SelfPayRates
Hospital Cheyenne, WY

Memorial Hospital of Laramie County

Memorial Hospital of Laramie County in Cheyenne, WY publishes cash prices for 71 common procedures listed here, from its own machine-readable price file updated Mar 25, 2026. Click a procedure to compare it with other hospitals nearby.

214 E. 23rd Street, Cheyenne, WY 82001 Collected Sep 23, 2026 Source price file

Scans and imaging

ProcedureCash price List priceOff list
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CHG CT ABDOMEN & PELVIS W/CONTRAST MATERIAL $1,032.81 $1,475.44 30%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 HC CT ABD AND PELVIS W CONTR $4,913.78 $7,019.68 30%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CHG CT ABDOMEN & PELVIS W/CONTRAST MATERIAL $1,032.81 $1,475.44 30%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 HC CT ABD AND PELVIS W CONTR $4,913.78 $7,019.68 30%
CT scan of the head or brain, no contrast dye CPT 70450 CHG CT HEAD/BRAIN W/O CONTRAST MATERIAL $555.34 $793.33 30%
CT scan of the head or brain, no contrast dye CPT 70450 HC CT STROKE HEAD WO CONTRAST $2,272.66 $3,246.65 30%
CT scan of the head or brain, no contrast dye CPT 70450 HC CT HEAD WO CONTRAST $2,310.63 $3,300.90 30%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 CHG CT HEAD/BRAIN W/O CONTRAST MATERIAL $555.34 $793.33 30%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 HC CT STROKE HEAD WO CONTRAST $2,272.66 $3,246.65 30%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 HC CT HEAD WO CONTRAST $2,310.63 $3,300.90 30%
CT scan of the pelvis, with contrast dye CPT 72193 CHG CT PELVIS W/CONTRAST MATERIAL $832.07 $1,188.66 30%
CT scan of the pelvis, with contrast dye CPT 72193 HC CT PELVIS W CONTRAST $2,897.00 $4,138.57 30%
CT scan of the pelvis, with contrast dye inpatient CPT 72193 CHG CT PELVIS W/CONTRAST MATERIAL $832.07 $1,188.66 30%
CT scan of the pelvis, with contrast dye inpatient CPT 72193 HC CT PELVIS W CONTRAST $2,897.00 $4,138.57 30%
Diagnostic mammogram, both breasts both sides CPT 77066 HC MAMMO DX INC CAD BILAT $341.81 $488.29 30%
Diagnostic mammogram, both breasts inpatient both sides CPT 77066 HC MAMMO DX INC CAD BILAT $341.81 $488.29 30%
MRI of knee or other lower-limb joint, no contrast dye CPT 73721 CHG MRI ANY JT LOWER EXTREM W/O CONTRAST MATRL $1,403.36 $2,004.79 30%
MRI of knee or other lower-limb joint, no contrast dye CPT 73721 HC MR LOW EXT JT WO CONTR $3,056.61 $4,366.58 30%
MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 CHG MRI ANY JT LOWER EXTREM W/O CONTRAST MATRL $1,403.36 $2,004.79 30%
MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 HC MR LOW EXT JT WO CONTR $3,056.61 $4,366.58 30%
MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 CHG MRI ANY JT LOWER EXTREM W/O & W/CONTRAST MATRL $2,005.59 $2,865.12 30%
MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 HC MR LOW EXT JT W WO CONT $4,479.40 $6,399.13 30%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 CHG MRI ANY JT LOWER EXTREM W/O & W/CONTRAST MATRL $2,005.59 $2,865.12 30%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 HC MR LOW EXT JT W WO CONT $4,479.40 $6,399.13 30%
MRI of the brain, no contrast dye CPT 70551 CHG MRI BRAIN BRAIN STEM W/O CONTRAST MATERIAL $1,460.57 $2,086.52 30%
MRI of the brain, no contrast dye CPT 70551 HC MR BRAIN WO CONTRAST $3,182.71 $4,546.72 30%
MRI of the brain, no contrast dye inpatient CPT 70551 CHG MRI BRAIN BRAIN STEM W/O CONTRAST MATERIAL $1,460.57 $2,086.52 30%
MRI of the brain, no contrast dye inpatient CPT 70551 HC MR BRAIN WO CONTRAST $3,182.71 $4,546.72 30%
MRI of the brain, with and without contrast dye CPT 70553 CHG MRI BRAIN BRAIN STEM W/O W/CONTRAST MATERIAL $2,067.50 $2,953.57 30%
MRI of the brain, with and without contrast dye CPT 70553 HC MR BRAIN W WO CONTRAST $4,764.95 $6,807.06 30%
MRI of the brain, with and without contrast dye inpatient CPT 70553 CHG MRI BRAIN BRAIN STEM W/O W/CONTRAST MATERIAL $2,067.50 $2,953.57 30%
MRI of the brain, with and without contrast dye inpatient CPT 70553 HC MR BRAIN W WO CONTRAST $4,764.95 $6,807.06 30%
MRI of the lower back, no contrast dye CPT 72148 CHG MRI SPINAL CANAL LUMBAR W/O CONTRAST MATERIAL $1,319.87 $1,885.52 30%
MRI of the lower back, no contrast dye CPT 72148 HC MR L SPINE WO CONTRAST $3,126.89 $4,466.98 30%
MRI of the lower back, no contrast dye inpatient CPT 72148 CHG MRI SPINAL CANAL LUMBAR W/O CONTRAST MATERIAL $1,319.87 $1,885.52 30%
MRI of the lower back, no contrast dye inpatient CPT 72148 HC MR L SPINE WO CONTRAST $3,126.89 $4,466.98 30%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 CHG US PREG UTERUS AFTER 1ST TRIMEST 1/1ST GESTATION $844.25 $1,206.07 30%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 HC US OB GTR 14 WK SGL $876.76 $1,252.51 30%
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 CHG US PREG UTERUS AFTER 1ST TRIMEST 1/1ST GESTATION $844.25 $1,206.07 30%
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 HC US OB GTR 14 WK SGL $876.76 $1,252.51 30%
Sleep study in a lab (polysomnography) CPT 95810 PR POLYSOM 6/>YRS SLEEP 4/> ADDL PARAM ATTND $2,711.02 $3,872.88 30%
Sleep study in a lab (polysomnography) inpatient CPT 95810 PR POLYSOM 6/>YRS SLEEP 4/> ADDL PARAM ATTND $2,711.02 $3,872.88 30%
Transvaginal pelvic ultrasound CPT 76830 HC US TRANSVAGINAL NON OB BEDSIDE $125.06 $178.65 30%
Transvaginal pelvic ultrasound CPT 76830 CHG US TRANSVAGINAL $707.31 $1,010.43 30%
Transvaginal pelvic ultrasound CPT 76830 HC US TRANSVAGINAL NON OB $902.02 $1,288.60 30%
Transvaginal pelvic ultrasound inpatient CPT 76830 HC US TRANSVAGINAL NON OB BEDSIDE $125.06 $178.65 30%
Transvaginal pelvic ultrasound inpatient CPT 76830 CHG US TRANSVAGINAL $707.31 $1,010.43 30%
Transvaginal pelvic ultrasound inpatient CPT 76830 HC US TRANSVAGINAL NON OB $902.02 $1,288.60 30%
