Hospital Williamsport, PA

UPMC Muncy

UPMC Muncy in Muncy, PA publishes cash prices for 335 common procedures listed here, from its own machine-readable price file updated Mar 6, 2026. Compared with other hospitals in the state, its outpatient cash prices are above the Pennsylvania median for 257 of 333 procedures and below it for 61. By typical cash price it ranks #78 of 108 Pennsylvania hospitals, cheapest first. Select a procedure to compare it with other hospitals nearby.

215 East Water Street, Muncy, PA 17756 Collected Sep 27, 2026 Source price file Check a bill from this hospital (570) 546-8282

Critical access hospital (rural, 25 beds or fewer) Nonprofit hospital Emergency department CMS star rating 4 of 5 CCN 391301 · CMS hospital register NPI 1609816198

Financial assistance

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

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

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

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

Scans and imaging

Procedure	Cash price	List price	Insurers pay	vs Pennsylvania	Off list
Abdominal CT scan without and with contrast CPT 74170 CT ABDOMEN W WO CON	$3,476.40	$5,794.00	$142.72–$5,504.30	84% above	40%
Abdominal CT scan without and with contrast inpatient CPT 74170 CT ABDOMEN W WO CON	$3,476.40	$5,794.00	$2,208.32–$5,504.30	—	40%
Abdominal X-ray, 2 views CPT 74019 ABDOMEN 2 VIEWS	$327.00	$545.00	$21.09–$517.75	at median	40%
Abdominal X-ray, 2 views inpatient CPT 74019 ABDOMEN 2 VIEWS	$327.00	$545.00	$233.48–$2,315.52	—	40%
Ankle X-ray, complete, 3 or more views CPT 73610 ANKLE COMP MIN 3 VIEWS	$307.20	$512.00	$23.97–$486.40	15% below	40%
Ankle X-ray, complete, 3 or more views inpatient CPT 73610 ANKLE COMP MIN 3 VIEWS	$307.20	$512.00	$219.34–$2,315.52	—	40%
Ankle-brachial index (ABI), blood pressure test for leg arteries both sides CPT 93922 UP/LOW EXT ART EVAL SNG LEV BI	$759.60	$1,266.00	$47.50–$1,202.70	—	40%
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 NON INVAS BIL SNGL LEVEL ABI S	$759.60	$1,266.00	$47.50–$1,202.70	70% above	40%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient both sides CPT 93922 UP/LOW EXT ART EVAL SNG LEV BI	$759.60	$1,266.00	$542.35–$2,315.52	—	40%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 NON INVAS BIL SNGL LEVEL ABI S	$759.60	$1,266.00	$542.35–$2,315.52	—	40%
Arm CT scan without contrast (shoulder to hand, any part) CPT 73200 CT UPPER EXTREM WO CON	$1,943.40	$3,239.00	$101.17–$3,077.05	65% above	40%
Arm CT scan without contrast (shoulder to hand, any part) inpatient CPT 73200 CT UPPER EXTREM WO CON	$1,943.40	$3,239.00	$1,387.59–$3,077.05	—	40%
Barium swallow (esophagus X-ray with contrast) CPT 74220 ESOPHAGUS X-RAY XM SNGL CNTRST	$713.40	$1,189.00	$28.80–$1,129.55	55% above	40%
Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 ESOPHAGUS X-RAY XM SNGL CNTRST	$713.40	$1,189.00	$509.37–$2,315.52	—	40%
Bone scan, whole body (nuclear medicine) CPT 78306 BONE/JNT IMAG WHOLE BODY	$1,474.20	$2,457.00	$78.72–$2,334.15	20% above	40%
Bone scan, whole body (nuclear medicine) inpatient CPT 78306 BONE/JNT IMAG WHOLE BODY	$1,474.20	$2,457.00	$1,052.58–$2,334.15	—	40%
Breast ultrasound, complete, one breast one side CPT 76641 US BREAST COMPLETE UNILATERAL	$546.60	$911.00	$68.39–$865.45	at median	40%
Breast ultrasound, complete, one breast inpatient one side CPT 76641 US BREAST COMPLETE UNILATERAL	$546.60	$911.00	$390.27–$2,315.52	—	40%
Breast ultrasound, limited (one breast or one area) one side CPT 76642 US BREAST LIMITED UNILATERAL	$479.40	$799.00	$52.40–$759.05	4% above	40%
Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 US BREAST LIMITED UNILATERAL	$479.40	$799.00	$342.29–$2,315.52	—	40%
CT angiography (CTA) of the abdomen and pelvis CPT 74174 CTA ABD&PLV W/WO CON W/POSTPRC	$7,318.20	$12,197.00	$427.14–$11,587.15	145% above	40%
CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174 CTA ABD&PLV W/WO CON W/POSTPRC	$7,318.20	$12,197.00	$2,208.32–$11,587.15	—	40%
CT angiography (CTA) of the head CPT 70496 CTA HEAD W/WO CON W/PST PROC	$4,092.00	$6,820.00	$256.26–$6,479.00	140% above	40%
CT angiography (CTA) of the head inpatient CPT 70496 CTA HEAD W/WO CON W/PST PROC	$4,092.00	$6,820.00	$2,208.32–$6,479.00	—	40%
CT angiography (CTA) of the neck CPT 70498 CTA NECK W/WO CON W/PST PROC	$2,598.60	$4,331.00	$256.26–$4,114.45	56% above	40%
CT angiography (CTA) of the neck inpatient CPT 70498 CTA NECK W/WO CON W/PST PROC	$2,598.60	$4,331.00	$1,855.40–$4,114.45	—	40%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CTA CHEST W/WO CON W/PST PROC	$3,384.00	$5,640.00	$277.50–$5,358.00	76% above	40%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CTA CHEST W/WO CON W/PST PROC	$3,384.00	$5,640.00	$2,208.32–$5,358.00	—	40%
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 CT ANGIO HRT W/3D IMAGE	$2,133.00	$3,555.00	$265.05–$3,377.25	8% above	40%
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score inpatient CPT 75574 CT ANGIO HRT W/3D IMAGE	$2,133.00	$3,555.00	$1,522.96–$3,377.25	—	40%
CT of the heart without contrast dye to measure coronary calcium CPT 75571 CT HRT W/O DYE W/CA TEST	$126.00	$210.00	$31.50–$199.50	29% below	40%
CT of the heart without contrast dye to measure coronary calcium inpatient CPT 75571 CT HRT W/O DYE W/CA TEST	$126.00	$210.00	$89.96–$2,315.52	—	40%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT ABD & PLVS WO CONTRAST	$3,320.40	$5,534.00	$129.37–$5,257.30	60% above	40%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT ABD & PLVS WO CONTRAST	$3,320.40	$5,534.00	$2,208.32–$5,257.30	—	40%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ABD & PLVS W CONTRAST	$4,453.20	$7,422.00	$246.69–$7,050.90	49% above	40%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT ABD & PLVS W CONTRAST	$4,453.20	$7,422.00	$2,208.32–$7,050.90	—	40%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT ABD & PLVS W WO CONTRAST	$5,723.40	$9,539.00	$326.02–$9,062.05	92% above	40%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT ABD & PLVS W WO CONTRAST	$5,723.40	$9,539.00	$2,208.32–$9,062.05	—	40%
CT scan of the abdomen with contrast CPT 74160 CT ABDOMEN W CON	$2,772.60	$4,621.00	$115.20–$4,389.95	68% above	40%
CT scan of the abdomen with contrast inpatient CPT 74160 CT ABDOMEN W CON	$2,772.60	$4,621.00	$1,979.64–$4,389.95	—	40%
CT scan of the abdomen without contrast CPT 74150 CT ABDOMEN WO CON	$2,175.00	$3,625.00	$99.20–$3,443.75	93% above	40%
CT scan of the abdomen without contrast inpatient CPT 74150 CT ABDOMEN WO CON	$2,175.00	$3,625.00	$1,552.95–$3,443.75	—	40%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT MAXILLOFACIAL WO CON	$1,590.60	$2,651.00	$99.20–$2,518.45	41% above	40%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT MAXILLOFACIAL WO CON	$1,590.60	$2,651.00	$1,135.69–$2,518.45	—	40%
CT scan of the head or brain, no contrast dye CPT 70450 CT HEAD WO CONTRAST	$1,602.60	$2,671.00	$99.20–$2,537.45	48% above	40%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT HEAD WO CONTRAST	$1,602.60	$2,671.00	$1,144.26–$2,537.45	—	40%
CT scan of the head with contrast CPT 70460 CT HEAD W CONTRAST	$2,371.20	$3,952.00	$102.40–$3,754.40	75% above	40%
CT scan of the head with contrast inpatient CPT 70460 CT HEAD W CONTRAST	$2,371.20	$3,952.00	$1,693.04–$3,754.40	—	40%
CT scan of the head without and with contrast CPT 70470 CT HEAD W WO CONTRAST	$2,704.20	$4,507.00	$128.00–$4,281.65	62% above	40%
CT scan of the head without and with contrast inpatient CPT 70470 CT HEAD W WO CONTRAST	$2,704.20	$4,507.00	$1,930.80–$4,281.65	—	40%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT LUMBAR SPINE WO CON	$2,051.40	$3,419.00	$112.77–$3,248.05	78% above	40%
CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 CT LUMBAR SPINE WO CON	$2,051.40	$3,419.00	$1,464.70–$3,248.05	—	40%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT CERVICAL SPINE WO CON	$2,108.40	$3,514.00	$106.37–$3,338.30	79% above	40%
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CT CERVICAL SPINE WO CON	$2,108.40	$3,514.00	$1,505.40–$3,338.30	—	40%
CT scan of the pelvis, with contrast dye CPT 72193 CT PELVIS W CON	$1,902.00	$3,170.00	$110.72–$3,011.50	12% above	40%
CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT PELVIS W CON	$1,902.00	$3,170.00	$1,358.03–$3,011.50	—	40%
Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 DUP CAROTID BILAT COMP	$1,433.40	$2,389.00	$152.76–$2,269.55	—	40%
Carotid artery ultrasound (duplex), both sides of the neck CPT 93880 DUPLEX EXTRACRANIAL ART BIL	$1,433.40	$2,389.00	$152.76–$2,269.55	77% above	40%
Carotid artery ultrasound (duplex), both sides of the neck inpatient both sides CPT 93880 DUP CAROTID BILAT COMP	$1,433.40	$2,389.00	$1,023.45–$2,315.52	—	40%
Carotid artery ultrasound (duplex), both sides of the neck inpatient CPT 93880 DUPLEX EXTRACRANIAL ART BIL	$1,433.40	$2,389.00	$1,023.45–$2,315.52	—	40%
Chest CT scan without and with contrast CPT 71270 CT THORAX DX W/WO CON	$3,152.40	$5,254.00	$132.48–$4,991.30	96% above	40%
Chest CT scan without and with contrast inpatient CPT 71270 CT THORAX DX W/WO CON	$3,152.40	$5,254.00	$2,208.32–$4,991.30	—	40%
Chest X-ray, 2 views CPT 71046 CHEST 2 VIEWS	$580.20	$967.00	$19.01–$918.65	80% above	40%
Chest X-ray, 2 views inpatient CPT 71046 CHEST 2 VIEWS	$580.20	$967.00	$414.26–$2,315.52	—	40%
Chest X-ray, single view CPT 71045 CHEST 1 VIEW	$175.20	$292.00	$10.38–$277.40	7% below	40%
Chest X-ray, single view inpatient CPT 71045 CHEST 1 VIEW	$175.20	$292.00	$125.09–$2,315.52	—	40%
Collarbone (clavicle) X-ray, complete CPT 73000 CLAVICLE COMPLETE	$258.60	$431.00	$14.72–$409.45	10% below	40%
Collarbone (clavicle) X-ray, complete inpatient CPT 73000 CLAVICLE COMPLETE	$258.60	$431.00	$184.64–$2,315.52	—	40%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US RETROPERITONEAL COMPLETE	$732.60	$1,221.00	$62.72–$1,159.95	1% above	40%
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US RETROPERITONEAL COMPLETE	$732.60	$1,221.00	$523.08–$2,315.52	—	40%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 DEXA AXIAL SKL 1 OR MORE SITES	$264.60	$441.00	$66.12–$418.95	3% below	40%
DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 DEXA AXIAL SKL 1 OR MORE SITES	$264.60	$441.00	$188.92–$2,315.52	—	40%
DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 DEXA APPEND SKEL PERIPHERAL	$127.20	$212.00	$22.63–$201.40	30% below	40%
DEXA bone density scan of the wrist, heel or finger (peripheral) inpatient CPT 77081 DEXA APPEND SKEL PERIPHERAL	$127.20	$212.00	$90.82–$2,315.52	—	40%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT THORAX DX WO CON	$2,244.60	$3,741.00	$106.37–$3,553.95	104% above	40%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT THORAX DX WO CON	$2,244.60	$3,741.00	$1,602.64–$3,553.95	—	40%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT THORAX DX W CON	$2,664.00	$4,440.00	$112.00–$4,218.00	87% above	40%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT THORAX DX W CON	$2,664.00	$4,440.00	$1,902.10–$4,218.00	—	40%
Diagnostic mammogram, both breasts both sides CPT 77066 MAMMO DIGITAL DX BILAT WWO CAD	$483.00	$805.00	$116.26–$764.75	—	40%
Diagnostic mammogram, both breasts inpatient both sides CPT 77066 MAMMO DIGITAL DX BILAT WWO CAD	$483.00	$805.00	$344.86–$2,315.52	—	40%
Diagnostic mammogram, one breast CPT 77065 MAMMO DIGITAL DX UNI WWO CAD	$316.80	$528.00	$79.20–$501.60	at median	40%
Diagnostic mammogram, one breast inpatient CPT 77065 MAMMO DIGITAL DX UNI WWO CAD	$316.80	$528.00	$226.20–$2,315.52	—	40%
Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 DUPLEX ART LWR EXT BILAT	$1,678.20	$2,797.00	$152.76–$2,657.15	—	40%
Duplex ultrasound of the leg arteries, both legs CPT 93925 DUPLEX LOWER EXT ARTERY BIL	$1,678.20	$2,797.00	$152.76–$2,657.15	104% above	40%
Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 DUPLEX ART LWR EXT BILAT	$1,678.20	$2,797.00	$1,198.23–$2,657.15	—	40%
Duplex ultrasound of the leg arteries, both legs inpatient CPT 93925 DUPLEX LOWER EXT ARTERY BIL	$1,678.20	$2,797.00	$1,198.23–$2,657.15	—	40%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 DUPLEX EXT VEINS W/COMP/MAN BI	$1,227.60	$2,046.00	$146.18–$1,943.70	—	40%
Duplex ultrasound of the leg veins, both legs CPT 93970 DUPLEX VENOUS UPR LWR BIL ADDL	$1,227.60	$2,046.00	$146.18–$1,943.70	41% above	40%
Duplex ultrasound of the leg veins, both legs CPT 93970 DUPLEX VENOUS UPPER LOWER BIL	$1,227.60	$2,046.00	$146.18–$1,943.70	41% above	40%
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 DUPLEX EXT VEINS W/COMP/MAN BI	$1,227.60	$2,046.00	$876.51–$2,315.52	—	40%
Duplex ultrasound of the leg veins, both legs inpatient CPT 93970 DUPLEX VENOUS UPR LWR BIL ADDL	$1,227.60	$2,046.00	$876.51–$2,315.52	—	40%
Duplex ultrasound of the leg veins, both legs inpatient CPT 93970 DUPLEX VENOUS UPPER LOWER BIL	$1,227.60	$2,046.00	$876.51–$2,315.52	—	40%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 TTE W / DOPPLER COMP (BUNDLED)	$2,265.00	$3,775.00	$125.62–$3,586.25	21% above	40%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 PORT TTE W DOPLR COMP(BUNDLED)	$2,265.00	$3,775.00	$125.62–$3,586.25	21% above	40%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 PORT TTE W DOPLR COMP(BUNDLED)	$2,265.00	$3,775.00	$1,617.21–$3,586.25	—	40%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 TTE W / DOPPLER COMP (BUNDLED)	$2,265.00	$3,775.00	$1,617.21–$3,586.25	—	40%
Elbow X-ray, 2 views CPT 73070 ELBOW 2 VIEWS	$544.80	$908.00	$14.72–$862.60	79% above	40%
Elbow X-ray, 2 views inpatient CPT 73070 ELBOW 2 VIEWS	$544.80	$908.00	$388.99–$2,315.52	—	40%
Elbow X-ray, complete, 3 or more views CPT 73080 ELBOW MIN 3 VIEWS	$373.80	$623.00	$14.72–$591.85	8% above	40%
Elbow X-ray, complete, 3 or more views inpatient CPT 73080 ELBOW MIN 3 VIEWS	$373.80	$623.00	$266.89–$2,315.52	—	40%
Eye socket (orbit) CT scan without contrast CPT 70480 CT ORBIT SELLA P FOS EAR WO	$1,623.00	$2,705.00	$145.92–$2,569.75	49% above	40%
Eye socket (orbit) CT scan without contrast inpatient CPT 70480 CT ORBIT SELLA P FOS EAR WO	$1,623.00	$2,705.00	$1,158.82–$2,569.75	—	40%
Facial bones X-ray, complete, 3 or more views CPT 70150 FACIAL BONES COMP MIN 3 VWS	$444.00	$740.00	$28.80–$703.00	8% above	40%
Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 FACIAL BONES COMP MIN 3 VWS	$444.00	$740.00	$317.02–$2,315.52	—	40%
Forearm X-ray (radius and ulna), 2 views CPT 73090 FOREARM 2 VIEWS	$545.40	$909.00	$14.72–$863.55	95% above	40%
Forearm X-ray (radius and ulna), 2 views inpatient CPT 73090 FOREARM 2 VIEWS	$545.40	$909.00	$389.42–$2,315.52	—	40%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 HEPATOBIL SYS IMG INC GB	$1,608.00	$2,680.00	$266.27–$2,546.00	31% above	40%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 HEPATOBIL SYS IMG INC GB	$1,608.00	$2,680.00	$1,148.11–$2,546.00	—	40%
Hand X-ray, 2 views CPT 73120 HAND 2 VIEWS	$564.60	$941.00	$12.80–$893.95	102% above	40%
Hand X-ray, 2 views inpatient CPT 73120 HAND 2 VIEWS	$564.60	$941.00	$403.12–$2,315.52	—	40%
Heel bone (calcaneus) X-ray, 2 or more views CPT 73650 CALCANEOUS MIN 2 VIEWS	$292.80	$488.00	$14.72–$463.60	11% above	40%
Heel bone (calcaneus) X-ray, 2 or more views inpatient CPT 73650 CALCANEOUS MIN 2 VIEWS	$292.80	$488.00	$209.06–$2,315.52	—	40%
Knee X-ray, 3 views CPT 73562 KNEE 3 VIEWS	$399.00	$665.00	$21.12–$631.75	at median	40%
Knee X-ray, 3 views inpatient CPT 73562 KNEE 3 VIEWS	$399.00	$665.00	$284.89–$2,315.52	—	40%
Knee X-ray, complete, 4 or more views CPT 73564 KNEE COMP 4 OR MORE VIEWS	$477.00	$795.00	$28.70–$755.25	9% above	40%
Knee X-ray, complete, 4 or more views inpatient CPT 73564 KNEE COMP 4 OR MORE VIEWS	$477.00	$795.00	$340.58–$2,315.52	—	40%
Leg CT scan without contrast (hip to foot, any part) CPT 73700 CT LOWER EXTREM WO CONT	$2,358.60	$3,931.00	$101.17–$3,734.45	123% above	40%
Leg CT scan without contrast (hip to foot, any part) inpatient CPT 73700 CT LOWER EXTREM WO CONT	$2,358.60	$3,931.00	$1,684.04–$3,734.45	—	40%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US ABD LIMITED	$690.60	$1,151.00	$48.00–$1,093.45	14% above	40%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 PORT US ABD LIMITED	$690.60	$1,151.00	$48.00–$1,093.45	14% above	40%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US ABD LIMITED	$690.60	$1,151.00	$493.09–$2,315.52	—	40%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 PORT US ABD LIMITED	$690.60	$1,151.00	$493.09–$2,315.52	—	40%
Limited ultrasound of an arm or leg (non-vascular) CPT 76882 PORT LMTD JT/FCL EVL NVASC XTR	$571.80	$953.00	$10.05–$905.35	45% above	40%
Limited ultrasound of an arm or leg (non-vascular) CPT 76882 US LMTD JT/FCL EVL NVASC XTR	$571.80	$953.00	$10.05–$905.35	45% above	40%
Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 US LMTD JT/FCL EVL NVASC XTR	$571.80	$953.00	$408.27–$2,315.52	—	40%
Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 PORT LMTD JT/FCL EVL NVASC XTR	$571.80	$953.00	$408.27–$2,315.52	—	40%
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 LOW DOSE CT LUNG CANCER SCRN	$253.20	$422.00	$63.30–$400.90	36% below	40%
Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 LOW DOSE CT LUNG CANCER SCRN	$253.20	$422.00	$180.78–$2,315.52	—	40%
Lower leg X-ray (tibia and fibula), 2 views CPT 73590 TIBIA FIBULA 2 VIEWS	$646.80	$1,078.00	$21.12–$1,024.10	94% above	40%
Lower leg X-ray (tibia and fibula), 2 views inpatient CPT 73590 TIBIA FIBULA 2 VIEWS	$646.80	$1,078.00	$461.82–$2,315.52	—	40%
Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 SPINE CERVICAL 4 OR 5 VIEWS	$526.20	$877.00	$33.92–$833.15	20% above	40%
Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 SPINE CERVICAL 4 OR 5 VIEWS	$526.20	$877.00	$375.71–$2,315.52	—	40%
Neck soft tissue CT scan with contrast CPT 70491 CT SOFT TISSUE NECK W CON	$2,511.00	$4,185.00	$105.60–$3,975.75	86% above	40%
Neck soft tissue CT scan with contrast inpatient CPT 70491 CT SOFT TISSUE NECK W CON	$2,511.00	$4,185.00	$1,792.85–$3,975.75	—	40%
Neck soft tissue CT scan without contrast CPT 70490 CT SOFT TISSUE NECK WO CON	$2,061.60	$3,436.00	$101.12–$3,264.20	90% above	40%
Neck soft tissue CT scan without contrast inpatient CPT 70490 CT SOFT TISSUE NECK WO CON	$2,061.60	$3,436.00	$1,471.98–$3,264.20	—	40%
Neck soft tissue X-ray CPT 70360 NECK SOFT TISSUE	$285.60	$476.00	$12.80–$452.20	2% above	40%
Neck soft tissue X-ray inpatient CPT 70360 NECK SOFT TISSUE	$285.60	$476.00	$203.92–$2,315.52	—	40%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 EXERCISE THALL/REC SPECT	$4,206.60	$7,011.00	$356.28–$6,660.45	7% above	40%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 HT MSCL IMG SPECT MLT	$4,206.60	$7,011.00	$356.28–$6,660.45	7% above	40%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 RESTING THALLIUM W RECIRC SPEC	$4,206.60	$7,011.00	$356.28–$6,660.45	7% above	40%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 EXER SEST/REST SEST SPECT	$4,206.60	$7,011.00	$356.28–$6,660.45	7% above	40%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 EXER SEST/W REST THALL SPECT	$4,206.60	$7,011.00	$356.28–$6,660.45	7% above	40%
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 RESTING THALLIUM W RECIRC SPEC	$4,206.60	$7,011.00	$2,208.32–$6,660.45	—	40%
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 HT MSCL IMG SPECT MLT	$4,206.60	$7,011.00	$2,208.32–$6,660.45	—	40%
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 EXERCISE THALL/REC SPECT	$4,206.60	$7,011.00	$2,208.32–$6,660.45	—	40%
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 EXER SEST/W REST THALL SPECT	$4,206.60	$7,011.00	$2,208.32–$6,660.45	—	40%
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 EXER SEST/REST SEST SPECT	$4,206.60	$7,011.00	$2,208.32–$6,660.45	—	40%
Pelvic CT scan without contrast CPT 72192 CT PELVIS WO CON	$1,313.40	$2,189.00	$86.40–$2,079.55	20% above	40%
Pelvic CT scan without contrast inpatient CPT 72192 CT PELVIS WO CON	$1,313.40	$2,189.00	$937.77–$2,315.52	—	40%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US PELVIC LTD/FOLLOW UP	$718.80	$1,198.00	$24.32–$1,138.10	61% above	40%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US PELVIC LTD/FOLLOW UP	$718.80	$1,198.00	$513.22–$2,315.52	—	40%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US PELVIS COMP (NONOBSTETRIC)	$732.00	$1,220.00	$59.52–$1,159.00	26% above	40%
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 US PELVIS COMP (NONOBSTETRIC)	$732.00	$1,220.00	$522.65–$2,315.52	—	40%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US PREGNANT UTERUS>14WKS	$690.60	$1,151.00	$59.52–$1,093.45	12% above	40%
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US PREGNANT UTERUS>14WKS	$690.60	$1,151.00	$493.09–$2,315.52	—	40%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 US PREG UTERUS 1ST TRI <14WKS	$690.60	$1,151.00	$49.14–$1,093.45	23% above	40%
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 US PREG UTERUS 1ST TRI <14WKS	$690.60	$1,151.00	$493.09–$2,315.52	—	40%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US PREGNANT UTERUS LTD	$658.80	$1,098.00	$49.92–$1,043.10	23% above	40%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 US PREGNANT UTERUS LTD	$658.80	$1,098.00	$470.38–$2,315.52	—	40%
Rib X-ray, one side, 2 views one side CPT 71100 RIBS UNILAT MIN 2 VWS	$304.80	$508.00	$21.12–$482.60	9% below	40%
Rib X-ray, one side, 2 views inpatient one side CPT 71100 RIBS UNILAT MIN 2 VWS	$304.80	$508.00	$217.63–$2,315.52	—	40%
Rib X-ray, one side, with a chest view, 3 or more views CPT 71101 RIBS UNI W/PA CXR MIN 3VW	$399.00	$665.00	$21.12–$631.75	3% below	40%
Rib X-ray, one side, with a chest view, 3 or more views inpatient CPT 71101 RIBS UNI W/PA CXR MIN 3VW	$399.00	$665.00	$284.89–$2,315.52	—	40%
Screening mammogram, both breasts both sides CPT 77067 MAMMO DIGI SCR BILAT WWO CAD	$237.60	$396.00	$59.40–$376.20	—	40%
Screening mammogram, both breasts inpatient both sides CPT 77067 MAMMO DIGI SCR BILAT WWO CAD	$237.60	$396.00	$169.65–$2,315.52	—	40%
Shoulder X-ray, complete, 2 or more views CPT 73030 SHOULDER MIN 2 VIEWS	$307.20	$512.00	$21.12–$486.40	9% below	40%
Shoulder X-ray, complete, 2 or more views inpatient CPT 73030 SHOULDER MIN 2 VIEWS	$307.20	$512.00	$219.34–$2,315.52	—	40%
Sinus X-ray, complete, 3 or more views CPT 70220 SINUS COMP MIN 3 VWS	$448.80	$748.00	$28.80–$710.60	6% above	40%
Sinus X-ray, complete, 3 or more views inpatient CPT 70220 SINUS COMP MIN 3 VWS	$448.80	$748.00	$320.44–$2,315.52	—	40%
Skull X-ray, fewer than 4 views CPT 70250 SKULL <4 VIEWS	$364.20	$607.00	$26.88–$576.65	2% above	40%
Skull X-ray, fewer than 4 views inpatient CPT 70250 SKULL <4 VIEWS	$364.20	$607.00	$260.04–$2,315.52	—	40%
Stress echocardiogram, complete, including the stress test and supervision CPT 93351 STRESS TTE COMP (MD SUPERVISD)	$1,989.60	$3,316.00	$152.59–$3,150.20	9% above	40%
Stress echocardiogram, complete, including the stress test and supervision inpatient CPT 93351 STRESS TTE COMP (MD SUPERVISD)	$1,989.60	$3,316.00	$1,420.57–$3,150.20	—	40%
Swallow study (modified barium swallow, video X-ray) CPT 74230 SWALLOWING FUNC ESOPH	$828.00	$1,380.00	$35.84–$1,311.00	40% above	40%
Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 SWALLOWING FUNC ESOPH	$828.00	$1,380.00	$591.19–$2,315.52	—	40%
Thigh bone (femur) X-ray, 2 or more views CPT 73552 X-RAY EXAM OF FEMUR 2/>	$599.40	$999.00	$21.82–$949.05	50% above	40%
Thigh bone (femur) X-ray, 2 or more views inpatient CPT 73552 X-RAY EXAM OF FEMUR 2/>	$599.40	$999.00	$427.97–$2,315.52	—	40%
Thoracic spine (mid back) CT scan without contrast CPT 72128 CT THORACIC SPINE WO CON	$2,074.20	$3,457.00	$115.97–$3,284.15	77% above	40%
Thoracic spine (mid back) CT scan without contrast inpatient CPT 72128 CT THORACIC SPINE WO CON	$2,074.20	$3,457.00	$1,480.98–$3,284.15	—	40%
Toe X-ray, 2 or more views CPT 73660 TOE(S) MIN 2 VIEWS	$364.80	$608.00	$11.52–$577.60	30% above	40%
Toe X-ray, 2 or more views inpatient CPT 73660 TOE(S) MIN 2 VIEWS	$364.80	$608.00	$260.47–$2,315.52	—	40%
Transvaginal pelvic ultrasound CPT 76830 US TRANSVAGINAL	$678.60	$1,131.00	$59.52–$1,074.45	21% above	40%
Transvaginal pelvic ultrasound inpatient CPT 76830 US TRANSVAGINAL	$678.60	$1,131.00	$484.52–$2,315.52	—	40%
Transvaginal ultrasound during pregnancy CPT 76817 US PREGNANT UTERUS TRANSVAG	$678.60	$1,131.00	$67.88–$1,074.45	23% above	40%
Transvaginal ultrasound during pregnancy inpatient CPT 76817 US PREGNANT UTERUS TRANSVAG	$678.60	$1,131.00	$484.52–$2,315.52	—	40%
Ultrasound of the abdomen, complete CPT 76700 US ABDOMINAL COMPLETE	$916.80	$1,528.00	$73.60–$1,451.60	17% above	40%
Ultrasound of the abdomen, complete inpatient CPT 76700 US ABDOMINAL COMPLETE	$916.80	$1,528.00	$654.60–$2,315.52	—	40%
Ultrasound of the scrotum and testicles CPT 76870 US SCROTUM TESTES	$646.20	$1,077.00	$56.32–$1,023.15	5% above	40%
Ultrasound of the scrotum and testicles inpatient CPT 76870 US SCROTUM TESTES	$646.20	$1,077.00	$461.39–$2,315.52	—	40%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US THYROID/NECK/SOFT TISSUE	$646.20	$1,077.00	$65.25–$1,023.15	13% above	40%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US THYROID/NECK/SOFT TISSUE	$646.20	$1,077.00	$461.39–$2,315.52	—	40%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 UGI W WO DLAYED FILMS W WO KUB	$580.20	$967.00	$49.92–$918.65	8% below	40%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 UGI W WO DLAYED FILMS W WO KUB	$580.20	$967.00	$414.26–$2,315.52	—	40%
Upper arm X-ray (humerus), 2 views CPT 73060 HUMERUS MIN 2 VIEWS	$567.00	$945.00	$14.72–$897.75	105% above	40%
Upper arm X-ray (humerus), 2 views inpatient CPT 73060 HUMERUS MIN 2 VIEWS	$567.00	$945.00	$404.84–$2,315.52	—	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 PORT DUP EX VEINS UNI/LTD	$847.80	$1,413.00	$100.61–$1,342.35	32% above	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 DUPLEX VENOUS UPR UNIL OR LTD	$847.80	$1,413.00	$100.61–$1,342.35	32% above	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 DUPLEX VENOUS UNIL OR LTD	$847.80	$1,413.00	$100.61–$1,342.35	32% above	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 DUPLEX VENOUS LWR UNIL OR LTD	$847.80	$1,413.00	$100.61–$1,342.35	32% above	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 DUP EX VEINS W/COM-MAN UNI/LTD	$847.80	$1,413.00	$100.61–$1,342.35	32% above	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 DUP EX VEINS W/COM-MAN UNI/LTD	$847.80	$1,413.00	$605.33–$2,315.52	—	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 PORT DUP EX VEINS UNI/LTD	$847.80	$1,413.00	$605.33–$2,315.52	—	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 DUPLEX VENOUS UPR UNIL OR LTD	$847.80	$1,413.00	$605.33–$2,315.52	—	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 DUPLEX VENOUS UNIL OR LTD	$847.80	$1,413.00	$605.33–$2,315.52	—	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 DUPLEX VENOUS LWR UNIL OR LTD	$847.80	$1,413.00	$605.33–$2,315.52	—	40%
Wrist X-ray, 2 views CPT 73100 WRIST 2 VIEWS	$587.40	$979.00	$14.72–$930.05	114% above	40%
Wrist X-ray, 2 views inpatient CPT 73100 WRIST 2 VIEWS	$587.40	$979.00	$419.40–$2,315.52	—	40%
Wrist X-ray, complete, 3 or more views CPT 73110 WRIST MIN 3 VIEWS	$309.60	$516.00	$14.72–$490.20	4% below	40%
Wrist X-ray, complete, 3 or more views inpatient CPT 73110 WRIST MIN 3 VIEWS	$309.60	$516.00	$221.05–$2,315.52	—	40%
X-ray of one hip, 2 or 3 views, with the pelvis when included CPT 73502 X-RAY EXAM HIP UNI 2-3 VIEWS	$653.40	$1,089.00	$28.62–$1,034.55	84% above	40%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient CPT 73502 X-RAY EXAM HIP UNI 2-3 VIEWS	$653.40	$1,089.00	$466.53–$2,315.52	—	40%
X-ray of the abdomen, 1 view CPT 74018 ABDOMEN 1 VIEW	$538.20	$897.00	$17.63–$852.15	92% above	40%
X-ray of the abdomen, 1 view inpatient CPT 74018 ABDOMEN 1 VIEW	$538.20	$897.00	$384.27–$2,315.52	—	40%
X-ray of the ankle, 2 views CPT 73600 ANKLE 2 VIEWS	$577.20	$962.00	$14.72–$913.90	71% above	40%
X-ray of the ankle, 2 views inpatient CPT 73600 ANKLE 2 VIEWS	$577.20	$962.00	$412.12–$2,315.52	—	40%
X-ray of the finger(s), 2 or more views CPT 73140 FINGER(S) MIN 2 VIEWS	$294.60	$491.00	$11.52–$466.45	22% above	40%
X-ray of the finger(s), 2 or more views inpatient CPT 73140 FINGER(S) MIN 2 VIEWS	$294.60	$491.00	$210.34–$2,315.52	—	40%
X-ray of the foot, 2 views CPT 73620 FOOT 2 VIEWS	$627.60	$1,046.00	$12.80–$993.70	93% above	40%
X-ray of the foot, 2 views inpatient CPT 73620 FOOT 2 VIEWS	$627.60	$1,046.00	$448.11–$2,315.52	—	40%
X-ray of the foot, complete, 3 or more views CPT 73630 FOOT MIN 3 VIEWS	$364.80	$608.00	$14.72–$577.60	at median	40%
X-ray of the foot, complete, 3 or more views inpatient CPT 73630 FOOT MIN 3 VIEWS	$364.80	$608.00	$260.47–$2,315.52	—	40%
X-ray of the hand, 3 or more views CPT 73130 HAND MIN 3 VIEWS	$294.60	$491.00	$14.72–$466.45	1% below	40%
X-ray of the hand, 3 or more views inpatient CPT 73130 HAND MIN 3 VIEWS	$294.60	$491.00	$210.34–$2,315.52	—	40%
X-ray of the knee, 1 or 2 views CPT 73560 KNEE 1 OR 2 VIEWS	$608.40	$1,014.00	$21.12–$963.30	116% above	40%
X-ray of the knee, 1 or 2 views inpatient CPT 73560 KNEE 1 OR 2 VIEWS	$608.40	$1,014.00	$434.40–$2,315.52	—	40%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 SPINE LUMBOSACRAL 2-3 VIEWS	$417.00	$695.00	$28.80–$660.25	14% above	40%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 SPINE LUMBOSACRAL 2-3 VIEWS	$417.00	$695.00	$297.74–$2,315.52	—	40%
X-ray of the lower back, 4 or more views CPT 72110 SPINE LUMBOSAC MIN 4 VWS	$710.40	$1,184.00	$28.80–$1,124.80	57% above	40%
X-ray of the lower back, 4 or more views inpatient CPT 72110 SPINE LUMBOSAC MIN 4 VWS	$710.40	$1,184.00	$507.23–$2,315.52	—	40%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 SPINE THORACIC 2 VIEWS	$642.00	$1,070.00	$25.84–$1,016.50	76% above	40%
X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 SPINE THORACIC 2 VIEWS	$642.00	$1,070.00	$458.39–$2,315.52	—	40%
X-ray of the nasal bones, 3 or more views CPT 70160 NASAL BONES COMP MIN 3 VWS	$262.20	$437.00	$14.72–$415.15	3% below	40%
X-ray of the nasal bones, 3 or more views inpatient CPT 70160 NASAL BONES COMP MIN 3 VWS	$262.20	$437.00	$187.21–$2,315.52	—	40%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 SPINE CERVICAL 3 VIEWS OR LESS	$637.20	$1,062.00	$21.12–$1,008.90	92% above	40%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 SPINE CERVICAL 3 VIEWS OR LESS	$637.20	$1,062.00	$454.96–$2,315.52	—	40%
X-ray of the pelvis, 1 or 2 views CPT 72170 PELVIS 1 OR 2 VIEWS	$511.20	$852.00	$12.80–$809.40	75% above	40%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 PELVIS 1 OR 2 VIEWS	$511.20	$852.00	$365.00–$2,315.52	—	40%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 SACRUM & COCCYX MIN 2 VWS	$387.60	$646.00	$21.12–$613.70	16% above	40%
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 SACRUM & COCCYX MIN 2 VWS	$387.60	$646.00	$276.75–$2,315.52	—	40%

