Hospital Dubuque, IA

MercyOne Dyersville Medical Center

Listed in its price file as “Mercy Medical Center - Dyersville”.

MercyOne Dyersville Medical Center in Dyersville, IA publishes cash prices for 267 common procedures listed here, from its own machine-readable price file updated Mar 31, 2026. Compared with other hospitals in the state, its outpatient cash prices are above the Iowa median for 182 of 266 procedures and below it for 61. By typical cash price it ranks #69 of 90 Iowa hospitals, cheapest first. Select a procedure to compare it with other hospitals nearby.

1111 Third St. SW, Dyersville, IA 52040 Collected Sep 23, 2026 Source price file Check a bill from this hospital (563) 875-2900

Critical access hospital (rural, 25 beds or fewer) Nonprofit hospital Emergency department CCN 161378 · CMS hospital register NPI 1205816725

Financial assistance

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

MercyOne Dyersville Medical Center 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.

CMS price transparency record

The federal Centers for Medicare & Medicaid Services (CMS) enforces the rule that makes hospitals publish their prices. Its public enforcement list shows 1 action for a hospital named MercyOne Dyersville Medical Center in Dyersville, IA:

Jul 11, 2025 Met requirements

Met requirements: CMS reviewed the hospital and found it met the requirements, so no further action was taken.

A notice records a step in a CMS review; it is not a court finding. Source: CMS, Hospital Price Transparency Enforcement Activities and Outcomes, actions through Jul 31, 2026.

