Hospital Lincoln, NE

Saint Elizabeth Regional Medical Center

Saint Elizabeth Regional Medical Center in Lincoln, NE publishes cash prices for 384 common procedures listed here, from its own machine-readable price file updated Sep 30, 2026. Compared with other hospitals in the state, its outpatient cash prices are below the Nebraska median for 252 of 381 procedures and above it for 120. By typical cash price it ranks #15 of 52 Nebraska hospitals, cheapest first. Select a procedure to compare it with other hospitals nearby.

555 South 70th Street, Lincoln, NE 68510 Collected Nov 4, 2026 Source price file Check a bill from this hospital (402) 219-7700

Acute care hospital Nonprofit hospital Emergency department CMS star rating 4 of 5 CCN 280020 · CMS hospital register NPI 1336155738

Financial assistance

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

Saint Elizabeth Regional 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.

Scans and imaging

Procedure	Cash price	List price	Insurers pay	vs Nebraska	Off list
Abdominal CT scan without and with contrast CPT 74170 HC CT ABDOMEN W WO CONTRAST	$1,520.16	$3,167.00	$142.36–$2,691.95	50% below	52%
Abdominal CT scan without and with contrast inpatient CPT 74170 HC CT ABDOMEN W WO CONTRAST	$1,520.16	$3,167.00	$1,836.86–$2,533.60	—	52%
Abdominal X-ray, 2 views CPT 74019 HC ABDOMEN COMPLETE 2V	$282.24	$588.00	$50.97–$499.80	23% below	52%
Abdominal X-ray, 2 views inpatient CPT 74019 HC ABDOMEN COMPLETE 2V	$282.24	$588.00	$341.04–$470.40	—	52%
Ankle X-ray, complete, 3 or more views CPT 73610 HC ANKLE COMPLETE	$251.04	$523.00	$54.93–$444.55	25% below	52%
Ankle X-ray, complete, 3 or more views inpatient CPT 73610 HC ANKLE COMPLETE	$251.04	$523.00	$303.34–$418.40	—	52%
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 HC ANKLE BRACHIAL INDEX	$272.64	$568.00	$107.99–$482.80	52% below	52%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 HC ANKLE BRACHIAL INDEX	$272.64	$568.00	$329.44–$454.40	—	52%
Arm CT scan without contrast (shoulder to hand, any part) CPT 73200 HC CT UPPER EXT WO CONTRAST	$1,179.84	$2,458.00	$84.85–$2,229.00	43% below	52%
Arm CT scan without contrast (shoulder to hand, any part) inpatient CPT 73200 HC CT UPPER EXT WO CONTRAST	$1,179.84	$2,458.00	$1,425.64–$1,966.40	—	52%
Barium swallow (esophagus X-ray with contrast) CPT 74220 HC ESOPHAGRAM	$448.32	$934.00	$133.36–$793.90	29% below	52%
Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 HC ESOPHAGRAM	$448.32	$934.00	$541.72–$747.20	—	52%
Bone scan, whole body (nuclear medicine) CPT 78306 HC NM BONE SCAN WHOLE BODY	$1,142.88	$2,381.00	$324.47–$2,023.85	38% below	52%
Bone scan, whole body (nuclear medicine) inpatient CPT 78306 HC NM BONE SCAN WHOLE BODY	$1,142.88	$2,381.00	$1,380.98–$1,904.80	—	52%
Breast ultrasound, complete, one breast CPT 76641 HC ULTRASOUND BREAST COMPLETE	$713.76	$1,487.00	$84.85–$1,263.95	45% above	52%
Breast ultrasound, complete, one breast inpatient CPT 76641 HC ULTRASOUND BREAST COMPLETE	$713.76	$1,487.00	$862.46–$1,189.60	—	52%
Breast ultrasound, limited (one breast or one area) CPT 76642 HC ULTRASOUND BREAST LIMITED	$713.76	$1,487.00	$70.64–$1,263.95	68% above	52%
Breast ultrasound, limited (one breast or one area) inpatient CPT 76642 HC ULTRASOUND BREAST LIMITED	$713.76	$1,487.00	$862.46–$1,189.60	—	52%
CT angiography (CTA) of the abdomen and pelvis CPT 74174 HC CT ANGIO AB PELV W WO CONTR	$1,557.60	$3,245.00	$283.16–$2,758.25	67% below	52%
CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174 HC CT ANGIO AB PELV W WO CONTR	$1,557.60	$3,245.00	$1,882.10–$2,596.00	—	52%
CT angiography (CTA) of the head CPT 70496 HC CT ANGIO HEAD W WO CONTRAST	$1,479.84	$3,083.00	$142.36–$2,620.55	48% below	52%
CT angiography (CTA) of the head inpatient CPT 70496 HC CT ANGIO HEAD W WO CONTRAST	$1,479.84	$3,083.00	$1,788.14–$2,466.40	—	52%
CT angiography (CTA) of the neck CPT 70498 HC CT ANGIO NECK W WO CONTRAST	$1,661.76	$3,462.00	$142.36–$2,942.70	42% below	52%
CT angiography (CTA) of the neck inpatient CPT 70498 HC CT ANGIO NECK W WO CONTRAST	$1,661.76	$3,462.00	$2,007.96–$2,769.60	—	52%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 HC CT ANGIO CHEST W WO CONTRST	$1,866.24	$3,888.00	$142.36–$3,304.80	44% below	52%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 HC CT ANGIO CHEST W WO CONTRST	$1,866.24	$3,888.00	$2,255.04–$3,110.40	—	52%
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 HC CTA HEART ARTERIES W CONTRA	$1,562.88	$3,256.00	$283.16–$2,767.60	17% above	52%
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score inpatient CPT 75574 HC CTA HEART ARTERIES W CONTRA	$1,562.88	$3,256.00	$1,888.48–$2,604.80	—	52%
CT of the heart without contrast dye to measure coronary calcium CPT 75571 HC CT HEART CALCIUM SCORING	$115.68	$241.00	$48.20–$2,229.00	17% below	52%
CT of the heart without contrast dye to measure coronary calcium inpatient CPT 75571 HC CT HEART CALCIUM SCORING	$115.68	$241.00	$139.78–$192.80	—	52%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 HC CT ABD PELVIS WO CONTRAST	$1,954.56	$4,072.00	$193.66–$3,461.20	48% below	52%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 HC CT ABD PELVIS WO CONTRAST	$1,954.56	$4,072.00	$2,361.76–$3,257.60	—	52%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 HC CT ABDOMEN PELVIS W CONTRST	$2,571.84	$5,358.00	$283.16–$4,554.30	40% below	52%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 HC CT ABDOMEN PELVIS W CONTRST	$2,571.84	$5,358.00	$3,107.64–$4,286.40	—	52%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 HC CT ABD PELVIS W WO CONTRAST	$3,677.28	$7,661.00	$283.16–$6,511.85	26% below	52%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 HC CT ABD PELVIS W WO CONTRAST	$3,677.28	$7,661.00	$4,443.38–$6,128.80	—	52%
CT scan of the abdomen with contrast CPT 74160 HC CT ABDOMEN W CONTRAST	$1,368.00	$2,850.00	$142.36–$2,422.50	48% below	52%
CT scan of the abdomen with contrast inpatient CPT 74160 HC CT ABDOMEN W CONTRAST	$1,368.00	$2,850.00	$1,653.00–$2,280.00	—	52%
CT scan of the abdomen without contrast CPT 74150 HC CT ABDOMEN WO CONTRAST	$1,033.92	$2,154.00	$84.85–$2,229.00	54% below	52%
CT scan of the abdomen without contrast inpatient CPT 74150 HC CT ABDOMEN WO CONTRAST	$1,033.92	$2,154.00	$1,249.32–$1,723.20	—	52%
CT scan of the face and sinuses, no contrast dye CPT 70486 HC CT MAXILLOFACIAL WO CONTRST	$1,072.32	$2,234.00	$84.85–$2,229.00	43% below	52%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 HC CT MAXILLOFACIAL WO CONTRST	$1,072.32	$2,234.00	$1,295.72–$1,787.20	—	52%
CT scan of the head or brain, no contrast dye CPT 70450 HC CT HEAD WO CONTRAST	$1,076.16	$2,242.00	$84.85–$2,229.00	45% below	52%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 HC CT HEAD WO CONTRAST	$1,076.16	$2,242.00	$1,300.36–$1,793.60	—	52%
CT scan of the head with contrast CPT 70460 HC CT HEAD W CONTRAST	$1,452.96	$3,027.00	$142.36–$2,572.95	31% below	52%
CT scan of the head with contrast inpatient CPT 70460 HC CT HEAD W CONTRAST	$1,452.96	$3,027.00	$1,755.66–$2,421.60	—	52%
CT scan of the head without and with contrast CPT 70470 HC CT HEAD W WO CONTRAST	$1,743.36	$3,632.00	$142.36–$3,087.20	30% below	52%
CT scan of the head without and with contrast inpatient CPT 70470 HC CT HEAD W WO CONTRAST	$1,743.36	$3,632.00	$2,106.56–$2,905.60	—	52%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 HC CT LUMBAR WO CONTRAST	$1,307.04	$2,723.00	$84.85–$2,314.55	42% below	52%
CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 HC CT LUMBAR WO CONTRAST	$1,307.04	$2,723.00	$1,579.34–$2,178.40	—	52%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 HC CT CERVICAL WO CONTRAST	$1,359.36	$2,832.00	$84.85–$2,407.20	42% below	52%
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 HC CT CERVICAL WO CONTRAST	$1,359.36	$2,832.00	$1,642.56–$2,265.60	—	52%
CT scan of the pelvis, with contrast dye CPT 72193 HC CT PELVIS W CONTRAST	$1,432.80	$2,985.00	$142.36–$2,537.25	43% below	52%
CT scan of the pelvis, with contrast dye inpatient CPT 72193 HC CT PELVIS W CONTRAST	$1,432.80	$2,985.00	$1,731.30–$2,388.00	—	52%
Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 HC CAROTID DUPLEX BILATERAL	$851.52	$1,774.00	$193.66–$1,507.90	—	52%
Carotid artery ultrasound (duplex), both sides of the neck inpatient both sides CPT 93880 HC CAROTID DUPLEX BILATERAL	$851.52	$1,774.00	$1,028.92–$1,419.20	—	52%
Chest CT scan without and with contrast CPT 71270 HC CT CHEST W WO CONTRAST	$1,564.80	$3,260.00	$142.36–$2,771.00	44% below	52%
Chest CT scan without and with contrast inpatient CPT 71270 HC CT CHEST W WO CONTRAST	$1,564.80	$3,260.00	$1,890.80–$2,608.00	—	52%
Chest X-ray, 2 views CPT 71046 HC CHEST 2 VIEWS PA LAT	$217.44	$453.00	$45.68–$385.05	28% below	52%
Chest X-ray, 2 views inpatient CPT 71046 HC CHEST 2 VIEWS PA LAT	$217.44	$453.00	$262.74–$362.40	—	52%
Chest X-ray, single view CPT 71045 HC CHEST 1 VIEW PA OR AP ONLY	$217.44	$453.00	$33.84–$385.05	18% below	52%
Chest X-ray, single view inpatient CPT 71045 HC CHEST 1 VIEW PA OR AP ONLY	$217.44	$453.00	$262.74–$362.40	—	52%
Collarbone (clavicle) X-ray, complete CPT 73000 HC CLAVICLE	$211.68	$441.00	$48.33–$374.85	27% below	52%
Collarbone (clavicle) X-ray, complete inpatient CPT 73000 HC CLAVICLE	$211.68	$441.00	$255.78–$352.80	—	52%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 HC US RETROPERITONEAL COMPLETE	$285.12	$594.00	$84.85–$524.42	64% below	52%
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 HC US RETROPERITONEAL COMPLETE	$285.12	$594.00	$344.52–$475.20	—	52%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 HC DEXA BONE DENSITY	$376.32	$784.00	$58.88–$666.40	14% below	52%
DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 HC DEXA BONE DENSITY	$376.32	$784.00	$454.72–$627.20	—	52%
Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 HC US PREG DTL TRANSABDOMINAL	$309.60	$645.00	$129.00–$571.87	39% below	52%
Detailed fetal anatomy ultrasound, through the belly, one baby inpatient CPT 76811 HC US PREG DTL TRANSABDOMINAL	$309.60	$645.00	$374.10–$516.00	—	52%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 HC CT CHEST WO CONTRAST	$933.60	$1,945.00	$84.85–$2,229.00	58% below	52%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 HC CT CHEST WO CONTRAST	$933.60	$1,945.00	$1,128.10–$1,556.00	—	52%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 HC CT CHEST W CONTRAST	$1,372.80	$2,860.00	$142.36–$2,431.00	46% below	52%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 HC CT CHEST W CONTRAST	$1,372.80	$2,860.00	$1,658.80–$2,288.00	—	52%
Diagnostic mammogram, both breasts both sides CPT 77066 HC DX MAMMO INCL CAD BI	$213.60	$445.00	$89.00–$378.25	—	52%
Diagnostic mammogram, both breasts inpatient both sides CPT 77066 HC DX MAMMO INCL CAD BI	$213.60	$445.00	$258.10–$356.00	—	52%
Diagnostic mammogram, one breast CPT 77065 HC MAMMOGRAM DIGITAL UNILATERL	$159.36	$332.00	$66.40–$282.20	52% below	52%
Diagnostic mammogram, one breast CPT 77065 HC DX MAMMO INCL CAD UNI	$192.48	$401.00	$80.20–$340.85	41% below	52%
Diagnostic mammogram, one breast inpatient CPT 77065 HC MAMMOGRAM DIGITAL UNILATERL	$159.36	$332.00	$192.56–$265.60	—	52%
Diagnostic mammogram, one breast inpatient CPT 77065 HC DX MAMMO INCL CAD UNI	$192.48	$401.00	$232.58–$320.80	—	52%
Duplex ultrasound of the leg arteries, both legs CPT 93925 HC ART DUPLEX LOW EXT BIL	$826.08	$1,721.00	$193.66–$1,462.85	30% below	52%
Duplex ultrasound of the leg arteries, both legs inpatient CPT 93925 HC ART DUPLEX LOW EXT BIL	$826.08	$1,721.00	$998.18–$1,376.80	—	52%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 HC VENOUS DUPLEX BILATERAL	$1,034.40	$2,155.00	$193.66–$1,831.75	—	52%
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 HC VENOUS DUPLEX BILATERAL	$1,034.40	$2,155.00	$1,249.90–$1,724.00	—	52%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 HC ECHO W PW CW CF DOPPLER	$1,643.52	$3,424.00	$248.46–$2,910.40	25% below	52%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 HC ECHO W PW CW CF DOPPLER	$1,643.52	$3,424.00	$1,985.92–$2,739.20	—	52%
Elbow X-ray, 2 views CPT 73070 HC ELBOW 2 VIEWS	$204.00	$425.00	$41.75–$361.25	23% below	52%
Elbow X-ray, 2 views inpatient CPT 73070 HC ELBOW 2 VIEWS	$204.00	$425.00	$246.50–$340.00	—	52%
Elbow X-ray, complete, 3 or more views CPT 73080 HC ELBOW COMPLETE	$259.20	$540.00	$47.66–$459.00	21% below	52%
Elbow X-ray, complete, 3 or more views inpatient CPT 73080 HC ELBOW COMPLETE	$259.20	$540.00	$313.20–$432.00	—	52%
Eye socket (orbit) CT scan without contrast CPT 70480 HC CT ORBIT WO CONTRAST	$1,272.00	$2,650.00	$84.85–$2,252.50	40% below	52%
Eye socket (orbit) CT scan without contrast inpatient CPT 70480 HC CT ORBIT WO CONTRAST	$1,272.00	$2,650.00	$1,537.00–$2,120.00	—	52%
Facial bones X-ray, complete, 3 or more views CPT 70150 HC FACIAL BONES COMPLETE	$332.64	$693.00	$67.44–$589.05	18% below	52%
Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 HC FACIAL BONES COMPLETE	$332.64	$693.00	$401.94–$554.40	—	52%
Forearm X-ray (radius and ulna), 2 views CPT 73090 HC FOREARM	$208.32	$434.00	$42.40–$368.90	28% below	52%
Forearm X-ray (radius and ulna), 2 views inpatient CPT 73090 HC FOREARM	$208.32	$434.00	$251.72–$347.20	—	52%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 HC HEPATOBILRY IMG W GALL BLAD	$952.80	$1,985.00	$324.47–$1,985.00	40% below	52%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 HC HEPATOBILRY IMG W GALL BLAD	$952.80	$1,985.00	$1,151.30–$1,588.00	—	52%
Hand X-ray, 2 views CPT 73120 HC HAND 2 VIEW	$218.40	$455.00	$45.68–$386.75	15% below	52%
Hand X-ray, 2 views inpatient CPT 73120 HC HAND 2 VIEW	$218.40	$455.00	$263.90–$364.00	—	52%
Heel bone (calcaneus) X-ray, 2 or more views CPT 73650 HC CALCANEUS	$139.68	$291.00	$40.42–$247.35	34% below	52%
Heel bone (calcaneus) X-ray, 2 or more views inpatient CPT 73650 HC CALCANEUS	$139.68	$291.00	$168.78–$232.80	—	52%
Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 HC SLEEP STUDY UNATTENDED	$205.44	$428.00	$85.60–$737.25	55% below	52%
Home sleep apnea test, unattended, recording breathing and oxygen inpatient CPT 95806 HC SLEEP STUDY UNATTENDED	$205.44	$428.00	$248.24–$342.40	—	52%
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 HC POLYSOMNOGRPHY=>6 YR CPAP	$2,483.52	$5,174.00	$697.00–$4,397.90	41% below	52%
In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 HC POLYSOMNOGRPHY=>6 YR CPAP	$2,483.52	$5,174.00	$3,000.92–$4,139.20	—	52%
Knee X-ray, 3 views CPT 73562 HC KNEE 3 VIEW	$297.60	$620.00	$62.17–$527.00	22% below	52%
Knee X-ray, 3 views inpatient CPT 73562 HC KNEE 3 VIEW	$297.60	$620.00	$359.60–$496.00	—	52%
Knee X-ray, complete, 4 or more views CPT 73564 HC KNEE 4 OR> VIEWS	$306.24	$638.00	$71.39–$542.30	21% below	52%
Knee X-ray, complete, 4 or more views inpatient CPT 73564 HC KNEE 4 OR> VIEWS	$306.24	$638.00	$370.04–$510.40	—	52%
Leg CT scan without contrast (hip to foot, any part) CPT 73700 HC CT LOWER EXT WO CONTRAST	$899.04	$1,873.00	$84.85–$2,229.00	58% below	52%
Leg CT scan without contrast (hip to foot, any part) inpatient CPT 73700 HC CT LOWER EXT WO CONTRAST	$899.04	$1,873.00	$1,086.34–$1,498.40	—	52%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 HC US ABDOMEN LIMITED	$223.68	$466.00	$84.85–$426.58	62% below	52%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 HC US ABDOMEN LIMITED	$223.68	$466.00	$270.28–$372.80	—	52%
Limited ultrasound of an arm or leg (non-vascular) CPT 76882 HC US LMTD JT/FCL EVL NVASC XTR	$351.36	$732.00	$62.17–$622.20	33% below	52%
Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 HC US LMTD JT/FCL EVL NVASC XTR	$351.36	$732.00	$424.56–$585.60	—	52%
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 HC LUNG CT SCREEN INITIAL	$233.76	$487.00	$84.85–$2,229.00	62% below	52%
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 HC LUNG CT SCREEN ANNUAL FU	$233.76	$487.00	$84.85–$2,229.00	62% below	52%
Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 HC LUNG CT SCREEN INITIAL	$233.76	$487.00	$282.46–$389.60	—	52%
Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 HC LUNG CT SCREEN ANNUAL FU	$233.76	$487.00	$282.46–$389.60	—	52%
Lower leg X-ray (tibia and fibula), 2 views CPT 73590 HC TIBIA FIBULA	$255.36	$532.00	$47.02–$452.20	18% below	52%
Lower leg X-ray (tibia and fibula), 2 views inpatient CPT 73590 HC TIBIA FIBULA	$255.36	$532.00	$308.56–$425.60	—	52%
MR angiography (MRA) of the head without contrast CPT 70544 HC MRA HEAD WO CONTRAST	$1,888.80	$3,935.00	$193.66–$3,344.75	40% below	52%
MR angiography (MRA) of the head without contrast inpatient CPT 70544 HC MRA HEAD WO CONTRAST	$1,888.80	$3,935.00	$2,282.30–$3,148.00	—	52%
MRI of knee or other lower-limb joint, no contrast dye CPT 73721 HC MR JOINT LOWER EXT WO CONT	$1,443.84	$3,008.00	$193.66–$2,917.00	43% below	52%
MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 HC MR JOINT LOWER EXT WO CONT	$1,443.84	$3,008.00	$1,744.64–$2,406.40	—	52%
MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 HC MR JNT LOWER EXT W WO CONT	$1,891.68	$3,941.00	$283.16–$3,349.85	44% below	52%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 HC MR JNT LOWER EXT W WO CONT	$1,891.68	$3,941.00	$2,285.78–$3,152.80	—	52%
MRI of the abdomen without contrast CPT 74181 HC MR ABDOMEN WO CONTRAST	$1,782.72	$3,714.00	$193.66–$3,156.90	42% below	52%
MRI of the abdomen without contrast inpatient CPT 74181 HC MR ABDOMEN WO CONTRAST	$1,782.72	$3,714.00	$2,154.12–$2,971.20	—	52%
MRI of the abdomen, without and then with contrast dye CPT 74183 HC MR ABDOMEN W WO CONTRAST	$2,285.28	$4,761.00	$283.16–$4,046.85	43% below	52%
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 HC MR ABDOMEN W WO CONTRAST	$2,285.28	$4,761.00	$2,761.38–$3,808.80	—	52%
MRI of the brain, no contrast dye CPT 70551 HC MR BRAIN WO CONTRAST	$1,742.40	$3,630.00	$193.66–$3,085.50	48% below	52%
MRI of the brain, no contrast dye inpatient CPT 70551 HC MR BRAIN WO CONTRAST	$1,742.40	$3,630.00	$2,105.40–$2,904.00	—	52%
MRI of the brain, with and without contrast dye CPT 70553 HC MR BRAIN W WO CONTRAST	$2,233.92	$4,654.00	$283.16–$3,955.90	44% below	52%
MRI of the brain, with and without contrast dye inpatient CPT 70553 HC MR BRAIN W WO CONTRAST	$2,233.92	$4,654.00	$2,699.32–$3,723.20	—	52%
MRI of the lower back, no contrast dye CPT 72148 HC MR LUMBAR WO CONTRAST	$1,443.84	$3,008.00	$193.66–$2,917.00	55% below	52%
MRI of the lower back, no contrast dye inpatient CPT 72148 HC MR LUMBAR WO CONTRAST	$1,443.84	$3,008.00	$1,744.64–$2,406.40	—	52%
MRI of the lower back, without and then with contrast dye CPT 72158 HC MR LUMBAR W WO CONTRAST	$1,992.48	$4,151.00	$283.16–$3,528.35	50% below	52%
MRI of the lower back, without and then with contrast dye inpatient CPT 72158 HC MR LUMBAR W WO CONTRAST	$1,992.48	$4,151.00	$2,407.58–$3,320.80	—	52%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 HC MR THORACIC WO CONTRAST	$1,881.60	$3,920.00	$193.66–$3,332.00	45% below	52%
MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 HC MR THORACIC WO CONTRAST	$1,881.60	$3,920.00	$2,273.60–$3,136.00	—	52%
MRI of the neck (cervical spine) without and with contrast CPT 72156 HC MR CERVICAL W WO CONTRAST	$2,355.84	$4,908.00	$283.16–$4,171.80	42% below	52%
MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 HC MR CERVICAL W WO CONTRAST	$2,355.84	$4,908.00	$2,846.64–$3,926.40	—	52%
MRI of the neck (cervical spine), no contrast dye CPT 72141 HC MR CERVICAL WO CONTRAST	$1,602.72	$3,339.00	$193.66–$2,917.00	52% below	52%
MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 HC MR CERVICAL WO CONTRAST	$1,602.72	$3,339.00	$1,936.62–$2,671.20	—	52%
MRI of the pelvis without and with contrast CPT 72197 HC MR PELVIS W WO CONTRAST	$2,028.48	$4,226.00	$283.16–$3,592.10	44% below	52%
MRI of the pelvis without and with contrast inpatient CPT 72197 HC MR PELVIS W WO CONTRAST	$2,028.48	$4,226.00	$2,451.08–$3,380.80	—	52%
MRI of the pelvis, no contrast dye CPT 72195 HC MR PELVIS WO CONTRAST	$1,724.64	$3,593.00	$193.66–$3,054.05	42% below	52%
MRI of the pelvis, no contrast dye inpatient CPT 72195 HC MR PELVIS WO CONTRAST	$1,724.64	$3,593.00	$2,083.94–$2,874.40	—	52%
MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 HC MR JOINT UP EXT WO CONTRAST	$1,435.20	$2,990.00	$193.66–$2,917.00	43% below	52%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 HC MR JOINT UP EXT WO CONTRAST	$1,435.20	$2,990.00	$1,734.20–$2,392.00	—	52%
Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 HC CERVICAL SPINE 4 OR 5 VIEWS	$358.08	$746.00	$80.64–$634.10	26% below	52%
Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 HC CERVICAL SPINE 4 OR 5 VIEWS	$358.08	$746.00	$432.68–$596.80	—	52%
Neck soft tissue CT scan with contrast CPT 70491 HC CT NECK W CONTRAST	$1,445.76	$3,012.00	$142.36–$2,560.20	39% below	52%
Neck soft tissue CT scan with contrast inpatient CPT 70491 HC CT NECK W CONTRAST	$1,445.76	$3,012.00	$1,746.96–$2,409.60	—	52%
Neck soft tissue CT scan without contrast CPT 70490 HC CT NECK WO CONT	$1,113.12	$2,319.00	$84.85–$2,229.00	44% below	52%
Neck soft tissue CT scan without contrast inpatient CPT 70490 HC CT NECK WO CONT	$1,113.12	$2,319.00	$1,345.02–$1,855.20	—	52%
Neck soft tissue X-ray CPT 70360 HC NECK SOFT TISSUE	$225.12	$469.00	$44.37–$398.65	25% below	52%
Neck soft tissue X-ray inpatient CPT 70360 HC NECK SOFT TISSUE	$225.12	$469.00	$272.02–$375.20	—	52%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 HC MYOCARDIAL SPCT STDY MUL	$2,226.24	$4,638.00	$683.02–$3,942.30	49% below	52%
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 HC MYOCARDIAL SPCT STDY MUL	$2,226.24	$4,638.00	$2,690.04–$3,710.40	—	52%
PET/CT scan from the base of the skull to mid-thigh CPT 78815 HC NM PET CT SK TO M THGH INT	$4,222.56	$8,797.00	$1,160.62–$7,477.45	21% below	52%
PET/CT scan from the base of the skull to mid-thigh CPT 78815 HC NM PET CT SK TO M THGH SUB	$4,222.56	$8,797.00	$1,160.62–$7,477.45	21% below	52%
PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 HC NM PET CT SK TO M THGH INT	$4,222.56	$8,797.00	$5,102.26–$7,037.60	—	52%
PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 HC NM PET CT SK TO M THGH SUB	$4,222.56	$8,797.00	$5,102.26–$7,037.60	—	52%
Pelvic CT scan without contrast CPT 72192 HC CT PELVIS WO CONTRAST	$1,160.64	$2,418.00	$84.85–$2,229.00	47% below	52%
Pelvic CT scan without contrast inpatient CPT 72192 HC CT PELVIS WO CONTRAST	$1,160.64	$2,418.00	$1,402.44–$1,934.40	—	52%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 HC US PELVIS GYN LIMITED	$130.08	$271.00	$52.28–$245.35	69% below	52%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 HC US PELVIS GYN LIMITED	$130.08	$271.00	$157.18–$216.80	—	52%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 HC US PELVIS GYN	$276.48	$576.00	$84.85–$519.54	65% below	52%
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 HC US PELVIS GYN	$276.48	$576.00	$334.08–$460.80	—	52%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 HC ULTRASOUND COMPLETE	$266.88	$556.00	$84.85–$556.00	64% below	52%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 HC US PREGNANCY >14 WKS	$712.80	$1,485.00	$84.85–$1,262.25	4% below	52%
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 HC ULTRASOUND COMPLETE	$266.88	$556.00	$322.48–$444.80	—	52%
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 HC US PREGNANCY >14 WKS	$712.80	$1,485.00	$861.30–$1,188.00	—	52%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 HC US PREG < 14 WKS TRANSABD	$259.20	$540.00	$84.85–$502.45	59% below	52%
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 HC US PREG < 14 WKS TRANSABD	$259.20	$540.00	$313.20–$432.00	—	52%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 HC ULTRASOUND LIMITED	$151.68	$316.00	$63.20–$316.00	63% below	52%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 HC ULTRASOUND LIMITED	$151.68	$316.00	$183.28–$252.80	—	52%
Rib X-ray, one side, 2 views one side CPT 71100 HC RIBS UNILATERAL	$193.92	$404.00	$50.97–$343.40	41% below	52%
Rib X-ray, one side, 2 views inpatient one side CPT 71100 HC RIBS UNILATERAL	$193.92	$404.00	$234.32–$323.20	—	52%
Rib X-ray, one side, with a chest view, 3 or more views CPT 71101 HC RIBS UNI PA CHEST	$261.60	$545.00	$57.55–$463.25	39% below	52%
Rib X-ray, one side, with a chest view, 3 or more views inpatient CPT 71101 HC RIBS UNI PA CHEST	$261.60	$545.00	$316.10–$436.00	—	52%
Screening mammogram, both breasts both sides CPT 77067 HC SCR MAMMO BI INCL CAD	$263.04	$548.00	$109.60–$465.80	—	52%
Screening mammogram, both breasts CPT 77067 HC SCR MAMMO UNI INCL CAD	$183.84	$383.00	$76.60–$325.55	34% below	52%
Screening mammogram, both breasts one side CPT 77067 HC MAMMOG DR UNILAT SCREEN M52	$88.32	$184.00	$36.80–$261.00	68% below	52%
Screening mammogram, both breasts inpatient both sides CPT 77067 HC SCR MAMMO BI INCL CAD	$263.04	$548.00	$317.84–$438.40	—	52%
Screening mammogram, both breasts inpatient CPT 77067 HC SCR MAMMO UNI INCL CAD	$183.84	$383.00	$222.14–$306.40	—	52%
Screening mammogram, both breasts inpatient one side CPT 77067 HC MAMMOG DR UNILAT SCREEN M52	$88.32	$184.00	$106.72–$147.20	—	52%
Shoulder X-ray, complete, 2 or more views CPT 73030 HC SHOULDER COMPLETE	$298.08	$621.00	$50.31–$527.85	17% below	52%
Shoulder X-ray, complete, 2 or more views inpatient CPT 73030 HC SHOULDER COMPLETE	$298.08	$621.00	$360.18–$496.80	—	52%
Sinus X-ray, complete, 3 or more views CPT 70220 HC SINUSES COMPLETE	$270.72	$564.00	$53.59–$479.40	15% below	52%
Sinus X-ray, complete, 3 or more views inpatient CPT 70220 HC SINUSES COMPLETE	$270.72	$564.00	$327.12–$451.20	—	52%
Skull X-ray, fewer than 4 views CPT 70250 HC SKULL PARTIAL <4	$133.44	$278.00	$53.59–$245.35	48% below	52%
Skull X-ray, fewer than 4 views inpatient CPT 70250 HC SKULL PARTIAL <4	$133.44	$278.00	$161.24–$222.40	—	52%
Sleep study in a lab (polysomnography) CPT 95810 HC POLYSOMNOGRAPHY=> 6 YR	$2,185.44	$4,553.00	$697.00–$3,870.05	42% below	52%
Sleep study in a lab (polysomnography) inpatient CPT 95810 HC POLYSOMNOGRAPHY=> 6 YR	$2,185.44	$4,553.00	$2,640.74–$3,642.40	—	52%
Stress echocardiogram, complete, including the stress test and supervision CPT 93351 HC STRESS ECHO W EKG MONITOR	$1,252.32	$2,609.00	$292.19–$2,217.65	31% below	52%
Stress echocardiogram, complete, including the stress test and supervision CPT 93351 HC STRESS ECHO W EKG MNTR	$1,514.40	$3,155.00	$292.19–$2,681.75	16% below	52%
Stress echocardiogram, complete, including the stress test and supervision inpatient CPT 93351 HC STRESS ECHO W EKG MONITOR	$1,252.32	$2,609.00	$1,513.22–$2,087.20	—	52%
Stress echocardiogram, complete, including the stress test and supervision inpatient CPT 93351 HC STRESS ECHO W EKG MNTR	$1,514.40	$3,155.00	$1,829.90–$2,524.00	—	52%
Swallow study (modified barium swallow, video X-ray) CPT 74230 HC SWALLOWING STUDY FOR SPEECH	$404.16	$842.00	$142.36–$715.70	33% below	52%
Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 HC SWALLOWING STUDY FOR SPEECH	$404.16	$842.00	$488.36–$673.60	—	52%
Thigh bone (femur) X-ray, 2 or more views CPT 73552 HC X-RAY EXAM OF FEMUR 2/>	$191.04	$398.00	$52.95–$338.30	40% below	52%
Thigh bone (femur) X-ray, 2 or more views inpatient CPT 73552 HC X-RAY EXAM OF FEMUR 2/>	$191.04	$398.00	$230.84–$318.40	—	52%
Thoracic spine (mid back) CT scan without contrast CPT 72128 HC CT THORACIC WO CONTRAST	$1,346.40	$2,805.00	$84.85–$2,384.25	42% below	52%
Thoracic spine (mid back) CT scan without contrast inpatient CPT 72128 HC CT THORACIC WO CONTRAST	$1,346.40	$2,805.00	$1,626.90–$2,244.00	—	52%
Toe X-ray, 2 or more views one side CPT 73660 HC TOE LT GREAT TOE TA	$188.64	$393.00	$44.37–$334.05	22% below	52%
Toe X-ray, 2 or more views inpatient one side CPT 73660 HC TOE LT GREAT TOE TA	$188.64	$393.00	$227.94–$314.40	—	52%
Transvaginal pelvic ultrasound CPT 76830 HC US TRANSVAGINAL	$462.24	$963.00	$84.85–$818.55	30% below	52%
Transvaginal pelvic ultrasound inpatient CPT 76830 HC US TRANSVAGINAL	$462.24	$963.00	$558.54–$770.40	—	52%
Transvaginal ultrasound during pregnancy CPT 76817 HC US PREG UTERUS TRANSVAGINAL	$432.96	$902.00	$84.85–$766.70	16% below	52%
Transvaginal ultrasound during pregnancy inpatient CPT 76817 HC US PREG UTERUS TRANSVAGINAL	$432.96	$902.00	$523.16–$721.60	—	52%
Ultrasound of the abdomen, complete CPT 76700 HC US ABDOMEN	$324.48	$676.00	$84.85–$574.60	62% below	52%
Ultrasound of the abdomen, complete inpatient CPT 76700 HC US ABDOMEN	$324.48	$676.00	$392.08–$540.80	—	52%
Ultrasound of the scrotum and testicles CPT 76870 HC US SCROTUM TESTICLE	$488.16	$1,017.00	$84.85–$864.45	26% below	52%
Ultrasound of the scrotum and testicles inpatient CPT 76870 HC US SCROTUM TESTICLE	$488.16	$1,017.00	$589.86–$813.60	—	52%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 HC US THYROID PARATHYROID NECK	$408.00	$850.00	$84.85–$722.50	32% below	52%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 HC US THYROID PARATHYROID NECK	$408.00	$850.00	$493.00–$680.00	—	52%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 HC UGI	$475.20	$990.00	$142.36–$841.50	7% below	52%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 HC UGI	$475.20	$990.00	$574.20–$792.00	—	52%
Upper arm X-ray (humerus), 2 views CPT 73060 HC RHC HUMERUS 2 VIEWS	$208.32	$434.00	$47.66–$368.90	35% below	52%
Upper arm X-ray (humerus), 2 views CPT 73060 HC HUMERUS	$220.32	$459.00	$47.66–$390.15	32% below	52%
Upper arm X-ray (humerus), 2 views inpatient CPT 73060 HC RHC HUMERUS 2 VIEWS	$208.32	$434.00	$251.72–$347.20	—	52%
Upper arm X-ray (humerus), 2 views inpatient CPT 73060 HC HUMERUS	$220.32	$459.00	$266.22–$367.20	—	52%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 HC VENOUS DUPLEX UNILATERAL	$994.56	$2,072.00	$84.85–$1,761.20	5% below	52%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 HC VENOUS DUPLEX UNILATERAL	$994.56	$2,072.00	$1,201.76–$1,657.60	—	52%
Wrist X-ray, 2 views CPT 73100 HC WRIST 2 VIEW	$158.40	$330.00	$50.31–$280.50	35% below	52%
Wrist X-ray, 2 views inpatient CPT 73100 HC WRIST 2 VIEW	$158.40	$330.00	$191.40–$264.00	—	52%
Wrist X-ray, complete, 3 or more views CPT 73110 HC WRIST COMPLETE	$259.68	$541.00	$64.82–$459.85	22% below	52%
Wrist X-ray, complete, 3 or more views inpatient CPT 73110 HC WRIST COMPLETE	$259.68	$541.00	$313.78–$432.80	—	52%
X-ray of one hip, 2 or 3 views, with the pelvis when included CPT 73502 HC RHC XRAY EXAM HIP UNI 2-3 VIEWS	$111.36	$232.00	$46.40–$204.24	66% below	52%
X-ray of one hip, 2 or 3 views, with the pelvis when included CPT 73502 HC X-RAY EXAM HIP UNI 2-3 VIEWS	$133.92	$279.00	$55.80–$237.15	59% below	52%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient CPT 73502 HC RHC XRAY EXAM HIP UNI 2-3 VIEWS	$111.36	$232.00	$134.56–$185.60	—	52%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient CPT 73502 HC X-RAY EXAM HIP UNI 2-3 VIEWS	$133.92	$279.00	$161.82–$223.20	—	52%
X-ray of the abdomen, 1 view CPT 74018 HC ABDOMEN 1 VIEW	$282.24	$588.00	$41.75–$499.80	1% below	52%
X-ray of the abdomen, 1 view inpatient CPT 74018 HC ABDOMEN 1 VIEW	$282.24	$588.00	$341.04–$470.40	—	52%
X-ray of the ankle, 2 views CPT 73600 HC ANKLE 2 VIEWS	$191.04	$398.00	$47.66–$338.30	25% below	52%
X-ray of the ankle, 2 views inpatient CPT 73600 HC ANKLE 2 VIEWS	$191.04	$398.00	$230.84–$318.40	—	52%
X-ray of the finger(s), 2 or more views one side CPT 73140 HC FINGER LT THUMB FA	$164.64	$343.00	$62.17–$291.55	30% below	52%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 HC FINGER LT THUMB FA	$164.64	$343.00	$198.94–$274.40	—	52%
X-ray of the foot, 2 views CPT 73620 HC FOOT 2 VIEW	$190.08	$396.00	$41.08–$336.60	26% below	52%
X-ray of the foot, 2 views inpatient CPT 73620 HC FOOT 2 VIEW	$190.08	$396.00	$229.68–$316.80	—	52%
X-ray of the foot, complete, 3 or more views CPT 73630 HC FOOT COMPLETE	$249.60	$520.00	$50.97–$442.00	26% below	52%
X-ray of the foot, complete, 3 or more views inpatient CPT 73630 HC FOOT COMPLETE	$249.60	$520.00	$301.60–$416.00	—	52%
X-ray of the hand, 3 or more views CPT 73130 HC HAND COMPLETE	$251.04	$523.00	$56.91–$444.55	27% below	52%
X-ray of the hand, 3 or more views inpatient CPT 73130 HC HAND COMPLETE	$251.04	$523.00	$303.34–$418.40	—	52%
X-ray of the knee, 1 or 2 views CPT 73560 HC KNEE 2 VIEW AP LAT	$276.48	$576.00	$50.97–$489.60	13% below	52%
X-ray of the knee, 1 or 2 views inpatient CPT 73560 HC KNEE 2 VIEW AP LAT	$276.48	$576.00	$334.08–$460.80	—	52%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 HC LUMBAR SPINE 2 OR 3V	$324.96	$677.00	$56.91–$575.45	26% below	52%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 HC LUMBAR SPINE 2 OR 3V	$324.96	$677.00	$392.66–$541.60	—	52%
X-ray of the lower back, 4 or more views CPT 72110 HC LUMBR SPINE W OBLIQUES 4OR>	$403.20	$840.00	$77.33–$714.00	20% below	52%
X-ray of the lower back, 4 or more views inpatient CPT 72110 HC LUMBR SPINE W OBLIQUES 4OR>	$403.20	$840.00	$487.20–$672.00	—	52%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 HC THORACIC SPINE 2 VIEW	$205.92	$429.00	$45.68–$364.65	38% below	52%
X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 HC THORACIC SPINE 2 VIEW	$205.92	$429.00	$248.82–$343.20	—	52%
X-ray of the nasal bones, 3 or more views CPT 70160 HC NASAL BONES =>3 VIEWS	$223.68	$466.00	$57.55–$396.10	24% below	52%
X-ray of the nasal bones, 3 or more views inpatient CPT 70160 HC NASAL BONES =>3 VIEWS	$223.68	$466.00	$270.28–$372.80	—	52%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 HC CERVICAL SPINE =<3 VIEWS	$259.68	$541.00	$56.91–$459.85	15% below	52%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 HC CERVICAL SPINE =<3 VIEWS	$259.68	$541.00	$313.78–$432.80	—	52%
X-ray of the pelvis, 1 or 2 views CPT 72170 HC PELVIS	$206.88	$431.00	$38.44–$366.35	28% below	52%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 HC PELVIS	$206.88	$431.00	$249.98–$344.80	—	52%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 HC SACRUM AND COCCYX	$170.88	$356.00	$47.66–$302.60	46% below	52%
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 HC SACRUM AND COCCYX	$170.88	$356.00	$206.48–$284.80	—	52%

