN TIME | $31.00 | $31.00 | — |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 HC - ASSAY OF THYROID STIMULATING HORMONE TSH | $291.00 | $291.00 | — |
| Urinalysis with microscope exam, automated CPT 81001 CHG URNLS DIP STICK/TABLET REAGENT AUTO MICROSCOPY | $10.00 | $10.00 | — |
| Urinalysis with microscope exam, automated CPT 81001 HC - URINALYSIS, CHEMICAL AND SEDIMENT, AUTOMATED | $102.00 | $102.00 | — |
| Urinalysis with microscope exam, automated inpatient CPT 81001 CHG URNLS DIP STICK/TABLET REAGENT AUTO MICROSCOPY | $10.00 | $10.00 | — |
| Urinalysis with microscope exam, manual CPT 81000 CHG URINLS DIP STICK/TABLET REAGNT NON-AUTO MICRSCPY | $10.00 | $10.00 | — |
| Urinalysis with microscope exam, manual inpatient CPT 81000 CHG URINLS DIP STICK/TABLET REAGNT NON-AUTO MICRSCPY | $10.00 | $10.00 | — |
| Urinalysis without microscope exam, automated CPT 81003 CHG URNLS DIP STICK/TABLET RGNT AUTO W/O MICROSCOPY | $32.00 | $32.00 | — |
| Urinalysis without microscope exam, automated CPT 81003 HC - URNLS DIP STICK/TABLET RGNT AUTO W/O MICROSCOPY | $65.00 | $65.00 | — |
| Urinalysis without microscope exam, automated inpatient CPT 81003 CHG URNLS DIP STICK/TABLET RGNT AUTO W/O MICROSCOPY | $32.00 | $32.00 | — |
| Urinalysis without microscope exam, manual CPT 81002 CHG URNLS DIP STICK/TABLET RGNT NON-AUTO W/O MICRSCP | $32.00 | $32.00 | — |
| Urinalysis without microscope exam, manual inpatient CPT 81002 CHG URNLS DIP STICK/TABLET RGNT NON-AUTO W/O MICRSCP | $32.00 | $32.00 | — |
Surgery and procedures
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Cesarean delivery, including prenatal and postpartum care CPT 59510 PR OB ANTEPARTUM CARE CESAREAN DLVR & POSTPARTUM | $7,930.00 | $7,930.00 | — |
| Cesarean delivery, including prenatal and postpartum care inpatient CPT 59510 PR OB ANTEPARTUM CARE CESAREAN DLVR & POSTPARTUM | $7,930.00 | $7,930.00 | — |
| Colonoscopy with polyp removal CPT 45385 HC - COLSC FLX W/RMVL OF TUMOR POLYP LESION SNARE TQ | $3,723.00 | $3,723.00 | — |
| Colonoscopy with polyp removal CPT 45385 PR COLSC FLX W/RMVL OF TUMOR POLYP LESION SNARE TQ | $3,867.00 | $3,867.00 | — |
| Colonoscopy with polyp removal inpatient CPT 45385 PR COLSC FLX W/RMVL OF TUMOR POLYP LESION SNARE TQ | $3,867.00 | $3,867.00 | — |
| Colonoscopy with tissue sample CPT 45380 PR COLONOSCOPY W/BIOPSY SINGLE/MULTIPLE | $2,955.00 | $2,955.00 | — |
| Colonoscopy with tissue sample CPT 45380 HC - COLONOSCOPY W/BIOPSY SINGLE/MULTIPLE | $3,723.00 | $3,723.00 | — |
| Colonoscopy with tissue sample inpatient CPT 45380 PR COLONOSCOPY W/BIOPSY SINGLE/MULTIPLE | $2,955.00 | $2,955.00 | — |
| Colonoscopy, diagnostic CPT 45378 PR COLONOSCOPY FLX DX W/COLLJ SPEC WHEN PFRMD | $2,397.00 | $2,397.00 | — |