Scans and imaging

Procedure	Cash price	List price	Insurers pay	vs Iowa	Off list
Abdominal CT scan without and with contrast CPT 74170 HC CT Abdomen W/O & W/Contrast	$1,951.30	$3,002.00	$1,134.76–$3,379.05	at median	35%
Abdominal CT scan without and with contrast inpatient CPT 74170 HC CT Abdomen W/O & W/Contrast	$1,951.30	$3,002.00	$1,134.76–$3,379.05	—	35%
Abdominal X-ray, 2 views CPT 74019 HC Xr Abdomen 2 Views	$250.90	$386.00	$145.91–$434.48	1% above	35%
Abdominal X-ray, 2 views inpatient CPT 74019 HC Xr Abdomen 2 Views	$250.90	$386.00	$145.91–$434.48	—	35%
Ankle X-ray, complete, 3 or more views CPT 73610 HC Xr Ankle > 3 Views Bl	$407.55	$627.00	$237.01–$705.75	79% above	35%
Ankle X-ray, complete, 3 or more views one side CPT 73610 HC Xr Ankle > 3 Views Rt	$271.70	$418.00	$158.00–$470.50	20% above	35%
Ankle X-ray, complete, 3 or more views one side CPT 73610 HC Xr Ankle > 3 Views Lt	$271.70	$418.00	$158.00–$470.50	20% above	35%
Ankle X-ray, complete, 3 or more views inpatient CPT 73610 HC Xr Ankle > 3 Views Bl	$407.55	$627.00	$237.01–$705.75	—	35%
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 HC Xr Ankle > 3 Views Rt	$271.70	$418.00	$158.00–$470.50	—	35%
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 HC Xr Ankle > 3 Views Lt	$271.70	$418.00	$158.00–$470.50	—	35%
Arm CT scan without contrast (shoulder to hand, any part) CPT 73200 HC CT Upper Extremity W/O Contrast Bl	$1,701.70	$2,618.00	$989.60–$2,946.82	41% above	35%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 HC CT Upper Extremity W/O Contrast Rt	$1,134.25	$1,745.00	$659.61–$1,964.17	6% below	35%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 HC CT Upper Extremity W/O Contrast Lt	$1,134.25	$1,745.00	$659.61–$1,964.17	6% below	35%
Arm CT scan without contrast (shoulder to hand, any part) inpatient CPT 73200 HC CT Upper Extremity W/O Contrast Bl	$1,701.70	$2,618.00	$989.60–$2,946.82	—	35%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 HC CT Upper Extremity W/O Contrast Rt	$1,134.25	$1,745.00	$659.61–$1,964.17	—	35%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 HC CT Upper Extremity W/O Contrast Lt	$1,134.25	$1,745.00	$659.61–$1,964.17	—	35%
CT angiography (CTA) of the abdomen and pelvis CPT 74174 HC CT Angiography Abdomen & Pelvis W/O & W/Contrast	$4,206.80	$6,472.00	$2,446.42–$7,284.88	42% above	35%
CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174 HC CT Angiography Abdomen & Pelvis W/O & W/Contrast	$4,206.80	$6,472.00	$2,446.42–$7,284.88	—	35%
CT angiography (CTA) of the head CPT 70496 HC Cta Head W/O &/or W/Contrast	$2,528.50	$3,890.00	$1,470.42–$4,378.58	29% above	35%
CT angiography (CTA) of the head inpatient CPT 70496 HC Cta Head W/O &/or W/Contrast	$2,528.50	$3,890.00	$1,470.42–$4,378.58	—	35%
CT angiography (CTA) of the neck CPT 70498 HC Cta Neck W/O &/or W/Contrast	$2,558.40	$3,936.00	$1,487.81–$4,430.36	23% above	35%
CT angiography (CTA) of the neck inpatient CPT 70498 HC Cta Neck W/O &/or W/Contrast	$2,558.40	$3,936.00	$1,487.81–$4,430.36	—	35%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 HC Cta Chest W/O & W/Contrast	$983.45	$1,513.00	$571.91–$1,703.03	54% below	35%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 HC Cta Chest W/O & W/Contrast	$983.45	$1,513.00	$571.91–$1,703.03	—	35%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 HC CT Abdomen & Pelvis W/O Contrast	$3,052.40	$4,696.00	$1,775.09–$5,285.82	18% above	35%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 HC CT Abdomen & Pelvis W/O Contrast	$3,052.40	$4,696.00	$1,775.09–$5,285.82	—	35%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 HC CT Abdomen & Pelvis W/Contrast	$3,664.05	$5,637.00	$2,130.79–$6,345.01	15% above	35%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 HC CT Abdomen & Pelvis W/Contrast	$3,664.05	$5,637.00	$2,130.79–$6,345.01	—	35%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 HC CT Abdomen & Pelvis W/O & W/Contrast	$4,115.15	$6,331.00	$2,393.12–$7,126.17	20% above	35%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 HC CT Abdomen & Pelvis W/O & W/Contrast	$4,115.15	$6,331.00	$2,393.12–$7,126.17	—	35%
CT scan of the abdomen with contrast CPT 74160 HC CT Abdomen W/Contrast	$1,591.20	$2,448.00	$925.34–$2,755.47	4% below	35%
CT scan of the abdomen with contrast inpatient CPT 74160 HC CT Abdomen W/Contrast	$1,591.20	$2,448.00	$925.34–$2,755.47	—	35%
CT scan of the face and sinuses, no contrast dye CPT 70486 HC CT Maxillofacial W/O Contrast	$1,275.30	$1,962.00	$741.64–$2,208.43	1% below	35%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 HC CT Maxillofacial W/O Contrast	$1,275.30	$1,962.00	$741.64–$2,208.43	—	35%
CT scan of the head or brain, no contrast dye CPT 70450 HC CT Head/Brain W/O Contrast	$1,368.25	$2,105.00	$795.69–$2,369.39	at median	35%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 HC CT Head/Brain W/O Contrast	$1,368.25	$2,105.00	$795.69–$2,369.39	—	35%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 HC CT Lumbar Spine W/O Contrast	$1,517.10	$2,334.00	$882.25–$2,627.15	at median	35%
CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 HC CT Lumbar Spine W/O Contrast	$1,517.10	$2,334.00	$882.25–$2,627.15	—	35%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 HC CT Cervical Spine W/O Contrast	$1,506.05	$2,317.00	$875.83–$2,608.02	at median	35%
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 HC CT Cervical Spine W/O Contrast	$1,506.05	$2,317.00	$875.83–$2,608.02	—	35%
CT scan of the pelvis, with contrast dye CPT 72193 HC CT Pelvis W/Contrast	$1,740.05	$2,677.00	$1,011.91–$3,013.23	1% above	35%
CT scan of the pelvis, with contrast dye inpatient CPT 72193 HC CT Pelvis W/Contrast	$1,740.05	$2,677.00	$1,011.91–$3,013.23	—	35%
Chest X-ray, 2 views CPT 71046 HC Xr Chest 2 Views	$206.70	$318.00	$120.20–$357.94	at median	35%
Chest X-ray, 2 views inpatient CPT 71046 HC Xr Chest 2 Views	$206.70	$318.00	$120.20–$357.94	—	35%
Chest X-ray, single view CPT 71045 HC Xr Chest Single View	$167.70	$258.00	$97.52–$290.40	at median	35%
Chest X-ray, single view inpatient CPT 71045 HC Xr Chest Single View	$167.70	$258.00	$97.52–$290.40	—	35%
Collarbone (clavicle) X-ray, complete CPT 73000 HC Xr Clavicle Complete Bl	$271.05	$417.00	$157.63–$469.38	38% above	35%
Collarbone (clavicle) X-ray, complete one side CPT 73000 HC Xr Clavicle Complete Rt	$180.70	$278.00	$105.08–$312.92	8% below	35%
Collarbone (clavicle) X-ray, complete one side CPT 73000 HC Xr Clavicle Complete Lt	$180.70	$278.00	$105.08–$312.92	8% below	35%
Collarbone (clavicle) X-ray, complete inpatient CPT 73000 HC Xr Clavicle Complete Bl	$271.05	$417.00	$157.63–$469.38	—	35%
Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 HC Xr Clavicle Complete Rt	$180.70	$278.00	$105.08–$312.92	—	35%
Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 HC Xr Clavicle Complete Lt	$180.70	$278.00	$105.08–$312.92	—	35%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 HC CT Thorax Diagnostic W/O Contrast	$1,441.70	$2,218.00	$838.40–$2,496.58	5% above	35%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 HC CT Thorax Diagnostic W/O Contrast	$1,441.70	$2,218.00	$838.40–$2,496.58	—	35%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 HC CT Thorax Diagnostic W/Contrast	$1,812.20	$2,788.00	$1,053.86–$3,138.17	1% above	35%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 HC CT Thorax Diagnostic W/Contrast	$1,812.20	$2,788.00	$1,053.86–$3,138.17	—	35%
Diagnostic mammogram, both breasts both sides CPT 77066 HC Mammography Diagnostic Bilateral	$445.90	$686.00	$142.21–$772.16	—	35%
Diagnostic mammogram, both breasts inpatient both sides CPT 77066 HC Mammography Diagnostic Bilateral	$445.90	$686.00	$142.21–$772.16	—	35%
Diagnostic mammogram, one breast one side CPT 77065 HC Mammography Diagnostic Unilateral Lt	$297.05	$457.00	$112.74–$514.40	2% above	35%
Diagnostic mammogram, one breast one side CPT 77065 HC Mammography Diagnostic Unilateral Rt	$297.05	$457.00	$112.74–$514.40	2% above	35%
Diagnostic mammogram, one breast inpatient one side CPT 77065 HC Mammography Diagnostic Unilateral Rt	$297.05	$457.00	$112.74–$514.40	—	35%
Diagnostic mammogram, one breast inpatient one side CPT 77065 HC Mammography Diagnostic Unilateral Lt	$297.05	$457.00	$112.74–$514.40	—	35%
Elbow X-ray, 2 views CPT 73070 HC Xr Elbow 2 Views Bl	$237.25	$365.00	$137.97–$410.84	43% above	35%
Elbow X-ray, 2 views one side CPT 73070 HC Xr Elbow 2 Views Lt	$157.95	$243.00	$91.85–$273.52	5% below	35%
Elbow X-ray, 2 views one side CPT 73070 HC Xr Elbow 2 Views Rt	$157.95	$243.00	$91.85–$273.52	5% below	35%
Elbow X-ray, 2 views inpatient CPT 73070 HC Xr Elbow 2 Views Bl	$237.25	$365.00	$137.97–$410.84	—	35%
Elbow X-ray, 2 views inpatient one side CPT 73070 HC Xr Elbow 2 Views Lt	$157.95	$243.00	$91.85–$273.52	—	35%
Elbow X-ray, 2 views inpatient one side CPT 73070 HC Xr Elbow 2 Views Rt	$157.95	$243.00	$91.85–$273.52	—	35%
Elbow X-ray, complete, 3 or more views CPT 73080 HC Xr Elbow >= 3 Views Bl	$327.60	$504.00	$190.51–$567.30	50% above	35%
Elbow X-ray, complete, 3 or more views one side CPT 73080 HC Xr Elbow >= 3 Views Lt	$218.40	$336.00	$127.01–$378.20	at median	35%
Elbow X-ray, complete, 3 or more views one side CPT 73080 HC Xr Elbow >= 3 Views Rt	$218.40	$336.00	$127.01–$378.20	at median	35%
Elbow X-ray, complete, 3 or more views inpatient CPT 73080 HC Xr Elbow >= 3 Views Bl	$327.60	$504.00	$190.51–$567.30	—	35%
Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 HC Xr Elbow >= 3 Views Rt	$218.40	$336.00	$127.01–$378.20	—	35%
Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 HC Xr Elbow >= 3 Views Lt	$218.40	$336.00	$127.01–$378.20	—	35%
Forearm X-ray (radius and ulna), 2 views CPT 73090 HC Xr Forearm 2 Views Bl	$349.05	$537.00	$202.99–$604.45	74% above	35%
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 HC Xr Forearm 2 Views Lt	$232.70	$358.00	$135.32–$402.96	16% above	35%
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 HC Xr Forearm 2 Views Rt	$232.70	$358.00	$135.32–$402.96	16% above	35%
Forearm X-ray (radius and ulna), 2 views inpatient CPT 73090 HC Xr Forearm 2 Views Bl	$349.05	$537.00	$202.99–$604.45	—	35%
Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 HC Xr Forearm 2 Views Rt	$232.70	$358.00	$135.32–$402.96	—	35%
Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 HC Xr Forearm 2 Views Lt	$232.70	$358.00	$135.32–$402.96	—	35%
Hand X-ray, 2 views CPT 73120 HC Xr Hand 2 Views Bl	$235.95	$363.00	$137.21–$408.59	42% above	35%
Hand X-ray, 2 views one side CPT 73120 HC Xr Hand 2 Views Rt	$157.30	$242.00	$91.48–$272.40	5% below	35%
Hand X-ray, 2 views one side CPT 73120 HC Xr Hand 2 Views Lt	$157.30	$242.00	$91.48–$272.40	5% below	35%
Hand X-ray, 2 views inpatient CPT 73120 HC Xr Hand 2 Views Bl	$235.95	$363.00	$137.21–$408.59	—	35%
Hand X-ray, 2 views inpatient one side CPT 73120 HC Xr Hand 2 Views Rt	$157.30	$242.00	$91.48–$272.40	—	35%
Hand X-ray, 2 views inpatient one side CPT 73120 HC Xr Hand 2 Views Lt	$157.30	$242.00	$91.48–$272.40	—	35%
Heel bone (calcaneus) X-ray, 2 or more views CPT 73650 HC Xr Heel/Calcaneus > 2 Views Bl	$274.95	$423.00	$159.89–$476.13	62% above	35%
Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 HC Xr Heel/Calcaneus > 2 Views Rt	$183.30	$282.00	$106.60–$317.42	8% above	35%
Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 HC Xr Heel/Calcaneus > 2 Views Lt	$183.30	$282.00	$106.60–$317.42	8% above	35%
Heel bone (calcaneus) X-ray, 2 or more views inpatient CPT 73650 HC Xr Heel/Calcaneus > 2 Views Bl	$274.95	$423.00	$159.89–$476.13	—	35%
Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 HC Xr Heel/Calcaneus > 2 Views Rt	$183.30	$282.00	$106.60–$317.42	—	35%
Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 HC Xr Heel/Calcaneus > 2 Views Lt	$183.30	$282.00	$106.60–$317.42	—	35%
Knee X-ray, 3 views CPT 73562 HC Xr Knee 3 Views Bl	$319.15	$491.00	$185.60–$552.67	41% above	35%
Knee X-ray, 3 views one side CPT 73562 HC Xr Knee 3 Views Rt	$212.55	$327.00	$123.61–$368.07	6% below	35%
Knee X-ray, 3 views one side CPT 73562 HC Xr Knee 3 Views Lt	$212.55	$327.00	$123.61–$368.07	6% below	35%
Knee X-ray, 3 views inpatient CPT 73562 HC Xr Knee 3 Views Bl	$319.15	$491.00	$185.60–$552.67	—	35%
Knee X-ray, 3 views inpatient one side CPT 73562 HC Xr Knee 3 Views Rt	$212.55	$327.00	$123.61–$368.07	—	35%
Knee X-ray, 3 views inpatient one side CPT 73562 HC Xr Knee 3 Views Lt	$212.55	$327.00	$123.61–$368.07	—	35%
Knee X-ray, complete, 4 or more views CPT 73564 HC Xr Knee >=4 Views Bl	$483.60	$744.00	$281.23–$837.45	75% above	35%
Knee X-ray, complete, 4 or more views one side CPT 73564 HC Xr Knee >=4 Views Lt	$322.40	$496.00	$187.49–$558.30	17% above	35%
Knee X-ray, complete, 4 or more views one side CPT 73564 HC Xr Knee >=4 Views Rt	$322.40	$496.00	$187.49–$558.30	17% above	35%
Knee X-ray, complete, 4 or more views inpatient CPT 73564 HC Xr Knee >=4 Views Bl	$483.60	$744.00	$281.23–$837.45	—	35%
Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 HC Xr Knee >=4 Views Rt	$322.40	$496.00	$187.49–$558.30	—	35%
Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 HC Xr Knee >=4 Views Lt	$322.40	$496.00	$187.49–$558.30	—	35%
Leg CT scan without contrast (hip to foot, any part) CPT 73700 HC CT Lower Extremity W/O Contrast Bl	$2,120.95	$3,263.00	$1,233.41–$3,672.83	61% above	35%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 HC CT Lower Extremity W/O Contrast Rt	$1,413.75	$2,175.00	$822.15–$2,448.18	7% above	35%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 HC CT Lower Extremity W/O Contrast Lt	$1,413.75	$2,175.00	$822.15–$2,448.18	7% above	35%
Leg CT scan without contrast (hip to foot, any part) inpatient CPT 73700 HC CT Lower Extremity W/O Contrast Bl	$2,120.95	$3,263.00	$1,233.41–$3,672.83	—	35%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 HC CT Lower Extremity W/O Contrast Lt	$1,413.75	$2,175.00	$822.15–$2,448.18	—	35%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 HC CT Lower Extremity W/O Contrast Rt	$1,413.75	$2,175.00	$822.15–$2,448.18	—	35%
Lower leg X-ray (tibia and fibula), 2 views CPT 73590 HC Xr Tibia/Fibula 2 Views Bl	$295.75	$455.00	$171.99–$512.15	51% above	35%
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 HC Xr Tibia/Fibula 2 Views Rt	$196.95	$303.00	$114.53–$341.06	at median	35%
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 HC Xr Tibia/Fibula 2 Views Lt	$196.95	$303.00	$114.53–$341.06	at median	35%
Lower leg X-ray (tibia and fibula), 2 views inpatient CPT 73590 HC Xr Tibia/Fibula 2 Views Bl	$295.75	$455.00	$171.99–$512.15	—	35%
Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 HC Xr Tibia/Fibula 2 Views Rt	$196.95	$303.00	$114.53–$341.06	—	35%
Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 HC Xr Tibia/Fibula 2 Views Lt	$196.95	$303.00	$114.53–$341.06	—	35%
Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 HC Xr Cervical Spine 4-5 Views	$351.00	$540.00	$204.12–$607.82	10% above	35%
Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 HC Xr Cervical Spine 4-5 Views	$351.00	$540.00	$204.12–$607.82	—	35%
Neck soft tissue CT scan with contrast CPT 70491 HC CT Neck Soft Tissue W/Contrast	$1,603.55	$2,467.00	$932.53–$2,776.86	at median	35%
Neck soft tissue CT scan with contrast inpatient CPT 70491 HC CT Neck Soft Tissue W/Contrast	$1,603.55	$2,467.00	$932.53–$2,776.86	—	35%
Neck soft tissue X-ray CPT 70360 HC Xr Neck Soft Tissue	$189.15	$291.00	$110.00–$327.55	5% above	35%
Neck soft tissue X-ray inpatient CPT 70360 HC Xr Neck Soft Tissue	$189.15	$291.00	$110.00–$327.55	—	35%
Pelvic CT scan without contrast CPT 72192 HC CT Pelvis W/O Contrast	$1,290.90	$1,986.00	$750.71–$2,235.44	at median	35%
Pelvic CT scan without contrast inpatient CPT 72192 HC CT Pelvis W/O Contrast	$1,290.90	$1,986.00	$750.71–$2,235.44	—	35%
Rib X-ray, one side, 2 views one side CPT 71100 HC Xr Ribs 2 Views Lt	$217.75	$335.00	$126.63–$377.08	1% above	35%
Rib X-ray, one side, 2 views one side CPT 71100 HC Xr Ribs 2 Views Rt	$217.75	$335.00	$126.63–$377.08	1% above	35%
Rib X-ray, one side, 2 views inpatient one side CPT 71100 HC Xr Ribs 2 Views Lt	$217.75	$335.00	$126.63–$377.08	—	35%
Rib X-ray, one side, 2 views inpatient one side CPT 71100 HC Xr Ribs 2 Views Rt	$217.75	$335.00	$126.63–$377.08	—	35%
Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 HC Xr Ribs W/Posterior Anterior Chest 3 Views Lt	$494.00	$760.00	$287.28–$855.46	73% above	35%
Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 HC Xr Ribs W/Posterior Anterior Chest 3 Views Rt	$494.00	$760.00	$287.28–$855.46	73% above	35%
Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 HC Xr Ribs W/Posterior Anterior Chest 3 Views Rt	$494.00	$760.00	$287.28–$855.46	—	35%
Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 HC Xr Ribs W/Posterior Anterior Chest 3 Views Lt	$494.00	$760.00	$287.28–$855.46	—	35%
Screening mammogram, both breasts both sides CPT 77067 HC Mammography Screen Bilateral	$461.50	$710.00	$81.59–$710.00	—	35%
Screening mammogram, both breasts one side CPT 77067 HC Mammography Screen Bl Reduced Service Unilateral Only Completed	$307.45	$473.00	$81.59–$473.00	at median	35%
Screening mammogram, both breasts inpatient both sides CPT 77067 HC Mammography Screen Bilateral	$461.50	$710.00	$81.59–$710.00	—	35%
Screening mammogram, both breasts inpatient one side CPT 77067 HC Mammography Screen Bl Reduced Service Unilateral Only Completed	$307.45	$473.00	$81.59–$473.00	—	35%
Shoulder X-ray, complete, 2 or more views CPT 73030 HC Xr Shoulder > 2 Views Bl	$386.10	$594.00	$224.53–$668.61	70% above	35%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 HC Xr Shoulder > 2 Views Rt	$257.40	$396.00	$149.69–$445.74	13% above	35%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 HC Xr Shoulder > 2 Views Lt	$257.40	$396.00	$149.69–$445.74	13% above	35%
Shoulder X-ray, complete, 2 or more views inpatient CPT 73030 HC Xr Shoulder > 2 Views Bl	$386.10	$594.00	$224.53–$668.61	—	35%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 HC Xr Shoulder > 2 Views Rt	$257.40	$396.00	$149.69–$445.74	—	35%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 HC Xr Shoulder > 2 Views Lt	$257.40	$396.00	$149.69–$445.74	—	35%
Thigh bone (femur) X-ray, 2 or more views CPT 73552 HC Xr Femur >=2 Views Bl	$403.65	$621.00	$234.74–$699.00	106% above	35%
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 HC Xr Femur >=2 Views Rt	$269.10	$414.00	$156.49–$466.00	37% above	35%
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 HC Xr Femur >=2 Views Lt	$269.10	$414.00	$156.49–$466.00	37% above	35%
Thigh bone (femur) X-ray, 2 or more views inpatient CPT 73552 HC Xr Femur >=2 Views Bl	$403.65	$621.00	$234.74–$699.00	—	35%
Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 HC Xr Femur >=2 Views Lt	$269.10	$414.00	$156.49–$466.00	—	35%
Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 HC Xr Femur >=2 Views Rt	$269.10	$414.00	$156.49–$466.00	—	35%
Thoracic spine (mid back) CT scan without contrast CPT 72128 HC CT Thoracic Spine W/O Contrast	$1,330.55	$2,047.00	$773.77–$2,304.10	4% below	35%
Thoracic spine (mid back) CT scan without contrast inpatient CPT 72128 HC CT Thoracic Spine W/O Contrast	$1,330.55	$2,047.00	$773.77–$2,304.10	—	35%
Toe X-ray, 2 or more views CPT 73660 HC Xr Toe(S) > 2 Views Bl	$270.40	$416.00	$157.25–$468.25	58% above	35%
Toe X-ray, 2 or more views one side CPT 73660 HC Xr Toe(S) > 2 Views Lt	$180.05	$277.00	$104.71–$311.79	5% above	35%
Toe X-ray, 2 or more views one side CPT 73660 HC Xr Toe(S) > 2 Views Rt	$180.05	$277.00	$104.71–$311.79	5% above	35%
Toe X-ray, 2 or more views inpatient CPT 73660 HC Xr Toe(S) > 2 Views Bl	$270.40	$416.00	$157.25–$468.25	—	35%
Toe X-ray, 2 or more views inpatient one side CPT 73660 HC Xr Toe(S) > 2 Views Rt	$180.05	$277.00	$104.71–$311.79	—	35%
Toe X-ray, 2 or more views inpatient one side CPT 73660 HC Xr Toe(S) > 2 Views Lt	$180.05	$277.00	$104.71–$311.79	—	35%
Upper arm X-ray (humerus), 2 views one side CPT 73060 HC Xr Humerus >= 2 Views Rt	$201.50	$310.00	$117.18–$348.94	2% above	35%
Upper arm X-ray (humerus), 2 views one side CPT 73060 HC Xr Humerus >= 2 Views Lt	$201.50	$310.00	$117.18–$348.94	2% above	35%
Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 HC Xr Humerus >= 2 Views Lt	$201.50	$310.00	$117.18–$348.94	—	35%
Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 HC Xr Humerus >= 2 Views Rt	$201.50	$310.00	$117.18–$348.94	—	35%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 HC Scan Duplex Extremity Veins Unilateral/Limited Study Rt	$735.80	$1,132.00	$427.90–$1,274.18	13% above	35%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 HC Scan Duplex Extremity Veins Unilateral/Limited Study	$735.80	$1,132.00	$427.90–$1,274.18	13% above	35%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 HC Scan Duplex Extremity Veins Unilateral/Limited Study Lt	$735.80	$1,132.00	$427.90–$1,274.18	13% above	35%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 HC Scan Duplex Extremity Veins Unilateral/Limited Study Rt	$735.80	$1,132.00	$427.90–$1,274.18	—	35%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 HC Scan Duplex Extremity Veins Unilateral/Limited Study Lt	$735.80	$1,132.00	$427.90–$1,274.18	—	35%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 HC Scan Duplex Extremity Veins Unilateral/Limited Study	$735.80	$1,132.00	$427.90–$1,274.18	—	35%
Wrist X-ray, 2 views CPT 73100 HC Xr Wrist 2 Views Bl	$370.50	$570.00	$215.46–$641.59	97% above	35%
Wrist X-ray, 2 views one side CPT 73100 HC Xr Wrist 2 Views Rt	$247.00	$380.00	$143.64–$427.73	31% above	35%
Wrist X-ray, 2 views one side CPT 73100 HC Xr Wrist 2 Views Lt	$247.00	$380.00	$143.64–$427.73	31% above	35%
Wrist X-ray, 2 views inpatient CPT 73100 HC Xr Wrist 2 Views Bl	$370.50	$570.00	$215.46–$641.59	—	35%
Wrist X-ray, 2 views inpatient one side CPT 73100 HC Xr Wrist 2 Views Rt	$247.00	$380.00	$143.64–$427.73	—	35%
Wrist X-ray, 2 views inpatient one side CPT 73100 HC Xr Wrist 2 Views Lt	$247.00	$380.00	$143.64–$427.73	—	35%
Wrist X-ray, complete, 3 or more views CPT 73110 HC Xr Wrist >= 3 Views Bl	$413.40	$636.00	$240.41–$715.88	86% above	35%
Wrist X-ray, complete, 3 or more views one side CPT 73110 HC Xr Wrist >= 3 Views Rt	$275.60	$424.00	$160.27–$477.25	24% above	35%
Wrist X-ray, complete, 3 or more views one side CPT 73110 HC Xr Wrist >= 3 Views Lt	$275.60	$424.00	$160.27–$477.25	24% above	35%
Wrist X-ray, complete, 3 or more views inpatient CPT 73110 HC Xr Wrist >= 3 Views Bl	$413.40	$636.00	$240.41–$715.88	—	35%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 HC Xr Wrist >= 3 Views Lt	$275.60	$424.00	$160.27–$477.25	—	35%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 HC Xr Wrist >= 3 Views Rt	$275.60	$424.00	$160.27–$477.25	—	35%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 HC Xr Hip With Pelvis When Performed Unilateral 2-3 Views Lt	$222.30	$342.00	$129.28–$384.96	8% above	35%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 HC Xr Hip With Pelvis When Performed Unilateral 2-3 Views Rt	$222.30	$342.00	$129.28–$384.96	8% above	35%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 HC Xr Hip With Pelvis When Performed Unilateral 2-3 Views Rt	$222.30	$342.00	$129.28–$384.96	—	35%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 HC Xr Hip With Pelvis When Performed Unilateral 2-3 Views Lt	$222.30	$342.00	$129.28–$384.96	—	35%
X-ray of the abdomen, 1 view CPT 74018 HC Xr Abdomen 1 View	$163.15	$251.00	$94.88–$282.53	9% below	35%
X-ray of the abdomen, 1 view inpatient CPT 74018 HC Xr Abdomen 1 View	$163.15	$251.00	$94.88–$282.53	—	35%
X-ray of the ankle, 2 views CPT 73600 HC Xr Ankle 2 Views Bl	$356.20	$548.00	$207.14–$616.83	108% above	35%
X-ray of the ankle, 2 views one side CPT 73600 HC Xr Ankle 2 Views Lt	$237.25	$365.00	$137.97–$410.84	39% above	35%
X-ray of the ankle, 2 views one side CPT 73600 HC Xr Ankle 2 Views Rt	$237.25	$365.00	$137.97–$410.84	39% above	35%
X-ray of the ankle, 2 views inpatient CPT 73600 HC Xr Ankle 2 Views Bl	$356.20	$548.00	$207.14–$616.83	—	35%
X-ray of the ankle, 2 views inpatient one side CPT 73600 HC Xr Ankle 2 Views Lt	$237.25	$365.00	$137.97–$410.84	—	35%
X-ray of the ankle, 2 views inpatient one side CPT 73600 HC Xr Ankle 2 Views Rt	$237.25	$365.00	$137.97–$410.84	—	35%
X-ray of the finger(s), 2 or more views CPT 73140 HC Xr Finger(S) >= 2 Views Bl	$282.75	$435.00	$164.43–$489.64	68% above	35%
X-ray of the finger(s), 2 or more views one side CPT 73140 HC Xr Finger(S) >= 2 Views Lt	$188.50	$290.00	$109.62–$326.42	12% above	35%
X-ray of the finger(s), 2 or more views one side CPT 73140 HC Xr Finger(S) >= 2 Views Rt	$188.50	$290.00	$109.62–$326.42	12% above	35%
X-ray of the finger(s), 2 or more views inpatient CPT 73140 HC Xr Finger(S) >= 2 Views Bl	$282.75	$435.00	$164.43–$489.64	—	35%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 HC Xr Finger(S) >= 2 Views Rt	$188.50	$290.00	$109.62–$326.42	—	35%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 HC Xr Finger(S) >= 2 Views Lt	$188.50	$290.00	$109.62–$326.42	—	35%
X-ray of the foot, complete, 3 or more views CPT 73630 HC Xr Foot > 3 Views Bl	$339.30	$522.00	$197.32–$587.56	55% above	35%
X-ray of the foot, complete, 3 or more views one side CPT 73630 HC Xr Foot > 3 Views Rt	$226.20	$348.00	$131.54–$391.71	3% above	35%
X-ray of the foot, complete, 3 or more views one side CPT 73630 HC Xr Foot > 3 Views Lt	$226.20	$348.00	$131.54–$391.71	3% above	35%
X-ray of the foot, complete, 3 or more views inpatient CPT 73630 HC Xr Foot > 3 Views Bl	$339.30	$522.00	$197.32–$587.56	—	35%
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 HC Xr Foot > 3 Views Rt	$226.20	$348.00	$131.54–$391.71	—	35%
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 HC Xr Foot > 3 Views Lt	$226.20	$348.00	$131.54–$391.71	—	35%
X-ray of the hand, 3 or more views CPT 73130 HC Xr Hand >= 3 Views Bl	$305.50	$470.00	$177.66–$529.03	49% above	35%
X-ray of the hand, 3 or more views one side CPT 73130 HC Xr Hand >= 3 Views Lt	$203.45	$313.00	$118.31–$352.31	1% below	35%
X-ray of the hand, 3 or more views one side CPT 73130 HC Xr Hand >= 3 Views Rt	$203.45	$313.00	$118.31–$352.31	1% below	35%
X-ray of the hand, 3 or more views inpatient CPT 73130 HC Xr Hand >= 3 Views Bl	$305.50	$470.00	$177.66–$529.03	—	35%
X-ray of the hand, 3 or more views inpatient one side CPT 73130 HC Xr Hand >= 3 Views Rt	$203.45	$313.00	$118.31–$352.31	—	35%
X-ray of the hand, 3 or more views inpatient one side CPT 73130 HC Xr Hand >= 3 Views Lt	$203.45	$313.00	$118.31–$352.31	—	35%
X-ray of the knee, 1 or 2 views CPT 73560 HC Xr Knee 1-2 Views Bl	$266.50	$410.00	$154.98–$461.50	36% above	35%
X-ray of the knee, 1 or 2 views one side CPT 73560 HC Xr Knee 1-2 Views Rt	$177.45	$273.00	$103.19–$307.29	10% below	35%
X-ray of the knee, 1 or 2 views one side CPT 73560 HC Xr Knee 1-2 Views Lt	$177.45	$273.00	$103.19–$307.29	10% below	35%
X-ray of the knee, 1 or 2 views inpatient CPT 73560 HC Xr Knee 1-2 Views Bl	$266.50	$410.00	$154.98–$461.50	—	35%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 HC Xr Knee 1-2 Views Rt	$177.45	$273.00	$103.19–$307.29	—	35%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 HC Xr Knee 1-2 Views Lt	$177.45	$273.00	$103.19–$307.29	—	35%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 HC Xr Lumbosacral Spine 2-3 Views	$286.00	$440.00	$166.32–$495.26	3% above	35%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 HC Xr Lumbosacral Spine 2-3 Views	$286.00	$440.00	$166.32–$495.26	—	35%
X-ray of the lower back, 4 or more views CPT 72110 HC Xr Lumbosacral Spine >= 4 Views	$369.20	$568.00	$214.70–$639.34	4% above	35%
X-ray of the lower back, 4 or more views inpatient CPT 72110 HC Xr Lumbosacral Spine >= 4 Views	$369.20	$568.00	$214.70–$639.34	—	35%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 HC Xr Thoracic Spine 2 Views	$261.30	$402.00	$151.96–$452.49	5% above	35%
X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 HC Xr Thoracic Spine 2 Views	$261.30	$402.00	$151.96–$452.49	—	35%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 HC Xr Cervical Spine 2-3 Views	$251.55	$387.00	$146.29–$435.61	2% above	35%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 HC Xr Cervical Spine 2-3 Views	$251.55	$387.00	$146.29–$435.61	—	35%
X-ray of the pelvis, 1 or 2 views CPT 72170 HC Xr Pelvis 1-2 Views	$226.85	$349.00	$131.92–$392.83	17% above	35%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 HC Xr Pelvis 1-2 Views	$226.85	$349.00	$131.92–$392.83	—	35%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 HC Xr Sacrum/Coccyx >= 2 Views	$221.65	$341.00	$128.90–$383.83	2% above	35%
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 HC Xr Sacrum/Coccyx >= 2 Views	$221.65	$341.00	$128.90–$383.83	—	35%