Lab tests

Procedure	Cash price	List price	Insurers pay	vs Nebraska	Off list
ACTH blood test CPT 82024 HC ACTH	$171.84	$358.00	$37.42–$358.00	20% below	52%
ACTH blood test inpatient CPT 82024 HC ACTH	$171.84	$358.00	$207.64–$286.40	—	52%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 HC ALT SGPT	$60.00	$125.00	$5.14–$106.25	2% below	52%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 HC ALT SGPT	$60.00	$125.00	$72.50–$100.00	—	52%
AST (aspartate aminotransferase) enzyme test CPT 84450 HC AST SGOT	$45.12	$94.00	$5.02–$79.90	27% below	52%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 HC AST SGOT	$45.12	$94.00	$54.52–$75.20	—	52%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 HC ACUTE HEPATITIS PANEL	$351.84	$733.00	$46.16–$623.05	10% above	52%
Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 HC ACUTE HEPATITIS PANEL	$351.84	$733.00	$425.14–$586.40	—	52%
Albumin blood test CPT 82040 HC ALBUMIN	$34.08	$71.00	$4.79–$60.35	26% below	52%
Albumin blood test inpatient CPT 82040 HC ALBUMIN	$34.08	$71.00	$41.18–$56.80	—	52%
Aldosterone blood test CPT 82088 HC ALDOSTERONE	$221.28	$461.00	$39.48–$415.78	3% below	52%
Aldosterone blood test inpatient CPT 82088 HC ALDOSTERONE	$221.28	$461.00	$267.38–$368.80	—	52%
Alkaline phosphatase (ALP) blood test CPT 84075 HC ALKALINE PHOSPHATASE	$54.72	$114.00	$5.02–$96.90	2% above	52%
Alkaline phosphatase (ALP) blood test inpatient CPT 84075 HC ALKALINE PHOSPHATASE	$54.72	$114.00	$66.12–$91.20	—	52%
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE CRUDE ALLERGEN EXTRACT EACH	$58.56	$122.00	$5.06–$103.70	19% above	52%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE CRUDE ALLERGEN EXTRACT EACH	$58.56	$122.00	$70.76–$97.60	—	52%
Alpha-fetoprotein (AFP) blood test CPT 82105 HC ALPHA FETOPROTEIN MATERNAL	$93.12	$194.00	$16.25–$171.16	1% below	52%
Alpha-fetoprotein (AFP) blood test CPT 82105 HC ALPHA FETOPROTN TUMR MARKR	$102.24	$213.00	$16.25–$181.05	9% above	52%
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 HC ALPHA FETOPROTEIN MATERNAL	$93.12	$194.00	$112.52–$155.20	—	52%
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 HC ALPHA FETOPROTN TUMR MARKR	$102.24	$213.00	$123.54–$170.40	—	52%
Ammonia blood test CPT 82140 HC AMMONIA	$125.76	$262.00	$14.12–$222.70	2% below	52%
Ammonia blood test inpatient CPT 82140 HC AMMONIA	$125.76	$262.00	$151.96–$209.60	—	52%
Amylase blood test CPT 82150 HC AMYLASE SERUM	$88.32	$184.00	$6.28–$156.40	1% above	52%
Amylase blood test CPT 82150 HC AMYLASE URINE	$92.16	$192.00	$6.28–$163.20	6% above	52%
Amylase blood test inpatient CPT 82150 HC AMYLASE SERUM	$88.32	$184.00	$106.72–$147.20	—	52%
Amylase blood test inpatient CPT 82150 HC AMYLASE URINE	$92.16	$192.00	$111.36–$153.60	—	52%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 HC CYCLIC CITRUL PEPTIDE ANTB	$73.92	$154.00	$12.55–$132.10	37% below	52%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 HC CYCLIC CITRUL PEPTIDE ANTB	$73.92	$154.00	$89.32–$123.20	—	52%
Antinuclear antibody (ANA) blood test, screen CPT 86038 HC ANA	$42.24	$88.00	$11.72–$88.00	48% below	52%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 HC ANA	$42.24	$88.00	$51.04–$70.40	—	52%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 HC CHF PEPTIDE	$179.04	$373.00	$38.05–$346.29	20% below	52%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 HC CHF PEPTIDE	$179.04	$373.00	$216.34–$298.40	—	52%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HC CULTURE - SPUTUM	$59.04	$123.00	$8.35–$104.55	28% below	52%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HC CULTURE NASAL OR THROAT	$115.68	$241.00	$8.35–$204.85	41% above	52%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 HC CULTURE - SPUTUM	$59.04	$123.00	$71.34–$98.40	—	52%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 HC CULTURE NASAL OR THROAT	$115.68	$241.00	$139.78–$192.80	—	52%
Basic metabolic panel (blood test) CPT 80048 HC BASIC METABOLIC PANEL	$181.44	$378.00	$8.20–$321.30	26% above	52%
Basic metabolic panel (blood test) inpatient CPT 80048 HC BASIC METABOLIC PANEL	$181.44	$378.00	$219.24–$302.40	—	52%
Bilirubin blood test, total CPT 82247 HC BILIRUBIN TOTAL	$63.36	$132.00	$4.87–$112.20	2% above	52%
Bilirubin blood test, total inpatient CPT 82247 HC BILIRUBIN TOTAL	$63.36	$132.00	$76.56–$105.60	—	52%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 HC LEVEL 4 GROSS EXAM	$74.88	$156.00	$31.20–$156.00	62% below	52%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 HC PROSTATE BIOPSIES	$212.64	$443.00	$33.13–$376.55	8% above	52%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 HC LEVEL 4 GROSS EXAM	$74.88	$156.00	$90.48–$124.80	—	52%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 HC PROSTATE BIOPSIES	$212.64	$443.00	$256.94–$354.40	—	52%
Blood culture for bacteria CPT 87040 HC CULTURE BLOOD	$205.92	$429.00	$10.00–$364.65	10% above	52%
Blood culture for bacteria inpatient CPT 87040 HC CULTURE BLOOD	$205.92	$429.00	$248.82–$343.20	—	52%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 HC VENIPUNCTURE COLLECTION	$30.72	$64.00	$2.70–$54.40	6% above	52%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 HC LEGAL BLOOD ALCOHOL DRAW	$52.32	$109.00	$2.70–$92.65	80% above	52%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 HC VENIPUNCTURE COLLECTION	$30.72	$64.00	$37.12–$51.20	—	52%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 HC LEGAL BLOOD ALCOHOL DRAW	$52.32	$109.00	$63.22–$87.20	—	52%
Blood glucose (sugar) test CPT 82947 HC GLUCOSE	$37.44	$78.00	$3.80–$66.30	28% below	52%
Blood glucose (sugar) test CPT 82947 HC POCT GLUCOSE	$41.28	$86.00	$3.80–$73.10	21% below	52%
Blood glucose (sugar) test inpatient CPT 82947 HC GLUCOSE	$37.44	$78.00	$45.24–$62.40	—	52%
Blood glucose (sugar) test inpatient CPT 82947 HC POCT GLUCOSE	$41.28	$86.00	$49.88–$68.80	—	52%
Blood lead test CPT 83655 HC LEAD	$70.56	$147.00	$11.73–$124.95	7% above	52%
Blood lead test inpatient CPT 83655 HC LEAD	$70.56	$147.00	$85.26–$117.60	—	52%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 HC HCG QUAL	$134.40	$280.00	$7.28–$238.00	9% above	52%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 HC HCG QUAL	$134.40	$280.00	$162.40–$224.00	—	52%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 HC REF PRO LAB ABO TYPE	$66.72	$139.00	$3.81–$312.24	7% below	52%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 HC ABO TYPE	$70.56	$147.00	$3.81–$312.24	2% below	52%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 HC REF PRO LAB ABO TYPE	$66.72	$139.00	$80.62–$111.20	—	52%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 HC ABO TYPE	$70.56	$147.00	$85.26–$117.60	—	52%
Blood urea nitrogen (BUN) test CPT 84520 HC BUN	$21.12	$44.00	$3.83–$40.26	59% below	52%
Blood urea nitrogen (BUN) test CPT 84520 HC POCT BUN	$26.40	$55.00	$3.83–$46.75	48% below	52%
Blood urea nitrogen (BUN) test inpatient CPT 84520 HC BUN	$21.12	$44.00	$25.52–$35.20	—	52%
Blood urea nitrogen (BUN) test inpatient CPT 84520 HC POCT BUN	$26.40	$55.00	$31.90–$44.00	—	52%
C-peptide blood test CPT 84681 HC C PEPTIDE	$114.24	$238.00	$20.17–$212.32	12% below	52%
C-peptide blood test inpatient CPT 84681 HC C PEPTIDE	$114.24	$238.00	$138.04–$190.40	—	52%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 HC CRP PROM SEROLOGY	$126.24	$263.00	$5.02–$223.55	24% above	52%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 HC CRP PROM SEROLOGY	$126.24	$263.00	$152.54–$210.40	—	52%
C. difficile toxin gene test (stool PCR) CPT 87493 HC C DIFFICILE DNA DETECTION	$172.80	$360.00	$36.12–$358.06	4% above	52%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 HC C DIFFICILE DNA DETECTION	$172.80	$360.00	$208.80–$288.00	—	52%
CA 19-9 blood test (tumor marker) CPT 86301 HC CA 19 09	$246.24	$513.00	$20.17–$436.05	37% above	52%
CA 19-9 blood test (tumor marker) inpatient CPT 86301 HC CA 19 09	$246.24	$513.00	$297.54–$410.40	—	52%
CA-125 blood test (ovarian cancer marker) CPT 86304 HC CA 125	$108.96	$227.00	$20.17–$212.32	28% below	52%
CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 HC CA 125	$108.96	$227.00	$131.66–$181.60	—	52%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 HC INFECTIOUS AGENT SARS-COV-2 AMP PROBE	$84.48	$176.00	$35.20–$149.60	37% below	52%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 HC INFECTIOUS AGENT SARS-COV-2 AMP PROBE	$84.48	$176.00	$102.08–$140.80	—	52%
Calcium blood test, total CPT 82310 HC CALCIUM	$85.92	$179.00	$5.00–$152.15	55% above	52%
Calcium blood test, total inpatient CPT 82310 HC CALCIUM	$85.92	$179.00	$103.82–$143.20	—	52%
Carcinoembryonic antigen (CEA) test CPT 82378 HC CEA	$104.64	$218.00	$18.37–$193.50	19% below	52%
Carcinoembryonic antigen (CEA) test inpatient CPT 82378 HC CEA	$104.64	$218.00	$126.44–$174.40	—	52%
Chickenpox (varicella) immunity blood test CPT 86787 HC VARICELLA ZOSTER	$80.64	$168.00	$12.48–$142.80	19% below	52%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 HC VARICELLA ZOSTER	$80.64	$168.00	$97.44–$134.40	—	52%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 HC CHLAMYD TRACHOMATS AMP PROB	$104.16	$217.00	$34.01–$217.00	9% below	52%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 HC CHLAMYD TRACHOMATS AMP PROB	$104.16	$217.00	$125.86–$173.60	—	52%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 HC LIPID PANEL	$142.56	$297.00	$12.97–$252.45	17% above	52%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 HC LIPID PANEL	$142.56	$297.00	$172.26–$237.60	—	52%
Complete blood count (CBC) with differential CPT 85025 HC CBC W AUTO DIFF	$101.28	$211.00	$7.53–$179.35	8% above	52%
Complete blood count (CBC) with differential inpatient CPT 85025 HC CBC W AUTO DIFF	$101.28	$211.00	$122.38–$168.80	—	52%
Complete blood count (CBC), no differential CPT 85027 HC HEMOGRAM CBC WITHOUT DIFF	$77.76	$162.00	$6.27–$137.70	8% above	52%
Complete blood count (CBC), no differential inpatient CPT 85027 HC HEMOGRAM CBC WITHOUT DIFF	$77.76	$162.00	$93.96–$129.60	—	52%
Comprehensive metabolic panel (blood test) CPT 80053 HC COMPREHENSIVE PANEL	$225.60	$470.00	$10.23–$399.50	36% above	52%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 HC COMPREHENSIVE PANEL	$225.60	$470.00	$272.60–$376.00	—	52%
Cortisol blood test, total CPT 82533 HC CORTISOL	$143.52	$299.00	$15.80–$254.15	15% above	52%
Cortisol blood test, total inpatient CPT 82533 HC CORTISOL	$143.52	$299.00	$173.42–$239.20	—	52%
Creatine kinase (CK) blood test, total CPT 82550 HC CPK	$114.24	$238.00	$6.30–$202.30	15% above	52%
Creatine kinase (CK) blood test, total inpatient CPT 82550 HC CPK	$114.24	$238.00	$138.04–$190.40	—	52%
Creatinine blood test CPT 82565 HC CREATININE	$49.44	$103.00	$4.96–$87.55	9% below	52%
Creatinine blood test CPT 82565 HC POCT CREATININE	$55.68	$116.00	$4.96–$98.60	2% above	52%
Creatinine blood test inpatient CPT 82565 HC CREATININE	$49.44	$103.00	$59.74–$82.40	—	52%
Creatinine blood test inpatient CPT 82565 HC POCT CREATININE	$55.68	$116.00	$67.28–$92.80	—	52%
Cytomegalovirus (CMV) antibody test CPT 86644 HC CMV IGG ANTIBODY	$78.24	$163.00	$13.94–$146.79	16% below	52%
Cytomegalovirus (CMV) antibody test CPT 86644 HC REF PRO CMV SCREEN	$82.08	$171.00	$13.94–$146.79	12% below	52%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 HC CMV IGG ANTIBODY	$78.24	$163.00	$94.54–$130.40	—	52%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 HC REF PRO CMV SCREEN	$82.08	$171.00	$99.18–$136.80	—	52%
D-dimer blood test (blood clot marker) CPT 85379 HC D DIMER QUANTITATIVE	$182.88	$381.00	$9.86–$323.85	30% above	52%
D-dimer blood test (blood clot marker) inpatient CPT 85379 HC D DIMER QUANTITATIVE	$182.88	$381.00	$220.98–$304.80	—	52%
DHEA sulfate (DHEA-S) blood test CPT 82627 HC DHEA S	$156.48	$326.00	$21.54–$277.10	8% above	52%