| Colonoscopy, diagnostic CPT 45378 HC - COLONOSCOPY FLX DX W/COLLJ SPEC WHEN PFRMD SCREENING HIGH RISK | $3,049.00 | $3,049.00 | — |
| Colonoscopy, diagnostic CPT 45378 HC - COLONOSCOPY FLX DX W/COLLJ SPEC WHEN PFRMD SCREENING LOW RISK | $3,049.00 | $3,049.00 | — |
| Colonoscopy, diagnostic CPT 45378 HC - COLONOSCOPY FLX DX W/COLLJ SPEC WHEN PFRMD | $3,049.00 | $3,049.00 | — |
| Colonoscopy, diagnostic inpatient CPT 45378 PR COLONOSCOPY FLX DX W/COLLJ SPEC WHEN PFRMD | $2,397.00 | $2,397.00 | — |
| Gallbladder removal, laparoscopic CPT 47562 PR LAPAROSCOPY SURG CHOLECYSTECTOMY | $6,163.00 | $6,163.00 | — |
| Gallbladder removal, laparoscopic inpatient CPT 47562 PR LAPAROSCOPY SURG CHOLECYSTECTOMY | $6,163.00 | $6,163.00 | — |
| Inguinal (groin) hernia repair, age 5 or older CPT 49505 PR RPR 1ST INGUN HRNA AGE 5 YRS/> REDUCIBLE | $1,574.00 | $1,574.00 | — |
| Inguinal (groin) hernia repair, age 5 or older inpatient CPT 49505 PR RPR 1ST INGUN HRNA AGE 5 YRS/> REDUCIBLE | $1,574.00 | $1,574.00 | — |
| Knee arthroscopy with meniscus trim CPT 29881 PR ARTHRS KNE SURG W/MENISCECTOMY MED/LAT W/SHVG | $2,458.00 | $2,458.00 | — |
| Knee arthroscopy with meniscus trim inpatient CPT 29881 PR ARTHRS KNE SURG W/MENISCECTOMY MED/LAT W/SHVG | $2,458.00 | $2,458.00 | — |
| Lower-back epidural injection, with imaging guidance CPT 62323 HC - NJX DX/THER SBST INTRLMNR LMBR/SAC W/IMG GDN | $1,037.00 | $1,037.00 | — |
| Lower-back epidural injection, with imaging guidance CPT 62323 PR NJX DX/THER SBST INTRLMNR LMBR/SAC W/IMG GDN | $1,769.00 | $1,769.00 | — |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 PR NJX DX/THER SBST INTRLMNR LMBR/SAC W/IMG GDN | $1,769.00 | $1,769.00 | — |
| Lower-back epidural injection, without imaging guidance CPT 62322 HC - NJX DX/THER SBST INTRLMNR LMBR/SAC W/O IMG GDN | $1,037.00 | $1,037.00 | — |
| Lower-back epidural injection, without imaging guidance CPT 62322 PR NJX DX/THER SBST INTRLMNR LMBR/SAC W/O IMG GDN | $1,629.00 | $1,629.00 | — |
| Lower-back epidural injection, without imaging guidance inpatient CPT 62322 PR NJX DX/THER SBST INTRLMNR LMBR/SAC W/O IMG GDN | $1,629.00 | $1,629.00 | — |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 HC - NJX AA&/STRD TFRML EPI LUMBAR/SACRAL 1 LEVEL | $1,027.00 | $1,027.00 | — |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 PR NJX AA&/STRD TFRML EPI LUMBAR/SACRAL 1 LEVEL | $2,156.00 | $2,156.00 | — |
| Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 PR NJX AA&/STRD TFRML EPI LUMBAR/SACRAL 1 LEVEL | $2,156.00 | $2,156.00 | — |
| Prostate biopsy CPT 55700 PR PROSTATE NEEDLE BIOPSY ANY APPROACH | $920.00 | $920.00 | — |
| Prostate biopsy inpatient CPT 55700 PR PROSTATE NEEDLE BIOPSY ANY APPROACH | $920.00 | $920.00 | — |
