ThedaCare Regional Medical Center-OSP
Listed in its price file as “ThedaCare Regional Medical Center-Appleton Inc.”.
ThedaCare Regional Medical Center-OSP in Appleton, WI publishes cash prices for 527 common procedures listed here, from its own machine-readable price file updated Aug 8, 2026. Compared with other hospitals in the state, its outpatient cash prices are below the Wisconsin median for 341 of 522 procedures and above it for 82. By typical cash price it ranks #22 of 103 Wisconsin hospitals, cheapest first. Select a procedure to compare it with other hospitals nearby.
2400 E Capitol Drive, Appleton, WI 54911-8728 Collected Sep 23, 2026 Source price file Check a bill from this hospital
Scans and imaging
| Procedure | Cash price | List price | Insurers pay | vs Wisconsin | Off list |
|---|---|---|---|---|---|
| Abdominal CT scan without and with contrast CPT 74170 HC CT Abdomen W/ W/O Contr | $1,766.41 | $3,154.30 | $410.06–$3,272.30 | 26% below | 44% |
| Abdominal CT scan without and with contrast CPT 74170 HC CT ABDOMEN W/ W/O CONTR | $1,801.74 | $3,217.40 | $410.06–$3,272.30 | 24% below | 44% |
| Abdominal X-ray, 2 views CPT 74019 RADIOLOGIC EXAM ABDOMEN 2 VIEWS | $163.74 | $292.40 | $11.51–$271.93 | 32% below | 44% |
| Abdominal X-ray, 2 views CPT 74019 HC Radiologic Exam Abdomen 2 Views | $242.59 | $433.20 | $56.32–$506.76 | 1% above | 44% |
| Abdominal X-ray, 2 views CPT 74019 HC RADIOLOGIC EXAM ABDOMEN 2 VIEWS | $266.84 | $476.50 | $56.32–$506.76 | 11% above | 44% |
| Ankle X-ray, complete, 3 or more views CPT 73610 HC Ankle X-Ray 3+ Vw | $154.95 | $276.70 | $35.97–$362.79 | 34% below | 44% |
| Ankle X-ray, complete, 3 or more views CPT 73610 ANKLE X-RAY 3+ VW | $163.24 | $291.50 | $8.66–$271.10 | 31% below | 44% |
| Ankle X-ray, complete, 3 or more views CPT 73610 HC ANKLE X-RAY 3+ VW | $201.43 | $359.70 | $35.97–$362.79 | 14% below | 44% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 HC US Abi 1-2 Levels(Limited) | $254.58 | $454.60 | $136.38–$430.78 | 34% below | 44% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 HC US ABI 1-2 LEVELS(LIMITED) | $285.15 | $509.20 | $136.38–$430.78 | 26% below | 44% |
| Arm CT scan without contrast (shoulder to hand, any part) CPT 73200 CT UPPER EXTREMITY W/O CONTRAST | $735.50 | $1,313.40 | $117.56–$1,221.46 | 49% below | 44% |
| Arm CT scan without contrast (shoulder to hand, any part) CPT 73200 HC CT Upper Extremity W/O Contrast | $1,469.89 | $2,624.80 | $341.22–$3,832.72 | 2% above | 44% |
| Arm CT scan without contrast (shoulder to hand, any part) CPT 73200 HC CT UPPER EXTREMITY W/O CONTRAST | $1,499.29 | $2,677.30 | $341.22–$3,832.72 | 4% above | 44% |
| Barium swallow (esophagus X-ray with contrast) CPT 74220 HC Esophagram X-Ray | $399.78 | $713.90 | $92.81–$730.33 | 25% below | 44% |
| Barium swallow (esophagus X-ray with contrast) CPT 74220 HC ESOPHAGRAM X-RAY | $439.77 | $785.30 | $92.81–$730.33 | 17% below | 44% |
| Bone scan, whole body (nuclear medicine) CPT 78306 HC NM Bone Scan (Whole Body) | $995.96 | $1,778.50 | $231.21–$2,150.25 | 33% below | 44% |
| Bone scan, whole body (nuclear medicine) CPT 78306 HC NM BONE SCAN (WHOLE BODY) | $1,294.78 | $2,312.10 | $231.21–$2,150.25 | 13% below | 44% |
| Breast ultrasound, complete, one breast CPT 76641 HC Ultrasound Breast Complete | $250.43 | $447.20 | $58.14–$767.81 | 53% below | 44% |
| Breast ultrasound, complete, one breast CPT 76641 HC ULTRASOUND BREAST COMPLETE | $257.94 | $460.60 | $58.14–$767.81 | 51% below | 44% |
| Breast ultrasound, limited (one breast or one area) CPT 76642 HC Ultrasound Breast Limited | $200.37 | $357.80 | $46.51–$698.34 | 49% below | 44% |
| Breast ultrasound, limited (one breast or one area) CPT 76642 HC ULTRASOUND BREAST LIMITED | $206.36 | $368.50 | $46.51–$698.34 | 47% below | 44% |
| CT angiography (CTA) of the abdomen and pelvis CPT 74174 HC CT Angio Abd&Pelv W/O&W/Dye | $2,215.02 | $3,955.40 | $514.20–$4,195.32 | 27% below | 44% |
| CT angiography (CTA) of the abdomen and pelvis CPT 74174 HC CT ANGIO ABD&PELV W/O&W/DYE | $2,259.32 | $4,034.50 | $514.20–$4,195.32 | 26% below | 44% |
| CT angiography (CTA) of the head CPT 70496 HC CT Angio Head W/Contrast Only | $2,074.58 | $3,704.60 | $481.60–$3,514.19 | at median | 44% |
| CT angiography (CTA) of the head CPT 70496 HC CT Angiography Head W & W/O Contrast | $2,074.58 | $3,704.60 | $481.60–$3,514.19 | at median | 44% |
| CT angiography (CTA) of the head CPT 70496 HC CT ANGIO HEAD W/CONTRAST ONLY | $2,116.07 | $3,778.70 | $481.60–$3,514.19 | 2% above | 44% |
| CT angiography (CTA) of the head CPT 70496 HC CT ANGIOGRAPHY HEAD W & W/O CONTRAST | $2,116.07 | $3,778.70 | $481.60–$3,514.19 | 2% above | 44% |
| CT angiography (CTA) of the neck CPT 70498 HC CT Angiography Neck W & W/O Contrast | $1,642.31 | $2,932.70 | $381.25–$3,198.74 | 19% below | 44% |
| CT angiography (CTA) of the neck CPT 70498 HC CT ANGIOGRAPHY NECK W & W/O CONTRAST | $1,675.18 | $2,991.40 | $381.25–$3,198.74 | 17% below | 44% |
| CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 HC CT Angiography Chest | $1,765.01 | $3,151.80 | $409.73–$3,377.95 | 13% below | 44% |
| CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 HC CT ANGIOGRAPHY CHEST | $1,800.29 | $3,214.80 | $409.73–$3,377.95 | 11% below | 44% |
| CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 HC CT Angio Hrt W/3d Image | $1,377.82 | $2,460.40 | $319.85–$2,333.93 | 21% below | 44% |
| CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 HC CT ANGIO HRT W/3D IMAGE | $1,405.38 | $2,509.60 | $319.85–$2,333.93 | 20% below | 44% |
| CT of the heart without contrast dye to measure coronary calcium CPT 75571 HC CT Hrt W/O Dye W/Ca Test | $28.00 | $50.00 | $6.50–$46.50 | 56% below | 44% |
| CT of the heart without contrast dye to measure coronary calcium CPT 75571 HC CT HRT W/O DYE W/CA TEST | $28.00 | $50.00 | $6.50–$46.50 | 56% below | 44% |
| CT scan of abdomen and pelvis, no contrast dye CPT 74176 HC CT ABD & PELVIS W/O CONTRAST | $1,904.00 | $3,400.00 | $442.00–$3,906.00 | 24% below | 44% |
| CT scan of abdomen and pelvis, no contrast dye CPT 74176 HC CT Abd & Pelvis W/O Contrast | $2,028.15 | $3,621.70 | $442.00–$3,906.00 | 19% below | 44% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ABDOMEN&PELVIS W/CONTRAST | $1,531.43 | $2,734.70 | $97.27–$2,543.27 | 52% below | 44% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 HC CT ABDOMEN&PELVIS W/CONTRAST | $2,072.00 | $3,700.00 | $481.00–$4,510.13 | 35% below | 44% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 HC CT Abdomen&Pelvis W/Contrast | $2,300.20 | $4,107.50 | $481.00–$4,510.13 | 28% below | 44% |
| CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 HC CT ABD&PELV 1+ SECTION/REGNS | $2,240.00 | $4,000.00 | $520.00–$4,836.00 | 39% below | 44% |
| CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 HC CT Abd&Pelv 1+ Section/Regns | $2,591.23 | $4,627.20 | $520.00–$4,836.00 | 30% below | 44% |
| CT scan of the abdomen with contrast CPT 74160 HC CT Scan of Abdomen W Contrast (74160) | $1,469.10 | $2,623.40 | $341.04–$2,974.98 | 10% below | 44% |
| CT scan of the abdomen with contrast CPT 74160 HC CT SCAN OF ABDOMEN W CONTRAST (74160) | $1,498.50 | $2,675.90 | $341.04–$2,974.98 | 9% below | 44% |
| CT scan of the abdomen without contrast CPT 74150 HC CT Scan of Abdomen WO Contrast (74150) | $1,042.38 | $1,861.40 | $241.98–$2,249.86 | 17% below | 44% |
| CT scan of the abdomen without contrast CPT 74150 HC CT SCAN OF ABDOMEN WO CONTRAST (74150) | $1,063.22 | $1,898.60 | $241.98–$2,249.86 | 16% below | 44% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 HC CT Scan of Face, Jaw WO Contrast | $989.91 | $1,767.70 | $229.80–$2,331.70 | 29% below | 44% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 HC CT SCAN OF FACE, JAW WO CONTRAST | $1,009.74 | $1,803.10 | $229.80–$2,331.70 | 27% below | 44% |
| CT scan of the head or brain, no contrast dye CPT 70450 HC CT Head W/O Contrast (70450) | $936.77 | $1,672.80 | $217.46–$2,395.96 | 27% below | 44% |
| CT scan of the head or brain, no contrast dye CPT 70450 HC CT HEAD W/O CONTRAST (70450) | $955.53 | $1,706.30 | $217.46–$2,395.96 | 26% below | 44% |
| CT scan of the head with contrast CPT 70460 HC CT Head W/ Contrast (70460) | $1,042.38 | $1,861.40 | $241.98–$2,635.25 | 32% below | 44% |
| CT scan of the head with contrast CPT 70460 HC CT HEAD W/ CONTRAST (70460) | $1,063.22 | $1,898.60 | $241.98–$2,635.25 | 31% below | 44% |
| CT scan of the head without and with contrast CPT 70470 HC CT Head W and W/O Contrast | $1,346.46 | $2,404.40 | $312.57–$2,898.44 | 27% below | 44% |
| CT scan of the head without and with contrast CPT 70470 HC CT HEAD W AND W/O CONTRAST | $1,373.40 | $2,452.50 | $312.57–$2,898.44 | 25% below | 44% |
| CT scan of the lower back (lumbar spine) without contrast CPT 72131 HC CT L-Spine WO Contrast (72131) | $1,088.02 | $1,942.90 | $252.58–$2,570.06 | 29% below | 44% |
| CT scan of the lower back (lumbar spine) without contrast CPT 72131 HC CT L-SPINE WO CONTRAST (72131) | $1,109.81 | $1,981.80 | $252.58–$2,570.06 | 28% below | 44% |
| CT scan of the neck (cervical spine), no contrast dye CPT 72125 HC CT Cervical Sp W/O Contrast | $1,088.02 | $1,942.90 | $252.58–$2,757.45 | 29% below | 44% |
| CT scan of the neck (cervical spine), no contrast dye CPT 72125 HC CT CERVICAL SP W/O CONTRAST | $1,109.81 | $1,981.80 | $252.58–$2,757.45 | 28% below | 44% |
| CT scan of the pelvis, with contrast dye CPT 72193 HC CT Scan of Pelvis Contrast | $1,002.18 | $1,789.60 | $232.65–$2,867.28 | 39% below | 44% |
| CT scan of the pelvis, with contrast dye CPT 72193 HC CT SCAN OF PELVIS CONTRAST | $1,022.22 | $1,825.40 | $232.65–$2,867.28 | 38% below | 44% |
| Carotid artery ultrasound (duplex), both sides of the neck CPT 93880 HC US Carotid Duplex | $627.54 | $1,120.60 | $336.18–$1,218.23 | 36% below | 44% |
| Carotid artery ultrasound (duplex), both sides of the neck CPT 93880 HC US CAROTID/TEMPORAL ART. DUPLEX | $702.86 | $1,255.10 | $336.18–$1,218.23 | 29% below | 44% |
| Carotid artery ultrasound (duplex), both sides of the neck CPT 93880 US CAROTID/TEMPORAL DUPLEX | $710.08 | $1,268.00 | $75.12–$933.25 | 28% below | 44% |
| Chest CT scan without and with contrast CPT 71270 HC CT Chest W/ & W/O Contrast | $1,563.18 | $2,791.40 | $362.88–$3,277.41 | 32% below | 44% |
| Chest CT scan without and with contrast CPT 71270 HC CT CHEST W/ & W/O CONTRAST | $1,594.43 | $2,847.20 | $362.88–$3,277.41 | 31% below | 44% |
| Chest X-ray, 2 views CPT 71046 RADIOLOGIC EXAM CHEST 2 VIEWS | $148.90 | $265.90 | $10.79–$247.29 | 31% below | 44% |
| Chest X-ray, 2 views CPT 71046 HC Radiologic Exam Chest 2 Views | $151.14 | $269.90 | $35.09–$390.60 | 30% below | 44% |
| Chest X-ray, 2 views CPT 71046 HC RADIOLOGIC EXAM CHEST 2 VIEWS | $235.20 | $420.00 | $35.09–$390.60 | 10% above | 44% |
| Chest X-ray, single view CPT 71045 RADIOLOGIC EXAM CHEST SINGLE VIEW | $114.58 | $204.60 | $9.01–$190.28 | 29% below | 44% |
| Chest X-ray, single view CPT 71045 HC RADIOLOGIC EXAM CHEST SINGLE VIEW | $207.20 | $370.00 | $48.10–$354.52 | 28% above | 44% |
| Chest X-ray, single view CPT 71045 HC Radiologic Exam Chest Single View | $213.47 | $381.20 | $48.10–$354.52 | 32% above | 44% |
| Collarbone (clavicle) X-ray, complete CPT 73000 HC X-Ray Clavicle | $116.42 | $207.90 | $27.03–$212.69 | 44% below | 44% |
| Collarbone (clavicle) X-ray, complete CPT 73000 HC X-RAY CLAVICLE | $128.07 | $228.70 | $27.03–$212.69 | 38% below | 44% |
| Collarbone (clavicle) X-ray, complete CPT 73000 X-RAY CLAVICLE | $142.58 | $254.60 | $8.28–$236.78 | 31% below | 44% |
| Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 HC US Retoperitoneal Abd | $387.35 | $691.70 | $89.92–$778.78 | 29% below | 44% |
| Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 HC US RETOPERITONEAL ABD | $399.00 | $712.50 | $89.92–$778.78 | 27% below | 44% |
| Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US RETOPERITONEAL ABD | $526.06 | $939.40 | $82.89–$873.64 | 4% below | 44% |
| DEXA bone density scan of the hip, pelvis or spine CPT 77080 DXA BONE DENSITY, AXIAL | $182.62 | $326.10 | $31.81–$303.27 | 54% below | 44% |
| DEXA bone density scan of the hip, pelvis or spine CPT 77080 HC DXA Bone Density, Axial | $212.41 | $379.30 | $49.31–$413.94 | 47% below | 44% |
| DEXA bone density scan of the hip, pelvis or spine CPT 77080 HC DXA BONE DENSITY, AXIAL | $233.52 | $417.00 | $49.31–$413.94 | 41% below | 44% |
| DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 HC DXA Bone Density/Peripheral | $146.05 | $260.80 | $33.90–$266.82 | 48% below | 44% |
| DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 HC DXA BONE DENSITY/PERIPHERAL | $160.66 | $286.90 | $33.90–$266.82 | 43% below | 44% |
| Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 HC OB US, Detailed, Sngl Fetus | $819.34 | $1,463.10 | $190.20–$1,401.51 | 19% above | 44% |
| Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 HC OB US, DETAILED, SNGL FETUS | $843.92 | $1,507.00 | $190.20–$1,401.51 | 23% above | 44% |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 HC CT Chest W/O Contrast (71250) | $1,094.30 | $1,954.10 | $254.03–$2,544.11 | 24% below | 44% |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 HC CT CHEST W/O CONTRAST (71250) | $1,116.19 | $1,993.20 | $254.03–$2,544.11 | 22% below | 44% |
| Diagnostic CT scan of the chest, with contrast dye CPT 71260 HC Cat Scan of Chest Contrast (71260) | $1,340.30 | $2,393.40 | $311.14–$2,962.61 | 18% below | 44% |
| Diagnostic CT scan of the chest, with contrast dye CPT 71260 HC CAT SCAN OF CHEST CONTRAST (71260) | $1,367.13 | $2,441.30 | $311.14–$2,962.61 | 17% below | 44% |
| Diagnostic mammogram, both breasts both sides CPT 77066 HC Diagnostic Mammography Computer-Aided Detcj Bi | $308.00 | $550.00 | $71.50–$614.73 | — | 44% |
| Diagnostic mammogram, both breasts both sides CPT 77066 HC DIAGNOSTIC MAMMOGRAPHY COMPUTER-AIDED DETCJ BI | $314.16 | $561.00 | $71.50–$614.73 | — | 44% |
| Diagnostic mammogram, one breast CPT 77065 HC Diagnostic Mammography Computer-Aided Detcj Uni | $308.00 | $550.00 | $71.50–$521.73 | at median | 44% |
| Diagnostic mammogram, one breast CPT 77065 HC DIAGNOSTIC MAMMOGRAPHY COMPUTER-AIDED DETCJ UNI | $314.16 | $561.00 | $71.50–$521.73 | 2% above | 44% |
| Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 HC Duplex Lo Extrem Art Bilat | $934.36 | $1,668.50 | $500.55–$1,375.36 | — | 44% |
| Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 HC DUPLEX LO EXTREM ART BILAT | $1,046.47 | $1,868.70 | $500.55–$1,375.36 | — | 44% |
| Duplex ultrasound of the leg veins, both legs both sides CPT 93970 HC Reflux Vascular or Guidance Bilat | $901.26 | $1,609.40 | $482.82–$1,343.64 | — | 44% |
| Duplex ultrasound of the leg veins, both legs both sides CPT 93970 HC Duplex Extrem Venous,Bilat | $901.26 | $1,609.40 | $482.82–$1,343.64 | — | 44% |
| Duplex ultrasound of the leg veins, both legs both sides CPT 93970 HC DUPLEX EXTREM VENOUS,BILAT | $1,009.40 | $1,802.50 | $482.82–$1,343.64 | — | 44% |
| Duplex ultrasound of the leg veins, both legs both sides CPT 93970 HC REFLUX VASCULAR OR GUIDANCE BILAT | $1,009.40 | $1,802.50 | $482.82–$1,343.64 | — | 44% |
| Echocardiogram through the chest wall, complete, with Doppler CPT 93306 ECHO TRANSTHORACIC W CONTRAST HC | $1,344.00 | $2,400.00 | $720.00–$2,209.32 | 23% below | 44% |
| Echocardiogram through the chest wall, complete, with Doppler CPT 93306 ECHO W SPECTRAL DOPPLER AND COLOR FLOW HC | $1,344.00 | $2,400.00 | $720.00–$2,209.32 | 23% below | 44% |
| Echocardiogram through the chest wall, complete, with Doppler CPT 93306 Echo Transthoracic W Contrast HC | $1,581.38 | $2,823.90 | $720.00–$2,209.32 | 10% below | 44% |
| Echocardiogram through the chest wall, complete, with Doppler CPT 93306 Echo W Spectral Doppler and Color Flow HC | $1,581.38 | $2,823.90 | $720.00–$2,209.32 | 10% below | 44% |
| Elbow X-ray, 2 views CPT 73070 X-RAY ELBOW 2 VW | $129.25 | $230.80 | $8.28–$214.64 | 32% below | 44% |
| Elbow X-ray, 2 views CPT 73070 HC X-Ray Elbow 2 Vw | $138.77 | $247.80 | $32.21–$299.55 | 27% below | 44% |
| Elbow X-ray, 2 views CPT 73070 HC X-RAY ELBOW 2 VW | $180.38 | $322.10 | $32.21–$299.55 | 6% below | 44% |
| Elbow X-ray, complete, 3 or more views CPT 73080 ELBOW X-RAY MIN 3 VIEWS | $144.09 | $257.30 | $8.66–$239.29 | 39% below | 44% |
| Elbow X-ray, complete, 3 or more views CPT 73080 HC Elbow X-Ray Min 3 Views | $170.07 | $303.70 | $39.48–$394.88 | 28% below | 44% |
| Elbow X-ray, complete, 3 or more views CPT 73080 HC ELBOW X-RAY MIN 3 VIEWS | $221.09 | $394.80 | $39.48–$394.88 | 6% below | 44% |
| Eye socket (orbit) CT scan without contrast CPT 70480 HC CT Orbit/Ear/Fossa W/O Dye | $1,042.38 | $1,861.40 | $241.98–$2,249.86 | 28% below | 44% |
| Eye socket (orbit) CT scan without contrast CPT 70480 HC CT ORBIT/EAR/FOSSA W/O DYE | $1,063.22 | $1,898.60 | $241.98–$2,249.86 | 26% below | 44% |
| Facial bones X-ray, complete, 3 or more views CPT 70150 HC Facial Bones Xray 3 View | $192.70 | $344.10 | $44.73–$387.35 | 36% below | 44% |
| Facial bones X-ray, complete, 3 or more views CPT 70150 HC FACIAL BONES XRAY 3 VIEW | $211.96 | $378.50 | $44.73–$387.35 | 29% below | 44% |
| Forearm X-ray (radius and ulna), 2 views CPT 73090 X-RAY FOREARM | $129.25 | $230.80 | $7.94–$214.64 | 34% below | 44% |
| Forearm X-ray (radius and ulna), 2 views CPT 73090 HC X-Ray Forearm | $142.30 | $254.10 | $33.03–$422.50 | 28% below | 44% |
| Forearm X-ray (radius and ulna), 2 views CPT 73090 HC X-RAY FOREARM | $156.52 | $279.50 | $33.03–$422.50 | 21% below | 44% |
| HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 HC Hepatobiliary System Imaging | $763.50 | $1,363.40 | $177.24–$1,648.15 | 48% below | 44% |
| HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 HC HEPATOBILIARY SYSTEM IMAGING | $809.31 | $1,445.20 | $177.24–$1,648.15 | 45% below | 44% |
| Hand X-ray, 2 views CPT 73120 X-RAY HAND 2 VW | $138.10 | $246.60 | $8.28–$229.34 | 27% below | 44% |
| Hand X-ray, 2 views CPT 73120 HC X-Ray Hand 2 Vw | $188.78 | $337.10 | $43.82–$322.90 | at median | 44% |
| Hand X-ray, 2 views CPT 73120 HC X-RAY HAND 2 VW | $191.07 | $341.20 | $43.82–$322.90 | 1% above | 44% |
| Heel bone (calcaneus) X-ray, 2 or more views CPT 73650 X-RAY HEEL | $126.28 | $225.50 | $21.39–$209.72 | 36% below | 44% |
| Heel bone (calcaneus) X-ray, 2 or more views CPT 73650 HC X-Ray Heel | $201.04 | $359.00 | $46.67–$367.26 | 1% above | 44% |
| Heel bone (calcaneus) X-ray, 2 or more views CPT 73650 HC X-RAY HEEL | $221.14 | $394.90 | $46.67–$367.26 | 11% above | 44% |
| Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 PULM DIAG-POLYSOMNOGRAPHY | $342.50 | $611.60 | $367.00–$603.00 | 44% below | 44% |
| Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 HC Pulm Diag-Polysomnography | $703.53 | $1,256.30 | $367.00–$603.00 | 15% above | 44% |
| Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 HC PULM DIAG-POLYSOMNOGRAPHY | $787.98 | $1,407.10 | $367.00–$603.00 | 28% above | 44% |
| In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 HC Polysomnography W/Cpap | $2,957.14 | $5,280.60 | $1,836.00–$2,787.00 | 19% below | 44% |
| In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 HC POLYSOMNOGRAPHY W/CPAP | $3,312.01 | $5,914.30 | $1,836.00–$2,787.00 | 10% below | 44% |
| Knee X-ray, 3 views CPT 73562 HC X-Ray Knee 3+ Vw | $170.07 | $303.70 | $39.48–$512.15 | 33% below | 44% |
| Knee X-ray, 3 views CPT 73562 X-RAY KNEE 3+ VW | $179.59 | $320.70 | $9.35–$298.25 | 29% below | 44% |
| Knee X-ray, 3 views CPT 73562 HC X-RAY KNEE 3+ VW | $221.09 | $394.80 | $39.48–$512.15 | 13% below | 44% |
| Knee X-ray, complete, 4 or more views CPT 73564 HC Knee X-Ray 4+ Views/Complete | $188.78 | $337.10 | $43.82–$544.05 | 32% below | 44% |
| Knee X-ray, complete, 4 or more views CPT 73564 KNEE X-RAY 4+ VIEWS/COMPLETE | $206.47 | $368.70 | $11.48–$342.89 | 25% below | 44% |
| Knee X-ray, complete, 4 or more views CPT 73564 HC KNEE X-RAY 4+ VIEWS/COMPLETE | $245.39 | $438.20 | $43.82–$544.05 | 11% below | 44% |
| Leg CT scan without contrast (hip to foot, any part) CPT 73700 HC CT Scan Lower Ext WO Contrast | $1,165.08 | $2,080.50 | $270.47–$2,526.53 | 20% below | 44% |
| Leg CT scan without contrast (hip to foot, any part) CPT 73700 HC CT SCAN LOWER EXT WO CONTRAST | $1,188.38 | $2,122.10 | $270.47–$2,526.53 | 18% below | 44% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US ABDOMEN LIMITED | $425.21 | $759.30 | $31.49–$706.15 | 4% below | 44% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 HC US Abdomen Limited | $492.18 | $878.90 | $114.26–$858.30 | 11% above | 44% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 HC US ABDOMEN LIMITED | $506.97 | $905.30 | $114.26–$858.30 | 14% above | 44% |
| Limited ultrasound of an arm or leg (non-vascular) CPT 76882 US LTD EXTREMITY NON VASCULAR | $202.83 | $362.20 | $19.55–$336.85 | 29% below | 44% |
| Limited ultrasound of an arm or leg (non-vascular) CPT 76882 HC US Lmtd Joint/Oth Nonvasc Xtr Strux R-T W/Img | $205.02 | $366.10 | $47.59–$519.87 | 28% below | 44% |
| Limited ultrasound of an arm or leg (non-vascular) CPT 76882 HC US LMTD JOINT/OTH NONVASC XTR STRUX R-T W/IMG | $211.18 | $377.10 | $47.59–$519.87 | 26% below | 44% |
| Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 HC US Extremety Limited- Right | $205.02 | $366.10 | $47.59–$519.87 | 28% below | 44% |
| Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 HC US Extremity Limited- Left | $205.02 | $366.10 | $47.59–$519.87 | 28% below | 44% |
| Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 HC US EXTREMETY LIMITED- RIGHT | $211.18 | $377.10 | $47.59–$519.87 | 26% below | 44% |
| Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 HC US EXTREMITY LIMITED- LEFT | $211.18 | $377.10 | $47.59–$519.87 | 26% below | 44% |
| Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 HC PR Ldct for Lung Ca Screen | $356.16 | $636.00 | $82.68–$604.50 | 20% below | 44% |
| Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 HC PR LDCT FOR LUNG CA SCREEN | $364.00 | $650.00 | $82.68–$604.50 | 18% below | 44% |
| Lower leg X-ray (tibia and fibula), 2 views CPT 73590 X-RAY LOWER LEG | $139.55 | $249.20 | $7.94–$231.76 | 34% below | 44% |
| Lower leg X-ray (tibia and fibula), 2 views CPT 73590 HC X-Ray Lower Leg | $222.21 | $396.80 | $51.58–$423.62 | 4% above | 44% |
| Lower leg X-ray (tibia and fibula), 2 views CPT 73590 HC X-RAY LOWER LEG | $244.44 | $436.50 | $51.58–$423.62 | 15% above | 44% |
| MR angiography (MRA) of the head without contrast CPT 70544 HC MR Angiography Head W/O Dye | $1,431.02 | $2,555.40 | $332.20–$3,815.98 | 35% below | 44% |
| MR angiography (MRA) of the head without contrast CPT 70544 HC MR ANGIOGRAPHY HEAD W/O DYE | $1,860.32 | $3,322.00 | $332.20–$3,815.98 | 16% below | 44% |
| MRI of both breasts, without and then with contrast dye both sides CPT 77049 MRI BREAST WITHOUT&WITH CONTRAST W/CAD BILATERAL | $1,201.87 | $2,146.20 | $279.01–$1,995.97 | — | 44% |
| MRI of both breasts, without and then with contrast dye both sides CPT 77049 MAGNETIC RESONANCE IMAGING, BREAST, W/WO CONTRAST BILATERAL | $1,201.87 | $2,146.20 | $279.01–$1,995.97 | — | 44% |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MRI, JOINT OF LEG | $1,015.17 | $1,812.80 | $163.18–$1,685.90 | 54% below | 44% |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 HC MRI, Joint of Leg | $1,889.50 | $3,374.10 | $438.63–$3,738.32 | 15% below | 44% |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 HC MRI, JOINT OF LEG | $2,251.03 | $4,019.70 | $438.63–$3,738.32 | 2% above | 44% |
| MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 HC MRI Lwr Extre Joint W/O&W Dye | $3,069.70 | $5,481.60 | $712.61–$5,862.53 | 10% below | 44% |
| MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 HC MRI LWR EXTRE JOINT W/O&W DYE | $3,530.13 | $6,303.80 | $712.61–$5,862.53 | 3% above | 44% |
| MRI of the abdomen without contrast CPT 74181 HC MRI, Abdomen | $1,854.83 | $3,312.20 | $430.59–$4,004.49 | 16% below | 44% |
| MRI of the abdomen without contrast CPT 74181 HC MRI, ABDOMEN | $2,411.30 | $4,305.90 | $430.59–$4,004.49 | 9% above | 44% |
| MRI of the abdomen, without and then with contrast dye CPT 74183 HC MRI Abdomen W/O&W Dye | $2,410.18 | $4,303.90 | $559.51–$5,131.93 | 29% below | 44% |
| MRI of the abdomen, without and then with contrast dye CPT 74183 HC MRI ABDOMEN W/O&W DYE | $3,090.19 | $5,518.20 | $559.51–$5,131.93 | 10% below | 44% |
| MRI of the brain, no contrast dye CPT 70551 HC MRI Brain | $1,531.94 | $2,735.60 | $355.63–$3,814.95 | 31% below | 44% |
| MRI of the brain, no contrast dye CPT 70551 HC MRI BRAIN | $1,685.04 | $3,009.00 | $355.63–$3,814.95 | 24% below | 44% |
| MRI of the brain, with and without contrast dye CPT 70553 HC MRI Brain WO and W Contrast | $1,818.15 | $3,246.70 | $422.07–$5,074.64 | 47% below | 44% |
| MRI of the brain, with and without contrast dye CPT 70553 HC MRI BRAIN WO AND W CONTRAST | $2,363.59 | $4,220.70 | $422.07–$5,074.64 | 31% below | 44% |
| MRI of the lower back, no contrast dye CPT 72148 HC MRI Lumbar Spine WO Contrast | $1,472.30 | $2,629.10 | $341.78–$4,101.39 | 33% below | 44% |
| MRI of the lower back, no contrast dye CPT 72148 HC MRI LUMBAR SPINE WO CONTRAST | $1,913.97 | $3,417.80 | $341.78–$4,101.39 | 13% below | 44% |
| MRI of the lower back, without and then with contrast dye CPT 72158 HC MRI, Lumbar Spine Combo | $2,306.08 | $4,118.00 | $535.34–$4,971.13 | 32% below | 44% |
| MRI of the lower back, without and then with contrast dye CPT 72158 HC MRI, LUMBAR SPINE COMBO | $2,993.37 | $5,345.30 | $535.34–$4,971.13 | 12% below | 44% |
| MRI of the mid back (thoracic spine), no contrast dye CPT 72146 HC Limited Combo-MRI Thoracic Spine W/O Contrast | $1,702.85 | $3,040.80 | $395.30–$4,606.94 | 23% below | 44% |
| MRI of the mid back (thoracic spine), no contrast dye CPT 72146 HC LIMITED COMBO-MRI THORACIC SPINE W/O CONTRAST | $1,984.14 | $3,543.10 | $395.30–$4,606.94 | 10% below | 44% |
| MRI of the neck (cervical spine) without and with contrast CPT 72156 HC MRI, Cerv Spine Combo | $2,058.50 | $3,675.90 | $477.87–$4,543.24 | 40% below | 44% |
| MRI of the neck (cervical spine) without and with contrast CPT 72156 HC MRI, CERV SPINE COMBO | $2,676.07 | $4,778.70 | $477.87–$4,543.24 | 22% below | 44% |
| MRI of the neck (cervical spine), no contrast dye CPT 72141 HC MRI Cervical Spine WO Contrast | $1,700.89 | $3,037.30 | $394.85–$3,892.05 | 23% below | 44% |
| MRI of the neck (cervical spine), no contrast dye CPT 72141 HC MRI CERVICAL SPINE WO CONTRAST | $2,044.73 | $3,651.30 | $394.85–$3,892.05 | 7% below | 44% |
| MRI of the pelvis without and with contrast CPT 72197 HC MRI Pelvis W and WO Contrast | $1,639.29 | $2,927.30 | $380.55–$4,668.60 | 52% below | 44% |
| MRI of the pelvis without and with contrast CPT 72197 HC MRI PELVIS W AND WO CONTRAST | $2,016.00 | $3,600.00 | $380.55–$4,668.60 | 41% below | 44% |
| MRI of the pelvis, no contrast dye CPT 72195 HC MRI Pelvis W/O Contrast | $1,201.14 | $2,144.90 | $278.84–$3,815.98 | 46% below | 44% |
| MRI of the pelvis, no contrast dye CPT 72195 HC MRI PELVIS W/O CONTRAST | $1,381.30 | $2,466.60 | $278.84–$3,815.98 | 37% below | 44% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 MRI, JOINT UPPER EXTREM | $1,016.79 | $1,815.70 | $163.18–$1,688.60 | 54% below | 44% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 HC MRI, Joint Upper Extrem | $1,901.93 | $3,396.30 | $441.52–$3,802.58 | 14% below | 44% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 HC MRI, JOINT UPPER EXTREM | $2,221.30 | $3,966.60 | $441.52–$3,802.58 | 1% above | 44% |
| Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 CERVICAL SP XRAY 4/5 VIEW | $236.38 | $422.10 | $41.25–$392.55 | 26% below | 44% |
| Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 HC Cervical Sp Xray 4/5 View | $340.82 | $608.60 | $79.12–$622.64 | 6% above | 44% |
| Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 HC CERVICAL SP XRAY 4/5 VIEW | $374.92 | $669.50 | $79.12–$622.64 | 17% above | 44% |
| Neck soft tissue CT scan with contrast CPT 70491 HC CT Neck Tissue Contrast | $1,383.93 | $2,471.30 | $321.27–$2,344.25 | 16% below | 44% |
| Neck soft tissue CT scan with contrast CPT 70491 HC CT NECK TISSUE CONTRAST | $1,411.59 | $2,520.70 | $321.27–$2,344.25 | 14% below | 44% |
| Neck soft tissue CT scan without contrast CPT 70490 HC CT Scan of Neck Tissue | $1,042.38 | $1,861.40 | $241.98–$2,120.40 | 27% below | 44% |
| Neck soft tissue CT scan without contrast CPT 70490 HC CT SCAN OF NECK TISSUE | $1,063.22 | $1,898.60 | $241.98–$2,120.40 | 25% below | 44% |
| Neck soft tissue X-ray CPT 70360 HC Neck Soft Tissue Xray | $150.36 | $268.50 | $34.91–$300.86 | 28% below | 44% |
| Neck soft tissue X-ray CPT 70360 HC NECK SOFT TISSUE XRAY | $165.42 | $295.40 | $34.91–$300.86 | 21% below | 44% |
| Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 Heart Spect Multi Image HC | $1,714.61 | $3,061.80 | $398.03–$4,494.69 | 45% below | 44% |
| Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 HEART SPECT MULTI IMAGE HC | $2,228.97 | $3,980.30 | $398.03–$4,494.69 | 28% below | 44% |
| PET/CT scan from the base of the skull to mid-thigh CPT 78815 HC Tumor Imag Pet W/CT; Skull Mid Thi | $3,672.70 | $6,558.40 | $852.59–$6,880.23 | 13% below | 44% |
| PET/CT scan from the base of the skull to mid-thigh CPT 78815 HC TUMOR IMAG PET W/CT; SKULL MID THI | $3,893.06 | $6,951.90 | $852.59–$6,880.23 | 8% below | 44% |
| Pelvic CT scan without contrast CPT 72192 HC CT Scan of Pelvis WO Contrast (72192) | $690.54 | $1,233.10 | $160.30–$2,730.57 | 46% below | 44% |
| Pelvic CT scan without contrast CPT 72192 HC CT SCAN OF PELVIS WO CONTRAST (72192) | $704.37 | $1,257.80 | $160.30–$2,730.57 | 45% below | 44% |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 HC US Pelvic Limited | $215.71 | $385.20 | $50.08–$414.41 | 46% below | 44% |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 HC US PELVIC LIMITED | $222.21 | $396.80 | $50.08–$414.41 | 45% below | 44% |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US PELVIC LIMITED | $235.48 | $420.50 | $28.09–$391.07 | 41% below | 44% |
| Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 HC US Pelvic | $429.41 | $766.80 | $99.68–$943.02 | 18% below | 44% |
| Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 HC US PELVIC | $442.29 | $789.80 | $99.68–$943.02 | 16% below | 44% |
| Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US PELVIC | $511.17 | $912.80 | $81.77–$848.90 | 2% below | 44% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 HC US OB >14 Weeks, Single Fetus | $488.15 | $871.70 | $113.32–$1,174.78 | 15% below | 44% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 HC US OB >14 WEEKS, SINGLE FETUS | $502.82 | $897.90 | $113.32–$1,174.78 | 12% below | 44% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 HC OB US < 14 Wks, Single Fetus | $389.98 | $696.40 | $90.53–$902.75 | 24% below | 44% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 HC OB US < 14 WKS, SINGLE FETUS | $401.69 | $717.30 | $90.53–$902.75 | 22% below | 44% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 OB US <14 WKS, SINGLE(76801) | $571.54 | $1,020.60 | $79.53–$949.16 | 11% above | 44% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 HC US Preg W Image Ltd & Amniotic Fluid 1 or More Fetuses | $319.14 | $569.90 | $74.09–$686.25 | 13% below | 44% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 HC US PREG W IMAGE LTD & AMNIOTIC FLUID 1 OR MORE FETUSES | $328.72 | $587.00 | $74.09–$686.25 | 11% below | 44% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US OB LTD 1 OR MORE FETUSES (76815) | $393.62 | $702.90 | $34.96–$653.70 | 7% above | 44% |
| Rib X-ray, one side, 2 views one side CPT 71100 RIBS XRAY, UNILAT 2 VIEW | $163.63 | $292.20 | $11.14–$271.75 | 27% below | 44% |
| Rib X-ray, one side, 2 views one side CPT 71100 HC Ribs Xray, Unilat 2 View | $204.06 | $364.40 | $47.37–$372.74 | 9% below | 44% |
| Rib X-ray, one side, 2 views one side CPT 71100 HC RIBS XRAY, UNILAT 2 VIEW | $224.45 | $400.80 | $47.37–$372.74 | at median | 44% |
| Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 HC X-Ray Ribs Unilateral, 3+ Vw | $248.70 | $444.10 | $57.73–$528.43 | 10% below | 44% |
| Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 HC X-RAY RIBS UNILATERAL, 3+ VW | $318.19 | $568.20 | $57.73–$528.43 | 15% above | 44% |
| Screening mammogram, both breasts both sides CPT 77067 HC Screening Mammography Bi 2-View Breast Inc Cad | $307.16 | $548.50 | $71.31–$534.75 | — | 44% |
| Screening mammogram, both breasts both sides CPT 77067 HC SCREENING MAMMOGRAPHY BI 2-VIEW BREAST INC CAD | $322.00 | $575.00 | $71.31–$534.75 | — | 44% |
| Shoulder X-ray, complete, 2 or more views CPT 73030 X-RAY SHOULDER 2+ VW | $152.99 | $273.20 | $9.35–$254.08 | 35% below | 44% |
| Shoulder X-ray, complete, 2 or more views CPT 73030 HC X-Ray Shoulder 2+ Vw | $153.50 | $274.10 | $35.63–$480.16 | 35% below | 44% |
| Shoulder X-ray, complete, 2 or more views CPT 73030 HC X-RAY SHOULDER 2+ VW | $199.53 | $356.30 | $35.63–$480.16 | 15% below | 44% |
| Sinus X-ray, complete, 3 or more views CPT 70220 HC Sinus Xray Routine | $173.82 | $310.40 | $40.35–$422.50 | 34% below | 44% |
| Sinus X-ray, complete, 3 or more views CPT 70220 HC SINUS XRAY ROUTINE | $191.18 | $341.40 | $40.35–$422.50 | 28% below | 44% |
| Skull X-ray, fewer than 4 views CPT 70250 HC X-Ray Skull <4 Vw | $110.38 | $197.10 | $25.62–$220.88 | 55% below | 44% |
| Skull X-ray, fewer than 4 views CPT 70250 HC X-RAY SKULL <4 VW | $121.41 | $216.80 | $25.62–$220.88 | 50% below | 44% |
| Sleep study in a lab (polysomnography) CPT 95810 HC Sleep Study-Psg | $2,457.67 | $4,388.70 | $1,836.00–$2,787.00 | 28% below | 44% |
| Sleep study in a lab (polysomnography) CPT 95810 HC SLEEP STUDY-PSG | $2,752.57 | $4,915.30 | $1,836.00–$2,787.00 | 19% below | 44% |
| Stress echocardiogram, complete, including the stress test and supervision CPT 93351 HC Echo Stress W Phy With Contrast | $1,263.98 | $2,257.10 | $677.13–$1,661.23 | 38% below | 44% |
| Stress echocardiogram, complete, including the stress test and supervision CPT 93351 HC ECHO STRESS W PHY WITH CONTRAST | $1,263.98 | $2,257.10 | $677.13–$1,661.23 | 38% below | 44% |
| Stress echocardiogram, complete, including the stress test and supervision CPT 93351 Stress Echo W Supervision | $1,263.98 | $2,257.10 | $677.13–$1,661.23 | 38% below | 44% |
| Stress echocardiogram, complete, including the stress test and supervision CPT 93351 STRESS ECHO W SUPERVISION | $1,263.98 | $2,257.10 | $677.13–$1,661.23 | 38% below | 44% |
| Swallow study (modified barium swallow, video X-ray) CPT 74230 HC Video Fluoro Esophagus | $349.16 | $623.50 | $81.06–$753.86 | 24% below | 44% |
| Swallow study (modified barium swallow, video X-ray) CPT 74230 HC VIDEO FLUORO ESOPHAGUS | $453.94 | $810.60 | $81.06–$753.86 | 1% below | 44% |
| Thigh bone (femur) X-ray, 2 or more views CPT 73552 XRAY FEMUR MINIMUM 2 VIEWS | $157.47 | $281.20 | $9.01–$261.52 | 36% below | 44% |
| Thigh bone (femur) X-ray, 2 or more views CPT 73552 HC Xray Femur Minimum 2 Views | $273.56 | $488.50 | $63.51–$467.98 | 11% above | 44% |
| Thigh bone (femur) X-ray, 2 or more views CPT 73552 HC XRAY FEMUR MINIMUM 2 VIEWS | $274.74 | $490.60 | $63.51–$467.98 | 12% above | 44% |
| Thoracic spine (mid back) CT scan without contrast CPT 72128 HC CT Thoracic Sp W/O Contrast | $1,022.62 | $1,826.10 | $237.39–$2,654.96 | 34% below | 44% |
| Thoracic spine (mid back) CT scan without contrast CPT 72128 HC CT THORACIC SP W/O CONTRAST | $1,043.06 | $1,862.60 | $237.39–$2,654.96 | 32% below | 44% |
| Toe X-ray, 2 or more views CPT 73660 X-RAY TOE(S) | $129.02 | $230.40 | $23.43–$214.27 | 36% below | 44% |
| Toe X-ray, 2 or more views CPT 73660 HC X-Ray Toe(S) | $153.50 | $274.10 | $35.63–$331.36 | 24% below | 44% |
| Toe X-ray, 2 or more views CPT 73660 HC X-RAY TOE(S) | $199.53 | $356.30 | $35.63–$331.36 | 1% below | 44% |
| Transvaginal pelvic ultrasound CPT 76830 HC US Transvaginal | $341.94 | $610.60 | $79.38–$921.26 | 27% below | 44% |
| Transvaginal pelvic ultrasound CPT 76830 HC US TRANSVAGINAL | $352.18 | $628.90 | $79.38–$921.26 | 25% below | 44% |
| Transvaginal pelvic ultrasound CPT 76830 US TRANSVAGINAL | $580.27 | $1,036.20 | $97.44–$963.67 | 24% above | 44% |
| Transvaginal ultrasound during pregnancy CPT 76817 HC Transvaginal US, Obstetric | $371.28 | $663.00 | $86.19–$687.46 | 5% below | 44% |
| Transvaginal ultrasound during pregnancy CPT 76817 HC TRANSVAGINAL US, OBSTETRIC | $382.42 | $682.90 | $86.19–$687.46 | 2% below | 44% |
| Transvaginal ultrasound during pregnancy CPT 76817 US OB TRANSVAGINAL (76817) | $449.06 | $801.90 | $63.88–$745.77 | 15% above | 44% |
| Ultrasound of the abdomen, complete CPT 76700 HC US Abdomen Complete | $552.22 | $986.10 | $128.19–$1,051.83 | 19% below | 44% |
| Ultrasound of the abdomen, complete CPT 76700 HC US ABDOMEN COMPLETE | $568.79 | $1,015.70 | $128.19–$1,051.83 | 16% below | 44% |
| Ultrasound of the scrotum and testicles CPT 76870 HC US Scrotum/Testicular | $376.60 | $672.50 | $87.43–$787.43 | 24% below | 44% |
| Ultrasound of the scrotum and testicles CPT 76870 HC US SCROTUM/TESTICULAR | $387.91 | $692.70 | $87.43–$787.43 | 21% below | 44% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 HC US Thyroid | $397.99 | $710.70 | $92.39–$787.43 | 22% below | 44% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 HC US THYROID | $409.92 | $732.00 | $92.39–$787.43 | 20% below | 44% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US THYROID | $537.43 | $959.70 | $94.45–$892.52 | 5% above | 44% |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 HC Upper GI W Kub | $420.90 | $751.60 | $97.71–$797.01 | 39% below | 44% |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 HC UPPER GI W KUB | $463.01 | $826.80 | $97.71–$797.01 | 32% below | 44% |
| Upper arm X-ray (humerus), 2 views CPT 73060 X-RAY HUMERUS | $142.58 | $254.60 | $8.28–$236.78 | 32% below | 44% |
| Upper arm X-ray (humerus), 2 views CPT 73060 HC X-Ray Humerus | $207.09 | $369.80 | $48.07–$402.32 | 1% below | 44% |
| Upper arm X-ray (humerus), 2 views CPT 73060 HC X-RAY HUMERUS | $227.81 | $406.80 | $48.07–$402.32 | 9% above | 44% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 HC Duplex Extrem Venous,Uni or Ltd | $538.27 | $961.20 | $288.36–$792.30 | 25% below | 44% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 HC DUPLEX EXTREM VENOUS,UNI OR LTD | $602.84 | $1,076.50 | $288.36–$792.30 | 16% below | 44% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 HC Duplex Extrem Venous, Right | $538.27 | $961.20 | $288.36–$792.30 | 25% below | 44% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 HC Duplex Extrem Venous, Left | $538.27 | $961.20 | $288.36–$792.30 | 25% below | 44% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 HC DUPLEX EXTREM VENOUS, LEFT | $602.84 | $1,076.50 | $288.36–$792.30 | 16% below | 44% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 HC DUPLEX EXTREM VENOUS, RIGHT | $602.84 | $1,076.50 | $288.36–$792.30 | 16% below | 44% |
| Wrist X-ray, 2 views CPT 73100 HC X-Ray Wrist 2 Vw | $115.86 | $206.90 | $26.90–$394.88 | 46% below | 44% |
| Wrist X-ray, 2 views CPT 73100 HC X-RAY WRIST 2 VW | $137.14 | $244.90 | $26.90–$394.88 | 36% below | 44% |
| Wrist X-ray, 2 views CPT 73100 X-RAY WRIST 2 VW | $149.91 | $267.70 | $8.28–$248.96 | 31% below | 44% |
| Wrist X-ray, complete, 3 or more views CPT 73110 X-RAY WRIST 3+ VW | $180.99 | $323.20 | $8.66–$300.58 | 29% below | 44% |
| Wrist X-ray, complete, 3 or more views CPT 73110 HC X-Ray Wrist 3+ Vw | $183.68 | $328.00 | $42.64–$513.27 | 28% below | 44% |
| Wrist X-ray, complete, 3 or more views CPT 73110 HC X-RAY WRIST 3+ VW | $238.78 | $426.40 | $42.64–$513.27 | 6% below | 44% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XRAY HIP UNILATERAL WITH PELVIS 2-3 VIEWS | $207.93 | $371.30 | $11.14–$345.31 | 29% below | 44% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 HC Xray Hip Unilateral With Pelvis 2-3 Views | $315.90 | $564.10 | $73.33–$552.79 | 8% above | 44% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 HC XRAY HIP UNILATERAL WITH PELVIS 2-3 VIEWS | $332.86 | $594.40 | $73.33–$552.79 | 14% above | 44% |
| X-ray of the abdomen, 1 view CPT 74018 RADIOLOGIC EXAM ABDOMEN 1 VIEW | $132.33 | $236.30 | $9.01–$219.76 | 37% below | 44% |
| X-ray of the abdomen, 1 view CPT 74018 HC Radiologic Exam Abdomen 1 View | $220.64 | $394.00 | $51.22–$453.47 | 5% above | 44% |
| X-ray of the abdomen, 1 view CPT 74018 HC RADIOLOGIC EXAM ABDOMEN 1 VIEW | $242.70 | $433.40 | $51.22–$453.47 | 15% above | 44% |
| X-ray of the ankle, 2 views CPT 73600 HC Ankle Xray 2 View | $138.77 | $247.80 | $32.21–$253.52 | 30% below | 44% |
| X-ray of the ankle, 2 views CPT 73600 ANKLE XRAY 2 VIEW | $143.98 | $257.10 | $8.28–$239.10 | 28% below | 44% |
| X-ray of the ankle, 2 views CPT 73600 HC ANKLE XRAY 2 VIEW | $152.66 | $272.60 | $32.21–$253.52 | 23% below | 44% |
| X-ray of the finger(s), 2 or more views CPT 73140 X-RAY EXAM OF FINGER(S) | $167.38 | $298.90 | $6.85–$277.98 | 32% below | 44% |
| X-ray of the finger(s), 2 or more views CPT 73140 HC X-Ray Exam of Finger(S) | $178.42 | $318.60 | $41.42–$385.21 | 27% below | 44% |
| X-ray of the finger(s), 2 or more views CPT 73140 HC X-RAY EXAM OF FINGER(S) | $231.95 | $414.20 | $41.42–$385.21 | 5% below | 44% |
| X-ray of the foot, 2 views CPT 73620 X-RAY FOOT 2 VW | $124.77 | $222.80 | $7.61–$207.20 | 34% below | 44% |
| X-ray of the foot, 2 views CPT 73620 HC X-Ray Foot 2 Vw | $203.28 | $363.00 | $47.19–$438.87 | 7% above | 44% |
| X-ray of the foot, 2 views CPT 73620 HC X-RAY FOOT 2 VW | $264.26 | $471.90 | $47.19–$438.87 | 39% above | 44% |
| X-ray of the foot, complete, 3 or more views CPT 73630 X-RAY FOOT 3+ VW | $151.48 | $270.50 | $8.31–$251.57 | 37% below | 44% |
| X-ray of the foot, complete, 3 or more views CPT 73630 HC X-Ray Foot 3+ Vw | $236.49 | $422.30 | $54.90–$481.18 | 2% below | 44% |
| X-ray of the foot, complete, 3 or more views CPT 73630 HC X-RAY FOOT 3+ VW | $289.74 | $517.40 | $54.90–$481.18 | 20% above | 44% |
| X-ray of the hand, 3 or more views CPT 73130 X-RAY HAND 3+ VW | $163.24 | $291.50 | $8.66–$271.10 | 30% below | 44% |
| X-ray of the hand, 3 or more views CPT 73130 HC X-Ray Hand 3+ Vw | $233.52 | $417.00 | $54.21–$504.15 | at median | 44% |
| X-ray of the hand, 3 or more views CPT 73130 HC X-RAY HAND 3+ VW | $303.58 | $542.10 | $54.21–$504.15 | 29% above | 44% |
| X-ray of the knee, 1 or 2 views CPT 73560 XRAY KNEE 1 OR 2 VW | $151.37 | $270.30 | $8.28–$251.38 | 29% below | 44% |
| X-ray of the knee, 1 or 2 views CPT 73560 HC Xray Knee 1 or 2 Vw | $153.50 | $274.10 | $35.63–$450.31 | 28% below | 44% |
| X-ray of the knee, 1 or 2 views CPT 73560 HC XRAY KNEE 1 OR 2 VW | $199.53 | $356.30 | $35.63–$450.31 | 6% below | 44% |
| X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 X-RAY LUMBAR SPINE 2 VW | $176.96 | $316.00 | $29.94–$293.88 | 39% below | 44% |
| X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 HC X-Ray Lumbar Spine 2 Vw | $188.78 | $337.10 | $43.82–$393.30 | 35% below | 44% |
| X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 HC X-RAY LUMBAR SPINE 2 VW | $236.82 | $422.90 | $43.82–$393.30 | 19% below | 44% |
| X-ray of the lower back, 4 or more views CPT 72110 X-RAY LUMBAR SPINE 4 VW | $227.47 | $406.20 | $13.38–$377.77 | 39% below | 44% |
| X-ray of the lower back, 4 or more views CPT 72110 HC X-Ray Lumbar Spine 4 Vw | $236.49 | $422.30 | $54.90–$576.04 | 37% below | 44% |
| X-ray of the lower back, 4 or more views CPT 72110 HC X-RAY LUMBAR SPINE 4 VW | $307.44 | $549.00 | $54.90–$576.04 | 18% below | 44% |
| X-ray of the mid back (thoracic spine), 2 views CPT 72070 X-RAY DORSAL SPINE 2 VW | $145.77 | $260.30 | $23.78–$242.08 | 39% below | 44% |