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 HC DHEA S	$156.48	$326.00	$189.08–$260.80	—	52%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC OPIATES	$53.28	$111.00	$22.20–$146.58	62% below	52%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC DRUG SCREEN SINGLE	$121.92	$254.00	$50.80–$215.90	14% below	52%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC DRUG SCRN ONE MULT CLS PROC	$125.28	$261.00	$52.20–$221.85	12% below	52%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC DRUG SCREEN LIST A 5	$204.00	$425.00	$60.21–$361.25	44% above	52%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC DRUG SCREEN LIST A 6	$268.32	$559.00	$60.21–$475.15	89% above	52%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC DRUG SCREEN LIST A 7	$311.04	$648.00	$60.21–$550.80	119% above	52%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC DRUG SCREEN LIST A 8	$357.60	$745.00	$60.21–$633.25	152% above	52%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC DRUG SCREEN LIST A 9	$400.32	$834.00	$60.21–$708.90	182% above	52%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC DRUG SCREEN LIST A 10	$446.88	$931.00	$60.21–$791.35	215% above	52%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC OPIATES	$53.28	$111.00	$64.38–$88.80	—	52%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC DRUG SCREEN SINGLE	$121.92	$254.00	$147.32–$203.20	—	52%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC DRUG SCRN ONE MULT CLS PROC	$125.28	$261.00	$151.38–$208.80	—	52%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC DRUG SCREEN LIST A 5	$204.00	$425.00	$246.50–$340.00	—	52%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC DRUG SCREEN LIST A 6	$268.32	$559.00	$324.22–$447.20	—	52%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC DRUG SCREEN LIST A 7	$311.04	$648.00	$375.84–$518.40	—	52%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC DRUG SCREEN LIST A 8	$357.60	$745.00	$432.10–$596.00	—	52%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC DRUG SCREEN LIST A 9	$400.32	$834.00	$483.72–$667.20	—	52%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC DRUG SCREEN LIST A 10	$446.88	$931.00	$539.98–$744.80	—	52%
Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 HC ELECTROLYTES	$102.72	$214.00	$6.79–$181.90	3% below	52%
Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 HC POCT ELECTROLYTES	$107.04	$223.00	$6.79–$189.55	1% above	52%
Electrolyte panel (sodium, potassium, chloride, CO2) inpatient CPT 80051 HC ELECTROLYTES	$102.72	$214.00	$124.12–$171.20	—	52%
Electrolyte panel (sodium, potassium, chloride, CO2) inpatient CPT 80051 HC POCT ELECTROLYTES	$107.04	$223.00	$129.34–$178.40	—	52%
Epstein-Barr virus (EBV) antibody test CPT 86665 HC EBV VIRAL CAPSID	$82.08	$171.00	$17.57–$145.35	21% below	52%
Epstein-Barr virus (EBV) antibody test CPT 86665 HC EBV ANTIBODY SCREEN	$85.44	$178.00	$17.57–$151.30	17% below	52%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 HC EBV VIRAL CAPSID	$82.08	$171.00	$99.18–$136.80	—	52%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 HC EBV ANTIBODY SCREEN	$85.44	$178.00	$103.24–$142.40	—	52%
Estradiol blood test CPT 82670 HC ESTRADIOL	$151.20	$315.00	$27.07–$270.49	8% above	52%
Estradiol blood test inpatient CPT 82670 HC ESTRADIOL	$151.20	$315.00	$182.70–$252.00	—	52%
FSH (follicle-stimulating hormone) test CPT 83001 HC FSH	$123.84	$258.00	$18.00–$219.30	7% above	52%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 HC FSH	$123.84	$258.00	$149.64–$206.40	—	52%
Fecal calprotectin (stool inflammation test) CPT 83993 HC CALPROTECTIN FECAL	$449.28	$936.00	$19.02–$795.60	22% above	52%
Fecal calprotectin (stool inflammation test) inpatient CPT 83993 HC CALPROTECTIN FECAL	$449.28	$936.00	$542.88–$748.80	—	52%
Ferritin blood test (iron stores) CPT 82728 HC FERRITIN	$112.80	$235.00	$13.21–$199.75	1% above	52%
Ferritin blood test (iron stores) inpatient CPT 82728 HC FERRITIN	$112.80	$235.00	$136.30–$188.00	—	52%
Fibrinogen blood test CPT 85384 HC FIBRINOGEN	$123.84	$258.00	$9.41–$219.30	16% above	52%
Fibrinogen blood test inpatient CPT 85384 HC FIBRINOGEN	$123.84	$258.00	$149.64–$206.40	—	52%
Folate (folic acid) blood test CPT 82746 HC FOLIC ACID	$109.44	$228.00	$14.25–$193.80	1% above	52%
Folate (folic acid) blood test inpatient CPT 82746 HC FOLIC ACID	$109.44	$228.00	$132.24–$182.40	—	52%
Free T3 thyroid hormone test CPT 84481 HC T3 FREE	$261.60	$545.00	$16.41–$463.25	63% above	52%
Free T3 thyroid hormone test inpatient CPT 84481 HC T3 FREE	$261.60	$545.00	$316.10–$436.00	—	52%
Free T4 (free thyroxine) thyroid blood test CPT 84439 HC T4 FREE	$70.56	$147.00	$8.74–$124.95	22% below	52%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 HC T4 FREE	$70.56	$147.00	$85.26–$117.60	—	52%
Free testosterone test CPT 84402 HC TESTOSTERONE FREE	$108.96	$227.00	$24.68–$227.00	13% below	52%
Free testosterone test inpatient CPT 84402 HC TESTOSTERONE FREE	$108.96	$227.00	$131.66–$181.60	—	52%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 HC GGTP	$62.88	$131.00	$6.98–$111.35	at median	52%
Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 HC GGTP	$62.88	$131.00	$75.98–$104.80	—	52%
General health panel: metabolic panel, blood count and TSH in one order CPT 80050 HC GENERAL HEALTH PANEL	$195.36	$407.00	$35.53–$345.95	39% below	52%
General health panel: metabolic panel, blood count and TSH in one order inpatient CPT 80050 HC GENERAL HEALTH PANEL	$195.36	$407.00	$236.06–$325.60	—	52%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 HC POST GLUCOSE DOSE	$61.44	$128.00	$4.60–$108.80	8% above	52%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 HC POST GLUCOSE DOSE	$61.44	$128.00	$74.24–$102.40	—	52%
Glucose tolerance test, 3 samples CPT 82951 HC GLUCOSE TOLERANCE TEST	$271.20	$565.00	$12.47–$480.25	100% above	52%
Glucose tolerance test, 3 samples inpatient CPT 82951 HC GLUCOSE TOLERANCE TEST	$271.20	$565.00	$327.70–$452.00	—	52%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 HC NEISSERIA GONORRHO AMP PROB	$82.08	$171.00	$34.01–$171.00	30% below	52%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 HC NEISSERIA GONORRHO AMP PROB	$82.08	$171.00	$99.18–$136.80	—	52%
H. pylori antibody blood test CPT 86677 HC H PYLORI	$43.20	$90.00	$16.33–$90.00	47% below	52%
H. pylori antibody blood test inpatient CPT 86677 HC H PYLORI	$43.20	$90.00	$52.20–$72.00	—	52%
H. pylori stool antigen test CPT 87338 HC HELICOBCTR PY STOOL ANTIGEN	$104.64	$218.00	$13.93–$185.30	37% below	52%
H. pylori stool antigen test inpatient CPT 87338 HC HELICOBCTR PY STOOL ANTIGEN	$104.64	$218.00	$126.44–$174.40	—	52%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HC HIV 1 RNA QUANT PCR	$678.24	$1,413.00	$82.47–$1,201.05	34% above	52%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HC HIV 1 RNA QUANT PCR	$678.24	$1,413.00	$819.54–$1,130.40	—	52%
HIV-1 and HIV-2 antibody test CPT 86703 HC HIV1 HIV2 ANTIBODY SNGL RES	$82.08	$171.00	$13.28–$145.35	11% above	52%
HIV-1 and HIV-2 antibody test inpatient CPT 86703 HC HIV1 HIV2 ANTIBODY SNGL RES	$82.08	$171.00	$99.18–$136.80	—	52%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HC HIV1 AG W HIV1 HIV2 AB	$125.28	$261.00	$23.34–$245.68	53% above	52%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HC HIV1 AG W HIV1 HIV2 AB	$125.28	$261.00	$151.38–$208.80	—	52%
HPV test for high-risk types, one combined (pooled) result CPT 87624 HC HPV HIGH RISK TYPES	$162.24	$338.00	$34.01–$338.00	43% above	52%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HC HPV HIGH RISK TYPES	$162.24	$338.00	$196.04–$270.40	—	52%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HC GLYCOSYLATED HEMOGLOBIN	$84.00	$175.00	$9.40–$148.75	5% above	52%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HC GLYCOSYLATED HEMOGLOBIN	$84.00	$175.00	$101.50–$140.00	—	52%
Hemoglobin blood test CPT 85018 HC HEMOGLOBIN	$33.60	$70.00	$2.29–$59.50	1% below	52%
Hemoglobin blood test inpatient CPT 85018 HC HEMOGLOBIN	$33.60	$70.00	$40.60–$56.00	—	52%
Hepatitis B core antibody test (total) CPT 86704 HC HEPATITIS B CORE AB TOTAL	$89.76	$187.00	$11.68–$158.95	14% below	52%
Hepatitis B core antibody test (total) inpatient CPT 86704 HC HEPATITIS B CORE AB TOTAL	$89.76	$187.00	$108.46–$149.60	—	52%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HC HEPATITIS B SURFACE AB	$99.84	$208.00	$10.40–$176.80	7% above	52%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HC HEPATITIS B SURFACE AB	$99.84	$208.00	$120.64–$166.40	—	52%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HC HEPATITIS B SURFACE AG	$89.28	$186.00	$10.01–$158.10	3% below	52%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HC HEPATITIS B SURFACE AG	$89.28	$186.00	$107.88–$148.80	—	52%
Hepatitis C antibody blood test (screening) CPT 86803 HC HEPATITIS C AB	$100.80	$210.00	$13.83–$178.50	8% above	52%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 HC HEPATITIS C AB	$100.80	$210.00	$121.80–$168.00	—	52%
Hepatitis C viral load (HCV RNA) test CPT 87522 HC HEPATITIS C QUANT	$360.96	$752.00	$41.51–$639.20	5% above	52%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HC HEPATITIS C QUANT	$360.96	$752.00	$436.16–$601.60	—	52%
Herpes blood test, HSV-1 antibody CPT 86695 HC HERPES SIMPLEX TYPE I	$154.56	$322.00	$12.78–$273.70	57% above	52%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 HC HERPES SIMPLEX TYPE I	$154.56	$322.00	$186.76–$257.60	—	52%
Herpes blood test, HSV-2 antibody CPT 86696 HC HERPES SIMPLEX TYPE II	$155.04	$323.00	$18.75–$274.55	45% above	52%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HC HERPES SIMPLEX TYPE II	$155.04	$323.00	$187.34–$258.40	—	52%
High-sensitivity CRP (hs-CRP) test CPT 86141 HC C REACTIVE PROTEIN HS	$115.20	$240.00	$12.55–$204.00	22% above	52%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 HC C REACTIVE PROTEIN HS	$115.20	$240.00	$139.20–$192.00	—	52%
Homocysteine blood test CPT 83090 HC HOMOCYSTEINE	$159.36	$332.00	$17.36–$282.20	4% below	52%
Homocysteine blood test inpatient CPT 83090 HC HOMOCYSTEINE	$159.36	$332.00	$192.56–$265.60	—	52%
Insulin blood test CPT 83525 HC INSULIN	$138.72	$289.00	$11.08–$245.65	26% above	52%
Insulin blood test inpatient CPT 83525 HC INSULIN	$138.72	$289.00	$167.62–$231.20	—	52%
Iron blood test (serum iron) CPT 83540 HC IRON	$65.28	$136.00	$6.27–$115.60	1% above	52%
Iron blood test (serum iron) CPT 83540 HC IRON LIVER TISSUE	$68.16	$142.00	$6.27–$120.70	6% above	52%
Iron blood test (serum iron) inpatient CPT 83540 HC IRON	$65.28	$136.00	$78.88–$108.80	—	52%
Iron blood test (serum iron) inpatient CPT 83540 HC IRON LIVER TISSUE	$68.16	$142.00	$82.36–$113.60	—	52%
Iron-binding capacity (TIBC) test CPT 83550 HC IRON BINDING CAPACITY	$87.36	$182.00	$8.47–$154.70	13% above	52%
Iron-binding capacity (TIBC) test inpatient CPT 83550 HC IRON BINDING CAPACITY	$87.36	$182.00	$105.56–$145.60	—	52%
Kidney function blood test panel CPT 80069 HC RENAL FUNCTION PANEL	$167.04	$348.00	$8.41–$295.80	11% above	52%
Kidney function blood test panel inpatient CPT 80069 HC RENAL FUNCTION PANEL	$167.04	$348.00	$201.84–$278.40	—	52%
LH (luteinizing hormone) test CPT 83002 HC LUTEINIZING HORMONE	$137.28	$286.00	$17.94–$243.10	8% above	52%
LH (luteinizing hormone) test inpatient CPT 83002 HC LUTEINIZING HORMONE	$137.28	$286.00	$165.88–$228.80	—	52%
Lactate (lactic acid) blood test CPT 83605 HC POCT LACTIC ACID	$110.40	$230.00	$11.21–$195.50	13% below	52%
Lactate (lactic acid) blood test CPT 83605 HC LACTIC ACID	$121.44	$253.00	$11.21–$215.05	5% below	52%
Lactate (lactic acid) blood test one side CPT 83605 HC RT POC LACTIC ACID	$98.40	$205.00	$11.21–$174.25	23% below	52%
Lactate (lactic acid) blood test inpatient CPT 83605 HC POCT LACTIC ACID	$110.40	$230.00	$133.40–$184.00	—	52%
Lactate (lactic acid) blood test inpatient CPT 83605 HC LACTIC ACID	$121.44	$253.00	$146.74–$202.40	—	52%
Lactate (lactic acid) blood test inpatient one side CPT 83605 HC RT POC LACTIC ACID	$98.40	$205.00	$118.90–$164.00	—	52%
Lactate dehydrogenase (LDH) blood test CPT 83615 HC LDH	$56.16	$117.00	$5.85–$99.45	1% above	52%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 HC LDH	$56.16	$117.00	$67.86–$93.60	—	52%
Lipase blood test (pancreas enzyme) CPT 83690 HC LIPASE	$105.60	$220.00	$6.68–$187.00	6% above	52%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 HC LIPASE	$105.60	$220.00	$127.60–$176.00	—	52%
Liver function blood test panel CPT 80076 HC HEPATIC PROFILE	$147.36	$307.00	$7.92–$260.95	8% above	52%
Liver function blood test panel inpatient CPT 80076 HC HEPATIC PROFILE	$147.36	$307.00	$178.06–$245.60	—	52%
Lyme disease antibody test CPT 86618 HC LYME DISEASE	$126.72	$264.00	$16.50–$224.40	14% below	52%
Lyme disease antibody test inpatient CPT 86618 HC LYME DISEASE	$126.72	$264.00	$153.12–$211.20	—	52%
Magnesium blood test CPT 83735 HC MAGNESIUM	$69.60	$145.00	$6.50–$123.25	8% below	52%
