Compare real prices at The Heart Hospital Baylor Plano in Denton, TX. Taven tracks 419 procedures at this hospital using data from their publicly filed transparency report. Last updated March 2026.
📊
419
Procedures Tracked
with pricing data
💰
5.9x
Markup Ratio
Avg = 3.0x
🏥
Grade C
Data Quality
Moderate data coverage
✓
CMS v3.0 Compliant
This hospital's pricing data meets the latest CMS v3.0 requirements, including actual allowed amounts from insurer remittance data.
Attested by: MARK VALENTINEOrg NPI: 1194753590
🔒 De-identification Notice: All pricing data shown on this page is derived from publicly available hospital machine-readable files and insurer transparency data as mandated by federal law. No individual patient data, protected health information (PHI), or personally identifiable information is collected, stored, or displayed. Aggregate statistics (such as allowed amount medians and percentiles) are calculated from de-identified claim payment data reported by hospitals per CMS requirements.
🔍
Had a procedure at The Heart Hospital Baylor Plano?
Get your bill reviewed for free — AI catches billing errors that save patients an average of $1,000+
Procedure Prices at The Heart Hospital Baylor Plano
419 procedures with pricing data. Prices reflect negotiated rates across insurance payers compared to the Dallas, TX metro average. Includes actual allowed amounts from insurer remittance data (CMS v3.0).
Last updated: March 26, 2026
| Procedure | Cash Price | Avg Negotiated | Median Allowed | Range (10th–90th) | Dallas Avg | vs. Avg | Payers |
|---|---|---|---|---|---|---|---|
| Skin Biopsy (Punch, Single Lesion) CPT 11104 Skin punch biopsy — removal of a small, full-thickness circular sample of skin for laboratory analysis to diagnose skin conditions. |
— | $131 | $131 | $50–$211 | $315 | -59% | 1 |
| Skin Graft Preparation CPT 15002 Skin Graft Preparation — CPT code 15002 covers skin graft preparation performed in a clinical or hospital setting. |
— | $50 | $50 | $50–$50 | $1,374 | -96% | 1 |
| Skin Substitute Graft (≤25 sq cm) CPT 15271 Skin Substitute Graft (≤25 sq cm) — CPT code 15271 covers skin substitute graft (≤25 sq cm) performed in a clinical or hospital setting. |
— | $1,964 | $1,964 | $50–$3,878 | $1,552 | +27% | 1 |
| Skin Substitute Graft (≤100 sq cm) CPT 15275 Skin Substitute Graft (≤100 sq cm) — CPT code 15275 covers skin substitute graft (≤100 sq cm) performed in a clinical or hospital setting. |
— | $1,964 | $1,964 | $50–$3,878 | $1,545 | +27% | 1 |
| Destruction of Premalignant Lesion (First) CPT 17000 Destruction of precancerous skin lesion — removal of a precancerous growth (actinic keratosis) using freezing, chemicals, or other methods. |
— | $418 | $418 | $418–$418 | $344 | +21% | 1 |
| Breast Excision CPT 19120 Surgical removal of a breast lump or abnormal tissue. This procedure removes a specific area of concern while preserving as much healthy breast tissue as possible. |
— | $50 | $50 | $50–$50 | $2,018 | -98% | 1 |
| Joint Injection (small joint) CPT 20600 Small joint injection — injection of medication into a small joint like a finger or toe to reduce pain and inflammation. |
— | $50 | $50 | $50–$50 | $284 | -82% | 1 |
| Joint Injection (medium joint) CPT 20605 Medium joint injection — injection of medication into a medium-sized joint like the elbow, wrist, or ankle to reduce pain and inflammation. |
— | $56 | $56 | $50–$62 | $268 | -79% | 1 |