| X-ray of the mid back (thoracic spine), 2 views CPT 72070 HC X-Ray Dorsal Spine 2 Vw | $184.63 | $329.70 | $42.86–$398.60 | 22% below | 44% |
| X-ray of the mid back (thoracic spine), 2 views CPT 72070 HC X-RAY DORSAL SPINE 2 VW | $240.02 | $428.60 | $42.86–$398.60 | 1% above | 44% |
| X-ray of the nasal bones, 3 or more views CPT 70160 HC Nasal Bones Xray | $163.97 | $292.80 | $38.06–$329.59 | 32% below | 44% |
| X-ray of the nasal bones, 3 or more views CPT 70160 HC NASAL BONES XRAY | $180.38 | $322.10 | $38.06–$329.59 | 26% below | 44% |
| X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 X-RAY CERV SPINE 3 VIEWS OR LESS | $175.45 | $313.30 | $11.14–$291.37 | 27% below | 44% |
| X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 HC X-Ray Cerv Spine 3 Views or Less | $245.62 | $438.60 | $57.02–$448.73 | 2% above | 44% |
| X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 HC X-RAY CERV SPINE 3 VIEWS OR LESS | $270.20 | $482.50 | $57.02–$448.73 | 12% above | 44% |
| X-ray of the pelvis, 1 or 2 views CPT 72170 XRAY PELVIS 1 OR 2 VIEWS | $123.42 | $220.40 | $19.99–$204.97 | 44% below | 44% |
| X-ray of the pelvis, 1 or 2 views CPT 72170 HC Xray Pelvis 1 or 2 Views | $218.40 | $390.00 | $50.70–$423.62 | 1% below | 44% |
| X-ray of the pelvis, 1 or 2 views CPT 72170 HC XRAY PELVIS 1 OR 2 VIEWS | $240.24 | $429.00 | $50.70–$423.62 | 8% above | 44% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 SACRUM/COCCYX X-RAY | $144.09 | $257.30 | $24.80–$239.29 | 33% below | 44% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 HC Sacrum/Coccyx X-Ray | $231.22 | $412.90 | $53.68–$422.41 | 7% above | 44% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 HC SACRUM/COCCYX X-RAY | $254.35 | $454.20 | $53.68–$422.41 | 18% above | 44% |
Lab tests
| Procedure | Cash price | List price | Insurers pay | vs Wisconsin | Off list |
|---|---|---|---|---|---|
| ACTH blood test CPT 82024 ADRENOCORTICOTROPIC HORMONE | $157.42 | $281.10 | — | 28% below | 44% |
| ALT (alanine aminotransferase) liver enzyme test CPT 84460 TRANSFERASE; ALANINE AMINO (ALT) (SGPT) | $21.62 | $38.60 | — | 38% below | 44% |
| ALT (alanine aminotransferase) liver enzyme test CPT 84460 ALANINE AMINO (ALT) (SGPT) | $21.62 | $38.60 | — | 38% below | 44% |
| AST (aspartate aminotransferase) enzyme test CPT 84450 TRANSFERASE (AST) (SGOT) | $21.06 | $37.60 | — | 56% below | 44% |
| Acute hepatitis panel (hepatitis A, B and C) CPT 80074 ACUTE HEPATITIS PANEL | $194.15 | $346.70 | — | 36% below | 44% |
| Albumin blood test CPT 82040 ALBUMIN | $20.16 | $36.00 | — | 46% below | 44% |
| Albumin blood test CPT 82040 ASSAY OF SERUM ALBUMIN | $20.16 | $36.00 | — | 46% below | 44% |
| Aldosterone blood test CPT 82088 ALDOSTERONE ASSAY | $166.15 | $296.70 | — | 15% below | 44% |
| Alkaline phosphatase (ALP) blood test CPT 84075 PHOSPHATASE, ALKALINE | $21.06 | $37.60 | — | 57% below | 44% |
| Alkaline phosphatase (ALP) blood test CPT 84075 ALKALINE PHOSPHATASE | $21.06 | $37.60 | — | 57% below | 44% |
| Allergy blood test, specific IgE, per allergen CPT 86003 IGE ANTIBODY, MULTI-ALLERGEN | $13.22 | $23.60 | — | 47% below | 44% |
| Allergy blood test, specific IgE, per allergen CPT 86003 IGE ANTIBODY, SINGLE ALLERGEN | $13.22 | $23.60 | — | 47% below | 44% |
| Alpha-fetoprotein (AFP) blood test CPT 82105 ALPHA FETOPROTEIN, TUMOR MARKER | $71.96 | $128.50 | — | 14% below | 44% |
| Alpha-fetoprotein (AFP) blood test CPT 82105 AFP SINGLE MARKER SCRN, MATERNAL | $71.96 | $128.50 | — | 14% below | 44% |
| Ammonia blood test CPT 82140 AMMONIUM, URINE | $59.42 | $106.10 | — | 34% below | 44% |
| Ammonia blood test CPT 82140 AMMONIA | $59.42 | $106.10 | — | 34% below | 44% |
| Amylase blood test CPT 82150 AMYLASE | $26.43 | $47.20 | — | 57% below | 44% |
| Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 C CITRULLINE PEP AB | $52.81 | $94.30 | — | 36% below | 44% |
| Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CCP ANTIBODY | $52.81 | $94.30 | — | 36% below | 44% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 ANTINUCLEAR ANTIBODIES (ANA) | $42.45 | $75.80 | — | 38% below | 44% |
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 BRAIN NATRIURETIC PEPTIDE | $138.38 | $247.10 | — | 3% below | 44% |
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 NT PRO BNP | $138.38 | $247.10 | — | 3% below | 44% |
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 NATRIURETIC PEPTIDE | $138.38 | $247.10 | — | 3% below | 44% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE OTHR SPECIMN AEROBIC | $43.79 | $78.20 | — | 17% below | 44% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE, BACTERIA, AEROBIC | $43.79 | $78.20 | — | 17% below | 44% |
| Basic metabolic panel (blood test) CPT 80048 BASIC METABOLIC PANEL | $34.50 | $61.60 | — | 61% below | 44% |
| Bilirubin blood test, total CPT 82247 BILIRUBIN, TOTAL | $20.44 | $36.50 | — | 56% below | 44% |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 MISC LEVEL IV | $39.65 | $70.80 | — | 82% below | 44% |
| Blood culture for bacteria CPT 87040 CULTURE, BLOOD | $52.81 | $94.30 | — | 38% below | 44% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 Venipuncture | $7.28 | $13.00 | — | 50% below | 44% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 DRAWING BLOOD FOR SPEC(NON-MOB | $7.45 | $13.30 | — | 49% below | 44% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 LINE DRAW | $8.40 | $15.00 | — | 43% below | 44% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 VENIPUNCTURE | $8.40 | $15.00 | — | 43% below | 44% |
| Blood glucose (sugar) test CPT 82947 GLUCOSE; QUANTITATIVE, BLOOD | $13.22 | $23.60 | — | 46% below | 44% |
| Blood glucose (sugar) test CPT 82947 Glucose, Blood | $13.22 | $23.60 | — | 46% below | 44% |
| Blood glucose (sugar) test CPT 82947 GLUCOSE, BLOOD | $13.22 | $23.60 | — | 46% below | 44% |
| Blood lead test CPT 83655 LEAD | $49.34 | $88.10 | — | 10% below | 44% |
| Blood lead test CPT 83655 LEAD, BLOOD | $49.34 | $88.10 | — | 10% below | 44% |
| Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 PREGNANCY TEST, SERUM, QUAL | $38.42 | $68.60 | — | 38% below | 44% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 BLOOD TYPING; ABO, COMMUNITY BLD CTR | $13.83 | $24.70 | — | 67% below | 44% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 ABO/RH | $13.83 | $24.70 | — | 67% below | 44% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 BLOOD TYPING, ABO | $13.83 | $24.70 | — | 67% below | 44% |
| Blood urea nitrogen (BUN) test CPT 84520 BLOOD URIEA NITROGEN | $16.07 | $28.70 | — | 38% below | 44% |
| Blood urea nitrogen (BUN) test CPT 84520 BLOOD UREA NITROGEN, BLOOD | $16.07 | $28.70 | — | 38% below | 44% |
| C-peptide blood test CPT 84681 C-PEPTIDE ASSAY | $40.99 | $73.20 | — | 53% below | 44% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C REACTIVE PROTEIN | $25.20 | $45.00 | — | 54% below | 44% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C-REACTIVE PROTEIN | $25.20 | $45.00 | — | 54% below | 44% |
| C. difficile toxin gene test (stool PCR) CPT 87493 CLOSTRIDIUM DIFFICILE TOXINS,PCR, STOOL | $143.02 | $255.40 | — | 5% below | 44% |
| C. difficile toxin gene test (stool PCR) CPT 87493 C DIFF AMPLIFIED PROBE | $143.02 | $255.40 | — | 5% below | 44% |
| CA 19-9 blood test (tumor marker) CPT 86301 CARBOHYDRATE ANTIGEN 19-9 | $84.84 | $151.50 | — | 25% below | 44% |
| CA 19-9 blood test (tumor marker) CPT 86301 IMMUNOASSAY-TUMOR CA 19-9 | $84.84 | $151.50 | — | 25% below | 44% |
| CA-125 blood test (ovarian cancer marker) CPT 86304 TUMOR ANTIGEN, QUANTITATIVE; CA125 | $97.78 | $174.60 | — | 19% below | 44% |
| CA-125 blood test (ovarian cancer marker) CPT 86304 CANCER ANTIGEN 125 | $97.78 | $174.60 | — | 19% below | 44% |
| COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 INFECTIOUS AGENT DETEC BY NUCLEIC ACID (SARS-COV-2), AMPLIFIED PROBE | $168.00 | $300.00 | — | 24% above | 44% |
| Calcium blood test, total CPT 82310 CALCIUM, TOTAL | $21.00 | $37.50 | — | 60% below | 44% |
| Carcinoembryonic antigen (CEA) test CPT 82378 CARCINOEMBRYOGENIC AG | $84.00 | $150.00 | — | 38% below | 44% |
| Chickenpox (varicella) immunity blood test CPT 86787 VARICELLA ZOSTER VIRUS AB, IGG | $25.82 | $46.10 | — | 65% below | 44% |
| Chickenpox (varicella) immunity blood test CPT 86787 ANTIBODY; VARICELLA-ZOSTER | $25.82 | $46.10 | — | 65% below | 44% |
| Chickenpox (varicella) immunity blood test CPT 86787 VARICELLA ZOSTER VIRUS AB, IGM | $25.82 | $46.10 | — | 65% below | 44% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA TRACHOMATIS, AMPLIFIED PROBE | $143.02 | $255.40 | — | at median | 44% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 C TRACHOMATIS, DNA OR RNA | $143.02 | $255.40 | — | at median | 44% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 C TRACHOMATIS,AMP,RNA | $143.02 | $255.40 | — | at median | 44% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PANEL | $54.60 | $97.50 | — | 39% below | 44% |
| Complete blood count (CBC) with differential CPT 85025 COMPLETE BLOOD CT W/DIFF | $31.81 | $56.80 | — | 56% below | 44% |
| Complete blood count (CBC), no differential CPT 85027 COMPLETE BLOOD CT W/MANUAL DIFF | $26.38 | $47.10 | — | 50% below | 44% |
| Complete blood count (CBC), no differential CPT 85027 COMPLETE BLOOD CT NO DIFF | $26.38 | $47.10 | — | 50% below | 44% |
| Comprehensive metabolic panel (blood test) CPT 80053 PANEL, COMPREHENSIVE METABOLIC | $43.06 | $76.90 | — | 62% below | 44% |
| Cortisol blood test, total CPT 82533 CORTISOL, TOTAL | $66.47 | $118.70 | — | 45% below | 44% |
| Creatine kinase (CK) blood test, total CPT 82550 CREATINE KINASE (CK), (CPK); TOTAL | $26.54 | $47.40 | — | 58% below | 44% |
| Creatine kinase (CK) blood test, total CPT 82550 CREATINE KINASE ASSAY | $26.54 | $47.40 | — | 58% below | 44% |
| Creatinine blood test CPT 82565 CREATININE, SERUM | $20.89 | $37.30 | — | 34% below | 44% |
| Cytomegalovirus (CMV) antibody test CPT 86644 CYTOMEGALOVIRUS (CMV) | $58.63 | $104.70 | — | 17% below | 44% |
| D-dimer blood test (blood clot marker) CPT 85379 D DIMER, QUANTITATIVE | $40.82 | $72.90 | — | 49% below | 44% |
| D-dimer blood test (blood clot marker) CPT 85379 D-DIMER REFLEX | $40.82 | $72.90 | — | 49% below | 44% |
| DHEA sulfate (DHEA-S) blood test CPT 82627 DHEA-S | $90.61 | $161.80 | — | 36% below | 44% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG TEST(S), PRESUMPTIVE W/CONFIRM, BY CHEM INSTRUMENT, PER DAY | $185.98 | $332.10 | — | 60% above | 44% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG TEST(S), PRESUMPTIVE, BY CHEM INSTRUMENT, PER DAY | $185.98 | $332.10 | — | 60% above | 44% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG TEST(S), PRESUMPTIVE W/CONFIRM, COC, BY CHEM INSTRUMENT, PER DAY | $185.98 | $332.10 | — | 60% above | 44% |
| Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 ELECTROLYTES | $28.62 | $51.10 | — | 41% below | 44% |
| Epstein-Barr virus (EBV) antibody test CPT 86665 ANTIBODY, EPSTEIN BARR VIRUS, VIRAL CAPSID | $76.78 | $137.10 | — | 7% below | 44% |
| Estradiol blood test CPT 82670 ESTRADIOL | $113.90 | $203.40 | — | 11% below | 44% |
| Estradiol blood test CPT 82670 ASSAY OF TOTAL ESTRADIOL | $113.90 | $203.40 | — | 11% below | 44% |
| FSH (follicle-stimulating hormone) test CPT 83001 FOLLICLE STIMULATING HORMONE | $75.77 | $135.30 | — | 35% below | 44% |
| Fecal calprotectin (stool inflammation test) CPT 83993 CALPROTECTIN, FECAL | $83.38 | $148.90 | — | 56% below | 44% |
| Ferritin blood test (iron stores) CPT 82728 FERRITIN | $55.55 | $99.20 | — | 39% below | 44% |
| Fibrinogen blood test CPT 85384 FIBRINOGEN; ACTIVITY, TEG | $37.80 | $67.50 | — | 44% below | 44% |
| Fibrinogen blood test CPT 85384 FIBRINOGEN | $37.80 | $67.50 | — | 44% below | 44% |
| Folate (folic acid) blood test CPT 82746 FOLIC ACID (FOLATE), SERUM | $59.92 | $107.00 | — | 39% below | 44% |
| Free T3 thyroid hormone test CPT 84481 FREE ASSAY (FT-3) | $48.16 | $86.00 | — | 51% below | 44% |
| Free T3 thyroid hormone test CPT 84481 T3 FREE | $48.16 | $86.00 | — | 51% below | 44% |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 T4, FREE | $36.74 | $65.60 | — | 55% below | 44% |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 ASSAY OF FREE THYROXINE | $36.74 | $65.60 | — | 55% below | 44% |
| Free testosterone test CPT 84402 TESTOSTERONE,FREE | $103.77 | $185.30 | — | 12% below | 44% |
| Gamma-glutamyl transferase (GGT) blood test CPT 82977 GAMMA GT(GGT) | $29.34 | $52.40 | — | 45% below | 44% |
| Gamma-glutamyl transferase (GGT) blood test CPT 82977 GLUTAMYLTRANSFERASE, GAMMA (GGT) | $29.34 | $52.40 | — | 45% below | 44% |
| General health panel: metabolic panel, blood count and TSH in one order CPT 80050 GENERAL HEALTH PANEL | $131.94 | $235.60 | — | 52% below | 44% |
| Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 ORAL GLUCOSE TOLERANCE | $16.18 | $28.90 | — | 67% below | 44% |
| Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GLUCOSE, 1 HR GESTATIONAL SCRN | $16.18 | $28.90 | — | 67% below | 44% |
| Glucose tolerance test, 3 samples CPT 82951 LAB-GLUC TOLER/GTT 3 SPC | $44.41 | $79.30 | — | 51% below | 44% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 NEISSERIA GONORRHOEAE, AMPLIFIED PROBE TECH | $143.02 | $255.40 | — | at median | 44% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 NEISSERIA GONORRHOEAE, AMPLIFIED PROBE TECHNIQUE | $143.02 | $255.40 | — | at median | 44% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 NEISSERIA GONORRHOEAE, AMPLIFIED PROBE | $143.02 | $255.40 | — | at median | 44% |
| H. pylori stool antigen test CPT 87338 H.PYLORI ANTIGEN,FECES | $61.21 | $109.30 | — | 53% below | 44% |
| HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV-1 RNA, QUANT, BLOOD | $346.86 | $619.40 | — | 10% below | 44% |
| HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV-1 QUANT/REFLEX TO GENOTYPE, BLOOD | $346.86 | $619.40 | — | 10% below | 44% |
| HIV-1 and HIV-2 antibody test CPT 86703 HIV 1 AND 2 | $55.89 | $99.80 | — | 28% below | 44% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV-1 AG W/HIV-1 & HIV-2 AB | $98.17 | $175.30 | — | 4% below | 44% |
| HPV test for high-risk types, one combined (pooled) result CPT 87624 HUMAN PAPILLOMA VIRUS | $143.02 | $255.40 | — | at median | 44% |
| HPV test for high-risk types, one combined (pooled) result CPT 87624 HUMAN PAPILLOMA VIRUS HIGH RISK | $143.02 | $255.40 | — | at median | 44% |
| HPV test for high-risk types, one combined (pooled) result CPT 87624 HUMAN PAPILLOMA VIRUS HIGH RISK FOR MEDICARE 30-65 | $143.02 | $255.40 | — | at median | 44% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HBA1C AND EST AV GLU,BLOOD | $40.82 | $72.90 | — | 41% below | 44% |
| Hemoglobin blood test CPT 85018 HEMOGLOBIN, BLOOD COUNT | $8.40 | $15.00 | — | 52% below | 44% |
| Hemoglobin blood test CPT 85018 HEMOGLOBIN BY HEMOCUE METHOD (POCT) | $8.62 | $15.40 | — | 51% below | 44% |
| Hepatitis B core antibody test (total) CPT 86704 HEPATITIS B CORE ANTIBODY | $49.11 | $87.70 | — | 39% below | 44% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEPATITIS B SURFACE ANTIBODY | $43.79 | $78.20 | — | 41% below | 44% |
| Hepatitis B surface antigen (HBsAg) test CPT 87340 HEPATITIS B SURFACE ANTIGEN | $42.11 | $75.20 | — | 35% below | 44% |
| Hepatitis C antibody blood test (screening) CPT 86803 HEPATITIS C ANTIBODY | $58.18 | $103.90 | — | 27% below | 44% |
| Hepatitis C viral load (HCV RNA) test CPT 87522 HEPATITIS C RNA,QUANT,BDNA | $174.72 | $312.00 | — | 26% below | 44% |
| Hepatitis C viral load (HCV RNA) test CPT 87522 HEPATITIS C RNA, QUANT,RT-PCR | $174.72 | $312.00 | — | 26% below | 44% |
| Herpes blood test, HSV-1 antibody CPT 86695 HERPES SIMPLEX,TYPE 1 | $53.76 | $96.00 | — | 21% below | 44% |
| Herpes blood test, HSV-2 antibody CPT 86696 HERPES SIMPLEX,TYPE 2 | $78.90 | $140.90 | — | 3% below | 44% |
| High-sensitivity CRP (hs-CRP) test CPT 86141 C-REACTIVE PROTEIN, HIGH SENS | $55.22 | $98.60 | — | 31% below | 44% |
| High-sensitivity CRP (hs-CRP) test CPT 86141 C-REACTIVE PROTEIN; HIGH SENSITIVITY | $55.22 | $98.60 | — | 31% below | 44% |
| High-sensitivity CRP (hs-CRP) test CPT 86141 HIGH SENSITIVITY CRP,BLOOD | $55.22 | $98.60 | — | 31% below | 44% |
| Homocysteine blood test CPT 83090 HOMOCYSTEINE | $74.37 | $132.80 | — | 37% below | 44% |
| Insulin blood test CPT 83525 INSULIN; TOTAL | $46.59 | $83.20 | — | 31% below | 44% |
| Insulin blood test CPT 83525 INSULIN, SERUM | $46.59 | $83.20 | — | 31% below | 44% |
| Iron blood test (serum iron) CPT 83540 IRON | $26.38 | $47.10 | — | 51% below | 44% |
| Iron-binding capacity (TIBC) test CPT 83550 IRON BINDING CAPACITY | $38.42 | $68.60 | — | 38% below | 44% |
| Kidney function blood test panel CPT 80069 RENAL FUNCTION PANEL | $44.41 | $79.30 | — | 57% below | 44% |
| LH (luteinizing hormone) test CPT 83002 GONADOTROPIN; LUTEINIZING HORMONE (LH) | $75.49 | $134.80 | — | 23% below | 44% |
| LH (luteinizing hormone) test CPT 83002 LUTEINIZING HORMONE (LH) | $75.49 | $134.80 | — | 23% below | 44% |
| Lactate (lactic acid) blood test CPT 83605 LACTIC ACID ASSAY | $46.82 | $83.60 | — | 33% below | 44% |
| Lactate (lactic acid) blood test CPT 83605 ASSAY OF LACTIC ACID | $46.82 | $83.60 | — | 33% below | 44% |
| Lactate dehydrogenase (LDH) blood test CPT 83615 LACTATE (LD) (LDH) ENZYME | $28.22 | $50.40 | — | 44% below | 44% |
| Lipase blood test (pancreas enzyme) CPT 83690 LIPASE | $35.39 | $63.20 | — | 48% below | 44% |
| Liver function blood test panel CPT 80076 LIVER PANEL | $33.60 | $60.00 | — | 67% below | 44% |
| Lyme disease antibody test CPT 86618 BORRELIA BURGDORFERI ANTIBODY (LYME DISEASE) | $69.44 | $124.00 | — | 17% below | 44% |
| Lyme disease antibody test CPT 86618 BORRELIA BURGDORFERI IGG ANTIBODY (LYME DISEASE) | $69.44 | $124.00 | — | 17% below | 44% |
| Lyme disease antibody test CPT 86618 BORRELIA BURGDORFERI IGM ANTIBODY (LYME DISEASE) | $69.44 | $124.00 | — | 17% below | 44% |
| Magnesium blood test CPT 83735 ASSAY MAGNESIUM | $34.22 | $61.10 | — | 35% below | 44% |
| Magnesium blood test CPT 83735 MAGNESIUM | $34.22 | $61.10 | — | 35% below | 44% |
| Measles (rubeola) antibody test CPT 86765 MEASLES (RUBEOLA) ANTIBODIES, I | $54.60 | $97.50 | — | 34% below | 44% |
| Mono test (heterophile antibody, Monospot) CPT 86308 MONOSPOT | $16.80 | $30.00 | — | 70% below | 44% |
| Mumps immunity blood test CPT 86735 ANTIBODY; MUMPS | $53.20 | $95.00 | — | 38% below | 44% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 PROSTATE SPECIFIC ANTIGEN, FREE | $74.98 | $133.90 | — | 19% below | 44% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 PROSTATE SPECIFIC ANTIGEN | $74.98 | $133.90 | — | 21% below | 44% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 PROSTATE SPECIFIC ANTIGEN, TOTAL | $74.98 | $133.90 | — | 21% below | 44% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 PROSTATIC SPC AG, SYMPTOMATIC | $74.98 | $133.90 | — | 21% below | 44% |
| Pap test (liquid-based, automated screening with review) CPT 88175 IMAGED THINPREP PAP SMEAR, DIAGNOSTIC | $105.28 | $188.00 | — | at median | 44% |
| Pap test (liquid-based, automated screening with review) CPT 88175 IMAGED THINPREP PAP SMEAR, SCREEN | $105.28 | $188.00 | — | at median | 44% |
| Pap test (liquid-based, automated screening with review) CPT 88175 IMAGED THINPREP PAP SMEAR | $105.28 | $188.00 | — | at median | 44% |
| Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 THINPREP PAP | $80.92 | $144.50 | — | 10% below | 44% |
| Parathyroid hormone (PTH) blood test CPT 83970 PARATHYROID HORMONE (PTH)INTACT | $168.28 | $300.50 | — | 21% below | 44% |
| Parathyroid hormone (PTH) blood test CPT 83970 ASSAY OF PARATHORMONE | $168.28 | $300.50 | — | 21% below | 44% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 PARTIAL THROMBOPLASTIN TIME | $24.47 | $43.70 | — | 53% below | 44% |
| Phosphorus (phosphate) blood test CPT 84100 ASSAY PHOSPHORUS | $19.32 | $34.50 | — | 54% below | 44% |
| Potassium blood test CPT 84132 POTASSIUM, SERUM | $18.76 | $33.50 | — | 32% below | 44% |
| Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) CPT 81420 FETAL CHROMOSOMAL ANEUPLOIDY GENOMIC SEQUENCE | $2,333.24 | $4,166.50 | — | 93% above | 44% |
| Progesterone blood test CPT 84144 PROGESTERONE | $75.82 | $135.40 | — | 37% below | 44% |
| Prolactin blood test CPT 84146 PROLACTIN ASSAY | $78.96 | $141.00 | — | 35% below | 44% |
| Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME | $12.26 | $21.90 | — | 64% below | 44% |
| Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 DRUG TEST, PRESUMPTIVE, QUAL-DIRECT OPTICAL OBS, PER DAY | $43.51 | $77.70 | — | 24% below | 44% |
| Rapid flu test (influenza antigen) CPT 87804 INFLUENZA A OR B DIFFERENTIATED | $52.81 | $94.30 | — | at median | 44% |
| Rapid strep A antigen test from a throat swab, read visually CPT 87880 RAPID GROUP A STREP THROAT SCREEN | $40.82 | $72.90 | — | 10% below | 44% |
| Renin blood test CPT 84244 RENIN ACTIVITY, PLASMA | $89.66 | $160.10 | — | 39% below | 44% |
| Rh blood typing CPT 86901 BLOOD TYPING; RH(D), COMMUNITY BLD CTR | $13.83 | $24.70 | — | 65% below | 44% |
| Rh blood typing CPT 86901 BLOOD TYPING, RH (D) | $13.83 | $24.70 | — | 65% below | 44% |
| Rheumatoid factor (RF) test CPT 86431 RHEUMATOID FACTOR,SERUM | $23.13 | $41.30 | — | 60% below | 44% |
| Rheumatoid factor (RF) test CPT 86431 RHEUMATOID FACTOR; QUANTITATIVE | $23.13 | $41.30 | — | 60% below | 44% |
| Rheumatoid factor (RF) test CPT 86431 RHEUMATOID FACTOR, BLOOD | $23.13 | $41.30 | — | 60% below | 44% |
| Rheumatoid factor (RF) test CPT 86431 RA TITER | $23.13 | $41.30 | — | 60% below | 44% |
| Rubella antibody test (immunity check) CPT 86762 ANTIBODY; RUBELLA | $58.63 | $104.70 | — | 29% below | 44% |
| Rubella antibody test (immunity check) CPT 86762 RUBELLA | $58.63 | $104.70 | — | 29% below | 44% |
| Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 ESR,AUTO (SED-RATE) | $12.60 | $22.50 | — | 70% below | 44% |