Lab tests

Procedure	Cash price	List price	Insurers pay	vs Pennsylvania	Off list
ACTH blood test CPT 82024 ACTH ADRENOCORTICOTROPIC HORMN	$616.80	$1,028.00	$38.17–$976.60	177% above	40%
ACTH blood test CPT 82024 ADRENOCORTICOTROPIC HORMONE	$616.80	$1,028.00	$38.17–$976.60	177% above	40%
ACTH blood test CPT 82024 ADRENOCORT HORMONE PLASMA	$616.80	$1,028.00	$38.17–$976.60	177% above	40%
ACTH blood test CPT 82024 ACTH PLASMA 2 SPECIMENS	$616.80	$1,028.00	$38.17–$976.60	177% above	40%
ACTH blood test inpatient CPT 82024 ADRENOCORTICOTROPIC HORMONE	$616.80	$1,028.00	$440.40–$2,315.52	—	40%
ACTH blood test inpatient CPT 82024 ACTH ADRENOCORTICOTROPIC HORMN	$616.80	$1,028.00	$440.40–$2,315.52	—	40%
ACTH blood test inpatient CPT 82024 ACTH PLASMA 2 SPECIMENS	$616.80	$1,028.00	$440.40–$2,315.52	—	40%
ACTH blood test inpatient CPT 82024 ADRENOCORT HORMONE PLASMA	$616.80	$1,028.00	$440.40–$2,315.52	—	40%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 ALANINE AMINO P3896	$133.80	$223.00	$5.24–$211.85	268% above	40%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 SGPT/ALT	$133.80	$223.00	$5.24–$211.85	268% above	40%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 ALANINE AMINO P9445	$133.80	$223.00	$5.24–$211.85	268% above	40%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 ALANINE AMINO P9445	$133.80	$223.00	$95.53–$2,315.52	—	40%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 ALANINE AMINO P3896	$133.80	$223.00	$95.53–$2,315.52	—	40%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 SGPT/ALT	$133.80	$223.00	$95.53–$2,315.52	—	40%
AST (aspartate aminotransferase) enzyme test CPT 84450 SGOT/AST	$39.60	$66.00	$5.12–$62.70	9% above	40%
AST (aspartate aminotransferase) enzyme test CPT 84450 TRANSFERASE P9445	$39.60	$66.00	$5.12–$62.70	9% above	40%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 TRANSFERASE P9445	$39.60	$66.00	$28.27–$2,315.52	—	40%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 SGOT/AST	$39.60	$66.00	$28.27–$2,315.52	—	40%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 ACUTE HEPATITIS PANEL	$762.60	$1,271.00	$47.07–$1,207.45	146% above	40%
Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 ACUTE HEPATITIS PANEL	$762.60	$1,271.00	$544.50–$2,315.52	—	40%
Albumin blood test CPT 82040 ALBUMIN PNL	$66.60	$111.00	$4.01–$105.45	108% above	40%
Albumin blood test CPT 82040 ALBUMIN P0913	$66.60	$111.00	$4.01–$105.45	108% above	40%
Albumin blood test CPT 82040 ALBUMIN SERUM P2435	$66.60	$111.00	$4.01–$105.45	108% above	40%
Albumin blood test CPT 82040 ALBUMIN SERUM P4556	$66.60	$111.00	$4.01–$105.45	108% above	40%
Albumin blood test inpatient CPT 82040 ALBUMIN PNL	$66.60	$111.00	$47.55–$2,315.52	—	40%
Albumin blood test inpatient CPT 82040 ALBUMIN P0913	$66.60	$111.00	$47.55–$2,315.52	—	40%
Albumin blood test inpatient CPT 82040 ALBUMIN SERUM P4556	$66.60	$111.00	$47.55–$2,315.52	—	40%
Albumin blood test inpatient CPT 82040 ALBUMIN SERUM P2435	$66.60	$111.00	$47.55–$2,315.52	—	40%
Aldosterone blood test CPT 82088 ALDOSTERONE	$569.40	$949.00	$28.60–$901.55	173% above	40%
Aldosterone blood test CPT 82088 ALDOSTERONE P2402	$569.40	$949.00	$28.60–$901.55	173% above	40%
Aldosterone blood test inpatient CPT 82088 ALDOSTERONE	$569.40	$949.00	$406.55–$2,315.52	—	40%
Aldosterone blood test inpatient CPT 82088 ALDOSTERONE P2402	$569.40	$949.00	$406.55–$2,315.52	—	40%
Alkaline phosphatase (ALP) blood test CPT 84075 TOTAL ALP PNL 1480	$130.80	$218.00	$5.12–$207.10	259% above	40%
Alkaline phosphatase (ALP) blood test CPT 84075 ALKALINE PHOSPHATASE	$130.80	$218.00	$5.12–$207.10	259% above	40%
Alkaline phosphatase (ALP) blood test CPT 84075 ALKALINE PHOSPHATASE BONE	$130.80	$218.00	$5.12–$207.10	259% above	40%
Alkaline phosphatase (ALP) blood test inpatient CPT 84075 ALKALINE PHOSPHATASE	$130.80	$218.00	$93.39–$2,315.52	—	40%
Alkaline phosphatase (ALP) blood test inpatient CPT 84075 TOTAL ALP PNL 1480	$130.80	$218.00	$93.39–$2,315.52	—	40%
Alkaline phosphatase (ALP) blood test inpatient CPT 84075 ALKALINE PHOSPHATASE BONE	$130.80	$218.00	$93.39–$2,315.52	—	40%
Allergy blood test, specific IgE, per allergen CPT 86003 BERMUDA ALLERGEN	$86.40	$144.00	$5.16–$136.80	167% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 POPPYSEED IGE	$86.40	$144.00	$5.16–$136.80	167% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN SPECIFIC IGE P0722	$86.40	$144.00	$5.16–$136.80	167% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 RAGWEED ALLERGEN	$86.40	$144.00	$5.16–$136.80	167% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 BRAZIL NUT IGE W/RFX COMP PN	$86.40	$144.00	$5.16–$136.80	167% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 RAT EPITHELIA IGE	$86.40	$144.00	$5.16–$136.80	167% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN IGE WHITE POPLAR	$86.40	$144.00	$5.16–$136.80	167% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 RED CEDAR IGE	$86.40	$144.00	$5.16–$136.80	167% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 BREWERS YEAST IGE	$86.40	$144.00	$5.16–$136.80	167% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 RED KIDNEY BEAN IGE	$86.40	$144.00	$5.16–$136.80	167% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 SHEEP EPITHELIA IGE	$86.40	$144.00	$5.16–$136.80	167% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 SWINE EPITHELIA IGE	$86.40	$144.00	$5.16–$136.80	167% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 SWEET GUM IGE	$86.40	$144.00	$5.16–$136.80	167% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 SUNFLOWER SEED IGE	$86.40	$144.00	$5.16–$136.80	167% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 SUNFLOWER IGE	$86.40	$144.00	$5.16–$136.80	167% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 SUGAR BEET IGE (ALLERGEN)	$86.40	$144.00	$5.16–$136.80	167% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 SQUID IGE	$86.40	$144.00	$5.16–$136.80	167% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 SOYBEAN ALLERGEN	$86.40	$144.00	$5.16–$136.80	167% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 CABBAGE IGE	$86.40	$144.00	$5.16–$136.80	167% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN GOAT MILK IGE	$86.40	$144.00	$5.16–$136.80	167% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 CANARY FEATHERS IGE	$86.40	$144.00	$5.16–$136.80	167% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN SPECI IGE EA ALLERGEN	$86.40	$144.00	$5.16–$136.80	167% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 CANTALOPE IGE	$86.40	$144.00	$5.16–$136.80	167% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN CULT RYE GRASS IGE	$86.40	$144.00	$5.16–$136.80	167% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 CASEIN ALLERGEN PNL 5416	$86.40	$144.00	$5.16–$136.80	167% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 CAT DANDER (EPITHEL) ALLERGEN	$86.40	$144.00	$5.16–$136.80	167% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN BEET ROOT	$86.40	$144.00	$5.16–$136.80	167% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 CHAETOMIUM GLOBOSUM IGE	$86.40	$144.00	$5.16–$136.80	167% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN SPEC IGE QUANT P1246	$86.40	$144.00	$5.16–$136.80	167% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 COCKATIEL FEATHERS/IGE	$86.40	$144.00	$5.16–$136.80	167% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN AVOCADO IGE	$86.40	$144.00	$5.16–$136.80	167% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 COWS MILK COMPONENT PANEL	$86.40	$144.00	$5.16–$136.80	167% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 WHEAT ALLERGEN	$86.40	$144.00	$5.16–$136.80	167% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 DOG FENNEL IGE	$86.40	$144.00	$5.16–$136.80	167% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 EGG COMPONENT PANEL	$86.40	$144.00	$5.16–$136.80	167% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 AL SPEC IGE CRUDE XTR EA P7115	$86.40	$144.00	$5.16–$136.80	167% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 EGG MIX IGE	$86.40	$144.00	$5.16–$136.80	167% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 EGG WHITE ALLERGEN	$86.40	$144.00	$5.16–$136.80	167% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 ACREMONIUM KILIENSE IGE	$86.40	$144.00	$5.16–$136.80	167% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 EGG YOLK ALLERGEN	$86.40	$144.00	$5.16–$136.80	167% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 WHITEFISH IGE	$86.40	$144.00	$5.16–$136.80	167% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 FERRET EPITHELIUM IGE	$86.40	$144.00	$5.16–$136.80	167% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 A LACTOALBUMIN ALLERGEN P 5416	$86.40	$144.00	$5.16–$136.80	167% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 FOOD ALLERGY PNL W/REFLEXES	$86.40	$144.00	$5.16–$136.80	167% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN SPEC IGE HACKBERRY	$86.40	$144.00	$5.16–$136.80	167% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 FOOD AND TREE NUT ALLERGY PN	$86.40	$144.00	$5.16–$136.80	167% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 A KILIENSE IGE	$86.40	$144.00	$5.16–$136.80	167% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 GALACTSE-ALPHA-1 3-GALACTS IGE	$86.40	$144.00	$5.16–$136.80	167% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 WHITE POLLOCK IGE	$86.40	$144.00	$5.16–$136.80	167% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 GERBIL IGE	$86.40	$144.00	$5.16–$136.80	167% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 GOAT EPITHELIA IGE	$86.40	$144.00	$5.16–$136.80	167% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 GUM CAROB/LOCUST BEAN IGE	$86.40	$144.00	$5.16–$136.80	167% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGY INSECT VENOM PANEL	$86.40	$144.00	$5.16–$136.80	167% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 LAMBS QUARTER ALLERGEN	$86.40	$144.00	$5.16–$136.80	167% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN SPEC IGE FUSARM SOLAN	$86.40	$144.00	$5.16–$136.80	167% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 LENTILS IGE	$86.40	$144.00	$5.16–$136.80	167% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGY PANEL MOLD GROUP	$86.40	$144.00	$5.16–$136.80	167% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 LIMA BEAN IGE	$86.40	$144.00	$5.16–$136.80	167% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN/IGE CHICK PEA	$86.40	$144.00	$5.16–$136.80	167% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGY PANEL REGION 6 WEEDS	$86.40	$144.00	$5.16–$136.80	167% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 MAHI MAHI IGE	$86.40	$144.00	$5.16–$136.80	167% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 MALT IGE	$86.40	$144.00	$5.16–$136.80	167% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN SPEC IGE EA P1235	$86.40	$144.00	$5.16–$136.80	167% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 MAPLE (BOX ELDER) TREE	$86.40	$144.00	$5.16–$136.80	167% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGY PN 12 ANIMAL GROUP	$86.40	$144.00	$5.16–$136.80	167% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 MELALEUCA IGE	$86.40	$144.00	$5.16–$136.80	167% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN SPECIFIC IGE P3921	$86.40	$144.00	$5.16–$136.80	167% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 MELONS IGE	$86.40	$144.00	$5.16–$136.80	167% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGY PN 13 STINGNG INSCT GR	$86.40	$144.00	$5.16–$136.80	167% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 MILK ALLERGEN	$86.40	$144.00	$5.16–$136.80	167% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN SINGLE ORDER	$86.40	$144.00	$5.16–$136.80	167% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 MILK COMPONENT PANEL	$86.40	$144.00	$5.16–$136.80	167% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 TURKEY FEATHERS IGE	$86.40	$144.00	$5.16–$136.80	167% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 TROUT IGE	$86.40	$144.00	$5.16–$136.80	167% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 TREE NUT ALL PN W/REFL TO COMP	$86.40	$144.00	$5.16–$136.80	167% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 TIMOTHY ALLERGEN	$86.40	$144.00	$5.16–$136.80	167% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGY PN REGION 6 GRASSES	$86.40	$144.00	$5.16–$136.80	167% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 MOUSE EPITHELIA IGE	$86.40	$144.00	$5.16–$136.80	167% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN/PEPPERMINT IGE	$86.40	$144.00	$5.16–$136.80	167% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 OREGANO IGE	$86.40	$144.00	$5.16–$136.80	167% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGY/SHELLFISH PANEL	$86.40	$144.00	$5.16–$136.80	167% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 OXEYE DAISY IGE	$86.40	$144.00	$5.16–$136.80	167% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN PRIVET IGE	$86.40	$144.00	$5.16–$136.80	167% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 PAPAIN (K201) IGE	$86.40	$144.00	$5.16–$136.80	167% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 ALRGY PNL18 NUT MIX GRP 7918X	$86.40	$144.00	$5.16–$136.80	167% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 PAPRIKA IGE	$86.40	$144.00	$5.16–$136.80	167% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN SPECIFIC IGE P0861	$86.40	$144.00	$5.16–$136.80	167% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 PEANUT TL RFX TO PEANT COM PN	$86.40	$144.00	$5.16–$136.80	167% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 ALTERNARIUS T ALLERGEN	$86.40	$144.00	$5.16–$136.80	167% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 PENICILLIN G IGE	$86.40	$144.00	$5.16–$136.80	167% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN MAPLE SUGAR SPEC IGE	$86.40	$144.00	$5.16–$136.80	167% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 PENICILLIN V IGE	$86.40	$144.00	$5.16–$136.80	167% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 B LACTOGLOBULIN ALLERGEN P5416	$86.40	$144.00	$5.16–$136.80	167% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 PEPPERTREE (RT217) IGE	$86.40	$144.00	$5.16–$136.80	167% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN/GINGER IGE	$86.40	$144.00	$5.16–$136.80	167% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 PERCH IGE	$86.40	$144.00	$5.16–$136.80	167% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 BANANA IGE	$86.40	$144.00	$5.16–$136.80	167% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 PINE NUT IGE	$86.40	$144.00	$5.16–$136.80	167% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 TILAPIA IGE	$86.40	$144.00	$5.16–$136.80	167% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 SWORDFISH IGE	$86.40	$144.00	$5.16–$136.80	167% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN LATEX IGE	$86.40	$144.00	$5.16–$136.80	167% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 PINTO BEAN IGE	$86.40	$144.00	$5.16–$136.80	167% above	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 EGG COMPONENT PANEL	$86.40	$144.00	$61.69–$2,315.52	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN/PEPPERMINT IGE	$86.40	$144.00	$61.69–$2,315.52	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN/IGE CHICK PEA	$86.40	$144.00	$61.69–$2,315.52	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN/GINGER IGE	$86.40	$144.00	$61.69–$2,315.52	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN SPECIFIC IGE P3921	$86.40	$144.00	$61.69–$2,315.52	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN SPECIFIC IGE P0861	$86.40	$144.00	$61.69–$2,315.52	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN SPECIFIC IGE P0722	$86.40	$144.00	$61.69–$2,315.52	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN SPECI IGE EA ALLERGEN	$86.40	$144.00	$61.69–$2,315.52	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN SPEC IGE QUANT P1246	$86.40	$144.00	$61.69–$2,315.52	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN SPEC IGE HACKBERRY	$86.40	$144.00	$61.69–$2,315.52	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN SPEC IGE FUSARM SOLAN	$86.40	$144.00	$61.69–$2,315.52	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN SPEC IGE EA P1235	$86.40	$144.00	$61.69–$2,315.52	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN SINGLE ORDER	$86.40	$144.00	$61.69–$2,315.52	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN PRIVET IGE	$86.40	$144.00	$61.69–$2,315.52	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN MAPLE SUGAR SPEC IGE	$86.40	$144.00	$61.69–$2,315.52	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN LATEX IGE	$86.40	$144.00	$61.69–$2,315.52	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN IGE WHITE POPLAR	$86.40	$144.00	$61.69–$2,315.52	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN GOAT MILK IGE	$86.40	$144.00	$61.69–$2,315.52	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN CULT RYE GRASS IGE	$86.40	$144.00	$61.69–$2,315.52	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN BEET ROOT	$86.40	$144.00	$61.69–$2,315.52	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN AVOCADO IGE	$86.40	$144.00	$61.69–$2,315.52	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 AL SPEC IGE CRUDE XTR EA P7115	$86.40	$144.00	$61.69–$2,315.52	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ACREMONIUM KILIENSE IGE	$86.40	$144.00	$61.69–$2,315.52	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 A LACTOALBUMIN ALLERGEN P 5416	$86.40	$144.00	$61.69–$2,315.52	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 A KILIENSE IGE	$86.40	$144.00	$61.69–$2,315.52	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGY PANEL MOLD GROUP	$86.40	$144.00	$61.69–$2,315.52	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGY PANEL REGION 6 WEEDS	$86.40	$144.00	$61.69–$2,315.52	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGY PN 12 ANIMAL GROUP	$86.40	$144.00	$61.69–$2,315.52	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGY PN 13 STINGNG INSCT GR	$86.40	$144.00	$61.69–$2,315.52	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGY PN REGION 6 GRASSES	$86.40	$144.00	$61.69–$2,315.52	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGY/SHELLFISH PANEL	$86.40	$144.00	$61.69–$2,315.52	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALRGY PNL18 NUT MIX GRP 7918X	$86.40	$144.00	$61.69–$2,315.52	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALTERNARIUS T ALLERGEN	$86.40	$144.00	$61.69–$2,315.52	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 B LACTOGLOBULIN ALLERGEN P5416	$86.40	$144.00	$61.69–$2,315.52	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 BANANA IGE	$86.40	$144.00	$61.69–$2,315.52	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 BERMUDA ALLERGEN	$86.40	$144.00	$61.69–$2,315.52	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 BRAZIL NUT IGE W/RFX COMP PN	$86.40	$144.00	$61.69–$2,315.52	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 BREWERS YEAST IGE	$86.40	$144.00	$61.69–$2,315.52	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CABBAGE IGE	$86.40	$144.00	$61.69–$2,315.52	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CANARY FEATHERS IGE	$86.40	$144.00	$61.69–$2,315.52	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CANTALOPE IGE	$86.40	$144.00	$61.69–$2,315.52	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CASEIN ALLERGEN PNL 5416	$86.40	$144.00	$61.69–$2,315.52	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CAT DANDER (EPITHEL) ALLERGEN	$86.40	$144.00	$61.69–$2,315.52	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CHAETOMIUM GLOBOSUM IGE	$86.40	$144.00	$61.69–$2,315.52	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 COCKATIEL FEATHERS/IGE	$86.40	$144.00	$61.69–$2,315.52	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 COWS MILK COMPONENT PANEL	$86.40	$144.00	$61.69–$2,315.52	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 DOG FENNEL IGE	$86.40	$144.00	$61.69–$2,315.52	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 EGG MIX IGE	$86.40	$144.00	$61.69–$2,315.52	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 EGG WHITE ALLERGEN	$86.40	$144.00	$61.69–$2,315.52	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 EGG YOLK ALLERGEN	$86.40	$144.00	$61.69–$2,315.52	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 FERRET EPITHELIUM IGE	$86.40	$144.00	$61.69–$2,315.52	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 FOOD ALLERGY PNL W/REFLEXES	$86.40	$144.00	$61.69–$2,315.52	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 FOOD AND TREE NUT ALLERGY PN	$86.40	$144.00	$61.69–$2,315.52	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 GALACTSE-ALPHA-1 3-GALACTS IGE	$86.40	$144.00	$61.69–$2,315.52	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 GERBIL IGE	$86.40	$144.00	$61.69–$2,315.52	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 GOAT EPITHELIA IGE	$86.40	$144.00	$61.69–$2,315.52	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 GUM CAROB/LOCUST BEAN IGE	$86.40	$144.00	$61.69–$2,315.52	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 LAMBS QUARTER ALLERGEN	$86.40	$144.00	$61.69–$2,315.52	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 LENTILS IGE	$86.40	$144.00	$61.69–$2,315.52	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 LIMA BEAN IGE	$86.40	$144.00	$61.69–$2,315.52	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 MAHI MAHI IGE	$86.40	$144.00	$61.69–$2,315.52	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 MALT IGE	$86.40	$144.00	$61.69–$2,315.52	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 MAPLE (BOX ELDER) TREE	$86.40	$144.00	$61.69–$2,315.52	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 MELALEUCA IGE	$86.40	$144.00	$61.69–$2,315.52	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 MELONS IGE	$86.40	$144.00	$61.69–$2,315.52	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 MILK ALLERGEN	$86.40	$144.00	$61.69–$2,315.52	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 MILK COMPONENT PANEL	$86.40	$144.00	$61.69–$2,315.52	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 MOUSE EPITHELIA IGE	$86.40	$144.00	$61.69–$2,315.52	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 OREGANO IGE	$86.40	$144.00	$61.69–$2,315.52	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 OXEYE DAISY IGE	$86.40	$144.00	$61.69–$2,315.52	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PAPAIN (K201) IGE	$86.40	$144.00	$61.69–$2,315.52	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PAPRIKA IGE	$86.40	$144.00	$61.69–$2,315.52	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PEANUT TL RFX TO PEANT COM PN	$86.40	$144.00	$61.69–$2,315.52	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PENICILLIN G IGE	$86.40	$144.00	$61.69–$2,315.52	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PENICILLIN V IGE	$86.40	$144.00	$61.69–$2,315.52	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PEPPERTREE (RT217) IGE	$86.40	$144.00	$61.69–$2,315.52	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PERCH IGE	$86.40	$144.00	$61.69–$2,315.52	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PINE NUT IGE	$86.40	$144.00	$61.69–$2,315.52	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PINTO BEAN IGE	$86.40	$144.00	$61.69–$2,315.52	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 POPPYSEED IGE	$86.40	$144.00	$61.69–$2,315.52	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAGWEED ALLERGEN	$86.40	$144.00	$61.69–$2,315.52	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAT EPITHELIA IGE	$86.40	$144.00	$61.69–$2,315.52	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RED CEDAR IGE	$86.40	$144.00	$61.69–$2,315.52	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RED KIDNEY BEAN IGE	$86.40	$144.00	$61.69–$2,315.52	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SHEEP EPITHELIA IGE	$86.40	$144.00	$61.69–$2,315.52	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SOYBEAN ALLERGEN	$86.40	$144.00	$61.69–$2,315.52	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SQUID IGE	$86.40	$144.00	$61.69–$2,315.52	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SUGAR BEET IGE (ALLERGEN)	$86.40	$144.00	$61.69–$2,315.52	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SUNFLOWER IGE	$86.40	$144.00	$61.69–$2,315.52	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SUNFLOWER SEED IGE	$86.40	$144.00	$61.69–$2,315.52	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SWEET GUM IGE	$86.40	$144.00	$61.69–$2,315.52	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SWINE EPITHELIA IGE	$86.40	$144.00	$61.69–$2,315.52	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SWORDFISH IGE	$86.40	$144.00	$61.69–$2,315.52	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 TILAPIA IGE	$86.40	$144.00	$61.69–$2,315.52	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 TIMOTHY ALLERGEN	$86.40	$144.00	$61.69–$2,315.52	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 TREE NUT ALL PN W/REFL TO COMP	$86.40	$144.00	$61.69–$2,315.52	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 TROUT IGE	$86.40	$144.00	$61.69–$2,315.52	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 TURKEY FEATHERS IGE	$86.40	$144.00	$61.69–$2,315.52	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 WHEAT ALLERGEN	$86.40	$144.00	$61.69–$2,315.52	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 WHITE POLLOCK IGE	$86.40	$144.00	$61.69–$2,315.52	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 WHITEFISH IGE	$86.40	$144.00	$61.69–$2,315.52	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGY INSECT VENOM PANEL	$86.40	$144.00	$61.69–$2,315.52	—	40%