| Le Fort I Osteotomy CPT 21141 Le Fort I Osteotomy — CPT code 21141 covers le fort i osteotomy performed in a clinical or hospital setting. |
— | $50 | $50 | $50–$50 | $2,462 | -98% | 1 |
| Lumbar Spinal Fusion (Posterior) CPT 22612 Lumbar spinal fusion (lower back) — surgery to permanently join two vertebrae in the lower spine to treat conditions like degenerative disc disease or spondylolisthesis. |
— | $14,246 | $14,246 | $50–$28,443 | $12,155 | +17% | 1 |
| Trigger Finger Release CPT 26055 Trigger finger release — a procedure to free a finger tendon that has become stuck, causing the finger to catch or lock when bending. |
— | $1,645 | $1,645 | $50–$3,239 | $1,480 | +11% | 1 |
| Total Hip Replacement CPT 27130 Total hip replacement surgery where the damaged hip joint is replaced with an artificial implant to relieve pain and improve mobility. |
— | $14,246 | $14,246 | $50–$28,443 | $11,729 | +21% | 1 |
| Knee Realignment Osteotomy CPT 27477 Surgical reshaping of the leg bones around the knee to redistribute weight and relieve pain, typically used for patients with arthritis affecting one side of the knee. |
— | $14,297 | $14,297 | $14,297–$14,297 | $6,288 | +127% | 1 |
| Bunionectomy with Metatarsal Osteotomy CPT 28296 Surgical correction of a bunion (hallux valgus) that includes cutting and realigning the metatarsal bone to straighten the big toe and relieve pain. |
— | $6,543 | $6,543 | $6,543–$6,543 | $4,374 | +50% | 1 |
| Arthroscopic Rotator Cuff Repair CPT 29827 Arthroscopic repair of a torn rotator cuff — the group of tendons that stabilize the shoulder. The surgeon reattaches the torn tendon to the bone using small anchors. |
— | $7,173 | $7,173 | $50–$14,297 | $5,642 | +27% | 1 |
| Knee Arthroscopy Medial & Lateral CPT 29880 Arthroscopic knee surgery to treat torn meniscus cartilage on both the inner and outer sides of the knee. Uses a small camera and tools to trim or repair the damaged cartilage. |
— | $3,296 | $3,296 | $50–$6,543 | $2,873 | +15% | 1 |
| Septoplasty (Deviated Septum Repair) CPT 30520 Septoplasty (Deviated Septum Repair) — CPT code 30520 covers septoplasty (deviated septum repair) performed in a clinical or hospital setting. |
— | $3,155 | $3,155 | $50–$6,260 | $4,323 | -27% | 1 |
| Ethmoidectomy - Partial CPT 31254 Ethmoidectomy - Partial — CPT code 31254 covers ethmoidectomy - partial performed in a clinical or hospital setting. |
— | $6,526 | $6,526 | $50–$13,002 | $4,442 | +47% | 1 |
| Sinus Surgery - Frontal CPT 31276 Sinus Surgery - Frontal — CPT code 31276 covers sinus surgery - frontal performed in a clinical or hospital setting. |
— | $13,002 | $13,002 | $13,002–$13,002 | $6,751 | +93% | 1 |
| Venipuncture (blood draw) CPT 36415 A routine blood draw where a needle is inserted into a vein (usually in the arm) to collect blood for laboratory testing. |
$24 | $26 | — | — | $29 | -12% | 2 |
| Central Venous Access - Jugular CPT 36573 Insertion of a central venous catheter into the jugular vein (in the neck) for direct access to the central bloodstream for medications or monitoring. |
— | $1,974 | $1,974 | $50–$3,898 | $1,770 | +12% | 1 |
| Upper Endoscopy with Dilation CPT 43249 Upper endoscopy with dilation — a flexible scope is used to stretch a narrowed area of the esophagus or stomach to improve swallowing. |
— | $1,886 | $1,886 | $50–$3,722 | $1,619 | +16% | 1 |