| Sodium blood test CPT 84295 SODIUM, SERUM | $19.60 | $35.00 | — | 21% below | 44% |
| Stool ova and parasites exam CPT 87177 OVA AND PARASITES | $37.80 | $67.50 | — | 42% below | 44% |
| Stool test for hidden blood (guaiac FOBT) CPT 82270 OCCULT BLOOD X 3, STOOL | $10.19 | $18.20 | — | 52% below | 44% |
| Stool test for hidden blood by immunoassay (FIT) CPT 82274 FECAL OCCULT BLOOD | $53.98 | $96.40 | — | 11% below | 44% |
| Syphilis antibody test (Treponema pallidum) CPT 86780 SYPHILIS CONFIRMATION | $34.78 | $62.10 | — | 37% below | 44% |
| Syphilis antibody test (Treponema pallidum) CPT 86780 SYPHILIS ANTIBODY | $34.78 | $62.10 | — | 37% below | 44% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 VDRL, SPINAL FLUID | $21.62 | $38.60 | — | 45% below | 44% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 RPR SEROLOGY | $21.62 | $38.60 | — | 45% below | 44% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 SYPHILIS TEST, VDRL, SERUM | $21.62 | $38.60 | — | 45% below | 44% |
| TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 QUANTIFERON TB GOLD, BLOOD | $252.62 | $451.10 | — | at median | 44% |
| Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE, TOTAL | $102.76 | $183.50 | — | 11% below | 44% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 MICROSOMAL ANTIBODIES, EACH | $59.30 | $105.90 | — | 15% below | 44% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 MICROSOMAL AB | $59.30 | $105.90 | — | 15% below | 44% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 LIVER/KIDNEY MICROSOME TYPE I A | $59.30 | $105.90 | — | 15% below | 44% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 THYROPEROXIDASE AB, SERUM | $59.30 | $105.90 | — | 15% below | 44% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 THYROID STIMULATING HORMONE (TSH) | $68.49 | $122.30 | — | 24% below | 44% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 ASSAY THYROID STIM HORMONE | $68.49 | $122.30 | — | 24% below | 44% |
| Total IgE blood test CPT 82785 ALLERGY,FOOD PANEL,PEDIATRIC | $69.61 | $124.30 | — | 32% below | 44% |
| Total IgE blood test CPT 82785 ALLERGY,FOOD PANEL,ADULT | $69.61 | $124.30 | — | 32% below | 44% |
| Total IgE blood test CPT 82785 ALLERGY,ENVIRO PANEL,ADULT | $69.61 | $124.30 | — | 32% below | 44% |
| Total IgE blood test CPT 82785 IGE IMMUNOGLOBULIN, SERUM | $69.61 | $124.30 | — | 32% below | 44% |
| Total cholesterol blood test CPT 82465 CHOLESTEROL, SERUM | $17.75 | $31.70 | — | 62% below | 44% |
| Total thyroxine (T4) blood test CPT 84436 ASSAY OF TOTAL THYROXINE | $29.40 | $52.50 | — | 43% below | 44% |
| Total thyroxine (T4) blood test CPT 84436 T4 | $29.40 | $52.50 | — | 43% below | 44% |
| Total triiodothyronine (T3) blood test CPT 84480 T3, TOTAL ONLY | $59.98 | $107.10 | — | 44% below | 44% |
| Transferrin blood test CPT 84466 TRANSFERRIN | $52.08 | $93.00 | — | 45% below | 44% |
| Trichomonas test (NAAT) CPT 87661 TRICHOMONAS VAGINALIS AMPLIF | $143.02 | $255.40 | — | 5% above | 44% |
| Trichomonas test (NAAT) CPT 87661 TRICHOMONAS VAGINALIS, AMP PROBE TECHNIQUE | $143.02 | $255.40 | — | 5% above | 44% |
| Triglycerides blood test CPT 84478 TRYGLYCERIDES | $24.02 | $42.90 | — | 55% below | 44% |
| Troponin test, quantitative CPT 84484 TROPONIN | $50.40 | $90.00 | — | 40% below | 44% |
| Uric acid blood test CPT 84550 URIC ACID ASSAY | $18.42 | $32.90 | — | 64% below | 44% |
| Urinalysis with microscope exam, automated CPT 81001 URINALYSIS,AUTO,W/MICRO | $10.19 | $18.20 | — | 72% below | 44% |
| Urinalysis with microscope exam, manual CPT 81000 URINALYSIS,NONAUTO,W/MICRO | $10.19 | $18.20 | — | 18% below | 44% |
| Urinalysis without microscope exam, automated CPT 81003 URINALYSIS, DIP ONLY, AUTO | $7.00 | $12.50 | — | 72% below | 44% |
| Urinalysis without microscope exam, manual CPT 81002 URINALYSIS, DIP ONLY, NONAUTO | $8.01 | $14.30 | — | 42% below | 44% |
| Urine culture for bacteria, with colony count CPT 87086 URINE CULTURE, COLONY COUNT | $38.42 | $68.60 | — | 49% below | 44% |
| Urine microalbumin (albumin) test CPT 82043 URINE, MICROALBUMIN, QUANTITATIVE | $24.02 | $42.90 | — | 63% below | 44% |
| Urine pregnancy test, read by color change CPT 81025 PREGNANCY TEST, URINE, QUAL | $21.62 | $38.60 | — | 56% below | 44% |
| Vitamin B12 (cobalamin) blood test CPT 82607 VITAMIN B12 | $61.43 | $109.70 | — | 40% below | 44% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D 25 HYDROXY D2/D3 | $120.68 | $215.50 | — | 22% below | 44% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D 25 HYDROXY | $120.68 | $215.50 | — | 22% below | 44% |
| Vitamin D, 1,25-dihydroxy blood test CPT 82652 VITAMIN D,1,25-DIHYDROXY, SERUM | $156.91 | $280.20 | — | 2% below | 44% |
| Zinc blood test CPT 84630 ZINC ASSAY | $42.22 | $75.40 | — | 47% below | 44% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 GONADOTROPIN, CHORIONIC (HCG) TOTAL | $58.80 | $105.00 | — | 50% below | 44% |
Surgery and procedures
| Procedure | Cash price | List price | Insurers pay | vs Wisconsin | Off list |
|---|---|---|---|---|---|
| Adenoid removal (adenoidectomy), child under 12 CPT 42830 REMOVAL ADENOIDS,PRIMARY,<12 Y/O | $1,393.78 | $2,488.90 | $746.67–$1,831.83 | at median | 44% |
| Adenoid removal (adenoidectomy), child under 12 CPT 42830 HC Removal Adenoids,Primary,<12 Y/O | $4,797.58 | $8,567.10 | $2,570.13–$6,997.67 | 244% above | 44% |
| Adenoid removal (adenoidectomy), child under 12 CPT 42830 HC REMOVAL ADENOIDS,PRIMARY,<12 Y/O | $4,941.50 | $8,824.10 | $2,570.13–$6,997.67 | 255% above | 44% |
| Anterior cervical discectomy and fusion (ACDF), one level CPT 22551 HC Neck Spine Fuse&Remove Addl | $6,937.95 | $12,389.20 | $3,716.76–$18,563.39 | at median | 44% |
| Anterior cervical discectomy and fusion (ACDF), one level CPT 22551 HC NECK SPINE FUSE&REMOVE ADDL | $9,019.36 | $16,106.00 | $3,716.76–$18,563.39 | 30% above | 44% |
| Appendectomy for a ruptured appendix with abscess or peritonitis CPT 44960 HC Appendectomy,Rupt Appendx+Abscess | $4,862.31 | $8,682.70 | $2,604.81–$6,582.20 | at median | 44% |
| Appendectomy for a ruptured appendix with abscess or peritonitis CPT 44960 HC APPENDECTOMY,RUPT APPENDX+ABSCESS | $5,008.19 | $8,943.20 | $2,604.81–$6,582.20 | 3% above | 44% |
| Appendectomy for a ruptured appendix with abscess or peritonitis CPT 44960 APPENDECTOMY,RUPT APPENDX+ABSCESS | $5,454.06 | $9,739.40 | $2,921.82–$7,168.20 | 12% above | 44% |
| Appendectomy, open surgery CPT 44950 HC Appendectomy | $2,439.70 | $4,356.60 | $1,306.98–$6,699.37 | at median | 44% |
| Appendectomy, open surgery CPT 44950 HC APPENDECTOMY | $3,171.84 | $5,664.00 | $1,306.98–$6,699.37 | 30% above | 44% |
| Arthroscopic ACL reconstruction or repair of the knee CPT 29888 HC Knee Scope,Aid Ant Cruciate Repair | $11,779.38 | $21,034.60 | $6,310.38–$15,945.88 | at median | 44% |
| Arthroscopic ACL reconstruction or repair of the knee CPT 29888 HC KNEE SCOPE,AID ANT CRUCIATE REPAIR | $12,132.74 | $21,665.60 | $6,310.38–$15,945.88 | 3% above | 44% |
| Arthroscopic rotator cuff repair of the shoulder CPT 29827 ARTHROSCOP ROTATOR CUFF REPR | $5,268.87 | $9,408.70 | $2,822.61–$6,924.80 | at median | 44% |
| Arthroscopic rotator cuff repair of the shoulder CPT 29827 HC Arthroscop Rotator Cuff Repr | $10,984.62 | $19,615.40 | $5,884.62–$14,720.00 | 108% above | 44% |
| Arthroscopic rotator cuff repair of the shoulder CPT 29827 HC ARTHROSCOP ROTATOR CUFF REPR | $11,200.00 | $20,000.00 | $5,884.62–$14,720.00 | 113% above | 44% |
| Balloon dilation of the maxillary sinus opening, one side CPT 31295 HC Maxillary Sinus Endo W/Balloon Dil | $4,424.84 | $7,901.50 | $2,370.45–$5,990.01 | 131% above | 44% |
| Balloon dilation of the maxillary sinus opening, one side CPT 31295 HC MAXILLARY SINUS ENDO W/BALLOON DIL | $4,557.62 | $8,138.60 | $2,370.45–$5,990.01 | 138% above | 44% |
| Botox injections for chronic migraine CPT 64615 CHEMODENERV MUSC MIGRAINE | $732.98 | $1,308.90 | $305.76–$963.35 | at median | 44% |
| Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion CPT 19081 BX BREAST W DEVICE 1ST LESION STEREOTACTIC GUIDE | $1,814.96 | $3,241.00 | $306.33–$2,385.38 | 29% below | 44% |
| Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion CPT 19081 HC Bx Breast W Device 1st Lesion Stereotactic Guide | $2,152.98 | $3,844.60 | $1,153.38–$2,956.81 | 15% below | 44% |
| Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion CPT 19081 HC BX BREAST W DEVICE 1ST LESION STEREOTACTIC GUIDE | $2,217.54 | $3,959.90 | $1,153.38–$2,956.81 | 13% below | 44% |
| Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 HC Cltx Dstl Fibular Fx Lat Malls W/O Manj | $418.54 | $747.40 | $224.22–$723.12 | 24% below | 44% |
| Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 HC CLTX DSTL FIBULAR FX LAT MALLS W/O MANJ | $456.18 | $814.60 | $224.22–$723.12 | 17% below | 44% |
| Bunion correction with a bone cut near the head of the first metatarsal CPT 28296 CORRJ HLX VLGS BNCTY SESMDC DSTL METAR OSTEOT | $4,489.69 | $8,017.30 | $1,388.85–$5,900.73 | at median | 44% |
| Bunion correction with a bone cut near the head of the first metatarsal CPT 28296 HC Corrj Hallux Valgus W/Sesmdc W/Dist Metar Osteot | $5,300.85 | $9,465.80 | $2,839.74–$7,175.85 | 18% above | 44% |
| Bunion correction with a bone cut near the head of the first metatarsal CPT 28296 HC CORRJ HALLUX VALGUS W/SESMDC W/DIST METAR OSTEOT | $5,459.89 | $9,749.80 | $2,839.74–$7,175.85 | 22% above | 44% |
| Bunion correction with removal of part of the big toe joint CPT 28292 CORRJ HLX VLGS BNCTY SESMDC RESCJ PROX PHLX BASE | $3,517.58 | $6,281.40 | $1,308.09–$4,623.11 | 38% below | 44% |
| Bunion correction with removal of part of the big toe joint CPT 28292 HC Corrj Hallux Valgus W/Sesmdc W/Rescj Prox Phal | $5,300.85 | $9,465.80 | $2,839.74–$7,175.85 | 6% below | 44% |
| Bunion correction with removal of part of the big toe joint CPT 28292 HC CORRJ HALLUX VALGUS W/SESMDC W/RESCJ PROX PHAL | $5,459.89 | $9,749.80 | $2,839.74–$7,175.85 | 3% below | 44% |
| Cardiac catheterization with coronary angiogram CPT 93458 HC L HRT ARTERY/VENTRICLE ANGIO (93458) | $7,248.64 | $12,944.00 | $9,180.00–$13,345.00 | 26% below | 44% |
| Cardiac catheterization with coronary angiogram CPT 93458 HC L Hrt Artery/Ventricle Angio (93458) | $7,629.94 | $13,624.90 | $9,180.00–$13,345.00 | 22% below | 44% |
| Cardioversion, elective (restoring heart rhythm) CPT 92960 HEART ELECTROCARDIOVERSION (92960) | $766.19 | $1,368.20 | $283.17–$1,007.00 | 22% below | 44% |
| Cardioversion, elective (restoring heart rhythm) CPT 92960 HC CARDIOVERSION | $1,177.51 | $2,102.70 | $630.81–$1,547.59 | 20% above | 44% |
| Cardioversion, elective (restoring heart rhythm) CPT 92960 HC-ELECTIVE CARDIOVERSION | $1,177.51 | $2,102.70 | $630.81–$1,547.59 | 20% above | 44% |
| Cardioversion, elective (restoring heart rhythm) CPT 92960 HC-Elective Cardioversion | $1,177.51 | $2,102.70 | $630.81–$1,547.59 | 20% above | 44% |
| Cardioversion, elective (restoring heart rhythm) CPT 92960 HC Cardioversion(92960) | $1,177.51 | $2,102.70 | $630.81–$1,547.59 | 20% above | 44% |
| Carpal tunnel release, open surgery CPT 64721 NEUROPLASTY MEDIAN NERVE CARPL | $2,228.86 | $3,980.10 | $1,172.07–$2,929.35 | at median | 44% |
| Carpal tunnel release, open surgery CPT 64721 HC Neuroplasty Median Nerve Carpl | $3,185.28 | $5,688.00 | $1,706.40–$4,311.93 | 43% above | 44% |
| Carpal tunnel release, open surgery CPT 64721 HC NEUROPLASTY MEDIAN NERVE CARPL | $3,280.82 | $5,858.60 | $1,706.40–$4,311.93 | 47% above | 44% |
| Cataract surgery with lens implant CPT 66984 HC Remv Cataract Extracap,Insert | $4,048.18 | $7,228.90 | $3,799.00 | at median | 44% |
| Cataract surgery with lens implant CPT 66984 HC REMV CATARACT EXTRACAP,INSERT | $4,169.65 | $7,445.80 | $3,799.00 | 3% above | 44% |
| Catheter ablation for atrial fibrillation CPT 93656 COMPRE EP EVAL ABLTJ ATR FIB PULM VEIN ISOLATION | $5,355.78 | $9,563.90 | $24,720.00–$27,869.00 | 70% below | 44% |
| Catheter ablation for atrial fibrillation CPT 93656 TX ATRIAL FIB PULM VEIN ISOL | $23,306.25 | $41,618.30 | $24,720.00–$27,869.00 | 32% above | 44% |
| Catheter ablation for atrial fibrillation CPT 93656 HC Ep/Transseptal/a Fib Abl W Vein Isolation (93656) | $23,306.25 | $41,618.30 | $24,720.00–$27,869.00 | 32% above | 44% |
| Cervical biopsy CPT 57500 BIOPSY/EXCIS CERVICAL LESN | $592.65 | $1,058.30 | $149.94–$778.91 | at median | 44% |
| Cervical biopsy CPT 57500 HC Biopsy/Excis Cervical Lesn | $844.09 | $1,507.30 | $452.19–$1,666.01 | 42% above | 44% |
| Cervical biopsy CPT 57500 HC BIOPSY/EXCIS CERVICAL LESN | $1,097.32 | $1,959.50 | $452.19–$1,666.01 | 85% above | 44% |
| Cesarean delivery, including prenatal and postpartum care CPT 59510 FULL ROUT OBSTE CARE,CESAREAN DELIV | $5,437.94 | $9,710.60 | $2,913.18–$7,147.00 | at median | 44% |
| Circumcision by surgical excision, older than 28 days (children and adults) CPT 54161 HC Circumcision,Othr | $929.04 | $1,659.00 | $497.70–$5,955.56 | at median | 44% |
| Circumcision by surgical excision, older than 28 days (children and adults) CPT 54161 HC CIRCUMCISION,OTHR | $956.93 | $1,708.80 | $497.70–$5,955.56 | 3% above | 44% |
| Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 HC Circumcision | $136.64 | $244.00 | $73.20–$187.68 | 33% below | 44% |
| Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 HC Circumcision,Clamp,Newborn | $136.64 | $244.00 | $73.20–$187.68 | 33% below | 44% |
| Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 HC CIRCUMCISION | $142.80 | $255.00 | $73.20–$187.68 | 30% below | 44% |
| Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 HC CIRCUMCISION,CLAMP,NEWBORN | $142.80 | $255.00 | $73.20–$187.68 | 30% below | 44% |
| Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 CIRCUMCISION,CLAMP,NEWBORN | $766.86 | $1,369.40 | $261.42–$1,007.88 | 276% above | 44% |
| Circumcision, surgical, older than a newborn CPT 54160 CIRCUMCISION,OTHR,NEWBORN | $742.28 | $1,325.50 | $397.65–$1,498.72 | at median | 44% |
| Circumcision, surgical, older than a newborn CPT 54160 HC Circumcision,Othr,Newborn | $2,835.22 | $5,062.90 | $1,518.87–$3,838.09 | 282% above | 44% |
| Circumcision, surgical, older than a newborn CPT 54160 HC CIRCUMCISION,OTHR,NEWBORN | $2,920.29 | $5,214.80 | $1,518.87–$3,838.09 | 293% above | 44% |
| Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 HC Closed Rx Dist Rad/Ulna Fx | $1,250.37 | $2,232.80 | $669.84–$1,692.65 | 103% above | 44% |
| Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 HC CLOSED RX DIST RAD/ULNA FX | $1,287.89 | $2,299.80 | $669.84–$1,692.65 | 109% above | 44% |
| Colonoscopy with endoscopic ultrasound CPT 45391 HC Colonoscopy W/Endoscope US | $2,369.02 | $4,230.40 | $1,269.12–$4,093.19 | 5% below | 44% |
| Colonoscopy with endoscopic ultrasound CPT 45391 HC COLONOSCOPY W/ENDOSCOPE US | $2,440.09 | $4,357.30 | $1,269.12–$4,093.19 | 2% below | 44% |
| Colonoscopy with polyp removal CPT 45385 HC Colsc Flx W/Rmvl of Tumor Polyp Lesion Snare Tq | $1,928.58 | $3,443.90 | $1,033.17–$2,610.74 | 21% below | 44% |
| Colonoscopy with polyp removal CPT 45385 HC COLSC FLX W/RMVL OF TUMOR POLYP LESION SNARE TQ | $1,986.43 | $3,547.20 | $1,033.17–$2,610.74 | 19% below | 44% |
| Colonoscopy with tissue sample CPT 45380 HC Colonoscopy W/Biopsy Single/Multiple | $1,928.58 | $3,443.90 | $1,033.17–$3,574.75 | 6% below | 44% |
| Colonoscopy with tissue sample CPT 45380 HC COLONOSCOPY W/BIOPSY SINGLE/MULTIPLE | $1,986.43 | $3,547.20 | $1,033.17–$3,574.75 | 3% below | 44% |
| Colonoscopy, diagnostic CPT 45378 HC Colonoscopy Flx Dx W/Collj Spec When Pfrmd | $1,741.38 | $3,109.60 | $932.88–$2,357.33 | at median | 44% |
| Colonoscopy, diagnostic CPT 45378 HC COLONOSCOPY FLX DX W/COLLJ SPEC WHEN PFRMD | $1,793.62 | $3,202.90 | $932.88–$2,357.33 | 3% above | 44% |
| Colonoscopy, diagnostic CPT 45378 COLONOSCOPY FLX DX W/COLLJ SPEC WHEN PFRMD | $2,233.11 | $3,987.70 | $630.21–$2,934.95 | 28% above | 44% |
| Colposcopy with LEEP (loop electrosurgical excision) CPT 57460 COLPOSCOPY,LOOP ELECTRD CERVIX EXCIS | $1,209.66 | $2,160.10 | $317.82–$1,589.83 | 41% above | 44% |
| Colposcopy with LEEP (loop electrosurgical excision) CPT 57460 HC Colposcopy,Loop Electrd Cervix Excis | $3,547.15 | $6,334.20 | $1,900.26–$5,285.80 | 312% above | 44% |
| Colposcopy with LEEP (loop electrosurgical excision) CPT 57460 HC COLPOSCOPY,LOOP ELECTRD CERVIX EXCIS | $3,653.55 | $6,524.20 | $1,900.26–$5,285.80 | 325% above | 44% |
| Colposcopy with cervical biopsy and scraping of the cervical canal CPT 57454 HC Colposcopy,Bx Cervix/Endocerv Curr | $522.42 | $932.90 | $279.87–$707.22 | 15% above | 44% |
| Colposcopy with cervical biopsy and scraping of the cervical canal CPT 57454 HC COLPOSCOPY,BX CERVIX/ENDOCERV CURR | $538.10 | $960.90 | $279.87–$707.22 | 19% above | 44% |
| Colposcopy with cervical biopsy and scraping of the cervical canal CPT 57454 COLPOSCOPY,BX CERVIX/ENDOCERV CURR | $640.30 | $1,143.40 | $265.47–$841.54 | 41% above | 44% |
| Complex cataract surgery with lens implant CPT 66982 HC Cataract Surgery Complex | $4,048.18 | $7,228.90 | $3,799.00 | at median | 44% |
| Complex cataract surgery with lens implant CPT 66982 HC CATARACT SURGERY COMPLEX | $4,169.65 | $7,445.80 | $3,799.00 | 3% above | 44% |
| Coronary stent placement, one artery CPT 92928 PERQ TCAT PLMT NTRAC ST 1 LES 1+C SEGMENTS | $2,675.51 | $4,777.70 | $24,463.00 | 66% below | 44% |
| Coronary stent placement, one artery CPT 92928 HC Stent, Bare Metal Cor Major Artery or Branch (92928) | $6,898.30 | $12,318.40 | $24,463.00 | 12% below | 44% |
| Coronary stent placement, one artery CPT 92928 HC STENT, BARE METAL COR MAJOR ARTERY OR BRANCH (92928) | $6,898.30 | $12,318.40 | $24,463.00 | 12% below | 44% |
| Cystoscopy with ureteral stent placement CPT 52332 HC Cystoscopy,Insert Ureteral Stent | $5,391.85 | $9,628.30 | $2,888.49–$8,832.00 | 24% above | 44% |
| Cystoscopy with ureteral stent placement CPT 52332 HC CYSTOSCOPY,INSERT URETERAL STENT | $6,720.00 | $12,000.00 | $2,888.49–$8,832.00 | 54% above | 44% |
| Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 HC Cystourethroscopy | $1,388.86 | $2,480.10 | $744.03–$1,880.11 | 40% above | 44% |
| Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 HC CYSTOURETHROSCOPY | $1,430.52 | $2,554.50 | $744.03–$1,880.11 | 44% above | 44% |
| D&C (dilation and curettage), not related to pregnancy CPT 58120 DILATION/CURETTAGE,DIAGNOSTIC | $1,133.83 | $2,024.70 | $471.03–$1,490.18 | at median | 44% |
| D&C (dilation and curettage), not related to pregnancy CPT 58120 HC Dilation/Curettage,Diagnostic | $3,547.15 | $6,334.20 | $1,900.26–$5,285.80 | 213% above | 44% |
| D&C (dilation and curettage), not related to pregnancy CPT 58120 HC DILATION/CURETTAGE,DIAGNOSTIC | $3,653.55 | $6,524.20 | $1,900.26–$5,285.80 | 222% above | 44% |
| Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 DESTRUCTION PREMALIGNANT LESION 1ST | $240.24 | $429.00 | $104.25–$315.74 | 33% above | 44% |
| Ear tube placement (tympanostomy) under general anesthesia, one ear CPT 69436 CREATE EARDRUM OPENING,GEN ANESTH | $610.62 | $1,090.40 | $327.12–$802.53 | at median | 44% |
| Ear tube placement (tympanostomy) under general anesthesia, one ear CPT 69436 HC Create Eardrum Opening,Gen Anesth | $2,433.70 | $4,345.90 | $1,303.77–$3,626.64 | 299% above | 44% |
| Ear tube placement (tympanostomy) under general anesthesia, one ear CPT 69436 HC CREATE EARDRUM OPENING,GEN ANESTH | $2,506.73 | $4,476.30 | $1,303.77–$3,626.64 | 311% above | 44% |
| Ear tube placement (tympanostomy) with local anesthesia, one ear CPT 69433 CREATE EARDRUM OPENING,LOCAL ANESTH | $781.20 | $1,395.00 | $271.08–$1,026.72 | 49% above | 44% |
| Ear tube placement (tympanostomy) with local anesthesia, one ear CPT 69433 HC Create Eardrum Opening,Local Anesth | $839.83 | $1,499.70 | $449.91–$1,136.90 | 61% above | 44% |
| Ear tube placement (tympanostomy) with local anesthesia, one ear CPT 69433 HC CREATE EARDRUM OPENING,LOCAL ANESTH | $865.03 | $1,544.70 | $449.91–$1,136.90 | 66% above | 44% |
| Earwax removal by irrigation (rinsing), one ear one side CPT 69209 HC Removal Impacted Cerumen Irrigation/Lvg Unilat | $139.16 | $248.50 | $74.55–$188.42 | 50% above | 44% |
| Earwax removal by irrigation (rinsing), one ear one side CPT 69209 HC REMOVAL IMPACTED CERUMEN IRRIGATION/LVG UNILAT | $143.36 | $256.00 | $74.55–$188.42 | 55% above | 44% |
| Earwax removal with instruments, one ear CPT 69210 HC Remove Impacted Ear Wax | $173.26 | $309.40 | $92.82–$234.56 | 107% above | 44% |
| Earwax removal with instruments, one ear CPT 69210 HC REMOVE IMPACTED EAR WAX | $178.47 | $318.70 | $92.82–$234.56 | 113% above | 44% |
| Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 BIOPSY OF UTERUS LINING | $387.24 | $691.50 | $125.76–$508.94 | 43% above | 44% |
| Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 HC Biopsy of Uterus Lining | $389.20 | $695.00 | $208.50–$526.90 | 43% above | 44% |
| Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 HC BIOPSY OF UTERUS LINING | $400.90 | $715.90 | $208.50–$526.90 | 48% above | 44% |
| Endoscopic sinus surgery: full ethmoid sinus opening CPT 31255 HC Nasal/Sinus Ndsc W/Total Ethoidectomy | $5,667.09 | $10,119.80 | $3,035.94–$7,671.62 | at median | 44% |
| Endoscopic sinus surgery: full ethmoid sinus opening CPT 31255 HC NASAL/SINUS NDSC W/TOTAL ETHOIDECTOMY | $5,837.10 | $10,423.40 | $3,035.94–$7,671.62 | 3% above | 44% |
| Endoscopic sinus surgery: opening the frontal sinus CPT 31276 HC Nasal/Sinus Ndsc W/Rmvl Tiss From Frontal Sinus | $4,424.84 | $7,901.50 | $2,370.45–$5,990.01 | at median | 44% |
| Endoscopic sinus surgery: opening the frontal sinus CPT 31276 HC NASAL/SINUS NDSC W/RMVL TISS FROM FRONTAL SINUS | $4,557.62 | $8,138.60 | $2,370.45–$5,990.01 | 3% above | 44% |
| Endoscopic sinus surgery: opening the maxillary (cheek) sinus CPT 31256 HC Nasal Scopy,Open Maxill Sinus | $2,896.04 | $5,171.50 | $1,551.45–$3,920.45 | 21% above | 44% |