Alpha-fetoprotein (AFP) blood test CPT 82105 AFP TUMOR MARKER SERUM	$139.20	$232.00	$16.57–$220.40	26% above	40%
Alpha-fetoprotein (AFP) blood test CPT 82105 ALPHA FETAPROTEIN	$139.20	$232.00	$16.57–$220.40	26% above	40%
Alpha-fetoprotein (AFP) blood test CPT 82105 ALPHA FETOPROTEIN MATRN SERUM	$139.20	$232.00	$16.57–$220.40	26% above	40%
Alpha-fetoprotein (AFP) blood test CPT 82105 ALPHA-FETOPROTEIN SERUM P0493	$139.20	$232.00	$16.57–$220.40	26% above	40%
Alpha-fetoprotein (AFP) blood test CPT 82105 ALPHA FETAPROTEIN MATERNAL OSL	$139.20	$232.00	$16.57–$220.40	26% above	40%
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 AFP TUMOR MARKER SERUM	$139.20	$232.00	$99.39–$2,315.52	—	40%
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 ALPHA FETAPROTEIN MATERNAL OSL	$139.20	$232.00	$99.39–$2,315.52	—	40%
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 ALPHA FETOPROTEIN MATRN SERUM	$139.20	$232.00	$99.39–$2,315.52	—	40%
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 ALPHA FETAPROTEIN	$139.20	$232.00	$99.39–$2,315.52	—	40%
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 ALPHA-FETOPROTEIN SERUM P0493	$139.20	$232.00	$99.39–$2,315.52	—	40%
Ammonia blood test CPT 82140 ALBUMIN	$126.00	$210.00	$5.50–$199.50	38% above	40%
Ammonia blood test CPT 82140 AMMONIA P7923	$126.00	$210.00	$5.50–$199.50	38% above	40%
Ammonia blood test CPT 82140 AMMONIA	$126.00	$210.00	$5.50–$199.50	38% above	40%
Ammonia blood test inpatient CPT 82140 AMMONIA P7923	$126.00	$210.00	$89.96–$2,315.52	—	40%
Ammonia blood test inpatient CPT 82140 AMMONIA	$126.00	$210.00	$89.96–$2,315.52	—	40%
Ammonia blood test inpatient CPT 82140 ALBUMIN	$126.00	$210.00	$89.96–$2,315.52	—	40%
Amylase blood test CPT 82150 AMYLASE	$113.40	$189.00	$5.50–$179.55	159% above	40%
Amylase blood test CPT 82150 AMYLASE/FLUID	$113.40	$189.00	$5.50–$179.55	159% above	40%
Amylase blood test CPT 82150 SALIVARY AMYLASE PNL 1190	$113.40	$189.00	$5.50–$179.55	159% above	40%
Amylase blood test inpatient CPT 82150 AMYLASE/FLUID	$113.40	$189.00	$80.97–$2,315.52	—	40%
Amylase blood test inpatient CPT 82150 AMYLASE	$113.40	$189.00	$80.97–$2,315.52	—	40%
Amylase blood test inpatient CPT 82150 SALIVARY AMYLASE PNL 1190	$113.40	$189.00	$80.97–$2,315.52	—	40%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 QUANT NOT OTHERWISE SPEC P3885	$251.40	$419.00	$12.80–$398.05	195% above	40%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CCP AB IGG ANTIBODIES	$251.40	$419.00	$12.80–$398.05	195% above	40%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CCP ANTIBODY P6842	$251.40	$419.00	$12.80–$398.05	195% above	40%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CYC CITRULLIN PEPTIDE AB P5076	$251.40	$419.00	$12.80–$398.05	195% above	40%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CYCLIC CITRULLINE PEP IGG	$251.40	$419.00	$12.80–$398.05	195% above	40%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CYCLIC CITRULLIN PEPTIDE P4262	$251.40	$419.00	$12.80–$398.05	195% above	40%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CYCLIC CITRULINATED PEPT P4307	$251.40	$419.00	$12.80–$398.05	195% above	40%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 ANTI-CCP	$251.40	$419.00	$12.80–$398.05	195% above	40%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 QUANT NOT OTHERWISE SPEC P3885	$251.40	$419.00	$179.50–$2,315.52	—	40%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 CYC CITRULLIN PEPTIDE AB P5076	$251.40	$419.00	$179.50–$2,315.52	—	40%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 CYCLIC CITRULINATED PEPT P4307	$251.40	$419.00	$179.50–$2,315.52	—	40%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 CCP AB IGG ANTIBODIES	$251.40	$419.00	$179.50–$2,315.52	—	40%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 ANTI-CCP	$251.40	$419.00	$179.50–$2,315.52	—	40%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 CCP ANTIBODY P6842	$251.40	$419.00	$179.50–$2,315.52	—	40%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 CYCLIC CITRULLIN PEPTIDE P4262	$251.40	$419.00	$179.50–$2,315.52	—	40%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 CYCLIC CITRULLINE PEP IGG	$251.40	$419.00	$179.50–$2,315.52	—	40%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANTINUCLEAR AB ANA P5076	$75.00	$125.00	$11.95–$118.75	1% above	40%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANTINUCLEAR AB	$75.00	$125.00	$11.95–$118.75	1% above	40%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANTI-NUCLEAR AB BODY FLUID	$75.00	$125.00	$11.95–$118.75	1% above	40%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANACHOICE SPEC ANTI CASCADING	$75.00	$125.00	$11.95–$118.75	1% above	40%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANTINUCLEAR ANTIBODIES P8130	$75.00	$125.00	$11.95–$118.75	1% above	40%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANACHOICE SCREEN W/RFX DSDNA	$75.00	$125.00	$11.95–$118.75	1% above	40%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA W/REFLEX LUPUS/SLE	$75.00	$125.00	$11.95–$118.75	1% above	40%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA SCR IFA W/RFX TITR&PAT/MIX	$75.00	$125.00	$11.95–$118.75	1% above	40%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA IFA W/RFX TITR/PAT/SCL ABS	$75.00	$125.00	$11.95–$118.75	1% above	40%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA IFA W/RFLX TITR/CASCADE	$75.00	$125.00	$11.95–$118.75	1% above	40%
Antinuclear antibody (ANA) blood test, screen CPT 86038 EXPANDED ENA SCREEN P1325	$75.00	$125.00	$11.95–$118.75	1% above	40%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA ANTIBODIES P4769	$75.00	$125.00	$11.95–$118.75	1% above	40%
Antinuclear antibody (ANA) blood test, screen CPT 86038 CENTROMERE AB W/TITER REFLEX	$75.00	$125.00	$11.95–$118.75	1% above	40%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA (ANTI NUCLEAR ANTIBODIES)	$75.00	$125.00	$11.95–$118.75	1% above	40%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANTINUCLEAR ANTIBODIES P5919	$75.00	$125.00	$11.95–$118.75	1% above	40%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANTINUCLEAR ANTIBODIES P6842	$75.00	$125.00	$11.95–$118.75	1% above	40%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANTINUCLEAR ANTIBODIES P5091	$75.00	$125.00	$11.95–$118.75	1% above	40%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANTINUCLEAR ANTIBODIES P4312	$75.00	$125.00	$11.95–$118.75	1% above	40%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANTINUCLEAR ANTIBODIES P4307	$75.00	$125.00	$11.95–$118.75	1% above	40%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANTINUCLEAR ANTIBODIES P4262	$75.00	$125.00	$11.95–$118.75	1% above	40%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANTINUCLEAR ANTIBODIES P0846	$75.00	$125.00	$11.95–$118.75	1% above	40%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 EXPANDED ENA SCREEN P1325	$75.00	$125.00	$53.55–$2,315.52	—	40%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA (ANTI NUCLEAR ANTIBODIES)	$75.00	$125.00	$53.55–$2,315.52	—	40%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA ANTIBODIES P4769	$75.00	$125.00	$53.55–$2,315.52	—	40%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA IFA W/RFLX TITR/CASCADE	$75.00	$125.00	$53.55–$2,315.52	—	40%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA IFA W/RFX TITR/PAT/SCL ABS	$75.00	$125.00	$53.55–$2,315.52	—	40%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA SCR IFA W/RFX TITR&PAT/MIX	$75.00	$125.00	$53.55–$2,315.52	—	40%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA W/REFLEX LUPUS/SLE	$75.00	$125.00	$53.55–$2,315.52	—	40%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANACHOICE SCREEN W/RFX DSDNA	$75.00	$125.00	$53.55–$2,315.52	—	40%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANACHOICE SPEC ANTI CASCADING	$75.00	$125.00	$53.55–$2,315.52	—	40%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANTI-NUCLEAR AB BODY FLUID	$75.00	$125.00	$53.55–$2,315.52	—	40%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANTINUCLEAR AB	$75.00	$125.00	$53.55–$2,315.52	—	40%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANTINUCLEAR AB ANA P5076	$75.00	$125.00	$53.55–$2,315.52	—	40%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANTINUCLEAR ANTIBODIES P0846	$75.00	$125.00	$53.55–$2,315.52	—	40%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANTINUCLEAR ANTIBODIES P4262	$75.00	$125.00	$53.55–$2,315.52	—	40%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANTINUCLEAR ANTIBODIES P4307	$75.00	$125.00	$53.55–$2,315.52	—	40%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANTINUCLEAR ANTIBODIES P4312	$75.00	$125.00	$53.55–$2,315.52	—	40%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANTINUCLEAR ANTIBODIES P5091	$75.00	$125.00	$53.55–$2,315.52	—	40%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANTINUCLEAR ANTIBODIES P5919	$75.00	$125.00	$53.55–$2,315.52	—	40%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANTINUCLEAR ANTIBODIES P6842	$75.00	$125.00	$53.55–$2,315.52	—	40%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANTINUCLEAR ANTIBODIES P8130	$75.00	$125.00	$53.55–$2,315.52	—	40%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 CENTROMERE AB W/TITER REFLEX	$75.00	$125.00	$53.55–$2,315.52	—	40%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 PRO BNP N TERMINAL	$342.00	$570.00	$38.79–$541.50	72% above	40%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 BNP B TYPE NATRIURETIC PEPTIDE	$342.00	$570.00	$38.79–$541.50	72% above	40%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 ASSAY OF NATRIURETIC PEPTIDE	$342.00	$570.00	$38.79–$541.50	72% above	40%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 BNP B TYPE NATRIURETIC PEPTIDE	$342.00	$570.00	$244.19–$2,315.52	—	40%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 ASSAY OF NATRIURETIC PEPTIDE	$342.00	$570.00	$244.19–$2,315.52	—	40%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 PRO BNP N TERMINAL	$342.00	$570.00	$244.19–$2,315.52	—	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE AEROBIC	$232.20	$387.00	$7.59–$367.65	345% above	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 OTHR SOURCE AEROBIC ISOL P0125	$232.20	$387.00	$7.59–$367.65	345% above	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 OTHR SOURCE AEROBIC ISOL P0125	$232.20	$387.00	$165.79–$2,315.52	—	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE AEROBIC	$232.20	$387.00	$165.79–$2,315.52	—	40%
Basic metabolic panel (blood test) CPT 80048 BASIC METABOLIC PANEL	$186.60	$311.00	$8.36–$295.45	154% above	40%
Basic metabolic panel (blood test) inpatient CPT 80048 BASIC METABOLIC PANEL	$186.60	$311.00	$133.23–$2,315.52	—	40%
Bilirubin blood test, total CPT 82247 BILIRUBIN - TOTAL	$76.20	$127.00	$4.96–$120.65	138% above	40%
Bilirubin blood test, total CPT 82247 BILIRUBIN TTL	$133.80	$223.00	$4.96–$211.85	318% above	40%
Bilirubin blood test, total CPT 82247 BILIRUBIN TOTAL P1635	$133.80	$223.00	$4.96–$211.85	318% above	40%
Bilirubin blood test, total CPT 82247 BILIRUBIN TOTAL P3896	$133.80	$223.00	$4.96–$211.85	318% above	40%
Bilirubin blood test, total CPT 82247 BILIRUBIN TOTAL P9445	$133.80	$223.00	$4.96–$211.85	318% above	40%
Bilirubin blood test, total CPT 82247 BILIRUBIN NEONATAL C	$133.80	$223.00	$4.96–$211.85	318% above	40%
Bilirubin blood test, total inpatient CPT 82247 BILIRUBIN - TOTAL	$76.20	$127.00	$54.41–$2,315.52	—	40%
Bilirubin blood test, total inpatient CPT 82247 BILIRUBIN TTL	$133.80	$223.00	$95.53–$2,315.52	—	40%
Bilirubin blood test, total inpatient CPT 82247 BILIRUBIN TOTAL P9445	$133.80	$223.00	$95.53–$2,315.52	—	40%
Bilirubin blood test, total inpatient CPT 82247 BILIRUBIN TOTAL P3896	$133.80	$223.00	$95.53–$2,315.52	—	40%
Bilirubin blood test, total inpatient CPT 82247 BILIRUBIN TOTAL P1635	$133.80	$223.00	$95.53–$2,315.52	—	40%
Bilirubin blood test, total inpatient CPT 82247 BILIRUBIN NEONATAL C	$133.80	$223.00	$95.53–$2,315.52	—	40%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 CELL BLOCK	$250.20	$417.00	$11.52–$396.15	41% above	40%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 LEVEL 4 GROSS & MICRO EXAM	$250.20	$417.00	$11.52–$396.15	41% above	40%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 CELL BLOCK	$250.20	$417.00	$178.64–$2,315.52	—	40%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 LEVEL 4 GROSS & MICRO EXAM	$250.20	$417.00	$178.64–$2,315.52	—	40%
Blood culture for bacteria CPT 87040 CULTURE BLOOD	$399.60	$666.00	$10.20–$632.70	371% above	40%
Blood culture for bacteria inpatient CPT 87040 CULTURE BLOOD	$399.60	$666.00	$285.31–$2,315.52	—	40%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 VENIPUNCTURE ROUTINE SPEC COLL	$27.60	$46.00	$6.69–$43.70	84% above	40%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 VENIPUNCTURE ROUTINE SPEC COLL	$27.60	$46.00	$19.71–$2,315.52	—	40%
Blood glucose (sugar) test CPT 82947 GLUCOSE QUANT P9445	$52.20	$87.00	$3.89–$82.65	102% above	40%
Blood glucose (sugar) test CPT 82947 GLUCOSE SERUM QUANT	$52.20	$87.00	$3.89–$82.65	102% above	40%
Blood glucose (sugar) test CPT 82947 GLUCOSE WHOLE BLOOD	$52.20	$87.00	$3.89–$82.65	102% above	40%
Blood glucose (sugar) test CPT 82947 WHOLE BLOOD GLUCOSE	$52.20	$87.00	$3.89–$82.65	102% above	40%
Blood glucose (sugar) test CPT 82947 GLUCOSE	$52.20	$87.00	$3.89–$82.65	102% above	40%
Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE QUANT P9445	$52.20	$87.00	$37.27–$2,315.52	—	40%
Blood glucose (sugar) test inpatient CPT 82947 WHOLE BLOOD GLUCOSE	$52.20	$87.00	$37.27–$2,315.52	—	40%
Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE	$52.20	$87.00	$37.27–$2,315.52	—	40%
Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE WHOLE BLOOD	$52.20	$87.00	$37.27–$2,315.52	—	40%
Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE SERUM QUANT	$52.20	$87.00	$37.27–$2,315.52	—	40%
Blood lead test CPT 83655 LEAD WHOLE BLOOD	$165.60	$276.00	$11.00–$262.20	112% above	40%
Blood lead test CPT 83655 LEAD	$165.60	$276.00	$11.00–$262.20	112% above	40%
Blood lead test CPT 83655 LEAD BLOOD PNL 2787	$165.60	$276.00	$11.00–$262.20	112% above	40%
Blood lead test CPT 83655 LEAD CAPILLARY	$165.60	$276.00	$11.00–$262.20	112% above	40%
Blood lead test CPT 83655 LEAD BLOOD OSHA	$165.60	$276.00	$11.00–$262.20	112% above	40%
Blood lead test inpatient CPT 83655 LEAD BLOOD PNL 2787	$165.60	$276.00	$118.24–$2,315.52	—	40%
Blood lead test inpatient CPT 83655 LEAD BLOOD OSHA	$165.60	$276.00	$118.24–$2,315.52	—	40%
Blood lead test inpatient CPT 83655 LEAD CAPILLARY	$165.60	$276.00	$118.24–$2,315.52	—	40%
Blood lead test inpatient CPT 83655 LEAD WHOLE BLOOD	$165.60	$276.00	$118.24–$2,315.52	—	40%
Blood lead test inpatient CPT 83655 LEAD	$165.60	$276.00	$118.24–$2,315.52	—	40%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 PREGNANCY SERUM QUAL	$102.60	$171.00	$7.43–$162.45	105% above	40%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 PREGNANCY SERUM QUAL	$102.60	$171.00	$73.26–$2,315.52	—	40%
Blood urea nitrogen (BUN) test CPT 84520 BUN	$39.60	$66.00	$3.90–$62.70	47% above	40%
Blood urea nitrogen (BUN) test CPT 84520 UREA NITROGEN P4233	$39.60	$66.00	$3.90–$62.70	47% above	40%
Blood urea nitrogen (BUN) test inpatient CPT 84520 UREA NITROGEN P4233	$39.60	$66.00	$28.27–$2,315.52	—	40%
Blood urea nitrogen (BUN) test inpatient CPT 84520 BUN	$39.60	$66.00	$28.27–$2,315.52	—	40%
C-peptide blood test CPT 84681 C-PEPTIDE RESP TO GLUC 2 SPEC	$348.60	$581.00	$20.57–$551.95	221% above	40%
C-peptide blood test CPT 84681 C-PEPTIDE	$348.60	$581.00	$20.57–$551.95	221% above	40%
C-peptide blood test inpatient CPT 84681 C-PEPTIDE	$348.60	$581.00	$248.90–$2,315.52	—	40%
C-peptide blood test inpatient CPT 84681 C-PEPTIDE RESP TO GLUC 2 SPEC	$348.60	$581.00	$248.90–$2,315.52	—	40%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C REACTIVE PROTEIN (CRP)	$238.20	$397.00	$3.30–$377.15	566% above	40%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C-REACTIVE PROTEIN	$238.20	$397.00	$3.30–$377.15	566% above	40%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C REACTIVE PROTEIN P6330	$238.20	$397.00	$3.30–$377.15	566% above	40%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C REACTIVE PROTEIN	$238.20	$397.00	$3.30–$377.15	566% above	40%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 C-REACTIVE PROTEIN	$238.20	$397.00	$170.07–$2,315.52	—	40%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 C REACTIVE PROTEIN (CRP)	$238.20	$397.00	$170.07–$2,315.52	—	40%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 C REACTIVE PROTEIN	$238.20	$397.00	$170.07–$2,315.52	—	40%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 C REACTIVE PROTEIN P6330	$238.20	$397.00	$170.07–$2,315.52	—	40%
C. difficile toxin gene test (stool PCR) CPT 87493 C DIFFICILE DNA	$286.80	$478.00	$36.84–$454.10	38% above	40%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 C DIFFICILE DNA	$286.80	$478.00	$204.78–$2,315.52	—	40%
CA 19-9 blood test (tumor marker) CPT 86301 CA-19-9 PANCREATIC CYST	$174.60	$291.00	$20.57–$276.45	31% above	40%
CA 19-9 blood test (tumor marker) CPT 86301 CA 19-1/CA 19-9 TUMOR MARKER	$174.60	$291.00	$20.57–$276.45	31% above	40%
CA 19-9 blood test (tumor marker) CPT 86301 CA 19-9 QUANT	$174.60	$291.00	$20.57–$276.45	31% above	40%
CA 19-9 blood test (tumor marker) CPT 86301 IMMUNOASSAY TUMOR CA 19-9	$174.60	$291.00	$20.57–$276.45	31% above	40%
CA 19-9 blood test (tumor marker) inpatient CPT 86301 CA-19-9 PANCREATIC CYST	$174.60	$291.00	$124.66–$2,315.52	—	40%
CA 19-9 blood test (tumor marker) inpatient CPT 86301 CA 19-9 QUANT	$174.60	$291.00	$124.66–$2,315.52	—	40%
CA 19-9 blood test (tumor marker) inpatient CPT 86301 IMMUNOASSAY TUMOR CA 19-9	$174.60	$291.00	$124.66–$2,315.52	—	40%
CA 19-9 blood test (tumor marker) inpatient CPT 86301 CA 19-1/CA 19-9 TUMOR MARKER	$174.60	$291.00	$124.66–$2,315.52	—	40%
CA-125 blood test (ovarian cancer marker) CPT 86304 CA 125 QUANT	$174.00	$290.00	$20.57–$275.50	33% above	40%
CA-125 blood test (ovarian cancer marker) CPT 86304 CA 125 TUMOR MARKER	$174.00	$290.00	$20.57–$275.50	33% above	40%
CA-125 blood test (ovarian cancer marker) CPT 86304 CA125	$174.00	$290.00	$20.57–$275.50	33% above	40%
CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 CA 125 QUANT	$174.00	$290.00	$124.24–$2,315.52	—	40%
CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 CA 125 TUMOR MARKER	$174.00	$290.00	$124.24–$2,315.52	—	40%
CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 CA125	$174.00	$290.00	$124.24–$2,315.52	—	40%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 COVID-19 BY PCR PERKINS/ELMER	$75.00	$125.00	$18.75–$118.75	18% below	40%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 INF AG DET AMP PRB TEC COVID19	$75.00	$125.00	$18.75–$118.75	18% below	40%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 IN AG DET NU AC(RNAORDNA)P5068	$75.00	$125.00	$18.75–$118.75	18% below	40%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 IN AG DET NU AC(RNAORDNA)P5063	$75.00	$125.00	$18.75–$118.75	18% below	40%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 IN AG DET NU AC(RNAORDNA)P5060	$75.00	$125.00	$18.75–$118.75	18% below	40%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 COVID-19 TEST	$75.00	$125.00	$18.75–$118.75	18% below	40%
COVID-19 PCR test (SARS-CoV-2 lab test) one side CPT 87635 SARS COVID19/2 RNA QL RT-PCR	$75.00	$125.00	$18.75–$118.75	18% below	40%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 IN AG DET NU AC(RNAORDNA)P5060	$75.00	$125.00	$53.55–$2,315.52	—	40%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 INF AG DET AMP PRB TEC COVID19	$75.00	$125.00	$53.55–$2,315.52	—	40%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 COVID-19 BY PCR PERKINS/ELMER	$75.00	$125.00	$53.55–$2,315.52	—	40%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 IN AG DET NU AC(RNAORDNA)P5068	$75.00	$125.00	$53.55–$2,315.52	—	40%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 IN AG DET NU AC(RNAORDNA)P5063	$75.00	$125.00	$53.55–$2,315.52	—	40%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 COVID-19 TEST	$75.00	$125.00	$53.55–$2,315.52	—	40%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient one side CPT 87635 SARS COVID19/2 RNA QL RT-PCR	$75.00	$125.00	$53.55–$2,315.52	—	40%
Calcium blood test, total CPT 82310 CALCIUM TOTAL P6970	$37.20	$62.00	$5.10–$58.90	11% above	40%
Calcium blood test, total CPT 82310 CALCIUM TOTAL	$39.60	$66.00	$5.10–$62.70	18% above	40%
Calcium blood test, total CPT 82310 CALCIUM (SERUM) PNL 2511	$39.60	$66.00	$5.10–$62.70	18% above	40%
Calcium blood test, total inpatient CPT 82310 CALCIUM TOTAL P6970	$37.20	$62.00	$26.56–$2,315.52	—	40%