| Upper GI Endoscopy with Band Ligation CPT 43270 Upper GI Endoscopy with Band Ligation — CPT code 43270 covers upper gi endoscopy with band ligation performed in a clinical or hospital setting. |
— | $50 | $50 | $50–$50 | $1,395 | -96% | 1 |
| Laparoscopic Hiatal Hernia Repair CPT 43282 Laparoscopic Hiatal Hernia Repair — CPT code 43282 covers laparoscopic hiatal hernia repair performed in a clinical or hospital setting. |
— | $20,107 | $20,107 | $20,107–$20,107 | $11,938 | +68% | 1 |
| Gastric Bypass - Open CPT 43846 Gastric Bypass - Open — CPT code 43846 covers gastric bypass - open performed in a clinical or hospital setting. |
— | $2,050 | $2,050 | $50–$4,049 | $3,245 | -37% | 1 |
| Laparoscopic Small Bowel Enterostomy CPT 44180 Laparoscopic Small Bowel Enterostomy — CPT code 44180 covers laparoscopic small bowel enterostomy performed in a clinical or hospital setting. |
— | $50 | $50 | $50–$50 | $3,536 | -99% | 1 |
| Colonoscopy (diagnostic) CPT 45378 Diagnostic colonoscopy — a flexible tube with a camera is inserted through the rectum to examine the entire large intestine for polyps, cancer, or other abnormalities. |
$2,513 | $938 | $938 | $50–$1,826 | $1,919 | -51% | 1 |
| Colonoscopy with Biopsy CPT 45380 Colonoscopy with biopsy — examination of the large intestine with a camera, during which tissue samples are taken from suspicious areas for laboratory analysis. |
— | $1,225 | $1,225 | $50–$2,400 | $1,946 | -37% | 1 |
| Colonoscopy with Polyp Removal CPT 45385 Colonoscopy with polyp removal — examination of the large intestine during which precancerous growths (polyps) are found and removed to prevent colon cancer. |
— | $1,225 | $1,225 | $50–$2,400 | $1,149 | +7% | 1 |
| Gallbladder Removal (Laparoscopic) CPT 47562 Minimally invasive removal of the gallbladder (laparoscopic cholecystectomy). Small incisions and a camera are used to remove the gallbladder, typically for gallstones or inflammation. |
— | $11,553 | $11,553 | $11,553–$11,553 | $6,981 | +65% | 1 |
| Gallbladder Removal with Cholangiography CPT 47563 Laparoscopic gallbladder removal with X-ray imaging of the bile ducts (cholangiography) to check for gallstones in the ducts during surgery. |
— | $5,801 | $5,801 | $50–$11,553 | $7,364 | -21% | 1 |
| Lithotripsy (Kidney Stone Treatment) CPT 50590 Lithotripsy — shock waves are used to break kidney stones into small pieces that can pass naturally through the urinary tract. |
$3,600 | $4,200 | — | — | $5,174 | -19% | 1 |
| Robotic Prostatectomy CPT 55866 Robotic Prostatectomy — CPT code 55866 covers robotic prostatectomy performed in a clinical or hospital setting. |
— | $50 | $50 | $50–$50 | $5,596 | -99% | 1 |
| Colposcopy with Biopsy (Cervical) CPT 57454 Colposcopy with Biopsy (Cervical) — CPT code 57454 covers colposcopy with biopsy (cervical) performed in a clinical or hospital setting. |
— | $50 | $50 | $50–$50 | $317 | -84% | 1 |
| Endometrial Biopsy CPT 58100 Endometrial Biopsy — CPT code 58100 covers endometrial biopsy performed in a clinical or hospital setting. |
— | $85 | $85 | $50–$121 | $238 | -64% | 1 |
| IUD Insertion CPT 58300 IUD Insertion — CPT code 58300 covers iud insertion performed in a clinical or hospital setting. |
— | $91 | $91 | $50–$133 | $254 | -64% | 1 |
| Laparoscopic Ovarian Cyst/Adnexal Removal CPT 58661 Laparoscopic removal of the uterus (hysterectomy) — minimally invasive surgery using small incisions and a camera to remove the uterus. |
— | $5,801 | $5,801 | $50–$11,553 | $7,639 | -24% | 1 |