| Endoscopic sinus surgery: opening the maxillary (cheek) sinus CPT 31256 HC NASAL SCOPY,OPEN MAXILL SINUS | $2,982.95 | $5,326.70 | $1,551.45–$3,920.45 | 25% above | 44% |
| Endoscopic sinus surgery: opening the maxillary sinus with removal of tissue CPT 31267 HC Nasal Scopy,Rmv Tiss Maxill Sinus | $4,073.27 | $7,273.70 | $2,182.11–$5,514.04 | at median | 44% |
| Endoscopic sinus surgery: opening the maxillary sinus with removal of tissue CPT 31267 HC NASAL SCOPY,RMV TISS MAXILL SINUS | $4,195.46 | $7,491.90 | $2,182.11–$5,514.04 | 3% above | 44% |
| Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 HC Njx Dx/Ther Sbst Intrlmnr Crv/Thrc W/Img Gdn | $1,147.44 | $2,049.00 | $614.70–$1,552.67 | 13% below | 44% |
| Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 HC Njx Dx/Ther Sbst Intrlmnr Crv/Thrc W/Img Gdn(62321) | $1,147.44 | $2,049.00 | $614.70–$2,083.10 | 13% below | 44% |
| Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 HC NJX DX/THER SBST INTRLMNR CRV/THRC W/IMG GDN(62321) | $1,181.38 | $2,109.60 | $614.70–$2,083.10 | 11% below | 44% |
| Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 HC NJX DX/THER SBST INTRLMNR CRV/THRC W/IMG GDN | $1,181.38 | $2,109.60 | $614.70–$1,552.67 | 11% below | 44% |
| Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 NJX DX/THER SBST INTRLMNR CRV/THRC W/IMG GDN(62321) | $1,336.27 | $2,386.20 | $285.90–$1,756.24 | 1% above | 44% |
| Eye injection into the vitreous (intravitreal injection) CPT 67028 HC INTRAVITREAL NJX PHARMACOLOGIC AGT SPX | $752.25 | $1,343.30 | $391.26–$1,261.95 | 86% above | 44% |
| Facet joint injection, lower back, one level, with imaging guidance CPT 64493 INJ PARAVERT FACET LUMBAR/SACRAL 1 LEVEL (64493) | $894.15 | $1,596.70 | $241.14–$1,175.17 | 45% below | 44% |
| Facet joint injection, lower back, one level, with imaging guidance CPT 64493 HC Inj Paravert Facet Lumbar/Sacral 1 Level (64493) | $1,482.82 | $2,647.90 | $794.37–$2,007.29 | 8% below | 44% |
| Facet joint injection, lower back, one level, with imaging guidance CPT 64493 HC INJ PARAVERT FACET LUMBAR/SACRAL 1 LEVEL (64493) | $1,527.29 | $2,727.30 | $794.37–$2,007.29 | 6% below | 44% |
| First repair of a front abdominal hernia (such as umbilical) 3 to 10 cm CPT 49593 HC Init Rpr Sliding Hernia of Abd 3-10 Cm | $6,402.09 | $11,432.30 | $3,429.69–$12,763.20 | at median | 44% |
| First repair of a front abdominal hernia (such as umbilical) 3 to 10 cm CPT 49593 HC INIT RPR SLIDING HERNIA OF ABD 3-10 CM | $6,594.17 | $11,775.30 | $3,429.69–$12,763.20 | 3% above | 44% |
| First repair of a front abdominal hernia larger than 10 cm CPT 49595 HC Init Rpr Sliding Hernia of Abd > 10 Cm | $6,402.09 | $11,432.30 | $3,429.69–$12,763.20 | at median | 44% |
| First repair of a front abdominal hernia larger than 10 cm CPT 49595 HC INIT RPR SLIDING HERNIA OF ABD > 10 CM | $6,594.17 | $11,775.30 | $3,429.69–$12,763.20 | 3% above | 44% |
| First repair of a small front abdominal hernia (e.g. umbilical), under 3 cm CPT 49591 RPR AA HERNIA 1ST < 3 CM REDUCIBLE | $2,114.00 | $3,775.00 | $1,132.50–$2,778.40 | at median | 44% |
| First repair of a small front abdominal hernia (e.g. umbilical), under 3 cm CPT 49591 HC Init Rpr Ss Hernia 1st < 3cm Red | $6,402.09 | $11,432.30 | $3,429.69–$12,763.20 | 203% above | 44% |
| First repair of a small front abdominal hernia (e.g. umbilical), under 3 cm CPT 49591 HC INIT RPR SS HERNIA 1ST < 3CM RED | $6,594.17 | $11,775.30 | $3,429.69–$12,763.20 | 212% above | 44% |
| Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 SIGMOIDOSCOPY FLX DX W/COLLJ SPEC BR/WA IF PFRMD | $1,232.56 | $2,201.00 | $192.75–$1,619.94 | 44% above | 44% |
| Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 HC Sigmoidoscopy Flx Dx W/Collj Spec Br/Wa if Pfrmd | $1,479.86 | $2,642.60 | $792.78–$2,013.03 | 73% above | 44% |
| Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 HC SIGMOIDOSCOPY FLX DX W/COLLJ SPEC BR/WA IF PFRMD | $1,524.26 | $2,721.90 | $792.78–$2,013.03 | 78% above | 44% |
| Gallbladder removal, laparoscopic CPT 47562 HC Cholecystectomy Laparoscopic | $8,873.59 | $15,845.70 | $4,753.71–$19,643.99 | 4% below | 44% |
| Gallbladder removal, laparoscopic CPT 47562 HC CHOLECYSTECTOMY LAPAROSCOPIC | $9,139.82 | $16,321.10 | $4,753.71–$19,643.99 | 1% below | 44% |
| Gallbladder removal, laparoscopic, with X-ray of the bile ducts during surgery CPT 47563 HC CHOLE WITH CHOLANGIOGRAPHY | $8,429.68 | $15,053.00 | $4,515.90–$11,662.44 | 10% below | 44% |
| Gallbladder removal, laparoscopic, with X-ray of the bile ducts during surgery CPT 47563 HC Chole With Cholangiography | $8,873.59 | $15,845.70 | $4,515.90–$11,662.44 | 5% below | 44% |
| Gallbladder removal, open surgery through a larger incision CPT 47600 HC REMOVAL OF GALLBLADDER | $2,808.06 | $5,014.40 | $1,504.32–$4,710.55 | at median | 44% |
| Hammertoe correction surgery CPT 28285 REPAIR OF HAMMERTOE,ONE | $2,716.39 | $4,850.70 | $1,041.75–$3,570.12 | at median | 44% |
| Hammertoe correction surgery CPT 28285 HC Repair of Hammertoe,One | $3,062.98 | $5,469.60 | $1,640.88–$4,146.40 | 13% above | 44% |
| Hammertoe correction surgery CPT 28285 HC REPAIR OF HAMMERTOE,ONE | $3,154.87 | $5,633.70 | $1,640.88–$4,146.40 | 16% above | 44% |
| Hemorrhoid banding (rubber band ligation) CPT 46221 HC Ligation of Hemorrhoid(S) | $1,391.77 | $2,485.30 | $745.59–$2,013.03 | 8% above | 44% |
| Hemorrhoid banding (rubber band ligation) CPT 46221 HC LIGATION OF HEMORRHOID(S) | $1,472.46 | $2,629.40 | $745.59–$2,013.03 | 15% above | 44% |
| Hemorrhoid banding (rubber band ligation) CPT 46221 LIGATION OF HEMORRHOID(S) | $1,867.49 | $3,334.80 | $671.70–$2,454.41 | 46% above | 44% |
| Hemorrhoidectomy (internal and external), one area CPT 46255 HEMORRHOIDECTOMY,INT/EXT,SIMPLE | $3,398.64 | $6,069.00 | $1,224.96–$4,466.78 | at median | 44% |
| Hemorrhoidectomy (internal and external), one area CPT 46255 HC Hemorrhoidectomy,Int/Ext,Simple | $4,284.39 | $7,650.70 | $2,295.21–$5,799.83 | 26% above | 44% |
| Hemorrhoidectomy (internal and external), one area CPT 46255 HC HEMORRHOIDECTOMY,INT/EXT,SIMPLE | $4,412.91 | $7,880.20 | $2,295.21–$5,799.83 | 30% above | 44% |
| Hip replacement after an earlier hip surgery (conversion to total hip) CPT 27132 CONVERT HIP REVSN TO TOTAL HIP | $8,157.97 | $14,567.80 | $4,370.34–$10,721.90 | at median | 44% |
| Hip replacement after an earlier hip surgery (conversion to total hip) CPT 27132 HC TOTAL HIP ARTHROPLASTY | $22,036.00 | $39,350.00 | $11,805.00–$41,475.29 | 170% above | 44% |
| Hysterectomy through an abdominal incision (total) CPT 58150 TOTAL ABDOM HYSTERECTOMY | $3,793.55 | $6,774.20 | $2,032.26–$4,985.81 | at median | 44% |
| Hysterectomy through an abdominal incision (total) CPT 58150 HC Total Abdominal Hysterect W/WO Rmvl Tube Ovary | $9,910.15 | $17,696.70 | $5,309.01–$17,122.67 | 161% above | 44% |
| Hysterectomy through an abdominal incision (total) CPT 58150 HC TOTAL ABDOMINAL HYSTERECT W/WO RMVL TUBE OVARY | $10,207.46 | $18,227.60 | $5,309.01–$17,122.67 | 169% above | 44% |
| Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 HC Cath/Inject Hysterosalpingogram | $231.22 | $412.90 | $123.87–$313.02 | 31% below | 44% |
| Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 HC CATH/INJECT HYSTEROSALPINGOGRAM | $238.17 | $425.30 | $123.87–$313.02 | 29% below | 44% |
| Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 CATH/INJECT HYSTEROSALPINGOGRAM | $952.73 | $1,701.30 | $115.08–$1,252.16 | 183% above | 44% |
| Hysteroscopy with endometrial ablation CPT 58563 HC Hysteroscopy Endometrial | $8,143.46 | $14,541.90 | $4,362.57–$12,134.43 | at median | 44% |
| Hysteroscopy with endometrial ablation CPT 58563 HYSTEROSCOPY ENDOMETRIAL | $8,294.94 | $14,812.40 | $3,213.96–$10,901.93 | 2% above | 44% |
| Hysteroscopy with endometrial ablation CPT 58563 HC HYSTEROSCOPY ENDOMETRIAL | $8,387.79 | $14,978.20 | $4,362.57–$12,134.43 | 3% above | 44% |
| Hysteroscopy with uterine lining sampling and/or polyp removal CPT 58558 HC HYSTEROSCOPY BIOPSY | $4,705.68 | $8,403.00 | $2,520.90–$6,509.99 | 30% above | 44% |
| Hysteroscopy with uterine lining sampling and/or polyp removal CPT 58558 HC Hysteroscopy Biopsy | $4,953.26 | $8,845.10 | $2,520.90–$6,509.99 | 37% above | 44% |
| Hysteroscopy with uterine lining sampling and/or polyp removal CPT 58558 HYSTEROSCOPY BIOPSY | $5,202.23 | $9,289.70 | $460.20–$6,837.22 | 44% above | 44% |
| IUD insertion (the device itself billed separately) CPT 58300 INSERT INTRAUTERINE DEVICE | $427.22 | $762.90 | $102.87–$561.49 | 40% above | 44% |
| IUD insertion (the device itself billed separately) CPT 58300 HC Insert Intrauterine Device | $1,482.38 | $2,647.10 | $794.13–$2,209.40 | 387% above | 44% |
| IUD insertion (the device itself billed separately) CPT 58300 HC INSERT INTRAUTERINE DEVICE | $1,526.84 | $2,726.50 | $794.13–$2,209.40 | 402% above | 44% |
| Incision and drainage of a simple or single skin abscess CPT 10060 HC Drain Skin Abscess Simple | $435.79 | $778.20 | $233.46–$753.15 | 49% above | 44% |
| Incision and drainage of a simple or single skin abscess CPT 10060 HC I&D SIMPLE | $448.90 | $801.60 | $233.46–$589.98 | 54% above | 44% |
| Incision and drainage of a simple or single skin abscess CPT 10060 HC DRAIN SKIN ABSCESS SIMPLE | $448.90 | $801.60 | $233.46–$753.15 | 54% above | 44% |
| Inguinal (groin) hernia repair, age 5 or older CPT 49505 HC Repair Ing Hernia,5+Y/O,Reducibl | $5,579.56 | $9,963.50 | $2,989.05–$8,654.11 | 12% below | 44% |
| Inguinal (groin) hernia repair, age 5 or older CPT 49505 HC REPAIR ING HERNIA,5+Y/O,REDUCIBL | $5,746.94 | $10,262.40 | $2,989.05–$8,654.11 | 9% below | 44% |
| Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 INJ TENDON/LIGAMENT (20550) | $290.75 | $519.20 | $103.62–$382.13 | 15% below | 44% |
| Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 HC Inj Tendon/Ligament | $535.25 | $955.80 | $286.74–$724.59 | 57% above | 44% |
| Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 HC INJ TENDON/LIGAMENT | $551.32 | $984.50 | $286.74–$724.59 | 62% above | 44% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/O US (20610) | $322.90 | $576.60 | $119.04–$424.38 | 26% below | 44% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 HC Arthrocentesis Aspir&/Inj Major Jt/Bursa W/O US | $532.62 | $951.10 | $285.33–$720.84 | 23% above | 44% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 HC Arthrocentesis Aspir&/Inj Major Jt/Bursa W/O US (20610) | $532.62 | $951.10 | $285.33–$720.84 | 23% above | 44% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 HC ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/O US (20610) | $548.46 | $979.40 | $285.33–$720.84 | 27% above | 44% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 HC ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/O US | $548.46 | $979.40 | $285.33–$720.84 | 27% above | 44% |
| Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 HC Insert Drug Implant Device | $206.58 | $368.90 | $110.67–$279.68 | 22% below | 44% |
| Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 HC INSERT DRUG IMPLANT DEVICE | $212.80 | $380.00 | $110.67–$279.68 | 19% below | 44% |
| Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 INSERTION DRUG DELIVERY IMPLANT | $352.30 | $629.10 | $114.84–$463.02 | 33% above | 44% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ARTHROCENTESIS ASPIR&/INJ INTERM JT/BURS W/O US | $276.47 | $493.70 | $97.77–$363.36 | 14% below | 44% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 HC Arthrocentesis Aspir&/Inj Interm Jt/Burs W/O US (20605) | $535.25 | $955.80 | $286.74–$724.59 | 67% above | 44% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 HC Arthrocentesis Aspir&/Inj Interm Jt/Burs W/O US | $535.25 | $955.80 | $286.74–$724.59 | 67% above | 44% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 HC ARTHROCENTESIS ASPIR&/INJ INTERM JT/BURS W/O US | $551.32 | $984.50 | $286.74–$724.59 | 72% above | 44% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 HC ARTHROCENTESIS ASPIR&/INJ INTERM JT/BURS W/O US (20605) | $551.32 | $984.50 | $286.74–$724.59 | 72% above | 44% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 ARTHROCENTESIS ASPIR&/INJ SMALL JT/BURSA W/O US | $266.62 | $476.10 | $94.35–$350.41 | 28% below | 44% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 HC Arthrocentesis Aspir&/Inj Small Jt/Bursa W/O US | $451.81 | $806.80 | $242.04–$651.80 | 22% above | 44% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 HC ARTHROCENTESIS ASPIR&/INJ SMALL JT/BURSA W/O US | $476.78 | $851.40 | $242.04–$651.80 | 28% above | 44% |
| Knee arthroscopy with meniscus repair (one side of the knee) CPT 29882 KNEE SCOPE,MED OR LAT MENIS REPAIR | $3,418.13 | $6,103.80 | $1,831.14–$4,492.40 | 51% below | 44% |
| Knee arthroscopy with meniscus repair (one side of the knee) CPT 29882 HC Knee Scope,Med or Lat Menis Repair | $4,273.92 | $7,632.00 | $2,289.60–$5,785.70 | 39% below | 44% |
| Knee arthroscopy with meniscus repair (one side of the knee) CPT 29882 HC KNEE SCOPE,MED OR LAT MENIS REPAIR | $4,402.16 | $7,861.00 | $2,289.60–$5,785.70 | 37% below | 44% |
| Knee arthroscopy with meniscus trim CPT 29881 HC Meniscectomy Medial or Lateral | $4,966.42 | $8,868.60 | $2,660.58–$6,723.14 | at median | 44% |
| Knee arthroscopy with meniscus trim CPT 29881 HC MENISCECTOMY MEDIAL OR LATERAL | $5,115.43 | $9,134.70 | $2,660.58–$6,723.14 | 3% above | 44% |
| Knee arthroscopy with removal of both torn meniscus parts CPT 29880 HC Meniscectomy Medial and Lateral | $5,498.58 | $9,818.90 | $2,945.67–$7,443.54 | at median | 44% |
| Knee arthroscopy with removal of both torn meniscus parts CPT 29880 HC MENISCECTOMY MEDIAL AND LATERAL | $5,663.56 | $10,113.50 | $2,945.67–$7,443.54 | 3% above | 44% |
| Knee arthroscopy with smoothing of damaged cartilage (chondroplasty) CPT 29877 KNEE SCOPE,SHAVE ARTICULAR CART | $3,084.87 | $5,508.70 | $1,652.61–$4,054.40 | at median | 44% |
| Knee arthroscopy with smoothing of damaged cartilage (chondroplasty) CPT 29877 HC Knee Scope,Shave Articular Cart | $4,273.92 | $7,632.00 | $2,289.60–$5,785.70 | 39% above | 44% |
| Knee arthroscopy with smoothing of damaged cartilage (chondroplasty) CPT 29877 HC KNEE SCOPE,SHAVE ARTICULAR CART | $4,402.16 | $7,861.00 | $2,289.60–$5,785.70 | 43% above | 44% |
| Laparoscopic Roux-en-Y gastric bypass, standard limb length CPT 43644 HC Lap Gastr Rstrc;Gastr Byps&Rouxeny | $7,401.46 | $13,216.90 | $3,965.07–$10,019.46 | at median | 44% |
| Laparoscopic Roux-en-Y gastric bypass, standard limb length CPT 43644 HC LAP GASTR RSTRC;GASTR BYPS&ROUXENY | $7,623.50 | $13,613.40 | $3,965.07–$10,019.46 | 3% above | 44% |
| Laparoscopic appendectomy (appendix removal through small cuts) CPT 44970 LAPAROSCOPY APPENDECTOMY | $3,771.32 | $6,734.50 | $2,020.35–$4,956.59 | 16% below | 44% |
| Laparoscopic appendectomy (appendix removal through small cuts) CPT 44970 HC Laparoscopy Appendectomy | $8,873.59 | $15,845.70 | $4,753.71–$12,012.33 | 96% above | 44% |
| Laparoscopic appendectomy (appendix removal through small cuts) CPT 44970 HC LAPAROSCOPY APPENDECTOMY | $9,139.82 | $16,321.10 | $4,753.71–$12,012.33 | 102% above | 44% |
| Laparoscopic fundoplication (anti-reflux surgery) CPT 43280 HC Laparoscopy Esophagogastric | $15,619.86 | $27,892.60 | $8,367.78–$21,144.84 | 470% above | 44% |
| Laparoscopic fundoplication (anti-reflux surgery) CPT 43280 HC LAPAROSCOPY ESOPHAGOGASTRIC | $16,088.46 | $28,729.40 | $8,367.78–$21,144.84 | 487% above | 44% |
| Laparoscopic hysterectomy (uterus 250 g or less) CPT 58570 HC Tlh, Uterus 250 G or Less | $5,080.60 | $9,072.50 | $2,721.75–$8,680.38 | at median | 44% |
| Laparoscopic hysterectomy (uterus 250 g or less) CPT 58570 HC TLH, UTERUS 250 G OR LESS | $6,604.64 | $11,794.00 | $2,721.75–$8,680.38 | 30% above | 44% |
| Laparoscopic hysterectomy, uterus 250 g or less, with tubes and/or ovaries CPT 58571 TLH W/T/O 250 G OR LESS | $3,403.23 | $6,077.20 | $1,823.16–$4,472.82 | at median | 44% |
| Laparoscopic hysterectomy, uterus 250 g or less, with tubes and/or ovaries CPT 58571 HC TLH W/T/O 250 G OR LESS | $12,394.48 | $22,133.00 | $6,639.90–$17,147.11 | 264% above | 44% |
| Laparoscopic hysterectomy, uterus 250 g or less, with tubes and/or ovaries CPT 58571 HC Tlh W/T/O 250 G or Less | $13,046.71 | $23,297.70 | $6,639.90–$17,147.11 | 283% above | 44% |
| Laparoscopic inguinal (groin) hernia repair, first repair on that side CPT 49650 INGUINAL HERNIA REPAIR | $2,722.61 | $4,861.80 | $1,458.54–$3,578.28 | at median | 44% |
| Laparoscopic inguinal (groin) hernia repair, first repair on that side CPT 49650 HC Inguinal Hernia Repair | $8,873.59 | $15,845.70 | $4,753.71–$12,012.33 | 226% above | 44% |
| Laparoscopic inguinal (groin) hernia repair, first repair on that side CPT 49650 HC INGUINAL HERNIA REPAIR | $9,139.82 | $16,321.10 | $4,753.71–$12,012.33 | 236% above | 44% |
| Laparoscopic inguinal (groin) hernia repair, recurrent hernia CPT 49651 HC Inguinal Hernia Repair | $7,273.95 | $12,989.20 | $3,896.76–$9,846.87 | at median | 44% |
| Laparoscopic inguinal (groin) hernia repair, recurrent hernia CPT 49651 HC INGUINAL HERNIA REPAIR | $7,492.18 | $13,378.90 | $3,896.76–$9,846.87 | 3% above | 44% |
| Laparoscopic removal of an adjustable gastric band and its port CPT 43774 HC Lap Remov Adj Gast Band/Port | $5,384.79 | $9,615.70 | $2,884.71–$7,289.49 | at median | 44% |
| Laparoscopic removal of an adjustable gastric band and its port CPT 43774 HC LAP REMOV ADJ GAST BAND/PORT | $5,546.35 | $9,904.20 | $2,884.71–$7,289.49 | 3% above | 44% |
| Laparoscopic removal of fallopian tubes and/or ovaries CPT 58661 LAPAROSCOPY, REMOVAL OF ADNEXAL STRUCTURES | $2,440.42 | $4,357.90 | $1,307.37–$3,207.41 | at median | 44% |
| Laparoscopic removal of fallopian tubes and/or ovaries CPT 58661 HC Laparoscopy, Removal of Adnexal Structures | $7,315.73 | $13,063.80 | $3,919.14–$10,900.45 | 200% above | 44% |
| Laparoscopic removal of fallopian tubes and/or ovaries CPT 58661 HC LAPAROSCOPY, REMOVAL OF ADNEXAL STRUCTURES | $7,535.19 | $13,455.70 | $3,919.14–$10,900.45 | 209% above | 44% |
| Laparoscopic sleeve gastrectomy for weight loss CPT 43775 HC Lap Sleeve Gastrectomy | $8,532.10 | $15,235.90 | $4,570.77–$11,550.05 | at median | 44% |
| Laparoscopic sleeve gastrectomy for weight loss CPT 43775 HC LAP SLEEVE GASTRECTOMY | $8,788.08 | $15,693.00 | $4,570.77–$11,550.05 | 3% above | 44% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 HC Layr Clos Wnd Trunk,Arm,Leg <2.5cm | $776.38 | $1,386.40 | $415.92–$1,051.01 | 47% above | 44% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 HC LAYR CLOS WND TRUNK,ARM,LEG <2.5CM | $799.68 | $1,428.00 | $415.92–$1,051.01 | 52% above | 44% |
| Left heart catheterization, diagnostic one side CPT 93452 HC LEFT HRT CATH INCLUDES LVG (93452) | $4,158.56 | $7,426.00 | $9,180.00–$13,345.00 | 39% below | 44% |
| Left heart catheterization, diagnostic one side CPT 93452 HC Left Hrt Cath Includes Lvg (93452) | $4,158.56 | $7,426.00 | $9,180.00–$13,345.00 | 39% below | 44% |
| Lower-back epidural injection, with imaging guidance CPT 62323 HC Njx Dx/Ther Sbst Intrlmnr Lmbr/Sac W/Img Gdn (62323) | $1,147.44 | $2,049.00 | $614.70–$1,665.79 | at median | 44% |
| Lower-back epidural injection, with imaging guidance CPT 62323 HC NJX DX/THER SBST INTRLMNR LMBR/SAC W/IMG GDN (62323) | $1,181.88 | $2,110.50 | $614.70–$1,665.79 | 3% above | 44% |
| Lower-back epidural injection, with imaging guidance CPT 62323 NJX DX/THER SBST INTRLMNR LMBR/SAC W/IMG GDN (62323) | $1,317.23 | $2,352.20 | $264.75–$1,731.22 | 15% above | 44% |
| Lower-back epidural injection, without imaging guidance CPT 62322 NJX DX/THER SBST INTRLMNR LMBR/SAC W/O IMG GDN | $700.34 | $1,250.60 | $214.17–$920.44 | 15% below | 44% |
| Lower-back epidural injection, without imaging guidance CPT 62322 HC Njx Dx/Ther Sbst Intrlmnr Lmbr/Sac W/O Img Gdn | $923.94 | $1,649.90 | $494.97–$1,578.65 | 12% above | 44% |
| Lower-back epidural injection, without imaging guidance CPT 62322 HC NJX DX/THER SBST INTRLMNR LMBR/SAC W/O IMG GDN | $1,201.14 | $2,144.90 | $494.97–$1,578.65 | 46% above | 44% |
| Lower-back nerve root steroid injection, with imaging guidance both sides CPT 64483 HC Lumbar Nerve Block Bilateral (64483.02) | $1,507.74 | $2,692.40 | $807.72–$2,041.08 | — | 44% |
| Lower-back nerve root steroid injection, with imaging guidance both sides CPT 64483 HC LUMBAR NERVE BLOCK BILATERAL (64483.02) | $1,552.99 | $2,773.20 | $807.72–$2,041.08 | — | 44% |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 TRANSFORAMINAL INJECTION LUMBAR OR SACRAL 1 LEVEL (64483) | $1,253.34 | $2,238.10 | $297.24–$1,647.24 | 17% above | 44% |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 HC Transforaminal Injection Lumbar or Sacral 1 Level (64483) | $1,507.74 | $2,692.40 | $807.72–$2,041.08 | 41% above | 44% |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 HC TRANSFORAMINAL INJECTION LUMBAR OR SACRAL 1 LEVEL (64483) | $1,552.99 | $2,773.20 | $807.72–$2,041.08 | 45% above | 44% |
| Lumbar discectomy or laminotomy to free a nerve root, one level CPT 63030 EXCIS LUMBAR DISK,ONE LEVEL | $4,376.79 | $7,815.70 | $2,344.71–$5,752.36 | 72% below | 44% |
| Lumbar discectomy or laminotomy to free a nerve root, one level CPT 63030 HC Excis Lumbar Disk,One Level | $12,752.32 | $22,772.00 | $6,831.60–$17,263.03 | 19% below | 44% |
| Lumbar discectomy or laminotomy to free a nerve root, one level CPT 63030 HC EXCIS LUMBAR DISK,ONE LEVEL | $13,134.91 | $23,455.20 | $6,831.60–$17,263.03 | 16% below | 44% |
| Lumbar fusion with interbody cage and posterolateral graft (TLIF), one level CPT 22633 HC Lumbar Spine Fusion Combined | $4,425.18 | $7,902.10 | $2,370.63–$7,560.93 | at median | 44% |
| Lumbar fusion with interbody cage and posterolateral graft (TLIF), one level CPT 22633 HC LUMBAR SPINE FUSION COMBINED | $5,752.88 | $10,273.00 | $2,370.63–$7,560.93 | 30% above | 44% |