Ultrasound of the abdomen, complete CPT 76700 CHG US ABDOMINAL REAL TIME W/IMAGE DOCUMENTATION $795.48 $1,136.39 30%
Ultrasound of the abdomen, complete CPT 76700 HC US ABDOMEN COMP $1,245.09 $1,778.69 30%
Ultrasound of the abdomen, complete inpatient CPT 76700 CHG US ABDOMINAL REAL TIME W/IMAGE DOCUMENTATION $795.48 $1,136.39 30%
Ultrasound of the abdomen, complete inpatient CPT 76700 HC US ABDOMEN COMP $1,245.09 $1,778.69 30%
X-ray of the lower back, 4 or more views CPT 72110 CHG RADEX SPINE LUMBOSACRAL MINIMUM 4 VIEWS $175.42 $250.59 30%
X-ray of the lower back, 4 or more views CPT 72110 HC XR SPINE LUMBR MIN 4V $773.34 $1,104.76 30%
X-ray of the lower back, 4 or more views inpatient CPT 72110 CHG RADEX SPINE LUMBOSACRAL MINIMUM 4 VIEWS $175.42 $250.59 30%
X-ray of the lower back, 4 or more views inpatient CPT 72110 HC XR SPINE LUMBR MIN 4V $773.34 $1,104.76 30%

Lab tests

ProcedureCash price List priceOff list
Basic metabolic panel (blood test) CPT 80048 CHG BASIC METABOLIC PANEL CALCIUM TOTAL $36.87 $52.67 30%
Basic metabolic panel (blood test) CPT 80048 HC BASIC METABOLIC PANEL W TOTAL CA 2422 23061 $123.04 $175.76 30%
Basic metabolic panel (blood test) inpatient CPT 80048 CHG BASIC METABOLIC PANEL CALCIUM TOTAL $36.87 $52.67 30%
Basic metabolic panel (blood test) inpatient CPT 80048 HC BASIC METABOLIC PANEL W TOTAL CA 2422 23061 $123.04 $175.76 30%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 HC LIPID PANEL 22798 $25.26 $36.08 30%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 HC LIPID PANEL 4033 $28.75 $41.07 30%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 HC LIPID PANEL 4031 $29.52 $42.16 30%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 HC LIPID PANEL 3111 $31.78 $45.39 30%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 HC LIPID PANEL 130245 $33.14 $47.33 30%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 HC LIPID PANEL 3108 $34.53 $49.32 30%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 HC LIPID PANEL 22950 $36.00 $51.42 30%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 HC LIPID PANEL 3127 $36.26 $51.79 30%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 HC LIPID PANEL 130332 $44.13 $63.03 30%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 CHG LIPID PANEL $50.85 $72.64 30%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 HC LIPID PANEL 3016847 $56.45 $80.64 30%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 HC LIPID PANEL 3016854 $60.88 $86.96 30%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 HC LIPID PANEL 3016870 $61.16 $87.37 30%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 HC LIPID PANEL 3017415 $63.24 $90.33 30%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 HC LIPID PANEL 22744 $63.93 $91.32 30%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 HC LIPID PANEL 3016862 $67.00 $95.71 30%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 HC LIPID PANEL 3016839 $71.43 $102.03 30%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 HC LIPID PANEL 130177 $80.99 $115.70 30%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 HC LIPOPROTEIN ELECTROPHORESIS LIPID PANEL $107.65 $153.78 30%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 HC LIPID PANEL PR137 $108.34 $154.76 30%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 HC LIPID PANEL 3400 130280 $113.44 $162.05 30%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 HC LIPID PANEL 6676 $159.65 $228.06 30%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 HC LIPID PANEL 22798 $25.26 $36.08 30%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 HC LIPID PANEL 4033 $28.75 $41.07 30%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 HC LIPID PANEL 4031 $29.52 $42.16 30%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 HC LIPID PANEL 3111 $31.78 $45.39 30%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 HC LIPID PANEL 130245 $33.14 $47.33 30%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 HC LIPID PANEL 3108 $34.53 $49.32 30%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 HC LIPID PANEL 22950 $36.00 $51.42 30%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 HC LIPID PANEL 3127 $36.26 $51.79 30%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 HC LIPID PANEL 130332 $44.13 $63.03 30%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 CHG LIPID PANEL $50.85 $72.64 30%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 HC LIPID PANEL 3016847 $56.45 $80.64 30%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 HC LIPID PANEL 3016854 $60.88 $86.96 30%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 HC LIPID PANEL 3016870 $61.16 $87.37 30%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 HC LIPID PANEL 3017415 $63.24 $90.33 30%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 HC LIPID PANEL 22744 $63.93 $91.32 30%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 HC LIPID PANEL 3016862 $67.00 $95.71 30%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 HC LIPID PANEL 3016839 $71.43 $102.03 30%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 HC LIPID PANEL 130177 $80.99 $115.70 30%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 HC LIPOPROTEIN ELECTROPHORESIS LIPID PANEL $107.65 $153.78 30%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 HC LIPID PANEL PR137 $108.34 $154.76 30%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 HC LIPID PANEL 3400 130280 $113.44 $162.05 30%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 HC LIPID PANEL 6676 $159.65 $228.06 30%
Complete blood count (CBC) with differential CPT 85025 HC COMPL CBC W PLT W AUTOM DIFF 4031 $21.91 $31.29 30%
Complete blood count (CBC) with differential CPT 85025 HC COMPL CBC W PLT W AUTOM DIFF 3111 4033 $22.36 $31.93 30%
Complete blood count (CBC) with differential CPT 85025 HC COMPL CBC W PLT W AUTOM DIFF 3108 $23.96 $34.22 30%