| Fetal Non-Stress Test CPT 59025 Fetal non-stress test — monitoring the baby's heart rate in response to its own movements to assess fetal wellbeing. |
— | $65 | $65 | $65–$65 | $225 | -71% | 1 |
| C-Section Delivery (global) CPT 59510 Routine obstetric care including prenatal visits, cesarean delivery, and postpartum care — comprehensive maternity care package with C-section. |
— | $5,771 | $5,771 | $5,771–$5,771 | $3,421 | +69% | 1 |
| Lumbar Laminectomy (Single Level) CPT 63047 Lumbar laminectomy — surgical removal of the bony arch (lamina) of a vertebra in the lower back to create more space for the spinal cord and nerves. |
— | $7,173 | $7,173 | $50–$14,297 | $6,378 | +12% | 1 |
| Facet Joint Destruction - Lumbar CPT 64635 Facet Joint Destruction - Lumbar — CPT code 64635 covers facet joint destruction - lumbar performed in a clinical or hospital setting. |
— | $2,080 | $2,080 | $50–$4,109 | $1,926 | +8% | 1 |
| Glaucoma Filter Surgery CPT 66170 Glaucoma Filter Surgery — CPT code 66170 covers glaucoma filter surgery performed in a clinical or hospital setting. |
— | $2,441 | $2,441 | $50–$4,832 | $2,184 | +12% | 1 |
| Complex Cataract Surgery CPT 66982 CT scan — complex cataract surgery. This imaging test uses X-rays and a computer to create detailed cross-sectional images of the body. |
— | $2,441 | $2,441 | $50–$4,832 | $1,877 | +30% | 1 |
| Tear Duct Probing CPT 68810 CT scan — tear duct probing. This imaging test uses X-rays and a computer to create detailed cross-sectional images of the body. |
— | $50 | $50 | $50–$50 | $341 | -85% | 1 |
| MRI Brain with/without Contrast CPT 70553 MRI of the brain with and without contrast dye — detailed imaging of the brain using magnetic fields and radio waves to diagnose tumors, stroke, or other conditions. |
$4,007 | $2,805 | — | — | $1,778 | +58% | 1 |
| Chest X-Ray (single view) CPT 71045 X-ray imaging — chest x-ray (single view). A quick imaging test using small amounts of radiation to create pictures of bones and internal structures. |
— | $332 | $332 | $305–$359 | $201 | +65% | 1 |
| Chest X-Ray (2 views) CPT 71046 Chest X-ray, two views — standard imaging of the lungs and chest from front and side to evaluate for pneumonia, heart problems, or other chest conditions. |
— | $296 | $305 | $226–$359 | $228 | +30% | 2 |
| CT Chest with Contrast CPT 71260 CT scan of the chest with contrast — detailed cross-sectional imaging of the chest after injecting contrast dye to better visualize blood vessels and tissues. |
$1,603 | $1,870 | — | — | $1,169 | +60% | 1 |
| Lumbar Spine X-Ray CPT 72100 X-ray imaging — lumbar spine x-ray. A quick imaging test using small amounts of radiation to create pictures of bones and internal structures. |
— | $408 | $408 | $375–$441 | $244 | +67% | 1 |
| MRI Lumbar Spine without Contrast CPT 72148 MRI of the lumbar spine (lower back) without contrast — detailed imaging of the lower spine to evaluate for herniated discs, spinal stenosis, or nerve compression. |
$1,672 | $1,951 | — | — | $1,381 | +41% | 1 |
| Shoulder X-Ray CPT 73030 X-ray imaging — shoulder x-ray. A quick imaging test using small amounts of radiation to create pictures of bones and internal structures. |
— | $332 | $332 | $305–$359 | $194 | +71% | 1 |
| Hand X-Ray CPT 73130 X-ray imaging — hand x-ray. A quick imaging test using small amounts of radiation to create pictures of bones and internal structures. |
— | $332 | $332 | $305–$359 | $191 | +74% | 1 |