| Lumbar interbody fusion (PLIF or TLIF), one level CPT 22630 ARTHRODESIS POSTERIOR INTERBODY 1 NTRSPC LUMBAR | $7,334.99 | $13,098.20 | $3,929.46–$9,640.28 | at median | 44% |
| Lumbar interbody fusion (PLIF or TLIF), one level CPT 22630 HC Arthrodesis Posterior Interbody Lumbar | $31,550.06 | $56,339.40 | $16,901.82–$54,511.77 | 330% above | 44% |
| Lumbar interbody fusion (PLIF or TLIF), one level CPT 22630 HC ARTHRODESIS POSTERIOR INTERBODY LUMBAR | $32,496.58 | $58,029.60 | $16,901.82–$54,511.77 | 343% above | 44% |
| Lumbar laminectomy (spinal decompression), one level CPT 63047 LAM FACETECTOMY & FORAMOTOMY 1 VRT SGM LUMBAR | $5,278.00 | $9,425.00 | $2,827.50–$6,936.80 | 57% below | 44% |
| Lumbar laminectomy (spinal decompression), one level CPT 63047 HC Laminec/Facetect/Foramin,Lumbar | $8,838.09 | $15,782.30 | $4,734.69–$11,964.27 | 27% below | 44% |
| Lumbar laminectomy (spinal decompression), one level CPT 63047 HC LAMINEC/FACETECT/FORAMIN,LUMBAR | $9,103.25 | $16,255.80 | $4,734.69–$11,964.27 | 25% below | 44% |
| Lumbar spinal fusion (posterior), one level CPT 22612 ARTHRODESIS POSTERIOR/PSTLAT TQ 1NTRSPC LUMBAR | $7,572.66 | $13,522.60 | $4,056.78–$9,952.63 | at median | 44% |
| Lumbar spinal fusion (posterior), one level CPT 22612 HC Lumbar Spine Fusn,Post Tech | $11,870.94 | $21,198.10 | $6,359.43–$20,510.26 | 57% above | 44% |
| Lumbar spinal fusion (posterior), one level CPT 22612 HC LUMBAR SPINE FUSN,POST TECH | $12,227.04 | $21,834.00 | $6,359.43–$20,510.26 | 61% above | 44% |
| Lumpectomy (partial mastectomy) CPT 19301 HC Partial Mastectomy | $3,164.50 | $5,650.90 | $1,695.27–$5,343.21 | at median | 44% |
| Lumpectomy (partial mastectomy) CPT 19301 HC PARTIAL MASTECTOMY | $3,259.42 | $5,820.40 | $1,695.27–$5,343.21 | 3% above | 44% |
| Mastectomy (total removal of the breast) CPT 19303 HC Mast, Simple, Complete | $4,076.24 | $7,279.00 | $2,183.70–$7,428.45 | 43% below | 44% |
| Mastectomy (total removal of the breast) CPT 19303 HC MAST, SIMPLE, COMPLETE | $4,198.54 | $7,497.40 | $2,183.70–$7,428.45 | 42% below | 44% |
| Miscarriage treatment with D&C, first trimester CPT 59820 SURG RX MISSED ABORTN,1ST TRI | $1,163.12 | $2,077.00 | $541.98–$1,528.67 | at median | 44% |
| Miscarriage treatment with D&C, first trimester CPT 59820 HC Surg Rx Missed Abortn,1st Tri | $4,059.61 | $7,249.30 | $2,174.79–$5,495.56 | 249% above | 44% |
| Miscarriage treatment with D&C, first trimester CPT 59820 HC SURG RX MISSED ABORTN,1ST TRI | $4,181.41 | $7,466.80 | $2,174.79–$5,495.56 | 259% above | 44% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 EXC SKIN BENIG <5MM TRUNK,ARM,LEG | $458.02 | $817.90 | $159.21–$601.97 | 31% above | 44% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 HC Exc Skin Benig <5mm Trunk,Arm,Leg | $874.16 | $1,561.00 | $468.30–$1,553.55 | 151% above | 44% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 HC EXC SKIN BENIG <5MM TRUNK,ARM,LEG | $1,136.35 | $2,029.20 | $468.30–$1,553.55 | 226% above | 44% |
| Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 EXC SKIN BENIG <5MM FACE,FACIAL | $514.98 | $919.60 | $202.59–$676.83 | at median | 44% |
| Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 HC Exc Skin Benig <5mm Face,Facial | $874.16 | $1,561.00 | $468.30–$1,493.56 | 70% above | 44% |
| Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 HC EXC SKIN BENIG <5MM FACE,FACIAL | $1,136.35 | $2,029.20 | $468.30–$1,493.56 | 121% above | 44% |
| Nail removal (partial or complete), one nail CPT 11730 HC Removal of Nail Plate | $449.57 | $802.80 | $240.84–$608.60 | 91% above | 44% |
| Nail removal (partial or complete), one nail CPT 11730 HC REMOVAL OF NAIL PLATE | $463.06 | $826.90 | $240.84–$608.60 | 97% above | 44% |
| Occipital nerve block (injection for headaches) CPT 64405 INJECTION AA&/STRD GREATER OCCIPITAL NERVE | $365.79 | $653.20 | $134.67–$480.76 | 21% below | 44% |
| Occipital nerve block (injection for headaches) CPT 64405 INJECT NERV BLCK, GREAT OCCIPTL (TECH) | $365.79 | $653.20 | $134.67–$480.76 | 21% below | 44% |
| Occipital nerve block (injection for headaches) CPT 64405 HC Injection, Anesthetic Agent; Trigeminal Ner(64405) | $772.80 | $1,380.00 | $414.00–$1,381.25 | 67% above | 44% |
| Occipital nerve block (injection for headaches) CPT 64405 HC Inject Nerv Blck,Great Occiptl (64405) | $772.80 | $1,380.00 | $414.00–$1,046.15 | 67% above | 44% |
| Occipital nerve block (injection for headaches) CPT 64405 HC Injection, Anesthetic Agent; Trigeminal Ner | $772.80 | $1,380.00 | $414.00–$1,381.25 | 67% above | 44% |
| Occipital nerve block (injection for headaches) CPT 64405 HC INJECT NERV BLCK,GREAT OCCIPTL (64405) | $795.98 | $1,421.40 | $414.00–$1,046.15 | 72% above | 44% |
| Occipital nerve block (injection for headaches) CPT 64405 HC INJECTION, ANESTHETIC AGENT; TRIGEMINAL NER | $795.98 | $1,421.40 | $414.00–$1,381.25 | 72% above | 44% |
| Occipital nerve block (injection for headaches) CPT 64405 HC INJECTION, ANESTHETIC AGENT; TRIGEMINAL NER(64405) | $795.98 | $1,421.40 | $414.00–$1,381.25 | 72% above | 44% |
| Open Roux-en-Y gastric bypass through an abdominal incision CPT 43846 Gastric Rstcv W/Byp W/Short Limb 150 Cm/< | $13,689.82 | $24,446.10 | $7,333.83–$18,532.11 | at median | 44% |
| Open Roux-en-Y gastric bypass through an abdominal incision CPT 43846 GASTRIC RSTCV W/BYP W/SHORT LIMB 150 CM/< | $14,100.52 | $25,179.50 | $7,333.83–$18,532.11 | 3% above | 44% |
| Pacemaker implant (dual chamber) CPT 33208 INSER HART PACER XVENOUS ATR/VENTR (33208) | $2,943.75 | $5,256.70 | $33,475.00 | 54% below | 44% |
| Pacemaker implant (dual chamber) CPT 33208 HC INSER HART PACER XVENOUS ATR/VENTR (33208) | $11,200.00 | $20,000.00 | $33,475.00 | 77% above | 44% |
| Pacemaker implant (dual chamber) CPT 33208 HC Inser Hart Pacer Xvenous Atr/Ventr (33208) | $11,644.86 | $20,794.40 | $33,475.00 | 84% above | 44% |
| Paracentesis with imaging guidance CPT 49083 HC Abd Paracentesis W/Imaging (49083) | $1,470.34 | $2,625.60 | $787.68–$2,116.74 | 14% above | 44% |
| Paracentesis with imaging guidance CPT 49083 HC ABD PARACENTESIS W/IMAGING (49083) | $1,514.63 | $2,704.70 | $787.68–$2,116.74 | 18% above | 44% |
| Paracentesis with imaging guidance CPT 49083 HC ABD PARACENTESIS W/IMAGING | $1,514.63 | $2,704.70 | $787.68–$1,990.66 | 18% above | 44% |
| Paracentesis with imaging guidance CPT 49083 ABD PARACENTESIS W/IMAGING (49083) | $1,955.63 | $3,492.20 | $367.68–$2,570.26 | 52% above | 44% |
| Partial knee replacement (one compartment) CPT 27446 ARTHROPLASTY KNEE,MED OR LAT COMPARTMT | $5,626.38 | $10,047.10 | $3,014.13–$7,394.67 | at median | 44% |
| Partial knee replacement (one compartment) CPT 27446 HC Arthroplasty Knee,Med or Lat Compartmt | $10,969.78 | $19,588.90 | $5,876.67–$18,953.40 | 95% above | 44% |
| Partial knee replacement (one compartment) CPT 27446 HC ARTHROPLASTY KNEE,MED OR LAT COMPARTMT | $11,298.90 | $20,176.60 | $5,876.67–$18,953.40 | 101% above | 44% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 HC Removal of Nail Bed | $776.38 | $1,386.40 | $415.92–$1,051.01 | 138% above | 44% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 HC REMOVAL OF NAIL BED | $799.68 | $1,428.00 | $415.92–$1,051.01 | 145% above | 44% |
| Prostate biopsy CPT 55700 HC Biopsy of Prostate,Needle/Punch | $2,702.22 | $4,825.40 | $1,447.62–$4,105.04 | 77% above | 44% |
| Prostate removal (prostatectomy), laparoscopic CPT 55866 LAPS SURG PRST8ECT RPBIC RAD W/NERVE SPARING | $6,062.39 | $10,825.70 | $3,247.71–$7,967.72 | at median | 44% |
| Prostate removal (prostatectomy), laparoscopic CPT 55866 HC Laparo Radical Prostatectomy | $8,723.46 | $15,577.60 | $4,673.28–$11,809.05 | 44% above | 44% |
| Prostate removal (prostatectomy), laparoscopic CPT 55866 HC LAPARO RADICAL PROSTATECTOMY | $8,985.14 | $16,044.90 | $4,673.28–$11,809.05 | 48% above | 44% |
| Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 HC DESTROY LUMB/SAC FACET JNT (64635) | $2,190.16 | $3,911.00 | $1,173.30–$3,030.11 | 12% below | 44% |
| Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 DESTROY LUMB/SAC FACET JNT (64635) | $2,252.99 | $4,023.20 | $515.40–$2,961.08 | 9% below | 44% |
| Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 HC Destroy Lumb/Sac Facet Jnt (64635) | $2,305.52 | $4,117.00 | $1,173.30–$3,030.11 | 7% below | 44% |
| Removal of a breast lump, open surgery CPT 19120 HC Excise Breast Lesion | $4,935.78 | $8,813.90 | $2,644.17–$6,681.63 | 147% above | 44% |
| Removal of a breast lump, open surgery CPT 19120 HC EXCISE BREAST LESION | $5,083.85 | $9,078.30 | $2,644.17–$6,681.63 | 154% above | 44% |
| Removal of a foreign object under the skin, simple CPT 10120 HC Remove Foreign Body Simple | $664.22 | $1,186.10 | $355.83–$899.17 | 97% above | 44% |
| Removal of a foreign object under the skin, simple CPT 10120 HC REMOVE FOREIGN BODY SIMPLE | $684.15 | $1,221.70 | $355.83–$899.17 | 103% above | 44% |
| Removal of one lobe of the thyroid (lobectomy) one side CPT 60220 THYROID LOBECTOMY,UNILAT | $2,634.86 | $4,705.10 | $1,411.53–$3,462.95 | at median | 44% |
| Removal of one lobe of the thyroid (lobectomy) one side CPT 60220 HC Thyroid Lobectomy,Unilat | $6,082.61 | $10,861.80 | $3,258.54–$8,234.15 | 131% above | 44% |
| Removal of one lobe of the thyroid (lobectomy) one side CPT 60220 HC THYROID LOBECTOMY,UNILAT | $6,265.11 | $11,187.70 | $3,258.54–$8,234.15 | 138% above | 44% |
| Screening colonoscopy for a person at average risk (Medicare code) HCPCS G0121 HC Colorec Canc Scrn,Scopy Not Hi Risk | $1,741.38 | $3,109.60 | $932.88–$2,357.33 | 9% below | 44% |
| Screening colonoscopy for a person at average risk (Medicare code) HCPCS G0121 HC COLOREC CANC SCRN,SCOPY NOT HI RISK | $1,793.62 | $3,202.90 | $932.88–$2,357.33 | 7% below | 44% |
| Screening colonoscopy, high risk of colorectal cancer (Medicare code) HCPCS G0105 HC Colorec Canc Scrn,Colonoscpy Hi Risk | $1,741.38 | $3,109.60 | $932.88–$2,517.12 | 8% below | 44% |
| Screening colonoscopy, high risk of colorectal cancer (Medicare code) HCPCS G0105 HC COLOREC CANC SCRN,COLONOSCPY HI RISK | $1,915.20 | $3,420.00 | $932.88–$2,517.12 | 1% above | 44% |
| Septoplasty to straighten the nasal septum CPT 30520 HC Repair of Nasal Septum | $3,593.07 | $6,416.20 | $1,924.86–$4,864.00 | at median | 44% |
| Septoplasty to straighten the nasal septum CPT 30520 HC REPAIR OF NASAL SEPTUM | $3,700.87 | $6,608.70 | $1,924.86–$4,864.00 | 3% above | 44% |
| Shock-wave lithotripsy to break up kidney stones (from outside the body) CPT 50590 HC Fragmenting of Kidney Stone | $4,469.81 | $7,981.80 | $10,098.00–$14,679.00 | 52% below | 44% |
| Shock-wave lithotripsy to break up kidney stones (from outside the body) CPT 50590 HC FRAGMENTING OF KIDNEY STONE | $4,603.93 | $8,221.30 | $10,098.00–$14,679.00 | 51% below | 44% |
| Short arm cast (elbow to hand) CPT 29075 HC Apply Forearm Cast | $489.89 | $874.80 | $262.44–$663.14 | 94% above | 44% |
| Short arm cast (elbow to hand) CPT 29075 HC APPLY FOREARM CAST | $504.56 | $901.00 | $262.44–$663.14 | 100% above | 44% |
| Short arm splint (forearm and hand) CPT 29125 HC Apply Forearm Splint,Static | $173.82 | $310.40 | $93.12–$235.30 | 1% below | 44% |
| Short arm splint (forearm and hand) CPT 29125 HC APPLY FOREARM SPLINT,STATIC | $179.03 | $319.70 | $93.12–$235.30 | 2% above | 44% |
| Short arm splint (forearm and hand) CPT 29125 HC Apply Splint, Short Arm | $250.32 | $447.00 | $134.10–$345.48 | 42% above | 44% |
| Short arm splint (forearm and hand) CPT 29125 HC APPLY SPLINT, SHORT ARM | $262.86 | $469.40 | $134.10–$345.48 | 50% above | 44% |
| Short leg cast (below the knee) CPT 29405 HC Apply Short Leg Cast | $378.84 | $676.50 | $202.95–$586.37 | 61% above | 44% |
| Short leg cast (below the knee) CPT 29405 HC APPLY SHORT LEG CAST | $428.96 | $766.00 | $202.95–$586.37 | 83% above | 44% |
| Short leg splint (calf to foot) CPT 29515 HC Application Lower Leg Splint | $231.17 | $412.80 | $123.84–$405.39 | 11% above | 44% |
| Short leg splint (calf to foot) CPT 29515 HC Apply Lower Leg Splint | $231.17 | $412.80 | $123.84–$334.95 | 11% above | 44% |
| Short leg splint (calf to foot) CPT 29515 HC Apply Splint, Short Leg | $231.17 | $412.80 | $123.84–$405.39 | 11% above | 44% |
| Short leg splint (calf to foot) CPT 29515 HC APPLICATION LOWER LEG SPLINT | $254.86 | $455.10 | $123.84–$405.39 | 23% above | 44% |
| Short leg splint (calf to foot) CPT 29515 HC APPLY LOWER LEG SPLINT | $254.86 | $455.10 | $123.84–$334.95 | 23% above | 44% |
| Short leg splint (calf to foot) CPT 29515 HC APPLY SPLINT, SHORT LEG | $254.86 | $455.10 | $123.84–$405.39 | 23% above | 44% |
| Shoulder arthroscopy with removal of the end of the collarbone (distal clavicle) CPT 29824 SHOULDER ARTHROSCOPY/SURGERY | $3,368.74 | $6,015.60 | $1,804.68–$4,427.48 | at median | 44% |
| Shoulder arthroscopy with removal of the end of the collarbone (distal clavicle) CPT 29824 HC Shoulder Arthroscopy/Surgery | $4,504.81 | $8,044.30 | $2,413.29–$8,258.51 | 34% above | 44% |
| Shoulder arthroscopy with removal of the end of the collarbone (distal clavicle) CPT 29824 HC SHOULDER ARTHROSCOPY/SURGERY | $4,639.94 | $8,285.60 | $2,413.29–$8,258.51 | 38% above | 44% |
| Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) CPT 29826 HC Shldr Arthroscop,Part Acromioplas | $2,186.35 | $3,904.20 | $1,171.26–$2,959.68 | at median | 44% |
| Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) CPT 29826 HC SHLDR ARTHROSCOP,PART ACROMIOPLAS | $2,251.93 | $4,021.30 | $1,171.26–$2,959.68 | 3% above | 44% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 HC REPR SUPERF WND BODY <2.5CM-SIMPLE CLOSURE | $325.36 | $581.00 | $174.30–$449.84 | at median | 44% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 HC Repr Superf Wnd Body <2.5cm-Simple Closure | $342.27 | $611.20 | $174.30–$449.84 | 5% above | 44% |
| Skin biopsy, punch, one lesion CPT 11104 PUNCH BIOPSY SKIN SINGLE LESION (11104) | $450.80 | $805.00 | $87.87–$592.48 | 88% above | 44% |
| Skin biopsy, punch, one lesion CPT 11104 HC Punch Bx of Skin; Single Lesion | $525.11 | $937.70 | $281.31–$707.66 | 119% above | 44% |
| Skin biopsy, punch, one lesion CPT 11104 HC PUNCH BX OF SKIN; SINGLE LESION | $538.44 | $961.50 | $281.31–$707.66 | 124% above | 44% |
| Skin cancer removal (excision), body, arms or legs, up to 0.5 cm CPT 11600 EXC SKIN MALIG <5MM TRUNK,ARM,LEG | $705.38 | $1,259.60 | $230.04–$927.07 | 92% above | 44% |
| Skin tag removal, up to 15 tags CPT 11200 HC Removal of Skin Tags Up to Including 15 | $141.57 | $252.80 | $75.84–$211.16 | at median | 44% |
| Skin tag removal, up to 15 tags CPT 11200 HC REMOVAL OF SKIN TAGS UP TO INCLUDING 15 | $145.82 | $260.40 | $75.84–$211.16 | 3% above | 44% |
| Skin tag removal, up to 15 tags CPT 11200 REMOVAL OF SKIN TAGS UP TO INCLUDING 15 | $325.92 | $582.00 | $145.02–$428.35 | 130% above | 44% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 HC Spinal Puncture,Lumbar,Diagnostic | $989.80 | $1,767.50 | $530.25–$1,649.01 | 64% above | 44% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 HC Spinal Puncture, Lumbar, Diagnostic | $989.80 | $1,767.50 | $530.25–$1,649.01 | 64% above | 44% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 HC SPINAL PUNCTURE,LUMBAR,DIAGNOSTIC | $1,118.49 | $1,997.30 | $530.25–$1,649.01 | 85% above | 44% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 HC SPINAL PUNCTURE, LUMBAR, DIAGNOSTIC | $1,118.49 | $1,997.30 | $530.25–$1,649.01 | 85% above | 44% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 HC Repr Sup Npterf Wnd Body 2.6-7.5 | $201.94 | $360.60 | $108.18–$273.35 | at median | 44% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 HC REPR SUP NPTERF WND BODY 2.6-7.5 | $207.98 | $371.40 | $108.18–$273.35 | 3% above | 44% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 HC SIMPLE REPAIR F/E/E/N/L/M 2.5CM/< | $427.84 | $764.00 | $229.20–$748.36 | 38% above | 44% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 HC REPR SUPERF WND FACE <2.5CM | $427.84 | $764.00 | $229.20–$591.52 | 38% above | 44% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 HC RPR F/E/E/N/L/M 2.5 CM/< | $427.84 | $764.00 | $229.20–$591.52 | 38% above | 44% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 HC Repr Superf Wnd Face <2.5cm | $450.07 | $803.70 | $229.20–$591.52 | 45% above | 44% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 HC Simple Repair F/E/E/N/L/M 2.5cm/< | $450.07 | $803.70 | $229.20–$748.36 | 45% above | 44% |
| TURP (transurethral resection of the prostate) CPT 52601 HC Transurethral Elec-Surg Prostatectom | $5,196.97 | $9,280.30 | $2,784.09–$7,035.20 | at median | 44% |
| TURP (transurethral resection of the prostate) CPT 52601 HC TRANSURETHRAL ELEC-SURG PROSTATECTOM | $5,352.87 | $9,558.70 | $2,784.09–$7,035.20 | 3% above | 44% |
| Tangential (shave-style) skin biopsy, one lesion CPT 11102 TANGENTIAL BIOPSY SKIN SINGLE LESION (11102) | $364.56 | $651.00 | $71.25–$479.14 | 52% above | 44% |
| Tangential (shave-style) skin biopsy, one lesion CPT 11102 HC Tangential Bx of Skin, Single Lesion (11102) | $532.78 | $951.40 | $285.42–$721.21 | 122% above | 44% |
| Tangential (shave-style) skin biopsy, one lesion CPT 11102 HC TANGENTIAL BX OF SKIN, SINGLE LESION | $548.74 | $979.90 | $285.42–$721.21 | 129% above | 44% |
| Thoracentesis with imaging guidance CPT 32555 HC Aspirate Pleura W/ Imaging (32555) | $1,369.14 | $2,444.90 | $733.47–$1,853.47 | 14% above | 44% |
| Thoracentesis with imaging guidance CPT 32555 HC Aspirate Pleura W/ Imaging | $1,375.98 | $2,457.10 | $737.13–$1,853.47 | 15% above | 44% |
| Thoracentesis with imaging guidance CPT 32555 HC ASPIRATE PLEURA W/ IMAGING (32555) | $1,410.25 | $2,518.30 | $733.47–$1,853.47 | 18% above | 44% |
| Thoracentesis with imaging guidance CPT 32555 HC ASPIRATE PLEURA W/ IMAGING | $1,410.25 | $2,518.30 | $733.47–$1,853.47 | 18% above | 44% |
| Thoracentesis with imaging guidance CPT 32555 ASPIRATE PLEURA W/ IMAGING (32555) | $1,574.38 | $2,811.40 | $284.40–$2,069.19 | 31% above | 44% |
| Tonsil and adenoid removal, age 12 or older CPT 42821 REMOVE TONSILS/ADENOIDS,12+ Y/O | $1,989.51 | $3,552.70 | $1,065.81–$2,614.79 | at median | 44% |
| Tonsil and adenoid removal, age 12 or older CPT 42821 HC Remove Tonsils/Adenoids,12+ Y/O | $4,797.58 | $8,567.10 | $2,570.13–$6,494.54 | 141% above | 44% |
| Tonsil and adenoid removal, age 12 or older CPT 42821 HC REMOVE TONSILS/ADENOIDS,12+ Y/O | $4,941.50 | $8,824.10 | $2,570.13–$6,494.54 | 148% above | 44% |
| Tonsil and adenoid removal, child under 12 CPT 42820 REMOVE TONSILS/ADENOIDS,<12 Y/O | $1,902.26 | $3,396.90 | $1,019.07–$2,500.12 | at median | 44% |
| Tonsil and adenoid removal, child under 12 CPT 42820 HC Remove Tonsils/Adenoids,<12 Y/O | $6,232.80 | $11,130.00 | $3,339.00–$8,437.43 | 228% above | 44% |
| Tonsil and adenoid removal, child under 12 CPT 42820 HC REMOVE TONSILS/ADENOIDS,<12 Y/O | $6,419.78 | $11,463.90 | $3,339.00–$8,437.43 | 237% above | 44% |
| Tonsil removal (tonsillectomy) only, age 12 or older CPT 42826 REMOVAL OF TONSILS,12+ Y/O | $1,674.12 | $2,989.50 | $896.85–$2,200.27 | at median | 44% |
| Tonsil removal (tonsillectomy) only, age 12 or older CPT 42826 HC Removal of Tonsils,12+ Y/O | $4,797.58 | $8,567.10 | $2,570.13–$6,494.54 | 187% above | 44% |
| Tonsil removal (tonsillectomy) only, age 12 or older CPT 42826 HC REMOVAL OF TONSILS,12+ Y/O | $4,941.50 | $8,824.10 | $2,570.13–$6,494.54 | 195% above | 44% |
| Tonsil removal (tonsillectomy) only, child under 12 CPT 42825 REMOVAL OF TONSILS,<12 Y/O | $1,761.14 | $3,144.90 | $943.47–$2,314.65 | at median | 44% |
| Tonsil removal (tonsillectomy) only, child under 12 CPT 42825 HC Removal of Tonsils,<12 Y/O | $7,666.34 | $13,689.90 | $4,106.97–$10,378.04 | 335% above | 44% |
| Tonsil removal (tonsillectomy) only, child under 12 CPT 42825 HC REMOVAL OF TONSILS,<12 Y/O | $7,896.34 | $14,100.60 | $4,106.97–$10,378.04 | 348% above | 44% |
| Total hip replacement CPT 27130 HC Total Hip Replacement | $3,621.58 | $6,467.10 | $1,940.13–$6,187.70 | at median | 44% |
| Total hip replacement CPT 27130 HC TOTAL HIP REPLACEMENT | $4,707.92 | $8,407.00 | $1,940.13–$6,187.70 | 30% above | 44% |
| Total hip replacement CPT 27130 TOTAL HIP REPLACEMENT | $6,281.30 | $11,216.60 | $3,364.98–$8,255.42 | 73% above | 44% |
| Total knee replacement CPT 27447 TOTAL KNEE REPLACEMENT | $6,275.53 | $11,206.30 | $3,361.89–$8,247.84 | at median | 44% |
| Total knee replacement CPT 27447 HC Total Knee Replacement | $8,384.94 | $14,973.10 | $4,491.93–$12,311.00 | 34% above | 44% |
| Total knee replacement CPT 27447 HC TOTAL KNEE REPLACEMENT | $8,636.49 | $15,422.30 | $4,491.93–$12,311.00 | 38% above | 44% |
| Total shoulder replacement CPT 23472 HC Reconstr Total Shoulder Implant | $6,045.20 | $10,795.00 | $3,238.50–$10,329.02 | at median | 44% |
| Total shoulder replacement CPT 23472 HC RECONSTR TOTAL SHOULDER IMPLANT | $7,859.04 | $14,034.00 | $3,238.50–$10,329.02 | 30% above | 44% |
| Total thyroid removal (thyroidectomy) CPT 60240 THYROIDECTOMY | $3,392.98 | $6,058.90 | $1,817.67–$4,459.35 | at median | 44% |
| Total thyroid removal (thyroidectomy) CPT 60240 HC Thyroidectomy | $4,749.02 | $8,480.40 | $2,544.12–$6,428.81 | 40% above | 44% |
| Total thyroid removal (thyroidectomy) CPT 60240 HC THYROIDECTOMY | $4,891.49 | $8,734.80 | $2,544.12–$6,428.81 | 44% above | 44% |
| Trigger finger release surgery CPT 26055 HC Incise Finger Tendon Sheath | $2,566.70 | $4,583.40 | $1,375.02–$3,474.58 | 70% above | 44% |
| Trigger finger release surgery CPT 26055 HC INCISE FINGER TENDON SHEATH | $2,643.70 | $4,720.90 | $1,375.02–$3,474.58 | 76% above | 44% |
| Trigger point injections, 1 or 2 muscles CPT 20552 1-2 TRIGGER POINTS INJECT (20552) | $266.62 | $476.10 | $98.91–$350.41 | 25% below | 44% |
| Trigger point injections, 1 or 2 muscles CPT 20552 HC Trigger Point Inject Sing/Multi 1-2 Muscles | $534.41 | $954.30 | $286.29–$723.41 | 51% above | 44% |