Calcium blood test, total inpatient CPT 82310 CALCIUM TOTAL	$39.60	$66.00	$28.27–$2,315.52	—	40%
Calcium blood test, total inpatient CPT 82310 CALCIUM (SERUM) PNL 2511	$39.60	$66.00	$28.27–$2,315.52	—	40%
Carcinoembryonic antigen (CEA) test CPT 82378 CEA	$411.00	$685.00	$18.70–$650.75	247% above	40%
Carcinoembryonic antigen (CEA) test CPT 82378 CEA PANCREATIC CYST FLUID	$411.00	$685.00	$18.70–$650.75	247% above	40%
Carcinoembryonic antigen (CEA) test CPT 82378 CARCINOEMBRYONIC AG	$411.00	$685.00	$18.70–$650.75	247% above	40%
Carcinoembryonic antigen (CEA) test inpatient CPT 82378 CEA PANCREATIC CYST FLUID	$411.00	$685.00	$293.45–$2,315.52	—	40%
Carcinoembryonic antigen (CEA) test inpatient CPT 82378 CEA	$411.00	$685.00	$293.45–$2,315.52	—	40%
Carcinoembryonic antigen (CEA) test inpatient CPT 82378 CARCINOEMBRYONIC AG	$411.00	$685.00	$293.45–$2,315.52	—	40%
Chickenpox (varicella) immunity blood test CPT 86787 VARICELLA ZOSTER AB IGM	$146.40	$244.00	$12.73–$231.80	73% above	40%
Chickenpox (varicella) immunity blood test CPT 86787 HERPES ZOSTER AB IGG	$146.40	$244.00	$12.73–$231.80	73% above	40%
Chickenpox (varicella) immunity blood test CPT 86787 VARICELLA-ZOST AB IMM SCR ACIF	$146.40	$244.00	$12.73–$231.80	73% above	40%
Chickenpox (varicella) immunity blood test CPT 86787 VARICELLA ZOSTER AB - IGG	$146.40	$244.00	$12.73–$231.80	73% above	40%
Chickenpox (varicella) immunity blood test CPT 86787 VARICELLA-ZOSTER P1665	$146.40	$244.00	$12.73–$231.80	73% above	40%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 VARICELLA ZOSTER AB IGM	$146.40	$244.00	$104.53–$2,315.52	—	40%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 VARICELLA-ZOST AB IMM SCR ACIF	$146.40	$244.00	$104.53–$2,315.52	—	40%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 VARICELLA-ZOSTER P1665	$146.40	$244.00	$104.53–$2,315.52	—	40%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 VARICELLA ZOSTER AB - IGG	$146.40	$244.00	$104.53–$2,315.52	—	40%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 HERPES ZOSTER AB IGG	$146.40	$244.00	$104.53–$2,315.52	—	40%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA TRACHOMATIS PCR	$276.00	$460.00	$25.51–$437.00	40% above	40%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA TRACHOMATIS P9043	$276.00	$460.00	$25.51–$437.00	40% above	40%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA TRACHOMATIS P3680	$276.00	$460.00	$25.51–$437.00	40% above	40%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA TRCH AMP PROBE P9292	$276.00	$460.00	$25.51–$437.00	40% above	40%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 C TRACHOMATIS TMA UROGENIIAL	$276.00	$460.00	$25.51–$437.00	40% above	40%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA TRACHOMATIS P4224	$276.00	$460.00	$25.51–$437.00	40% above	40%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA TRACH MISC SITES NAA	$276.00	$460.00	$25.51–$437.00	40% above	40%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 C TRACHOMATIS AMPL PROBE P1815	$276.00	$460.00	$25.51–$437.00	40% above	40%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHYLMD TRACH DNA AMP PR P4792	$276.00	$460.00	$25.51–$437.00	40% above	40%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMYDIA TRACHOMATIS PCR	$276.00	$460.00	$197.06–$2,315.52	—	40%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMYDIA TRACHOMATIS P9043	$276.00	$460.00	$197.06–$2,315.52	—	40%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMYDIA TRACHOMATIS P4224	$276.00	$460.00	$197.06–$2,315.52	—	40%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMYDIA TRACHOMATIS P3680	$276.00	$460.00	$197.06–$2,315.52	—	40%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMYDIA TRACH MISC SITES NAA	$276.00	$460.00	$197.06–$2,315.52	—	40%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 C TRACHOMATIS TMA UROGENIIAL	$276.00	$460.00	$197.06–$2,315.52	—	40%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 C TRACHOMATIS AMPL PROBE P1815	$276.00	$460.00	$197.06–$2,315.52	—	40%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMYDIA TRCH AMP PROBE P9292	$276.00	$460.00	$197.06–$2,315.52	—	40%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHYLMD TRACH DNA AMP PR P4792	$276.00	$460.00	$197.06–$2,315.52	—	40%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PROFILE	$228.00	$380.00	$13.24–$361.00	155% above	40%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PANEL P4483	$228.00	$380.00	$13.24–$361.00	155% above	40%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PANEL P4483	$228.00	$380.00	$162.79–$2,315.52	—	40%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PROFILE	$228.00	$380.00	$162.79–$2,315.52	—	40%
Complete blood count (CBC) with differential CPT 85025 CBC & PLT & AUTO COMP DIFF	$95.40	$159.00	$6.60–$151.05	87% above	40%
Complete blood count (CBC) with differential CPT 85025 OXLDL	$95.40	$159.00	$6.60–$151.05	87% above	40%
Complete blood count (CBC) with differential inpatient CPT 85025 CBC & PLT & AUTO COMP DIFF	$95.40	$159.00	$68.12–$2,315.52	—	40%
Complete blood count (CBC) with differential inpatient CPT 85025 OXLDL	$95.40	$159.00	$68.12–$2,315.52	—	40%
Complete blood count (CBC), no differential CPT 85027 CBC & PLT ONLY	$80.40	$134.00	$6.39–$127.30	86% above	40%
Complete blood count (CBC), no differential inpatient CPT 85027 CBC & PLT ONLY	$80.40	$134.00	$57.41–$2,315.52	—	40%
Comprehensive metabolic panel (blood test) CPT 80053 COMPREHENSIVE METABOLIC PANEL	$215.40	$359.00	$10.43–$341.05	143% above	40%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 COMPREHENSIVE METABOLIC PANEL	$215.40	$359.00	$153.80–$2,315.52	—	40%
Cortisol blood test, total CPT 82533 CORTISOL A.M.	$273.00	$455.00	$13.20–$432.25	165% above	40%
Cortisol blood test, total CPT 82533 AM CORTISOL	$273.00	$455.00	$13.20–$432.25	165% above	40%
Cortisol blood test, total CPT 82533 CORTISOL TOTAL LC/MS/MS	$273.00	$455.00	$13.20–$432.25	165% above	40%
Cortisol blood test, total CPT 82533 CORTISOL SERUM	$273.00	$455.00	$13.20–$432.25	165% above	40%
Cortisol blood test, total CPT 82533 CORTISOL TOTAL	$273.00	$455.00	$13.20–$432.25	165% above	40%
Cortisol blood test, total CPT 82533 CORTISOL	$273.00	$455.00	$13.20–$432.25	165% above	40%
Cortisol blood test, total CPT 82533 SALIVARY CORTISOL	$273.00	$455.00	$13.20–$432.25	165% above	40%
Cortisol blood test, total CPT 82533 DEXAMETHASONE SUPPRESSION	$273.00	$455.00	$13.20–$432.25	165% above	40%
Cortisol blood test, total inpatient CPT 82533 SALIVARY CORTISOL	$273.00	$455.00	$194.92–$2,315.52	—	40%
Cortisol blood test, total inpatient CPT 82533 AM CORTISOL	$273.00	$455.00	$194.92–$2,315.52	—	40%
Cortisol blood test, total inpatient CPT 82533 CORTISOL	$273.00	$455.00	$194.92–$2,315.52	—	40%
Cortisol blood test, total inpatient CPT 82533 CORTISOL A.M.	$273.00	$455.00	$194.92–$2,315.52	—	40%
Cortisol blood test, total inpatient CPT 82533 CORTISOL SERUM	$273.00	$455.00	$194.92–$2,315.52	—	40%
Cortisol blood test, total inpatient CPT 82533 CORTISOL TOTAL	$273.00	$455.00	$194.92–$2,315.52	—	40%
Cortisol blood test, total inpatient CPT 82533 CORTISOL TOTAL LC/MS/MS	$273.00	$455.00	$194.92–$2,315.52	—	40%
Cortisol blood test, total inpatient CPT 82533 DEXAMETHASONE SUPPRESSION	$273.00	$455.00	$194.92–$2,315.52	—	40%
Creatine kinase (CK) blood test, total CPT 82550 CREATINE KINASE CK CPK TOTAL	$127.20	$212.00	$6.44–$201.40	183% above	40%
Creatine kinase (CK) blood test, total CPT 82550 CREATINE KINASE P2392	$127.20	$212.00	$6.44–$201.40	183% above	40%
Creatine kinase (CK) blood test, total CPT 82550 CK (CPK) TOTAL	$127.20	$212.00	$6.44–$201.40	183% above	40%
Creatine kinase (CK) blood test, total CPT 82550 CPK (CREATINE PHOSPHOKINASE)	$127.20	$212.00	$6.44–$201.40	183% above	40%
Creatine kinase (CK) blood test, total inpatient CPT 82550 CREATINE KINASE P2392	$127.20	$212.00	$90.82–$2,315.52	—	40%
Creatine kinase (CK) blood test, total inpatient CPT 82550 CREATINE KINASE CK CPK TOTAL	$127.20	$212.00	$90.82–$2,315.52	—	40%
Creatine kinase (CK) blood test, total inpatient CPT 82550 CK (CPK) TOTAL	$127.20	$212.00	$90.82–$2,315.52	—	40%
Creatine kinase (CK) blood test, total inpatient CPT 82550 CPK (CREATINE PHOSPHOKINASE)	$127.20	$212.00	$90.82–$2,315.52	—	40%
Creatinine blood test CPT 82565 CREATININE P4233	$39.60	$66.00	$5.07–$62.70	17% above	40%
Creatinine blood test CPT 82565 WHOLE BLOOD CREATININE	$39.60	$66.00	$5.07–$62.70	17% above	40%
Creatinine blood test CPT 82565 ASSAY OF CREATININE	$39.60	$66.00	$5.07–$62.70	17% above	40%
Creatinine blood test CPT 82565 CREATININE SERUM	$39.60	$66.00	$5.07–$62.70	17% above	40%
Creatinine blood test inpatient CPT 82565 WHOLE BLOOD CREATININE	$39.60	$66.00	$28.27–$2,315.52	—	40%
Creatinine blood test inpatient CPT 82565 CREATININE SERUM	$39.60	$66.00	$28.27–$2,315.52	—	40%
Creatinine blood test inpatient CPT 82565 ASSAY OF CREATININE	$39.60	$66.00	$28.27–$2,315.52	—	40%
Creatinine blood test inpatient CPT 82565 CREATININE P4233	$39.60	$66.00	$28.27–$2,315.52	—	40%
Cytomegalovirus (CMV) antibody test CPT 86644 CYTOMEGALOVIRUS(CMV)(IGG)AB	$146.40	$244.00	$14.22–$231.80	69% above	40%
Cytomegalovirus (CMV) antibody test CPT 86644 CYTOMEGALOVIRUS IGG AB PNL8733	$146.40	$244.00	$14.22–$231.80	69% above	40%
Cytomegalovirus (CMV) antibody test CPT 86644 CMV IGG AVIDITY INDEX	$146.40	$244.00	$14.22–$231.80	69% above	40%
Cytomegalovirus (CMV) antibody test CPT 86644 DONOR CMV AB TTL W/REFL TO IGM	$146.40	$244.00	$14.22–$231.80	69% above	40%
Cytomegalovirus (CMV) antibody test CPT 86644 CMV IGG	$146.40	$244.00	$14.22–$231.80	69% above	40%
Cytomegalovirus (CMV) antibody test CPT 86644 CYTOMEGALOVIRUS P0786	$146.40	$244.00	$14.22–$231.80	69% above	40%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 CMV IGG	$146.40	$244.00	$104.53–$2,315.52	—	40%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 CYTOMEGALOVIRUS IGG AB PNL8733	$146.40	$244.00	$104.53–$2,315.52	—	40%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 CYTOMEGALOVIRUS P0786	$146.40	$244.00	$104.53–$2,315.52	—	40%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 DONOR CMV AB TTL W/REFL TO IGM	$146.40	$244.00	$104.53–$2,315.52	—	40%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 CYTOMEGALOVIRUS(CMV)(IGG)AB	$146.40	$244.00	$104.53–$2,315.52	—	40%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 CMV IGG AVIDITY INDEX	$146.40	$244.00	$104.53–$2,315.52	—	40%
D-dimer blood test (blood clot marker) CPT 85379 D-DIMER QUANTITATIVE	$148.20	$247.00	$10.06–$234.65	117% above	40%
D-dimer blood test (blood clot marker) CPT 85379 D DIMER QUANTITATIVE BCS	$148.20	$247.00	$10.06–$234.65	117% above	40%
D-dimer blood test (blood clot marker) CPT 85379 D DIMER P P7021	$148.20	$247.00	$10.06–$234.65	117% above	40%
D-dimer blood test (blood clot marker) inpatient CPT 85379 D DIMER P P7021	$148.20	$247.00	$105.81–$2,315.52	—	40%
D-dimer blood test (blood clot marker) inpatient CPT 85379 D DIMER QUANTITATIVE BCS	$148.20	$247.00	$105.81–$2,315.52	—	40%
D-dimer blood test (blood clot marker) inpatient CPT 85379 D-DIMER QUANTITATIVE	$148.20	$247.00	$105.81–$2,315.52	—	40%
DHEA sulfate (DHEA-S) blood test CPT 82627 DHEA-S	$184.20	$307.00	$21.97–$291.65	37% above	40%
DHEA sulfate (DHEA-S) blood test CPT 82627 DHEA-S (ESOTERIX)	$184.20	$307.00	$21.97–$291.65	37% above	40%
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 DHEA-S	$184.20	$307.00	$131.52–$2,315.52	—	40%
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 DHEA-S (ESOTERIX)	$184.20	$307.00	$131.52–$2,315.52	—	40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DRG TOX MON ETHYL AL W/CONF UR	$53.40	$89.00	$13.35–$108.81	71% below	40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 AMPHETAMINE QUAL	$53.40	$89.00	$13.35–$108.81	71% below	40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 BUPRENORPHINE SCREEN URINE	$53.40	$89.00	$13.35–$108.81	71% below	40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG CLASS SNGL METHOD P0560	$53.40	$89.00	$13.35–$108.81	71% below	40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG MONITORING W/CONF URINE	$53.40	$89.00	$13.35–$108.81	71% below	40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG MONITORING PANEL 6 W/CONF	$53.40	$89.00	$13.35–$108.81	71% below	40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG MONITORING PNL 5 SCR URN	$53.40	$89.00	$13.35–$108.81	71% below	40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG MONITORING W/CONF URINE	$53.40	$89.00	$13.35–$108.81	71% below	40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG SCREEN FORENSIC(GC/MS)UR	$53.40	$89.00	$13.35–$108.81	71% below	40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG SCREEN P4015	$53.40	$89.00	$13.35–$108.81	71% below	40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG SCREEN PANEL 9 MECONIUM	$53.40	$89.00	$13.35–$108.81	71% below	40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG SCREEN QUALITATIVE P3632	$53.40	$89.00	$13.35–$108.81	71% below	40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG SCREEN SINGLE CLASS P1603	$53.40	$89.00	$13.35–$108.81	71% below	40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG TOX MONITOR 8 W/CONF UR	$53.40	$89.00	$13.35–$108.81	71% below	40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG TOX MONITORING 1 SCR UR	$53.40	$89.00	$13.35–$108.81	71% below	40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DTM FENTANYL WITH CONF URINE	$53.40	$89.00	$13.35–$108.81	71% below	40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 ETHANOL	$53.40	$89.00	$13.35–$108.81	71% below	40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 IMMUNOASSAY EACH DRUG CL P1261	$53.40	$89.00	$13.35–$108.81	71% below	40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 NICOTINE AND METABOLITE	$53.40	$89.00	$13.35–$108.81	71% below	40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 NICOTINE-COTININE URINE	$53.40	$89.00	$13.35–$108.81	71% below	40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 NOVEL PSYCHOACT SUBST SCR 2	$53.40	$89.00	$13.35–$108.81	71% below	40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 NOVEL PSYCHOACT SUBST SCR UR	$53.40	$89.00	$13.35–$108.81	71% below	40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 PAIN MANAGEMENT AMPHETAMINES	$53.40	$89.00	$13.35–$108.81	71% below	40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 PM ALCOHOL METABOLITE W/CONF	$53.40	$89.00	$13.35–$108.81	71% below	40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 POSTMORTEM BASIC BLD FORENSIC	$53.40	$89.00	$13.35–$108.81	71% below	40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 POSTMORTEM EXPD SER FORENSIC	$53.40	$89.00	$13.35–$108.81	71% below	40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 SNGLE DRUG CLASS METHD P9910	$53.40	$89.00	$13.35–$108.81	71% below	40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 SYN CANNABINOID MET SCR-EXP UR	$53.40	$89.00	$13.35–$108.81	71% below	40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 TOX 10+ALCOHOL/URINE	$53.40	$89.00	$13.35–$108.81	71% below	40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 TRICYCLICS QUAL	$53.40	$89.00	$13.35–$108.81	71% below	40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 URINE DRUGS OF ABUSE SCREEN	$53.40	$89.00	$13.35–$108.81	71% below	40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 URINE TOX7 W/O THC+OXY+BUP	$53.40	$89.00	$13.35–$108.81	71% below	40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG SCREEN FORENSIC(GC/MS)UR	$53.40	$89.00	$38.13–$2,315.52	—	40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 POSTMORTEM EXPD SER FORENSIC	$53.40	$89.00	$38.13–$2,315.52	—	40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 URINE TOX7 W/O THC+OXY+BUP	$53.40	$89.00	$38.13–$2,315.52	—	40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG TOX MONITOR 8 W/CONF UR	$53.40	$89.00	$38.13–$2,315.52	—	40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG MONITORING W/CONF URINE	$53.40	$89.00	$38.13–$2,315.52	—	40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG CLASS SNGL METHOD P0560	$53.40	$89.00	$38.13–$2,315.52	—	40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG MONITORING PANEL 6 W/CONF	$53.40	$89.00	$38.13–$2,315.52	—	40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG MONITORING PNL 5 SCR URN	$53.40	$89.00	$38.13–$2,315.52	—	40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 SNGLE DRUG CLASS METHD P9910	$53.40	$89.00	$38.13–$2,315.52	—	40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG TOX MONITORING 1 SCR UR	$53.40	$89.00	$38.13–$2,315.52	—	40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 AMPHETAMINE QUAL	$53.40	$89.00	$38.13–$2,315.52	—	40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DTM FENTANYL WITH CONF URINE	$53.40	$89.00	$38.13–$2,315.52	—	40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG SCREEN SINGLE CLASS P1603	$53.40	$89.00	$38.13–$2,315.52	—	40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 ETHANOL	$53.40	$89.00	$38.13–$2,315.52	—	40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 BUPRENORPHINE SCREEN URINE	$53.40	$89.00	$38.13–$2,315.52	—	40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 IMMUNOASSAY EACH DRUG CL P1261	$53.40	$89.00	$38.13–$2,315.52	—	40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 SYN CANNABINOID MET SCR-EXP UR	$53.40	$89.00	$38.13–$2,315.52	—	40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 NICOTINE AND METABOLITE	$53.40	$89.00	$38.13–$2,315.52	—	40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG SCREEN QUALITATIVE P3632	$53.40	$89.00	$38.13–$2,315.52	—	40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 NICOTINE-COTININE URINE	$53.40	$89.00	$38.13–$2,315.52	—	40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 TOX 10+ALCOHOL/URINE	$53.40	$89.00	$38.13–$2,315.52	—	40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 NOVEL PSYCHOACT SUBST SCR 2	$53.40	$89.00	$38.13–$2,315.52	—	40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRG TOX MON ETHYL AL W/CONF UR	$53.40	$89.00	$38.13–$2,315.52	—	40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 NOVEL PSYCHOACT SUBST SCR UR	$53.40	$89.00	$38.13–$2,315.52	—	40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 TRICYCLICS QUAL	$53.40	$89.00	$38.13–$2,315.52	—	40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 PAIN MANAGEMENT AMPHETAMINES	$53.40	$89.00	$38.13–$2,315.52	—	40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG SCREEN PANEL 9 MECONIUM	$53.40	$89.00	$38.13–$2,315.52	—	40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 PM ALCOHOL METABOLITE W/CONF	$53.40	$89.00	$38.13–$2,315.52	—	40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 URINE DRUGS OF ABUSE SCREEN	$53.40	$89.00	$38.13–$2,315.52	—	40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 POSTMORTEM BASIC BLD FORENSIC	$53.40	$89.00	$38.13–$2,315.52	—	40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG SCREEN P4015	$53.40	$89.00	$38.13–$2,315.52	—	40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG MONITORING W/CONF URINE	$53.40	$89.00	$38.13–$2,315.52	—	40%
Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 ELECTROLYTE PANEL	$130.80	$218.00	$6.92–$207.10	148% above	40%
Electrolyte panel (sodium, potassium, chloride, CO2) inpatient CPT 80051 ELECTROLYTE PANEL	$130.80	$218.00	$93.39–$2,315.52	—	40%
Epstein-Barr virus (EBV) antibody test CPT 86665 EBV CAPSID AB IGG IGM	$292.20	$487.00	$17.93–$462.65	155% above	40%
Epstein-Barr virus (EBV) antibody test CPT 86665 EBV (VCA) IGG PNL 1380	$292.20	$487.00	$17.93–$462.65	155% above	40%
Epstein-Barr virus (EBV) antibody test CPT 86665 EBV (VCA) IGM PNL 1380	$292.20	$487.00	$17.93–$462.65	155% above	40%
Epstein-Barr virus (EBV) antibody test CPT 86665 EBV VIRAL CAPSID AG IGM	$292.20	$487.00	$17.93–$462.65	155% above	40%
Epstein-Barr virus (EBV) antibody test CPT 86665 EBV VIRAL CAPSID AG IGG	$292.20	$487.00	$17.93–$462.65	155% above	40%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 EBV (VCA) IGG PNL 1380	$292.20	$487.00	$208.63–$2,315.52	—	40%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 EBV VIRAL CAPSID AG IGG	$292.20	$487.00	$208.63–$2,315.52	—	40%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 EBV VIRAL CAPSID AG IGM	$292.20	$487.00	$208.63–$2,315.52	—	40%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 EBV CAPSID AB IGG IGM	$292.20	$487.00	$208.63–$2,315.52	—	40%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 EBV (VCA) IGM PNL 1380	$292.20	$487.00	$208.63–$2,315.52	—	40%
Estradiol blood test CPT 82670 ESTRADIOL/FREE/SERUM	$177.60	$296.00	$23.65–$281.20	7% above	40%
Estradiol blood test CPT 82670 ESTRADIOL (E2)	$177.60	$296.00	$23.65–$281.20	7% above	40%
Estradiol blood test CPT 82670 ESTRADIOL EXTRACTION	$177.60	$296.00	$23.65–$281.20	7% above	40%
Estradiol blood test CPT 82670 ESTRADIOL E2 TOTAL	$373.20	$622.00	$23.65–$590.90	124% above	40%
Estradiol blood test inpatient CPT 82670 ESTRADIOL/FREE/SERUM	$177.60	$296.00	$126.81–$2,315.52	—	40%
Estradiol blood test inpatient CPT 82670 ESTRADIOL EXTRACTION	$177.60	$296.00	$126.81–$2,315.52	—	40%
Estradiol blood test inpatient CPT 82670 ESTRADIOL (E2)	$177.60	$296.00	$126.81–$2,315.52	—	40%
Estradiol blood test inpatient CPT 82670 ESTRADIOL E2 TOTAL	$373.20	$622.00	$266.46–$2,315.52	—	40%
FSH (follicle-stimulating hormone) test CPT 83001 FSH/3RD GENERATION	$280.80	$468.00	$18.37–$444.60	135% above	40%
FSH (follicle-stimulating hormone) test CPT 83001 FOLLICLE STIMULATING HORMO	$280.80	$468.00	$18.37–$444.60	135% above	40%
FSH (follicle-stimulating hormone) test CPT 83001 FSH PNL 2828	$280.80	$468.00	$18.37–$444.60	135% above	40%
FSH (follicle-stimulating hormone) test CPT 83001 SPECIFIC GRAVITY URINE-C	$280.80	$468.00	$18.37–$444.60	135% above	40%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 SPECIFIC GRAVITY URINE-C	$280.80	$468.00	$200.49–$2,315.52	—	40%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 FOLLICLE STIMULATING HORMO	$280.80	$468.00	$200.49–$2,315.52	—	40%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 FSH/3RD GENERATION	$280.80	$468.00	$200.49–$2,315.52	—	40%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 FSH PNL 2828	$280.80	$468.00	$200.49–$2,315.52	—	40%
Fecal calprotectin (stool inflammation test) CPT 83993 CALPROTECTIN STOOL	$290.40	$484.00	$19.40–$459.80	125% above	40%
Fecal calprotectin (stool inflammation test) inpatient CPT 83993 CALPROTECTIN STOOL	$290.40	$484.00	$207.35–$2,315.52	—	40%
Ferritin blood test (iron stores) CPT 82728 FERRITIN	$223.20	$372.00	$13.20–$353.40	158% above	40%
Ferritin blood test (iron stores) CPT 82728 FERRITIN P9262	$223.20	$372.00	$13.20–$353.40	158% above	40%
Ferritin blood test (iron stores) inpatient CPT 82728 FERRITIN	$223.20	$372.00	$159.36–$2,315.52	—	40%
Ferritin blood test (iron stores) inpatient CPT 82728 FERRITIN P9262	$223.20	$372.00	$159.36–$2,315.52	—	40%
Fibrinogen blood test CPT 85384 FIBRINOGEN ACTIVITY P4341	$133.20	$222.00	$9.61–$210.90	101% above	40%
Fibrinogen blood test CPT 85384 FIBRINOGEN ACTIVITY CLAUSS	$133.20	$222.00	$9.61–$210.90	101% above	40%