Lab tests

Procedure	Cash price	List price	Insurers pay	vs Iowa	Off list
ACTH blood test CPT 82024 HC Warde Adrenocorticotropic Hormone (Acth)	$243.75	$375.00	$141.75–$422.10	40% above	35%
ACTH blood test inpatient CPT 82024 HC Warde Adrenocorticotropic Hormone (Acth)	$243.75	$375.00	$141.75–$422.10	—	35%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 HC Alt/Sgpt	$67.60	$104.00	$39.31–$117.06	55% above	35%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 HC Alt/Sgpt	$67.60	$104.00	$39.31–$117.06	—	35%
AST (aspartate aminotransferase) enzyme test CPT 84450 HC Ast/Sgot	$59.15	$91.00	$34.40–$102.43	38% above	35%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 HC Ast/Sgot	$59.15	$91.00	$34.40–$102.43	—	35%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 HC Acute Hepatitis Panel	$316.55	$487.00	$184.09–$548.17	40% above	35%
Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 HC Acute Hepatitis Panel	$316.55	$487.00	$184.09–$548.17	—	35%
Albumin blood test CPT 82040 HC Albumin Serum Plasma or Whole Blood	$57.85	$89.00	$33.64–$100.18	35% above	35%
Albumin blood test inpatient CPT 82040 HC Albumin Serum Plasma or Whole Blood	$57.85	$89.00	$33.64–$100.18	—	35%
Aldosterone blood test CPT 82088 HC Mayo Aldosterone 24 Hour Urine	$178.75	$275.00	$103.95–$309.54	7% above	35%
Aldosterone blood test CPT 82088 HC Mayo Aldosterone	$287.30	$442.00	$167.08–$497.52	72% above	35%
Aldosterone blood test inpatient CPT 82088 HC Mayo Aldosterone 24 Hour Urine	$178.75	$275.00	$103.95–$309.54	—	35%
Aldosterone blood test inpatient CPT 82088 HC Mayo Aldosterone	$287.30	$442.00	$167.08–$497.52	—	35%
Alkaline phosphatase (ALP) blood test CPT 84075 HC Alkaline Phosphatase	$40.95	$63.00	$23.81–$70.91	4% below	35%
Alkaline phosphatase (ALP) blood test inpatient CPT 84075 HC Alkaline Phosphatase	$40.95	$63.00	$23.81–$70.91	—	35%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Walnut Tree Ige	$28.60	$44.00	$16.63–$49.53	21% below	35%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Soybean Ige	$28.60	$44.00	$16.63–$49.53	21% below	35%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Wheat Ige	$28.60	$44.00	$16.63–$49.53	21% below	35%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Ragweed Short/Common Ige	$28.60	$44.00	$16.63–$49.53	21% below	35%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Pecan Nut Ige	$28.60	$44.00	$16.63–$49.53	21% below	35%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Penicillium Ige	$28.60	$44.00	$16.63–$49.53	21% below	35%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Strawberry Ige	$28.60	$44.00	$16.63–$49.53	21% below	35%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen White Ash Ige	$28.60	$44.00	$16.63–$49.53	21% below	35%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Rice Ige	$28.60	$44.00	$16.63–$49.53	21% below	35%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Timothy Grass Ige	$28.60	$44.00	$16.63–$49.53	21% below	35%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Pigweed Rough Ige	$28.60	$44.00	$16.63–$49.53	21% below	35%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Sweet Chestnut Ige	$28.60	$44.00	$16.63–$49.53	21% below	35%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Garlic Ige	$28.60	$44.00	$16.63–$49.53	21% below	35%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Gluten Ige	$28.60	$44.00	$16.63–$49.53	21% below	35%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Mulberry Tree (Morus Alba) Ige	$28.60	$44.00	$16.63–$49.53	21% below	35%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Oat Ige	$28.60	$44.00	$16.63–$49.53	21% below	35%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Cladosporium Herbarum Ige	$28.60	$44.00	$16.63–$49.53	21% below	35%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Dermatophagoides Farinae (House Dust Mite) Ige	$28.60	$44.00	$16.63–$49.53	21% below	35%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Clams Ige	$28.60	$44.00	$16.63–$49.53	21% below	35%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Hazelnut	$28.60	$44.00	$16.63–$49.53	21% below	35%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Dermatophagoides Pteronyssinus (House Dust Mite) Ige	$28.60	$44.00	$16.63–$49.53	21% below	35%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Peanut Ige	$28.60	$44.00	$16.63–$49.53	21% below	35%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Coconut Ige	$28.60	$44.00	$16.63–$49.53	21% below	35%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Lobster Ige	$28.60	$44.00	$16.63–$49.53	21% below	35%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Dog Epithelia Ige	$28.60	$44.00	$16.63–$49.53	21% below	35%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Codfish Ige	$28.60	$44.00	$16.63–$49.53	21% below	35%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Egg White Ige	$28.60	$44.00	$16.63–$49.53	21% below	35%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Maple Box Elder Ige	$28.60	$44.00	$16.63–$49.53	21% below	35%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Cashew Ige	$28.60	$44.00	$16.63–$49.53	21% below	35%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Corn Ige	$28.60	$44.00	$16.63–$49.53	21% below	35%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Milk Ige	$28.60	$44.00	$16.63–$49.53	21% below	35%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Egg Yolk Ige	$28.60	$44.00	$16.63–$49.53	21% below	35%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Cat Epithellium Ige	$28.60	$44.00	$16.63–$49.53	21% below	35%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Cottonwood Tree Ige	$28.60	$44.00	$16.63–$49.53	21% below	35%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Elm Tree Ige	$28.60	$44.00	$16.63–$49.53	21% below	35%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Mountain Cedar Ige	$28.60	$44.00	$16.63–$49.53	21% below	35%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Chicken Meat	$28.60	$44.00	$16.63–$49.53	21% below	35%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Crab Ige	$28.60	$44.00	$16.63–$49.53	21% below	35%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Avocado Ige	$28.60	$44.00	$16.63–$49.53	21% below	35%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Cacao Ige	$28.60	$44.00	$16.63–$49.53	21% below	35%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Macadamia Nut Ige	$28.60	$44.00	$16.63–$49.53	21% below	35%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Turkey Meat Ige	$28.60	$44.00	$16.63–$49.53	21% below	35%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Cheese Cheddar Ige	$28.60	$44.00	$16.63–$49.53	21% below	35%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Maple Leaf Sycamore London Plane Ige	$28.60	$44.00	$16.63–$49.53	21% below	35%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Cinnamon Ige	$28.60	$44.00	$16.63–$49.53	21% below	35%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Chick Pea Ige	$28.60	$44.00	$16.63–$49.53	21% below	35%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Hickory Pecan Tree Ige	$28.60	$44.00	$16.63–$49.53	21% below	35%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Galactose-Alpha-1,3-Galactose Ige	$28.60	$44.00	$16.63–$49.53	21% below	35%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Lima Bean Ige	$28.60	$44.00	$16.63–$49.53	21% below	35%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Marsh Elder Rough Ige	$28.60	$44.00	$16.63–$49.53	21% below	35%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Pea Ige	$28.60	$44.00	$16.63–$49.53	21% below	35%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Mountain Juniper Ige	$28.60	$44.00	$16.63–$49.53	21% below	35%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Horse Dander Ige	$28.60	$44.00	$16.63–$49.53	21% below	35%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Russian Thistle Ige	$28.60	$44.00	$16.63–$49.53	21% below	35%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Bakers Yeast Ige	$28.60	$44.00	$16.63–$49.53	21% below	35%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Banana Ige	$28.60	$44.00	$16.63–$49.53	21% below	35%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Beef Ige	$28.60	$44.00	$16.63–$49.53	21% below	35%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Bermuda Grass Ige	$28.60	$44.00	$16.63–$49.53	21% below	35%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Brazil Nut Ige	$28.60	$44.00	$16.63–$49.53	21% below	35%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Latex Ige	$28.60	$44.00	$16.63–$49.53	21% below	35%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Almonds Ige	$28.60	$44.00	$16.63–$49.53	21% below	35%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Aspergillus Fumigatus Ige	$28.60	$44.00	$16.63–$49.53	21% below	35%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Tomato Ige	$28.60	$44.00	$16.63–$49.53	21% below	35%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Alternaria Alternata Ige	$28.60	$44.00	$16.63–$49.53	21% below	35%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Pine Nut (Pinus Edulis) Ige	$28.60	$44.00	$16.63–$49.53	21% below	35%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Salmon Ige	$28.60	$44.00	$16.63–$49.53	21% below	35%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Scallop Ige	$28.60	$44.00	$16.63–$49.53	21% below	35%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Tuna Ige	$28.60	$44.00	$16.63–$49.53	21% below	35%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Pistachio (Pistacia Vera) Ige	$28.60	$44.00	$16.63–$49.53	21% below	35%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Cockroach Ige	$28.60	$44.00	$16.63–$49.53	21% below	35%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Sesame Seed Ige	$28.60	$44.00	$16.63–$49.53	21% below	35%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Walnut Ige	$28.60	$44.00	$16.63–$49.53	21% below	35%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Mouse Urine Protein Ige	$28.60	$44.00	$16.63–$49.53	21% below	35%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Pork Ige	$28.60	$44.00	$16.63–$49.53	21% below	35%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Oak Tree Ige	$28.60	$44.00	$16.63–$49.53	21% below	35%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Shrimp Ige	$28.60	$44.00	$16.63–$49.53	21% below	35%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Potato Ige	$28.60	$44.00	$16.63–$49.53	21% below	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Wheat Ige	$28.60	$44.00	$16.63–$49.53	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Horse Dander Ige	$28.60	$44.00	$16.63–$49.53	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Russian Thistle Ige	$28.60	$44.00	$16.63–$49.53	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Mountain Juniper Ige	$28.60	$44.00	$16.63–$49.53	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Pea Ige	$28.60	$44.00	$16.63–$49.53	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Marsh Elder Rough Ige	$28.60	$44.00	$16.63–$49.53	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Lima Bean Ige	$28.60	$44.00	$16.63–$49.53	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Galactose-Alpha-1,3-Galactose Ige	$28.60	$44.00	$16.63–$49.53	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Hickory Pecan Tree Ige	$28.60	$44.00	$16.63–$49.53	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Chick Pea Ige	$28.60	$44.00	$16.63–$49.53	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Cinnamon Ige	$28.60	$44.00	$16.63–$49.53	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Maple Leaf Sycamore London Plane Ige	$28.60	$44.00	$16.63–$49.53	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Cheese Cheddar Ige	$28.60	$44.00	$16.63–$49.53	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Turkey Meat Ige	$28.60	$44.00	$16.63–$49.53	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Macadamia Nut Ige	$28.60	$44.00	$16.63–$49.53	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Cacao Ige	$28.60	$44.00	$16.63–$49.53	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Avocado Ige	$28.60	$44.00	$16.63–$49.53	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Crab Ige	$28.60	$44.00	$16.63–$49.53	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Chicken Meat	$28.60	$44.00	$16.63–$49.53	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Mountain Cedar Ige	$28.60	$44.00	$16.63–$49.53	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Elm Tree Ige	$28.60	$44.00	$16.63–$49.53	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Cottonwood Tree Ige	$28.60	$44.00	$16.63–$49.53	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Cat Epithellium Ige	$28.60	$44.00	$16.63–$49.53	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Egg Yolk Ige	$28.60	$44.00	$16.63–$49.53	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Milk Ige	$28.60	$44.00	$16.63–$49.53	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Corn Ige	$28.60	$44.00	$16.63–$49.53	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Cashew Ige	$28.60	$44.00	$16.63–$49.53	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Maple Box Elder Ige	$28.60	$44.00	$16.63–$49.53	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Egg White Ige	$28.60	$44.00	$16.63–$49.53	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Codfish Ige	$28.60	$44.00	$16.63–$49.53	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Dog Epithelia Ige	$28.60	$44.00	$16.63–$49.53	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Lobster Ige	$28.60	$44.00	$16.63–$49.53	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Coconut Ige	$28.60	$44.00	$16.63–$49.53	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Peanut Ige	$28.60	$44.00	$16.63–$49.53	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Dermatophagoides Pteronyssinus (House Dust Mite) Ige	$28.60	$44.00	$16.63–$49.53	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Hazelnut	$28.60	$44.00	$16.63–$49.53	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Clams Ige	$28.60	$44.00	$16.63–$49.53	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Dermatophagoides Farinae (House Dust Mite) Ige	$28.60	$44.00	$16.63–$49.53	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Cladosporium Herbarum Ige	$28.60	$44.00	$16.63–$49.53	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Oat Ige	$28.60	$44.00	$16.63–$49.53	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Mulberry Tree (Morus Alba) Ige	$28.60	$44.00	$16.63–$49.53	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Gluten Ige	$28.60	$44.00	$16.63–$49.53	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Garlic Ige	$28.60	$44.00	$16.63–$49.53	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Sweet Chestnut Ige	$28.60	$44.00	$16.63–$49.53	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Pigweed Rough Ige	$28.60	$44.00	$16.63–$49.53	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Timothy Grass Ige	$28.60	$44.00	$16.63–$49.53	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Rice Ige	$28.60	$44.00	$16.63–$49.53	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen White Ash Ige	$28.60	$44.00	$16.63–$49.53	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Strawberry Ige	$28.60	$44.00	$16.63–$49.53	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Penicillium Ige	$28.60	$44.00	$16.63–$49.53	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Pecan Nut Ige	$28.60	$44.00	$16.63–$49.53	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Ragweed Short/Common Ige	$28.60	$44.00	$16.63–$49.53	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Soybean Ige	$28.60	$44.00	$16.63–$49.53	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Walnut Tree Ige	$28.60	$44.00	$16.63–$49.53	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Potato Ige	$28.60	$44.00	$16.63–$49.53	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Shrimp Ige	$28.60	$44.00	$16.63–$49.53	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Oak Tree Ige	$28.60	$44.00	$16.63–$49.53	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Pork Ige	$28.60	$44.00	$16.63–$49.53	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Mouse Urine Protein Ige	$28.60	$44.00	$16.63–$49.53	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Walnut Ige	$28.60	$44.00	$16.63–$49.53	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Sesame Seed Ige	$28.60	$44.00	$16.63–$49.53	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Cockroach Ige	$28.60	$44.00	$16.63–$49.53	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Pistachio (Pistacia Vera) Ige	$28.60	$44.00	$16.63–$49.53	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Tuna Ige	$28.60	$44.00	$16.63–$49.53	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Scallop Ige	$28.60	$44.00	$16.63–$49.53	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Salmon Ige	$28.60	$44.00	$16.63–$49.53	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Pine Nut (Pinus Edulis) Ige	$28.60	$44.00	$16.63–$49.53	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Alternaria Alternata Ige	$28.60	$44.00	$16.63–$49.53	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Tomato Ige	$28.60	$44.00	$16.63–$49.53	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Aspergillus Fumigatus Ige	$28.60	$44.00	$16.63–$49.53	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Almonds Ige	$28.60	$44.00	$16.63–$49.53	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Latex Ige	$28.60	$44.00	$16.63–$49.53	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Brazil Nut Ige	$28.60	$44.00	$16.63–$49.53	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Bermuda Grass Ige	$28.60	$44.00	$16.63–$49.53	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Beef Ige	$28.60	$44.00	$16.63–$49.53	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Banana Ige	$28.60	$44.00	$16.63–$49.53	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Bakers Yeast Ige	$28.60	$44.00	$16.63–$49.53	—	35%