| Trigger point injections, 1 or 2 muscles CPT 20552 HC Inject Trigger Point, 1 or 2 (20552) | $534.41 | $954.30 | $286.29–$723.41 | 51% above | 44% |
| Trigger point injections, 1 or 2 muscles CPT 20552 HC INJECT TRIGGER POINT, 1 OR 2 (20552) | $550.42 | $982.90 | $286.29–$723.41 | 55% above | 44% |
| Trigger point injections, 1 or 2 muscles CPT 20552 HC TRIGGER POINT INJECT SING/MULTI 1-2 MUSCLES | $550.42 | $982.90 | $286.29–$723.41 | 55% above | 44% |
| Tubal ligation, laparoscopic (tubes sealed by cautery) CPT 58670 LAPAROSCOPY FULGURATION | $1,400.95 | $2,501.70 | $750.51–$1,841.25 | at median | 44% |
| Tubal ligation, laparoscopic (tubes sealed by cautery) CPT 58670 HC Laparoscopy Fulguration | $8,092.11 | $14,450.20 | $4,335.06–$12,056.56 | 478% above | 44% |
| Tubal ligation, laparoscopic (tubes sealed by cautery) CPT 58670 HC LAPAROSCOPY FULGURATION | $8,334.87 | $14,883.70 | $4,335.06–$12,056.56 | 495% above | 44% |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 BX BREAST W DEVICE 1ST LESION ULTRASOUND GUIDE | $1,816.19 | $3,243.20 | $288.33–$2,387.00 | 10% below | 44% |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 HC Bx Breast W Device 1st Lesion Ultrasound Guide | $2,670.42 | $4,768.60 | $1,430.58–$3,615.01 | 32% above | 44% |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 HC BX BREAST W DEVICE 1ST LESION ULTRASOUND GUIDE | $2,750.55 | $4,911.70 | $1,430.58–$3,615.01 | 36% above | 44% |
| Upper endoscopy (EGD) with balloon widening of the esophagus CPT 43249 HC Up GI Endoscopy,Ball Dil,30mm | $2,848.38 | $5,086.40 | $1,525.92–$3,855.90 | 7% above | 44% |
| Upper endoscopy (EGD) with balloon widening of the esophagus CPT 43249 HC UP GI ENDOSCOPY,BALL DIL,30MM | $2,933.84 | $5,239.00 | $1,525.92–$3,855.90 | 10% above | 44% |
| Upper endoscopy (EGD) with biopsy CPT 43239 HC Upper GI Endoscopy,Biopsy | $1,467.98 | $2,621.40 | $786.42–$2,162.15 | 7% below | 44% |
| Upper endoscopy (EGD) with biopsy CPT 43239 HC UPPER GI ENDOSCOPY,BIOPSY | $1,514.24 | $2,704.00 | $786.42–$2,162.15 | 4% below | 44% |
| Upper endoscopy (EGD) with injection into the lining CPT 43236 HC Uppr GI Scope W/Submuc Inj | $1,418.98 | $2,533.90 | $760.17–$2,070.15 | 7% below | 44% |
| Upper endoscopy (EGD) with injection into the lining CPT 43236 HC UPPR GI SCOPE W/SUBMUC INJ | $1,514.24 | $2,704.00 | $760.17–$2,070.15 | 1% below | 44% |
| Upper endoscopy (EGD) with polyp removal by snare CPT 43251 HC Up GI Endoscopy,Remv Tumor,Snare | $2,848.38 | $5,086.40 | $1,525.92–$3,855.90 | 29% above | 44% |
| Upper endoscopy (EGD) with polyp removal by snare CPT 43251 HC UP GI ENDOSCOPY,REMV TUMOR,SNARE | $2,933.84 | $5,239.00 | $1,525.92–$3,855.90 | 33% above | 44% |
| Upper endoscopy (EGD) with polyp removal by snare CPT 43251 UP GI ENDOSCOPY,REMV TUMOR,SNARE | $3,283.34 | $5,863.10 | $670.71–$4,315.24 | 48% above | 44% |
| Upper endoscopy (EGD) with widening of the esophagus over a guide wire CPT 43248 HC UP GI ENDOSCOPY,DILATN W GUIDE | $1,400.00 | $2,500.00 | $750.00–$3,778.62 | 24% below | 44% |
| Upper endoscopy (EGD) with widening of the esophagus over a guide wire CPT 43248 HC Up GI Endoscopy,Dilatn W Guide | $1,470.34 | $2,625.60 | $750.00–$3,778.62 | 21% below | 44% |
| Upper endoscopy (EGD), diagnostic CPT 43235 HC Upper GI Endoscopy,Diagnosis | $1,467.98 | $2,621.40 | $786.42–$2,637.38 | at median | 44% |
| Upper endoscopy (EGD), diagnostic CPT 43235 HC UPPER GI ENDOSCOPY,DIAGNOSIS | $1,514.24 | $2,704.00 | $786.42–$2,637.38 | 3% above | 44% |
| Upper endoscopy with drainage of a pseudocyst through the stomach wall CPT 43240 HC Egd W/Transmural Drain Cyst | $6,930.45 | $12,375.80 | $3,712.74–$9,381.87 | 95% above | 44% |
| Upper endoscopy with drainage of a pseudocyst through the stomach wall CPT 43240 HC EGD W/TRANSMURAL DRAIN CYST | $7,138.38 | $12,747.10 | $3,712.74–$9,381.87 | 101% above | 44% |
| Ureteroscopy with laser stone breaking (lithotripsy) CPT 52353 HC Cystouretero W/Lithotripsy | $2,907.46 | $5,191.90 | $1,557.57–$6,891.24 | at median | 44% |
| Ureteroscopy with laser stone breaking (lithotripsy) CPT 52353 HC CYSTOURETERO W/LITHOTRIPSY | $2,994.71 | $5,347.70 | $1,557.57–$6,891.24 | 3% above | 44% |
| Ureteroscopy with laser stone breaking and stent placement CPT 52356 CYSTO/URETERO W/LITHOTRIPSY &INDWELL STENT INSRT | $2,086.11 | $3,725.20 | $1,117.56–$2,741.75 | at median | 44% |
| Ureteroscopy with laser stone breaking and stent placement CPT 52356 HC Cysto/Uretero W/Lithotripsy &Indwell Stent Insrt | $7,801.19 | $13,930.70 | $4,179.21–$10,560.57 | 274% above | 44% |
| Ureteroscopy with laser stone breaking and stent placement CPT 52356 HC CYSTO/URETERO W/LITHOTRIPSY &INDWELL STENT INSRT | $8,035.22 | $14,348.60 | $4,179.21–$10,560.57 | 285% above | 44% |
| Vaginal birth after cesarean (VBAC), including prenatal and postpartum care CPT 59610 ROUT OB CARE,VAG DELIV,PREV C-SEC | $5,143.88 | $9,185.50 | $2,755.65–$6,760.53 | at median | 44% |
| Vasectomy, one or both sides, including follow-up semen testing CPT 55250 REMOVAL OF SPERM DUCT(S) | $1,739.64 | $3,106.50 | $630.36–$2,286.38 | 11% above | 44% |
| Vasectomy, one or both sides, including follow-up semen testing CPT 55250 HC Removal of Sperm Duct(S) | $3,489.70 | $6,231.60 | $1,869.48–$5,356.17 | 122% above | 44% |
| Vasectomy, one or both sides, including follow-up semen testing CPT 55250 HC REMOVAL OF SPERM DUCT(S) | $3,594.42 | $6,418.60 | $1,869.48–$5,356.17 | 129% above | 44% |
| Vein ablation, radiofrequency, first vein CPT 36475 HC Endovenus Ablat Tx Vein Ext Rf;1 Vn | $4,009.15 | $7,159.20 | $2,147.76–$5,427.26 | 3% above | 44% |
| Vein ablation, radiofrequency, first vein CPT 36475 HC ENDOVENUS ABLAT TX VEIN EXT RF;1 VN | $4,129.44 | $7,374.00 | $2,147.76–$5,427.26 | 6% above | 44% |
| Wart removal, up to 14 warts CPT 17110 HC Destruc Benign Lesion 1-14 | $190.46 | $340.10 | $102.03–$257.82 | 3% below | 44% |
| Wart removal, up to 14 warts CPT 17110 HC DESTRUC BENIGN LESION 1-14 | $196.17 | $350.30 | $102.03–$257.82 | at median | 44% |
| Wart removal, up to 14 warts CPT 17110 DESTRUC BENIGN LESION 1-14 | $407.96 | $728.50 | $127.92–$536.18 | 107% above | 44% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 HC Debride of Skin and Subcut | $783.61 | $1,399.30 | $419.79–$1,030.11 | 47% above | 44% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 HC Debride of Skin & Subcut | $783.61 | $1,399.30 | $419.79–$1,030.11 | 47% above | 44% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 HC DEBRIDE OF SKIN AND SUBCUT | $783.78 | $1,399.60 | $419.79–$1,030.11 | 47% above | 44% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 HC DEBRIDE OF SKIN & SUBCUT | $783.78 | $1,399.60 | $419.79–$1,030.11 | 47% above | 44% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 HC DEBRIDEMENT SUBCUTANEOUS TISSUE 20 SQ CM/< | $783.78 | $1,399.60 | $419.79–$1,030.11 | 47% above | 44% |
| Wrist fracture surgery (plate and screws), distal radius CPT 25607 HC Treat Fx Rad Extra-Articul | $9,096.92 | $16,244.50 | $4,873.35–$12,314.60 | at median | 44% |
| Wrist fracture surgery (plate and screws), distal radius CPT 25607 HC TREAT FX RAD EXTRA-ARTICUL | $9,369.81 | $16,731.80 | $4,873.35–$12,314.60 | 3% above | 44% |
Doctor visits and therapy
| Procedure | Cash price | List price | Insurers pay | vs Wisconsin | Off list |
|---|---|---|---|---|---|
| Blood transfusion (giving blood or blood components) CPT 36430 HC BLOOD TRANSFUSION | $565.66 | $1,010.10 | $303.03–$743.43 | 3% below | 44% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 PRESSURIZED/NONPRESSURIZED INHALATION TREATMENT | $35.78 | $63.90 | $19.17–$47.03 | 59% below | 44% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HC MED AEROSOL SUBSEQUENT | $150.25 | $268.30 | $80.49–$197.47 | 74% above | 44% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HC Mdi Tx Each Med Initial | $150.25 | $268.30 | $80.49–$197.47 | 74% above | 44% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HC Mdi Tx Each Med Subsequent | $150.25 | $268.30 | $80.49–$197.47 | 74% above | 44% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HC Med Aerosol Initial | $150.25 | $268.30 | $80.49–$197.47 | 74% above | 44% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HC Med Aerosol Subsequent | $150.25 | $268.30 | $80.49–$197.47 | 74% above | 44% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HC Airway Inhalation Treatment | $150.25 | $268.30 | $80.49–$197.47 | 74% above | 44% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HC MDI TX EACH MED INITIAL | $150.25 | $268.30 | $80.49–$197.47 | 74% above | 44% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HC MDI TX EACH MED SUBSEQUENT | $150.25 | $268.30 | $80.49–$197.47 | 74% above | 44% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HC MED AEROSOL INITIAL | $150.25 | $268.30 | $80.49–$197.47 | 74% above | 44% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HC AIRWAY INHALATION TREATMENT | $150.25 | $268.30 | $80.49–$197.47 | 74% above | 44% |
| Chemotherapy IV infusion, first hour CPT 96413 CHEMO, IV INFUSION, 1HR | $499.80 | $892.50 | $267.75–$656.88 | 11% below | 44% |
| Chemotherapy IV infusion, first hour CPT 96413 CHEMO, IV INFUSION, 1 HR | $499.80 | $892.50 | $267.75–$656.88 | 11% below | 44% |
| Chemotherapy IV infusion, first hour CPT 96413 HC Chemo, IV Infusion, 1hr | $582.12 | $1,039.50 | $311.85–$765.44 | 4% above | 44% |
| Chemotherapy IV infusion, first hour CPT 96413 HC CHEMO, IV INFUSION, 1HR | $582.40 | $1,040.00 | $311.85–$765.44 | 4% above | 44% |
| Critical care, first 30 to 74 minutes CPT 99291 HC Critical Care 1st Hour | $1,785.95 | $3,189.20 | $2,232.44–$5,701.00 | at median | 44% |
| Critical care, first 30 to 74 minutes CPT 99291 HC CRITICAL CARE 1ST HOUR | $1,876.00 | $3,350.00 | $2,232.44–$5,701.00 | 5% above | 44% |
| EEG (brain wave test), awake and drowsy, routine CPT 95816 HC Rapid Eeg Awake,Drowsy W Stimulatn | $551.99 | $985.70 | $295.71–$812.54 | 18% below | 44% |
| EEG (brain wave test), awake and drowsy, routine CPT 95816 HC Eeg Awake,Drowsy W Stimulatn | $551.99 | $985.70 | $295.71–$812.54 | 18% below | 44% |
| EEG (brain wave test), awake and drowsy, routine CPT 95816 HC EEG AWAKE,DROWSY W STIMULATN | $618.24 | $1,104.00 | $295.71–$812.54 | 8% below | 44% |
| EEG (brain wave test), awake and drowsy, routine CPT 95816 HC RAPID EEG AWAKE,DROWSY W STIMULATN | $618.24 | $1,104.00 | $295.71–$812.54 | 8% below | 44% |
| Electrocardiogram (ECG/EKG) with interpretation CPT 93000 ELECTROCARDIOGRAM, COMPLETE | $53.03 | $94.70 | $28.41–$69.70 | 21% below | 44% |
| Electrocardiogram (ECG/EKG) with interpretation CPT 93000 HC Ekg-Electrocardiogram, Global | $162.57 | $290.30 | $87.09–$226.47 | 141% above | 44% |
| Electrocardiogram (ECG/EKG) with interpretation CPT 93000 HC EKG-ELECTROCARDIOGRAM, GLOBAL | $172.31 | $307.70 | $87.09–$226.47 | 155% above | 44% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 ECG-ELECTROCARDIOGRAM,TRACING | $22.85 | $40.80 | $12.24–$30.03 | 85% below | 44% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 HC Ekg-Electrocardiogram,Tracing | $148.57 | $265.30 | $79.59–$206.96 | 1% above | 44% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 HC EKG-ELECTROCARDIOGRAM,TRACING | $157.47 | $281.20 | $79.59–$206.96 | 7% above | 44% |
| Electroconvulsive therapy (ECT), one session CPT 90870 ELECTROCONVULSIVE THERAPY,1 SEIZ | $364.90 | $651.60 | $123.00–$479.58 | 50% below | 44% |
| Electroconvulsive therapy (ECT), one session CPT 90870 HC Electroconvulsive Therapy,1 Seiz | $928.42 | $1,657.90 | $497.37–$1,293.45 | 27% above | 44% |
| Electroconvulsive therapy (ECT), one session CPT 90870 HC ELECTROCONVULSIVE THERAPY,1 SEIZ | $984.14 | $1,757.40 | $497.37–$1,293.45 | 35% above | 44% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 EMERGENCY DEPT VISIT,LEVEL I | $49.28 | $88.00 | $180.00–$503.00 | 74% below | 44% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 HC Emergency Dept Visit,Level I | $147.28 | $263.00 | $180.00–$503.00 | 21% below | 44% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 HC EMERGENCY DEPT VISIT,LEVEL I | $154.00 | $275.00 | $180.00–$503.00 | 18% below | 44% |
| Emergency room visit, level 2 of 5, straightforward problem CPT 99282 EMERGENCY DEPT VISIT,LEVEL II | $135.35 | $241.70 | $361.00 | 58% below | 44% |
| Emergency room visit, level 2 of 5, straightforward problem CPT 99282 HC Emergency Dept Visit,Level II | $337.68 | $603.00 | $361.00 | 5% above | 44% |
| Emergency room visit, level 2 of 5, straightforward problem CPT 99282 HC EMERGENCY DEPT VISIT,LEVEL II | $364.00 | $650.00 | $361.00 | 13% above | 44% |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 EMERGENCY DEPT VISIT,LEVEL III | $231.90 | $414.10 | $826.00–$1,457.00 | 61% below | 44% |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 HC Emergency Dept Visit,Level III | $608.72 | $1,087.00 | $826.00–$1,457.00 | 3% above | 44% |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 HC EMERGENCY DEPT VISIT,LEVEL III | $672.00 | $1,200.00 | $826.00–$1,457.00 | 13% above | 44% |
| Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 EMERGENCY DEPT VISIT,LEVEL IV | $392.45 | $700.80 | $1,836.00–$2,669.00 | 57% below | 44% |
| Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 HC Emergency Dept Visit,Level IV | $917.28 | $1,638.00 | $1,836.00–$2,669.00 | at median | 44% |
| Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 HC EMERGENCY DEPT VISIT,LEVEL IV | $963.20 | $1,720.00 | $1,836.00–$2,669.00 | 5% above | 44% |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 HC Emergency Dept Visit,Level V | $1,446.48 | $2,583.00 | $2,009.00 | 1% below | 44% |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 HC EMERGENCY DEPT VISIT,LEVEL V | $1,447.60 | $2,585.00 | $2,009.00 | 1% below | 44% |
| Exercise stress test, tracing only, the hospital charge CPT 93017 Stress Tracing for NM and Echo | $511.28 | $913.00 | $273.90–$946.86 | 35% below | 44% |
| Exercise stress test, tracing only, the hospital charge CPT 93017 STRESS TRACING FOR NM AND ECHO | $511.28 | $913.00 | $273.90–$946.86 | 35% below | 44% |
| Family therapy with the patient, 50 minutes CPT 90847 HC Family Mtg W Pt Present | $148.85 | $265.80 | $79.74–$254.29 | 22% below | 44% |
| Family therapy with the patient, 50 minutes CPT 90847 HC Family Visit Lvl 2 | $148.85 | $265.80 | $79.74–$254.29 | 22% below | 44% |
| Family therapy with the patient, 50 minutes CPT 90847 HC Iop Family Mtg W Pt Present | $148.85 | $265.80 | $79.74–$254.29 | 22% below | 44% |
| Family therapy with the patient, 50 minutes CPT 90847 HC IOP FAMILY MTG W PT PRESENT | $193.48 | $345.50 | $79.74–$254.29 | 2% above | 44% |
| Family therapy with the patient, 50 minutes CPT 90847 HC FAMILY VISIT LVL 2 | $193.48 | $345.50 | $79.74–$254.29 | 2% above | 44% |
| Family therapy with the patient, 50 minutes CPT 90847 HC FAMILY MTG W PT PRESENT | $193.48 | $345.50 | $79.74–$254.29 | 2% above | 44% |
| Family therapy with the patient, 50 minutes CPT 90847 FAMILY VISIT LEVEL 1 | $209.38 | $373.90 | $111.78–$275.19 | 10% above | 44% |
| Family therapy with the patient, 50 minutes CPT 90847 FAMILY PSYCHOTHERAPY W/PATIENT PRESENT 50 MINS | $220.98 | $394.60 | $117.60–$290.43 | 16% above | 44% |
| Family therapy without the patient, 50 minutes CPT 90846 HC Family Mtg W/O Pt Present | $168.62 | $301.10 | $90.33–$230.37 | 8% below | 44% |
| Family therapy without the patient, 50 minutes CPT 90846 HC Iop Family Psychotherapy W/O Pat 50 Min | $168.62 | $301.10 | $90.33–$230.37 | 8% below | 44% |
| Family therapy without the patient, 50 minutes CPT 90846 HC IOP FAMILY PSYCHOTHERAPY W/O PAT 50 MIN | $175.28 | $313.00 | $90.33–$230.37 | 4% below | 44% |
| Family therapy without the patient, 50 minutes CPT 90846 HC FAMILY MTG W/O PT PRESENT | $175.28 | $313.00 | $90.33–$230.37 | 4% below | 44% |
| Family therapy without the patient, 50 minutes CPT 90846 FAMILY PSYCHOTHERAPY-NO PT | $200.70 | $358.40 | $107.16–$263.78 | 10% above | 44% |
| Family therapy without the patient, 50 minutes CPT 90846 FAMILY PSYCHOTHERAPY W/O PATIENT PRESENT 50 MINS | $212.58 | $379.60 | $113.13–$279.39 | 16% above | 44% |
| Group psychotherapy session CPT 90853 HC Group Therapy Level 2 Hr | $136.19 | $243.20 | $72.96–$186.21 | 80% above | 44% |
| Group psychotherapy session CPT 90853 HC Group Psychotherapy | $136.19 | $243.20 | $72.96–$186.21 | 80% above | 44% |
| Group psychotherapy session CPT 90853 GROUP PSYCHOTHERAPY | $141.62 | $252.90 | $66.48–$186.13 | 88% above | 44% |
| Group psychotherapy session CPT 90853 GROUP THERAPY W/MOD (1 HR) | $141.62 | $252.90 | $66.48–$186.13 | 88% above | 44% |
| Group psychotherapy session CPT 90853 HC GROUP PSYCHOTHERAPY | $141.68 | $253.00 | $72.96–$186.21 | 88% above | 44% |
| Group psychotherapy session CPT 90853 HC IOP GROUP PSYCHOTHERAPY | $141.68 | $253.00 | $72.96–$186.21 | 88% above | 44% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 HYDRATION IV INFUSION, INIT | $121.18 | $216.40 | $80.31–$1,047.03 | 58% below | 44% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 HYDRATION IV INFUSION, INIT (31 MIN TO 1 HR) | $121.18 | $216.40 | $80.31–$1,047.03 | 58% below | 44% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 HC IV Therapy Hydration 31 Min-1hr | $347.87 | $621.20 | $80.31–$1,047.03 | 22% above | 44% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 HC IV THERAPY HYDRATION 31 MIN-1HR | $367.30 | $655.90 | $80.31–$1,047.03 | 29% above | 44% |
| IV infusion of a medicine, first hour CPT 96365 THER/PROPH/DIAG IV INF, INIT (16-60 MIN) | $236.04 | $421.50 | $80.31–$1,047.03 | 26% below | 44% |
| IV infusion of a medicine, first hour CPT 96365 THER/PROPH/DIAG IV INF, INIT | $236.04 | $421.50 | $80.31–$1,047.03 | 26% below | 44% |
| IV infusion of a medicine, first hour CPT 96365 HC IV Therapy Prophylaxis 1st Hr | $368.03 | $657.20 | $80.31–$1,047.03 | 16% above | 44% |
| IV infusion of a medicine, first hour CPT 96365 HC IV THERAPY PROPHYLAXIS 1ST HR | $390.10 | $696.60 | $80.31–$1,047.03 | 23% above | 44% |
| IV push of a medicine, first drug CPT 96374 THER/PROPH/DIAG INJ, IV PUSH | $137.87 | $246.20 | $80.31–$1,047.03 | 16% below | 44% |
| IV push of a medicine, first drug CPT 96374 HC IV Push | $141.57 | $252.80 | $80.31–$1,047.03 | 14% below | 44% |
| IV push of a medicine, first drug CPT 96374 HC IV PUSH | $168.22 | $300.40 | $80.31–$1,047.03 | 2% above | 44% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 THER/PROPH/DIAG INJ, SUBCUTANEOUS/INTRAMUSCULAR | $52.58 | $93.90 | $80.31–$1,047.03 | 35% below | 44% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 THERAPEUTIC PROPHYLACTIC | $52.58 | $93.90 | $80.31–$1,047.03 | 35% below | 44% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 IM INJECTION (752) | $52.58 | $93.90 | $80.31–$1,047.03 | 35% below | 44% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 HC INJECTION - SUB Q/IM | $110.88 | $198.00 | $80.31–$1,047.03 | 38% above | 44% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 HC Injection - Sub Q/Im | $110.99 | $198.20 | $80.31–$1,047.03 | 38% above | 44% |
| Mental health diagnostic evaluation (intake), without medical services CPT 90791 HC PSYCHIATRIC DIAG EVAL | $260.68 | $465.50 | $139.65–$360.64 | 19% above | 44% |
| Mental health diagnostic evaluation (intake), without medical services CPT 90791 HC Psychiatric Diag Eval | $274.40 | $490.00 | $139.65–$360.64 | 25% above | 44% |
| Mental health diagnostic evaluation (intake), without medical services CPT 90791 PSYCHIATRIC DIAGNOSTIC EVALUATION | $366.58 | $654.60 | $170.04–$481.79 | 67% above | 44% |
| Nerve conduction study, 7 or 8 nerve studies CPT 95910 NRV CNDJ TEST 7-8 STUDIES | $656.10 | $1,171.60 | $208.41–$862.30 | 32% below | 44% |
| Nerve conduction study, 7 or 8 nerve studies CPT 95910 HC Nerve Conduction Studies; 7-8 Studies | $1,162.45 | $2,075.80 | $622.74–$1,711.13 | 21% above | 44% |
| Nerve conduction study, 7 or 8 nerve studies CPT 95910 HC NERVE CONDUCTION STUDIES; 7-8 STUDIES | $1,301.94 | $2,324.90 | $622.74–$1,711.13 | 35% above | 44% |
| Neuromuscular re-education, 15 minutes CPT 97112 LAT NEUROMUSCULAR/15 MIN(747) | $133.11 | $237.70 | $70.02–$80.31 | 39% above | 44% |
| New patient office visit, about 30 minutes CPT 99203 HC New Pt Level 3 | $168.62 | $301.10 | $90.33–$221.61 | 15% below | 44% |
| New patient office visit, about 30 minutes CPT 99203 HC NEW PT LEVEL 3 | $168.62 | $301.10 | $90.33–$221.61 | 15% below | 44% |
| New patient office visit, about 30 minutes CPT 99203 OFFICE/OUTPATIENT NEW LOW MDM 30 MINUTES | $228.48 | $408.00 | $89.76–$379.44 | 16% above | 44% |
| New patient office visit, about 45 minutes CPT 99204 HC NEW PT LEVEL 4 | $175.56 | $313.50 | $94.05–$230.74 | 22% below | 44% |
| New patient office visit, about 45 minutes CPT 99204 HC New Pt Level 4 | $175.56 | $313.50 | $94.05–$230.74 | 22% below | 44% |
| New patient office visit, about 45 minutes CPT 99204 OFFICE/OUTPATIENT NEW MODERATE MDM 45 MINUTES | $340.82 | $608.60 | $145.50–$566.00 | 52% above | 44% |
| New patient office visit, about 60 minutes CPT 99205 HC New Pt Level 5 | $304.53 | $543.80 | $163.14–$400.24 | at median | 44% |
| New patient office visit, about 60 minutes CPT 99205 HC NEW PT LEVEL 5 | $304.53 | $543.80 | $163.14–$400.24 | at median | 44% |