Magnesium blood test inpatient CPT 83735 HC MAGNESIUM	$69.60	$145.00	$84.10–$116.00	—	52%
Measles (rubeola) antibody test CPT 86765 HC RUBEOLA IGG IGM	$79.68	$166.00	$12.48–$141.10	11% below	52%
Measles (rubeola) antibody test inpatient CPT 86765 HC RUBEOLA IGG IGM	$79.68	$166.00	$96.28–$132.80	—	52%
Mono test (heterophile antibody, Monospot) CPT 86308 HC MONONUCLEOSIS	$73.92	$154.00	$5.02–$130.90	10% above	52%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 HC MONONUCLEOSIS	$73.92	$154.00	$89.32–$123.20	—	52%
Mumps immunity blood test CPT 86735 HC MUMPS ANTIBODY	$20.16	$42.00	$8.40–$42.00	79% below	52%
Mumps immunity blood test inpatient CPT 86735 HC MUMPS ANTIBODY	$20.16	$42.00	$24.36–$33.60	—	52%
Obstetric blood test panel CPT 80055 HC OBSTETRIC PANEL	$294.72	$614.00	$46.33–$521.90	14% above	52%
Obstetric blood test panel inpatient CPT 80055 HC OBSTETRIC PANEL	$294.72	$614.00	$356.12–$491.20	—	52%
PSA (prostate-specific antigen) blood test, free CPT 84154 HC PSA FREE	$160.80	$335.00	$17.82–$284.75	15% above	52%
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 HC PSA FREE	$160.80	$335.00	$194.30–$268.00	—	52%
PSA (prostate-specific antigen) blood test, total CPT 84153 HC PSA	$102.72	$214.00	$17.82–$187.65	6% below	52%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 HC PSA	$102.72	$214.00	$124.12–$171.20	—	52%
Pap test (liquid-based, automated screening with review) CPT 88175 HC PAP SCRN AUTO W MAN RESCRN	$87.84	$183.00	$25.79–$183.00	2% above	52%
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 HC PAP SCRN AUTO W MAN RESCRN	$87.84	$183.00	$106.14–$146.40	—	52%
Parathyroid hormone (PTH) blood test CPT 83970 HC PARATHYROID	$218.88	$456.00	$40.00–$421.11	1% above	52%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 HC PARATHYROID	$218.88	$456.00	$264.48–$364.80	—	52%
Partial thromboplastin time (PTT) clotting test CPT 85730 HC PTT	$73.92	$154.00	$5.82–$130.90	8% below	52%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 HC PTT	$73.92	$154.00	$89.32–$123.20	—	52%
Phosphorus (phosphate) blood test CPT 84100 HC PHOSPHORUS	$52.32	$109.00	$4.59–$92.65	3% above	52%
Phosphorus (phosphate) blood test inpatient CPT 84100 HC PHOSPHORUS	$52.32	$109.00	$63.22–$87.20	—	52%
Potassium blood test CPT 84132 HC POTASSIUM	$47.04	$98.00	$4.61–$83.30	2% above	52%
Potassium blood test CPT 84132 HC POCT POTASSIUM	$51.84	$108.00	$4.61–$91.80	13% above	52%
Potassium blood test inpatient CPT 84132 HC POTASSIUM	$47.04	$98.00	$56.84–$78.40	—	52%
Potassium blood test inpatient CPT 84132 HC POCT POTASSIUM	$51.84	$108.00	$62.64–$86.40	—	52%
Progesterone blood test CPT 84144 HC PROGESTERONE	$116.16	$242.00	$20.22–$212.84	at median	52%
Progesterone blood test inpatient CPT 84144 HC PROGESTERONE	$116.16	$242.00	$140.36–$193.60	—	52%
Prolactin blood test CPT 84146 HC PROLACTIN	$98.40	$205.00	$18.78–$197.70	24% below	52%
Prolactin blood test inpatient CPT 84146 HC PROLACTIN	$98.40	$205.00	$118.90–$164.00	—	52%
Prothrombin time (PT/INR) clotting test CPT 85610 HC PT	$60.96	$127.00	$4.16–$107.95	17% above	52%
Prothrombin time (PT/INR) clotting test CPT 85610 HC POCT PT	$63.36	$132.00	$4.16–$112.20	22% above	52%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 HC PT	$60.96	$127.00	$73.66–$101.60	—	52%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 HC POCT PT	$63.36	$132.00	$76.56–$105.60	—	52%
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 HC DRUG SCREEN QUAL EA PROC	$86.40	$180.00	$12.21–$153.00	14% below	52%
Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 HC DRUG SCREEN QUAL EA PROC	$86.40	$180.00	$104.40–$144.00	—	52%
Rapid flu test (influenza antigen) CPT 87804 HC INFLUENZA AB	$21.12	$44.00	$8.80–$44.00	71% below	52%
Rapid flu test (influenza antigen) inpatient CPT 87804 HC INFLUENZA AB	$21.12	$44.00	$25.52–$35.20	—	52%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 HC STREP SCREEN	$113.28	$236.00	$15.29–$200.60	132% above	52%
Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 HC STREP SCREEN	$113.28	$236.00	$136.88–$188.80	—	52%
Renin blood test CPT 84244 HC RENIN	$135.84	$283.00	$21.31–$240.55	12% below	52%
Renin blood test inpatient CPT 84244 HC RENIN	$135.84	$283.00	$164.14–$226.40	—	52%
Rh blood typing CPT 86901 HC REF PRO RH TYPE	$47.52	$99.00	$3.81–$87.67	14% below	52%
Rh blood typing CPT 86901 HC RH TYPE	$52.80	$110.00	$3.81–$93.50	4% below	52%
Rh blood typing inpatient CPT 86901 HC REF PRO RH TYPE	$47.52	$99.00	$57.42–$79.20	—	52%
Rh blood typing inpatient CPT 86901 HC RH TYPE	$52.80	$110.00	$63.80–$88.00	—	52%
Rheumatoid factor (RF) test CPT 86431 HC RA QUANT	$49.44	$103.00	$5.50–$87.55	10% below	52%
Rheumatoid factor (RF) test inpatient CPT 86431 HC RA QUANT	$49.44	$103.00	$59.74–$82.40	—	52%
Rubella antibody test (immunity check) CPT 86762 HC RUBELLA	$84.48	$176.00	$13.94–$149.60	7% above	52%
Rubella antibody test (immunity check) inpatient CPT 86762 HC RUBELLA	$84.48	$176.00	$102.08–$140.80	—	52%
Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 HC SED RATE AUTOMATED	$59.04	$123.00	$2.62–$104.55	12% above	52%
Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 HC SED RATE AUTOMATED	$59.04	$123.00	$71.34–$98.40	—	52%
Sodium blood test CPT 84295 HC SODIUM	$55.68	$116.00	$4.66–$98.60	5% above	52%
Sodium blood test inpatient CPT 84295 HC SODIUM	$55.68	$116.00	$67.28–$92.80	—	52%
Stool ova and parasites exam CPT 87177 HC OVA PARASITES	$71.52	$149.00	$8.63–$126.65	13% below	52%
Stool ova and parasites exam inpatient CPT 87177 HC OVA PARASITES	$71.52	$149.00	$86.42–$119.20	—	52%
Stool test for hidden blood (guaiac FOBT) CPT 82270 HC RHC HEMOCCULT	$31.20	$65.00	$4.15–$55.25	10% above	52%
Stool test for hidden blood (guaiac FOBT) CPT 82270 HC HEMOCCULT	$31.68	$66.00	$4.15–$56.10	12% above	52%
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 HC RHC HEMOCCULT	$31.20	$65.00	$37.70–$52.00	—	52%
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 HC HEMOCCULT	$31.68	$66.00	$38.28–$52.80	—	52%
Stool test for hidden blood by immunoassay (FIT) CPT 82274 HC BLOOD OCCULT FECL HEMO	$26.40	$55.00	$11.00–$55.00	39% below	52%
Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 HC BLOOD OCCULT FECL HEMO	$26.40	$55.00	$31.90–$44.00	—	52%
Syphilis antibody test (Treponema pallidum) CPT 86780 HC ANTIBODY TREPONEMA PALLIDUM	$54.72	$114.00	$12.83–$96.90	at median	52%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 HC ANTIBODY TREPONEMA PALLIDUM	$54.72	$114.00	$66.12–$91.20	—	52%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 HC SYPHILIS TEST QUALITATIVE	$47.52	$99.00	$4.14–$84.15	3% above	52%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 HC SYPHILIS TEST QUALITATIVE	$47.52	$99.00	$57.42–$79.20	—	52%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 HC TB TEST CELL IMMUN MEASURE	$209.28	$436.00	$60.06–$436.00	at median	52%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 HC TB TEST CELL IMMUN MEASURE	$209.28	$436.00	$252.88–$348.80	—	52%
Testosterone blood test, total (not free testosterone) CPT 84403 HC TESTOSTERONE TOTAL	$140.16	$292.00	$25.01–$263.37	19% above	52%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 HC TESTOSTERONE TOTAL	$140.16	$292.00	$169.36–$233.60	—	52%
Thyroid peroxidase (TPO) antibody test CPT 86376 HC MICROSOMAL ANTIBODY	$120.00	$250.00	$14.10–$212.50	20% above	52%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 HC MICROSOMAL ANTIBODY	$120.00	$250.00	$145.00–$200.00	—	52%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 HC TSH	$124.32	$259.00	$16.28–$220.15	11% above	52%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 HC TSH	$124.32	$259.00	$150.22–$207.20	—	52%
Total IgE blood test CPT 82785 HC IGE	$96.00	$200.00	$15.95–$170.00	4% below	52%
Total IgE blood test inpatient CPT 82785 HC IGE	$96.00	$200.00	$116.00–$160.00	—	52%
Total cholesterol blood test CPT 82465 HC CHOLESTEROL	$24.96	$52.00	$4.21–$44.38	53% below	52%
Total cholesterol blood test inpatient CPT 82465 HC CHOLESTEROL	$24.96	$52.00	$30.16–$41.60	—	52%
Total thyroxine (T4) blood test CPT 84436 HC T4	$37.44	$78.00	$6.66–$70.10	34% below	52%
Total thyroxine (T4) blood test inpatient CPT 84436 HC T4	$37.44	$78.00	$45.24–$62.40	—	52%
Total triiodothyronine (T3) blood test CPT 84480 HC T3 TOTAL	$95.52	$199.00	$13.74–$169.15	at median	52%
Total triiodothyronine (T3) blood test inpatient CPT 84480 HC T3 TOTAL	$95.52	$199.00	$115.42–$159.20	—	52%
Transferrin blood test CPT 84466 HC TRANSFERRIN	$84.48	$176.00	$12.36–$149.60	19% below	52%
Transferrin blood test inpatient CPT 84466 HC TRANSFERRIN	$84.48	$176.00	$102.08–$140.80	—	52%
Trichomonas test (NAAT) CPT 87661 HC TRICHOMONAS VAGINALIS AMPLIF	$97.92	$204.00	$34.01–$204.00	2% above	52%
Trichomonas test (NAAT) inpatient CPT 87661 HC TRICHOMONAS VAGINALIS AMPLIF	$97.92	$204.00	$118.32–$163.20	—	52%
Triglycerides blood test CPT 84478 HC TRIGLYCERIDE	$66.72	$139.00	$5.56–$118.15	7% above	52%
Triglycerides blood test inpatient CPT 84478 HC TRIGLYCERIDE	$66.72	$139.00	$80.62–$111.20	—	52%
Troponin test, quantitative CPT 84484 HC TROPONIN	$171.36	$357.00	$12.09–$303.45	11% below	52%
Troponin test, quantitative inpatient CPT 84484 HC TROPONIN	$171.36	$357.00	$207.06–$285.60	—	52%
Uric acid blood test CPT 84550 HC URIC ACID	$58.08	$121.00	$4.38–$102.85	7% above	52%
Uric acid blood test inpatient CPT 84550 HC URIC ACID	$58.08	$121.00	$70.18–$96.80	—	52%
Urinalysis with microscope exam, automated CPT 81001 HC URINALYSIS	$64.32	$134.00	$3.07–$113.90	11% above	52%
Urinalysis with microscope exam, automated CPT 81001 HC URINALYSIS AUTOMATD W MICRO	$67.68	$141.00	$3.07–$119.85	17% above	52%
Urinalysis with microscope exam, automated inpatient CPT 81001 HC URINALYSIS	$64.32	$134.00	$77.72–$107.20	—	52%
Urinalysis with microscope exam, automated inpatient CPT 81001 HC URINALYSIS AUTOMATD W MICRO	$67.68	$141.00	$81.78–$112.80	—	52%
Urinalysis without microscope exam, automated CPT 81003 HC POC URINE AUTO WO MICRO	$32.64	$68.00	$2.18–$57.80	3% below	52%
Urinalysis without microscope exam, automated CPT 81003 HC URINALYSIS AUTO WO MICRO	$35.04	$73.00	$2.18–$62.05	4% above	52%
Urinalysis without microscope exam, automated inpatient CPT 81003 HC POC URINE AUTO WO MICRO	$32.64	$68.00	$39.44–$54.40	—	52%
Urinalysis without microscope exam, automated inpatient CPT 81003 HC URINALYSIS AUTO WO MICRO	$35.04	$73.00	$42.34–$58.40	—	52%
Urinalysis without microscope exam, manual CPT 81002 HC URINALYSIS MANUAL	$14.88	$31.00	$3.26–$26.35	32% below	52%
Urinalysis without microscope exam, manual inpatient CPT 81002 HC URINALYSIS MANUAL	$14.88	$31.00	$17.98–$24.80	—	52%
Urine culture for bacteria, with colony count CPT 87086 HC CULTURE URINE	$74.40	$155.00	$7.82–$131.75	1% above	52%
Urine culture for bacteria, with colony count inpatient CPT 87086 HC CULTURE URINE	$74.40	$155.00	$89.90–$124.00	—	52%
Urine microalbumin (albumin) test CPT 82043 HC ALBUMIN URINE MICROALBUMIN QUANTIATIVE	$59.52	$124.00	$5.60–$105.40	30% below	52%
Urine microalbumin (albumin) test inpatient CPT 82043 HC ALBUMIN URINE MICROALBUMIN QUANTIATIVE	$59.52	$124.00	$71.92–$99.20	—	52%
Urine pregnancy test, read by color change CPT 81025 HC HCG URINE	$70.08	$146.00	$8.06–$124.10	8% above	52%
Urine pregnancy test, read by color change inpatient CPT 81025 HC HCG URINE	$70.08	$146.00	$84.68–$116.80	—	52%
Vitamin B12 (cobalamin) blood test CPT 82607 HC VITAMIN B12	$117.12	$244.00	$14.62–$207.40	at median	52%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 HC VITAMIN B12	$117.12	$244.00	$141.52–$195.20	—	52%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 HC VITAMIN D 25OH	$256.80	$535.00	$28.68–$454.75	68% above	52%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 HC VITAMIN D 25OH	$256.80	$535.00	$310.30–$428.00	—	52%
Vitamin D, 1,25-dihydroxy blood test CPT 82652 HC VITAMIN D 1 25	$282.72	$589.00	$37.31–$500.65	8% above	52%
Vitamin D, 1,25-dihydroxy blood test inpatient CPT 82652 HC VITAMIN D 1 25	$282.72	$589.00	$341.62–$471.20	—	52%
Zinc blood test CPT 84630 HC ZINC	$41.28	$86.00	$11.04–$73.10	49% below	52%
Zinc blood test inpatient CPT 84630 HC ZINC	$41.28	$86.00	$49.88–$68.80	—	52%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HC HCG QUANT	$97.44	$203.00	$14.59–$172.55	14% below	52%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HC HCG QUANT	$97.44	$203.00	$117.74–$162.40	—	52%