Complete blood count (CBC) with differential CPT 85025 HC COMPL CBC W PLT W AUTOM DIFF 22950 $25.16 $35.93 30%
Complete blood count (CBC) with differential CPT 85025 HC COMPL CBC W PLT W AUTOM DIFF 3127 $25.24 $36.05 30%
Complete blood count (CBC) with differential CPT 85025 HC COMPL CBC W PLT W AUTOM DIFF 130332 $30.82 $44.02 30%
Complete blood count (CBC) with differential CPT 85025 HC COMPL CBC W PLT W AUTOM DIFF 3016847 $39.34 $56.20 30%
Complete blood count (CBC) with differential CPT 85025 HC COMPL CBC W PLT W AUTOM DIFF 3016854 $42.47 $60.67 30%
Complete blood count (CBC) with differential CPT 85025 HC COMPL CBC W PLT W AUTOM DIFF 3016870 $42.76 $61.08 30%
Complete blood count (CBC) with differential CPT 85025 HC COMPL CBC W PLT W AUTOM DIFF 3016862 $46.70 $66.71 30%
Complete blood count (CBC) with differential CPT 85025 HC COMPL CBC W PLT W AUTOM DIFF 3016839 $49.90 $71.28 30%
Complete blood count (CBC) with differential CPT 85025 CHG BLOOD COUNT COMPLETE AUTO&AUTO DIFRNTL WBC $53.65 $76.64 30%
Complete blood count (CBC) with differential CPT 85025 HC COMPL CBC W PLT W AUTOM DIFF PR137 $99.01 $141.43 30%
Complete blood count (CBC) with differential CPT 85025 HC COMPL CBC W PLT W AUTOM DIFF PR147 $99.01 $141.43 30%
Complete blood count (CBC) with differential CPT 85025 HC COMPL CBC W PLT W AUTOM DIFF 130173 1500 22744 $104.96 $149.94 30%
Complete blood count (CBC) with differential inpatient CPT 85025 HC COMPL CBC W PLT W AUTOM DIFF 4031 $21.91 $31.29 30%
Complete blood count (CBC) with differential inpatient CPT 85025 HC COMPL CBC W PLT W AUTOM DIFF 3111 4033 $22.36 $31.93 30%
Complete blood count (CBC) with differential inpatient CPT 85025 HC COMPL CBC W PLT W AUTOM DIFF 3108 $23.96 $34.22 30%
Complete blood count (CBC) with differential inpatient CPT 85025 HC COMPL CBC W PLT W AUTOM DIFF 22950 $25.16 $35.93 30%
Complete blood count (CBC) with differential inpatient CPT 85025 HC COMPL CBC W PLT W AUTOM DIFF 3127 $25.24 $36.05 30%
Complete blood count (CBC) with differential inpatient CPT 85025 HC COMPL CBC W PLT W AUTOM DIFF 130332 $30.82 $44.02 30%
Complete blood count (CBC) with differential inpatient CPT 85025 HC COMPL CBC W PLT W AUTOM DIFF 3016847 $39.34 $56.20 30%
Complete blood count (CBC) with differential inpatient CPT 85025 HC COMPL CBC W PLT W AUTOM DIFF 3016854 $42.47 $60.67 30%
Complete blood count (CBC) with differential inpatient CPT 85025 HC COMPL CBC W PLT W AUTOM DIFF 3016870 $42.76 $61.08 30%
Complete blood count (CBC) with differential inpatient CPT 85025 HC COMPL CBC W PLT W AUTOM DIFF 3016862 $46.70 $66.71 30%
Complete blood count (CBC) with differential inpatient CPT 85025 HC COMPL CBC W PLT W AUTOM DIFF 3016839 $49.90 $71.28 30%
Complete blood count (CBC) with differential inpatient CPT 85025 CHG BLOOD COUNT COMPLETE AUTO&AUTO DIFRNTL WBC $53.65 $76.64 30%
Complete blood count (CBC) with differential inpatient CPT 85025 HC COMPL CBC W PLT W AUTOM DIFF PR137 $99.01 $141.43 30%
Complete blood count (CBC) with differential inpatient CPT 85025 HC COMPL CBC W PLT W AUTOM DIFF PR147 $99.01 $141.43 30%
Complete blood count (CBC) with differential inpatient CPT 85025 HC COMPL CBC W PLT W AUTOM DIFF 130173 1500 22744 $104.96 $149.94 30%
Complete blood count (CBC), no differential CPT 85027 CHG BLOOD COUNT COMPLETE AUTOMATED $53.65 $76.64 30%
Complete blood count (CBC), no differential CPT 85027 HC COMPL AUTOM CBC W PLT 130212 3890 3895 $78.83 $112.61 30%
Complete blood count (CBC), no differential inpatient CPT 85027 CHG BLOOD COUNT COMPLETE AUTOMATED $53.65 $76.64 30%
Complete blood count (CBC), no differential inpatient CPT 85027 HC COMPL AUTOM CBC W PLT 130212 3890 3895 $78.83 $112.61 30%
Comprehensive metabolic panel (blood test) CPT 80053 HC COMPREH METABOLIC PANEL 130332 $41.94 $59.91 30%
Comprehensive metabolic panel (blood test) CPT 80053 HC COMPREHENSVE METABOLIC PANEL 3016847 $53.53 $76.46 30%
Comprehensive metabolic panel (blood test) CPT 80053 HC COMPREHENSVE METABOLIC PANEL 3016854 $59.62 $85.17 30%
Comprehensive metabolic panel (blood test) CPT 80053 HC COMPREHENSVE METABOLIC PANEL 3016870 $60.07 $85.81 30%
Comprehensive metabolic panel (blood test) CPT 80053 CHG COMPREHENSIVE METABOLIC PANEL $64.87 $92.66 30%
Comprehensive metabolic panel (blood test) CPT 80053 HC COMPREHENSVE METABOLIC PANEL 3016862 $65.60 $93.71 30%
Comprehensive metabolic panel (blood test) CPT 80053 HC COMPREHENSVE METABOLIC PANEL 3016839 $70.10 $100.13 30%
Comprehensive metabolic panel (blood test) CPT 80053 HC COMPREHENSVE METABOLIC PANEL PR147 $98.56 $140.79 30%
Comprehensive metabolic panel (blood test) CPT 80053 HC COMPREHENSVE METABOLIC PANEL PR137 $98.56 $140.79 30%
Comprehensive metabolic panel (blood test) CPT 80053 HC COMPREH METABOLIC PANEL 23063 $98.56 $140.79 30%
Comprehensive metabolic panel (blood test) CPT 80053 HC COMP METABOLIC PANEL 3017415 $138.82 $198.31 30%
Comprehensive metabolic panel (blood test) CPT 80053 HC COMPREHENSVE METABOLIC PANEL 2425 130280 $144.72 $206.74 30%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 HC COMPREH METABOLIC PANEL 130332 $41.94 $59.91 30%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 HC COMPREHENSVE METABOLIC PANEL 3016847 $53.53 $76.46 30%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 HC COMPREHENSVE METABOLIC PANEL 3016854 $59.62 $85.17 30%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 HC COMPREHENSVE METABOLIC PANEL 3016870 $60.07 $85.81 30%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 CHG COMPREHENSIVE METABOLIC PANEL $64.87 $92.66 30%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 HC COMPREHENSVE METABOLIC PANEL 3016862 $65.60 $93.71 30%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 HC COMPREHENSVE METABOLIC PANEL 3016839 $70.10 $100.13 30%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 HC COMPREHENSVE METABOLIC PANEL PR147 $98.56 $140.79 30%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 HC COMPREH METABOLIC PANEL 23063 $98.56 $140.79 30%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 HC COMPREHENSVE METABOLIC PANEL PR137 $98.56 $140.79 30%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 HC COMP METABOLIC PANEL 3017415 $138.82 $198.31 30%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 HC COMPREHENSVE METABOLIC PANEL 2425 130280 $144.72 $206.74 30%