| New patient office visit, about 60 minutes CPT 99205 OFFICE/OUTPATIENT NEW HIGH MDM 60 MINUTES | $449.74 | $803.10 | $197.55–$746.88 | 48% above | 44% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 OFFICE/OUTPATIENT NEW SF MDM 15 MINUTES | $148.51 | $265.20 | $52.50–$246.64 | 14% above | 44% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 HC New Pt Level 2 | $153.50 | $274.10 | $82.23–$201.74 | 17% above | 44% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 HC NEW PT LEVEL 2 | $153.50 | $274.10 | $82.23–$201.74 | 17% above | 44% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 HC Nutrition Ther Init/15 Min | $38.92 | $69.50 | $70.02–$80.31 | 35% below | 44% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 HC NUTRITION THER INIT/15 MIN | $50.62 | $90.40 | $70.02–$80.31 | 16% below | 44% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 NUTRITION THER INIT/15 MIN | $138.43 | $247.20 | $70.02–$80.31 | 131% above | 44% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 MED NUTRITION INDIV INT | $138.43 | $247.20 | $70.02–$80.31 | 131% above | 44% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MANUAL THERAPY TECHNIQUES | $106.74 | $190.60 | $70.02–$80.31 | 10% above | 44% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MANUAL TREATMENT/15 MIN(747) | $106.74 | $190.60 | $70.02–$80.31 | 10% above | 44% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 LAT THERAPUTIC EXERCISE | $115.98 | $207.10 | $70.02–$80.31 | 20% above | 44% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 LAT THERAPUTIC EXERCISE W/MOD 15 MIN(747) | $115.98 | $207.10 | $70.02–$80.31 | 20% above | 44% |
| Preventive checkup, new patient aged 18–39 CPT 99385 PREVENTIVE VISIT,NEW,18-39 | $251.44 | $449.00 | $101.07–$330.46 | 80% above | 44% |
| Preventive checkup, new patient aged 40–64 CPT 99386 PREVENTIVE VISIT,NEW,40-64 | $290.98 | $519.60 | $122.58–$382.43 | 93% above | 44% |
| Preventive checkup, new patient aged 65 or older CPT 99387 PREVENTIVE VISIT,NEW,65 & OVER | $315.28 | $563.00 | $131.67–$414.37 | 77% above | 44% |
| Preventive checkup, returning patient aged 18–39 CPT 99395 PREVENTIVE VISIT,EST,18-39 | $226.07 | $403.70 | $92.10–$297.12 | 46% above | 44% |
| Preventive checkup, returning patient aged 40–64 CPT 99396 PREVENTIVE VISIT,EST,40-64 | $241.36 | $431.00 | $100.32–$317.22 | 43% above | 44% |
| Preventive checkup, returning patient aged 65 or older CPT 99397 PREVENTIVE VISIT,EST,65 & OVER | $259.73 | $463.80 | $105.48–$341.36 | 74% above | 44% |
| Psychiatric evaluation with medical services CPT 90792 PSYCHIATRIC DIAGNOSTIC EVALUATION WITH MEDICAL SERVICES | $408.35 | $729.20 | $192.06–$536.69 | 48% above | 44% |
| Psychological testing evaluation by a psychologist or physician, first hour CPT 96130 PSYCHOLOGICAL TST EVAL SVC PHYS/QHP FIRST HOUR | $250.49 | $447.30 | $121.56–$329.21 | at median | 44% |
| Psychotherapy for crisis, first 60 minutes CPT 90839 PSYCHOTHERAPY FOR CRISIS; FIRST 60 MINUTES | $295.46 | $527.60 | $141.12–$388.31 | at median | 44% |
| Psychotherapy session, 30 minutes CPT 90832 HC Php Individual Psychotherapy Lvl 1 | $109.09 | $194.80 | $58.44–$149.19 | 3% above | 44% |
| Psychotherapy session, 30 minutes CPT 90832 HC Psych Therapy 30 Min W/Pt &/or Family | $109.09 | $194.80 | $58.44–$149.19 | 3% above | 44% |
| Psychotherapy session, 30 minutes CPT 90832 HC Individual Psychotherapy Lvl 1 | $109.09 | $194.80 | $58.44–$149.19 | 3% above | 44% |
| Psychotherapy session, 30 minutes CPT 90832 HC PHP INDIVIDUAL PSYCHOTHERAPY LVL 1 | $113.51 | $202.70 | $58.44–$149.19 | 7% above | 44% |
| Psychotherapy session, 30 minutes CPT 90832 HC IOP INDIVIDUAL PSYCHOTHERAPY LVL 1 | $113.51 | $202.70 | $58.44–$149.19 | 7% above | 44% |
| Psychotherapy session, 30 minutes CPT 90832 HC INDIVIDUAL PSYCHOTHERAPY LVL 1 | $113.51 | $202.70 | $58.44–$149.19 | 7% above | 44% |
| Psychotherapy session, 30 minutes CPT 90832 PSYCHOTHERAPY W/PATIENT 30 MINUTES | $158.70 | $283.40 | $75.03–$208.58 | 49% above | 44% |
| Psychotherapy session, 45 minutes CPT 90834 PSYCHOTHERAPY W/PATIENT 45 MINUTES | $209.61 | $374.30 | $99.33–$275.48 | 48% above | 44% |
| Psychotherapy session, 45 minutes CPT 90834 HC Php Individual Psychotherapy Lvl 2 | $215.21 | $384.30 | $115.29–$341.06 | 52% above | 44% |
| Psychotherapy session, 45 minutes CPT 90834 HC Individual Psychotherapy Lvl 2 | $215.21 | $384.30 | $115.29–$341.06 | 52% above | 44% |
| Psychotherapy session, 45 minutes CPT 90834 HC Psych Therapy 45 Min W/Pt &/or Family | $215.21 | $384.30 | $115.29–$341.06 | 52% above | 44% |
| Psychotherapy session, 45 minutes CPT 90834 HC PHP INDIVIDUAL PSYCHOTHERAPY LVL 2 | $259.50 | $463.40 | $115.29–$341.06 | 83% above | 44% |
| Psychotherapy session, 45 minutes CPT 90834 HC INDIVIDUAL PSYCHOTHERAPY LVL 2 | $259.50 | $463.40 | $115.29–$341.06 | 83% above | 44% |
| Psychotherapy session, 45 minutes CPT 90834 HC IOP INDIVIDUAL PSYCHOTHERAPY LVL 2 | $259.50 | $463.40 | $115.29–$341.06 | 83% above | 44% |
| Psychotherapy session, 60 minutes CPT 90837 HC Php Psych Therapy 60 Min W/Pt &/or Family | $214.93 | $383.80 | $115.14–$341.06 | 1% above | 44% |
| Psychotherapy session, 60 minutes CPT 90837 HC Psych Therapy 60 Min W/Pt &/or Family | $214.93 | $383.80 | $115.14–$341.06 | 1% above | 44% |
| Psychotherapy session, 60 minutes CPT 90837 HC PSYCH THERAPY 60 MIN W/PT &/OR FAMILY | $259.50 | $463.40 | $115.14–$341.06 | 22% above | 44% |
| Psychotherapy session, 60 minutes CPT 90837 HC PHP PSYCH THERAPY 60 MIN W/PT &/OR FAMILY | $259.50 | $463.40 | $115.14–$341.06 | 22% above | 44% |
| Psychotherapy session, 60 minutes CPT 90837 HC IOP PSYCH THERAPY 60 MIN W/PT &/OR FAMILY | $259.50 | $463.40 | $115.14–$341.06 | 22% above | 44% |
| Psychotherapy session, 60 minutes CPT 90837 PSYCHOTHERAPY W/PATIENT 60 MINUTES | $308.78 | $551.40 | $146.13–$405.83 | 45% above | 44% |
| Quit-smoking counseling, 3 to 10 minutes CPT 99406 BEHAV CHNG SMOKING 3-10 MIN | $29.18 | $52.10 | $12.63–$38.35 | 1% above | 44% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 OFFICE/OUTPATIENT ESTABLISHED HIGH MDM 40 MIN | $326.31 | $582.70 | $139.32–$541.91 | 11% above | 44% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 HC Est Pt Level 5 | $328.16 | $586.00 | $175.80–$431.30 | 11% above | 44% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 HC EST PT LEVEL 5 | $328.16 | $586.00 | $175.80–$431.30 | 11% above | 44% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 OFFICE/OUTPATIENT ESTABLISHED LOW MDM 20 MIN | $164.36 | $293.50 | $64.08–$272.96 | at median | 44% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 HC EST PT LEVEL 3 | $175.56 | $313.50 | $94.05–$230.74 | 7% above | 44% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 HC Est Pt Level 3 | $175.56 | $313.50 | $94.05–$230.74 | 7% above | 44% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 HC Est Pt Level 4 | $182.45 | $325.80 | $97.74–$239.79 | 2% below | 44% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 HC EST PT LEVEL 4 | $182.45 | $325.80 | $97.74–$239.79 | 2% below | 44% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 FLIGHT PHYSICAL | $232.74 | $415.60 | $94.80–$305.88 | 25% above | 44% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 OFFICE/OUTPATIENT ESTABLISHED MOD MDM 30 MIN | $232.74 | $415.60 | $94.80–$386.51 | 25% above | 44% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 WIAA PHYSICAL | $16.80 | $30.00 | $9.00–$22.08 | 83% below | 44% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 OFFICE/OUTPATIENT ESTABLISHED SF MDM 10 MIN | $102.76 | $183.50 | $34.38–$170.66 | 6% above | 44% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 HC Est Pt Level 2 | $153.50 | $274.10 | $82.23–$201.74 | 59% above | 44% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 HC EST PT LEVEL 2 | $153.50 | $274.10 | $82.23–$201.74 | 59% above | 44% |
| Specialist consultation, low complexity or 30+ minutes CPT 99243 OFFICE CONSULTATION,LEVEL III | $250.43 | $447.20 | $104.49–$329.14 | 25% above | 44% |
| Specialist consultation, moderate complexity or 40+ minutes CPT 99244 OFFICE CONSULTATION,LEVEL IV | $350.56 | $626.00 | $158.46–$460.74 | 9% above | 44% |
| Spirometry (breathing test) CPT 94010 SPIROMETRY | $99.12 | $177.00 | $53.10–$130.27 | 65% below | 44% |
| Spirometry (breathing test) CPT 94010 HC Spirometry Study | $228.14 | $407.40 | $122.22–$341.95 | 18% below | 44% |
| Spirometry (breathing test) CPT 94010 HC SPIROMETRY STUDY | $260.18 | $464.60 | $122.22–$341.95 | 7% below | 44% |
| Spirometry before and after a bronchodilator CPT 94060 SPIROMETRY, PRE & POST | $143.08 | $255.50 | $76.65–$188.05 | 71% below | 44% |
| Spirometry before and after a bronchodilator CPT 94060 HC Bronchodilator Study | $493.92 | $882.00 | $264.60–$687.57 | 2% above | 44% |
| Spirometry before and after a bronchodilator CPT 94060 HC BRONCHODILATOR STUDY | $515.31 | $920.20 | $264.60–$687.57 | 6% above | 44% |
| TMS (transcranial magnetic stimulation), first session with mapping CPT 90867 TCRANIAL MAGN STIM TX PLAN | $1,474.59 | $2,633.20 | $789.96–$1,938.04 | 267% above | 44% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 HC Ot Treat-Indv Psych 15min | $75.43 | $134.70 | $70.02–$80.31 | 16% below | 44% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 HC OT TREAT-INDV PSYCH 15MIN | $86.91 | $155.20 | $70.02–$80.31 | 3% below | 44% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 THERAPEUTIC ACTIVITIES | $145.54 | $259.90 | $70.02–$80.31 | 62% above | 44% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 THERAPUTIC ACTIVITIES/15 MIN(747) | $145.54 | $259.90 | $70.02–$80.31 | 62% above | 44% |
| Therapeutic phlebotomy (removing blood as treatment) CPT 99195 HC Phlebotomy Therapeutic | $109.76 | $196.00 | $58.80–$236.92 | 45% below | 44% |
| Therapeutic phlebotomy (removing blood as treatment) CPT 99195 HC PHLEBOTOMY THERAPEUTIC | $142.69 | $254.80 | $58.80–$236.92 | 29% below | 44% |
| Therapeutic phlebotomy (removing blood as treatment) CPT 99195 THERAPEUTIC PHLEBOTOMY | $356.38 | $636.40 | $190.92–$468.39 | 78% above | 44% |
Vaccines
| Procedure | Cash price | List price | Insurers pay | vs Wisconsin | Off list |
|---|---|---|---|---|---|
| COVID-19 vaccine (Moderna), age 12 and older CPT 91322 COVID-19 mRNA Vac 12y+ Moderna 50 mcg/0.5 mL Susy 0.5 mL Syringe | $139.64 | $249.36 | $1.62–$58,699.64 | 16% below | 44% |
| COVID-19 vaccine (Moderna), age 12 and older CPT 91322 COVID-19 mRNA Vac Moderna 50 mcg/0.5 mL Susp 0.5 mL Vial | $139.64 | $249.36 | $1.62–$58,699.64 | 16% below | 44% |
| COVID-19 vaccine (Moderna), age 12 and older CPT 91322 SARSCOV2 VACCINE 50 MCG/0.5 ML FOR IM USE | $305.42 | $545.40 | — | 83% above | 44% |
| Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 VARICELLA VACCINE | $168.06 | $300.10 | — | 3% above | 44% |
| Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 varicella virus vaccine live 1,350 PFU/0.5 mL Susr 1 each Vial | $221.18 | $394.97 | $1.62–$58,699.64 | 35% above | 44% |
| DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) CPT 90696 DTAP-IPV VACC 4-6 YR IM | $84.17 | $150.30 | — | at median | 44% |
| DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 DTAP IMMUNIZATION | $39.09 | $69.80 | — | 5% below | 44% |
| DTaP, hepatitis B and polio combination vaccine (Pediarix) CPT 90723 DTAP-HEPB-IPV VACCINE INTRAMUSCULAR | $113.90 | $203.40 | — | 18% below | 44% |
| DTaP, polio and Hib combination vaccine (Pentacel) CPT 90698 DTAP-IPV/HIB VACCINE FOR INTRAMUSCULAR USE | $116.59 | $208.20 | — | at median | 44% |
| Flu shot, recombinant, egg-free (Flublok) CPT 90673 RIV3 VACCINE PRESERVATIVE FREE FOR IM USE | $72.69 | $129.80 | — | 3% below | 44% |
| Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 INFLUENZA VIRUS VACCINE,PF,MA 19YRS + | $31.92 | $57.00 | — | at median | 44% |
| Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 INFLUENZA VIRUS VACCINE,MA 3-18YRS,FREE SUPPLY | $31.92 | $57.00 | — | at median | 44% |
| Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 IIV3 VACC PRESERVATIVE FREE 0.5 ML DOSAGE IM USE | $31.92 | $57.00 | — | at median | 44% |
| Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 influenza virus trivalent vacc iiv3 split PF 0.5 mL Susy 0.5 mL Syringe | $38.12 | $68.07 | $1.62–$58,699.64 | 19% above | 44% |
| HPV vaccine, 9-valent (Gardasil 9) CPT 90651 9VHPV VACCINE 3 DOSE SCHEDULE FOR IM USE | $318.64 | $569.00 | — | at median | 44% |
| Hepatitis A and B combination vaccine, adult (Twinrix) CPT 90636 HEPA/HEPB VACCINE ADULT IM | $142.86 | $255.10 | — | 25% below | 44% |
| Hepatitis A vaccine, adult dose CPT 90632 hepatitis A vaccine 50 Units/mL Susp 1 mL Syringe | $54.07 | $96.56 | $1.62–$58,699.64 | 59% below | 44% |
| Hepatitis A vaccine, adult dose CPT 90632 hepatitis A vaccine 1,440 EL U/mL Susp 1 mL Vial | $88.91 | $158.77 | $1.62–$58,699.64 | 33% below | 44% |
| Hepatitis A vaccine, adult dose CPT 90632 hepatitis A vaccine 1,440 EL U/mL Susp 1 mL Syringe | $96.67 | $172.63 | $1.62–$58,699.64 | 27% below | 44% |
| Hepatitis A vaccine, adult dose CPT 90632 HEPA VACCINE ADULT IM | $104.61 | $186.80 | — | 21% below | 44% |
| Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 HEPATITIS A(PED 2 DOSE) | $51.91 | $92.70 | — | at median | 44% |
| Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 hepatitis A vaccine 25 Units/0.5 mL Susp 0.5 mL Syringe | $52.42 | $93.60 | $1.62–$58,699.64 | 1% above | 44% |
| Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 hepatitis A Vaccine 720 EL U/0.5 mL Susy 0.5 mL Syringe | $55.45 | $99.02 | $1.62–$58,699.64 | 7% above | 44% |
| Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 hepatitis B vaccine recombinant 10 mcg/mL Susp 1 mL Vial | $47.20 | $84.29 | $1.62–$58,699.64 | 59% below | 44% |
| Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 hepatitis B vaccine recombinant 20 mcg/mL Susy 1 mL Syringe | $71.86 | $128.32 | $1.62–$58,699.64 | 38% below | 44% |
| Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 HEPATITIS B VACCINE, OVER 20YR | $105.11 | $187.70 | — | 9% below | 44% |
| Hepatitis B vaccine, adult, 2-dose schedule (Heplisav-B) CPT 90739 HEP B VACC ADULT 2 DOSE IM | $211.51 | $377.70 | — | 1% below | 44% |
| Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 hepatitis B vaccine recombinant 5 mcg/0.5 mL Susp 0.5 mL Vial | $36.55 | $65.26 | $1.62–$58,699.64 | 35% below | 44% |
| Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 hepatitis B vaccine recombinant 10 mcg/0.5 mL Susy 0.5 mL Syringe | $43.37 | $77.45 | $1.62–$58,699.64 | 23% below | 44% |
| Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 HEPATITIS B VACCINE, THRU 19YR | $50.51 | $90.20 | — | 10% below | 44% |
| Hib vaccine (Haemophilus influenzae type b), 3-dose schedule (PedvaxHIB) CPT 90647 HIB VACCINE, PRP-OMP, IM | $43.79 | $78.20 | — | 13% below | 44% |
| Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) CPT 90648 HIB VACCINE, PRP-T, IM | $41.78 | $74.60 | — | at median | 44% |
| High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 FLUZONE HIGH-DOSE | $82.17 | $146.74 | $1.62–$58,699.64 | 4% above | 44% |
| High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 FLU VACC PRSV FREE INC ANTIG HIGH DOSE | $153.61 | $274.30 | — | 94% above | 44% |
| Japanese encephalitis vaccine (Ixiaro), 2-dose schedule CPT 90738 JAPANESE ENCEPHALITIS VIRUS VACCINE, INACTIVATED, INTRAMUSCULAR USE | $279.16 | $498.50 | — | at median | 44% |
| MMR vaccine (measles, mumps and rubella), live CPT 90707 MMR VIRUS IMMUNIZATION | $92.12 | $164.50 | — | 40% below | 44% |
| MMR vaccine (measles, mumps and rubella), live CPT 90707 measles, mumps & rubella vac Solr 1 each Vial | $118.88 | $212.28 | $1.62–$58,699.64 | 22% below | 44% |
| MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) CPT 90710 COMBINED VACCINE,MMR+VARICELLA | $518.17 | $925.30 | — | 104% above | 44% |
| Meningococcal ACWY (MenACWY) vaccine CPT 90734 MCV4 MENACWY-D CONJ VACC GRPS ACYW-135 IM USE | $490.50 | $875.90 | — | 114% above | 44% |
| Meningococcal ACWY vaccine (MenQuadfi) CPT 90619 MCV4 MENACWY-TT CONJ VACC GRPS ACYW IM USE | $216.16 | $386.00 | — | 6% above | 44% |
| Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 MENINGOCOCCAL RECOMBINANT 2 DOSE IM | $231.62 | $413.60 | — | at median | 44% |
| Meningococcal B vaccine (Trumenba) CPT 90621 MENINGOCOCCAL FULLY RECOMBINANT 3 DOSE IM | $190.40 | $340.00 | — | 1% below | 44% |
| Nasal spray flu vaccine, live (FluMist) CPT 90660 FLU VACCINE, NASAL | $38.81 | $69.30 | — | at median | 44% |
| Pneumonia vaccine, 13-valent conjugate (Prevnar 13) CPT 90670 PNEUMOCOCCAL 13 | $322.84 | $576.50 | — | 10% above | 44% |
| Pneumonia vaccine, 15-valent conjugate (Vaxneuvance) CPT 90671 PNEUMOCOCCAL CONJUGATE VACCINE, 15 VALENT (PCV15), INTRAMUSCULAR USE | $336.73 | $601.30 | — | 15% above | 44% |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 pneumococcal 20-val conj vacc 0.5 mL Susy 0.5 mL Syringe | $281.67 | $502.99 | $1.62–$58,699.64 | 4% below | 44% |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 PNEUMOCOCCAL CONJUGATE VACCINE, 20 VALENT (PCV20), INTRAMUSCULAR USE | $364.50 | $650.90 | — | 25% above | 44% |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PNEUMOCOCCAL(PNEUMOVAX) IMMUNI | $168.22 | $300.40 | — | 19% above | 44% |
| Polio vaccine, inactivated (IPV) CPT 90713 POLIO IMMUNIZATION, INJECTABLE | $43.79 | $78.20 | — | 27% below | 44% |
| Polio vaccine, inactivated (IPV) CPT 90713 poliovirus vaccine inactivated Susp 5 mL Vial | $474.22 | $846.82 | $1.62–$58,699.64 | 693% above | 44% |
| RSV antibody shot for infants and toddlers, larger dose (1 mL, 100 mg) CPT 90381 nirsevimab-alip 100 mg/mL Sosy 1 mL Syringe | $564.66 | $1,008.33 | $1.62–$58,699.64 | 45% below | 44% |
| RSV antibody shot for infants and toddlers, larger dose (1 mL, 100 mg) CPT 90381 RSV MONOCLONAL ANTB SEASONAL DOSE 1 ML IM USE | $1,131.82 | $2,021.10 | $606.33–$1,487.53 | 11% above | 44% |
| RSV antibody shot for infants, seasonal dose (0.5 mL) CPT 90380 nirsevimab-alip 50 mg/0.5 mL Sosy 0.5 mL Syringe | $537.91 | $960.56 | $1.62–$58,699.64 | 47% below | 44% |
| RSV antibody shot for infants, seasonal dose (0.5 mL) CPT 90380 RSV MONOCLONAL ANTB SEASONAL DOSE 0.5ML IM USE | $565.94 | $1,010.60 | $303.18–$743.80 | 45% below | 44% |
| RSV vaccine (Abrysvo), one dose for older adults or during pregnancy CPT 90678 RSV VACCINE PREF SUBUNIT BIVALENT FOR IM USE | $293.55 | $524.20 | — | 47% below | 44% |
| RSV vaccine with adjuvant (Arexvy), one dose for older adults CPT 90679 RESPIRATORY SYNCYTIAL VIRUS VACCINE, PREF, RECOMBINANT, | $281.79 | $503.20 | — | 48% below | 44% |
| Rabies vaccine, one dose CPT 90675 rabies virus vaccine Susr 1 each Vial | $435.98 | $778.53 | $1.62–$58,699.64 | 25% below | 44% |
| Rabies vaccine, one dose CPT 90675 RABIES VACCINE, IM | $467.94 | $835.60 | — | 19% below | 44% |
| Rotavirus vaccine, oral, 2-dose schedule (Rotarix) CPT 90681 ROTAVIRUS VACC 2 DOSE ORAL (ROTARIX) | $178.98 | $319.60 | — | 18% above | 44% |
| Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) CPT 90680 ROTAVIRUS VACC 3 DOSE ORAL (ROTATEQ) | $116.59 | $208.20 | — | at median | 44% |
| Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 HZV ZOSTER VACC RECOMBINANT ADJUVANTED IM NJX | $197.90 | $353.40 | — | at median | 44% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TETANUS DIPHTHERIA PRESERVATIVE FREE | $41.44 | $74.00 | — | at median | 44% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 tetanus-diphtheria (age 7 yrs-adult) adult Susp 0.5 mL Syringe | $66.63 | $118.99 | $1.62–$58,699.64 | 61% above | 44% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 tetanus toxoid-diphtheria-acellular pertussis Tdap adult Susy 0.5 mL Syringe | $58.07 | $103.69 | $1.62–$58,699.64 | 29% below | 44% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 TDAP IMMUNIZATION (BOOSTRIX) | $70.95 | $126.70 | — | 13% below | 44% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 TDAP IMMUNIZATION (ADACEL) | $70.95 | $126.70 | — | 13% below | 44% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 TDAP VACC IND 7 YEARS/OLDER IM USE | $70.95 | $126.70 | — | 13% below | 44% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMINISTRATION, 1 VACCINE | $55.61 | $99.30 | — | 44% above | 44% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION, 1ST OR ONLY INJ | $55.61 | $99.30 | — | 44% above | 44% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 FLU OR PNEUMO ADMINISTATION FEE | $55.61 | $99.30 | — | 44% above | 44% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION, 1ST OR ONLY INJ SELF PAY | $55.61 | $99.30 | — | 44% above | 44% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 HC Immunization Administration | $56.00 | $100.00 | — | 45% above | 44% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 HC IMMUNIZATION ADMINISTRATION | $61.60 | $110.00 | — | 59% above | 44% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 HC Immunization Administration, Each Additional Vaccine | $38.58 | $68.90 | — | 19% above | 44% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 HC IMMUNIZATION ADMINISTRATION, EACH ADDITIONAL VACCINE | $39.20 | $70.00 | — | 21% above | 44% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMUNIZATION, ADDITIONAL INJ | $39.82 | $71.10 | — | 23% above | 44% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMUNIZATION ADMINISTRATION, EACH ADDITIONAL VACCINE | $39.82 | $71.10 | — | 23% above | 44% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMUNIZATION, ADDITIONAL INJ SELF PAY | $39.82 | $71.10 | — | 23% above | 44% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMUNIZATION SUBSEQUENT FLU/PNEUMONIA | $39.82 | $71.10 | — | 23% above | 44% |
Dental
| Procedure | Cash price | List price | Insurers pay | vs Wisconsin | Off list |
|---|---|---|---|---|---|
| Routine teeth cleaning (prophylaxis), adult or teen CDT D1110 HC Dental Prophylaxis Adult | $267.68 | $478.00 | $143.40–$362.33 | at median | 44% |
| Routine teeth cleaning (prophylaxis), adult or teen CDT D1110 HC DENTAL PROPHYLAXIS ADULT | $275.69 | $492.30 | $143.40–$362.33 | 3% above | 44% |
| Simple extraction of a tooth or exposed root that is above the gum CDT D7140 HC Extrac Erupted Tooth/Exposed Root | $1,207.86 | $2,156.90 | $647.07–$2,063.74 | at median | 44% |
| Simple extraction of a tooth or exposed root that is above the gum CDT D7140 HC EXTRAC ERUPTED TOOTH/EXPOSED ROOT | $1,570.24 | $2,804.00 | $647.07–$2,063.74 | 30% above | 44% |
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.