Surgery and procedures

Procedure	Cash price	List price	Insurers pay	vs Nebraska	Off list
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion CPT 19081 HC BX BREAST 1ST LESN STRTCTC	$2,507.04	$5,223.00	$322.77–$8,251.00	1% below	52%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion CPT 19081 HC BX BREAST W/ DEVICE 1ST LESION STEREOTACTIC GUID	$2,507.04	$5,223.00	$322.77–$8,251.00	1% below	52%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion inpatient CPT 19081 HC BX BREAST 1ST LESN STRTCTC	$2,507.04	$5,223.00	$3,029.34–$4,178.40	—	52%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion inpatient CPT 19081 HC BX BREAST W/ DEVICE 1ST LESION STEREOTACTIC GUID	$2,507.04	$5,223.00	$3,029.34–$4,178.40	—	52%
Cardiac catheterization with coronary angiogram one side CPT 93458 HC LEFT HEART CATH	$9,477.60	$19,745.00	$1,394.39–$16,783.25	28% below	52%
Cardiac catheterization with coronary angiogram inpatient one side CPT 93458 HC LEFT HEART CATH	$9,477.60	$19,745.00	$11,452.10–$15,796.00	—	52%
Cardioversion, elective (restoring heart rhythm) CPT 92960 HC CARDIOVERSION ELECTRIC EXT	$525.60	$1,095.00	$216.45–$6,416.00	64% below	52%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 HC CARDIOVERSION ELECTRIC EXT	$525.60	$1,095.00	$635.10–$876.00	—	52%
Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 HC CIRCUMCISION W CLAMP OTH DEV W BLOCK	$1,042.08	$2,171.00	$189.91–$8,251.00	2% below	52%
Circumcision with a clamp or device and a numbing nerve block, usually newborns inpatient CPT 54150 HC CIRCUMCISION W CLAMP OTH DEV W BLOCK	$1,042.08	$2,171.00	$1,259.18–$1,736.80	—	52%
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 HC CLS DST RAD FX WWO UL SYLD	$405.60	$845.00	$169.00–$4,582.00	13% below	52%
Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 HC CLS DST RAD FX WWO UL SYLD	$405.60	$845.00	$490.10–$676.00	—	52%
Coronary stent placement, one artery CPT 92928 HC PLCMT CORONARY STENT SINGLE	$3,313.92	$6,904.00	$1,091.71–$27,091.57	70% below	52%
Coronary stent placement, one artery CPT 92928 HC COR STENT SINGLE	$11,095.68	$23,116.00	$1,091.71–$27,091.57	at median	52%
Coronary stent placement, one artery inpatient CPT 92928 HC PLCMT CORONARY STENT SINGLE	$3,313.92	$6,904.00	$4,004.32–$5,523.20	—	52%
Coronary stent placement, one artery inpatient CPT 92928 HC COR STENT SINGLE	$11,095.68	$23,116.00	$13,407.28–$18,492.80	—	52%
Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 HC CYSTOURETHROSCOPY	$837.60	$1,745.00	$158.72–$6,416.00	14% below	52%
Cystoscopy, diagnostic look inside the bladder and urethra inpatient CPT 52000 HC CYSTOURETHROSCOPY	$837.60	$1,745.00	$1,012.10–$1,396.00	—	52%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 HC DESTRUCTION/LN ONE LESION	$127.20	$265.00	$53.00–$4,582.00	3% below	52%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 HC DESTRUCTION/LN ONE LESION	$127.20	$265.00	$153.70–$212.00	—	52%
Earwax removal by irrigation (rinsing), one ear both sides CPT 69209 HC REM IMP EAR WAX IRR/LAV BI	$136.32	$284.00	$30.53–$4,582.00	—	52%
Earwax removal by irrigation (rinsing), one ear CPT 69209 HC REM IMP EAR WAX IRR/LAV UNI	$68.16	$142.00	$28.40–$4,582.00	8% above	52%
Earwax removal by irrigation (rinsing), one ear inpatient both sides CPT 69209 HC REM IMP EAR WAX IRR/LAV BI	$136.32	$284.00	$164.72–$227.20	—	52%
Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 HC REM IMP EAR WAX IRR/LAV UNI	$68.16	$142.00	$82.36–$113.60	—	52%
Earwax removal with instruments, one ear both sides CPT 69210 HC SP NP CERUMEN IMPACTION REM BI	$84.96	$177.00	$35.40–$4,582.00	—	52%
Earwax removal with instruments, one ear both sides CPT 69210 HC REM IMP EAR WAX INST BI	$84.96	$177.00	$35.40–$4,582.00	—	52%
Earwax removal with instruments, one ear CPT 69210 HC REM IMP EAR WAX INST UNI	$71.04	$148.00	$29.60–$4,582.00	16% below	52%
Earwax removal with instruments, one ear inpatient both sides CPT 69210 HC SP NP CERUMEN IMPACTION REM BI	$84.96	$177.00	$102.66–$141.60	—	52%
Earwax removal with instruments, one ear inpatient both sides CPT 69210 HC REM IMP EAR WAX INST BI	$84.96	$177.00	$102.66–$141.60	—	52%
Earwax removal with instruments, one ear inpatient CPT 69210 HC REM IMP EAR WAX INST UNI	$71.04	$148.00	$85.84–$118.40	—	52%
Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 HC ENDOMET BX WO CERVICAL DILA	$196.32	$409.00	$81.80–$4,582.00	6% below	52%
Endometrial biopsy (uterine lining sample) without dilating the cervix inpatient CPT 58100 HC ENDOMET BX WO CERVICAL DILA	$196.32	$409.00	$237.22–$327.20	—	52%
Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 HC NJX INTRLMNR CRV THRC W IMG GDN	$847.68	$1,766.00	$215.27–$6,416.00	39% below	52%
Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 HC NJX INTRLMNR CRV THRC W IMG GDN	$847.68	$1,766.00	$1,024.28–$1,412.80	—	52%
Facet joint injection, lower back, one level, with imaging guidance CPT 64493 HC FACET LUMBOSACRAL SINGLE	$1,299.36	$2,707.00	$181.94–$6,416.00	21% below	52%
Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 HC FACET LUMBOSACRAL SINGLE	$1,299.36	$2,707.00	$1,570.06–$2,165.60	—	52%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 HC INJECT HYSTERO	$311.52	$649.00	$113.99–$4,582.00	26% below	52%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes inpatient CPT 58340 HC INJECT HYSTERO	$311.52	$649.00	$376.42–$519.20	—	52%
IUD insertion (the device itself billed separately) CPT 58300 HC INSERTION OF IUD	$144.48	$301.00	$60.20–$4,582.00	26% below	52%
IUD insertion (the device itself billed separately) inpatient CPT 58300 HC INSERTION OF IUD	$144.48	$301.00	$174.58–$240.80	—	52%
Incision and drainage of a simple or single skin abscess CPT 10060 HC DRAIN SKIN ABSCESS SMPL SNGL	$240.96	$502.00	$100.40–$4,582.00	17% below	52%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 HC DRAIN SKIN ABSCESS SMPL SNGL	$240.96	$502.00	$291.16–$401.60	—	52%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 HC DRAIN INJ JOINT BURSA MAJOR	$195.84	$408.00	$81.60–$4,582.00	3% below	52%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 HC DRAIN INJ JOINT BURSA MAJOR M50	$391.68	$816.00	$88.61–$4,582.00	94% above	52%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 HC DRAIN INJ JOINT BURSA MAJOR	$195.84	$408.00	$236.64–$326.40	—	52%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 HC DRAIN INJ JOINT BURSA MAJOR M50	$391.68	$816.00	$473.28–$652.80	—	52%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 HC ASPIRATE INJ INTERMED JOINT	$208.80	$435.00	$73.04–$4,582.00	18% below	52%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 HC ASPIRATE INJ INTERMED JOINT	$208.80	$435.00	$252.30–$348.00	—	52%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 HC DRAIN INJ ASP JNT BURSA SM	$189.60	$395.00	$70.93–$4,582.00	15% below	52%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 HC DRAIN INJ ASP JNT BURSA SM	$189.60	$395.00	$229.10–$316.00	—	52%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 HC LCW INTER H/T/E <2.5CM	$321.12	$669.00	$133.80–$4,582.00	34% below	52%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 HC LCW INTER H/T/E <2.5CM	$321.12	$669.00	$388.02–$535.20	—	52%
Left heart catheterization, diagnostic one side CPT 93452 HC LEFT HEART CATH NO ANGIO	$7,547.52	$15,724.00	$1,235.34–$16,444.00	9% above	52%
Left heart catheterization, diagnostic inpatient one side CPT 93452 HC LEFT HEART CATH NO ANGIO	$7,547.52	$15,724.00	$9,119.92–$12,579.20	—	52%
Lower-back epidural injection, with imaging guidance CPT 62323 HC INJ ANE DRG LUM SAC W IMG GDN	$1,002.24	$2,088.00	$199.00–$6,416.00	24% below	52%
Lower-back epidural injection, with imaging guidance inpatient CPT 62323 HC INJ ANE DRG LUM SAC W IMG GDN	$1,002.24	$2,088.00	$1,211.04–$1,670.40	—	52%
Lower-back epidural injection, without imaging guidance CPT 62322 HC INJ ANE DRG LUM SAC W O IMG GDN	$940.32	$1,959.00	$156.43–$6,416.00	21% above	52%
Lower-back epidural injection, without imaging guidance inpatient CPT 62322 HC INJ ANE DRG LUM SAC W O IMG GDN	$940.32	$1,959.00	$1,136.22–$1,567.20	—	52%
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 HC INJ TRNSFRM LUM SNGL W IMAG	$564.96	$1,177.00	$223.76–$6,416.00	62% below	52%
Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 HC INJ TRNSFRM LUM SNGL W IMAG	$564.96	$1,177.00	$682.66–$941.60	—	52%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 HC EXCN BENIGN LESN TAL <0.5CM	$476.16	$992.00	$169.03–$6,416.00	24% above	52%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 HC EXCN BENIGN LESN TAL <0.5CM	$476.16	$992.00	$575.36–$793.60	—	52%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 HC EXC BEN FA/EY/NOS <.5CM	$690.24	$1,438.00	$215.85–$6,416.00	60% above	52%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 HC EXC BEN FA/EY/NOS <.5CM	$690.24	$1,438.00	$834.04–$1,150.40	—	52%
Nail removal (partial or complete), one nail CPT 11730 HC AVULSION NAIL PL SMPL SNGL	$310.08	$646.00	$108.86–$4,582.00	28% above	52%
Nail removal (partial or complete), one nail inpatient CPT 11730 HC AVULSION NAIL PL SMPL SNGL	$310.08	$646.00	$374.68–$516.80	—	52%
Occipital nerve block (injection for headaches) CPT 64405 HC OCCIPITAL BLOCK STERIOD	$373.44	$778.00	$100.70–$4,582.00	12% below	52%
Occipital nerve block (injection for headaches) inpatient CPT 64405 HC OCCIPITAL BLOCK STERIOD	$373.44	$778.00	$451.24–$622.40	—	52%
Paracentesis with imaging guidance CPT 49083 HC ABD PARACENTESIS W IMAGING	$837.12	$1,744.00	$210.73–$8,251.00	23% below	52%
Paracentesis with imaging guidance inpatient CPT 49083 HC ABD PARACENTESIS W IMAGING	$837.12	$1,744.00	$1,011.52–$1,395.20	—	52%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 HC PERMANENT REMOVAL NAILBED	$269.28	$561.00	$112.20–$4,582.00	22% below	52%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 HC PERMANENT REMOVAL NAILBED	$269.28	$561.00	$325.38–$448.80	—	52%
Prostate biopsy CPT 55700 HC BIOPSY PROSTATE	$1,004.16	$2,092.00	$256.55–$6,809.00	23% below	52%
Prostate biopsy inpatient CPT 55700 HC BIOPSY PROSTATE	$1,004.16	$2,092.00	$1,213.36–$1,673.60	—	52%
Removal of a foreign object under the skin, simple CPT 10120 HC RFB SUBQ TISSUE SIMPLE	$420.48	$876.00	$175.20–$4,582.00	21% above	52%
Removal of a foreign object under the skin, simple inpatient CPT 10120 HC RFB SUBQ TISSUE SIMPLE	$420.48	$876.00	$508.08–$700.80	—	52%
Short arm cast (elbow to hand) CPT 29075 HC PT CASTING OF ARM SHORT	$207.84	$433.00	$86.60–$4,582.00	at median	52%
Short arm cast (elbow to hand) CPT 29075 HC CASTING OF ARM SHORT	$248.64	$518.00	$103.60–$4,582.00	20% above	52%
Short arm cast (elbow to hand) inpatient CPT 29075 HC PT CASTING OF ARM SHORT	$207.84	$433.00	$251.14–$346.40	—	52%
Short arm cast (elbow to hand) inpatient CPT 29075 HC CASTING OF ARM SHORT	$248.64	$518.00	$300.44–$414.40	—	52%
Short arm splint (forearm and hand) CPT 29125 HC OT SPLINTING OF FOREARM	$188.16	$392.00	$78.40–$4,582.00	14% above	52%
Short arm splint (forearm and hand) CPT 29125 HC SPLINTING OF FOREARM	$188.16	$392.00	$78.40–$4,582.00	14% above	52%
Short arm splint (forearm and hand) CPT 29125 HC PT SPLINTING OF FOREARM	$188.16	$392.00	$78.40–$4,582.00	14% above	52%
Short arm splint (forearm and hand) inpatient CPT 29125 HC OT SPLINTING OF FOREARM	$188.16	$392.00	$227.36–$313.60	—	52%
Short arm splint (forearm and hand) inpatient CPT 29125 HC SPLINTING OF FOREARM	$188.16	$392.00	$227.36–$313.60	—	52%
Short arm splint (forearm and hand) inpatient CPT 29125 HC PT SPLINTING OF FOREARM	$188.16	$392.00	$227.36–$313.60	—	52%
Short leg cast (below the knee) CPT 29405 HC APPL SHORT LEG CAST	$202.08	$421.00	$84.20–$4,582.00	at median	52%
Short leg cast (below the knee) inpatient CPT 29405 HC APPL SHORT LEG CAST	$202.08	$421.00	$244.18–$336.80	—	52%
Short leg splint (calf to foot) CPT 29515 HC SPLINTING OF LOWER LEG	$172.32	$359.00	$71.80–$4,582.00	9% below	52%
Short leg splint (calf to foot) CPT 29515 HC OT SPLINTING OF LOWER LEG	$172.32	$359.00	$71.80–$4,582.00	9% below	52%
Short leg splint (calf to foot) inpatient CPT 29515 HC SPLINTING OF LOWER LEG	$172.32	$359.00	$208.22–$287.20	—	52%
Short leg splint (calf to foot) inpatient CPT 29515 HC OT SPLINTING OF LOWER LEG	$172.32	$359.00	$208.22–$287.20	—	52%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 HC RSW SIMPLE H/N/T/E <2.5CM	$224.64	$468.00	$86.28–$4,582.00	4% above	52%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 HC RSW SIMPLE H/N/T/E <2.5CM	$224.64	$468.00	$271.44–$374.40	—	52%
Skin biopsy, punch, one lesion CPT 11104 HC PUNCH BIOPSY SKIN SINGLE LESION	$279.84	$583.00	$92.81–$4,582.00	7% above	52%
Skin biopsy, punch, one lesion inpatient CPT 11104 HC PUNCH BIOPSY SKIN SINGLE LESION	$279.84	$583.00	$338.14–$466.40	—	52%
Skin tag removal, up to 15 tags CPT 11200 HC REMOVE SKIN TAGS <=15 LESIONS	$188.64	$393.00	$78.60–$4,582.00	2% below	52%
Skin tag removal, up to 15 tags inpatient CPT 11200 HC REMOVE SKIN TAGS <=15 LESIONS	$188.64	$393.00	$227.94–$314.40	—	52%
Spinal tap (lumbar puncture), diagnostic CPT 62270 HC LUMBAR PUNCTURE DIAGNOSTIC	$508.80	$1,060.00	$122.14–$6,416.00	at median	52%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 HC LUMBAR PUNCTURE DIAGNOSTIC	$508.80	$1,060.00	$614.80–$848.00	—	52%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 HC RSW SIMPL H/N/T/E 2.6-7.5CM	$249.60	$520.00	$104.00–$13,145.00	3% below	52%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 HC RSW SIMPL H/N/T/E 2.6-7.5CM	$249.60	$520.00	$301.60–$416.00	—	52%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 HC RSW SIMPLE FACE <2.5CM	$248.16	$517.00	$103.40–$13,145.00	4% above	52%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 HC RSW SIMPLE FACE <2.5CM	$248.16	$517.00	$299.86–$413.60	—	52%
Tangential (shave-style) skin biopsy, one lesion CPT 11102 HC TANGENTIAL BIOPSY SKIN SINGLE LESION	$203.04	$423.00	$75.10–$4,582.00	5% above	52%
Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 HC TANGENTIAL BIOPSY SKIN SINGLE LESION	$203.04	$423.00	$245.34–$338.40	—	52%
Thoracentesis with imaging guidance CPT 32555 HC THORACENTESIS W IMAGE GUIDE	$492.48	$1,026.00	$205.20–$6,416.00	48% below	52%
Thoracentesis with imaging guidance CPT 32555 HC ASP PLEURA W/GUIDANCE	$492.48	$1,026.00	$205.20–$6,416.00	48% below	52%
Thoracentesis with imaging guidance inpatient CPT 32555 HC ASP PLEURA W/GUIDANCE	$492.48	$1,026.00	$595.08–$820.80	—	52%
Thoracentesis with imaging guidance inpatient CPT 32555 HC THORACENTESIS W IMAGE GUIDE	$492.48	$1,026.00	$595.08–$820.80	—	52%
Trigger point injections, 1 or 2 muscles CPT 20552 HC INJ TRIGGER PTS 1 OR 2 MUSC	$199.68	$416.00	$72.70–$4,582.00	8% above	52%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 HC INJ TRIGGER PTS 1 OR 2 MUSC	$199.68	$416.00	$241.28–$332.80	—	52%
Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 HC BX BREAST 1ST LESION US IMG	$1,611.36	$3,357.00	$303.84–$8,251.00	22% below	52%
Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient CPT 19083 HC BX BREAST 1ST LESION US IMG	$1,611.36	$3,357.00	$1,947.06–$2,685.60	—	52%
Upper endoscopy (EGD) with biopsy CPT 43239 HC EGD BIOPSY SINGLE MULTIPLE	$1,512.48	$3,151.00	$271.71–$8,251.00	26% below	52%
Upper endoscopy (EGD) with biopsy inpatient CPT 43239 HC EGD BIOPSY SINGLE MULTIPLE	$1,512.48	$3,151.00	$1,827.58–$2,520.80	—	52%
Upper endoscopy (EGD), diagnostic CPT 43235 HC EGD DIAGNOSTIC BRUSH WASH	$1,016.16	$2,117.00	$241.13–$8,251.00	39% below	52%
Upper endoscopy (EGD), diagnostic inpatient CPT 43235 HC EGD DIAGNOSTIC BRUSH WASH	$1,016.16	$2,117.00	$1,227.86–$1,693.60	—	52%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 HC DEBRIDE SKIN SUBCUTANEOUS	$752.16	$1,567.00	$120.25–$4,582.00	109% above	52%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 HC DEBRIDE SKIN SUBCUTANEOUS	$752.16	$1,567.00	$908.86–$1,253.60	—	52%