Kidney function blood test panel CPT 80069 CHG RENAL FUNCTION PANEL $41.09 $58.70 30%
Kidney function blood test panel CPT 80069 HC RENAL FUNCTION PANEL 2426 $83.65 $119.50 30%
Kidney function blood test panel inpatient CPT 80069 CHG RENAL FUNCTION PANEL $41.09 $58.70 30%
Kidney function blood test panel inpatient CPT 80069 HC RENAL FUNCTION PANEL 2426 $83.65 $119.50 30%
Liver function blood test panel CPT 80076 HC HEPATIC FUNCTION PANEL 130244 22744 $10.50 $14.99 30%
Liver function blood test panel CPT 80076 HC HEPATIC FUNCTION PANEL 22798 $17.46 $24.94 30%
Liver function blood test panel CPT 80076 HC HEPATIC FUNCTION PANEL 3111 $22.07 $31.52 30%
Liver function blood test panel CPT 80076 HC HEPATIC FUNCTION PANEL 130245 $22.87 $32.66 30%
Liver function blood test panel CPT 80076 HC HEPATIC FUNCTION PANEL 3108 $23.80 $33.99 30%
Liver function blood test panel CPT 80076 HC HEPATIC FUNCTION PANEL 3127 $25.00 $35.71 30%
Liver function blood test panel CPT 80076 CHG HEPATIC FUNCTION PANEL $37.53 $53.61 30%
Liver function blood test panel CPT 80076 HC HEPATIC FUNCTION PANEL 3017415 $43.63 $62.32 30%
Liver function blood test panel CPT 80076 HC HEPATIC FUNCTION PANEL 2045 $86.59 $123.70 30%
Liver function blood test panel inpatient CPT 80076 HC HEPATIC FUNCTION PANEL 130244 22744 $10.50 $14.99 30%
Liver function blood test panel inpatient CPT 80076 HC HEPATIC FUNCTION PANEL 22798 $17.46 $24.94 30%
Liver function blood test panel inpatient CPT 80076 HC HEPATIC FUNCTION PANEL 3111 $22.07 $31.52 30%
Liver function blood test panel inpatient CPT 80076 HC HEPATIC FUNCTION PANEL 130245 $22.87 $32.66 30%
Liver function blood test panel inpatient CPT 80076 HC HEPATIC FUNCTION PANEL 3108 $23.80 $33.99 30%
Liver function blood test panel inpatient CPT 80076 HC HEPATIC FUNCTION PANEL 3127 $25.00 $35.71 30%
Liver function blood test panel inpatient CPT 80076 CHG HEPATIC FUNCTION PANEL $37.53 $53.61 30%
Liver function blood test panel inpatient CPT 80076 HC HEPATIC FUNCTION PANEL 3017415 $43.63 $62.32 30%
Liver function blood test panel inpatient CPT 80076 HC HEPATIC FUNCTION PANEL 2045 $86.59 $123.70 30%
Obstetric blood test panel CPT 80055 CHG OBSTETRIC PANEL $166.04 $237.20 30%
Obstetric blood test panel CPT 80055 HC OBSTETRIC PANEL 25523 25525 8170 $248.48 $354.96 30%
Obstetric blood test panel inpatient CPT 80055 CHG OBSTETRIC PANEL $166.04 $237.20 30%
Obstetric blood test panel inpatient CPT 80055 HC OBSTETRIC PANEL 25523 25525 8170 $248.48 $354.96 30%
PSA (prostate-specific antigen) blood test, free CPT 84154 CHG ASSAY OF PROSTATE SPECIFIC ANTIGEN FREE $60.97 $87.10 30%
PSA (prostate-specific antigen) blood test, free CPT 84154 HC FREE PSA $95.65 $136.63 30%
PSA (prostate-specific antigen) blood test, free CPT 84154 HC PSA FREE 23003 $171.47 $244.95 30%
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 CHG ASSAY OF PROSTATE SPECIFIC ANTIGEN FREE $60.97 $87.10 30%
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 HC FREE PSA $95.65 $136.63 30%
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 HC PSA FREE 23003 $171.47 $244.95 30%
PSA (prostate-specific antigen) blood test, total CPT 84153 CHG ASSAY OF PROSTATE SPECIFIC ANTIGEN TOTAL $62.86 $89.79 30%
PSA (prostate-specific antigen) blood test, total CPT 84153 HC PSA SCREENING MALE PANEL B 3016854 $100.42 $143.45 30%
PSA (prostate-specific antigen) blood test, total CPT 84153 HC PSA SCREENING MALE PANEL C 3016862 $110.49 $157.83 30%
PSA (prostate-specific antigen) blood test, total CPT 84153 HC PSA FREE PERCENTAGE 23003 $114.37 $163.38 30%
PSA (prostate-specific antigen) blood test, total CPT 84153 HC PSA SCREENING 12631 23043 130002 $163.31 $233.29 30%
PSA (prostate-specific antigen) blood test, total CPT 84153 HC PSA DIAGNOSTIC 12634 130219 $163.31 $233.29 30%
PSA (prostate-specific antigen) blood test, total CPT 84153 HC PSA ULTRASENSITIVE 22608 $373.60 $533.71 30%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 CHG ASSAY OF PROSTATE SPECIFIC ANTIGEN TOTAL $62.86 $89.79 30%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 HC PSA SCREENING MALE PANEL B 3016854 $100.42 $143.45 30%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 HC PSA SCREENING MALE PANEL C 3016862 $110.49 $157.83 30%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 HC PSA FREE PERCENTAGE 23003 $114.37 $163.38 30%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 HC PSA DIAGNOSTIC 12634 130219 $163.31 $233.29 30%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 HC PSA SCREENING 12631 23043 130002 $163.31 $233.29 30%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 HC PSA ULTRASENSITIVE 22608 $373.60 $533.71 30%
Partial thromboplastin time (PTT) clotting test CPT 85730 CHG THROMBOPLASTIN TIME PARTIAL PLASMA/WHOLE BLOOD $25.33 $36.18 30%
Partial thromboplastin time (PTT) clotting test CPT 85730 HC ANTIPHOSPHOLIPID SYN PTT $30.02 $42.88 30%
Partial thromboplastin time (PTT) clotting test CPT 85730 HC PTT PLASMA OR WHOLE BLOOD 25517 $61.35 $87.64 30%
Partial thromboplastin time (PTT) clotting test CPT 85730 HC PTT PLASMA OR WHOLE BLOOD 130137 $61.65 $88.07 30%
Partial thromboplastin time (PTT) clotting test CPT 85730 HC PTT PLASMA OR WHOLE BLOOD 130234 7040 $64.74 $92.48 30%
Partial thromboplastin time (PTT) clotting test CPT 85730 HC PTT PLASMA OR WHOLE BLOOD 6664 $74.84 $106.91 30%