Alpha-fetoprotein (AFP) blood test CPT 82105 HC Alpha-Fetoprotein Tumor Marker	$129.35	$199.00	$75.22–$223.99	39% above	35%
Alpha-fetoprotein (AFP) blood test CPT 82105 HC Mayo Alpha Fetoprotein Maternal	$129.35	$199.00	$75.22–$223.99	39% above	35%
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 HC Alpha-Fetoprotein Tumor Marker	$129.35	$199.00	$75.22–$223.99	—	35%
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 HC Mayo Alpha Fetoprotein Maternal	$129.35	$199.00	$75.22–$223.99	—	35%
Ammonia blood test CPT 82140 HC Ammonia	$154.70	$238.00	$14.42–$267.89	75% above	35%
Ammonia blood test CPT 82140 HC Warde 3717400 Ammonia 24 Hour Urine	$154.70	$238.00	$14.42–$267.89	75% above	35%
Ammonia blood test inpatient CPT 82140 HC Ammonia	$154.70	$238.00	$14.42–$267.89	—	35%
Ammonia blood test inpatient CPT 82140 HC Warde 3717400 Ammonia 24 Hour Urine	$154.70	$238.00	$14.42–$267.89	—	35%
Amylase blood test CPT 82150 HC Amylase Urine	$71.50	$110.00	$41.58–$123.82	34% above	35%
Amylase blood test CPT 82150 HC Amylase 24 Hour Urine	$71.50	$110.00	$41.58–$123.82	34% above	35%
Amylase blood test CPT 82150 HC Amylase	$71.50	$110.00	$41.58–$123.82	34% above	35%
Amylase blood test CPT 82150 HC Amylase Body Fluid	$71.50	$110.00	$41.58–$123.82	34% above	35%
Amylase blood test inpatient CPT 82150 HC Amylase Body Fluid	$71.50	$110.00	$41.58–$123.82	—	35%
Amylase blood test inpatient CPT 82150 HC Amylase	$71.50	$110.00	$41.58–$123.82	—	35%
Amylase blood test inpatient CPT 82150 HC Amylase Urine	$71.50	$110.00	$41.58–$123.82	—	35%
Amylase blood test inpatient CPT 82150 HC Amylase 24 Hour Urine	$71.50	$110.00	$41.58–$123.82	—	35%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 HC Cyclic Citrullinated Peptide Antibody	$97.50	$150.00	$56.70–$168.84	23% above	35%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 HC Cyclic Citrullinated Peptide Antibody	$97.50	$150.00	$56.70–$168.84	—	35%
Antinuclear antibody (ANA) blood test, screen CPT 86038 HC Antinuclear Antibodies	$105.95	$163.00	$61.61–$183.47	47% above	35%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 HC Antinuclear Antibodies	$105.95	$163.00	$61.61–$183.47	—	35%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 HC Natriuretic Peptide	$204.10	$314.00	$38.86–$353.44	31% above	35%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 HC Natriuretic Peptide	$204.10	$314.00	$38.86–$353.44	—	35%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HC Culture Throat	$94.90	$146.00	$55.19–$164.34	57% above	35%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HC Culture Wound	$94.90	$146.00	$55.19–$164.34	57% above	35%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HC Culture Body Fluid	$94.90	$146.00	$55.19–$164.34	57% above	35%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HC Culture Respiratory	$94.90	$146.00	$55.19–$164.34	57% above	35%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HC Culture Bacterial Other Source	$94.90	$146.00	$55.19–$164.34	57% above	35%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HC Culture Tissue	$94.90	$146.00	$55.19–$164.34	57% above	35%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HC Culture Catheter Tip	$94.90	$146.00	$55.19–$164.34	57% above	35%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HC Culture Environmental	$94.90	$146.00	$55.19–$164.34	57% above	35%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HC Culture CSF	$94.90	$146.00	$55.19–$164.34	57% above	35%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HC Culture Nasal	$94.90	$146.00	$55.19–$164.34	57% above	35%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HC Culture Eye	$94.90	$146.00	$55.19–$164.34	57% above	35%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HC Culture Ear	$94.90	$146.00	$55.19–$164.34	57% above	35%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HC Culture Genital	$94.90	$146.00	$55.19–$164.34	57% above	35%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HC Culture Sputum	$94.90	$146.00	$55.19–$164.34	57% above	35%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 HC Culture Bacterial Other Source	$94.90	$146.00	$55.19–$164.34	—	35%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 HC Culture Environmental	$94.90	$146.00	$55.19–$164.34	—	35%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 HC Culture Catheter Tip	$94.90	$146.00	$55.19–$164.34	—	35%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 HC Culture Sputum	$94.90	$146.00	$55.19–$164.34	—	35%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 HC Culture Eye	$94.90	$146.00	$55.19–$164.34	—	35%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 HC Culture Genital	$94.90	$146.00	$55.19–$164.34	—	35%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 HC Culture Ear	$94.90	$146.00	$55.19–$164.34	—	35%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 HC Culture Nasal	$94.90	$146.00	$55.19–$164.34	—	35%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 HC Culture Wound	$94.90	$146.00	$55.19–$164.34	—	35%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 HC Culture Body Fluid	$94.90	$146.00	$55.19–$164.34	—	35%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 HC Culture Respiratory	$94.90	$146.00	$55.19–$164.34	—	35%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 HC Culture Tissue	$94.90	$146.00	$55.19–$164.34	—	35%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 HC Culture Throat	$94.90	$146.00	$55.19–$164.34	—	35%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 HC Culture CSF	$94.90	$146.00	$55.19–$164.34	—	35%
Basic metabolic panel (blood test) CPT 80048 HC Basic Metabolic Panel (Calcium Total)	$103.35	$159.00	$60.10–$178.97	20% above	35%
Basic metabolic panel (blood test) CPT 80048 HC Basic Metabolic Panel (Calcium Total)	$448.50	—	$9.09	419% above	—
Basic metabolic panel (blood test) inpatient CPT 80048 HC Basic Metabolic Panel (Calcium Total)	$103.35	$159.00	$60.10–$178.97	—	35%
Bilirubin blood test, total CPT 82247 HC Bilirubin Total	$54.60	$84.00	$31.75–$94.55	20% above	35%
Bilirubin blood test, total CPT 82247 HC Mayo Bilirubin Total Body Fluid	$64.35	$99.00	$37.42–$111.43	41% above	35%
Bilirubin blood test, total inpatient CPT 82247 HC Bilirubin Total	$54.60	$84.00	$31.75–$94.55	—	35%
Bilirubin blood test, total inpatient CPT 82247 HC Mayo Bilirubin Total Body Fluid	$64.35	$99.00	$37.42–$111.43	—	35%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 HC Surgical Pathology Level 4 Gross & Microscopic Examination	$178.10	$274.00	$31.45–$308.41	at median	35%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 HC Surgical Pathology Level 4 Gross & Microscopic Examination	$178.10	$274.00	$31.45–$308.41	—	35%
Blood culture for bacteria CPT 87040 HC Culture Blood	$118.95	$183.00	$69.17–$205.98	30% above	35%
Blood culture for bacteria inpatient CPT 87040 HC Culture Blood	$118.95	$183.00	$69.17–$205.98	—	35%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 HC Collection of Venous Blood by Venipuncture	$29.25	$45.00	$9.09–$50.65	44% above	35%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 HC Collection of Venous Blood by Venipuncture	$29.25	$45.00	$9.09–$50.65	—	35%
Blood glucose (sugar) test CPT 82947 HC Glucose Blood Quantitative Fasting	$36.40	$56.00	$21.17–$63.03	at median	35%
Blood glucose (sugar) test CPT 82947 HC Glucose Blood Quantitative	$36.40	$56.00	$21.17–$63.03	at median	35%
Blood glucose (sugar) test inpatient CPT 82947 HC Glucose Blood Quantitative Fasting	$36.40	$56.00	$21.17–$63.03	—	35%
Blood glucose (sugar) test inpatient CPT 82947 HC Glucose Blood Quantitative	$36.40	$56.00	$21.17–$63.03	—	35%
Blood lead test CPT 83655 HC Lead Capillary	$90.35	$139.00	$52.54–$156.46	64% above	35%
Blood lead test CPT 83655 HC Warde 3400949 Lead 24 Hour Urine	$90.35	$139.00	$52.54–$156.46	64% above	35%
Blood lead test inpatient CPT 83655 HC Warde 3400949 Lead 24 Hour Urine	$90.35	$139.00	$52.54–$156.46	—	35%
Blood lead test inpatient CPT 83655 HC Lead Capillary	$90.35	$139.00	$52.54–$156.46	—	35%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 HC Hcg Qualitative	$85.15	$131.00	$49.52–$147.45	37% above	35%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 HC Hcg Qualitative Urine	$85.15	$131.00	$49.52–$147.45	37% above	35%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 HC Hcg Qualitative Urine	$85.15	$131.00	$49.52–$147.45	—	35%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 HC Hcg Qualitative	$85.15	$131.00	$49.52–$147.45	—	35%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 HC Blood Typing Abo Reference	$83.85	$129.00	$48.76–$145.20	47% above	35%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 HC Blood Typing Abo	$83.85	$129.00	$48.76–$145.20	47% above	35%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 HC Blood Typing Abo	$83.85	$129.00	$48.76–$145.20	—	35%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 HC Blood Typing Abo Reference	$83.85	$129.00	$48.76–$145.20	—	35%
Blood urea nitrogen (BUN) test CPT 84520 HC Urea Nitrogen	$42.25	$65.00	$24.57–$73.16	4% above	35%
Blood urea nitrogen (BUN) test inpatient CPT 84520 HC Urea Nitrogen	$42.25	$65.00	$24.57–$73.16	—	35%
C-peptide blood test CPT 84681 HC C-Peptide	$163.80	$252.00	$95.26–$283.65	57% above	35%
C-peptide blood test inpatient CPT 84681 HC C-Peptide	$163.80	$252.00	$95.26–$283.65	—	35%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 HC C-Reactive Protein	$70.85	$109.00	$41.20–$122.69	21% above	35%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 HC C-Reactive Protein	$70.85	$109.00	$41.20–$122.69	—	35%
C. difficile toxin gene test (stool PCR) CPT 87493 HC Infectious Agent Nucleic Acid Amplified Probe Clostridium Difficile Toxin Gene(S)	$126.10	$194.00	$73.33–$218.37	8% above	35%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 HC Infectious Agent Nucleic Acid Amplified Probe Clostridium Difficile Toxin Gene(S)	$126.10	$194.00	$73.33–$218.37	—	35%
CA 19-9 blood test (tumor marker) CPT 86301 HC Warde Immunoassay Tumor Antigen Quantitative Ca 19-9	$104.65	$161.00	$60.86–$181.22	7% above	35%
CA 19-9 blood test (tumor marker) CPT 86301 HC Immunoassay Tumor Antigen Quantitative Ca 19-9	$104.65	$161.00	$60.86–$181.22	7% above	35%
CA 19-9 blood test (tumor marker) inpatient CPT 86301 HC Warde Immunoassay Tumor Antigen Quantitative Ca 19-9	$104.65	$161.00	$60.86–$181.22	—	35%
CA 19-9 blood test (tumor marker) inpatient CPT 86301 HC Immunoassay Tumor Antigen Quantitative Ca 19-9	$104.65	$161.00	$60.86–$181.22	—	35%
CA-125 blood test (ovarian cancer marker) CPT 86304 HC Immunoassay Tumor Antigen Quantitative Ca 125	$131.95	$203.00	$76.73–$228.50	15% above	35%
CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 HC Immunoassay Tumor Antigen Quantitative Ca 125	$131.95	$203.00	$76.73–$228.50	—	35%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 HC Infectious Agent Nucleic Acid Amplified Probe Sars-Cov-2/Covid-19	$187.20	$288.00	$51.31–$324.17	57% above	35%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 HC Infectious Agent Nucleic Acid Amplified Probe Sars-Cov-2/Covid-19	$187.20	$288.00	$51.31–$324.17	—	35%
Calcium blood test, total CPT 82310 HC Calcium Total	$63.70	$98.00	$5.06–$98.00	49% above	35%
Calcium blood test, total CPT 82310 HC Calcium Total Urine	$63.70	$98.00	$5.06–$98.00	49% above	35%
Calcium blood test, total inpatient CPT 82310 HC Calcium Total Urine	$63.70	$98.00	$5.06–$98.00	—	35%
Calcium blood test, total inpatient CPT 82310 HC Calcium Total	$63.70	$98.00	$5.06–$98.00	—	35%
Carcinoembryonic antigen (CEA) test CPT 82378 HC Carcinoembryonic Ag (Cea)	$165.75	$255.00	$96.39–$287.03	59% above	35%
Carcinoembryonic antigen (CEA) test inpatient CPT 82378 HC Carcinoembryonic Ag (Cea)	$165.75	$255.00	$96.39–$287.03	—	35%
Chickenpox (varicella) immunity blood test CPT 86787 HC Varicella Zoster Antibody Igg	$90.35	$139.00	$52.54–$156.46	46% above	35%
Chickenpox (varicella) immunity blood test CPT 86787 HC Warde 3000906 Varicella Zoster Antibody Igg	$90.35	$139.00	$52.54–$156.46	46% above	35%
Chickenpox (varicella) immunity blood test CPT 86787 HC Mayo Varicella Zoster Antibody Igg CSF	$90.35	$139.00	$52.54–$156.46	46% above	35%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 HC Warde 3000906 Varicella Zoster Antibody Igg	$90.35	$139.00	$52.54–$156.46	—	35%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 HC Mayo Varicella Zoster Antibody Igg CSF	$90.35	$139.00	$52.54–$156.46	—	35%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 HC Varicella Zoster Antibody Igg	$90.35	$139.00	$52.54–$156.46	—	35%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 HC Mayo Infectious Agent Nucleic Acid Amplified Probe Chlamydia Trachomatis	$200.85	$309.00	$116.80–$347.81	76% above	35%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 HC Infectious Agent Nucleic Acid Amplified Probe Chlamydia Trachomatis	$200.85	$309.00	$116.80–$347.81	76% above	35%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 HC Infectious Agent Nucleic Acid Amplified Probe Chlamydia Trachomatis	$200.85	$309.00	$116.80–$347.81	—	35%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 HC Mayo Infectious Agent Nucleic Acid Amplified Probe Chlamydia Trachomatis	$200.85	$309.00	$116.80–$347.81	—	35%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 HC Lipid Panel	$110.50	$170.00	$64.26–$191.35	27% above	35%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 HC Lipid Panel	$110.50	$170.00	$64.26–$191.35	—	35%
Complete blood count (CBC) with differential CPT 85025 HC Cbc Automated/Differential Wbc Automated	$72.80	$112.00	$42.34–$126.07	11% above	35%
Complete blood count (CBC) with differential inpatient CPT 85025 HC Cbc Automated/Differential Wbc Automated	$72.80	$112.00	$42.34–$126.07	—	35%
Complete blood count (CBC), no differential CPT 85027 HC Cbc Automated	$56.55	$87.00	$6.47–$97.93	16% above	35%
Complete blood count (CBC), no differential inpatient CPT 85027 HC Cbc Automated	$56.55	$87.00	$6.47–$97.93	—	35%
Comprehensive metabolic panel (blood test) CPT 80053 HC Comprehensive Metabolic Panel	$126.10	$194.00	$73.33–$218.37	2% above	35%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 HC Comprehensive Metabolic Panel	$126.10	$194.00	$73.33–$218.37	—	35%
Cortisol blood test, total CPT 82533 HC Cortisol Total	$122.20	$188.00	$71.06–$211.61	25% above	35%
Cortisol blood test, total CPT 82533 HC Mayo Cortisol Total Saliva	$122.20	$188.00	$71.06–$211.61	25% above	35%
Cortisol blood test, total CPT 82533 HC Cortisol Total Am	$122.20	$188.00	$71.06–$211.61	25% above	35%
Cortisol blood test, total CPT 82533 HC Cortisol Total Pm	$122.20	$188.00	$71.06–$211.61	25% above	35%
Cortisol blood test, total inpatient CPT 82533 HC Cortisol Total	$122.20	$188.00	$71.06–$211.61	—	35%
Cortisol blood test, total inpatient CPT 82533 HC Cortisol Total Pm	$122.20	$188.00	$71.06–$211.61	—	35%
Cortisol blood test, total inpatient CPT 82533 HC Cortisol Total Am	$122.20	$188.00	$71.06–$211.61	—	35%
Cortisol blood test, total inpatient CPT 82533 HC Mayo Cortisol Total Saliva	$122.20	$188.00	$71.06–$211.61	—	35%
Creatine kinase (CK) blood test, total CPT 82550 HC Creatine Kinase	$66.30	$102.00	$6.44–$114.81	20% above	35%
Creatine kinase (CK) blood test, total inpatient CPT 82550 HC Creatine Kinase	$66.30	$102.00	$6.44–$114.81	—	35%
Creatinine blood test CPT 82565 HC Creatinine	$42.25	$65.00	$24.57–$73.16	at median	35%
Creatinine blood test inpatient CPT 82565 HC Creatinine	$42.25	$65.00	$24.57–$73.16	—	35%
Cytomegalovirus (CMV) antibody test CPT 86644 HC Cytomegalovirus (Cmv) Antibody Igg	$94.90	$146.00	$55.19–$164.34	41% above	35%
Cytomegalovirus (CMV) antibody test CPT 86644 HC Warde 3000445 Cytomegalovirus (Cmv) Antibody Igg	$94.90	$146.00	$55.19–$164.34	41% above	35%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 HC Warde 3000445 Cytomegalovirus (Cmv) Antibody Igg	$94.90	$146.00	$55.19–$164.34	—	35%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 HC Cytomegalovirus (Cmv) Antibody Igg	$94.90	$146.00	$55.19–$164.34	—	35%