Fibrinogen blood test CPT 85384 FIBRINOGEN CLAUSS P P7021	$133.20	$222.00	$9.61–$210.90	101% above	40%
Fibrinogen blood test CPT 85384 FIBRINOGEN ASSAY	$133.20	$222.00	$9.61–$210.90	101% above	40%
Fibrinogen blood test CPT 85384 FIBRINOGEN ACTIVITY P2672	$133.20	$222.00	$9.61–$210.90	101% above	40%
Fibrinogen blood test inpatient CPT 85384 FIBRINOGEN ACTIVITY CLAUSS	$133.20	$222.00	$95.10–$2,315.52	—	40%
Fibrinogen blood test inpatient CPT 85384 FIBRINOGEN CLAUSS P P7021	$133.20	$222.00	$95.10–$2,315.52	—	40%
Fibrinogen blood test inpatient CPT 85384 FIBRINOGEN ASSAY	$133.20	$222.00	$95.10–$2,315.52	—	40%
Fibrinogen blood test inpatient CPT 85384 FIBRINOGEN ACTIVITY P4341	$133.20	$222.00	$95.10–$2,315.52	—	40%
Fibrinogen blood test inpatient CPT 85384 FIBRINOGEN ACTIVITY P2672	$133.20	$222.00	$95.10–$2,315.52	—	40%
Folate (folic acid) blood test CPT 82746 FOLATE SERUM	$202.20	$337.00	$13.20–$320.15	133% above	40%
Folate (folic acid) blood test CPT 82746 FOLIC ACID (SERUM FOLATE)	$202.20	$337.00	$13.20–$320.15	133% above	40%
Folate (folic acid) blood test CPT 82746 FOLIC ACID SERUM PNL 2979	$202.20	$337.00	$13.20–$320.15	133% above	40%
Folate (folic acid) blood test inpatient CPT 82746 FOLATE SERUM	$202.20	$337.00	$144.37–$2,315.52	—	40%
Folate (folic acid) blood test inpatient CPT 82746 FOLIC ACID SERUM PNL 2979	$202.20	$337.00	$144.37–$2,315.52	—	40%
Folate (folic acid) blood test inpatient CPT 82746 FOLIC ACID (SERUM FOLATE)	$202.20	$337.00	$144.37–$2,315.52	—	40%
Free T3 thyroid hormone test CPT 84481 DIRECT FREE T3	$137.40	$229.00	$16.74–$217.55	29% above	40%
Free T3 thyroid hormone test CPT 84481 FREE T3 PNL 2257	$137.40	$229.00	$16.74–$217.55	29% above	40%
Free T3 thyroid hormone test CPT 84481 FREE ASSAY (FT-3)	$137.40	$229.00	$16.74–$217.55	29% above	40%
Free T3 thyroid hormone test inpatient CPT 84481 FREE T3 PNL 2257	$137.40	$229.00	$98.10–$2,315.52	—	40%
Free T3 thyroid hormone test inpatient CPT 84481 DIRECT FREE T3	$137.40	$229.00	$98.10–$2,315.52	—	40%
Free T3 thyroid hormone test inpatient CPT 84481 FREE ASSAY (FT-3)	$137.40	$229.00	$98.10–$2,315.52	—	40%
Free T4 (free thyroxine) thyroid blood test CPT 84439 THYROXINE FREE	$300.00	$500.00	$8.80–$475.00	400% above	40%
Free T4 (free thyroxine) thyroid blood test CPT 84439 DIRECT FREE T4 (THYROXINE)	$300.00	$500.00	$8.80–$475.00	400% above	40%
Free T4 (free thyroxine) thyroid blood test CPT 84439 T4 FREE ANALOG METHOD	$300.00	$500.00	$8.80–$475.00	400% above	40%
Free T4 (free thyroxine) thyroid blood test CPT 84439 T4 FREE OSL	$300.00	$500.00	$8.80–$475.00	400% above	40%
Free T4 (free thyroxine) thyroid blood test CPT 84439 THROXINE FREE P4354	$300.00	$500.00	$8.80–$475.00	400% above	40%
Free T4 (free thyroxine) thyroid blood test CPT 84439 FREE T4 EQUILBRIUM DIALYSIS	$300.00	$500.00	$8.80–$475.00	400% above	40%
Free T4 (free thyroxine) thyroid blood test CPT 84439 T4 (THYROXINE) FREE S	$300.00	$500.00	$8.80–$475.00	400% above	40%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 T4 (THYROXINE) FREE S	$300.00	$500.00	$214.20–$2,315.52	—	40%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 FREE T4 EQUILBRIUM DIALYSIS	$300.00	$500.00	$214.20–$2,315.52	—	40%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 DIRECT FREE T4 (THYROXINE)	$300.00	$500.00	$214.20–$2,315.52	—	40%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 T4 FREE ANALOG METHOD	$300.00	$500.00	$214.20–$2,315.52	—	40%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 THYROXINE FREE	$300.00	$500.00	$214.20–$2,315.52	—	40%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 T4 FREE OSL	$300.00	$500.00	$214.20–$2,315.52	—	40%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 THROXINE FREE P4354	$300.00	$500.00	$214.20–$2,315.52	—	40%
Free testosterone test CPT 84402 TESTOSTERONE FREE	$72.00	$120.00	$18.00–$114.00	55% below	40%
Free testosterone test CPT 84402 FREE TESTOSTERONE PNL 1540	$72.00	$120.00	$18.00–$114.00	55% below	40%
Free testosterone test CPT 84402 TESTOSTERONE FREE P4882	$72.00	$120.00	$18.00–$114.00	55% below	40%
Free testosterone test inpatient CPT 84402 FREE TESTOSTERONE PNL 1540	$72.00	$120.00	$51.41–$2,315.52	—	40%
Free testosterone test inpatient CPT 84402 TESTOSTERONE FREE	$72.00	$120.00	$51.41–$2,315.52	—	40%
Free testosterone test inpatient CPT 84402 TESTOSTERONE FREE P4882	$72.00	$120.00	$51.41–$2,315.52	—	40%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 GGT	$111.00	$185.00	$7.12–$175.75	133% above	40%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 GLUTAMYLTRANS GAMMA GGT P3896	$111.00	$185.00	$7.12–$175.75	133% above	40%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 GLUTAMYLTRANSFERASE P9445	$111.00	$185.00	$7.12–$175.75	133% above	40%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 GGTP(GAMMA GLUTAMYL TRANSF)	$111.00	$185.00	$7.12–$175.75	133% above	40%
Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 GGT	$111.00	$185.00	$79.25–$2,315.52	—	40%
Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 GGTP(GAMMA GLUTAMYL TRANSF)	$111.00	$185.00	$79.25–$2,315.52	—	40%
Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 GLUTAMYLTRANS GAMMA GGT P3896	$111.00	$185.00	$79.25–$2,315.52	—	40%
Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 GLUTAMYLTRANSFERASE P9445	$111.00	$185.00	$79.25–$2,315.52	—	40%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GLUCOSE TEST 1HR POST GLUCOLA	$37.20	$62.00	$4.70–$58.90	at median	40%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 GLUCOSE TEST 1HR POST GLUCOLA	$37.20	$62.00	$26.56–$2,315.52	—	40%
Glucose tolerance test, 3 samples CPT 82951 GLUCOSE TOLERANCE 3 SPECIMENS	$199.80	$333.00	$12.72–$316.35	146% above	40%
Glucose tolerance test, 3 samples CPT 82951 TOLERANCE TST GTT 3 SPEC P0281	$199.80	$333.00	$12.72–$316.35	146% above	40%
Glucose tolerance test, 3 samples inpatient CPT 82951 TOLERANCE TST GTT 3 SPEC P0281	$199.80	$333.00	$142.66–$2,315.52	—	40%
Glucose tolerance test, 3 samples inpatient CPT 82951 GLUCOSE TOLERANCE 3 SPECIMENS	$199.80	$333.00	$142.66–$2,315.52	—	40%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 NEISSERIA GONORRHOEAE PCR ONLY	$276.00	$460.00	$25.51–$437.00	50% above	40%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 N GONORRHOEAE AMPL PROBE P1815	$276.00	$460.00	$25.51–$437.00	50% above	40%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 NEISSERIA GONORRHOEAE P3680	$276.00	$460.00	$25.51–$437.00	50% above	40%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 NEISERIA GONORRHOEAE P9043	$276.00	$460.00	$25.51–$437.00	50% above	40%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 N GONORRHOEAE TMA UROGENITAL	$276.00	$460.00	$25.51–$437.00	50% above	40%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 NEISSRIA GONOR AMP PROBE P9292	$276.00	$460.00	$25.51–$437.00	50% above	40%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 NEISSERIA GONORRHOEAE P4224	$276.00	$460.00	$25.51–$437.00	50% above	40%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 N GONORRHOEAE DNA AMP PR P4792	$276.00	$460.00	$25.51–$437.00	50% above	40%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 N GONORRHOEAE TMA UROGENITAL	$276.00	$460.00	$197.06–$2,315.52	—	40%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 NEISSERIA GONORRHOEAE PCR ONLY	$276.00	$460.00	$197.06–$2,315.52	—	40%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 NEISSERIA GONORRHOEAE P4224	$276.00	$460.00	$197.06–$2,315.52	—	40%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 NEISERIA GONORRHOEAE P9043	$276.00	$460.00	$197.06–$2,315.52	—	40%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 NEISSRIA GONOR AMP PROBE P9292	$276.00	$460.00	$197.06–$2,315.52	—	40%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 NEISSERIA GONORRHOEAE P3680	$276.00	$460.00	$197.06–$2,315.52	—	40%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 N GONORRHOEAE AMPL PROBE P1815	$276.00	$460.00	$197.06–$2,315.52	—	40%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 N GONORRHOEAE DNA AMP PR P4792	$276.00	$460.00	$197.06–$2,315.52	—	40%
H. pylori stool antigen test CPT 87338 ANTIGEN QUALITATIVE STOOL	$166.80	$278.00	$11.23–$264.10	73% above	40%
H. pylori stool antigen test inpatient CPT 87338 ANTIGEN QUALITATIVE STOOL	$166.80	$278.00	$119.10–$2,315.52	—	40%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV-1 RNA/QUANT/REAL-TIME PCR	$1,066.20	$1,777.00	$84.10–$1,688.15	115% above	40%
HIV viral load test (HIV-1 RNA, quantitative) one side CPT 87536 HIV-1 RNA QN RT-PCR RFX IN GN	$1,066.20	$1,777.00	$84.10–$1,688.15	115% above	40%
HIV viral load test (HIV-1 RNA, quantitative) one side CPT 87536 QUANT HIV-1 RT-PCR	$1,066.20	$1,777.00	$84.10–$1,688.15	115% above	40%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HIV-1 RNA/QUANT/REAL-TIME PCR	$1,066.20	$1,777.00	$761.27–$2,315.52	—	40%
HIV viral load test (HIV-1 RNA, quantitative) inpatient one side CPT 87536 QUANT HIV-1 RT-PCR	$1,066.20	$1,777.00	$761.27–$2,315.52	—	40%
HIV viral load test (HIV-1 RNA, quantitative) inpatient one side CPT 87536 HIV-1 RNA QN RT-PCR RFX IN GN	$1,066.20	$1,777.00	$761.27–$2,315.52	—	40%
HIV-1 and HIV-2 antibody test CPT 86703 DONOR HIV-1/2 AB SCREEN	$200.40	$334.00	$13.54–$317.30	94% above	40%
HIV-1 and HIV-2 antibody test inpatient CPT 86703 DONOR HIV-1/2 AB SCREEN	$200.40	$334.00	$143.09–$2,315.52	—	40%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV 1/HIV 2 ANTIBODY	$226.20	$377.00	$23.80–$358.15	60% above	40%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV AG/AB 5TH GENERATION	$226.20	$377.00	$23.80–$358.15	60% above	40%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV 1/2 AG/AB 4TH GEN W/RFX	$226.20	$377.00	$23.80–$358.15	60% above	40%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HIV 1/2 AG/AB 4TH GEN W/RFX	$226.20	$377.00	$161.51–$2,315.52	—	40%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HIV 1/HIV 2 ANTIBODY	$226.20	$377.00	$161.51–$2,315.52	—	40%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HIV AG/AB 5TH GENERATION	$226.20	$377.00	$161.51–$2,315.52	—	40%
HPV test for high-risk types, one combined (pooled) result CPT 87624 HPV HIGH RISK TYPES	$222.00	$370.00	$34.68–$351.50	7% above	40%
HPV test for high-risk types, one combined (pooled) result CPT 87624 HPV MRNA E6/E7 SUREPATH VIAL	$325.20	$542.00	$34.68–$514.90	56% above	40%
HPV test for high-risk types, one combined (pooled) result CPT 87624 HPV MRNA E6/E7 RFX TO GENOTYP	$325.20	$542.00	$34.68–$514.90	56% above	40%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HPV HIGH RISK TYPES	$222.00	$370.00	$158.51–$2,315.52	—	40%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HPV MRNA E6/E7 RFX TO GENOTYP	$325.20	$542.00	$232.19–$2,315.52	—	40%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HPV MRNA E6/E7 SUREPATH VIAL	$325.20	$542.00	$232.19–$2,315.52	—	40%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HEMOGLOBIN A1C WITH EAG	$165.60	$276.00	$7.70–$262.20	225% above	40%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HEMOGLO A1C W/RFX TO GLYCOMARK	$165.60	$276.00	$7.70–$262.20	225% above	40%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HEMOGLBN A1C&MEAN PLASMA GLUCO	$165.60	$276.00	$7.70–$262.20	225% above	40%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HEMOGLOBIN GLYCOSYLATED	$165.60	$276.00	$7.70–$262.20	225% above	40%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HEMOGLOBIN A1C	$165.60	$276.00	$7.70–$262.20	225% above	40%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HEMOGLBN A1C&MEAN PLASMA GLUCO	$165.60	$276.00	$118.24–$2,315.52	—	40%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HEMOGLOBIN GLYCOSYLATED	$165.60	$276.00	$118.24–$2,315.52	—	40%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HEMOGLOBIN A1C WITH EAG	$165.60	$276.00	$118.24–$2,315.52	—	40%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HEMOGLOBIN A1C	$165.60	$276.00	$118.24–$2,315.52	—	40%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HEMOGLO A1C W/RFX TO GLYCOMARK	$165.60	$276.00	$118.24–$2,315.52	—	40%
Hemoglobin blood test CPT 85018 HEMOGLOBIN	$45.60	$76.00	$2.35–$72.20	166% above	40%
Hemoglobin blood test CPT 85018 HEMOGLOBIN P9262	$45.60	$76.00	$2.35–$72.20	166% above	40%
Hemoglobin blood test CPT 85018 HEMOGLOBIN P0581	$45.60	$76.00	$2.35–$72.20	166% above	40%
Hemoglobin blood test CPT 85018 HEMOGLOBIN WHOLE BLOOD	$45.60	$76.00	$2.35–$72.20	166% above	40%
Hemoglobin blood test inpatient CPT 85018 HEMOGLOBIN WHOLE BLOOD	$45.60	$76.00	$32.56–$2,315.52	—	40%
Hemoglobin blood test inpatient CPT 85018 HEMOGLOBIN	$45.60	$76.00	$32.56–$2,315.52	—	40%
Hemoglobin blood test inpatient CPT 85018 HEMOGLOBIN P0581	$45.60	$76.00	$32.56–$2,315.52	—	40%
Hemoglobin blood test inpatient CPT 85018 HEMOGLOBIN P9262	$45.60	$76.00	$32.56–$2,315.52	—	40%
Hepatitis B core antibody test (total) CPT 86704 HEP B CORE ANTIBODY IGG+IGM	$455.40	$759.00	$11.91–$721.05	440% above	40%
Hepatitis B core antibody test (total) CPT 86704 HEPATITIS B CORE AB TOT W/REFL	$455.40	$759.00	$11.91–$721.05	440% above	40%
Hepatitis B core antibody test (total) CPT 86704 HEP B CORE ANTIBODY TOTAL	$455.40	$759.00	$11.91–$721.05	440% above	40%
Hepatitis B core antibody test (total) CPT 86704 HEPATITIS B CORE AB P4933	$455.40	$759.00	$11.91–$721.05	440% above	40%
Hepatitis B core antibody test (total) CPT 86704 HEPATITIS B CORE ANTIBODY	$455.40	$759.00	$11.91–$721.05	440% above	40%
Hepatitis B core antibody test (total) CPT 86704 HEPATITIS B CORE AB P9276	$455.40	$759.00	$11.91–$721.05	440% above	40%
Hepatitis B core antibody test (total) CPT 86704 HEP B CORE AB TOTAL P5760	$455.40	$759.00	$11.91–$721.05	440% above	40%
Hepatitis B core antibody test (total) inpatient CPT 86704 HEPATITIS B CORE AB TOT W/REFL	$455.40	$759.00	$325.16–$2,315.52	—	40%
Hepatitis B core antibody test (total) inpatient CPT 86704 HEPATITIS B CORE ANTIBODY	$455.40	$759.00	$325.16–$2,315.52	—	40%
Hepatitis B core antibody test (total) inpatient CPT 86704 HEP B CORE ANTIBODY IGG+IGM	$455.40	$759.00	$325.16–$2,315.52	—	40%
Hepatitis B core antibody test (total) inpatient CPT 86704 HEPATITIS B CORE AB P4933	$455.40	$759.00	$325.16–$2,315.52	—	40%
Hepatitis B core antibody test (total) inpatient CPT 86704 HEPATITIS B CORE AB P9276	$455.40	$759.00	$325.16–$2,315.52	—	40%
Hepatitis B core antibody test (total) inpatient CPT 86704 HEP B CORE ANTIBODY TOTAL	$455.40	$759.00	$325.16–$2,315.52	—	40%
Hepatitis B core antibody test (total) inpatient CPT 86704 HEP B CORE AB TOTAL P5760	$455.40	$759.00	$325.16–$2,315.52	—	40%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEPATITIS B SURFACE AB P9276	$137.40	$229.00	$10.62–$217.55	88% above	40%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEP B SURFACE ANTIBODY (EIA)	$137.40	$229.00	$10.62–$217.55	88% above	40%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEP B SURFACE AB P5760	$137.40	$229.00	$10.62–$217.55	88% above	40%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEPATITIS B SURFACE ANTIBODY	$137.40	$229.00	$10.62–$217.55	88% above	40%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEP B SURFACE AB	$137.40	$229.00	$10.62–$217.55	88% above	40%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HEPATITIS B SURFACE AB P9276	$137.40	$229.00	$98.10–$2,315.52	—	40%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HEP B SURFACE AB	$137.40	$229.00	$98.10–$2,315.52	—	40%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HEP B SURFACE AB P5760	$137.40	$229.00	$98.10–$2,315.52	—	40%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HEP B SURFACE ANTIBODY (EIA)	$137.40	$229.00	$98.10–$2,315.52	—	40%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HEPATITIS B SURFACE ANTIBODY	$137.40	$229.00	$98.10–$2,315.52	—	40%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HEPATITIS B SURFACE AG	$723.60	$1,206.00	$10.21–$1,145.70	940% above	40%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HEP B SURFACE ANTIGEN W/ REFLX	$723.60	$1,206.00	$10.21–$1,145.70	940% above	40%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HEPATITIS B SURFACE AG P9276	$723.60	$1,206.00	$10.21–$1,145.70	940% above	40%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HEPATITIS B SURFACE ANTIGEN	$723.60	$1,206.00	$10.21–$1,145.70	940% above	40%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HEPATITIS B SURFACE ANTIGEN	$723.60	$1,206.00	$516.65–$2,315.52	—	40%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HEP B SURFACE ANTIGEN W/ REFLX	$723.60	$1,206.00	$516.65–$2,315.52	—	40%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HEPATITIS B SURFACE AG	$723.60	$1,206.00	$516.65–$2,315.52	—	40%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HEPATITIS B SURFACE AG P9276	$723.60	$1,206.00	$516.65–$2,315.52	—	40%
Hepatitis C antibody blood test (screening) CPT 86803 HEPATITIS C ANTIBODY	$279.60	$466.00	$14.10–$442.70	181% above	40%
Hepatitis C antibody blood test (screening) CPT 86803 HEPC AB RF HCV RNA PCR RF LIPA	$279.60	$466.00	$14.10–$442.70	181% above	40%
Hepatitis C antibody blood test (screening) CPT 86803 HEPATITIS C AB P9276	$279.60	$466.00	$14.10–$442.70	181% above	40%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 HEPATITIS C AB P9276	$279.60	$466.00	$199.63–$2,315.52	—	40%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 HEPC AB RF HCV RNA PCR RF LIPA	$279.60	$466.00	$199.63–$2,315.52	—	40%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 HEPATITIS C ANTIBODY	$279.60	$466.00	$199.63–$2,315.52	—	40%
Hepatitis C viral load (HCV RNA) test CPT 87522 HCV RNA QN PCR W/RFL GENOTYPE	$778.80	$1,298.00	$42.34–$1,233.10	174% above	40%
Hepatitis C viral load (HCV RNA) test CPT 87522 HEPATITIS C RNA BY PCR (QUANT)	$778.80	$1,298.00	$42.34–$1,233.10	174% above	40%
Hepatitis C viral load (HCV RNA) test CPT 87522 HCV RNA QN RL TME PCR W/RFX QL	$778.80	$1,298.00	$42.34–$1,233.10	174% above	40%
Hepatitis C viral load (HCV RNA) test one side CPT 87522 HEP C VIR RNA QN RT-PCR W/RFX	$778.80	$1,298.00	$42.34–$1,233.10	174% above	40%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HEPATITIS C RNA BY PCR (QUANT)	$778.80	$1,298.00	$556.06–$2,315.52	—	40%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HCV RNA QN PCR W/RFL GENOTYPE	$778.80	$1,298.00	$556.06–$2,315.52	—	40%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HCV RNA QN RL TME PCR W/RFX QL	$778.80	$1,298.00	$556.06–$2,315.52	—	40%
Hepatitis C viral load (HCV RNA) test inpatient one side CPT 87522 HEP C VIR RNA QN RT-PCR W/RFX	$778.80	$1,298.00	$556.06–$2,315.52	—	40%
Herpes blood test, HSV-1 antibody CPT 86695 HSV-1 IGG AB	$271.80	$453.00	$13.03–$430.35	240% above	40%
Herpes blood test, HSV-1 antibody CPT 86695 HSV TYPE I P5909	$271.80	$453.00	$13.03–$430.35	240% above	40%
Herpes blood test, HSV-1 antibody CPT 86695 HSV TYPE 1 IGG AB P0086	$271.80	$453.00	$13.03–$430.35	240% above	40%
Herpes blood test, HSV-1 antibody CPT 86695 HERPES SIMPLEX TYPE 1 P3731	$271.80	$453.00	$13.03–$430.35	240% above	40%
Herpes blood test, HSV-1 antibody CPT 86695 HERPES SIMPLEX TYPE 1 P3497	$271.80	$453.00	$13.03–$430.35	240% above	40%
Herpes blood test, HSV-1 antibody CPT 86695 HERPES SIMPLEX TYPE 1 P3301	$271.80	$453.00	$13.03–$430.35	240% above	40%
Herpes blood test, HSV-1 antibody CPT 86695 HERPES SIMPLEX AB IGM	$271.80	$453.00	$13.03–$430.35	240% above	40%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 HSV TYPE I P5909	$271.80	$453.00	$194.07–$2,315.52	—	40%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 HSV-1 IGG AB	$271.80	$453.00	$194.07–$2,315.52	—	40%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 HERPES SIMPLEX TYPE 1 P3497	$271.80	$453.00	$194.07–$2,315.52	—	40%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 HERPES SIMPLEX AB IGM	$271.80	$453.00	$194.07–$2,315.52	—	40%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 HERPES SIMPLEX TYPE 1 P3301	$271.80	$453.00	$194.07–$2,315.52	—	40%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 HERPES SIMPLEX TYPE 1 P3731	$271.80	$453.00	$194.07–$2,315.52	—	40%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 HSV TYPE 1 IGG AB P0086	$271.80	$453.00	$194.07–$2,315.52	—	40%
Herpes blood test, HSV-2 antibody CPT 86696 HSV TYPE 2 P5909	$91.80	$153.00	$19.13–$145.35	15% below	40%
Herpes blood test, HSV-2 antibody CPT 86696 HSV-2 IGG AB	$91.80	$153.00	$19.13–$145.35	15% below	40%
Herpes blood test, HSV-2 antibody CPT 86696 HSV TYPE 2 IGG AB P0086	$91.80	$153.00	$19.13–$145.35	15% below	40%
Herpes blood test, HSV-2 antibody CPT 86696 HERPES SIMPLEX TYPE 2 P3731	$91.80	$153.00	$19.13–$145.35	15% below	40%
Herpes blood test, HSV-2 antibody CPT 86696 HERPES SIMPLEX TYPE 2 P3497	$91.80	$153.00	$19.13–$145.35	15% below	40%
Herpes blood test, HSV-2 antibody CPT 86696 HERPES SIMPLEX TYPE 2 P3301	$91.80	$153.00	$19.13–$145.35	15% below	40%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HSV-2 IGG AB	$91.80	$153.00	$65.55–$2,315.52	—	40%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HSV TYPE 2 P5909	$91.80	$153.00	$65.55–$2,315.52	—	40%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HSV TYPE 2 IGG AB P0086	$91.80	$153.00	$65.55–$2,315.52	—	40%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HERPES SIMPLEX TYPE 2 P3497	$91.80	$153.00	$65.55–$2,315.52	—	40%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HERPES SIMPLEX TYPE 2 P3731	$91.80	$153.00	$65.55–$2,315.52	—	40%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HERPES SIMPLEX TYPE 2 P3301	$91.80	$153.00	$65.55–$2,315.52	—	40%
High-sensitivity CRP (hs-CRP) test CPT 86141 CRP HIGH SENSITIVITY	$452.40	$754.00	$11.58–$716.30	476% above	40%
High-sensitivity CRP (hs-CRP) test CPT 86141 CARDIO CRP (QUANTATATIVE CRP)	$452.40	$754.00	$11.58–$716.30	476% above	40%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 CRP HIGH SENSITIVITY	$452.40	$754.00	$323.01–$2,315.52	—	40%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 CARDIO CRP (QUANTATATIVE CRP)	$452.40	$754.00	$323.01–$2,315.52	—	40%
Homocysteine blood test CPT 83090 HOMOCYSTINE SERUM	$301.80	$503.00	$17.71–$477.85	152% above	40%
Homocysteine blood test CPT 83090 HOMOCYSTEINE TOTAL URINE	$301.80	$503.00	$17.71–$477.85	152% above	40%
Homocysteine blood test CPT 83090 HOMOCYSTEINE NUTR/CONGNT P8743	$301.80	$503.00	$17.71–$477.85	152% above	40%
Homocysteine blood test inpatient CPT 83090 HOMOCYSTEINE TOTAL URINE	$301.80	$503.00	$215.49–$2,315.52	—	40%
Homocysteine blood test inpatient CPT 83090 HOMOCYSTEINE NUTR/CONGNT P8743	$301.80	$503.00	$215.49–$2,315.52	—	40%
Homocysteine blood test inpatient CPT 83090 HOMOCYSTINE SERUM	$301.80	$503.00	$215.49–$2,315.52	—	40%
Insulin blood test CPT 83525 INSULIN LEVEL SINGLE	$165.60	$276.00	$11.30–$262.20	128% above	40%
Insulin blood test CPT 83525 INSULIN	$165.60	$276.00	$11.30–$262.20	128% above	40%
Insulin blood test inpatient CPT 83525 INSULIN	$165.60	$276.00	$118.24–$2,315.52	—	40%
Insulin blood test inpatient CPT 83525 INSULIN LEVEL SINGLE	$165.60	$276.00	$118.24–$2,315.52	—	40%
Iron blood test (serum iron) CPT 83540 IRON P6970	$45.60	$76.00	$6.39–$72.20	at median	40%
Iron blood test (serum iron) CPT 83540 FE	$48.00	$80.00	$6.39–$76.00	5% above	40%