Partial thromboplastin time (PTT) clotting test CPT 85730 HC PTT HEPARIN 1 WHOLE BLOOD OR PLASMA LUPUS REFLEX $79.85 $114.06 30%
Partial thromboplastin time (PTT) clotting test CPT 85730 HC PTT PLASMA OR WHOLE BLOOD 7050 $80.96 $115.65 30%
Partial thromboplastin time (PTT) clotting test CPT 85730 HC PTT PLASMA OR WHOLE BLOOD 220007 $85.81 $122.58 30%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 CHG THROMBOPLASTIN TIME PARTIAL PLASMA/WHOLE BLOOD $25.33 $36.18 30%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 HC ANTIPHOSPHOLIPID SYN PTT $30.02 $42.88 30%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 HC PTT PLASMA OR WHOLE BLOOD 25517 $61.35 $87.64 30%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 HC PTT PLASMA OR WHOLE BLOOD 130137 $61.65 $88.07 30%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 HC PTT PLASMA OR WHOLE BLOOD 130234 7040 $64.74 $92.48 30%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 HC PTT PLASMA OR WHOLE BLOOD 6664 $74.84 $106.91 30%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 HC PTT HEPARIN 1 WHOLE BLOOD OR PLASMA LUPUS REFLEX $79.85 $114.06 30%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 HC PTT PLASMA OR WHOLE BLOOD 7050 $80.96 $115.65 30%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 HC PTT PLASMA OR WHOLE BLOOD 220007 $85.81 $122.58 30%
Prothrombin time (PT/INR) clotting test CPT 85610 HC ANTIPHOSPHOLIPID SYN PROTIME $21.42 $30.60 30%
Prothrombin time (PT/INR) clotting test CPT 85610 CHG PROTHROMBIN TIME $25.05 $35.78 30%
Prothrombin time (PT/INR) clotting test CPT 85610 HC PROTHROMBIN TIME 25516 $32.83 $46.90 30%
Prothrombin time (PT/INR) clotting test CPT 85610 HC PROTHROMBIN TIME 130234 $38.06 $54.37 30%
Prothrombin time (PT/INR) clotting test CPT 85610 HC PROTHROMBIN TIME 6664 $39.68 $56.68 30%
Prothrombin time (PT/INR) clotting test CPT 85610 HC PROTHROMBIN TIME 7050 $42.91 $61.30 30%
Prothrombin time (PT/INR) clotting test CPT 85610 HC PROTHROMBIN TIME 3015559 7030 $45.87 $65.52 30%
Prothrombin time (PT/INR) clotting test CPT 85610 HC PROTHROMBIN TIME 220007 $47.28 $67.53 30%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 HC ANTIPHOSPHOLIPID SYN PROTIME $21.42 $30.60 30%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 CHG PROTHROMBIN TIME $25.05 $35.78 30%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 HC PROTHROMBIN TIME 25516 $32.83 $46.90 30%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 HC PROTHROMBIN TIME 130234 $38.06 $54.37 30%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 HC PROTHROMBIN TIME 6664 $39.68 $56.68 30%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 HC PROTHROMBIN TIME 7050 $42.91 $61.30 30%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 HC PROTHROMBIN TIME 3015559 7030 $45.87 $65.52 30%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 HC PROTHROMBIN TIME 220007 $47.28 $67.53 30%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 HC THYROID STIMULATING HORMONE 22798 $44.19 $63.12 30%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 HC THYROID STIMULATING HORMONE 3127 $50.60 $72.28 30%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 CHG ASSAY OF THYROID STIMULATING HORMONE TSH $55.54 $79.33 30%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 HC THYROID STIMULATING HORMONE 3016847 $79.00 $112.85 30%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 HC THYROID STIMULATING HORMONE 3016854 $85.16 $121.65 30%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 HC THYROID STIMULATING HORMONE 3017415 $88.55 $126.49 30%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 HC THYROID STIMULATING HORMONE 22552 $92.04 $131.48 30%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 HC THYROID STIMULATING HORMONE 3016862 $93.78 $133.96 30%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 HC THYROID STIMULATING HORMONE 3016839 $100.15 $143.07 30%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 HC THYROID STIMULATING HORMONE 22746 $110.10 $157.28 30%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 HC THYROID STIMULATING HORMONE 22520 $110.18 $157.40 30%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 HC THYROID STIMULATING HORMONE 3163 $123.03 $175.75 30%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 HC THYROID STIMULATING HORMONE 3016870 $128.06 $182.93 30%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 HC THYROID STIMULATING HORMONE PR137 $128.29 $183.26 30%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 HC THYROID STIMULATING HORMONE PR147 $128.29 $183.26 30%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 HC THYROID STIMULATING HORMONE 130220 3385 $134.27 $191.81 30%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 HC THYROID STIMULATING HORMONE 3116 $152.88 $218.39 30%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 HC THYROID STIMULATING HORMONE 130058 3173 $152.95 $218.49 30%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 HC THYROID STIMULATING HORMONE 22798 $44.19 $63.12 30%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 HC THYROID STIMULATING HORMONE 3127 $50.60 $72.28 30%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 CHG ASSAY OF THYROID STIMULATING HORMONE TSH $55.54 $79.33 30%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 HC THYROID STIMULATING HORMONE 3016847 $79.00 $112.85 30%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 HC THYROID STIMULATING HORMONE 3016854 $85.16 $121.65 30%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 HC THYROID STIMULATING HORMONE 3017415 $88.55 $126.49 30%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 HC THYROID STIMULATING HORMONE 22552 $92.04 $131.48 30%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 HC THYROID STIMULATING HORMONE 3016862 $93.78 $133.96 