| Removal of a breast lump, open surgery CPT 19120 PR EXC CYST/ABERRANT BREAST TISSUE OPEN 1/> LESION | $662.00 | $662.00 | — |
| Removal of a breast lump, open surgery inpatient CPT 19120 PR EXC CYST/ABERRANT BREAST TISSUE OPEN 1/> LESION | $662.00 | $662.00 | — |
| Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) CPT 29826 PR SURGICAL ARTHROSCOPY SHO W/CORACOACRM LIGM RLS | $1,400.00 | $1,400.00 | — |
| Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) inpatient CPT 29826 PR SURGICAL ARTHROSCOPY SHO W/CORACOACRM LIGM RLS | $1,400.00 | $1,400.00 | — |
| Total hip replacement CPT 27130 PR ARTHRP ACETBLR/PROX FEM PROSTC AGRFT/ALGRFT | $5,515.00 | $5,515.00 | — |
| Total hip replacement inpatient CPT 27130 PR ARTHRP ACETBLR/PROX FEM PROSTC AGRFT/ALGRFT | $5,515.00 | $5,515.00 | — |
| Total knee replacement CPT 27447 PR ARTHRP KNE CONDYLE&PLATU MEDIAL&LAT COMPARTMENTS | $5,897.00 | $5,897.00 | — |
| Total knee replacement inpatient CPT 27447 PR ARTHRP KNE CONDYLE&PLATU MEDIAL&LAT COMPARTMENTS | $5,897.00 | $5,897.00 | — |
| Upper endoscopy (EGD) with biopsy CPT 43239 PR EGD TRANSORAL BIOPSY SINGLE/MULTIPLE | $2,478.00 | $2,478.00 | — |
| Upper endoscopy (EGD) with biopsy CPT 43239 HC - EGD TRANSORAL BIOPSY SINGLE/MULTIPLE | $3,723.00 | $3,723.00 | — |
| Upper endoscopy (EGD) with biopsy inpatient CPT 43239 PR EGD TRANSORAL BIOPSY SINGLE/MULTIPLE | $2,478.00 | $2,478.00 | — |
| Upper endoscopy (EGD), diagnostic CPT 43235 PR ESOPHAGOGASTRODUODENOSCOPY TRANSORAL DIAGNOSTIC | $2,101.00 | $2,101.00 | — |
| Upper endoscopy (EGD), diagnostic CPT 43235 HC - ESOPHAGOGASTRODUODENOSCOPY TRANSORAL DIAGNOSTIC | $2,205.00 | $2,205.00 | — |
| Upper endoscopy (EGD), diagnostic inpatient CPT 43235 PR ESOPHAGOGASTRODUODENOSCOPY TRANSORAL DIAGNOSTIC | $2,101.00 | $2,101.00 | — |
| Vaginal birth after cesarean (VBAC), including prenatal and postpartum care CPT 59610 PR ROUTINE OB CARE VAG DLVRY & POSTPARTUM CARE VB | $5,182.00 | $5,182.00 | — |
| Vaginal birth after cesarean (VBAC), including prenatal and postpartum care inpatient CPT 59610 PR ROUTINE OB CARE VAG DLVRY & POSTPARTUM CARE VB | $5,182.00 | $5,182.00 | — |
| Vaginal delivery, including prenatal and postpartum care CPT 59400 PR OB CARE ANTEPARTUM VAG DLVR & POSTPARTUM | $7,135.00 | $7,135.00 | — |
| Vaginal delivery, including prenatal and postpartum care inpatient CPT 59400 PR OB CARE ANTEPARTUM VAG DLVR & POSTPARTUM | $7,135.00 | $7,135.00 | — |
Doctor visits and therapy
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Electrocardiogram (ECG/EKG) with interpretation CPT 93000 PR ECG ROUTINE ECG W/LEAST 12 LDS W/I&R | $78.00 | $78.00 | — |
| Electrocardiogram (ECG/EKG) with interpretation inpatient CPT 93000 PR ECG ROUTINE ECG W/LEAST 12 LDS W/I&R | $78.00 | $78.00 | — |