D-dimer blood test (blood clot marker) CPT 85379 HC Fibrin Degradation D Dimer Quantitative	$145.60	$224.00	$84.67–$252.13	71% above	35%
D-dimer blood test (blood clot marker) inpatient CPT 85379 HC Fibrin Degradation D Dimer Quantitative	$145.60	$224.00	$84.67–$252.13	—	35%
DHEA sulfate (DHEA-S) blood test CPT 82627 HC Dhea-S (Dehydroepiand Sulfate)	$185.90	$286.00	$108.11–$321.92	68% above	35%
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 HC Dhea-S (Dehydroepiand Sulfate)	$185.90	$286.00	$108.11–$321.92	—	35%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC Drug Test(S) Presumptive Any Class Instrument Chemistry Analyzers Salicylate	$137.15	$211.00	$61.51–$237.50	3% above	35%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC Drug Test(S) Presumptive Any Class Instrument Chemistry Analyzers Acetaminophen	$137.15	$211.00	$61.51–$237.50	3% above	35%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC Mayo Drug Test(S) Presumptive Any Class Instrument Chemistry Analyzers Prescription/Otc	$137.15	$211.00	$61.51–$237.50	3% above	35%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC Drug Test(S) Presumptive Any Class Instrument Chemistry Analyzers	$137.15	$211.00	$61.51–$237.50	3% above	35%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC Mayo Drug Test(S) Presumptive Any Class Instrument Chem Anal Drug Screen Prescription Otc Urine	$137.15	$211.00	$61.51–$237.50	3% above	35%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC Mayo Drug Test(S) Presumptive Any Class Instrument Chemistry Analyzers	$137.15	$211.00	$61.51–$237.50	3% above	35%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC Mayo Drug Test(S) Presumptive Any Class Instrument Chemistry Analyzers	$137.15	$211.00	$61.51–$237.50	—	35%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC Mayo Drug Test(S) Presumptive Any Class Instrument Chemistry Analyzers Prescription/Otc	$137.15	$211.00	$61.51–$237.50	—	35%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC Mayo Drug Test(S) Presumptive Any Class Instrument Chem Anal Drug Screen Prescription Otc Urine	$137.15	$211.00	$61.51–$237.50	—	35%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC Drug Test(S) Presumptive Any Class Instrument Chemistry Analyzers Salicylate	$137.15	$211.00	$61.51–$237.50	—	35%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC Drug Test(S) Presumptive Any Class Instrument Chemistry Analyzers Acetaminophen	$137.15	$211.00	$61.51–$237.50	—	35%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC Drug Test(S) Presumptive Any Class Instrument Chemistry Analyzers	$137.15	$211.00	$61.51–$237.50	—	35%
Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 HC Electrolyte Panel	$63.05	$97.00	$36.67–$109.18	17% below	35%
Electrolyte panel (sodium, potassium, chloride, CO2) inpatient CPT 80051 HC Electrolyte Panel	$63.05	$97.00	$36.67–$109.18	—	35%
Epstein-Barr virus (EBV) antibody test CPT 86665 HC Epstein Barr Viral Capsid Antigen Antibody Igm	$120.90	$186.00	$70.31–$209.36	68% above	35%
Epstein-Barr virus (EBV) antibody test CPT 86665 HC Epstein Barr Viral Capsid Antigen Antibody Igg	$120.90	$186.00	$70.31–$209.36	68% above	35%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 HC Epstein Barr Viral Capsid Antigen Antibody Igm	$120.90	$186.00	$70.31–$209.36	—	35%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 HC Epstein Barr Viral Capsid Antigen Antibody Igg	$120.90	$186.00	$70.31–$209.36	—	35%
Estradiol blood test CPT 82670 HC Estradiol Total	$154.70	$238.00	$89.96–$267.89	23% above	35%
Estradiol blood test inpatient CPT 82670 HC Estradiol Total	$154.70	$238.00	$89.96–$267.89	—	35%
FSH (follicle-stimulating hormone) test CPT 83001 HC Gonadotropin Follicle Stimulating Hormone (Fsh)	$133.25	$205.00	$77.49–$230.75	29% above	35%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 HC Gonadotropin Follicle Stimulating Hormone (Fsh)	$133.25	$205.00	$77.49–$230.75	—	35%
Fecal calprotectin (stool inflammation test) CPT 83993 HC Mayo Calprotectin Fecal	$160.55	$247.00	$93.37–$278.02	4% below	35%
Fecal calprotectin (stool inflammation test) CPT 83993 HC Calprotectin Fecal	$160.55	$247.00	$93.37–$278.02	4% below	35%
Fecal calprotectin (stool inflammation test) inpatient CPT 83993 HC Calprotectin Fecal	$160.55	$247.00	$93.37–$278.02	—	35%
Fecal calprotectin (stool inflammation test) inpatient CPT 83993 HC Mayo Calprotectin Fecal	$160.55	$247.00	$93.37–$278.02	—	35%
Ferritin blood test (iron stores) CPT 82728 HC Ferritin	$107.25	$165.00	$62.37–$185.72	17% above	35%
Ferritin blood test (iron stores) inpatient CPT 82728 HC Ferritin	$107.25	$165.00	$62.37–$185.72	—	35%
Fibrinogen blood test CPT 85384 HC Fibrinogen Activity Teg	$67.60	$104.00	$10.30–$117.06	3% above	35%
Fibrinogen blood test CPT 85384 HC Fibrinogen Activity	$67.60	$104.00	$10.30–$117.06	3% above	35%
Fibrinogen blood test inpatient CPT 85384 HC Fibrinogen Activity	$67.60	$104.00	$10.30–$117.06	—	35%
Fibrinogen blood test inpatient CPT 85384 HC Fibrinogen Activity Teg	$67.60	$104.00	$10.30–$117.06	—	35%
Folate (folic acid) blood test CPT 82746 HC Folic Acid	$94.25	$145.00	$14.55–$163.21	5% above	35%
Folate (folic acid) blood test inpatient CPT 82746 HC Folic Acid	$94.25	$145.00	$14.55–$163.21	—	35%
Free T3 thyroid hormone test CPT 84481 HC T3 (Triiodothyronine) Free	$122.20	$188.00	$71.06–$211.61	18% above	35%
Free T3 thyroid hormone test inpatient CPT 84481 HC T3 (Triiodothyronine) Free	$122.20	$188.00	$71.06–$211.61	—	35%
Free T4 (free thyroxine) thyroid blood test CPT 84439 HC T4 (Thyroxine) Free	$78.65	$121.00	$45.74–$136.20	20% above	35%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 HC T4 (Thyroxine) Free	$78.65	$121.00	$45.74–$136.20	—	35%
Free testosterone test CPT 84402 HC Mayo Tgrp Testosterone Free	$152.10	$234.00	$88.45–$263.39	50% above	35%
Free testosterone test CPT 84402 HC Mayo Ttfb Testosterone Free	$152.10	$234.00	$88.45–$263.39	50% above	35%
Free testosterone test inpatient CPT 84402 HC Mayo Ttfb Testosterone Free	$152.10	$234.00	$88.45–$263.39	—	35%
Free testosterone test inpatient CPT 84402 HC Mayo Tgrp Testosterone Free	$152.10	$234.00	$88.45–$263.39	—	35%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 HC Gamma Glutamyltransferase	$60.45	$93.00	$35.15–$104.68	17% above	35%
Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 HC Gamma Glutamyltransferase	$60.45	$93.00	$35.15–$104.68	—	35%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 HC Glucose 2 Hr Post Dose	$41.60	$64.00	$24.19–$72.04	3% below	35%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 HC Glucose 1 Hr Post Dose	$41.60	$64.00	$24.19–$72.04	3% below	35%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 HC Glucose 2 Hr Post Dose	$41.60	$64.00	$24.19–$72.04	—	35%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 HC Glucose 1 Hr Post Dose	$41.60	$64.00	$24.19–$72.04	—	35%
Glucose tolerance test, 3 samples CPT 82951 HC Glucose Tolerance Test (Gtt) 3 Specimens	$92.30	$142.00	$21.62–$159.84	2% above	35%
Glucose tolerance test, 3 samples inpatient CPT 82951 HC Glucose Tolerance Test (Gtt) 3 Specimens	$92.30	$142.00	$21.62–$159.84	—	35%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 HC Infectious Agent Nucleic Acid Amplified Probe Neisseria Gonorrhoeae	$193.05	$297.00	$112.27–$334.30	78% above	35%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 HC Infectious Agent Nucleic Acid Amplified Probe Neisseria Gonorrhoeae	$193.05	$297.00	$112.27–$334.30	—	35%
H. pylori antibody blood test CPT 86677 HC Helicobacter Pylori Antibody Igm	$79.95	$123.00	$46.49–$138.45	2% above	35%
H. pylori antibody blood test inpatient CPT 86677 HC Helicobacter Pylori Antibody Igm	$79.95	$123.00	$46.49–$138.45	—	35%
H. pylori stool antigen test CPT 87338 HC Infectious Agent Antigen Immunoassay Ql/Sq Multi Step Helicobacter Pylori Stool	$210.60	$324.00	$14.67–$364.69	85% above	35%
H. pylori stool antigen test inpatient CPT 87338 HC Infectious Agent Antigen Immunoassay Ql/Sq Multi Step Helicobacter Pylori Stool	$210.60	$324.00	$14.67–$364.69	—	35%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HC Infectious Agent Nucleic Acid Quantification Hiv-1	$219.05	$337.00	$127.39–$379.33	20% below	35%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HC Mayo Infectious Agent Nucleic Acid Quantification Hiv-1	$219.05	$337.00	$127.39–$379.33	20% below	35%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HC Mayo Infectious Agent Nucleic Acid Quantification Hiv-1	$219.05	$337.00	$127.39–$379.33	—	35%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HC Infectious Agent Nucleic Acid Quantification Hiv-1	$219.05	$337.00	$127.39–$379.33	—	35%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HC Infectious Agent Antigen Immunoassay Ql/Sq Multi Step Hiv-1 Antigen(S) Hiv-1&2 Antibodies	$123.50	$190.00	$71.82–$213.86	63% above	35%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HC Mayo Infectious Agent Antigen Immunoassay Ql/Sq Multi Step Hiv-1 Antigen(S) Hiv-1&2 Antibodies	$123.50	$190.00	$71.82–$213.86	63% above	35%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HC Mayo Infectious Agent Antigen Immunoassay Ql/Sq Multi Step Hiv-1 Antigen(S) Hiv-1&2 Antibodies	$123.50	$190.00	$71.82–$213.86	—	35%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HC Infectious Agent Antigen Immunoassay Ql/Sq Multi Step Hiv-1 Antigen(S) Hiv-1&2 Antibodies	$123.50	$190.00	$71.82–$213.86	—	35%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HC Hemoglobin Glycosylated (A1c)	$79.30	$122.00	$46.12–$137.32	22% above	35%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HC Hemoglobin Glycosylated (A1c)	$79.30	$122.00	$46.12–$137.32	—	35%
Hemoglobin blood test CPT 85018 HC Hemoglobin	$25.35	$39.00	$14.74–$43.90	13% below	35%
Hemoglobin blood test CPT 85018 HC Hemoglobin	$538.85	—	$9.09	1758% above	—
Hemoglobin blood test inpatient CPT 85018 HC Hemoglobin	$25.35	$39.00	$14.74–$43.90	—	35%
Hepatitis B core antibody test (total) CPT 86704 HC Hepatitis B Core Antibody Total	$96.20	$148.00	$55.94–$166.59	35% above	35%
Hepatitis B core antibody test (total) inpatient CPT 86704 HC Hepatitis B Core Antibody Total	$96.20	$148.00	$55.94–$166.59	—	35%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HC Hepatitis B Surface Antibody	$107.90	$166.00	$62.75–$186.85	57% above	35%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HC Hepatitis B Surface Antibody	$107.90	$166.00	$62.75–$186.85	—	35%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HC Infectious Agent Antigen Immunoassay Ql/Sq Multi Step Hepatitis B Surface Agn	$94.25	$145.00	$10.12–$145.00	34% above	35%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HC Infectious Agent Antigen Immunoassay Ql/Sq Multi Step Hepatitis B Surface Agn	$94.25	$145.00	$10.12–$145.00	—	35%
Hepatitis C antibody blood test (screening) CPT 86803 HC Hepatitis C Antibody	$126.75	$195.00	$13.98–$195.00	62% above	35%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 HC Hepatitis C Antibody	$126.75	$195.00	$13.98–$195.00	—	35%
Hepatitis C viral load (HCV RNA) test CPT 87522 HC Infectious Agent Nucleic Acid Quantification Hepatitis C	$308.10	$474.00	$179.17–$533.53	10% above	35%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HC Infectious Agent Nucleic Acid Quantification Hepatitis C	$308.10	$474.00	$179.17–$533.53	—	35%
Herpes blood test, HSV-1 antibody CPT 86695 HC Herpes Simplex Type 1 Antibody Igg	$85.80	$132.00	$49.90–$148.58	27% above	35%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 HC Herpes Simplex Type 1 Antibody Igg	$85.80	$132.00	$49.90–$148.58	—	35%
Herpes blood test, HSV-2 antibody CPT 86696 HC Herpes Simplex Type 2 Antibody Igg	$57.85	$89.00	$33.64–$100.18	at median	35%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HC Herpes Simplex Type 2 Antibody Igg	$57.85	$89.00	$33.64–$100.18	—	35%
High-sensitivity CRP (hs-CRP) test CPT 86141 HC C-Reactive Protein High Sensitivity	$129.35	$199.00	$12.69–$199.00	60% above	35%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 HC C-Reactive Protein High Sensitivity	$129.35	$199.00	$12.69–$199.00	—	35%
Homocysteine blood test CPT 83090 HC Homocysteine	$181.35	$279.00	$105.46–$314.04	89% above	35%
Homocysteine blood test inpatient CPT 83090 HC Homocysteine	$181.35	$279.00	$105.46–$314.04	—	35%
Insulin blood test CPT 83525 HC Insulin Total	$85.80	$132.00	$49.90–$148.58	12% above	35%
Insulin blood test inpatient CPT 83525 HC Insulin Total	$85.80	$132.00	$49.90–$148.58	—	35%
Iron blood test (serum iron) CPT 83540 HC Iron	$53.30	$82.00	$31.00–$92.30	18% above	35%
Iron blood test (serum iron) inpatient CPT 83540 HC Iron	$53.30	$82.00	$31.00–$92.30	—	35%
Iron-binding capacity (TIBC) test CPT 83550 HC Iron Binding Capacity	$63.05	$97.00	$36.67–$109.18	27% above	35%
Iron-binding capacity (TIBC) test inpatient CPT 83550 HC Iron Binding Capacity	$63.05	$97.00	$36.67–$109.18	—	35%
Kidney function blood test panel CPT 80069 HC Renal Function Panel	$94.25	$145.00	$54.81–$163.21	7% above	35%
Kidney function blood test panel inpatient CPT 80069 HC Renal Function Panel	$94.25	$145.00	$54.81–$163.21	—	35%
LH (luteinizing hormone) test CPT 83002 HC Gonadotropin Luteinizing Hormone (Lh)	$135.20	$208.00	$78.62–$234.12	51% above	35%
LH (luteinizing hormone) test inpatient CPT 83002 HC Gonadotropin Luteinizing Hormone (Lh)	$135.20	$208.00	$78.62–$234.12	—	35%
Lactate (lactic acid) blood test CPT 83605 HC Lactic Acid CSF	$81.90	$126.00	$47.63–$141.83	at median	35%
Lactate (lactic acid) blood test CPT 83605 HC Lactic Acid	$81.90	$126.00	$47.63–$141.83	at median	35%
Lactate (lactic acid) blood test CPT 83605 HC Lactic Acid Venous Whole Blood	$81.90	$126.00	$47.63–$141.83	at median	35%
Lactate (lactic acid) blood test inpatient CPT 83605 HC Lactic Acid	$81.90	$126.00	$47.63–$141.83	—	35%
Lactate (lactic acid) blood test inpatient CPT 83605 HC Lactic Acid CSF	$81.90	$126.00	$47.63–$141.83	—	35%
Lactate (lactic acid) blood test inpatient CPT 83605 HC Lactic Acid Venous Whole Blood	$81.90	$126.00	$47.63–$141.83	—	35%
Lactate dehydrogenase (LDH) blood test CPT 83615 HC Lactate Dehydrogenase (Ldh)	$48.75	$75.00	$28.35–$84.42	9% above	35%
Lactate dehydrogenase (LDH) blood test CPT 83615 HC Mayo Ld_I Lactate Dehydrogenase (Ldh)	$48.75	$75.00	$28.35–$84.42	9% above	35%
Lactate dehydrogenase (LDH) blood test CPT 83615 HC Lactate Dehydrogenase (Ldh) Body Fluid	$48.75	$75.00	$28.35–$84.42	9% above	35%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 HC Lactate Dehydrogenase (Ldh)	$48.75	$75.00	$28.35–$84.42	—	35%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 HC Lactate Dehydrogenase (Ldh) Body Fluid	$48.75	$75.00	$28.35–$84.42	—	35%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 HC Mayo Ld_I Lactate Dehydrogenase (Ldh)	$48.75	$75.00	$28.35–$84.42	—	35%
Lipase blood test (pancreas enzyme) CPT 83690 HC Lipase	$83.20	$128.00	$48.38–$144.08	28% above	35%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 HC Lipase	$83.20	$128.00	$48.38–$144.08	—	35%
Liver function blood test panel CPT 80076 HC Hepatic Function Panel	$110.50	$170.00	$64.26–$191.35	24% above	35%
Liver function blood test panel inpatient CPT 80076 HC Hepatic Function Panel	$110.50	$170.00	$64.26–$191.35	—	35%
Lyme disease antibody test CPT 86618 HC Borrelia Burgdorferi (Lyme Disease) Antibody Igm	$136.50	$210.00	$79.38–$236.38	56% above	35%
Lyme disease antibody test CPT 86618 HC Mayo Borrelia Burgdorferi (Lyme Disease) Antibody Igg CSF	$136.50	$210.00	$79.38–$236.38	56% above	35%
Lyme disease antibody test CPT 86618 HC Borrelia Burgdorferi (Lyme Disease) Antibody Nonspecific	$136.50	$210.00	$79.38–$236.38	56% above	35%
Lyme disease antibody test CPT 86618 HC Borrelia Burgdorferi (Lyme Disease) Antibody Igg	$136.50	$210.00	$79.38–$236.38	56% above	35%
Lyme disease antibody test inpatient CPT 86618 HC Borrelia Burgdorferi (Lyme Disease) Antibody Igg	$136.50	$210.00	$79.38–$236.38	—	35%
Lyme disease antibody test inpatient CPT 86618 HC Borrelia Burgdorferi (Lyme Disease) Antibody Nonspecific	$136.50	$210.00	$79.38–$236.38	—	35%
Lyme disease antibody test inpatient CPT 86618 HC Mayo Borrelia Burgdorferi (Lyme Disease) Antibody Igg CSF	$136.50	$210.00	$79.38–$236.38	—	35%
Lyme disease antibody test inpatient CPT 86618 HC Borrelia Burgdorferi (Lyme Disease) Antibody Igm	$136.50	$210.00	$79.38–$236.38	—	35%
Magnesium blood test CPT 83735 HC Magnesium Urine	$69.55	$107.00	$40.45–$120.44	38% above	35%
Magnesium blood test CPT 83735 HC Magnesium	$69.55	$107.00	$40.45–$120.44	38% above	35%
Magnesium blood test CPT 83735 HC Magnesium 24 Hour Urine	$69.55	$107.00	$40.45–$120.44	38% above	35%
Magnesium blood test inpatient CPT 83735 HC Magnesium 24 Hour Urine	$69.55	$107.00	$40.45–$120.44	—	35%
Magnesium blood test inpatient CPT 83735 HC Magnesium	$69.55	$107.00	$40.45–$120.44	—	35%
Magnesium blood test inpatient CPT 83735 HC Magnesium Urine	$69.55	$107.00	$40.45–$120.44	—	35%