30%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 HC THYROID STIMULATING HORMONE 3016839 $100.15 $143.07 30%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 HC THYROID STIMULATING HORMONE 22746 $110.10 $157.28 30%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 HC THYROID STIMULATING HORMONE 22520 $110.18 $157.40 30%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 HC THYROID STIMULATING HORMONE 3163 $123.03 $175.75 30%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 HC THYROID STIMULATING HORMONE 3016870 $128.06 $182.93 30%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 HC THYROID STIMULATING HORMONE PR147 $128.29 $183.26 30%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 HC THYROID STIMULATING HORMONE PR137 $128.29 $183.26 30%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 HC THYROID STIMULATING HORMONE 130220 3385 $134.27 $191.81 30%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 HC THYROID STIMULATING HORMONE 3116 $152.88 $218.39 30%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 HC THYROID STIMULATING HORMONE 130058 3173 $152.95 $218.49 30%
Urinalysis with microscope exam, automated CPT 81001 CHG URNLS DIP STICK/TABLET REAGENT AUTO MICROSCOPY $16.60 $23.71 30%
Urinalysis with microscope exam, automated CPT 81001 HC AUTOM URINALYS W MICRO 2005 2006 22628 $41.92 $59.88 30%
Urinalysis with microscope exam, automated inpatient CPT 81001 CHG URNLS DIP STICK/TABLET REAGENT AUTO MICROSCOPY $16.60 $23.71 30%
Urinalysis with microscope exam, automated inpatient CPT 81001 HC AUTOM URINALYS W MICRO 2005 2006 22628 $41.92 $59.88 30%
Urinalysis with microscope exam, manual CPT 81000 CHG URINLS DIP STICK/TABLET REAGNT NON-AUTO MICRSCPY $15.01 $21.44 30%
Urinalysis with microscope exam, manual inpatient CPT 81000 CHG URINLS DIP STICK/TABLET REAGNT NON-AUTO MICRSCPY $15.01 $21.44 30%
Urinalysis without microscope exam, automated CPT 81003 CHG URNLS DIP STICK/TABLET RGNT AUTO W/O MICROSCOPY $14.08 $20.11 30%
Urinalysis without microscope exam, automated CPT 81003 HC AUTOM URINALYSIS WO MICRO 2010 2011 22626 23022 $21.05 $30.07 30%
Urinalysis without microscope exam, automated inpatient CPT 81003 CHG URNLS DIP STICK/TABLET RGNT AUTO W/O MICROSCOPY $14.08 $20.11 30%
Urinalysis without microscope exam, automated inpatient CPT 81003 HC AUTOM URINALYSIS WO MICRO 2010 2011 22626 23022 $21.05 $30.07 30%
Urinalysis without microscope exam, manual CPT 81002 CHG URNLS DIP STICK/TABLET RGNT NON-AUTO W/O MICRSCP $12.47 $17.81 30%
Urinalysis without microscope exam, manual CPT 81002 HC UA DIP NON-AUTOMATED WO MICRO BENZENE EXPOS PANEL NMS $21.35 $30.49 30%
Urinalysis without microscope exam, manual CPT 81002 HC NON AUTOM URINALYS WO MICRO 10777 $28.42 $40.60 30%
Urinalysis without microscope exam, manual CPT 81002 HC NON AUTOM URINALYS WO MICRO 10795 $30.40 $43.42 30%
Urinalysis without microscope exam, manual CPT 81002 HC NON AUTOM URINALYS WO MICRO $35.64 $50.91 30%
Urinalysis without microscope exam, manual CPT 81002 HC NON AUTOM URINALYS WO MICRO 10805 $36.19 $51.69 30%
Urinalysis without microscope exam, manual CPT 81002 HC NON AUTOM URINALYS WO MICRO 10657 $38.06 $54.37 30%
Urinalysis without microscope exam, manual inpatient CPT 81002 CHG URNLS DIP STICK/TABLET RGNT NON-AUTO W/O MICRSCP $12.47 $17.81 30%
Urinalysis without microscope exam, manual inpatient CPT 81002 HC UA DIP NON-AUTOMATED WO MICRO BENZENE EXPOS PANEL NMS $21.35 $30.49 30%
Urinalysis without microscope exam, manual inpatient CPT 81002 HC NON AUTOM URINALYS WO MICRO 10777 $28.42 $40.60 30%
Urinalysis without microscope exam, manual inpatient CPT 81002 HC NON AUTOM URINALYS WO MICRO 10795 $30.40 $43.42 30%
Urinalysis without microscope exam, manual inpatient CPT 81002 HC NON AUTOM URINALYS WO MICRO $35.64 $50.91 30%
Urinalysis without microscope exam, manual inpatient CPT 81002 HC NON AUTOM URINALYS WO MICRO 10805 $36.19 $51.69 30%
Urinalysis without microscope exam, manual inpatient CPT 81002 HC NON AUTOM URINALYS WO MICRO 10657 $38.06 $54.37 30%

Surgery and procedures

ProcedureCash price List priceOff list
Cataract surgery with lens implant CPT 66984 PR XCAPSL CTRC RMVL INSJ IO LENS PROSTH W/O ECP $2,089.07 $2,984.38 30%
Cataract surgery with lens implant inpatient CPT 66984 PR XCAPSL CTRC RMVL INSJ IO LENS PROSTH W/O ECP $2,089.07 $2,984.38 30%
Cesarean delivery, including prenatal and postpartum care CPT 59510 PR OB ANTEPARTUM CARE CESAREAN DLVR & POSTPARTUM $5,962.74 $8,518.19 30%
Cesarean delivery, including prenatal and postpartum care inpatient CPT 59510 PR OB ANTEPARTUM CARE CESAREAN DLVR & POSTPARTUM $5,962.74 $8,518.19 30%
Colonoscopy with endoscopic ultrasound CPT 45391 PR COLSC FLX W/NDSC US XM RCTM ET AL LMTD&ADJ STRUX $862.37 $1,231.95 30%
Colonoscopy with endoscopic ultrasound inpatient CPT 45391 PR COLSC FLX W/NDSC US XM RCTM ET AL LMTD&ADJ STRUX $862.37 $1,231.95 30%
Colonoscopy with polyp removal CPT 45385 PR COLSC FLX W/RMVL OF TUMOR POLYP LESION SNARE TQ $1,649.97 $2,357.09 30%
Colonoscopy with polyp removal CPT 45385 HC COLONOSCOPY RM TUMR POLYP LSN SNARE $4,245.48 $6,064.96 30%
Colonoscopy with polyp removal inpatient CPT 45385 PR COLSC FLX W/RMVL OF TUMOR POLYP LESION SNARE TQ $1,649.97 $2,357.09 30%
Colonoscopy with polyp removal inpatient CPT 45385 HC COLONOSCOPY RM TUMR POLYP LSN SNARE $4,245.48 $6,064.96 30%
Colonoscopy with tissue sample CPT 45380 PR COLONOSCOPY W/BIOPSY SINGLE/MULTIPLE $1,464.23 $2,091.75 30%
Colonoscopy with tissue sample CPT 45380 HC COLONOSCOPY BX SGL OR MULT $3,932.50 $5,617.85 30%
Colonoscopy with tissue sample inpatient CPT 45380 PR COLONOSCOPY W/BIOPSY SINGLE/MULTIPLE $1,464.23 $2,091.75 30%
Colonoscopy with tissue sample inpatient CPT 45380 HC COLONOSCOPY BX SGL OR MULT $3,932.50 $5,617.85 30%
Colonoscopy, diagnostic CPT 45378 PR COLONOSCOPY FLX DX W/COLLJ SPEC WHEN PFRMD $1,225.40 $1,750.57 30%