Iron blood test (serum iron) CPT 83540 IRON PNL 1160	$48.00	$80.00	$6.39–$76.00	5% above	40%
Iron blood test (serum iron) CPT 83540 IRON (X)	$48.00	$80.00	$6.39–$76.00	5% above	40%
Iron blood test (serum iron) CPT 83540 IRON URINE PNL	$48.00	$80.00	$6.39–$76.00	5% above	40%
Iron blood test (serum iron) inpatient CPT 83540 IRON P6970	$45.60	$76.00	$32.56–$2,315.52	—	40%
Iron blood test (serum iron) inpatient CPT 83540 FE	$48.00	$80.00	$34.27–$2,315.52	—	40%
Iron blood test (serum iron) inpatient CPT 83540 IRON URINE PNL	$48.00	$80.00	$34.27–$2,315.52	—	40%
Iron blood test (serum iron) inpatient CPT 83540 IRON (X)	$48.00	$80.00	$34.27–$2,315.52	—	40%
Iron blood test (serum iron) inpatient CPT 83540 IRON PNL 1160	$48.00	$80.00	$34.27–$2,315.52	—	40%
Iron-binding capacity (TIBC) test CPT 83550 TIBC PNL 1160	$100.80	$168.00	$5.50–$159.60	69% above	40%
Iron-binding capacity (TIBC) test inpatient CPT 83550 TIBC PNL 1160	$100.80	$168.00	$71.97–$2,315.52	—	40%
Kidney function blood test panel CPT 80069 RENAL FUNCTION PANEL	$156.00	$260.00	$8.58–$247.00	128% above	40%
Kidney function blood test panel inpatient CPT 80069 RENAL FUNCTION PANEL	$156.00	$260.00	$111.38–$2,315.52	—	40%
LH (luteinizing hormone) test CPT 83002 LH	$255.60	$426.00	$18.31–$404.70	114% above	40%
LH (luteinizing hormone) test CPT 83002 LH 3RD GENERATION	$255.60	$426.00	$18.31–$404.70	114% above	40%
LH (luteinizing hormone) test CPT 83002 LH/3RD GENERATION PNL 2828	$255.60	$426.00	$18.31–$404.70	114% above	40%
LH (luteinizing hormone) test CPT 83002 LUTENIZING HORMONE	$255.60	$426.00	$18.31–$404.70	114% above	40%
LH (luteinizing hormone) test inpatient CPT 83002 LH 3RD GENERATION	$255.60	$426.00	$182.50–$2,315.52	—	40%
LH (luteinizing hormone) test inpatient CPT 83002 LH/3RD GENERATION PNL 2828	$255.60	$426.00	$182.50–$2,315.52	—	40%
LH (luteinizing hormone) test inpatient CPT 83002 LUTENIZING HORMONE	$255.60	$426.00	$182.50–$2,315.52	—	40%
LH (luteinizing hormone) test inpatient CPT 83002 LH	$255.60	$426.00	$182.50–$2,315.52	—	40%
Lactate (lactic acid) blood test CPT 83605 LACTATE WHOLE BLOOD STAT ICU	$121.80	$203.00	$8.80–$192.85	59% above	40%
Lactate (lactic acid) blood test CPT 83605 LACTATE-ER ONLY	$121.80	$203.00	$8.80–$192.85	59% above	40%
Lactate (lactic acid) blood test CPT 83605 LACTIA/LACTIV	$121.80	$203.00	$8.80–$192.85	59% above	40%
Lactate (lactic acid) blood test CPT 83605 LACTIC ACID	$121.80	$203.00	$8.80–$192.85	59% above	40%
Lactate (lactic acid) blood test CPT 83605 LACTIC ACID PNL	$121.80	$203.00	$8.80–$192.85	59% above	40%
Lactate (lactic acid) blood test CPT 83605 ISTAT LACTATE	$121.80	$203.00	$8.80–$192.85	59% above	40%
Lactate (lactic acid) blood test inpatient CPT 83605 LACTIC ACID PNL	$121.80	$203.00	$86.97–$2,315.52	—	40%
Lactate (lactic acid) blood test inpatient CPT 83605 LACTATE-ER ONLY	$121.80	$203.00	$86.97–$2,315.52	—	40%
Lactate (lactic acid) blood test inpatient CPT 83605 ISTAT LACTATE	$121.80	$203.00	$86.97–$2,315.52	—	40%
Lactate (lactic acid) blood test inpatient CPT 83605 LACTIC ACID	$121.80	$203.00	$86.97–$2,315.52	—	40%
Lactate (lactic acid) blood test inpatient CPT 83605 LACTATE WHOLE BLOOD STAT ICU	$121.80	$203.00	$86.97–$2,315.52	—	40%
Lactate (lactic acid) blood test inpatient CPT 83605 LACTIA/LACTIV	$121.80	$203.00	$86.97–$2,315.52	—	40%
Lactate dehydrogenase (LDH) blood test CPT 83615 LDH-LACTIC DEHYDROGENASE	$42.60	$71.00	$5.98–$67.45	16% above	40%
Lactate dehydrogenase (LDH) blood test CPT 83615 LD SYNOVIAL FLUID	$42.60	$71.00	$5.98–$67.45	16% above	40%
Lactate dehydrogenase (LDH) blood test CPT 83615 LD CSF	$42.60	$71.00	$5.98–$67.45	16% above	40%
Lactate dehydrogenase (LDH) blood test CPT 83615 LACTATE DEHYDROGENASE	$42.60	$71.00	$5.98–$67.45	16% above	40%
Lactate dehydrogenase (LDH) blood test CPT 83615 TOTAL LD PNL 1900	$42.60	$71.00	$5.98–$67.45	16% above	40%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 TOTAL LD PNL 1900	$42.60	$71.00	$30.42–$2,315.52	—	40%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 LDH-LACTIC DEHYDROGENASE	$42.60	$71.00	$30.42–$2,315.52	—	40%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 LD CSF	$42.60	$71.00	$30.42–$2,315.52	—	40%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 LACTATE DEHYDROGENASE	$42.60	$71.00	$30.42–$2,315.52	—	40%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 LD SYNOVIAL FLUID	$42.60	$71.00	$30.42–$2,315.52	—	40%
Lipase blood test (pancreas enzyme) CPT 83690 LIPASE PLEURAL FLUID	$139.80	$233.00	$5.50–$221.35	198% above	40%
Lipase blood test (pancreas enzyme) CPT 83690 LIPASE	$139.80	$233.00	$5.50–$221.35	198% above	40%
Lipase blood test (pancreas enzyme) CPT 83690 LIPASE PERITONEAL FLUID	$139.80	$233.00	$5.50–$221.35	198% above	40%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 LIPASE PLEURAL FLUID	$139.80	$233.00	$99.82–$2,315.52	—	40%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 LIPASE	$139.80	$233.00	$99.82–$2,315.52	—	40%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 LIPASE PERITONEAL FLUID	$139.80	$233.00	$99.82–$2,315.52	—	40%
Liver function blood test panel CPT 80076 HEPATIC FUNCTION PANEL	$232.20	$387.00	$8.08–$367.65	197% above	40%
Liver function blood test panel inpatient CPT 80076 HEPATIC FUNCTION PANEL	$232.20	$387.00	$165.79–$2,315.52	—	40%
Lyme disease antibody test CPT 86618 LYME DIS AB W/RFLX TO IMMUNOA	$70.80	$118.00	$16.83–$112.10	25% below	40%
Lyme disease antibody test CPT 86618 BORRELIA BURGDORFERI P0913	$70.80	$118.00	$16.83–$112.10	25% below	40%
Lyme disease antibody test CPT 86618 BORRELIA BURGDORFERI P2435	$70.80	$118.00	$16.83–$112.10	25% below	40%
Lyme disease antibody test CPT 86618 BORRELIA BURGDORFERI P8139	$70.80	$118.00	$16.83–$112.10	25% below	40%
Lyme disease antibody test CPT 86618 LYME POLYV AIB SCREEN W/REF	$70.80	$118.00	$16.83–$112.10	25% below	40%
Lyme disease antibody test inpatient CPT 86618 BORRELIA BURGDORFERI P0913	$70.80	$118.00	$50.55–$2,315.52	—	40%
Lyme disease antibody test inpatient CPT 86618 LYME POLYV AIB SCREEN W/REF	$70.80	$118.00	$50.55–$2,315.52	—	40%
Lyme disease antibody test inpatient CPT 86618 LYME DIS AB W/RFLX TO IMMUNOA	$70.80	$118.00	$50.55–$2,315.52	—	40%
Lyme disease antibody test inpatient CPT 86618 BORRELIA BURGDORFERI P8139	$70.80	$118.00	$50.55–$2,315.52	—	40%
Lyme disease antibody test inpatient CPT 86618 BORRELIA BURGDORFERI P2435	$70.80	$118.00	$50.55–$2,315.52	—	40%
Magnesium blood test CPT 83735 MAGNESIUM P6970	$118.80	$198.00	$6.62–$188.10	186% above	40%
Magnesium blood test CPT 83735 MAGNESIUM	$124.80	$208.00	$6.62–$197.60	200% above	40%
Magnesium blood test CPT 83735 MAGNESIUM P7923	$124.80	$208.00	$6.62–$197.60	200% above	40%
Magnesium blood test CPT 83735 MAGNESIUM - 24HR URINE	$124.80	$208.00	$6.62–$197.60	200% above	40%
Magnesium blood test CPT 83735 MAGNESIUM RBC	$124.80	$208.00	$6.62–$197.60	200% above	40%
Magnesium blood test inpatient CPT 83735 MAGNESIUM P6970	$118.80	$198.00	$84.82–$2,315.52	—	40%
Magnesium blood test inpatient CPT 83735 MAGNESIUM	$124.80	$208.00	$89.11–$2,315.52	—	40%
Magnesium blood test inpatient CPT 83735 MAGNESIUM P7923	$124.80	$208.00	$89.11–$2,315.52	—	40%
Magnesium blood test inpatient CPT 83735 MAGNESIUM - 24HR URINE	$124.80	$208.00	$89.11–$2,315.52	—	40%
Magnesium blood test inpatient CPT 83735 MAGNESIUM RBC	$124.80	$208.00	$89.11–$2,315.52	—	40%
Measles (rubeola) antibody test CPT 86765 MEASLES ANTIBODY (IGG)	$219.60	$366.00	$12.73–$347.70	172% above	40%
Measles (rubeola) antibody test CPT 86765 RUBEOLA P7969	$219.60	$366.00	$12.73–$347.70	172% above	40%
Measles (rubeola) antibody test CPT 86765 RUBEOLA P3261	$219.60	$366.00	$12.73–$347.70	172% above	40%
Measles (rubeola) antibody test inpatient CPT 86765 MEASLES ANTIBODY (IGG)	$219.60	$366.00	$156.79–$2,315.52	—	40%
Measles (rubeola) antibody test inpatient CPT 86765 RUBEOLA P7969	$219.60	$366.00	$156.79–$2,315.52	—	40%
Measles (rubeola) antibody test inpatient CPT 86765 RUBEOLA P3261	$219.60	$366.00	$156.79–$2,315.52	—	40%
Mono test (heterophile antibody, Monospot) CPT 86308 MONOSPOT	$56.40	$94.00	$5.12–$89.30	52% above	40%
Mono test (heterophile antibody, Monospot) CPT 86308 MONOTEST (HETEROPHILE SCREEN)	$56.40	$94.00	$5.12–$89.30	52% above	40%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 MONOSPOT	$56.40	$94.00	$40.27–$2,315.52	—	40%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 MONOTEST (HETEROPHILE SCREEN)	$56.40	$94.00	$40.27–$2,315.52	—	40%
Mumps immunity blood test CPT 86735 MUMPS AB (IGG/M) PANEL	$285.60	$476.00	$10.19–$452.20	251% above	40%
Mumps immunity blood test CPT 86735 MUMPS P3261	$285.60	$476.00	$10.19–$452.20	251% above	40%
Mumps immunity blood test CPT 86735 MUMPS IGG	$285.60	$476.00	$10.19–$452.20	251% above	40%
Mumps immunity blood test CPT 86735 MUMPS ANTIBODY - IGG	$285.60	$476.00	$10.19–$452.20	251% above	40%
Mumps immunity blood test inpatient CPT 86735 MUMPS P3261	$285.60	$476.00	$203.92–$2,315.52	—	40%
Mumps immunity blood test inpatient CPT 86735 MUMPS IGG	$285.60	$476.00	$203.92–$2,315.52	—	40%
Mumps immunity blood test inpatient CPT 86735 MUMPS AB (IGG/M) PANEL	$285.60	$476.00	$203.92–$2,315.52	—	40%
Mumps immunity blood test inpatient CPT 86735 MUMPS ANTIBODY - IGG	$285.60	$476.00	$203.92–$2,315.52	—	40%
Obstetric blood test panel CPT 80055 OBSTETRICS PANEL	$228.00	$380.00	$13.20–$361.00	27% below	40%
Obstetric blood test panel inpatient CPT 80055 OBSTETRICS PANEL	$228.00	$380.00	$162.79–$2,315.52	—	40%
PSA (prostate-specific antigen) blood test, free CPT 84154 FREE PSA	$421.20	$702.00	$18.17–$666.90	270% above	40%
PSA (prostate-specific antigen) blood test, free CPT 84154 FREE PSA PNL 2770	$421.20	$702.00	$18.17–$666.90	270% above	40%
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 FREE PSA PNL 2770	$421.20	$702.00	$300.74–$2,315.52	—	40%
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 FREE PSA	$421.20	$702.00	$300.74–$2,315.52	—	40%
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA POST-PROSTECTOMY HAMA	$208.20	$347.00	$18.17–$329.65	90% above	40%
PSA (prostate-specific antigen) blood test, total CPT 84153 DIAGNOSTIC PSA	$208.20	$347.00	$18.17–$329.65	90% above	40%
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA TOTAL REFLEX TO FREE PSA	$208.20	$347.00	$18.17–$329.65	90% above	40%
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA ULTRA-SENSITIVE	$208.20	$347.00	$18.17–$329.65	90% above	40%
PSA (prostate-specific antigen) blood test, total CPT 84153 TOTAL PSA PNL 2770	$208.20	$347.00	$18.17–$329.65	90% above	40%
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA DIAGNOSTIC	$208.20	$347.00	$18.17–$329.65	90% above	40%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 DIAGNOSTIC PSA	$208.20	$347.00	$148.65–$2,315.52	—	40%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA ULTRA-SENSITIVE	$208.20	$347.00	$148.65–$2,315.52	—	40%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA TOTAL REFLEX TO FREE PSA	$208.20	$347.00	$148.65–$2,315.52	—	40%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 TOTAL PSA PNL 2770	$208.20	$347.00	$148.65–$2,315.52	—	40%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA DIAGNOSTIC	$208.20	$347.00	$148.65–$2,315.52	—	40%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA POST-PROSTECTOMY HAMA	$208.20	$347.00	$148.65–$2,315.52	—	40%
Pap test (liquid-based, automated screening with review) CPT 88175 PAP SMEAR DX THIN W/RESCREEN	$82.20	$137.00	$20.55–$130.15	at median	40%
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 PAP SMEAR DX THIN W/RESCREEN	$82.20	$137.00	$58.69–$2,315.52	—	40%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 THIN PREP-DIAGNOSTIC	$64.20	$107.00	$16.05–$101.65	5% above	40%
Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 THIN PREP-DIAGNOSTIC	$64.20	$107.00	$45.84–$2,315.52	—	40%
Parathyroid hormone (PTH) blood test CPT 83970 INTACT PTH PNL 2511	$188.40	$314.00	$40.80–$298.30	14% below	40%
Parathyroid hormone (PTH) blood test CPT 83970 PARATHYROID HORMONE QUICK	$188.40	$314.00	$40.80–$298.30	14% below	40%
Parathyroid hormone (PTH) blood test CPT 83970 PARATHYROID HORMONE	$188.40	$314.00	$40.80–$298.30	14% below	40%
Parathyroid hormone (PTH) blood test CPT 83970 PARATHYROID HORMNE LV ASPIRATE	$188.40	$314.00	$40.80–$298.30	14% below	40%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 INTACT PTH PNL 2511	$188.40	$314.00	$134.52–$2,315.52	—	40%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 PARATHYROID HORMONE QUICK	$188.40	$314.00	$134.52–$2,315.52	—	40%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 PARATHYROID HORMONE	$188.40	$314.00	$134.52–$2,315.52	—	40%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 PARATHYROID HORMNE LV ASPIRATE	$188.40	$314.00	$134.52–$2,315.52	—	40%
Partial thromboplastin time (PTT) clotting test CPT 85730 ACT PART THROMBOP TIME P P7021	$105.60	$176.00	$5.94–$167.20	156% above	40%
Partial thromboplastin time (PTT) clotting test CPT 85730 PARTIAL THROMBOPLASTIN PL 2848	$423.00	$705.00	$5.94–$669.75	924% above	40%
Partial thromboplastin time (PTT) clotting test CPT 85730 THROMBOPLASTIN TIME P3417	$423.00	$705.00	$5.94–$669.75	924% above	40%
Partial thromboplastin time (PTT) clotting test CPT 85730 APTT (BASELINE) PNL 5464	$423.00	$705.00	$5.94–$669.75	924% above	40%
Partial thromboplastin time (PTT) clotting test CPT 85730 THROMBOPLASTIN TIME P0267	$423.00	$705.00	$5.94–$669.75	924% above	40%
Partial thromboplastin time (PTT) clotting test CPT 85730 THROMBOPL TIME PARTL(PTT)P2441	$423.00	$705.00	$5.94–$669.75	924% above	40%
Partial thromboplastin time (PTT) clotting test CPT 85730 THROMBOPLASTIN TIME P2635	$423.00	$705.00	$5.94–$669.75	924% above	40%
Partial thromboplastin time (PTT) clotting test CPT 85730 THROMBOPLASTIN TIME P3391	$423.00	$705.00	$5.94–$669.75	924% above	40%
Partial thromboplastin time (PTT) clotting test CPT 85730 ACTIVATED PTT	$423.00	$705.00	$5.94–$669.75	924% above	40%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 ACT PART THROMBOP TIME P P7021	$105.60	$176.00	$75.40–$2,315.52	—	40%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 THROMBOPLASTIN TIME P3417	$423.00	$705.00	$302.02–$2,315.52	—	40%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 APTT (BASELINE) PNL 5464	$423.00	$705.00	$302.02–$2,315.52	—	40%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PARTIAL THROMBOPLASTIN PL 2848	$423.00	$705.00	$302.02–$2,315.52	—	40%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 THROMBOPLASTIN TIME P3391	$423.00	$705.00	$302.02–$2,315.52	—	40%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 THROMBOPLASTIN TIME P0267	$423.00	$705.00	$302.02–$2,315.52	—	40%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 ACTIVATED PTT	$423.00	$705.00	$302.02–$2,315.52	—	40%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 THROMBOPLASTIN TIME P2635	$423.00	$705.00	$302.02–$2,315.52	—	40%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 THROMBOPL TIME PARTL(PTT)P2441	$423.00	$705.00	$302.02–$2,315.52	—	40%
Phosphorus (phosphate) blood test CPT 84100 PHOSPHORUS SERUM	$262.80	$438.00	$4.69–$416.10	708% above	40%
Phosphorus (phosphate) blood test inpatient CPT 84100 PHOSPHORUS SERUM	$262.80	$438.00	$187.64–$2,315.52	—	40%
Potassium blood test CPT 84132 POTASSIUM/RADIOMETER	$39.60	$66.00	$4.70–$62.70	24% above	40%
Potassium blood test CPT 84132 BLOOD GAS POTASSIUM	$39.60	$66.00	$4.70–$62.70	24% above	40%
Potassium blood test CPT 84132 POTASSIUM STAT ICU	$39.60	$66.00	$4.70–$62.70	24% above	40%
Potassium blood test CPT 84132 POTASSIUM SERUM	$39.60	$66.00	$4.70–$62.70	24% above	40%
Potassium blood test CPT 84132 POTASSIUM RBC	$39.60	$66.00	$4.70–$62.70	24% above	40%
Potassium blood test inpatient CPT 84132 POTASSIUM SERUM	$39.60	$66.00	$28.27–$2,315.52	—	40%
Potassium blood test inpatient CPT 84132 POTASSIUM/RADIOMETER	$39.60	$66.00	$28.27–$2,315.52	—	40%
Potassium blood test inpatient CPT 84132 POTASSIUM STAT ICU	$39.60	$66.00	$28.27–$2,315.52	—	40%
Potassium blood test inpatient CPT 84132 BLOOD GAS POTASSIUM	$39.60	$66.00	$28.27–$2,315.52	—	40%
Potassium blood test inpatient CPT 84132 POTASSIUM RBC	$39.60	$66.00	$28.27–$2,315.52	—	40%
Progesterone blood test CPT 84144 PROGESTERONE	$268.20	$447.00	$18.70–$424.65	95% above	40%
Progesterone blood test CPT 84144 PROGESTERONE LC/MS/MS	$268.20	$447.00	$18.70–$424.65	95% above	40%
Progesterone blood test CPT 84144 PROGESTERONE LEVEL	$268.20	$447.00	$18.70–$424.65	95% above	40%
Progesterone blood test inpatient CPT 84144 PROGESTERONE LEVEL	$268.20	$447.00	$191.49–$2,315.52	—	40%
Progesterone blood test inpatient CPT 84144 PROGESTERONE	$268.20	$447.00	$191.49–$2,315.52	—	40%
Progesterone blood test inpatient CPT 84144 PROGESTERONE LC/MS/MS	$268.20	$447.00	$191.49–$2,315.52	—	40%
Prolactin blood test CPT 84146 MACROPROLACTIN	$307.20	$512.00	$19.15–$486.40	146% above	40%
Prolactin blood test CPT 84146 PROLACTIN DILUTION STUDY	$307.20	$512.00	$19.15–$486.40	146% above	40%
Prolactin blood test CPT 84146 PROLACTIN	$307.20	$512.00	$19.15–$486.40	146% above	40%
Prolactin blood test inpatient CPT 84146 MACROPROLACTIN	$307.20	$512.00	$219.34–$2,315.52	—	40%
Prolactin blood test inpatient CPT 84146 PROLACTIN	$307.20	$512.00	$219.34–$2,315.52	—	40%
Prolactin blood test inpatient CPT 84146 PROLACTIN DILUTION STUDY	$307.20	$512.00	$219.34–$2,315.52	—	40%
Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME P P7021	$77.40	$129.00	$4.24–$122.55	172% above	40%
Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME PNL 2848	$77.40	$129.00	$4.24–$122.55	172% above	40%
Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME P2680	$77.40	$129.00	$4.24–$122.55	172% above	40%
Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME P2672	$77.40	$129.00	$4.24–$122.55	172% above	40%
Prothrombin time (PT/INR) clotting test CPT 85610 PT PROTHROMBIN TIME	$77.40	$129.00	$4.24–$122.55	172% above	40%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PT PROTHROMBIN TIME	$77.40	$129.00	$55.26–$2,315.52	—	40%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTHROMBIN TIME P P7021	$77.40	$129.00	$55.26–$2,315.52	—	40%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTHROMBIN TIME P2672	$77.40	$129.00	$55.26–$2,315.52	—	40%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTHROMBIN TIME P2680	$77.40	$129.00	$55.26–$2,315.52	—	40%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTHROMBIN TIME PNL 2848	$77.40	$129.00	$55.26–$2,315.52	—	40%
Rapid flu test (influenza antigen) CPT 87804 RAPID INFLUENZA A&B ANTIGEN	$379.20	$632.00	$12.48–$600.40	591% above	40%
Rapid flu test (influenza antigen) inpatient CPT 87804 RAPID INFLUENZA A&B ANTIGEN	$379.20	$632.00	$270.75–$2,315.52	—	40%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 STREP A DIRECT	$29.40	$49.00	$6.93–$46.55	54% below	40%
Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 STREP A DIRECT	$29.40	$49.00	$20.99–$2,315.52	—	40%
Renin blood test CPT 84244 RENIN P2402	$184.20	$307.00	$13.20–$291.65	27% above	40%
Renin blood test CPT 84244 RENIN ACTIVITY PLASMA	$184.20	$307.00	$13.20–$291.65	27% above	40%
Renin blood test inpatient CPT 84244 RENIN P2402	$184.20	$307.00	$131.52–$2,315.52	—	40%
Renin blood test inpatient CPT 84244 RENIN ACTIVITY PLASMA	$184.20	$307.00	$131.52–$2,315.52	—	40%
Rh blood typing CPT 86901 RH TYPING	$40.20	$67.00	$2.96–$63.65	29% below	40%
Rh blood typing inpatient CPT 86901 RH TYPING	$40.20	$67.00	$28.70–$2,315.52	—	40%
Rheumatoid factor (RF) test CPT 86431 QUANTITATIVE P4262	$141.60	$236.00	$5.61–$224.20	262% above	40%
Rheumatoid factor (RF) test CPT 86431 QUANTITATIVE P4307	$141.60	$236.00	$5.61–$224.20	262% above	40%
Rheumatoid factor (RF) test CPT 86431 QUANTITATIVE P4312	$141.60	$236.00	$5.61–$224.20	262% above	40%
Rheumatoid factor (RF) test CPT 86431 QUANTITATIVE P5091	$141.60	$236.00	$5.61–$224.20	262% above	40%
Rheumatoid factor (RF) test CPT 86431 QUANTITATIVE P5919	$141.60	$236.00	$5.61–$224.20	262% above	40%
Rheumatoid factor (RF) test CPT 86431 QUANTITATIVE P6842	$141.60	$236.00	$5.61–$224.20	262% above	40%
Rheumatoid factor (RF) test CPT 86431 QUANTITATIVE P8130	$141.60	$236.00	$5.61–$224.20	262% above	40%
Rheumatoid factor (RF) test CPT 86431 RF (RHEUMATOID FACTOR) IGA	$141.60	$236.00	$5.61–$224.20	262% above	40%
Rheumatoid factor (RF) test CPT 86431 RF (RHEUMATOID FACTOR) IGM	$141.60	$236.00	$5.61–$224.20	262% above	40%
Rheumatoid factor (RF) test CPT 86431 RHEUMATOID FACTOR BODY FLUID	$141.60	$236.00	$5.61–$224.20	262% above	40%
Rheumatoid factor (RF) test CPT 86431 RHEUMATOID FACTR(RA/RF FACTR)	$141.60	$236.00	$5.61–$224.20	262% above	40%
Rheumatoid factor (RF) test CPT 86431 RHEUMO FACT QUANT P3355	$141.60	$236.00	$5.61–$224.20	262% above	40%
Rheumatoid factor (RF) test CPT 86431 RHEUMATOID FACTOR QN P5076	$141.60	$236.00	$5.61–$224.20	262% above	40%
Rheumatoid factor (RF) test CPT 86431 RHEUMATOID FACTOR TITER QUANT	$141.60	$236.00	$5.61–$224.20	262% above	40%
Rheumatoid factor (RF) test inpatient CPT 86431 RHEUMATOID FACTR(RA/RF FACTR)	$141.60	$236.00	$101.10–$2,315.52	—	40%
Rheumatoid factor (RF) test inpatient CPT 86431 QUANTITATIVE P6842	$141.60	$236.00	$101.10–$2,315.52	—	40%
Rheumatoid factor (RF) test inpatient CPT 86431 QUANTITATIVE P5919	$141.60	$236.00	$101.10–$2,315.52	—	40%
Rheumatoid factor (RF) test inpatient CPT 86431 QUANTITATIVE P5091	$141.60	$236.00	$101.10–$2,315.52	—	40%
Rheumatoid factor (RF) test inpatient CPT 86431 QUANTITATIVE P4312	$141.60	$236.00	$101.10–$2,315.52	—	40%
Rheumatoid factor (RF) test inpatient CPT 86431 QUANTITATIVE P8130	$141.60	$236.00	$101.10–$2,315.52	—	40%
Rheumatoid factor (RF) test inpatient CPT 86431 RF (RHEUMATOID FACTOR) IGA	$141.60	$236.00	$101.10–$2,315.52	—	40%
Rheumatoid factor (RF) test inpatient CPT 86431 RF (RHEUMATOID FACTOR) IGM	$141.60	$236.00	$101.10–$2,315.52	—	40%
Rheumatoid factor (RF) test inpatient CPT 86431 RHEUMATOID FACTOR BODY FLUID	$141.60	$236.00	$101.10–$2,315.52	—	40%
Rheumatoid factor (RF) test inpatient CPT 86431 RHEUMO FACT QUANT P3355	$141.60	$236.00	$101.10–$2,315.52	—	40%
Rheumatoid factor (RF) test inpatient CPT 86431 RHEUMATOID FACTOR TITER QUANT	$141.60	$236.00	$101.10–$2,315.52	—	40%
Rheumatoid factor (RF) test inpatient CPT 86431 RHEUMATOID FACTOR QN P5076	$141.60	$236.00	$101.10–$2,315.52	—	40%
Rheumatoid factor (RF) test inpatient CPT 86431 QUANTITATIVE P4307	$141.60	$236.00	$101.10–$2,315.52	—	40%
Rheumatoid factor (RF) test inpatient CPT 86431 QUANTITATIVE P4262	$141.60	$236.00	$101.10–$2,315.52	—	40%
Rubella antibody test (immunity check) CPT 86762 RUBELLA ANTIBODY - IGG	$130.20	$217.00	$14.22–$206.15	54% above	40%
Rubella antibody test (immunity check) CPT 86762 SCREEN RUBELLA AB IGG	$130.20	$217.00	$14.22–$206.15	54% above	40%
Rubella antibody test (immunity check) CPT 86762 RUBELLA AB(IGG IGM) DIAGNOSTIC	$130.20	$217.00	$14.22–$206.15	54% above	40%
Rubella antibody test (immunity check) CPT 86762 RUBELLA P3261	$130.20	$217.00	$14.22–$206.15	54% above	40%
Rubella antibody test (immunity check) inpatient CPT 86762 SCREEN RUBELLA AB IGG	$130.20	$217.00	$92.96–$2,315.52	—	40%
Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA AB(IGG IGM) DIAGNOSTIC	$130.20	$217.00	$92.96–$2,315.52	—	40%
Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA ANTIBODY - IGG	$130.20	$217.00	$92.96–$2,315.52	—	40%
Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA P3261	$130.20	$217.00	$92.96–$2,315.52	—	40%
Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 SED RATE AUTOMATED	$57.00	$95.00	$2.67–$90.25	164% above	40%
Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 SED RATE AUTOMATED	$57.00	$95.00	$40.70–$2,315.52	—	40%
Semen analysis: volume, sperm count, motility and morphology CPT 89320 SEMEN ANALYSIS	$195.60	$326.00	$9.61–$309.70	120% above	40%
Semen analysis: volume, sperm count, motility and morphology inpatient CPT 89320 SEMEN ANALYSIS	$195.60	$326.00	$139.66–$2,315.52	—	40%
Sodium blood test CPT 84295 SODIUM PNL	$39.60	$66.00	$4.76–$62.70	22% above	40%
Sodium blood test CPT 84295 WHOLE BLOOD SODIUM	$39.60	$66.00	$4.76–$62.70	22% above	40%
Sodium blood test CPT 84295 BLOOD GAS SODIUM	$39.60	$66.00	$4.76–$62.70	22% above	40%
Sodium blood test CPT 84295 SODIUM	$39.60	$66.00	$4.76–$62.70	22% above	40%
Sodium blood test inpatient CPT 84295 WHOLE BLOOD SODIUM	$39.60	$66.00	$28.27–$2,315.52	—	40%
Sodium blood test inpatient CPT 84295 SODIUM	$39.60	$66.00	$28.27–$2,315.52	—	40%
Sodium blood test inpatient CPT 84295 SODIUM PNL	$39.60	$66.00	$28.27–$2,315.52	—	40%
Sodium blood test inpatient CPT 84295 BLOOD GAS SODIUM	$39.60	$66.00	$28.27–$2,315.52	—	40%
Stool ova and parasites exam CPT 87177 OVA AND PARASITES PNL 5271	$41.40	$69.00	$8.25–$65.55	29% below	40%
Stool ova and parasites exam CPT 87177 OVA & PARASITES P4048	$41.40	$69.00	$8.25–$65.55	29% below	40%
Stool ova and parasites exam CPT 87177 OVA & PARASITE CONCTRN PNL2831	$41.40	$69.00	$8.25–$65.55	29% below	40%
Stool ova and parasites exam inpatient CPT 87177 OVA & PARASITES P4048	$41.40	$69.00	$29.56–$2,315.52	—	40%
Stool ova and parasites exam inpatient CPT 87177 OVA & PARASITE CONCTRN PNL2831	$41.40	$69.00	$29.56–$2,315.52	—	40%
Stool ova and parasites exam inpatient CPT 87177 OVA AND PARASITES PNL 5271	$41.40	$69.00	$29.56–$2,315.52	—	40%
Stool test for hidden blood (guaiac FOBT) CPT 82270 OCCULT BLOOD FECES	$21.00	$35.00	$3.82–$33.25	3% above	40%
Stool test for hidden blood (guaiac FOBT) CPT 82270 SCREENING HEMOCCULT	$21.00	$35.00	$3.82–$33.25	3% above	40%
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 SCREENING HEMOCCULT	$21.00	$35.00	$14.99–$2,315.52	—	40%
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 OCCULT BLOOD FECES	$21.00	$35.00	$14.99–$2,315.52	—	40%
Stool test for hidden blood by immunoassay (FIT) CPT 82274 FECAL GLOBIN IMMUNOCHEMISTRY	$230.40	$384.00	$3.08–$364.80	540% above	40%
Stool test for hidden blood by immunoassay (FIT) CPT 82274 BLD OCC FEC ASSAY 1-3 SIM QUAL	$230.40	$384.00	$3.08–$364.80	540% above	40%
Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 FECAL GLOBIN IMMUNOCHEMISTRY	$230.40	$384.00	$164.51–$2,315.52	—	40%
Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 BLD OCC FEC ASSAY 1-3 SIM QUAL	$230.40	$384.00	$164.51–$2,315.52	—	40%
Syphilis antibody test (Treponema pallidum) CPT 86780 TREPONEMA PALLIDUM AB IGG IGM	$146.40	$244.00	$13.08–$231.80	96% above	40%
Syphilis antibody test (Treponema pallidum) CPT 86780 TREPONMA PALLIDM AB PART AGGLU	$146.40	$244.00	$13.08–$231.80	96% above	40%
Syphilis antibody test (Treponema pallidum) CPT 86780 TREPONEMA PALLIDUM CONFIRM	$146.40	$244.00	$13.08–$231.80	96% above	40%
Syphilis antibody test (Treponema pallidum) CPT 86780 FTA - SERUM	$146.40	$244.00	$13.08–$231.80	96% above	40%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 FTA - SERUM	$146.40	$244.00	$104.53–$2,315.52	—	40%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 TREPONEMA PALLIDUM AB IGG IGM	$146.40	$244.00	$104.53–$2,315.52	—	40%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 TREPONEMA PALLIDUM CONFIRM	$146.40	$244.00	$104.53–$2,315.52	—	40%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 TREPONMA PALLIDM AB PART AGGLU	$146.40	$244.00	$104.53–$2,315.52	—	40%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 VDRL QUAL CSF	$38.40	$64.00	$4.22–$60.80	37% above	40%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 VDRL - CSF	$38.40	$64.00	$4.22–$60.80	37% above	40%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 RPR QUAL	$38.40	$64.00	$4.22–$60.80	37% above	40%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 RPR SCREEN	$38.40	$64.00	$4.22–$60.80	37% above	40%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 VDRL SERUM	$38.40	$64.00	$4.22–$60.80	37% above	40%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 RPR	$38.40	$64.00	$4.22–$60.80	37% above	40%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 VDRL QUAL CSF	$38.40	$64.00	$27.42–$2,315.52	—	40%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 RPR	$38.40	$64.00	$27.42–$2,315.52	—	40%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 RPR QUAL	$38.40	$64.00	$27.42–$2,315.52	—	40%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 RPR SCREEN	$38.40	$64.00	$27.42–$2,315.52	—	40%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 VDRL - CSF	$38.40	$64.00	$27.42–$2,315.52	—	40%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 VDRL SERUM	$38.40	$64.00	$27.42–$2,315.52	—	40%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 QUANTIFERON TB GOLD PLUS	$209.40	$349.00	$52.35–$331.55	32% below	40%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 QUANTIFERON - TB GOLD	$209.40	$349.00	$52.35–$331.55	32% below	40%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 QUANTIFERON - TB GOLD	$209.40	$349.00	$149.51–$2,315.52	—	40%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 QUANTIFERON TB GOLD PLUS	$209.40	$349.00	$149.51–$2,315.52	—	40%
Testosterone blood test, total (not free testosterone) CPT 84403 TOTAL HORMONE P4556	$184.20	$307.00	$25.52–$291.65	13% above	40%
Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE TOTAL P4882	$184.20	$307.00	$25.52–$291.65	13% above	40%
Testosterone blood test, total (not free testosterone) CPT 84403 TOTAL TESTOSTERONE PNL 1540	$184.20	$307.00	$25.52–$291.65	13% above	40%
Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE TOTAL LC/MS/MS	$184.20	$307.00	$25.52–$291.65	13% above	40%
Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE (ANDROGEN)	$184.20	$307.00	$25.52–$291.65	13% above	40%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TOTAL HORMONE P4556	$184.20	$307.00	$131.52–$2,315.52	—	40%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE (ANDROGEN)	$184.20	$307.00	$131.52–$2,315.52	—	40%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE TOTAL LC/MS/MS	$184.20	$307.00	$131.52–$2,315.52	—	40%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE TOTAL P4882	$184.20	$307.00	$131.52–$2,315.52	—	40%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TOTAL TESTOSTERONE PNL 1540	$184.20	$307.00	$131.52–$2,315.52	—	40%
Thyroid peroxidase (TPO) antibody test CPT 86376 ANTI THYROID PEROXIDASE AB	$219.60	$366.00	$8.70–$347.70	192% above	40%
Thyroid peroxidase (TPO) antibody test CPT 86376 THYROPEROXIDASE AB S	$219.60	$366.00	$8.70–$347.70	192% above	40%
Thyroid peroxidase (TPO) antibody test CPT 86376 ANTI-LIVER/KIDNEY MICROSOML AB	$219.60	$366.00	$8.70–$347.70	192% above	40%
Thyroid peroxidase (TPO) antibody test CPT 86376 PEROXIDASE ANTIBODY	$219.60	$366.00	$8.70–$347.70	192% above	40%
Thyroid peroxidase (TPO) antibody test CPT 86376 ANTI-THYROID PEROXIDASE PL2554	$219.60	$366.00	$8.70–$347.70	192% above	40%
Thyroid peroxidase (TPO) antibody test CPT 86376 MICROSOMAL ANTIBODIES P9705	$219.60	$366.00	$8.70–$347.70	192% above	40%
Thyroid peroxidase (TPO) antibody test CPT 86376 MICROSOMAL ANTIBODIES P5091	$219.60	$366.00	$8.70–$347.70	192% above	40%
Thyroid peroxidase (TPO) antibody test CPT 86376 MICROSOMAL ANTIBODIES P4758	$219.60	$366.00	$8.70–$347.70	192% above	40%
Thyroid peroxidase (TPO) antibody test CPT 86376 MICROSOM AB EA P3355	$219.60	$366.00	$8.70–$347.70	192% above	40%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 ANTI-THYROID PEROXIDASE PL2554	$219.60	$366.00	$156.79–$2,315.52	—	40%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 MICROSOM AB EA P3355	$219.60	$366.00	$156.79–$2,315.52	—	40%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 ANTI-LIVER/KIDNEY MICROSOML AB	$219.60	$366.00	$156.79–$2,315.52	—	40%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 ANTI THYROID PEROXIDASE AB	$219.60	$366.00	$156.79–$2,315.52	—	40%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 THYROPEROXIDASE AB S	$219.60	$366.00	$156.79–$2,315.52	—	40%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 PEROXIDASE ANTIBODY	$219.60	$366.00	$156.79–$2,315.52	—	40%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 MICROSOMAL ANTIBODIES P9705	$219.60	$366.00	$156.79–$2,315.52	—	40%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 MICROSOMAL ANTIBODIES P5091	$219.60	$366.00	$156.79–$2,315.52	—	40%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 MICROSOMAL ANTIBODIES P4758	$219.60	$366.00	$156.79–$2,315.52	—	40%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 THYROID STIMULATING HORMONE	$448.80	$748.00	$16.60–$710.60	348% above	40%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH	$448.80	$748.00	$16.60–$710.60	348% above	40%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 THYROID FUNCTION CASCADE SERUM	$448.80	$748.00	$16.60–$710.60	348% above	40%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH THIRD GENERATION	$448.80	$748.00	$16.60–$710.60	348% above	40%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 THYROID FUNCTION CASCADE SERUM	$448.80	$748.00	$320.44–$2,315.52	—	40%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH	$448.80	$748.00	$320.44–$2,315.52	—	40%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 THYROID STIMULATING HORMONE	$448.80	$748.00	$320.44–$2,315.52	—	40%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH THIRD GENERATION	$448.80	$748.00	$320.44–$2,315.52	—	40%
Total IgE blood test CPT 82785 IGE P3921	$226.80	$378.00	$16.27–$359.10	119% above	40%
Total IgE blood test CPT 82785 IMMUNOGLOBULIN IGE	$226.80	$378.00	$16.27–$359.10	119% above	40%
Total IgE blood test CPT 82785 IMMUNOGLOBULIN E (IGE)	$226.80	$378.00	$16.27–$359.10	119% above	40%
Total IgE blood test CPT 82785 IGE P0722	$226.80	$378.00	$16.27–$359.10	119% above	40%
Total IgE blood test CPT 82785 IGE P3280	$226.80	$378.00	$16.27–$359.10	119% above	40%
Total IgE blood test CPT 82785 GAMMAGLOBULIN IGE P1235	$226.80	$378.00	$16.27–$359.10	119% above	40%
Total IgE blood test inpatient CPT 82785 IGE P0722	$226.80	$378.00	$161.94–$2,315.52	—	40%
Total IgE blood test inpatient CPT 82785 GAMMAGLOBULIN IGE P1235	$226.80	$378.00	$161.94–$2,315.52	—	40%
Total IgE blood test inpatient CPT 82785 IMMUNOGLOBULIN E (IGE)	$226.80	$378.00	$161.94–$2,315.52	—	40%
Total IgE blood test inpatient CPT 82785 IGE P3280	$226.80	$378.00	$161.94–$2,315.52	—	40%
Total IgE blood test inpatient CPT 82785 IGE P3921	$226.80	$378.00	$161.94–$2,315.52	—	40%
Total IgE blood test inpatient CPT 82785 IMMUNOGLOBULIN IGE	$226.80	$378.00	$161.94–$2,315.52	—	40%
Total cholesterol blood test CPT 82465 CHOLESTRL SERUM WHOLE BL P9445	$39.60	$66.00	$4.30–$62.70	31% above	40%
Total cholesterol blood test CPT 82465 CHOLESTEROL PNL	$39.60	$66.00	$4.30–$62.70	31% above	40%
Total cholesterol blood test inpatient CPT 82465 CHOLESTEROL PNL	$39.60	$66.00	$28.27–$2,315.52	—	40%
Total cholesterol blood test inpatient CPT 82465 CHOLESTRL SERUM WHOLE BL P9445	$39.60	$66.00	$28.27–$2,315.52	—	40%
Total thyroxine (T4) blood test CPT 84436 THYROXINE TOTAL P4354	$82.80	$138.00	$6.79–$131.10	84% above	40%
Total thyroxine (T4) blood test CPT 84436 T4 THYROXINE	$82.80	$138.00	$6.79–$131.10	84% above	40%
Total thyroxine (T4) blood test CPT 84436 THYROXINE T4 PNL	$82.80	$138.00	$6.79–$131.10	84% above	40%
Total thyroxine (T4) blood test inpatient CPT 84436 THYROXINE T4 PNL	$82.80	$138.00	$59.12–$2,315.52	—	40%
Total thyroxine (T4) blood test inpatient CPT 84436 T4 THYROXINE	$82.80	$138.00	$59.12–$2,315.52	—	40%
Total thyroxine (T4) blood test inpatient CPT 84436 THYROXINE TOTAL P4354	$82.80	$138.00	$59.12–$2,315.52	—	40%
Total triiodothyronine (T3) blood test CPT 84480 T3 (TRIIODOTHYRONINE) TOTAL S	$222.60	$371.00	$8.80–$352.45	130% above	40%
Total triiodothyronine (T3) blood test CPT 84480 TOTAL T3 PNL 2257	$222.60	$371.00	$8.80–$352.45	130% above	40%
Total triiodothyronine (T3) blood test CPT 84480 T3 TOTAL	$222.60	$371.00	$8.80–$352.45	130% above	40%
Total triiodothyronine (T3) blood test CPT 84480 TOTAL T3 (TRIIODOTHYRONINE)	$222.60	$371.00	$8.80–$352.45	130% above	40%
Total triiodothyronine (T3) blood test inpatient CPT 84480 TOTAL T3 PNL 2257	$222.60	$371.00	$158.94–$2,315.52	—	40%
Total triiodothyronine (T3) blood test inpatient CPT 84480 TOTAL T3 (TRIIODOTHYRONINE)	$222.60	$371.00	$158.94–$2,315.52	—	40%
Total triiodothyronine (T3) blood test inpatient CPT 84480 T3 TOTAL	$222.60	$371.00	$158.94–$2,315.52	—	40%
Total triiodothyronine (T3) blood test inpatient CPT 84480 T3 (TRIIODOTHYRONINE) TOTAL S	$222.60	$371.00	$158.94–$2,315.52	—	40%
Transferrin blood test CPT 84466 TRANSFERRIN	$108.00	$180.00	$12.62–$171.00	26% above	40%
Transferrin blood test inpatient CPT 84466 TRANSFERRIN	$108.00	$180.00	$77.11–$2,315.52	—	40%
Trichomonas test (NAAT) CPT 87661 TRICHOMONAS VAG AMPLIF P3030	$381.00	$635.00	$34.68–$603.25	107% above	40%
Trichomonas test (NAAT) CPT 87661 CHLAM TRACH AMP PRB TECH P3680	$381.00	$635.00	$34.68–$603.25	107% above	40%
Trichomonas test (NAAT) CPT 87661 TRICHOMONAS VAGINALIS P6785	$381.00	$635.00	$34.68–$603.25	107% above	40%
Trichomonas test (NAAT) CPT 87661 SURESWAB THRIC VAG RNA QL MALE	$381.00	$635.00	$34.68–$603.25	107% above	40%
Trichomonas test (NAAT) CPT 87661 T VAGINALIS RNA QL MALES	$381.00	$635.00	$34.68–$603.25	107% above	40%
Trichomonas test (NAAT) CPT 87661 SURESWAB TRICH VAGINAL RNA QL	$381.00	$635.00	$34.68–$603.25	107% above	40%
Trichomonas test (NAAT) inpatient CPT 87661 T VAGINALIS RNA QL MALES	$381.00	$635.00	$272.03–$2,315.52	—	40%
Trichomonas test (NAAT) inpatient CPT 87661 SURESWAB THRIC VAG RNA QL MALE	$381.00	$635.00	$272.03–$2,315.52	—	40%
Trichomonas test (NAAT) inpatient CPT 87661 SURESWAB TRICH VAGINAL RNA QL	$381.00	$635.00	$272.03–$2,315.52	—	40%
Trichomonas test (NAAT) inpatient CPT 87661 TRICHOMONAS VAG AMPLIF P3030	$381.00	$635.00	$272.03–$2,315.52	—	40%
Trichomonas test (NAAT) inpatient CPT 87661 TRICHOMONAS VAGINALIS P6785	$381.00	$635.00	$272.03–$2,315.52	—	40%
Trichomonas test (NAAT) inpatient CPT 87661 CHLAM TRACH AMP PRB TECH P3680	$381.00	$635.00	$272.03–$2,315.52	—	40%
Triglycerides blood test CPT 84478 CHYLOMICRONE PNL	$121.80	$203.00	$5.68–$192.85	207% above	40%
Triglycerides blood test CPT 84478 TRIGLYCERIDES	$121.80	$203.00	$5.68–$192.85	207% above	40%
Triglycerides blood test inpatient CPT 84478 TRIGLYCERIDES	$121.80	$203.00	$86.97–$2,315.52	—	40%
Triglycerides blood test inpatient CPT 84478 CHYLOMICRONE PNL	$121.80	$203.00	$86.97–$2,315.52	—	40%
Troponin test, quantitative CPT 84484 ASSAY OF TROPONIN QUANT	$91.20	$152.00	$10.86–$144.40	11% above	40%
Troponin test, quantitative CPT 84484 TROPONIN T	$91.20	$152.00	$10.86–$144.40	11% above	40%
Troponin test, quantitative CPT 84484 TROPONIN T HIGH SENSITIVITY	$91.20	$152.00	$10.86–$144.40	11% above	40%
Troponin test, quantitative CPT 84484 TROPONIN I QUANT	$91.20	$152.00	$10.86–$144.40	11% above	40%
Troponin test, quantitative inpatient CPT 84484 TROPONIN T	$91.20	$152.00	$65.12–$2,315.52	—	40%
Troponin test, quantitative inpatient CPT 84484 TROPONIN T HIGH SENSITIVITY	$91.20	$152.00	$65.12–$2,315.52	—	40%
Troponin test, quantitative inpatient CPT 84484 ASSAY OF TROPONIN QUANT	$91.20	$152.00	$65.12–$2,315.52	—	40%
Troponin test, quantitative inpatient CPT 84484 TROPONIN I QUANT	$91.20	$152.00	$65.12–$2,315.52	—	40%
Uric acid blood test CPT 84550 URIC ACID	$48.60	$81.00	$4.47–$76.95	53% above	40%
Uric acid blood test inpatient CPT 84550 URIC ACID	$48.60	$81.00	$34.70–$2,315.52	—	40%
Urinalysis with microscope exam, automated CPT 81001 URINALYSIS R & M	$70.20	$117.00	$3.13–$111.15	113% above	40%
Urinalysis with microscope exam, automated CPT 81001 UR COMPL W/REFLEX TO CULTURE	$70.20	$117.00	$3.13–$111.15	113% above	40%
Urinalysis with microscope exam, automated inpatient CPT 81001 URINALYSIS R & M	$70.20	$117.00	$50.12–$2,315.52	—	40%
Urinalysis with microscope exam, automated inpatient CPT 81001 UR COMPL W/REFLEX TO CULTURE	$70.20	$117.00	$50.12–$2,315.52	—	40%
Urinalysis without microscope exam, automated CPT 81003 URINE MACRO	$37.80	$63.00	$2.22–$59.85	112% above	40%
Urinalysis without microscope exam, automated CPT 81003 URINALYSIS AUTOMATED	$37.80	$63.00	$2.22–$59.85	112% above	40%
Urinalysis without microscope exam, automated inpatient CPT 81003 URINE MACRO	$37.80	$63.00	$26.99–$2,315.52	—	40%
Urinalysis without microscope exam, automated inpatient CPT 81003 URINALYSIS AUTOMATED	$37.80	$63.00	$26.99–$2,315.52	—	40%
Urinalysis without microscope exam, manual CPT 81002 URINALYSIS DIPSTICK	$51.00	$85.00	$3.44–$80.75	143% above	40%
Urinalysis without microscope exam, manual inpatient CPT 81002 URINALYSIS DIPSTICK	$51.00	$85.00	$36.41–$2,315.52	—	40%
Urine culture for bacteria, with colony count CPT 87086 CULTURE URINE QNT COL CT	$218.40	$364.00	$7.98–$345.80	285% above	40%
Urine culture for bacteria, with colony count CPT 87086 CULTURE URINE SPECIAL	$218.40	$364.00	$7.98–$345.80	285% above	40%
Urine culture for bacteria, with colony count inpatient CPT 87086 CULTURE URINE QNT COL CT	$218.40	$364.00	$155.94–$2,315.52	—	40%
Urine culture for bacteria, with colony count inpatient CPT 87086 CULTURE URINE SPECIAL	$218.40	$364.00	$155.94–$2,315.52	—	40%
Urine microalbumin (albumin) test CPT 82043 ALBUMIN URINE	$349.20	$582.00	$5.71–$552.90	782% above	40%
Urine microalbumin (albumin) test CPT 82043 ALBUMIN RAND UR W/O CREATININE	$349.20	$582.00	$5.71–$552.90	782% above	40%
Urine microalbumin (albumin) test CPT 82043 URINE-MICROALBUMIN	$349.20	$582.00	$5.71–$552.90	782% above	40%
Urine microalbumin (albumin) test inpatient CPT 82043 URINE-MICROALBUMIN	$349.20	$582.00	$249.33–$2,315.52	—	40%
Urine microalbumin (albumin) test inpatient CPT 82043 ALBUMIN URINE	$349.20	$582.00	$249.33–$2,315.52	—	40%
Urine microalbumin (albumin) test inpatient CPT 82043 ALBUMIN RAND UR W/O CREATININE	$349.20	$582.00	$249.33–$2,315.52	—	40%
Urine pregnancy test, read by color change CPT 81025 URINE PREGNANCY TEST	$112.80	$188.00	$4.40–$178.60	206% above	40%
Urine pregnancy test, read by color change CPT 81025 PREGNANCY URINE QUAL BETA HCG	$112.80	$188.00	$4.40–$178.60	206% above	40%
Urine pregnancy test, read by color change CPT 81025 PREGNANCY TEST VIS COLOR COMP	$112.80	$188.00	$4.40–$178.60	206% above	40%
Urine pregnancy test, read by color change inpatient CPT 81025 URINE PREGNANCY TEST	$112.80	$188.00	$80.54–$2,315.52	—	40%
Urine pregnancy test, read by color change inpatient CPT 81025 PREGNANCY TEST VIS COLOR COMP	$112.80	$188.00	$80.54–$2,315.52	—	40%
Urine pregnancy test, read by color change inpatient CPT 81025 PREGNANCY URINE QUAL BETA HCG	$112.80	$188.00	$80.54–$2,315.52	—	40%
Vitamin B12 (cobalamin) blood test CPT 82607 VITAMIN B12	$133.80	$223.00	$14.30–$211.85	42% above	40%
Vitamin B12 (cobalamin) blood test CPT 82607 VITAMIN B12 PNL 2979	$133.80	$223.00	$14.30–$211.85	42% above	40%
Vitamin B12 (cobalamin) blood test CPT 82607 VITAMIN B 12 TEST	$133.80	$223.00	$14.30–$211.85	42% above	40%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 VITAMIN B 12 TEST	$133.80	$223.00	$95.53–$2,315.52	—	40%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 VITAMIN B12 PNL 2979	$133.80	$223.00	$95.53–$2,315.52	—	40%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 VITAMIN B12	$133.80	$223.00	$95.53–$2,315.52	—	40%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 25-HYDROXY-VITAMIN-D	$226.80	$378.00	$29.26–$359.10	52% above	40%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D IMMUNOASSAY	$226.80	$378.00	$29.26–$359.10	52% above	40%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 25-OH VITAMIN D3 P3433	$226.80	$378.00	$29.26–$359.10	52% above	40%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D/25-HYDROXY	$226.80	$378.00	$29.26–$359.10	52% above	40%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 VITAMIN D/25-HYDROXY	$226.80	$378.00	$161.94–$2,315.52	—	40%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 25-HYDROXY-VITAMIN-D	$226.80	$378.00	$161.94–$2,315.52	—	40%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 VITAMIN D IMMUNOASSAY	$226.80	$378.00	$161.94–$2,315.52	—	40%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 25-OH VITAMIN D3 P3433	$226.80	$378.00	$161.94–$2,315.52	—	40%
Vitamin D, 1,25-dihydroxy blood test CPT 82652 VITAMIN D 1 25-DIHYDROXY	$579.00	$965.00	$38.05–$916.75	141% above	40%
Vitamin D, 1,25-dihydroxy blood test CPT 82652 DIHYDROXYVITAMIN D 1-25 P3433	$579.00	$965.00	$38.05–$916.75	141% above	40%
Vitamin D, 1,25-dihydroxy blood test inpatient CPT 82652 DIHYDROXYVITAMIN D 1-25 P3433	$579.00	$965.00	$413.41–$2,315.52	—	40%
Vitamin D, 1,25-dihydroxy blood test inpatient CPT 82652 VITAMIN D 1 25-DIHYDROXY	$579.00	$965.00	$413.41–$2,315.52	—	40%
Zinc blood test CPT 84630 ZINC P6970	$246.00	$410.00	$11.26–$389.50	240% above	40%
Zinc blood test CPT 84630 ZINC RBC	$258.60	$431.00	$11.26–$409.45	258% above	40%
Zinc blood test CPT 84630 ZINC SERUM	$258.60	$431.00	$11.26–$409.45	258% above	40%
Zinc blood test CPT 84630 ZINC BLOOD	$258.60	$431.00	$11.26–$409.45	258% above	40%
Zinc blood test inpatient CPT 84630 ZINC P6970	$246.00	$410.00	$175.64–$2,315.52	—	40%
Zinc blood test inpatient CPT 84630 ZINC RBC	$258.60	$431.00	$184.64–$2,315.52	—	40%
Zinc blood test inpatient CPT 84630 ZINC BLOOD	$258.60	$431.00	$184.64–$2,315.52	—	40%
Zinc blood test inpatient CPT 84630 ZINC SERUM	$258.60	$431.00	$184.64–$2,315.52	—	40%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HCG ALTERNATE METHOD	$301.80	$503.00	$14.88–$477.85	237% above	40%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HCG QUANTITATIVE INTACT	$301.80	$503.00	$14.88–$477.85	237% above	40%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 GONADOTROPIN CHORIO QUAN P0493	$301.80	$503.00	$14.88–$477.85	237% above	40%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 BHCG OTHER	$301.80	$503.00	$14.88–$477.85	237% above	40%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 BETA-HCG QN TUMOR MARKER	$301.80	$503.00	$14.88–$477.85	237% above	40%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 BETA-HCG QN TUMOR MARKER	$301.80	$503.00	$215.49–$2,315.52	—	40%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 BHCG OTHER	$301.80	$503.00	$215.49–$2,315.52	—	40%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 GONADOTROPIN CHORIO QUAN P0493	$301.80	$503.00	$215.49–$2,315.52	—	40%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HCG ALTERNATE METHOD	$301.80	$503.00	$215.49–$2,315.52	—	40%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HCG QUANTITATIVE INTACT	$301.80	$503.00	$215.49–$2,315.52	—	40%