| New patient office visit, about 30 minutes CPT 99203 HC - OFFICE/OUTPATIENT NEW LOW MDM 30 MINUTES | $335.00 | $335.00 | — |
| New patient office visit, about 30 minutes CPT 99203 PR OFFICE/OUTPATIENT NEW LOW MDM 30 MINUTES | $463.00 | $463.00 | — |
| New patient office visit, about 30 minutes inpatient CPT 99203 PR OFFICE/OUTPATIENT NEW LOW MDM 30 MINUTES | $463.00 | $463.00 | — |
| New patient office visit, about 45 minutes CPT 99204 HC - OFFICE/OUTPATIENT NEW MODERATE MDM 45 MINUTES | $515.00 | $515.00 | — |
| New patient office visit, about 45 minutes CPT 99204 PR OFFICE/OUTPATIENT NEW MODERATE MDM 45 MINUTES | $613.00 | $613.00 | — |
| New patient office visit, about 45 minutes inpatient CPT 99204 PR OFFICE/OUTPATIENT NEW MODERATE MDM 45 MINUTES | $613.00 | $613.00 | — |
| New patient office visit, about 60 minutes CPT 99205 HC - OFFICE/OUTPATIENT NEW HIGH MDM 60 MINUTES | $540.00 | $540.00 | — |
| New patient office visit, about 60 minutes CPT 99205 PR OFFICE/OUTPATIENT NEW HIGH MDM 60 MINUTES | $719.00 | $719.00 | — |
| New patient office visit, about 60 minutes inpatient CPT 99205 PR OFFICE/OUTPATIENT NEW HIGH MDM 60 MINUTES | $719.00 | $719.00 | — |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HC - PT THERAPEUTIC PX 1/> AREAS EACH 15 MIN EXERCISES | $127.00 | $127.00 | — |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HC - OT THERAPEUTIC PX 1/> AREAS EACH 15 MIN EXERCISES | $127.00 | $127.00 | — |
| Preventive checkup, new patient aged 18–39 CPT 99385 PR INITIAL PREVENTIVE MEDICINE NEW PT AGE 18-39YRS | $509.00 | $509.00 | — |
| Preventive checkup, new patient aged 18–39 inpatient CPT 99385 PR INITIAL PREVENTIVE MEDICINE NEW PT AGE 18-39YRS | $509.00 | $509.00 | — |
| Preventive checkup, new patient aged 40–64 CPT 99386 PR INITIAL PREVENTIVE MEDICINE NEW PATIENT 40-64YRS | $603.00 | $603.00 | — |
| Preventive checkup, new patient aged 40–64 inpatient CPT 99386 PR INITIAL PREVENTIVE MEDICINE NEW PATIENT 40-64YRS | $603.00 | $603.00 | — |
| Specialist consultation, low complexity or 30+ minutes CPT 99243 PR OFFICE/OP CONSLTJ NEW/EST PT LOW MDM 30 MINUTES | $281.00 | $281.00 | — |
| Specialist consultation, low complexity or 30+ minutes inpatient CPT 99243 PR OFFICE/OP CONSLTJ NEW/EST PT LOW MDM 30 MINUTES | $281.00 | $281.00 | — |
| Specialist consultation, moderate complexity or 40+ minutes CPT 99244 PR OFFICE/OP CONSLTJ NEW/EST PT MOD MDM 40 MINUTES | $430.00 | $430.00 | — |
| Specialist consultation, moderate complexity or 40+ minutes inpatient CPT 99244 PR OFFICE/OP CONSLTJ NEW/EST PT MOD MDM 40 MINUTES | $430.00 | $430.00 | — |
Source file: https://www.uvmhealth.org/sites/default/files/150346515_alice-hyde-medical-center_standardcharges.csv