Colonoscopy, diagnostic CPT 45378 HC COLONOSCOPY FLEX DX $3,796.99 $5,424.26 30%
Colonoscopy, diagnostic inpatient CPT 45378 PR COLONOSCOPY FLX DX W/COLLJ SPEC WHEN PFRMD $1,225.40 $1,750.57 30%
Colonoscopy, diagnostic inpatient CPT 45378 HC COLONOSCOPY FLEX DX $3,796.99 $5,424.26 30%
Gallbladder removal, laparoscopic CPT 47562 PR LAPAROSCOPY SURG CHOLECYSTECTOMY $1,925.00 $2,750.00 30%
Gallbladder removal, laparoscopic inpatient CPT 47562 PR LAPAROSCOPY SURG CHOLECYSTECTOMY $1,925.00 $2,750.00 30%
Inguinal (groin) hernia repair, age 5 or older CPT 49505 PR RPR 1ST INGUN HRNA AGE 5 YRS/> REDUCIBLE $2,353.61 $3,362.29 30%
Inguinal (groin) hernia repair, age 5 or older inpatient CPT 49505 PR RPR 1ST INGUN HRNA AGE 5 YRS/> REDUCIBLE $2,353.61 $3,362.29 30%
Knee arthroscopy with meniscus trim CPT 29881 PR ARTHRS KNEE SURG W/MENISCECTOMY MED/LAT W/SHVG $2,341.32 $3,344.74 30%
Knee arthroscopy with meniscus trim inpatient CPT 29881 PR ARTHRS KNEE SURG W/MENISCECTOMY MED/LAT W/SHVG $2,341.32 $3,344.74 30%
Laser treatment of clouding after cataract surgery (YAG) CPT 66821 PR POST-CATARACT LASER SURGERY $885.54 $1,265.05 30%
Laser treatment of clouding after cataract surgery (YAG) inpatient CPT 66821 PR POST-CATARACT LASER SURGERY $885.54 $1,265.05 30%
Left heart catheterization, diagnostic CPT 93452 PR L HRT CATH W/NJX L VENTRICULOGRAPHY IMG S&I $2,385.51 $3,407.86 30%
Left heart catheterization, diagnostic one side CPT 93452 HC LEFT HRT CATH W VENTRCLGRPHY $19,976.30 $28,537.56 30%
Left heart catheterization, diagnostic inpatient CPT 93452 PR L HRT CATH W/NJX L VENTRICULOGRAPHY IMG S&I $2,385.51 $3,407.86 30%
Left heart catheterization, diagnostic inpatient one side CPT 93452 HC LEFT HRT CATH W VENTRCLGRPHY $19,976.30 $28,537.56 30%
Lower-back epidural injection, with imaging guidance CPT 62323 PR NJX DX/THER SBST INTRLMNR LMBR/SAC W/IMG GDN $575.82 $822.60 30%
Lower-back epidural injection, with imaging guidance CPT 62323 HC INJ SPINE LUMBR/SACRL CAUDAL W/GUIDANCE $3,077.55 $4,396.49 30%
Lower-back epidural injection, with imaging guidance inpatient CPT 62323 PR NJX DX/THER SBST INTRLMNR LMBR/SAC W/IMG GDN $575.82 $822.60 30%
Lower-back epidural injection, with imaging guidance inpatient CPT 62323 HC INJ SPINE LUMBR/SACRL CAUDAL W/GUIDANCE $3,077.55 $4,396.49 30%
Lower-back epidural injection, without imaging guidance CPT 62322 PR NJX DX/THER SBST INTRLMNR LMBR/SAC W/O IMG GDN $368.09 $525.84 30%
Lower-back epidural injection, without imaging guidance inpatient CPT 62322 PR NJX DX/THER SBST INTRLMNR LMBR/SAC W/O IMG GDN $368.09 $525.84 30%
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 PR NJX AA&/STRD TFRML EPI LUMBAR/SACRAL 1 LEVEL $807.21 $1,153.15 30%
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 HC INJ FORAMEN EPIDURL L S SGL LVL $2,483.74 $3,548.20 30%
Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 PR NJX AA&/STRD TFRML EPI LUMBAR/SACRAL 1 LEVEL $807.21 $1,153.15 30%
Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 HC INJ FORAMEN EPIDURL L S SGL LVL $2,483.74 $3,548.20 30%
Prostate biopsy CPT 55700 PR PROSTATE NEEDLE BIOPSY ANY APPROACH $663.21 $947.44 30%
Prostate biopsy inpatient CPT 55700 PR PROSTATE NEEDLE BIOPSY ANY APPROACH $663.21 $947.44 30%
Prostate removal (prostatectomy), laparoscopic CPT 55866 PR LAPS SURG PRST8ECT RPBIC RAD W/NERVE SPARING $5,416.11 $7,737.30 30%
Prostate removal (prostatectomy), laparoscopic inpatient CPT 55866 PR LAPS SURG PRST8ECT RPBIC RAD W/NERVE SPARING $5,416.11 $7,737.30 30%
Removal of a breast lump, open surgery CPT 19120 PR EXC CYST/ABERRANT BREAST TISSUE OPEN 1/> LESION $1,318.93 $1,884.18 30%
Removal of a breast lump, open surgery inpatient CPT 19120 PR EXC CYST/ABERRANT BREAST TISSUE OPEN 1/> LESION $1,318.93 $1,884.18 30%
Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) CPT 29826 PR SURGICAL ARTHROSCOPY SHO W/CORACOACRM LIGM RLS $2,421.34 $3,459.05 30%
Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) inpatient CPT 29826 PR SURGICAL ARTHROSCOPY SHO W/CORACOACRM LIGM RLS $2,421.34 $3,459.05 30%
Tonsil and adenoid removal, child under 12 CPT 42820 PR TONSILLECTOMY & ADENOIDECTOMY <AGE 12 $833.00 $1,190.00 30%
Tonsil and adenoid removal, child under 12 inpatient CPT 42820 PR TONSILLECTOMY & ADENOIDECTOMY <AGE 12 $833.00 $1,190.00 30%
Total hip replacement CPT 27130 PR ARTHRP ACETBLR/PROX FEM PROSTC AGRFT/ALGRFT $5,684.03 $8,120.04 30%
Total hip replacement inpatient CPT 27130 PR ARTHRP ACETBLR/PROX FEM PROSTC AGRFT/ALGRFT $5,684.03 $8,120.04 30%
Total knee replacement CPT 27447 PR ARTHRP KNE CONDYLE&PLATU MEDIAL&LAT COMPARTMENTS $5,312.28 $7,588.96 30%
Total knee replacement inpatient CPT 27447 PR ARTHRP KNE CONDYLE&PLATU MEDIAL&LAT COMPARTMENTS $5,312.28 $7,588.96 30%
Upper endoscopy (EGD) with biopsy CPT 43239 PR EGD TRANSORAL BIOPSY SINGLE/MULTIPLE $971.84 $1,388.34 30%
Upper endoscopy (EGD) with biopsy CPT 43239 HC UGI W BIOPSY SGL OR MULTI $2,701.86 $3,859.80 30%
Upper endoscopy (EGD) with biopsy inpatient CPT 43239 PR EGD TRANSORAL BIOPSY SINGLE/MULTIPLE $971.84 $1,388.34 30%
Upper endoscopy (EGD) with biopsy inpatient CPT 43239 HC UGI W BIOPSY SGL OR MULTI $2,701.86 $3,859.80 30%
Upper endoscopy (EGD), diagnostic CPT 43235 PR ESOPHAGOGASTRODUODENOSCOPY TRANSORAL DIAGNOSTIC $838.64 $1,198.05 30%
Upper endoscopy (EGD), diagnostic CPT 43235 HC UGI ENDOSCOPY DIAGNOSTIC $2,204.74 $3,149.62 30%
Upper endoscopy (EGD), diagnostic inpatient CPT 43235 PR ESOPHAGOGASTRODUODENOSCOPY TRANSORAL DIAGNOSTIC $838.64 $1,198.05 30%
Upper endoscopy (EGD), diagnostic inpatient CPT 43235 HC UGI ENDOSCOPY DIAGNOSTIC $2,204.74 $3,149.62 30%
Vaginal birth after cesarean (VBAC), including prenatal and postpartum care CPT 59610 PR ROUTINE OB CARE VAG DLVRY & POSTPARTUM CARE VB $5,642.38 $8,060.54 30%