Surgery and procedures

Procedure	Cash price	List price	Insurers pay	vs Pennsylvania	Off list
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion CPT 19081 BX BREAST 1ST LESION STRTCTC	$3,700.20	$6,167.00	$163.13–$5,858.65	5% below	40%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion inpatient CPT 19081 BX BREAST 1ST LESION STRTCTC	$3,700.20	$6,167.00	$2,208.32–$5,858.65	—	40%
Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 LAT MALLEOLUS FX WO REDUCT	$825.60	$1,376.00	$130.35–$1,307.20	25% above	40%
Broken ankle (outer ankle bone) treatment without surgery or setting inpatient CPT 27786 LAT MALLEOLUS FX WO REDUCT	$825.60	$1,376.00	$589.48–$2,315.52	—	40%
Broken foot (metatarsal) treatment without surgery or setting CPT 28470 METATARSAL FX WO REDUCT	$825.60	$1,376.00	$92.95–$1,307.20	59% above	40%
Broken foot (metatarsal) treatment without surgery or setting inpatient CPT 28470 METATARSAL FX WO REDUCT	$825.60	$1,376.00	$589.48–$2,315.52	—	40%
Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDOVERSION ELECTIVE EXTERNAL	$1,245.00	$2,075.00	$95.70–$1,971.25	15% below	40%
Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION	$1,245.00	$2,075.00	$95.70–$1,971.25	15% below	40%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 CARDOVERSION ELECTIVE EXTERNAL	$1,245.00	$2,075.00	$888.93–$2,315.52	—	40%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 CARDIOVERSION	$1,245.00	$2,075.00	$888.93–$2,315.52	—	40%
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 DISTAL RADIUS/COLLES FX WO RED	$825.60	$1,376.00	$125.95–$1,307.20	25% above	40%
Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 DISTAL RADIUS/COLLES FX WO RED	$825.60	$1,376.00	$589.48–$2,315.52	—	40%
Colonoscopy with polyp removal CPT 45385 COLONOSCOPY W/SNARE TECHNIQUE	$3,252.60	$5,421.00	$294.89–$5,149.95	28% above	40%
Colonoscopy with polyp removal inpatient CPT 45385 COLONOSCOPY W/SNARE TECHNIQUE	$3,252.60	$5,421.00	$2,208.32–$5,149.95	—	40%
Colonoscopy with tissue sample CPT 45380 COLONOSCOPY W/BX SINGLE/MULT	$3,252.60	$5,421.00	$247.96–$5,149.95	47% above	40%
Colonoscopy with tissue sample inpatient CPT 45380 COLONOSCOPY W/BX SINGLE/MULT	$3,252.60	$5,421.00	$2,208.32–$5,149.95	—	40%
Colonoscopy, diagnostic CPT 45378 COLONOSCOPY DIAG W/WO BRUSHING	$1,653.60	$2,756.00	$198.55–$2,618.20	10% above	40%
Colonoscopy, diagnostic inpatient CPT 45378 COLONOSCOPY DIAG W/WO BRUSHING	$1,653.60	$2,756.00	$1,180.67–$2,618.20	—	40%
Cystoscopy with ureteral stent placement CPT 52332 CYSTOSCOPY W STENT INSERTION	$4,764.60	$7,941.00	$158.09–$7,543.95	at median	40%
Cystoscopy with ureteral stent placement inpatient CPT 52332 CYSTOSCOPY W STENT INSERTION	$4,764.60	$7,941.00	$2,208.32–$7,543.95	—	40%
Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 CYSTOURETHROSCOPY	$1,287.60	$2,146.00	$82.50–$2,038.70	24% below	40%
Cystoscopy, diagnostic look inside the bladder and urethra inpatient CPT 52000 CYSTOURETHROSCOPY	$1,287.60	$2,146.00	$919.35–$2,315.52	—	40%
Ear tube placement (tympanostomy) under general anesthesia, one ear one side CPT 69436 MYRINGOTOMY W TUBE UNILATERAL	$7,126.80	$11,878.00	$108.35–$11,284.10	123% above	40%
Ear tube placement (tympanostomy) under general anesthesia, one ear inpatient one side CPT 69436 MYRINGOTOMY W TUBE UNILATERAL	$7,126.80	$11,878.00	$2,208.32–$11,284.10	—	40%
Earwax removal by irrigation (rinsing), one ear CPT 69209 RMV IMPACT CERUMEN IRR/LAV	$117.00	$195.00	$16.06–$993.28	16% below	40%
Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 RMV IMPACT CERUMEN IRR/LAV	$117.00	$195.00	$83.54–$2,315.52	—	40%
Earwax removal with instruments, one ear CPT 69210 RMV IMPACT CERUMEN INSTR	$247.20	$412.00	$61.80–$993.28	84% above	40%
Earwax removal with instruments, one ear inpatient CPT 69210 RMV IMPACT CERUMEN INSTR	$247.20	$412.00	$176.50–$2,315.52	—	40%
Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 FLEX SIG DIAG W/WO BRUSHING	$659.40	$1,099.00	$58.47–$1,044.05	43% below	40%
Flexible sigmoidoscopy, diagnostic (lower colon only) inpatient CPT 45330 FLEX SIG DIAG W/WO BRUSHING	$659.40	$1,099.00	$470.81–$2,315.52	—	40%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 INJ HYSTEROSALPINGOGRAM	$380.40	$634.00	$57.20–$993.28	1% below	40%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes inpatient CPT 58340 INJ HYSTEROSALPINGOGRAM	$380.40	$634.00	$271.61–$2,315.52	—	40%
Incision and drainage of a simple or single skin abscess CPT 10060 ID SIMPLE ABSCESS	$589.80	$983.00	$25.85–$933.85	16% above	40%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 ID SIMPLE ABSCESS	$589.80	$983.00	$421.12–$2,315.52	—	40%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 INJ TEND/LIGAMENT/GANG CYST	$616.20	$1,027.00	$35.20–$975.65	8% above	40%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 INJ TEND/LIGAMENT/GANG CYST	$616.20	$1,027.00	$439.97–$2,315.52	—	40%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ARTHRO ASP/INJ LG JT WO/US	$1,473.60	$2,456.00	$25.85–$2,333.20	215% above	40%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ARTHRO ASP/INJ LG JT WO/US	$1,473.60	$2,456.00	$1,052.15–$2,333.20	—	40%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ARTHRO ASP/INJ INT JT WO/US	$825.60	$1,376.00	$23.65–$1,400.32	133% above	40%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 ARTHRO ASP/INJ INT JT WO/US	$825.60	$1,376.00	$589.48–$2,315.52	—	40%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 ARTHRO ASP/INJ SMALL JOINT	$825.60	$1,376.00	$19.80–$1,307.20	101% above	40%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 ARTHRO ASP/INJ SMALL JOINT	$825.60	$1,376.00	$589.48–$2,315.52	—	40%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 INT LAC RPR 0-2.5CM SCLP TRNK	$825.60	$1,376.00	$26.95–$1,307.20	41% above	40%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 INT LAC RPR 0-2.5CM SCLP TRNK	$825.60	$1,376.00	$589.48–$2,315.52	—	40%
Lower-back epidural injection, without imaging guidance CPT 62322 NJX INTERLAMINAR LMBR/SAC	$1,260.60	$2,101.00	$78.27–$1,995.95	34% below	40%
Lower-back epidural injection, without imaging guidance inpatient CPT 62322 NJX INTERLAMINAR LMBR/SAC	$1,260.60	$2,101.00	$900.07–$2,315.52	—	40%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 EX BEN LES<0.5CM TRNK/LIMB	$1,440.00	$2,400.00	$41.25–$2,280.00	8% above	40%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 EX BEN LES<0.5CM TRNK/LIMB	$1,440.00	$2,400.00	$1,028.16–$2,315.52	—	40%
Nail removal (partial or complete), one nail CPT 11730 NAIL AVULSION COMP/PART SNGL	$471.00	$785.00	$28.32–$993.28	at median	40%
Nail removal (partial or complete), one nail inpatient CPT 11730 NAIL AVULSION COMP/PART SNGL	$471.00	$785.00	$336.29–$2,315.52	—	40%
Occipital nerve block (injection for headaches) CPT 64405 OCCIPITAL NERVE BLOCK	$568.20	$947.00	$38.50–$993.28	1% above	40%
Occipital nerve block (injection for headaches) inpatient CPT 64405 OCCIPITAL NERVE BLOCK	$568.20	$947.00	$405.69–$2,315.52	—	40%
Paracentesis with imaging guidance CPT 49083 ABD PARACNT DX/THR W IMG GUID	$1,689.00	$2,815.00	$92.76–$2,674.25	at median	40%
Paracentesis with imaging guidance inpatient CPT 49083 ABD PARACNT DX/THR W IMG GUID	$1,689.00	$2,815.00	$1,205.95–$2,674.25	—	40%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 EXCISION NAIL COMP/PART	$1,470.60	$2,451.00	$367.65–$2,328.45	76% above	40%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 EXCISION NAIL COMP/PART	$1,470.60	$2,451.00	$1,050.01–$2,328.45	—	40%
Removal of a foreign object under the skin, simple CPT 10120 SUBCUT FB REMOVAL SIMPLE	$589.80	$983.00	$33.55–$994.56	8% above	40%
Removal of a foreign object under the skin, simple inpatient CPT 10120 SUBCUT FB REMOVAL SIMPLE	$589.80	$983.00	$421.12–$2,315.52	—	40%
Screening colonoscopy for a person at average risk (Medicare code) HCPCS G0121 COLONOSCOPY SCREEN AVG RISK	$1,512.00	$2,520.00	$378.00–$2,394.00	1% below	40%
Screening colonoscopy for a person at average risk (Medicare code) inpatient HCPCS G0121 COLONOSCOPY SCREEN AVG RISK	$1,512.00	$2,520.00	$1,079.57–$2,394.00	—	40%
Screening colonoscopy, high risk of colorectal cancer (Medicare code) HCPCS G0105 COLONOSCOPY SCREEN HIGH RISK	$1,575.00	$2,625.00	$393.75–$2,493.75	8% below	40%
Screening colonoscopy, high risk of colorectal cancer (Medicare code) inpatient HCPCS G0105 COLONOSCOPY SCREEN HIGH RISK	$1,575.00	$2,625.00	$1,124.55–$2,493.75	—	40%
Short arm cast (elbow to hand) CPT 29075 SHORT ARM CAST APPLICATION	$825.60	$1,376.00	$50.05–$1,307.20	99% above	40%
Short arm cast (elbow to hand) inpatient CPT 29075 SHORT ARM CAST APPLICATION	$825.60	$1,376.00	$589.48–$2,315.52	—	40%
Short arm splint (forearm and hand) CPT 29125 APPLY FOREARM SPLINT	$471.00	$785.00	$28.60–$745.75	50% above	40%
Short arm splint (forearm and hand) inpatient CPT 29125 APPLY FOREARM SPLINT	$471.00	$785.00	$336.29–$2,315.52	—	40%
Short leg splint (calf to foot) CPT 29515 APPLY LOWER LEG SPLINT	$471.00	$785.00	$38.50–$745.75	2% above	40%
Short leg splint (calf to foot) inpatient CPT 29515 APPLY LOWER LEG SPLINT	$471.00	$785.00	$336.29–$2,315.52	—	40%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 SMPL LAC RPR 0-2.5CM SCALP	$589.80	$983.00	$26.95–$933.85	15% above	40%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 SMPL LAC RPR 0-2.5CM SCALP	$589.80	$983.00	$421.12–$2,315.52	—	40%
Skin tag removal, up to 15 tags CPT 11200 REMOVAL OF SKIN TAGS UP TO 15	$471.00	$785.00	$34.10–$993.28	22% below	40%
Skin tag removal, up to 15 tags inpatient CPT 11200 REMOVAL OF SKIN TAGS UP TO 15	$471.00	$785.00	$336.29–$2,315.52	—	40%
Spinal tap (lumbar puncture), diagnostic CPT 62270 SPINAL PUNC LUMBAR DX	$1,470.60	$2,451.00	$46.20–$2,328.45	20% above	40%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 SPINAL PUNC LUMBAR DX	$1,470.60	$2,451.00	$1,050.01–$2,328.45	—	40%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 SMPL LAC RPR 2.6-7.5CM SCALP	$589.80	$983.00	$39.05–$993.28	12% above	40%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 SMPL LAC RPR 2.6-7.5CM SCALP	$589.80	$983.00	$421.12–$2,315.52	—	40%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 SMPL LAC RPR 0-2.5CM FACE	$589.80	$983.00	$34.65–$933.85	16% above	40%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 SMPL LAC RPR 0-2.5CM FACE	$589.80	$983.00	$421.12–$2,315.52	—	40%
Thoracentesis with imaging guidance CPT 32555 THORACENTESIS W GUIDANCE	$1,422.60	$2,371.00	$355.65–$2,252.45	4% below	40%
Thoracentesis with imaging guidance CPT 32555 PORT THORACENTESIS W/GDE	$1,422.60	$2,371.00	$355.65–$2,252.45	4% below	40%
Thoracentesis with imaging guidance inpatient CPT 32555 PORT THORACENTESIS W/GDE	$1,422.60	$2,371.00	$1,015.74–$2,315.52	—	40%
Thoracentesis with imaging guidance inpatient CPT 32555 THORACENTESIS W GUIDANCE	$1,422.60	$2,371.00	$1,015.74–$2,315.52	—	40%
Trigger point injections, 1 or 2 muscles CPT 20552 INJ SG/MUL TRG PTS 1-2 MUSCLES	$825.60	$1,376.00	$34.17–$1,307.20	53% above	40%
Trigger point injections, 1 or 2 muscles CPT 20552 INJ SNG/MUL TRG PTS 1-2 MUS GR	$825.60	$1,376.00	$34.17–$1,307.20	53% above	40%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 INJ SNG/MUL TRG PTS 1-2 MUS GR	$825.60	$1,376.00	$589.48–$2,315.52	—	40%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 INJ SG/MUL TRG PTS 1-2 MUSCLES	$825.60	$1,376.00	$589.48–$2,315.52	—	40%
Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 BX BREAST 1ST LESION US IMAG	$3,828.00	$6,380.00	$152.78–$6,061.00	7% above	40%
Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient CPT 19083 BX BREAST 1ST LESION US IMAG	$3,828.00	$6,380.00	$2,208.32–$6,061.00	—	40%
Upper endoscopy (EGD) with balloon widening of the esophagus CPT 43249 EGD W/BALLOON DILATION	$3,414.00	$5,690.00	$666.36–$5,405.50	at median	40%
Upper endoscopy (EGD) with balloon widening of the esophagus inpatient CPT 43249 EGD W/BALLOON DILATION	$3,414.00	$5,690.00	$2,208.32–$5,405.50	—	40%
Upper endoscopy (EGD) with biopsy CPT 43239 EGD W/BIOPSY SINGLE/MULT	$3,526.20	$5,877.00	$163.44–$5,583.15	62% above	40%
Upper endoscopy (EGD) with biopsy inpatient CPT 43239 EGD W/BIOPSY SINGLE/MULT	$3,526.20	$5,877.00	$2,208.32–$5,583.15	—	40%
Upper endoscopy (EGD) with polyp removal by snare CPT 43251 EGD W/REMOVAL BY SNARE	$3,414.00	$5,690.00	$208.28–$5,405.50	8% above	40%
Upper endoscopy (EGD) with polyp removal by snare inpatient CPT 43251 EGD W/REMOVAL BY SNARE	$3,414.00	$5,690.00	$2,208.32–$5,405.50	—	40%
Upper endoscopy (EGD) with widening of the esophagus over a guide wire CPT 43248 EGD W/DILATION OVER WIRE	$3,526.20	$5,877.00	$686.69–$5,583.15	42% above	40%
Upper endoscopy (EGD) with widening of the esophagus over a guide wire inpatient CPT 43248 EGD W/DILATION OVER WIRE	$3,526.20	$5,877.00	$2,208.32–$5,583.15	—	40%
Upper endoscopy (EGD), diagnostic CPT 43235 EGD W/WO BRUSHINGS	$3,526.20	$5,877.00	$137.74–$5,583.15	86% above	40%
Upper endoscopy (EGD), diagnostic inpatient CPT 43235 EGD W/WO BRUSHINGS	$3,526.20	$5,877.00	$2,208.32–$5,583.15	—	40%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBRID SKIN AND SQ TISSUE	$825.60	$1,376.00	$36.30–$1,307.20	23% below	40%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DEBRID SKIN AND SQ TISSUE	$825.60	$1,376.00	$589.48–$2,315.52	—	40%

Doctor visits and therapy

Procedure	Cash price	List price	Insurers pay	vs Pennsylvania	Off list
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD TX (CELL SAVER/BLD BANK)	$1,821.00	$3,035.00	$30.62–$2,883.25	93% above	40%
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION BLOOD/COMPONENTS	$1,821.00	$3,035.00	$30.62–$2,883.25	93% above	40%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD TX (CELL SAVER/BLD BANK)	$1,821.00	$3,035.00	$1,300.19–$2,883.25	—	40%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 TRANSFUSION BLOOD/COMPONENTS	$1,821.00	$3,035.00	$1,300.19–$2,883.25	—	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 IPV INITIAL	$124.80	$208.00	$31.20–$197.60	44% below	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 MDI INITIAL	$243.00	$405.00	$37.90–$384.75	9% above	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 DRUG AEROSOL ADMIN INITIAL	$286.80	$478.00	$37.90–$454.10	29% above	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 DRUG AEROSOL INITIAL	$286.80	$478.00	$37.90–$454.10	29% above	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 IPV INITIAL	$124.80	$208.00	$89.11–$2,315.52	—	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 MDI INITIAL	$243.00	$405.00	$173.50–$2,315.52	—	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 DRUG AEROSOL INITIAL	$286.80	$478.00	$204.78–$2,315.52	—	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 DRUG AEROSOL ADMIN INITIAL	$286.80	$478.00	$204.78–$2,315.52	—	40%
Chemotherapy IV infusion, first hour CPT 96413 IV INF CHEMO 1ST HR	$808.20	$1,347.00	$137.28–$1,279.65	12% above	40%
Chemotherapy IV infusion, first hour inpatient CPT 96413 IV INF CHEMO 1ST HR	$808.20	$1,347.00	$577.05–$2,315.52	—	40%
Critical care, first 30 to 74 minutes CPT 99291 CRITICAL CARE - FIRST 30-74MIN	$1,796.40	$2,994.00	$166.79–$2,844.30	4% below	40%
Critical care, first 30 to 74 minutes inpatient CPT 99291 CRITICAL CARE - FIRST 30-74MIN	$1,796.40	$2,994.00	$1,282.63–$2,844.30	—	40%
EEG (brain wave test), awake and drowsy, routine CPT 95816 EEG AWAKE & DROWSY	$1,189.80	$1,983.00	$17.28–$1,883.85	56% above	40%
EEG (brain wave test), awake and drowsy, routine inpatient CPT 95816 EEG AWAKE & DROWSY	$1,189.80	$1,983.00	$849.52–$2,315.52	—	40%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG TRACING WO INTERP & RPT	$271.80	$453.00	$11.51–$430.35	56% above	40%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG TRACING WO INTERP & RPT	$271.80	$453.00	$194.07–$2,315.52	—	40%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 ACUITY LEVEL 1 NON EMERGENT	$252.60	$421.00	$51.60–$399.95	17% below	40%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 ACUITY LEVEL 1	$252.60	$421.00	$51.60–$399.95	17% below	40%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 ACUITY LEVEL 1 NON EMERGENT	$252.60	$421.00	$180.36–$2,315.52	—	40%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 ACUITY LEVEL 1	$252.60	$421.00	$180.36–$2,315.52	—	40%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 ACUITY LEVEL 2	$406.80	$678.00	$36.28–$644.10	15% below	40%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 ACUITY LEVEL 2 NON EMERGENT	$406.80	$678.00	$36.28–$644.10	15% below	40%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 ACUITY LEVEL 2 NON EMERGENT	$406.80	$678.00	$290.46–$2,315.52	—	40%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 ACUITY LEVEL 2	$406.80	$678.00	$290.46–$2,315.52	—	40%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 ACUITY LEVEL 3	$744.00	$1,240.00	$62.31–$1,178.00	at median	40%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 ACUITY LEVEL 3	$744.00	$1,240.00	$531.22–$2,315.52	—	40%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 ACUITY LEVEL 4	$1,243.80	$2,073.00	$104.86–$1,969.35	2% above	40%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 ACUITY LEVEL 4	$1,243.80	$2,073.00	$888.07–$2,315.52	—	40%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 ACUITY LEVEL 5	$1,287.60	$2,146.00	$152.61–$2,038.70	19% below	40%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 ACUITY LEVEL 5	$1,287.60	$2,146.00	$919.35–$2,315.52	—	40%
Exercise stress test, tracing only, the hospital charge CPT 93017 PROGRESSIVE STRESS TEST	$1,618.20	$2,697.00	$51.15–$2,562.15	71% above	40%
Exercise stress test, tracing only, the hospital charge CPT 93017 STRESS TEST W/PHARMACEUTICALS	$1,618.20	$2,697.00	$51.15–$2,562.15	71% above	40%
Exercise stress test, tracing only, the hospital charge CPT 93017 TREADMILL/BIKE EXERCISE	$1,618.20	$2,697.00	$51.15–$2,562.15	71% above	40%
Exercise stress test, tracing only, the hospital charge CPT 93017 ISOTOPIC EXERCISE TEST	$1,618.20	$2,697.00	$51.15–$2,562.15	71% above	40%
Exercise stress test, tracing only, the hospital charge CPT 93017 STRESS TEST W WO PHARMACEUTICA	$1,618.20	$2,697.00	$51.15–$2,562.15	71% above	40%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 TREADMILL/BIKE EXERCISE	$1,618.20	$2,697.00	$1,155.39–$2,562.15	—	40%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 STRESS TEST W/PHARMACEUTICALS	$1,618.20	$2,697.00	$1,155.39–$2,562.15	—	40%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 STRESS TEST W WO PHARMACEUTICA	$1,618.20	$2,697.00	$1,155.39–$2,562.15	—	40%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 PROGRESSIVE STRESS TEST	$1,618.20	$2,697.00	$1,155.39–$2,562.15	—	40%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 ISOTOPIC EXERCISE TEST	$1,618.20	$2,697.00	$1,155.39–$2,562.15	—	40%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV INF HYDRATION 1ST HR	$1,143.00	$1,905.00	$34.79–$1,809.75	162% above	40%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV INF HYDRATION 1ST HR	$1,143.00	$1,905.00	$816.10–$2,315.52	—	40%
IV infusion of a medicine, first hour CPT 96365 IV INF NONCHEMO 1ST HR	$1,143.00	$1,905.00	$43.23–$1,809.75	154% above	40%
IV infusion of a medicine, first hour inpatient CPT 96365 IV INF NONCHEMO 1ST HR	$1,143.00	$1,905.00	$816.10–$2,315.52	—	40%
IV push of a medicine, first drug CPT 96374 IV PUSH NONCHEMO 1ST DRUG	$165.60	$276.00	$34.12–$262.20	50% below	40%
IV push of a medicine, first drug inpatient CPT 96374 IV PUSH NONCHEMO 1ST DRUG	$165.60	$276.00	$118.24–$2,315.52	—	40%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJECTION IM/SQ	$147.00	$245.00	$13.97–$232.75	19% above	40%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INJECTION IM/SQ	$147.00	$245.00	$104.96–$2,315.52	—	40%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 SMOKE/TOBACCO COUNSEL 3-10 MIN	$31.20	$52.00	$7.80–$49.40	32% below	40%
Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 SMOKE/TOBACCO COUNSEL 3-10 MIN	$31.20	$52.00	$22.28–$2,315.52	—	40%
Spirometry (breathing test) CPT 94010 SPIROMETRY VC EXP FLOW MVV	$228.00	$380.00	$11.52–$361.00	24% below	40%
Spirometry (breathing test) inpatient CPT 94010 SPIROMETRY VC EXP FLOW MVV	$228.00	$380.00	$162.79–$2,315.52	—	40%
Spirometry before and after a bronchodilator CPT 94060 SPIROMETRY PRE & POST BRONCH	$526.80	$878.00	$14.59–$834.10	19% below	40%
Spirometry before and after a bronchodilator inpatient CPT 94060 SPIROMETRY PRE & POST BRONCH	$526.80	$878.00	$376.14–$2,315.52	—	40%
Therapeutic activities (functional training), 15 minutes CPT 97530 CQ FUNCT TRAINING-NON THERAP	$61.80	$103.00	$14.30–$97.85	52% below	40%
Therapeutic activities (functional training), 15 minutes CPT 97530 FUNCT TRAINING-NON THERAPIST	$61.80	$103.00	$14.30–$97.85	52% below	40%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 CQ FUNCT TRAINING-NON THERAP	$61.80	$103.00	$44.13–$2,315.52	—	40%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 FUNCT TRAINING-NON THERAPIST	$61.80	$103.00	$44.13–$2,315.52	—	40%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 PHLEBOTOMY THERAPEUTIC	$193.20	$322.00	$11.00–$305.90	16% below	40%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 PHLEBOTOMY THERAPEUTIC	$193.20	$322.00	$137.94–$2,315.52	—	40%

Vaccines

Procedure	Cash price	List price	Insurers pay	vs Pennsylvania	Off list
COVID-19 vaccine (Moderna), age 12 and older CPT 91322 COVID-19(MODERNA-12+YR) 23-24	$209.40	$349.00	$44.00–$331.55	5% above	40%
COVID-19 vaccine (Moderna), age 12 and older CPT 91322 COVID-19 SPIKEVAX MODERNA 12+Y	$209.40	$349.00	$44.00–$331.55	5% above	40%
COVID-19 vaccine (Moderna), age 12 and older CPT 91322 COVID-19 SPIKEVAX MODERNA 12+Y	$340.00	$425.00	$44.00–$403.75	71% above	20%
COVID-19 vaccine (Moderna), age 12 and older inpatient CPT 91322 COVID-19 SPIKEVAX MODERNA 12+Y	$209.40	$349.00	$96.71–$2,315.52	—	40%
COVID-19 vaccine (Moderna), age 12 and older inpatient CPT 91322 COVID-19(MODERNA-12+YR) 23-24	$209.40	$349.00	$96.71–$2,315.52	—	40%
COVID-19 vaccine (Moderna), age 12 and older inpatient CPT 91322 COVID-19 SPIKEVAX MODERNA 12+Y	$340.00	$425.00	$117.77–$2,315.52	—	20%
Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 VARIVAX .5ML INJ	$748.80	$936.00	$11.00–$889.20	264% above	20%
Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 VARIVAX .5ML INJ	$748.80	$936.00	$259.37–$2,315.52	—	20%
Flu shot, recombinant, egg-free (Flublok) CPT 90673 FLUBLOK 0.5ML PFS LTX/EGG FREE	$30.00	$50.00	$7.50–$107.98	at median	40%
Flu shot, recombinant, egg-free (Flublok) CPT 90673 FLUBLOK 0.5ML PFS LTX/EGG FREE	$40.00	$50.00	$7.50–$107.98	33% above	20%
Flu shot, recombinant, egg-free (Flublok) inpatient CPT 90673 FLUBLOK 0.5ML PFS LTX/EGG FREE	$30.00	$50.00	$13.86–$2,315.52	—	40%
Flu shot, recombinant, egg-free (Flublok) inpatient CPT 90673 FLUBLOK 0.5ML PFS LTX/EGG FREE	$40.00	$50.00	$13.86–$2,315.52	—	20%
Hepatitis A vaccine, adult dose CPT 90632 HEPAT A VACC 1440U/ML VIAL	$81.00	$135.00	$11.00–$128.25	9% below	40%
Hepatitis A vaccine, adult dose CPT 90632 HEPAT A VACC 1440U/ML VIAL	$108.00	$135.00	$11.00–$128.25	21% above	20%
Hepatitis A vaccine, adult dose inpatient CPT 90632 HEPAT A VACC 1440U/ML VIAL	$81.00	$135.00	$37.41–$2,315.52	—	40%
Hepatitis A vaccine, adult dose inpatient CPT 90632 HEPAT A VACC 1440U/ML VIAL	$108.00	$135.00	$37.41–$2,315.52	—	20%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 VAC HEP B 20MCG/ 1ML ADULT INJ	$64.80	$108.00	$11.00–$153.25	21% below	40%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 VAC HEP B 20MCG/ 1ML ADULT INJ	$86.40	$108.00	$11.00–$153.25	5% above	20%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 HEPATITIS BVAC 20MCG/0.5ML ADT	$653.40	$1,089.00	$11.00–$1,034.55	692% above	40%
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 VAC HEP B 20MCG/ 1ML ADULT INJ	$64.80	$108.00	$29.93–$2,315.52	—	40%
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 VAC HEP B 20MCG/ 1ML ADULT INJ	$86.40	$108.00	$29.93–$2,315.52	—	20%
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 HEPATITIS BVAC 20MCG/0.5ML ADT	$653.40	$1,089.00	$301.76–$2,315.52	—	40%
Hepatitis B vaccine, adult, 2-dose schedule (Heplisav-B) CPT 90739 HEPATITIS B VAC 20MCG/0.5 ML	$168.80	$211.00	$11.00–$200.45	3% below	20%
Hepatitis B vaccine, adult, 2-dose schedule (Heplisav-B) inpatient CPT 90739 HEPATITIS B VAC 20MCG/0.5 ML	$168.80	$211.00	$58.47–$2,315.52	—	20%
Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 ENGERIX-B 10MCG/.5ML PED INJ	$47.40	$79.00	$11.00–$75.05	at median	40%
Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 ENGERIX-B 10MCG/.5ML PED INJ	$63.20	$79.00	$11.00–$75.05	33% above	20%
Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 ENGERIX-B 10MCG/.5ML PED INJ	$47.40	$79.00	$21.89–$2,315.52	—	40%
Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 ENGERIX-B 10MCG/.5ML PED INJ	$63.20	$79.00	$21.89–$2,315.52	—	20%
MMR vaccine (measles, mumps and rubella), live CPT 90707 VACCINE MEAS/MUMPS/RUBELLA INJ	$48.60	$81.00	$11.00–$76.95	26% below	40%
MMR vaccine (measles, mumps and rubella), live CPT 90707 VACCINE MEAS/MUMPS/RUBELLA INJ	$64.80	$81.00	$11.00–$76.95	1% below	20%
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 VACCINE MEAS/MUMPS/RUBELLA INJ	$48.60	$81.00	$22.45–$2,315.52	—	40%
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 VACCINE MEAS/MUMPS/RUBELLA INJ	$64.80	$81.00	$22.45–$2,315.52	—	20%
Meningococcal ACWY (MenACWY) vaccine CPT 90734 MENVEO INJECTION (VACCINE)	$81.60	$136.00	$11.00–$129.20	13% below	40%
Meningococcal ACWY (MenACWY) vaccine CPT 90734 MENVEO INJECTION (VACCINE)	$108.80	$136.00	$11.00–$129.20	16% above	20%
Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 MENVEO INJECTION (VACCINE)	$81.60	$136.00	$37.69–$2,315.52	—	40%
Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 MENVEO INJECTION (VACCINE)	$108.80	$136.00	$37.69–$2,315.52	—	20%
Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 MENINGOCOCCAL GRP B VACC 0.5ML	$82.20	$137.00	$11.00–$130.15	57% below	40%
Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 MENINGOCOCCAL GRP B VACC 0.5ML	$109.60	$137.00	$11.00–$130.15	43% below	20%
Meningococcal B vaccine (Bexsero), 2-dose schedule inpatient CPT 90620 MENINGOCOCCAL GRP B VACC 0.5ML	$82.20	$137.00	$37.96–$2,315.52	—	40%
Meningococcal B vaccine (Bexsero), 2-dose schedule inpatient CPT 90620 MENINGOCOCCAL GRP B VACC 0.5ML	$109.60	$137.00	$37.96–$2,315.52	—	20%
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) CPT 90670 PNEUMOC 13-VAL VAC 0.5ML	$144.00	$240.00	$11.00–$283.79	at median	40%
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) inpatient CPT 90670 PNEUMOC 13-VAL VAC 0.5ML	$144.00	$240.00	$66.50–$2,315.52	—	40%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 PNEUMOCOCCAL 20 VACC 0.5ML INJ	$144.00	$240.00	$11.00–$344.19	55% below	40%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 PNEUMOCOCCAL 20 VACC 0.5ML INJ	$192.00	$240.00	$11.00–$344.19	41% below	20%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 PNEUMOCOCCAL 20 VACC 0.5ML INJ	$144.00	$240.00	$66.50–$2,315.52	—	40%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 PNEUMOCOCCAL 20 VACC 0.5ML INJ	$192.00	$240.00	$66.50–$2,315.52	—	20%
Pneumonia vaccine, 21-valent conjugate (Capvaxive) CPT 90684 CAPVAXIVE VACCINE 0.5 ML SYR	$189.60	$316.00	$11.00–$360.68	at median	40%
Pneumonia vaccine, 21-valent conjugate (Capvaxive) CPT 90684 CAPVAXIVE VACCINE 0.5 ML SYR	$252.80	$316.00	$11.00–$360.68	33% above	20%
Pneumonia vaccine, 21-valent conjugate (Capvaxive) inpatient CPT 90684 CAPVAXIVE VACCINE 0.5 ML SYR	$189.60	$316.00	$87.56–$2,315.52	—	40%
Pneumonia vaccine, 21-valent conjugate (Capvaxive) inpatient CPT 90684 CAPVAXIVE VACCINE 0.5 ML SYR	$252.80	$316.00	$87.56–$2,315.52	—	20%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PNEUMOCOCCAL VAC POLYVAL INJ	$75.00	$125.00	$11.00–$146.82	42% below	40%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 PNEUMOCOCCAL VAC POLYVAL INJ	$75.00	$125.00	$34.64–$2,315.52	—	40%
Polio vaccine, inactivated (IPV) CPT 90713 IPOL POLIOVIRUS VAC .5ML INJ	$38.40	$64.00	$9.60–$60.80	36% below	40%
Polio vaccine, inactivated (IPV) inpatient CPT 90713 IPOL POLIOVIRUS VAC .5ML INJ	$38.40	$64.00	$17.73–$2,315.52	—	40%
RSV antibody shot for infants, seasonal dose (0.5 mL) CPT 90380 NIRSEVIMAB-ALIP RSV 50MG/0.5ML	$1,184.80	$1,481.00	$11.00–$1,406.95	32% above	20%
RSV antibody shot for infants, seasonal dose (0.5 mL) inpatient CPT 90380 NIRSEVIMAB-ALIP RSV 50MG/0.5ML	$1,184.80	$1,481.00	$410.39–$2,315.52	—	20%
RSV vaccine (Abrysvo), one dose for older adults or during pregnancy CPT 90678 RSV VAC PREF A-PREF B(ABRYSVO)	$672.00	$840.00	$11.00–$798.00	33% above	20%
RSV vaccine (Abrysvo), one dose for older adults or during pregnancy inpatient CPT 90678 RSV VAC PREF A-PREF B(ABRYSVO)	$672.00	$840.00	$232.76–$2,315.52	—	20%
Rabies vaccine, one dose CPT 90675 RABAVERT RABIES VIAL/KIT	$600.00	$1,000.00	$11.00–$950.00	at median	40%
Rabies vaccine, one dose CPT 90675 RABAVERT RABIES VIAL/KIT	$800.00	$1,000.00	$11.00–$950.00	34% above	20%
Rabies vaccine, one dose inpatient CPT 90675 RABAVERT RABIES VIAL/KIT	$600.00	$1,000.00	$277.10–$2,315.52	—	40%
Rabies vaccine, one dose inpatient CPT 90675 RABAVERT RABIES VIAL/KIT	$800.00	$1,000.00	$277.10–$2,315.52	—	20%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TETANUS/DIPTHERIA INJ	$55.80	$93.00	$11.00–$88.35	at median	40%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TETANUS/DIPTHERIA INJ	$74.40	$93.00	$11.00–$88.35	33% above	20%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 TETANUS/DIPTHERIA INJ	$55.80	$93.00	$25.77–$2,315.52	—	40%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 TETANUS/DIPTHERIA INJ	$74.40	$93.00	$25.77–$2,315.52	—	20%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 BOOSTRIX VACCINE	$31.80	$53.00	$7.95–$50.35	43% below	40%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 BOOSTRIX VACCINE	$42.40	$53.00	$7.95–$50.35	24% below	20%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 BOOSTRIX VACCINE	$31.80	$53.00	$14.69–$2,315.52	—	40%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 BOOSTRIX VACCINE	$42.40	$53.00	$14.69–$2,315.52	—	20%
Typhoid vaccine, injectable (Vi polysaccharide) CPT 90691 TYPHOID VACCINE 0.5ML INACTIVE	$39.00	$65.00	$9.75–$61.75	53% below	40%
Typhoid vaccine, injectable (Vi polysaccharide) inpatient CPT 90691 TYPHOID VACCINE 0.5ML INACTIVE	$39.00	$65.00	$18.01–$2,315.52	—	40%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMM ADM ONE VAC SGL/COMB	$12.60	$21.00	$3.15–$19.95	80% below	40%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMM ADM ONE VAC SGL/COMB	$12.60	$21.00	$9.00–$2,315.52	—	40%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMUN ADM EA ADDL VACC SGL/COM	$12.60	$21.00	$3.15–$19.95	53% below	40%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 IMMUN ADM EA ADDL VACC SGL/COM	$12.60	$21.00	$9.00–$2,315.52	—	40%

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

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

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

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

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

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

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

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

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

Source file: https://dam.upmc.com/-/media/upmc/locations/hospitals/documents/cdm-json-files/240806023_upmc-muncy_standardcharges.csv?la=en&rev=b797323e0cb5490ca50f2f8c6c70d0ab&hash=40742ECC7202BA5C321E393791135EBE