Doctor visits and therapy

Procedure	Cash price	List price	Insurers pay	vs Nebraska	Off list
Blood transfusion (giving blood or blood components) CPT 36430 HC BLOOD TRANSFUSION 1 UNIT ER	$436.80	$910.00	$83.70–$4,582.00	42% below	52%
Blood transfusion (giving blood or blood components) CPT 36430 HC BLOOD TRANSFUSION 1 UNIT	$455.04	$948.00	$83.70–$4,582.00	40% below	52%
Blood transfusion (giving blood or blood components) CPT 36430 HC TRANSFUSION BLOOD/BLOOD COMPONENTS	$457.44	$953.00	$83.70–$4,582.00	39% below	52%
Blood transfusion (giving blood or blood components) CPT 36430 HC BLOOD TRANSFUSION 2 UNIT ER	$759.84	$1,583.00	$83.70–$4,582.00	1% above	52%
Blood transfusion (giving blood or blood components) CPT 36430 HC BLOOD TRANSFUSION 2 UNIT	$787.20	$1,640.00	$83.70–$4,582.00	4% above	52%
Blood transfusion (giving blood or blood components) CPT 36430 HC BLOOD TRANSFUSION 3 OR > UNITS	$1,115.04	$2,323.00	$83.70–$4,582.00	48% above	52%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 HC BLOOD TRANSFUSION 1 UNIT ER	$436.80	$910.00	$527.80–$728.00	—	52%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 HC BLOOD TRANSFUSION 1 UNIT	$455.04	$948.00	$549.84–$758.40	—	52%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 HC TRANSFUSION BLOOD/BLOOD COMPONENTS	$457.44	$953.00	$552.74–$762.40	—	52%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 HC BLOOD TRANSFUSION 2 UNIT ER	$759.84	$1,583.00	$918.14–$1,266.40	—	52%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 HC BLOOD TRANSFUSION 2 UNIT	$787.20	$1,640.00	$951.20–$1,312.00	—	52%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 HC BLOOD TRANSFUSION 3 OR > UNITS	$1,115.04	$2,323.00	$1,347.34–$1,858.40	—	52%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HC MDI IN-LINE TREATMENT	$129.12	$269.00	$15.38–$513.88	13% below	52%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HC MDI IN-LINE TREATMENT	$129.12	$269.00	$156.02–$215.20	—	52%
Chemotherapy IV infusion, first hour CPT 96413 HC CHEMO INF INIT UP TO 1HR SC	$288.48	$601.00	$120.20–$775.16	47% below	52%
Chemotherapy IV infusion, first hour CPT 96413 HC CHEMO INFUSN INIT UP TO 1HR	$650.40	$1,355.00	$242.22–$1,151.75	21% above	52%
Chemotherapy IV infusion, first hour inpatient CPT 96413 HC CHEMO INF INIT UP TO 1HR SC	$288.48	$601.00	$348.58–$480.80	—	52%
Chemotherapy IV infusion, first hour inpatient CPT 96413 HC CHEMO INFUSN INIT UP TO 1HR	$650.40	$1,355.00	$785.90–$1,084.00	—	52%
Critical care, first 30 to 74 minutes CPT 99291 HC ER CRITICAL CARE CEN	$1,473.60	$3,070.00	$426.65–$5,923.00	13% below	52%
Critical care, first 30 to 74 minutes inpatient CPT 99291 HC ER CRITICAL CARE CEN	$1,473.60	$3,070.00	$1,780.60–$2,456.00	—	52%
EEG (brain wave test), awake and drowsy, routine CPT 95816 HC EEG AWAKE AND DROWSY	$762.24	$1,588.00	$175.26–$1,349.80	13% above	52%
EEG (brain wave test), awake and drowsy, routine inpatient CPT 95816 HC EEG AWAKE AND DROWSY	$762.24	$1,588.00	$921.04–$1,270.40	—	52%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 HC EKG ROUTINE	$56.16	$117.00	$13.67–$138.45	77% below	52%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 HC EKG PACER W WO MAGNET	$206.40	$430.00	$13.67–$365.50	15% below	52%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 HC EKG ROUTINE	$56.16	$117.00	$67.86–$93.60	—	52%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 HC EKG PACER W WO MAGNET	$206.40	$430.00	$249.40–$344.00	—	52%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 HC ER LEVEL 1 CEN	$181.44	$378.00	$11.72–$693.00	12% below	52%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 HC ER LEVEL 1 CEN	$181.44	$378.00	$219.24–$302.40	—	52%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 HC ER LEVEL 2 CEN	$283.20	$590.00	$83.52–$1,112.00	24% below	52%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 HC ER LEVEL 2 CEN	$283.20	$590.00	$342.20–$472.00	—	52%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 HC ER LEVEL 3 CEN	$498.24	$1,038.00	$141.56–$1,903.00	22% below	52%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 HC ER LEVEL 3 CEN	$498.24	$1,038.00	$602.04–$830.40	—	52%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 HC ER LEVEL 4 CEN	$668.16	$1,392.00	$240.84–$4,740.00	31% below	52%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 HC ER LEVEL 4 CEN	$668.16	$1,392.00	$807.36–$1,113.60	—	52%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 HC ER LEVEL 5 CEN	$1,131.84	$2,358.00	$348.97–$6,042.00	20% below	52%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 HC ER LEVEL 5 CEN	$1,131.84	$2,358.00	$1,367.64–$1,886.40	—	52%
Exercise stress test, tracing only, the hospital charge CPT 93017 HC CARDIOLITE NUCLEAR STRESS	$683.52	$1,424.00	$82.66–$1,210.40	39% below	52%
Exercise stress test, tracing only, the hospital charge CPT 93017 HC CARDIOVASCULAR STRESS TEST	$864.96	$1,802.00	$82.66–$1,531.70	23% below	52%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 HC CARDIOLITE NUCLEAR STRESS	$683.52	$1,424.00	$825.92–$1,139.20	—	52%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 HC CARDIOVASCULAR STRESS TEST	$864.96	$1,802.00	$1,045.16–$1,441.60	—	52%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 HC HYDRA INF INIT 31 MIN -1 HR	$171.36	$357.00	$61.86–$499.17	55% below	52%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 HC HYDRA INF INIT 31MIN-1HR ER	$171.36	$357.00	$61.86–$693.00	55% below	52%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 HC HYDRA INF INIT 31 MIN -1 HR	$171.36	$357.00	$207.06–$285.60	—	52%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 HC HYDRA INF INIT 31MIN-1HR ER	$171.36	$357.00	$207.06–$285.60	—	52%
IV infusion of a medicine, first hour CPT 96365 HC THERP INFSN INIT UP TO 1 HR	$249.12	$519.00	$103.80–$499.17	35% below	52%
IV infusion of a medicine, first hour CPT 96365 HC THERAPY INF INITIAL 1ST HR	$249.12	$519.00	$103.80–$693.00	35% below	52%
IV infusion of a medicine, first hour inpatient CPT 96365 HC THERAPY INF INITIAL 1ST HR	$249.12	$519.00	$301.02–$415.20	—	52%
IV infusion of a medicine, first hour inpatient CPT 96365 HC THERP INFSN INIT UP TO 1 HR	$249.12	$519.00	$301.02–$415.20	—	52%
IV push of a medicine, first drug CPT 96374 HC IV PUSH INIT SNGL DRUG SCD	$168.00	$350.00	$69.39–$499.17	30% below	52%
IV push of a medicine, first drug CPT 96374 HC IV PUSH INITIAL SINGLE DRUG	$213.60	$445.00	$69.39–$693.00	11% below	52%
IV push of a medicine, first drug CPT 96374 HC IV PUSH INIT SNGL DRUG THER	$213.60	$445.00	$69.39–$499.17	11% below	52%
IV push of a medicine, first drug inpatient CPT 96374 HC IV PUSH INIT SNGL DRUG SCD	$168.00	$350.00	$203.00–$280.00	—	52%
IV push of a medicine, first drug inpatient CPT 96374 HC IV PUSH INITIAL SINGLE DRUG	$213.60	$445.00	$258.10–$356.00	—	52%
IV push of a medicine, first drug inpatient CPT 96374 HC IV PUSH INIT SNGL DRUG THER	$213.60	$445.00	$258.10–$356.00	—	52%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 HC INJ SUBQ IM THRP PROPHYL DX	$98.88	$206.00	$28.91–$175.10	3% below	52%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 HC INJECTION SUBQ IM THERP ER	$98.88	$206.00	$28.91–$693.00	3% below	52%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 HC INJ SUBQ IM THRP PROPHYL DX	$98.88	$206.00	$119.48–$164.80	—	52%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 HC INJECTION SUBQ IM THERP ER	$98.88	$206.00	$119.48–$164.80	—	52%
Neuromuscular re-education, 15 minutes CPT 97112 HC OT NEUROMUSCULAR RE-EDU 15M	$53.76	$112.00	$22.40–$225.00	45% below	52%
Neuromuscular re-education, 15 minutes CPT 97112 HC PT NEUROMUSCULAR RE-EDU 15M	$53.76	$112.00	$22.40–$225.00	45% below	52%
Neuromuscular re-education, 15 minutes CPT 97112 HC ST NEUROMUSCULAR RE-EDU 15M	$53.76	$112.00	$22.40–$225.00	45% below	52%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 HC ST NEUROMUSCULAR RE-EDU 15M	$53.76	$112.00	$64.96–$89.60	—	52%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 HC OT NEUROMUSCULAR RE-EDU 15M	$53.76	$112.00	$64.96–$89.60	—	52%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 HC PT NEUROMUSCULAR RE-EDU 15M	$53.76	$112.00	$64.96–$89.60	—	52%
New patient office visit, about 30 minutes CPT 99203 HC OFFICE OUTPATIENT NEW 30-44 MINS	$194.88	$406.00	$81.20–$345.10	5% below	52%
New patient office visit, about 30 minutes inpatient CPT 99203 HC OFFICE OUTPATIENT NEW 30-44 MINS	$194.88	$406.00	$235.48–$324.80	—	52%
New patient office visit, about 45 minutes CPT 99204 HC OFFICE OUTPATIENT NEW 45-59 MINS	$295.68	$616.00	$123.20–$523.60	1% below	52%
New patient office visit, about 45 minutes inpatient CPT 99204 HC OFFICE OUTPATIENT NEW 45-59 MINS	$295.68	$616.00	$357.28–$492.80	—	52%
New patient office visit, about 60 minutes CPT 99205 HC OFFICE OUTPATIENT NEW 60-74 MINS	$372.96	$777.00	$155.40–$660.45	2% above	52%
New patient office visit, about 60 minutes inpatient CPT 99205 HC OFFICE OUTPATIENT NEW 60-74 MINS	$372.96	$777.00	$450.66–$621.60	—	52%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 HC OFFICE O/P NEW SF 15-29 MIN	$111.36	$232.00	$46.40–$197.20	7% below	52%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 HC OFFICE O/P NEW SF 15-29 MIN	$111.36	$232.00	$134.56–$185.60	—	52%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 HC MEDICL NUTRITION THERAPY IP	$39.84	$83.00	$15.49–$79.30	23% below	52%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 HC MEDICL NUTRITION THERAPY IP	$39.84	$83.00	$48.14–$66.40	—	52%
Occupational therapy evaluation, low complexity CPT 97165 HC OT EVAL LOW COMPLEXITY	$92.16	$192.00	$38.40–$225.59	47% below	52%
Occupational therapy evaluation, low complexity inpatient CPT 97165 HC OT EVAL LOW COMPLEXITY	$92.16	$192.00	$111.36–$153.60	—	52%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 HC PT EVAL HIGH COMPLEXITY	$100.80	$210.00	$42.00–$225.00	57% below	52%
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 HC PT EVAL HIGH COMPLEXITY	$100.80	$210.00	$121.80–$168.00	—	52%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 HC PT EVAL LOW COMPLEXITY	$77.76	$162.00	$32.40–$225.00	54% below	52%
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 HC PT EVAL LOW COMPLEXITY	$77.76	$162.00	$93.96–$129.60	—	52%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 HC PT EVAL MODERATE COMPLEX	$84.48	$176.00	$35.20–$225.00	56% below	52%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 HC PT EVAL MODERATE COMPLEX	$84.48	$176.00	$102.08–$140.80	—	52%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 HC PT MANUAL THERAPY EA 15MIN	$60.48	$126.00	$23.75–$225.00	42% below	52%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 HC OT MANUAL THERAPY EA 15MIN	$60.48	$126.00	$23.75–$225.00	42% below	52%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 HC OT MANUAL THERAPY EA 15MIN	$60.48	$126.00	$73.08–$100.80	—	52%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 HC PT MANUAL THERAPY EA 15MIN	$60.48	$126.00	$73.08–$100.80	—	52%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HC OT THERAPEUTIC EXERCISE 15M	$47.04	$98.00	$19.60–$225.00	53% below	52%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HC PT THERAPEUTIC EXERCISE 15M	$47.04	$98.00	$19.60–$225.00	53% below	52%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 HC OT THERAPEUTIC EXERCISE 15M	$47.04	$98.00	$56.84–$78.40	—	52%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 HC PT THERAPEUTIC EXERCISE 15M	$47.04	$98.00	$56.84–$78.40	—	52%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 HC SMOKE CESS INTERMED 3-10 MIN	$22.56	$47.00	$9.40–$87.94	28% below	52%
Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 HC SMOKE CESS INTERMED 3-10 MIN	$22.56	$47.00	$27.26–$37.60	—	52%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 HC OFFICE VISIT EST 40-54 MINS	$264.48	$551.00	$110.20–$468.35	10% above	52%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 HC OFFICE VISIT EST 40-54 MINS	$264.48	$551.00	$319.58–$440.80	—	52%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 HC OFFICE VISIT EST 20-29 MINS	$183.84	$383.00	$76.60–$325.55	30% above	52%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 HC OFFICE VISIT EST 20-29 MINS	$183.84	$383.00	$222.14–$306.40	—	52%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 HC OFFICE VISIT EST 30-39 MINS	$194.88	$406.00	$81.20–$345.10	4% above	52%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 HC OFFICE VISIT EST 30-39 MINS	$194.88	$406.00	$235.48–$324.80	—	52%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 HC OFFICE VISIT EST 10-19 MINS	$167.04	$348.00	$69.60–$295.80	79% above	52%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 HC OFFICE VISIT EST 10-19 MINS	$167.04	$348.00	$201.84–$278.40	—	52%
Speech and language evaluation CPT 92523 HC ST EVAL SOUND LANG COMPREH	$204.48	$426.00	$85.20–$503.36	37% below	52%
Speech and language evaluation inpatient CPT 92523 HC ST EVAL SOUND LANG COMPREH	$204.48	$426.00	$247.08–$340.80	—	52%
Speech therapy session, individual CPT 92507 HC ST SPEECH TREATMENT INDIVID	$198.72	$414.00	$77.91–$351.90	21% below	52%
Speech therapy session, individual inpatient CPT 92507 HC ST SPEECH TREATMENT INDIVID	$198.72	$414.00	$240.12–$331.20	—	52%
Spirometry (breathing test) CPT 94010 HC SPIROMETRY	$198.72	$414.00	$37.80–$506.71	31% below	52%
Spirometry (breathing test) inpatient CPT 94010 HC SPIROMETRY	$198.72	$414.00	$240.12–$331.20	—	52%
Spirometry before and after a bronchodilator CPT 94060 HC SPIROMETRY PRE POST BRONCH	$285.12	$594.00	$56.91–$875.70	51% below	52%
Spirometry before and after a bronchodilator inpatient CPT 94060 HC SPIROMETRY PRE POST BRONCH	$285.12	$594.00	$344.52–$475.20	—	52%
Therapeutic activities (functional training), 15 minutes CPT 97530 HC OT THER ACTIVITY EA 15MIN	$49.44	$103.00	$20.60–$225.00	51% below	52%
Therapeutic activities (functional training), 15 minutes CPT 97530 HC PT THER ACTIVITY EA 15MIN	$49.44	$103.00	$20.60–$225.00	51% below	52%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 HC OT THER ACTIVITY EA 15MIN	$49.44	$103.00	$59.74–$82.40	—	52%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 HC PT THER ACTIVITY EA 15MIN	$49.44	$103.00	$59.74–$82.40	—	52%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 HC PHLEBOTOMY THERPAPEUTIC	$186.72	$389.00	$77.80–$13,145.00	3% below	52%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 HC THERAPEUTIC PHLEBOTOMY	$186.72	$389.00	$77.80–$13,145.00	3% below	52%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 HC THERAPEUTIC PHLEBOTOMY	$186.72	$389.00	$225.62–$311.20	—	52%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 HC PHLEBOTOMY THERPAPEUTIC	$186.72	$389.00	$225.62–$311.20	—	52%