Vaginal birth after cesarean (VBAC), including prenatal and postpartum care inpatient CPT 59610 PR ROUTINE OB CARE VAG DLVRY & POSTPARTUM CARE VB $5,642.38 $8,060.54 30%
Vaginal delivery, including prenatal and postpartum care CPT 59400 PR OB CARE ANTEPARTUM VAG DLVR & POSTPARTUM $4,352.37 $6,217.66 30%
Vaginal delivery, including prenatal and postpartum care inpatient CPT 59400 PR OB CARE ANTEPARTUM VAG DLVR & POSTPARTUM $4,352.37 $6,217.66 30%

Doctor visits and therapy

ProcedureCash price List priceOff list
Electrocardiogram (ECG/EKG) with interpretation CPT 93000 PR ECG ROUTINE ECG W/LEAST 12 LDS W/I&R $33.95 $48.50 30%
Electrocardiogram (ECG/EKG) with interpretation inpatient CPT 93000 PR ECG ROUTINE ECG W/LEAST 12 LDS W/I&R $33.95 $48.50 30%
Family therapy with the patient, 50 minutes CPT 90847 PR FAMILY PSYCHOTHERAPY W/PATIENT PRESENT 50 MINS $210.09 $300.12 30%
Family therapy with the patient, 50 minutes inpatient CPT 90847 PR FAMILY PSYCHOTHERAPY W/PATIENT PRESENT 50 MINS $210.09 $300.12 30%
Family therapy without the patient, 50 minutes CPT 90846 PR FAMILY PSYCHOTHERAPY W/O PATIENT PRESENT 50 MINS $203.02 $290.02 30%
Family therapy without the patient, 50 minutes inpatient CPT 90846 PR FAMILY PSYCHOTHERAPY W/O PATIENT PRESENT 50 MINS $203.02 $290.02 30%
Group psychotherapy session CPT 90853 PR GROUP PSYCHOTHERAPY $71.95 $102.78 30%
Group psychotherapy session inpatient CPT 90853 PR GROUP PSYCHOTHERAPY $71.95 $102.78 30%
New patient office visit, about 30 minutes CPT 99203 PR OFFICE/OUTPATIENT NEW LOW MDM 30 MINUTES $214.33 $306.18 30%
New patient office visit, about 30 minutes CPT 99203 HC OUTPATIENT VISIT NEW LVL 3 $502.44 $717.76 30%
New patient office visit, about 30 minutes inpatient CPT 99203 PR OFFICE/OUTPATIENT NEW LOW MDM 30 MINUTES $214.33 $306.18 30%
New patient office visit, about 30 minutes inpatient CPT 99203 HC OUTPATIENT VISIT NEW LVL 3 $502.44 $717.76 30%
New patient office visit, about 45 minutes CPT 99204 PR OFFICE/OUTPATIENT NEW MODERATE MDM 45 MINUTES $327.51 $467.87 30%
New patient office visit, about 45 minutes CPT 99204 HC OUTPATIENT VISIT NEW LVL 4 $630.69 $900.98 30%
New patient office visit, about 45 minutes inpatient CPT 99204 PR OFFICE/OUTPATIENT NEW MODERATE MDM 45 MINUTES $327.51 $467.87 30%
New patient office visit, about 45 minutes inpatient CPT 99204 HC OUTPATIENT VISIT NEW LVL 4 $630.69 $900.98 30%
New patient office visit, about 60 minutes CPT 99205 PR OFFICE/OUTPATIENT NEW HIGH MDM 60 MINUTES $413.81 $591.15 30%
New patient office visit, about 60 minutes CPT 99205 HC OUTPATIENT VISIT NEW LVL 5 $630.69 $900.98 30%
New patient office visit, about 60 minutes inpatient CPT 99205 PR OFFICE/OUTPATIENT NEW HIGH MDM 60 MINUTES $413.81 $591.15 30%
New patient office visit, about 60 minutes inpatient CPT 99205 HC OUTPATIENT VISIT NEW LVL 5 $630.69 $900.98 30%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 PR THERAPEUTIC PX 1/> AREAS EACH 15 MIN EXERCISES $64.73 $92.46 30%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HC OT THER EXERCISE EA 15 MIN $112.91 $161.30 30%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HC PT THER EXERCISE EA 15 MIN $112.91 $161.30 30%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 PR THERAPEUTIC PX 1/> AREAS EACH 15 MIN EXERCISES $64.73 $92.46 30%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 HC PT THER EXERCISE EA 15 MIN $112.91 $161.30 30%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 HC OT THER EXERCISE EA 15 MIN $112.91 $161.30 30%
Preventive checkup, new patient aged 18–39 CPT 99385 PR INITIAL PREVENTIVE MEDICINE NEW PT AGE 18-39YRS $265.26 $378.94 30%
Preventive checkup, new patient aged 18–39 inpatient CPT 99385 PR INITIAL PREVENTIVE MEDICINE NEW PT AGE 18-39YRS $265.26 $378.94 30%
Preventive checkup, new patient aged 40–64 CPT 99386 PR INITIAL PREVENTIVE MEDICINE NEW PATIENT 40-64YRS $307.00 $438.56 30%
Preventive checkup, new patient aged 40–64 inpatient CPT 99386 PR INITIAL PREVENTIVE MEDICINE NEW PATIENT 40-64YRS $307.00 $438.56 30%
Psychotherapy session, 30 minutes CPT 90832 PR PSYCHOTHERAPY W/PATIENT 30 MINUTES $139.35 $199.07 30%
Psychotherapy session, 30 minutes inpatient CPT 90832 PR PSYCHOTHERAPY W/PATIENT 30 MINUTES $139.35 $199.07 30%
Psychotherapy session, 45 minutes CPT 90834 PR PSYCHOTHERAPY W/PATIENT 45 MINUTES $185.33 $264.75 30%
Psychotherapy session, 45 minutes inpatient CPT 90834 PR PSYCHOTHERAPY W/PATIENT 45 MINUTES $185.33 $264.75 30%
Psychotherapy session, 60 minutes CPT 90837 PR PSYCHOTHERAPY W/PATIENT 60 MINUTES $277.29 $396.12 30%
Psychotherapy session, 60 minutes inpatient CPT 90837 PR PSYCHOTHERAPY W/PATIENT 60 MINUTES $277.29 $396.12 30%
Specialist consultation, low complexity or 30+ minutes CPT 99243 HC LEVEL 3 CONSULTATION $198.32 $283.31 30%
Specialist consultation, low complexity or 30+ minutes CPT 99243 PR OFFICE/OP CONSLTJ NEW/EST PT LOW MDM 30 MINUTES $246.87 $352.67 30%
Specialist consultation, low complexity or 30+ minutes inpatient CPT 99243 HC LEVEL 3 CONSULTATION $198.32 $283.31 30%
Specialist consultation, low complexity or 30+ minutes inpatient CPT 99243 PR OFFICE/OP CONSLTJ NEW/EST PT LOW MDM 30 MINUTES $246.87 $352.67 30%
Specialist consultation, moderate complexity or 40+ minutes CPT 99244 HC LEVEL 4 CONSULTATION $199.64 $285.20 30%
Specialist consultation, moderate complexity or 40+ minutes CPT 99244 PR OFFICE/OP CONSLTJ NEW/EST PT MOD MDM 40 MINUTES $497.19 $710.26 30%
Specialist consultation, moderate complexity or 40+ minutes inpatient CPT 99244 HC LEVEL 4 CONSULTATION $199.64 $285.20 30%
Specialist consultation, moderate complexity or 40+ minutes inpatient CPT 99244 PR OFFICE/OP CONSLTJ NEW/EST PT MOD MDM 40 MINUTES $497.19 $710.26 30%

Source file: https://sthpiprd.blob.core.windows.net/machine-readable-files/10177/836000194_memorial-hospital-of-laramie-county_standardcharges.csv