Measles (rubeola) antibody test CPT 86765 HC Rubeola Antibody Igg	$48.10	$74.00	$27.97–$83.29	24% below	35%
Measles (rubeola) antibody test inpatient CPT 86765 HC Rubeola Antibody Igg	$48.10	$74.00	$27.97–$83.29	—	35%
Mono test (heterophile antibody, Monospot) CPT 86308 HC Heterophile Antibodies Screening	$52.00	$80.00	$30.24–$90.05	at median	35%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 HC Heterophile Antibodies Screening	$52.00	$80.00	$30.24–$90.05	—	35%
Mumps immunity blood test CPT 86735 HC Mayo Mmpgm Mumps Antibody Igg	$78.00	$120.00	$45.36–$135.07	42% above	35%
Mumps immunity blood test CPT 86735 HC Mumps Antibody Igg	$78.00	$120.00	$45.36–$135.07	42% above	35%
Mumps immunity blood test inpatient CPT 86735 HC Mayo Mmpgm Mumps Antibody Igg	$78.00	$120.00	$45.36–$135.07	—	35%
Mumps immunity blood test inpatient CPT 86735 HC Mumps Antibody Igg	$78.00	$120.00	$45.36–$135.07	—	35%
PSA (prostate-specific antigen) blood test, free CPT 84154 HC Mayo Psaft Prostate Specific Antigen Free	$140.40	$216.00	$81.65–$243.13	52% above	35%
PSA (prostate-specific antigen) blood test, free CPT 84154 HC Prostate Specific Antigen Free	$140.40	$216.00	$81.65–$243.13	52% above	35%
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 HC Mayo Psaft Prostate Specific Antigen Free	$140.40	$216.00	$81.65–$243.13	—	35%
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 HC Prostate Specific Antigen Free	$140.40	$216.00	$81.65–$243.13	—	35%
PSA (prostate-specific antigen) blood test, total CPT 84153 HC Mayo Psaft Prostate Specific Antigen Total	$122.20	$188.00	$71.06–$211.61	27% above	35%
PSA (prostate-specific antigen) blood test, total CPT 84153 HC Prostate Specific Antigen Total	$122.20	$188.00	$71.06–$211.61	27% above	35%
PSA (prostate-specific antigen) blood test, total CPT 84153 HC Mayo Prostate Specific Antigen Total Ultrasensitive	$122.20	$188.00	$71.06–$211.61	27% above	35%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 HC Prostate Specific Antigen Total	$122.20	$188.00	$71.06–$211.61	—	35%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 HC Mayo Psaft Prostate Specific Antigen Total	$122.20	$188.00	$71.06–$211.61	—	35%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 HC Mayo Prostate Specific Antigen Total Ultrasensitive	$122.20	$188.00	$71.06–$211.61	—	35%
Parathyroid hormone (PTH) blood test CPT 83970 HC Parathormone (Pth) Intact Intraoperative	$238.55	$367.00	$138.73–$413.10	34% above	35%
Parathyroid hormone (PTH) blood test CPT 83970 HC Parathormone (Pth) Intact	$238.55	$367.00	$138.73–$413.10	34% above	35%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 HC Parathormone (Pth) Intact Intraoperative	$238.55	$367.00	$138.73–$413.10	—	35%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 HC Parathormone (Pth) Intact	$238.55	$367.00	$138.73–$413.10	—	35%
Partial thromboplastin time (PTT) clotting test CPT 85730 HC Thromboplastin Time Partial (Ptt)	$64.35	$99.00	$37.42–$111.43	32% above	35%
Partial thromboplastin time (PTT) clotting test CPT 85730 HC Thromboplastin Time Partial (Ptt)	$378.30	—	$9.09	678% above	—
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 HC Thromboplastin Time Partial (Ptt)	$64.35	$99.00	$37.42–$111.43	—	35%
Phosphorus (phosphate) blood test CPT 84100 HC Phosphorus	$52.00	$80.00	$30.24–$90.05	24% above	35%
Phosphorus (phosphate) blood test inpatient CPT 84100 HC Phosphorus	$52.00	$80.00	$30.24–$90.05	—	35%
Potassium blood test CPT 84132 HC Potassium Serum/Plasma/Whole Blood	$43.55	$67.00	$25.33–$75.42	6% above	35%
Potassium blood test inpatient CPT 84132 HC Potassium Serum/Plasma/Whole Blood	$43.55	$67.00	$25.33–$75.42	—	35%
Progesterone blood test CPT 84144 HC Progesterone	$107.25	$165.00	$62.37–$185.72	9% above	35%
Progesterone blood test inpatient CPT 84144 HC Progesterone	$107.25	$165.00	$62.37–$185.72	—	35%
Prolactin blood test CPT 84146 HC Prolactin	$149.50	$230.00	$86.94–$258.89	43% above	35%
Prolactin blood test inpatient CPT 84146 HC Prolactin	$149.50	$230.00	$86.94–$258.89	—	35%
Prothrombin time (PT/INR) clotting test CPT 85610 HC Prothrombin Time	$42.90	$66.00	$24.95–$74.29	31% above	35%
Prothrombin time (PT/INR) clotting test CPT 85610 HC Prothrombin Time	$72.15	—	$9.09	120% above	—
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 HC Prothrombin Time	$42.90	$66.00	$24.95–$74.29	—	35%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 HC Infectious Agent Antigen Immunoassay Direct Optical Observation Streptococcus A	$94.25	$145.00	$54.81–$163.21	75% above	35%
Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 HC Infectious Agent Antigen Immunoassay Direct Optical Observation Streptococcus A	$94.25	$145.00	$54.81–$163.21	—	35%
Renin blood test CPT 84244 HC Mayo Renin	$120.25	$185.00	$69.93–$208.24	13% above	35%
Renin blood test CPT 84244 HC Warde Renin	$120.25	$185.00	$69.93–$208.24	13% above	35%
Renin blood test inpatient CPT 84244 HC Mayo Renin	$120.25	$185.00	$69.93–$208.24	—	35%
Renin blood test inpatient CPT 84244 HC Warde Renin	$120.25	$185.00	$69.93–$208.24	—	35%
Rh blood typing CPT 86901 HC Blood Typing Rh (D)	$44.85	$69.00	$26.08–$77.67	at median	35%
Rh blood typing CPT 86901 HC Blood Typing Rh (D) Reference	$44.85	$69.00	$26.08–$77.67	at median	35%
Rh blood typing inpatient CPT 86901 HC Blood Typing Rh (D)	$44.85	$69.00	$26.08–$77.67	—	35%
Rh blood typing inpatient CPT 86901 HC Blood Typing Rh (D) Reference	$44.85	$69.00	$26.08–$77.67	—	35%
Rheumatoid factor (RF) test CPT 86431 HC Rheumatoid Factor Quantitative	$70.20	$108.00	$40.82–$121.56	28% above	35%
Rheumatoid factor (RF) test inpatient CPT 86431 HC Rheumatoid Factor Quantitative	$70.20	$108.00	$40.82–$121.56	—	35%
Rubella antibody test (immunity check) CPT 86762 HC Rubella Antibody Igm	$76.70	$118.00	$19.14–$118.00	20% above	35%
Rubella antibody test (immunity check) CPT 86762 HC Rubella Antibody Igg	$76.70	$118.00	$19.14–$118.00	20% above	35%
Rubella antibody test (immunity check) inpatient CPT 86762 HC Rubella Antibody Igm	$76.70	$118.00	$19.14–$118.00	—	35%
Rubella antibody test (immunity check) inpatient CPT 86762 HC Rubella Antibody Igg	$76.70	$118.00	$19.14–$118.00	—	35%
Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 HC Sedimentation Rate Erythrocyte Automated	$44.20	$68.00	$25.70–$76.54	20% above	35%
Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 HC Sedimentation Rate Erythrocyte Automated	$44.20	$68.00	$25.70–$76.54	—	35%
Sodium blood test CPT 84295 HC Sodium Serum/Plasma/Whole Blood	$39.65	$61.00	$4.71–$61.00	at median	35%
Sodium blood test inpatient CPT 84295 HC Sodium Serum/Plasma/Whole Blood	$39.65	$61.00	$4.71–$61.00	—	35%
Stool ova and parasites exam CPT 87177 HC Ova & Parasites Direct Smear Concentration and ID	$59.80	$92.00	$8.72–$92.00	24% above	35%
Stool ova and parasites exam inpatient CPT 87177 HC Ova & Parasites Direct Smear Concentration and ID	$59.80	$92.00	$8.72–$92.00	—	35%
Stool test for hidden blood by immunoassay (FIT) CPT 82274 HC Blood Occult Fecal Hemoglobin Immunoassay Qualitative 1-3 Simultaneous Determinations Diagnostic	$42.90	$66.00	$24.95–$74.29	27% below	35%
Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 HC Blood Occult Fecal Hemoglobin Immunoassay Qualitative 1-3 Simultaneous Determinations Diagnostic	$42.90	$66.00	$24.95–$74.29	—	35%
Syphilis antibody test (Treponema pallidum) CPT 86780 HC Warde Treponema Pallidum Antibody	$130.00	$200.00	$75.60–$225.12	137% above	35%
Syphilis antibody test (Treponema pallidum) CPT 86780 HC Treponema Pallidum Antibody	$130.00	$200.00	$75.60–$225.12	137% above	35%
Syphilis antibody test (Treponema pallidum) CPT 86780 HC Mayo Treponema Pallidum Antibody	$130.00	$200.00	$75.60–$225.12	137% above	35%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 HC Warde Treponema Pallidum Antibody	$130.00	$200.00	$75.60–$225.12	—	35%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 HC Mayo Treponema Pallidum Antibody	$130.00	$200.00	$75.60–$225.12	—	35%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 HC Treponema Pallidum Antibody	$130.00	$200.00	$75.60–$225.12	—	35%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 HC Syphilis Test Non-Treponemal Antibody Qualitative Rpr	$53.95	$83.00	$31.37–$93.42	11% above	35%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 HC Mayo Syphilis Test Non-Treponemal Antibody Qualitative Vdrl CSF	$53.95	$83.00	$31.37–$93.42	11% above	35%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 HC Mayo Syphilis Test Non-Treponemal Antibody Qualitative Vdrl	$53.95	$83.00	$31.37–$93.42	11% above	35%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 HC Mayo Syphilis Test Non-Treponemal Antibody Qualitative Vdrl CSF	$53.95	$83.00	$31.37–$93.42	—	35%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 HC Mayo Syphilis Test Non-Treponemal Antibody Qualitative Vdrl	$53.95	$83.00	$31.37–$93.42	—	35%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 HC Syphilis Test Non-Treponemal Antibody Qualitative Rpr	$53.95	$83.00	$31.37–$93.42	—	35%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 HC TB Test Cell Mediated Immunity Antigen Response Gamma Interferon	$164.45	$253.00	$95.63–$284.78	6% above	35%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 HC Warde TB Test Cell Mediated Immunity Antigen Response Gamma Interferon	$164.45	$253.00	$95.63–$284.78	6% above	35%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 HC TB Test Cell Mediated Immunity Antigen Response Gamma Interferon	$164.45	$253.00	$95.63–$284.78	—	35%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 HC Warde TB Test Cell Mediated Immunity Antigen Response Gamma Interferon	$164.45	$253.00	$95.63–$284.78	—	35%
Testosterone blood test, total (not free testosterone) CPT 84403 HC Mayo Testosterone Total	$180.70	$278.00	$105.08–$312.92	80% above	35%
Testosterone blood test, total (not free testosterone) CPT 84403 HC Mayo Ttfb Testosterone Total	$180.70	$278.00	$105.08–$312.92	80% above	35%
Testosterone blood test, total (not free testosterone) CPT 84403 HC Testosterone Total	$180.70	$278.00	$105.08–$312.92	80% above	35%
Testosterone blood test, total (not free testosterone) CPT 84403 HC Mayo Tgrp Testosterone Total	$180.70	$278.00	$105.08–$312.92	80% above	35%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 HC Mayo Tgrp Testosterone Total	$180.70	$278.00	$105.08–$312.92	—	35%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 HC Mayo Testosterone Total	$180.70	$278.00	$105.08–$312.92	—	35%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 HC Testosterone Total	$180.70	$278.00	$105.08–$312.92	—	35%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 HC Mayo Ttfb Testosterone Total	$180.70	$278.00	$105.08–$312.92	—	35%
Thyroid peroxidase (TPO) antibody test CPT 86376 HC Microsomal Antibody Thyroid	$114.40	$176.00	$66.53–$198.11	48% above	35%
Thyroid peroxidase (TPO) antibody test CPT 86376 HC Mayo Microsomal Antibody Liver-Kidney	$114.40	$176.00	$66.53–$198.11	48% above	35%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 HC Microsomal Antibody Thyroid	$114.40	$176.00	$66.53–$198.11	—	35%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 HC Mayo Microsomal Antibody Liver-Kidney	$114.40	$176.00	$66.53–$198.11	—	35%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 HC Thyroid Stimulating Hormone	$124.80	$192.00	$72.58–$216.12	26% above	35%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 HC Thyroid Stimulating Hormone	$124.80	$192.00	$72.58–$216.12	—	35%
Total IgE blood test CPT 82785 HC Gammaglobulin Ige	$83.85	$129.00	$48.76–$145.20	at median	35%
Total IgE blood test inpatient CPT 82785 HC Gammaglobulin Ige	$83.85	$129.00	$48.76–$145.20	—	35%
Total cholesterol blood test CPT 82465 HC Cholesterol	$40.95	$63.00	$23.81–$70.91	2% below	35%
Total cholesterol blood test inpatient CPT 82465 HC Cholesterol	$40.95	$63.00	$23.81–$70.91	—	35%
Total thyroxine (T4) blood test CPT 84436 HC T4 (Thyroxine) Total	$52.65	$81.00	$6.73–$81.00	2% below	35%
Total thyroxine (T4) blood test inpatient CPT 84436 HC T4 (Thyroxine) Total	$52.65	$81.00	$6.73–$81.00	—	35%
Total triiodothyronine (T3) blood test CPT 84480 HC T3 (Triiodothyronine) Total	$96.85	$149.00	$56.32–$167.71	25% above	35%
Total triiodothyronine (T3) blood test inpatient CPT 84480 HC T3 (Triiodothyronine) Total	$96.85	$149.00	$56.32–$167.71	—	35%
Transferrin blood test CPT 84466 HC Transferrin	$109.85	$169.00	$12.63–$190.23	44% above	35%
Transferrin blood test inpatient CPT 84466 HC Transferrin	$109.85	$169.00	$12.63–$190.23	—	35%
Trichomonas test (NAAT) CPT 87661 HC Infectious Agent Nucleic Acid Amplified Probe Trichomonas Vaginalis	$202.15	$311.00	$117.56–$350.06	77% above	35%
Trichomonas test (NAAT) inpatient CPT 87661 HC Infectious Agent Nucleic Acid Amplified Probe Trichomonas Vaginalis	$202.15	$311.00	$117.56–$350.06	—	35%
Triglycerides blood test CPT 84478 HC Triglycerides	$50.05	$77.00	$5.63–$77.00	17% above	35%
Triglycerides blood test CPT 84478 HC Triglycerides Body Fluid	$50.05	$77.00	$5.63–$77.00	17% above	35%
Triglycerides blood test inpatient CPT 84478 HC Triglycerides	$50.05	$77.00	$5.63–$77.00	—	35%
Triglycerides blood test inpatient CPT 84478 HC Triglycerides Body Fluid	$50.05	$77.00	$5.63–$77.00	—	35%
Troponin test, quantitative CPT 84484 HC Troponin Quantitative	$124.80	$192.00	$12.34–$216.12	3% above	35%
Troponin test, quantitative CPT 84484 HC Troponin Quantitative	$1,290.57	—	$9.09	966% above	—
Troponin test, quantitative inpatient CPT 84484 HC Troponin Quantitative	$124.80	$192.00	$12.34–$216.12	—	35%
Uric acid blood test CPT 84550 HC Uric Acid Blood	$57.85	$89.00	$33.64–$100.18	35% above	35%
Uric acid blood test inpatient CPT 84550 HC Uric Acid Blood	$57.85	$89.00	$33.64–$100.18	—	35%
Urinalysis with microscope exam, automated CPT 81001 HC Urinalysis With Microscopy Automated	$44.20	$68.00	$25.70–$76.54	at median	35%
Urinalysis with microscope exam, automated inpatient CPT 81001 HC Urinalysis With Microscopy Automated	$44.20	$68.00	$25.70–$76.54	—	35%
Urinalysis without microscope exam, automated CPT 81003 HC Urinalysis Without Microscopy Automated	$39.65	$61.00	$23.06–$68.66	33% above	35%
Urinalysis without microscope exam, automated inpatient CPT 81003 HC Urinalysis Without Microscopy Automated	$39.65	$61.00	$23.06–$68.66	—	35%
Urine culture for bacteria, with colony count CPT 87086 HC Culture Colony Count Urine	$58.50	$90.00	$34.02–$101.30	at median	35%
Urine culture for bacteria, with colony count inpatient CPT 87086 HC Culture Colony Count Urine	$58.50	$90.00	$34.02–$101.30	—	35%
Urine microalbumin (albumin) test CPT 82043 HC Albumin (Microalbumin) Urine Quantitative	$57.20	$88.00	$33.26–$99.05	4% above	35%
Urine microalbumin (albumin) test CPT 82043 HC Albumin (Microalbumin) 24 Hour Urine Quantitative	$57.20	$88.00	$33.26–$99.05	4% above	35%
Urine microalbumin (albumin) test inpatient CPT 82043 HC Albumin (Microalbumin) 24 Hour Urine Quantitative	$57.20	$88.00	$33.26–$99.05	—	35%
Urine microalbumin (albumin) test inpatient CPT 82043 HC Albumin (Microalbumin) Urine Quantitative	$57.20	$88.00	$33.26–$99.05	—	35%
Urine pregnancy test, read by color change CPT 81025 HC Urine Pregnancy Test	$42.25	$65.00	$24.57–$73.16	at median	35%
Urine pregnancy test, read by color change inpatient CPT 81025 HC Urine Pregnancy Test	$42.25	$65.00	$24.57–$73.16	—	35%
Vitamin B12 (cobalamin) blood test CPT 82607 HC Vitamin B-12	$94.90	$146.00	$55.19–$164.34	9% above	35%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 HC Vitamin B-12	$94.90	$146.00	$55.19–$164.34	—	35%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 HC Vitamin D 25-Hydroxy	$174.85	$269.00	$101.68–$302.79	20% above	35%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 HC Mayo Vitamin D 25-Hydroxy D2/D3	$174.85	$269.00	$101.68–$302.79	20% above	35%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 HC Mayo Vitamin D 25-Hydroxy D2/D3	$174.85	$269.00	$101.68–$302.79	—	35%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 HC Vitamin D 25-Hydroxy	$174.85	$269.00	$101.68–$302.79	—	35%
Vitamin D, 1,25-dihydroxy blood test CPT 82652 HC Warde Vitamin D (1 25 Dihydroxy)	$209.30	$322.00	$121.72–$362.44	21% above	35%
Vitamin D, 1,25-dihydroxy blood test inpatient CPT 82652 HC Warde Vitamin D (1 25 Dihydroxy)	$209.30	$322.00	$121.72–$362.44	—	35%
Zinc blood test CPT 84630 HC Warde Zinc	$97.50	$150.00	$56.70–$168.84	85% above	35%
Zinc blood test inpatient CPT 84630 HC Warde Zinc	$97.50	$150.00	$56.70–$168.84	—	35%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HC Mayo Hcg Quantitative	$109.20	$168.00	$15.05–$189.10	20% above	35%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HC Hcg Quantitative	$109.20	$168.00	$15.05–$189.10	20% above	35%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HC Hcg Quantitative	$109.20	$168.00	$15.05–$189.10	—	35%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HC Mayo Hcg Quantitative	$109.20	$168.00	$15.05–$189.10	—	35%