Vaccines

Procedure	Cash price	List price	Insurers pay	vs Nebraska	Off list
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	$52.32	$109.00	$21.80–$197.04	34% below	52%
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	$52.32	$109.00	$23.98–$87.20	—	52%
COVID-19 vaccine (Pfizer-BioNTech), age 12 and older CPT 91320 COVID VACC 2025-2026 (12 YRS UP) (PFIZER)(PF) 30 MCG/0.3 ML IM SYRINGE	$219.99	$458.30	$91.66–$389.56	5% above	52%
COVID-19 vaccine (Pfizer-BioNTech), age 12 and older inpatient CPT 91320 COVID VACC 2025-2026 (12 YRS UP) (PFIZER)(PF) 30 MCG/0.3 ML IM SYRINGE	$219.99	$458.30	$265.82–$366.64	—	52%
Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 VARICELLA VIRUS VACCINE LIVE (PF) 1350 UNIT/0.5 ML SUBCUTANEOUS SUSP	$227.57	$474.10	$64.72–$431.88	1% below	52%
Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 VARICELLA VIRUS VACCINE LIVE (PF) 1350 UNIT/0.5 ML SUBCUTANEOUS SUSP	$227.57	$474.10	$274.98–$379.28	—	52%
DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) CPT 90696 DIPHPERTUS(ACELL)TETPOLIO (PF) 25 LF-58 MCG-10 LF/0.5 ML IM SYRINGE	$119.93	$249.84	$49.97–$212.37	33% above	52%
DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) inpatient CPT 90696 DIPHPERTUS(ACELL)TETPOLIO (PF) 25 LF-58 MCG-10 LF/0.5 ML IM SYRINGE	$119.93	$249.84	$144.91–$199.88	—	52%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 DIPHPERTUS(ACEL)TET PED(PF) 25 LF UNIT-58 MCG-10 LF/0.5ML IM SYRINGE	$55.04	$114.65	$12.80–$97.46	12% above	52%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 DIPHPERTUS(ACEL)TET PEDI (PF) 15 LF UNIT-10 MCG-5 LF/0.5 ML IM SUSP	$70.44	$146.73	$12.80–$124.73	43% above	52%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 inpatient CPT 90700 DIPHPERTUS(ACEL)TET PED(PF) 25 LF UNIT-58 MCG-10 LF/0.5ML IM SYRINGE	$55.04	$114.65	$66.50–$91.72	—	52%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 inpatient CPT 90700 DIPHPERTUS(ACEL)TET PEDI (PF) 15 LF UNIT-10 MCG-5 LF/0.5 ML IM SUSP	$70.44	$146.73	$85.11–$117.39	—	52%
DTaP, hepatitis B and polio combination vaccine (Pediarix) CPT 90723 HEP B-DP(A)T-POLIO VACC (PF) 10 MCG-25LF-25 MCG-10LF/0.5 ML IM SYRINGE	$162.13	$337.76	$67.56–$287.10	12% above	52%
DTaP, hepatitis B and polio combination vaccine (Pediarix) inpatient CPT 90723 HEP B-DP(A)T-POLIO VACC (PF) 10 MCG-25LF-25 MCG-10LF/0.5 ML IM SYRINGE	$162.13	$337.76	$195.91–$270.21	—	52%
DTaP, polio and Hib combination vaccine (Pentacel) CPT 90698 DTAP-IPV COMPONENT 1OF2(PF) 15 LF-48MCG-5 LF-62 DU/0.5ML IM SUSPENSION	$47.76	$99.50	$19.90–$292.31	41% below	52%
DTaP, polio and Hib combination vaccine (Pentacel) inpatient CPT 90698 DTAP-IPV COMPONENT 1OF2(PF) 15 LF-48MCG-5 LF-62 DU/0.5ML IM SUSPENSION	$47.76	$99.50	$57.71–$79.60	—	52%
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	$23.52	$49.00	$9.80–$52.75	26% below	52%
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	$23.52	$49.00	$10.78–$39.20	—	52%
Hepatitis A vaccine, adult dose CPT 90632 HEPATITIS A VIRUS VACCINE (PF) 720 ELISA UNIT/0.5 ML IM SYRINGE	$70.01	$145.84	$29.17–$169.00	27% below	52%
Hepatitis A vaccine, adult dose CPT 90632 HEPATITIS A VACCINE (PF) 1440 ELISA UNIT/ML INTRAMUSCULAR SYRINGE	$169.86	$353.87	$60.02–$300.79	76% above	52%
Hepatitis A vaccine, adult dose inpatient CPT 90632 HEPATITIS A VIRUS VACCINE (PF) 720 ELISA UNIT/0.5 ML IM SYRINGE	$70.01	$145.84	$84.59–$116.68	—	52%
Hepatitis A vaccine, adult dose inpatient CPT 90632 HEPATITIS A VACCINE (PF) 1440 ELISA UNIT/ML INTRAMUSCULAR SYRINGE	$169.86	$353.87	$205.25–$283.10	—	52%
Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 HEPATITIS A VIRUS VACCINE (PF) 25 UNIT/0.5 ML INTRAMUSCULAR SYRINGE	$69.05	$143.85	$17.35–$122.28	37% above	52%
Hepatitis A vaccine, child and teen dose (2-dose schedule) inpatient CPT 90633 HEPATITIS A VIRUS VACCINE (PF) 25 UNIT/0.5 ML INTRAMUSCULAR SYRINGE	$69.05	$143.85	$83.44–$115.08	—	52%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 HEPATITIS B VIRUS VACCINE RECOMB (PF) 10 MCG/ML INTRAMUSCULAR SUSP	$92.84	$193.40	$38.68–$166.10	4% below	52%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 HEPATITIS B VIRUS VACCINE RECOMB (PF) 20 MCG/ML INTRAMUSCULAR SUSP	$113.73	$236.93	$47.39–$201.40	17% above	52%
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 HEPATITIS B VIRUS VACCINE RECOMB (PF) 10 MCG/ML INTRAMUSCULAR SUSP	$92.84	$193.40	$42.55–$154.72	—	52%
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 HEPATITIS B VIRUS VACCINE RECOMB (PF) 20 MCG/ML INTRAMUSCULAR SUSP	$113.73	$236.93	$52.13–$189.55	—	52%
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	$48.77	$101.60	$20.32–$86.36	8% below	52%
Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 HEPATITIS B VIRUS VACCINE RECOMB (PF) 10 MCG/ML INTRAMUSCULAR SYRINGE	$92.84	$193.40	$26.33–$164.39	75% above	52%
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	$48.77	$101.60	$22.36–$81.28	—	52%
Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 HEPATITIS B VIRUS VACCINE RECOMB (PF) 10 MCG/ML INTRAMUSCULAR SYRINGE	$92.84	$193.40	$42.55–$154.72	—	52%
Hib vaccine (Haemophilus influenzae type b), 3-dose schedule (PedvaxHIB) CPT 90647 HAEMOPH B POLYSAC CONJ-MENING (PF) 7.5 MCG/0.5 ML INTRAMUSCULAR SOLN	$69.40	$144.58	$17.56–$122.90	11% above	52%
Hib vaccine (Haemophilus influenzae type b), 3-dose schedule (PedvaxHIB) inpatient CPT 90647 HAEMOPH B POLYSAC CONJ-MENING (PF) 7.5 MCG/0.5 ML INTRAMUSCULAR SOLN	$69.40	$144.58	$83.86–$115.67	—	52%
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	$135.45	$282.18	$18.55–$239.86	156% above	52%
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	$135.45	$282.18	$163.67–$225.75	—	52%
MMR vaccine (measles, mumps and rubella), live CPT 90707 MEASLESMUMPSRUBELLA VACCINE LIVE(PF)1000-12500TCID50/0.5 ML SUBCUT	$211.62	$440.86	$37.30–$374.74	12% above	52%
MMR vaccine (measles, mumps and rubella), live CPT 90707 RSVPREF3 ANTIGEN-AS01E ADJUVANT(PF) 120 MCG/0.5 ML IM SUSPENSION KIT	$574.14	$1,196.12	$37.30–$1,016.71	205% above	52%
MMR vaccine (measles, mumps and rubella), live CPT 90707 RESP SYNCYTIAL VIRUS VAC PREF A AND B (PF) 120 MCG/0.5 ML IM SOLUTION	$710.55	$1,480.30	$37.30–$1,258.26	277% above	52%
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 MEASLESMUMPSRUBELLA VACCINE LIVE(PF)1000-12500TCID50/0.5 ML SUBCUT	$211.62	$440.86	$255.70–$352.69	—	52%
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 RSVPREF3 ANTIGEN-AS01E ADJUVANT(PF) 120 MCG/0.5 ML IM SUSPENSION KIT	$574.14	$1,196.12	$693.75–$956.90	—	52%
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 RESP SYNCYTIAL VIRUS VAC PREF A AND B (PF) 120 MCG/0.5 ML IM SOLUTION	$710.55	$1,480.30	$858.58–$1,184.24	—	52%
MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) CPT 90710 MEASLESMUMPSRUBELVARICEL LIV(PF)10E3-4.3-3-3.99TCID50/0.5 ML SUBCUT	$384.48	$800.98	$160.20–$680.84	8% above	52%
MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) inpatient CPT 90710 MEASLESMUMPSRUBELVARICEL LIV(PF)10E3-4.3-3-3.99TCID50/0.5 ML SUBCUT	$384.48	$800.98	$464.57–$640.79	—	52%
Meningococcal ACWY (MenACWY) vaccine CPT 90734 MENINGOC VAC ACYW-135 DIP(PF) 10 MCG-5 MCG/0.5 ML IM KIT (2 VIALS)	$270.76	$564.08	$112.82–$479.47	12% above	52%
Meningococcal ACWY (MenACWY) vaccine CPT 90734 MENINGOC VAC ACYW-135 DIP (PF) 4 MCG/0.5 ML INTRAMUSCULAR SOLUTION	$300.96	$626.99	$125.40–$532.95	24% above	52%
Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 MENINGOC VAC ACYW-135 DIP(PF) 10 MCG-5 MCG/0.5 ML IM KIT (2 VIALS)	$270.76	$564.08	$327.17–$451.27	—	52%
Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 MENINGOC VAC ACYW-135 DIP (PF) 4 MCG/0.5 ML INTRAMUSCULAR SOLUTION	$300.96	$626.99	$363.66–$501.60	—	52%
Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 MENINGOCOCCAL B VAC4-CMP 50 MCG-50 MCG-50 MCG-25 MCG/0.5ML IM SYRINGE	$362.87	$755.96	$151.20–$642.57	12% above	52%
Meningococcal B vaccine (Bexsero), 2-dose schedule inpatient CPT 90620 MENINGOCOCCAL B VAC4-CMP 50 MCG-50 MCG-50 MCG-25 MCG/0.5ML IM SYRINGE	$362.87	$755.96	$438.46–$604.77	—	52%
Mpox and smallpox vaccine (Jynneos), 2-dose schedule CPT 90611 SMALLPOXMPOX LIVE VACCINE(PF) 0.5X TO 3.95X 10EXP8/0.5 ML IDRM SUSP	$130.75	$272.38	$54.48–$231.53	14% below	52%
Mpox and smallpox vaccine (Jynneos), 2-dose schedule inpatient CPT 90611 SMALLPOXMPOX LIVE VACCINE(PF) 0.5X TO 3.95X 10EXP8/0.5 ML IDRM SUSP	$130.75	$272.38	$157.99–$217.91	—	52%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 PNEUMOCOCCAL 20-VALENT CONJ VACCINE-DIP CRM (PF) 0.5 ML IM SYRINGE	$544.08	$1,133.48	$226.70–$963.46	12% above	52%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 PNEUMOCOCCAL 20-VALENT CONJ VACCINE-DIP CRM (PF) 0.5 ML IM SYRINGE	$544.08	$1,133.48	$657.42–$906.79	—	52%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PNEUMOCOCCAL 23 POLYVALENT VACCINE 25 MCG/0.5 ML INJECTION SYRINGE	$244.05	$508.43	$101.69–$432.17	12% above	52%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 PNEUMOCOCCAL 23 POLYVALENT VACCINE 25 MCG/0.5 ML INJECTION SYRINGE	$244.05	$508.43	$111.86–$406.75	—	52%
Polio vaccine, inactivated (IPV) CPT 90713 POLIOVIRUS VACCINE 40 UNIT-8 UNIT-32 UNIT/0.5 ML INJECTION SUSPENSION	$1,103.72	$2,299.40	$22.30–$1,954.49	1352% above	52%
Polio vaccine, inactivated (IPV) inpatient CPT 90713 POLIOVIRUS VACCINE 40 UNIT-8 UNIT-32 UNIT/0.5 ML INJECTION SUSPENSION	$1,103.72	$2,299.40	$1,333.66–$1,839.52	—	52%
RSV antibody shot for infants and toddlers, larger dose (1 mL, 100 mg) CPT 90381 NIRSEVIMAB-ALIP 100 MG/ML INTRAMUSCULAR SYRINGE	$1,075.19	$2,239.97	$448.00–$1,903.98	12% above	52%
RSV antibody shot for infants and toddlers, larger dose (1 mL, 100 mg) inpatient CPT 90381 NIRSEVIMAB-ALIP 100 MG/ML INTRAMUSCULAR SYRINGE	$1,075.19	$2,239.97	$1,299.19–$1,791.98	—	52%
RSV antibody shot for infants, seasonal dose (0.5 mL) CPT 90380 NIRSEVIMAB-ALIP 50 MG/0.5 ML INTRAMUSCULAR SYRINGE	$1,075.19	$2,239.97	$448.00–$1,903.98	12% above	52%
RSV antibody shot for infants, seasonal dose (0.5 mL) inpatient CPT 90380 NIRSEVIMAB-ALIP 50 MG/0.5 ML INTRAMUSCULAR SYRINGE	$1,075.19	$2,239.97	$1,299.19–$1,791.98	—	52%
Rabies vaccine, one dose CPT 90675 RABIES VACCINE PURIFIED CHICKEN EMBRYO CELL (PF) 2.5 UNIT IM SUSP	$956.24	$1,992.15	$263.08–$1,693.33	31% above	52%
Rabies vaccine, one dose CPT 90675 RABIES VACCINEHUMAN DIPLOID (PF) 2.5 UNIT INTRAMUSCULAR SOLUTION	$1,043.52	$2,174.00	$263.08–$1,847.90	42% above	52%
Rabies vaccine, one dose inpatient CPT 90675 RABIES VACCINE PURIFIED CHICKEN EMBRYO CELL (PF) 2.5 UNIT IM SUSP	$956.24	$1,992.15	$1,155.45–$1,593.72	—	52%
Rabies vaccine, one dose inpatient CPT 90675 RABIES VACCINEHUMAN DIPLOID (PF) 2.5 UNIT INTRAMUSCULAR SOLUTION	$1,043.52	$2,174.00	$1,260.92–$1,739.20	—	52%
Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) CPT 90680 ROTAVIRUS VACCINE LIVE PENTAVALENT 2 ML ORAL SOLUTION	$202.58	$422.04	$84.41–$358.74	70% above	52%
Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) inpatient CPT 90680 ROTAVIRUS VACCINE LIVE PENTAVALENT 2 ML ORAL SOLUTION	$202.58	$422.04	$244.79–$337.64	—	52%
Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 VARICELLA-ZOSTER GLYCOE VACC-AS01B ADJ(PF) 50 MCG/0.5 ML IM SUSP KIT	$343.97	$716.60	$143.32–$609.11	8% above	52%
Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 VARICELLA-ZOSTER GLYCOE VACCINE-AS01B ADJ(PF) 50 MCG/0.5 ML IM SYRINGE	$481.41	$1,002.93	$200.59–$852.50	51% above	52%
Shingles vaccine (Shingrix), recombinant, one dose inpatient CPT 90750 VARICELLA-ZOSTER GLYCOE VACC-AS01B ADJ(PF) 50 MCG/0.5 ML IM SUSP KIT	$343.97	$716.60	$415.63–$573.28	—	52%
Shingles vaccine (Shingrix), recombinant, one dose inpatient CPT 90750 VARICELLA-ZOSTER GLYCOE VACCINE-AS01B ADJ(PF) 50 MCG/0.5 ML IM SYRINGE	$481.41	$1,002.93	$581.70–$802.35	—	52%
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 SYRINGE	$51.65	$107.59	$21.52–$91.46	14% below	52%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TETANUS-DIPHTHERIA TOXOIDS-TD 2 LF UNIT-2 LF UNIT/0.5 ML IM SUSPENSION	$52.22	$108.78	$21.76–$92.47	14% below	52%
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 SUSP	$101.72	$211.91	$32.23–$180.13	68% above	52%
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 SYRINGE	$51.65	$107.59	$62.41–$86.08	—	52%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 TETANUS-DIPHTHERIA TOXOIDS-TD 2 LF UNIT-2 LF UNIT/0.5 ML IM SUSPENSION	$52.22	$108.78	$63.10–$87.03	—	52%
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 SUSP	$101.72	$211.91	$122.91–$169.53	—	52%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 DIPHTHPERTUSSIS(ACEL)TETANUS 2.5 LF UNIT-8 MCG-5 LF/0.5ML IM SYRINGE	$90.92	$189.41	$31.93–$161.00	12% above	52%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 DIPHTHPERTUS(ACEL)TETANUS(PF)2LF-(2.5-5-3-5MCG)-5 LF/0.5 ML IM SUSP	$117.25	$244.27	$31.93–$207.63	44% above	52%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 DIPHTHPERTUS(AC)TETANUS(PF)2 LF-(2.5-5-3-5MCG)-5 LF/0.5 ML IM SYRINGE	$117.25	$244.26	$31.93–$207.63	44% above	52%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 DIPHTHPERTUSSIS(ACEL)TETANUS 2.5 LF UNIT-8 MCG-5 LF/0.5ML IM SYRINGE	$90.92	$189.41	$109.86–$151.53	—	52%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 DIPHTHPERTUS(ACEL)TETANUS(PF)2LF-(2.5-5-3-5MCG)-5 LF/0.5 ML IM SUSP	$117.25	$244.27	$141.68–$195.42	—	52%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 DIPHTHPERTUS(AC)TETANUS(PF)2 LF-(2.5-5-3-5MCG)-5 LF/0.5 ML IM SYRINGE	$117.25	$244.26	$141.68–$195.41	—	52%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 HC ADMIN INFLUENZA VACC	$73.44	$153.00	$16.17–$168.96	67% above	52%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 HC ADMIN INFLUENZA VACC	$73.44	$153.00	$88.74–$122.40	—	52%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 HC IMMUNIZATION ADMIN EACH ADDTL	$60.96	$127.00	$25.40–$107.95	83% above	52%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 HC IMMUNIZATION ADMIN EACH ADDTL	$60.96	$127.00	$73.66–$101.60	—	52%

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://www.chihealth.com/content/dam/chihealthcom/documents/patients-and-visitors/financial-assistance/price-transparency-standard-charges/470379836-1336155738_saint-elizabeth-regional-medical-center_standardcharges.json