Surgery and procedures

Procedure	Cash price	List price	Insurers pay	vs Iowa	Off list
Cataract surgery with lens implant CPT 66984 PR Rem Cataract Extracapsular Insert Intraocular Lens Prosth Man/Mech Tech	$5,699.46	—	$0.96–$3.44	25% above	—

Doctor visits and therapy

Procedure	Cash price	List price	Insurers pay	vs Iowa	Off list
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HC Treatment Inhalation Pressurized/Nonpressurized Acute Airway Obstruction	$197.60	$304.00	$114.91–$342.18	66% above	35%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HC Treatment Inhalation Pressurized/Nonpressurized Acute Airway Obstruction	$197.60	$304.00	$114.91–$342.18	—	35%
Chemotherapy IV infusion, first hour CPT 96413 HC Administration Chemotherapy IV Infusion Up to 1 Hour Single/Initial Substance/Drug	$543.40	$836.00	$316.01–$941.00	at median	35%
Chemotherapy IV infusion, first hour inpatient CPT 96413 HC Administration Chemotherapy IV Infusion Up to 1 Hour Single/Initial Substance/Drug	$543.40	$836.00	$316.01–$941.00	—	35%
Critical care, first 30 to 74 minutes CPT 99291 HC Critical Care 30-74 Minutes	$1,240.20	$1,908.00	$721.22–$2,147.64	2% below	35%
Critical care, first 30 to 74 minutes inpatient CPT 99291 HC Critical Care 30-74 Minutes	$1,240.20	$1,908.00	$721.22–$2,147.64	—	35%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 HC Ecg 12 Lead Tracing Only	$159.25	$245.00	$5.46–$275.77	at median	35%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 HC Ecg 12 Lead Tracing Only	$159.25	$245.00	$5.46–$275.77	—	35%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 HC ED Type a Level 1 Sane_Safe	$341.25	$525.00	$184.75–$590.94	88% above	35%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 HC ED Type a Level 1	$341.25	$525.00	$184.75–$590.94	88% above	35%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 HC ED Type a Level 1	$341.25	$525.00	$184.75–$590.94	—	35%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 HC ED Type a Level 1 Sane_Safe	$341.25	$525.00	$184.75–$590.94	—	35%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 HC ED Type a Level 2	$487.50	$750.00	$260.10–$844.20	67% above	35%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 HC ED Type a Level 2 Sane_Safe	$487.50	$750.00	$260.10–$844.20	67% above	35%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 HC ED Type a Level 2 Sane_Safe	$487.50	$750.00	$260.10–$844.20	—	35%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 HC ED Type a Level 2	$487.50	$750.00	$260.10–$844.20	—	35%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 HC ED Type a Level 3 Sane_Safe	$602.55	$927.00	$321.48–$1,043.43	37% above	35%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 HC ED Type a Level 3	$602.55	$927.00	$321.48–$1,043.43	37% above	35%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 HC ED Type a Level 3 Sane_Safe	$602.55	$927.00	$321.48–$1,043.43	—	35%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 HC ED Type a Level 3	$602.55	$927.00	$321.48–$1,043.43	—	35%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 HC ED Type a Level 4 Sane_Safe	$832.00	$1,280.00	$443.90–$1,440.77	19% above	35%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 HC ED Type a Level 4	$832.00	$1,280.00	$443.90–$1,440.77	19% above	35%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 HC ED Type a Level 4	$1,987.05	—	$0.35–$9.09	185% above	—
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 HC ED Type a Level 4 Sane_Safe	$832.00	$1,280.00	$443.90–$1,440.77	—	35%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 HC ED Type a Level 4	$832.00	$1,280.00	$443.90–$1,440.77	—	35%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 HC ED Type a Level 5	$4,659.00	—	$2.80–$9.09	344% above	—
Group psychotherapy session CPT 90853 HC Psychotherapy Group Therapy Msw	$501.80	$772.00	$291.82–$868.96	100% above	35%
Group psychotherapy session CPT 90853 HC Psychotherapy Group Therapy	$501.80	$772.00	$291.82–$868.96	100% above	35%
Group psychotherapy session inpatient CPT 90853 HC Psychotherapy Group Therapy	$501.80	$772.00	$291.82–$868.96	—	35%
Group psychotherapy session inpatient CPT 90853 HC Psychotherapy Group Therapy Msw	$501.80	$772.00	$291.82–$868.96	—	35%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 HC Hydration IV Infusion Initial 31minutes - 1 Hour	$239.85	$369.00	$139.48–$415.35	14% below	35%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 HC Hydration IV Infusion Initial 31minutes - 1 Hour	$239.85	$369.00	$139.48–$415.35	—	35%
IV infusion of a medicine, first hour CPT 96365 HC IV Infusion Therapy/Prophylaxis/Diagnosis Initial Up to 1 Hour	$289.25	$445.00	$168.21–$500.89	9% below	35%
IV infusion of a medicine, first hour CPT 96365 HC IV Infusion Therapy/Prophylaxis/Diagnosis Initial Up to 1 Hour	$14,463.15	—	$5,763.60	4429% above	—
IV infusion of a medicine, first hour inpatient CPT 96365 HC IV Infusion Therapy/Prophylaxis/Diagnosis Initial Up to 1 Hour	$289.25	$445.00	$168.21–$500.89	—	35%
IV push of a medicine, first drug CPT 96374 HC Injection Therapeutic/Prophylactic/Diagnostic IV Push Single/Initial Substance/Drug	$201.50	$310.00	$117.18–$348.94	9% above	35%
IV push of a medicine, first drug CPT 96374 HC Injection Therapeutic/Prophylactic/Diagnostic IV Push Single/Initial Substance/Drug	$5,813.86	—	$3.84–$9.09	3042% above	—
IV push of a medicine, first drug inpatient CPT 96374 HC Injection Therapeutic/Prophylactic/Diagnostic IV Push Single/Initial Substance/Drug	$201.50	$310.00	$117.18–$348.94	—	35%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 HC Injection Therapeutic/Prophylactic/Diagnostic Subcutaneous/Im	$103.35	$159.00	$60.10–$178.97	16% above	35%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 HC Injection Therapeutic/Prophylactic/Diagnostic Subcutaneous/Im	$103.35	$159.00	$60.10–$178.97	—	35%
Neuromuscular re-education, 15 minutes CPT 97112 HC Pt Therapeutic Procedure Neuromuscular Reeducate Each 15 Minutes	$129.35	$199.00	$75.22–$223.99	41% above	35%
Neuromuscular re-education, 15 minutes CPT 97112 HC Ot Therapeutic Procedure Neuromuscular Reeducate Each 15 Minutes	$129.35	$199.00	$75.22–$223.99	41% above	35%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 HC Ot Therapeutic Procedure Neuromuscular Reeducate Each 15 Minutes	$129.35	$199.00	$75.22–$223.99	—	35%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 HC Pt Therapeutic Procedure Neuromuscular Reeducate Each 15 Minutes	$129.35	$199.00	$75.22–$223.99	—	35%
Occupational therapy evaluation, low complexity CPT 97165 HC Ot Evaluation Low Complexity Patient/Family	$179.40	$276.00	$104.33–$310.67	at median	35%
Occupational therapy evaluation, low complexity inpatient CPT 97165 HC Ot Evaluation Low Complexity Patient/Family	$179.40	$276.00	$104.33–$310.67	—	35%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 HC Pt Evaluation High Complexity Patient/Family	$196.95	$303.00	$114.53–$341.06	7% below	35%
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 HC Pt Evaluation High Complexity Patient/Family	$196.95	$303.00	$114.53–$341.06	—	35%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 HC Pt Evaluation Low Complexity Patient/Family	$222.95	$343.00	$129.65–$386.08	17% above	35%
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 HC Pt Evaluation Low Complexity Patient/Family	$222.95	$343.00	$129.65–$386.08	—	35%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 HC Pt Evaluation Moderate Complexity Patient/Family	$194.35	$299.00	$113.02–$336.55	1% below	35%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 HC Pt Evaluation Moderate Complexity Patient/Family	$194.35	$299.00	$113.02–$336.55	—	35%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 HC Ot Manual Therpy Techniques >=1 Region Each 15 Minutes	$128.70	$198.00	$74.84–$222.87	32% above	35%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 HC Pt Manual Therpy Techniques >=1 Region Each 15 Minutes	$128.70	$198.00	$74.84–$222.87	32% above	35%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 HC Ot Manual Therpy Techniques >=1 Region Each 15 Minutes	$128.70	$198.00	$74.84–$222.87	—	35%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 HC Pt Manual Therpy Techniques >=1 Region Each 15 Minutes	$128.70	$198.00	$74.84–$222.87	—	35%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HC Pt Therapeutic Procedure >=1 Area Therapeutic Exercise Each 15 Minutes	$129.35	$199.00	$75.22–$223.99	34% above	35%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HC Ot Therapeutic Procedure >=1 Area Therapeutic Exercise Each 15 Minutes	$129.35	$199.00	$75.22–$223.99	34% above	35%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 HC Pt Therapeutic Procedure >=1 Area Therapeutic Exercise Each 15 Minutes	$129.35	$199.00	$75.22–$223.99	—	35%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 HC Ot Therapeutic Procedure >=1 Area Therapeutic Exercise Each 15 Minutes	$129.35	$199.00	$75.22–$223.99	—	35%
Psychotherapy session, 30 minutes CPT 90832 HC Psychotherapy Patient Individual Therapy 30 Minutes	$396.50	$610.00	$230.58–$686.62	131% above	35%
Psychotherapy session, 30 minutes inpatient CPT 90832 HC Psychotherapy Patient Individual Therapy 30 Minutes	$396.50	$610.00	$230.58–$686.62	—	35%
Psychotherapy session, 45 minutes CPT 90834 HC Psychotherapy Patient Individual Therapy 45 Minutes	$490.75	$755.00	$285.39–$849.83	109% above	35%
Psychotherapy session, 45 minutes inpatient CPT 90834 HC Psychotherapy Patient Individual Therapy 45 Minutes	$490.75	$755.00	$285.39–$849.83	—	35%
Psychotherapy session, 60 minutes CPT 90837 HC Psychotherapy Patient Individual Therapy 60 Minutes	$500.50	$770.00	$291.06–$866.71	78% above	35%
Psychotherapy session, 60 minutes inpatient CPT 90837 HC Psychotherapy Patient Individual Therapy 60 Minutes	$500.50	$770.00	$291.06–$866.71	—	35%
Speech and language evaluation CPT 92523 HC St Evaluate Speech Sound Production Comprehensive/Expressive	$428.35	$659.00	$249.10–$741.77	39% above	35%
Speech and language evaluation inpatient CPT 92523 HC St Evaluate Speech Sound Production Comprehensive/Expressive	$428.35	$659.00	$249.10–$741.77	—	35%
Speech therapy session, individual CPT 92507 HC St Treatment Speech Individual	$245.70	$378.00	$142.88–$425.48	14% above	35%
Speech therapy session, individual inpatient CPT 92507 HC St Treatment Speech Individual	$245.70	$378.00	$142.88–$425.48	—	35%
Therapeutic activities (functional training), 15 minutes CPT 97530 HC Ot Therapeutic Activities Direct Patient Contact Each 15 Minutes	$128.70	$198.00	$74.84–$222.87	27% above	35%
Therapeutic activities (functional training), 15 minutes CPT 97530 HC Pt Therapeutic Activities Direct Patient Contact Each 15 Minutes	$128.70	$198.00	$74.84–$222.87	27% above	35%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 HC Pt Therapeutic Activities Direct Patient Contact Each 15 Minutes	$128.70	$198.00	$74.84–$222.87	—	35%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 HC Ot Therapeutic Activities Direct Patient Contact Each 15 Minutes	$128.70	$198.00	$74.84–$222.87	—	35%

Vaccines

Procedure	Cash price	List price	Insurers pay	vs Iowa	Off list
Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older CPT 90653 HC Vaccine Influenza Inactivated Adjuvant Im	$53.95	$83.00	$31.37–$98.16	5% below	35%
Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older CPT 90653 FLU VACC 2025-26(65YR UP)-MF59C(PF) 45 MCG(15 MCGX3)/0.5 ML IM SYRINGE	$303.40	$303.40	$98.16–$341.51	437% above	—
Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older inpatient CPT 90653 HC Vaccine Influenza Inactivated Adjuvant Im	$53.95	$83.00	$31.37–$98.16	—	35%
Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older inpatient CPT 90653 FLU VACC 2025-26(65YR UP)-MF59C(PF) 45 MCG(15 MCGX3)/0.5 ML IM SYRINGE	$303.40	$303.40	$98.16–$341.51	—	—
COVID-19 vaccine (Moderna), age 12 and older CPT 91322 HC Vaccine Covid-19 Moderna >=12yrs 50mcg/0.5ml	$273.00	$420.00	$158.76–$472.75	4% above	35%
COVID-19 vaccine (Moderna), age 12 and older inpatient CPT 91322 HC Vaccine Covid-19 Moderna >=12yrs 50mcg/0.5ml	$273.00	$420.00	$158.76–$472.75	—	35%
COVID-19 vaccine (Pfizer-BioNTech), age 12 and older CPT 91320 HC Vaccine Covid-19 Pfizer Tris-Sucrose >=12yrs 30mcg/0.3ml Im	$98.15	$151.00	$57.08–$169.97	33% below	35%
COVID-19 vaccine (Pfizer-BioNTech), age 12 and older inpatient CPT 91320 HC Vaccine Covid-19 Pfizer Tris-Sucrose >=12yrs 30mcg/0.3ml Im	$98.15	$151.00	$57.08–$169.97	—	35%
Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 HC Vaccine Varicella Live Subcutaneous	$148.85	$229.00	$86.56–$257.76	11% below	35%
Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 VARICELLA VIRUS VACCINE LIVE (PF) 1,350 UNIT/0.5 ML SUBCUTANEOUS SUSP	$960.60	$960.60	$183.00–$1,081.25	473% above	—
Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 HC Vaccine Varicella Live Subcutaneous	$148.85	$229.00	$86.56–$257.76	—	35%
Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 VARICELLA VIRUS VACCINE LIVE (PF) 1,350 UNIT/0.5 ML SUBCUTANEOUS SUSP	$960.60	$960.60	$183.00–$1,081.25	—	—
DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) CPT 90696 HC Vaccine Dtap-Ipv 4-6 Years Im	$54.60	$84.00	$31.75–$94.55	37% below	35%
DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) inpatient CPT 90696 HC Vaccine Dtap-Ipv 4-6 Years Im	$54.60	$84.00	$31.75–$94.55	—	35%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 HC Vaccine Dtap < 7 Years Im	$33.15	$51.00	$19.28–$57.41	25% below	35%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 DIPHTHERIA-PERTUSSIS(ACEL)-TETANUS PEDIATRIC 25 LF UNIT-58 MCG-10 LF/0.5ML IM (WRAPPER)	$142.05	$142.05	$29.59–$159.89	221% above	—
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 inpatient CPT 90700 HC Vaccine Dtap < 7 Years Im	$33.15	$51.00	$19.28–$57.41	—	35%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 inpatient CPT 90700 DIPHTHERIA-PERTUSSIS(ACEL)-TETANUS PEDIATRIC 25 LF UNIT-58 MCG-10 LF/0.5ML IM (WRAPPER)	$142.05	$142.05	$29.59–$159.89	—	—
DTaP, hepatitis B and polio combination vaccine (Pediarix) CPT 90723 HC Vaccine Dtap-Hep B-Ipv Im	$95.55	$147.00	$55.57–$165.46	18% below	35%
DTaP, hepatitis B and polio combination vaccine (Pediarix) inpatient CPT 90723 HC Vaccine Dtap-Hep B-Ipv Im	$95.55	$147.00	$55.57–$165.46	—	35%
DTaP, polio and Hib combination vaccine (Pentacel) CPT 90698 HC Vaccine Dtap-Ipv/Hib Im	$98.15	$151.00	$57.08–$169.97	6% below	35%
DTaP, polio and Hib combination vaccine (Pentacel) inpatient CPT 90698 HC Vaccine Dtap-Ipv/Hib Im	$98.15	$151.00	$57.08–$169.97	—	35%
DTaP, polio, Hib and hepatitis B combination vaccine (Vaxelis) CPT 90697 HC Vaccine Dtap-Ipv-Hib-Hepb Im	$128.70	$198.00	$74.84–$222.87	17% below	35%
DTaP, polio, Hib and hepatitis B combination vaccine (Vaxelis) inpatient CPT 90697 HC Vaccine Dtap-Ipv-Hib-Hepb Im	$128.70	$198.00	$74.84–$222.87	—	35%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 HC Vaccine Influenza Preservative Free Trivalent (Iiv3) 0.5ml Dose Im	$19.50	$30.00	$11.34–$33.77	13% below	35%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 FLU VACCINE TS 2025-26(6MOS UP)(PF) 45 MCG(15MCG X3)/0.5 ML IM SYRINGE	$102.45	$102.45	$23.22–$115.32	357% above	—
Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 HC Vaccine Influenza Preservative Free Trivalent (Iiv3) 0.5ml Dose Im	$19.50	$30.00	$11.34–$33.77	—	35%
Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 FLU VACCINE TS 2025-26(6MOS UP)(PF) 45 MCG(15MCG X3)/0.5 ML IM SYRINGE	$102.45	$102.45	$23.22–$115.32	—	—
HPV vaccine, 9-valent (Gardasil 9) CPT 90651 HC Vaccine Hpv Types 6/11/16/18/31/33/45/52/58 Nonvalent (9vhpv) 2 or 3 Dose Im	$245.05	$377.00	$142.51–$424.35	22% below	35%
HPV vaccine, 9-valent (Gardasil 9) inpatient CPT 90651 HC Vaccine Hpv Types 6/11/16/18/31/33/45/52/58 Nonvalent (9vhpv) 2 or 3 Dose Im	$245.05	$377.00	$142.51–$424.35	—	35%
Hepatitis A and B combination vaccine, adult (Twinrix) CPT 90636 HC Vaccine Hepatitis a (Hepa) Hepatitis B (Hepb) Adult Im	$118.95	$183.00	$69.17–$205.98	5% below	35%
Hepatitis A and B combination vaccine, adult (Twinrix) inpatient CPT 90636 HC Vaccine Hepatitis a (Hepa) Hepatitis B (Hepb) Adult Im	$118.95	$183.00	$69.17–$205.98	—	35%
Hepatitis A vaccine, adult dose CPT 90632 HC Vaccine Hepatitis a (Hepa) Adult Im	$135.85	$209.00	$72.68–$235.25	10% above	35%
Hepatitis A vaccine, adult dose inpatient CPT 90632 HC Vaccine Hepatitis a (Hepa) Adult Im	$135.85	$209.00	$72.68–$235.25	—	35%
Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 HC Vaccine Hepatitis a (Hepa) Pediatric/Adolescent 2 Dose Im	$43.55	$67.00	$25.33–$75.42	16% below	35%
Hepatitis A vaccine, child and teen dose (2-dose schedule) inpatient CPT 90633 HC Vaccine Hepatitis a (Hepa) Pediatric/Adolescent 2 Dose Im	$43.55	$67.00	$25.33–$75.42	—	35%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 HC Vaccine Hepatitis B (Hepb) Adult 3 Dose Im	$136.50	$210.00	$70.38–$236.38	25% above	35%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 HEPATITIS B VIRUS VACCINE RECOMB (PF) 20 MCG/ML IM (WRAPPER)	$345.70	$345.70	$70.38–$389.12	215% above	—
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 HC Vaccine Hepatitis B (Hepb) Adult 3 Dose Im	$136.50	$210.00	$70.38–$236.38	—	35%
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 HEPATITIS B VIRUS VACCINE RECOMB (PF) 20 MCG/ML IM (WRAPPER)	$345.70	$345.70	$70.38–$389.12	—	—
Hepatitis B vaccine, adult, 2-dose schedule (Heplisav-B) CPT 90739 HC Vaccine Hepatitis B (Hepb) Adult Dosage 2 Dose Schedule Im	$310.70	$478.00	$177.56–$538.04	at median	35%
Hepatitis B vaccine, adult, 2-dose schedule (Heplisav-B) inpatient CPT 90739 HC Vaccine Hepatitis B (Hepb) Adult Dosage 2 Dose Schedule Im	$310.70	$478.00	$177.56–$538.04	—	35%
Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 HC Vaccine Hepatitis B (Hepb) Pediatric/Adolescent 3 Dose Im	$58.50	$90.00	$31.67–$101.30	2% below	35%
Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 HEPATITIS B VIRUS VACCINE RECOMB (PF) 10 MCG/0.5 ML IM SYRINGE (WRAPPER)	$138.80	$138.80	$31.67–$156.23	134% above	—
Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 HC Vaccine Hepatitis B (Hepb) Pediatric/Adolescent 3 Dose Im	$58.50	$90.00	$31.67–$101.30	—	35%
Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 HEPATITIS B VIRUS VACCINE RECOMB (PF) 10 MCG/0.5 ML IM SYRINGE (WRAPPER)	$138.80	$138.80	$31.67–$156.23	—	—
Hib vaccine (Haemophilus influenzae type b), 3-dose schedule (PedvaxHIB) CPT 90647 HC Vaccine Haemophilus Influenzae Type B (Hib) Prp-Omp 3 Dose Im	$37.05	$57.00	$21.55–$64.16	32% below	35%
Hib vaccine (Haemophilus influenzae type b), 3-dose schedule (PedvaxHIB) inpatient CPT 90647 HC Vaccine Haemophilus Influenzae Type B (Hib) Prp-Omp 3 Dose Im	$37.05	$57.00	$21.55–$64.16	—	35%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) CPT 90648 HC Vaccine Haemophilus Influenzae Type B (Hib) Prp-T 4 Dose Im	$35.10	$54.00	$13.17–$60.78	5% below	35%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) CPT 90648 HAEMOPHILUS B POLYSACCHARID CONJ-TETANUS TOX(PF) 10 MCG/0.5 ML IM SOLN	$64.30	$64.30	$13.17–$72.38	74% above	—
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) inpatient CPT 90648 HC Vaccine Haemophilus Influenzae Type B (Hib) Prp-T 4 Dose Im	$35.10	$54.00	$13.17–$60.78	—	35%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) inpatient CPT 90648 HAEMOPHILUS B POLYSACCHARID CONJ-TETANUS TOX(PF) 10 MCG/0.5 ML IM SOLN	$64.30	$64.30	$13.17–$72.38	—	—
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 HC Vaccine Influenza (Iiv) Preservative Free Antigen Content Im	$142.35	$219.00	$82.78–$246.51	90% above	35%
High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 HC Vaccine Influenza (Iiv) Preservative Free Antigen Content Im	$142.35	$219.00	$82.78–$246.51	—	35%
MMR vaccine (measles, mumps and rubella), live CPT 90707 HC Vaccine Mmr Live Subcutaneous	$79.30	$122.00	$46.12–$137.32	40% below	35%
MMR vaccine (measles, mumps and rubella), live CPT 90707 MEASLES,MUMPS,RUBELLA VACCINE LIVE(PF)1,000-12,500TCID50/0.5 ML SUBCUT	$466.05	$466.05	$95.20–$524.59	252% above	—
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 HC Vaccine Mmr Live Subcutaneous	$79.30	$122.00	$46.12–$137.32	—	35%
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 MEASLES,MUMPS,RUBELLA VACCINE LIVE(PF)1,000-12,500TCID50/0.5 ML SUBCUT	$466.05	$466.05	$95.20–$524.59	—	—
MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) CPT 90710 HC Vaccine Mmrv Live Subcutaneous	$403.65	$621.00	$234.74–$699.00	9% above	35%
MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) inpatient CPT 90710 HC Vaccine Mmrv Live Subcutaneous	$403.65	$621.00	$234.74–$699.00	—	35%
Meningococcal ACWY (MenACWY) vaccine CPT 90734 HC Vaccine Meningococcal Serogroups a/C/W/Y Quadrivalent Diphtheria Toxoid(Menacwy-D/Menacwy-CRM) Im	$382.20	$588.00	$166.75–$661.85	65% above	35%
Meningococcal ACWY (MenACWY) vaccine CPT 90734 MENINGOCOCCAL A CONJ VACC 2 OF 2(PF) 10 MCG/0.5 ML (FINAL) IM SOLUTION	$813.00	$813.00	$166.75–$915.11	252% above	—
Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 HC Vaccine Meningococcal Serogroups a/C/W/Y Quadrivalent Diphtheria Toxoid(Menacwy-D/Menacwy-CRM) Im	$382.20	$588.00	$166.75–$661.85	—	35%
Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 MENINGOCOCCAL A CONJ VACC 2 OF 2(PF) 10 MCG/0.5 ML (FINAL) IM SOLUTION	$813.00	$813.00	$166.75–$915.11	—	—
Meningococcal ACWY vaccine (MenQuadfi) CPT 90619 HC Vaccine Menigococcal Serogroups a/C/W/Y Quadrivalent Tetanus Toxoid(Menacwy-Tt) Im	$142.35	$219.00	$82.78–$246.51	5% below	35%
Meningococcal ACWY vaccine (MenQuadfi) inpatient CPT 90619 HC Vaccine Menigococcal Serogroups a/C/W/Y Quadrivalent Tetanus Toxoid(Menacwy-Tt) Im	$142.35	$219.00	$82.78–$246.51	—	35%
Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 HC Vaccine Mengingoccocal Serogroup B 2 Dose Im	$180.70	$278.00	$105.08–$312.92	26% below	35%
Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 MENINGOCOCCAL B VAC,4-CMP 50 MCG-50 MCG-50 MCG-25 MCG/0.5ML IM SYRINGE	$1,156.10	$1,156.10	$237.13–$1,301.31	373% above	—
Meningococcal B vaccine (Bexsero), 2-dose schedule inpatient CPT 90620 HC Vaccine Mengingoccocal Serogroup B 2 Dose Im	$180.70	$278.00	$105.08–$312.92	—	35%
Meningococcal B vaccine (Bexsero), 2-dose schedule inpatient CPT 90620 MENINGOCOCCAL B VAC,4-CMP 50 MCG-50 MCG-50 MCG-25 MCG/0.5ML IM SYRINGE	$1,156.10	$1,156.10	$237.13–$1,301.31	—	—
Meningococcal B vaccine (Trumenba) CPT 90621 HC Vaccine Mengingoccocal Serogroup B 2 or 3 Dose Im	$161.20	$248.00	$93.74–$279.15	9% below	35%
Meningococcal B vaccine (Trumenba) inpatient CPT 90621 HC Vaccine Mengingoccocal Serogroup B 2 or 3 Dose Im	$161.20	$248.00	$93.74–$279.15	—	35%
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) CPT 90670 HC Vaccine Pneumococcal Conjugate 13 Valent (Pcv13) Im	$499.85	$769.00	$257.99–$865.59	16% above	35%
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) inpatient CPT 90670 HC Vaccine Pneumococcal Conjugate 13 Valent (Pcv13) Im	$499.85	$769.00	$257.99–$865.59	—	35%
Pneumonia vaccine, 15-valent conjugate (Vaxneuvance) CPT 90671 HC Vaccine Pneumonococcal Conjugate 15 Valent (Pcv15) Im	$477.10	$734.00	$261.15–$826.19	at median	35%
Pneumonia vaccine, 15-valent conjugate (Vaxneuvance) inpatient CPT 90671 HC Vaccine Pneumonococcal Conjugate 15 Valent (Pcv15) Im	$477.10	$734.00	$261.15–$826.19	—	35%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 HC Vaccine Pneumonococcal Conjugate 20 Valent (Pcv20) Im	$559.00	$860.00	$312.90–$968.02	9% above	35%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 PNEUMOCOCCAL 20-VALENT CONJ VACCINE-DIP CRM (PF) 0.5 ML IM SYRINGE	$1,419.70	$1,419.70	$312.90–$1,598.01	177% above	—
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 HC Vaccine Pneumonococcal Conjugate 20 Valent (Pcv20) Im	$559.00	$860.00	$312.90–$968.02	—	35%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 PNEUMOCOCCAL 20-VALENT CONJ VACCINE-DIP CRM (PF) 0.5 ML IM SYRINGE	$1,419.70	$1,419.70	$312.90–$1,598.01	—	—
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 HC Vaccine Pneumococcal 23 Valent (Ppsv23) Subcutaneous/Im	$258.70	$398.00	$133.47–$447.99	18% above	35%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PNEUMOCOCCAL 23 POLYVALENT VACCINE 25 MCG/0.5 ML (WRAPPER)	$556.15	$556.15	$133.47–$626.00	153% above	—
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 HC Vaccine Pneumococcal 23 Valent (Ppsv23) Subcutaneous/Im	$258.70	$398.00	$133.47–$447.99	—	35%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 PNEUMOCOCCAL 23 POLYVALENT VACCINE 25 MCG/0.5 ML (WRAPPER)	$556.15	$556.15	$133.47–$626.00	—	—
Polio vaccine, inactivated (IPV) CPT 90713 HC Vaccine Polio (Ipv) Subcutaneous/Im	$36.40	$56.00	$21.17–$63.03	35% below	35%
Polio vaccine, inactivated (IPV) inpatient CPT 90713 HC Vaccine Polio (Ipv) Subcutaneous/Im	$36.40	$56.00	$21.17–$63.03	—	35%
RSV antibody shot for infants and toddlers, larger dose (1 mL, 100 mg) CPT 90381 HC Vaccine Respiratory Syncytial Virus Monoclonal Antibody Seasonal Dose 1 Ml Im	$421.85	$649.00	$245.32–$730.51	28% below	35%
RSV antibody shot for infants and toddlers, larger dose (1 mL, 100 mg) inpatient CPT 90381 HC Vaccine Respiratory Syncytial Virus Monoclonal Antibody Seasonal Dose 1 Ml Im	$421.85	$649.00	$245.32–$730.51	—	35%
RSV antibody shot for infants, seasonal dose (0.5 mL) CPT 90380 HC Vaccine Respiratory Syncytial Virus Monoclonal Antibody Seasonal Dose 0.5 Ml Im	$421.85	$649.00	$245.32–$730.51	44% below	35%
RSV antibody shot for infants, seasonal dose (0.5 mL) inpatient CPT 90380 HC Vaccine Respiratory Syncytial Virus Monoclonal Antibody Seasonal Dose 0.5 Ml Im	$421.85	$649.00	$245.32–$730.51	—	35%
RSV vaccine (Abrysvo), one dose for older adults or during pregnancy CPT 90678 HC Vaccine Respiratory Syncytial Virus Bivalent Subunit/Preservative Free Im	$251.55	$387.00	$146.29–$435.61	20% below	35%
RSV vaccine (Abrysvo), one dose for older adults or during pregnancy inpatient CPT 90678 HC Vaccine Respiratory Syncytial Virus Bivalent Subunit/Preservative Free Im	$251.55	$387.00	$146.29–$435.61	—	35%
RSV vaccine with adjuvant (Arexvy), one dose for older adults CPT 90679 HC Vaccine Respiratory Syncytial Virus Recombinant Subunit Adjuvanted/Preservative Free Im	$239.20	$368.00	$139.10–$414.22	5% below	35%
RSV vaccine with adjuvant (Arexvy), one dose for older adults inpatient CPT 90679 HC Vaccine Respiratory Syncytial Virus Recombinant Subunit Adjuvanted/Preservative Free Im	$239.20	$368.00	$139.10–$414.22	—	35%
Rabies vaccine, one dose CPT 90675 HC Vaccine Rabies Im	$1,083.55	$1,667.00	$312.03–$1,876.38	48% above	35%
Rabies vaccine, one dose CPT 90675 RABIES VACCINE, PURIFIED CHICKEN EMBRYO CELL (PF) 2.5 UNIT IM SUSP	$1,998.80	$1,998.80	$312.03–$2,249.85	173% above	—
Rabies vaccine, one dose inpatient CPT 90675 HC Vaccine Rabies Im	$1,083.55	$1,667.00	$312.03–$1,876.38	—	35%
Rabies vaccine, one dose inpatient CPT 90675 RABIES VACCINE, PURIFIED CHICKEN EMBRYO CELL (PF) 2.5 UNIT IM SUSP	$1,998.80	$1,998.80	$312.03–$2,249.85	—	—
Rotavirus vaccine, oral, 2-dose schedule (Rotarix) CPT 90681 HC Vaccine Rotavirus Attenuated (Rv1) Live 2 Dose Oral	$115.05	$177.00	$66.91–$199.23	37% below	35%
Rotavirus vaccine, oral, 2-dose schedule (Rotarix) inpatient CPT 90681 HC Vaccine Rotavirus Attenuated (Rv1) Live 2 Dose Oral	$115.05	$177.00	$66.91–$199.23	—	35%
Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) CPT 90680 HC Vaccine Rotavirus Pentavalent (Rv5) Live 3 Dose Oral	$97.50	$150.00	$56.70–$168.84	11% below	35%
Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) inpatient CPT 90680 HC Vaccine Rotavirus Pentavalent (Rv5) Live 3 Dose Oral	$97.50	$150.00	$56.70–$168.84	—	35%
Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 HC Hzv Zoster Vacc Recombinant Adjuvanted Im Inj	$169.00	$260.00	$98.28–$292.66	22% below	35%
Shingles vaccine (Shingrix), recombinant, one dose inpatient CPT 90750 HC Hzv Zoster Vacc Recombinant Adjuvanted Im Inj	$169.00	$260.00	$98.28–$292.66	—	35%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 HC Vaccine Td Preservative Free >= 7 Years Im	$57.20	$88.00	$33.26–$99.05	4% below	35%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TETANUS AND DIPHTHERIA TOX (PF) 5 LF UNIT-2 LF UNIT/0.5 ML IM (WRAPPER)	$211.80	$211.80	$36.37–$238.40	254% above	—
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 HC Vaccine Td Preservative Free >= 7 Years Im	$57.20	$88.00	$33.26–$99.05	—	35%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 TETANUS AND DIPHTHERIA TOX (PF) 5 LF UNIT-2 LF UNIT/0.5 ML IM (WRAPPER)	$211.80	$211.80	$36.37–$238.40	—	—
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 HC Vaccine Tdap >=7 Years Im	$115.70	$178.00	$39.71–$200.36	35% above	35%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 DIPHTHERIA-PERTUSSIS(ACEL)-TETANUS VACCINE 2.5 LF UNIT- 8 MCG-5 LF/0.5 ML IM (WRAPPER)	$231.55	$231.55	$39.71–$260.63	170% above	—
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 HC Vaccine Tdap >=7 Years Im	$115.70	$178.00	$39.71–$200.36	—	35%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 DIPHTHERIA-PERTUSSIS(ACEL)-TETANUS VACCINE 2.5 LF UNIT- 8 MCG-5 LF/0.5 ML IM (WRAPPER)	$231.55	$231.55	$39.71–$260.63	—	—
Typhoid vaccine, injectable (Vi polysaccharide) CPT 90691 HC Vaccine Typhoid Vicps Im	$113.75	$175.00	$66.15–$196.98	5% below	35%
Typhoid vaccine, injectable (Vi polysaccharide) inpatient CPT 90691 HC Vaccine Typhoid Vicps Im	$113.75	$175.00	$66.15–$196.98	—	35%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 HC Vfc Administration Immunization 1 Vaccine	$12.79	$19.68	$7.44–$22.15	63% below	35%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 HC Administration Immunization 1 Vaccine	$95.55	$147.00	$55.57–$165.46	179% above	35%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 HC Vfc Administration Immunization 1 Vaccine	$12.79	$19.68	$7.44–$22.15	—	35%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 HC Administration Immunization 1 Vaccine	$95.55	$147.00	$55.57–$165.46	—	35%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 HC Vfc Administration Immunization Each Additional Vaccine	$12.79	$19.68	$7.44–$22.15	55% below	35%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 HC Administration Immunization Each Additional Vaccine	$65.00	$100.00	$37.80–$112.56	129% above	35%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 HC Vfc Administration Immunization Each Additional Vaccine	$12.79	$19.68	$7.44–$22.15	—	35%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 HC Administration Immunization Each Additional Vaccine	$65.00	$100.00	$37.80–$112.56	—	35%
Yellow fever vaccine, live CPT 90717 HC Vaccine Yellow Fever Live Subcutaneous	$130.65	$201.00	$75.98–$226.25	5% below	35%
Yellow fever vaccine, live inpatient CPT 90717 HC Vaccine Yellow Fever Live Subcutaneous	$130.65	$201.00	$75.98–$226.25	—	35%

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://hpt.trinity-health.org/202552602_mercy-medical-center-dyersville_standardcharges.zip