| Knee X-Ray CPT 73560 X-ray imaging — knee x-ray. A quick imaging test using small amounts of radiation to create pictures of bones and internal structures. |
— | $332 | $332 | $305–$359 | $186 | +78% | 1 |
| Ankle X-Ray CPT 73610 X-ray imaging — ankle x-ray. A quick imaging test using small amounts of radiation to create pictures of bones and internal structures. |
— | $332 | $332 | $305–$359 | $190 | +75% | 1 |
| CT Abdomen/Pelvis without Contrast CPT 74176 CT scan of the abdomen and pelvis without contrast followed by with contrast — complete imaging study of the abdomen and pelvis. |
— | $1,081 | $1,081 | $1,081–$1,081 | $1,078 | avg | 1 |
| CT Abdomen/Pelvis with Contrast CPT 74177 CT scan of the abdomen and pelvis with contrast — comprehensive cross-sectional imaging of the abdominal and pelvic organs after contrast injection. |
$5,187 | $3,631 | — | — | $2,319 | +57% | 1 |
| Breast Ultrasound CPT 76642 Ultrasound — breast ultrasound. This imaging test uses sound waves to create pictures of organs and structures inside the body. |
— | $332 | $332 | $305–$359 | $242 | +37% | 1 |
| Abdominal Ultrasound CPT 76700 Abdominal ultrasound — uses sound waves to create images of organs in the abdomen including the liver, gallbladder, kidneys, and pancreas. |
— | $408 | $408 | $375–$441 | $313 | +30% | 1 |
| OB Ultrasound (first trimester) CPT 76801 Ultrasound — ob ultrasound (first trimester). This imaging test uses sound waves to create pictures of organs and structures inside the body. |
— | $408 | $408 | $375–$441 | $308 | +32% | 1 |
| OB Ultrasound (complete) CPT 76805 Ultrasound — ob ultrasound (complete). This imaging test uses sound waves to create pictures of organs and structures inside the body. |
— | $408 | $408 | $375–$441 | $309 | +32% | 1 |
| Transvaginal Ultrasound CPT 76830 Transvaginal ultrasound — an ultrasound probe is placed internally to obtain detailed images of the uterus, ovaries, and pelvic structures. |
— | $408 | $408 | $375–$441 | $321 | +27% | 1 |
| Pelvic Ultrasound CPT 76856 Pelvic ultrasound — uses sound waves to examine the uterus, ovaries, bladder, and other pelvic organs. |
— | $408 | $408 | $375–$441 | $284 | +44% | 1 |
| 3D Mammography (Tomosynthesis) CPT 77063 3D Mammography (Tomosynthesis) — CPT code 77063 covers 3d mammography (tomosynthesis) performed in a clinical or hospital setting. |
— | $98 | $98 | $90–$105 | $92 | +6% | 1 |
| Diagnostic Mammogram (unilateral) CPT 77065 Screening mammogram of one breast — X-ray imaging of one breast to check for early signs of breast cancer. |
— | $325 | $326 | $266–$383 | $233 | +39% | 2 |
| Diagnostic Mammogram (bilateral) CPT 77066 Screening mammogram of both breasts — routine X-ray imaging of both breasts to detect early breast cancer in women without symptoms. |
— | $452 | $452 | $415–$489 | $316 | +43% | 1 |
| Screening Mammogram (bilateral) CPT 77067 Screening mammogram of both breasts including computer-aided detection — enhanced breast X-ray with software assistance for improved cancer detection. |
$303 | $194 | — | — | $205 | -5% | 2 |
| Nuclear Stress Test (SPECT MPI) CPT 78452 Myocardial perfusion imaging (stress test with nuclear imaging) — evaluates blood flow to the heart muscle during rest and stress to detect blocked arteries. |
— | $5,068 | $5,068 | $4,657–$5,478 | $2,932 | +73% | 1 |
| BMP (Basic Metabolic Panel) CPT 80048 Basic metabolic panel — a blood test measuring 8 substances (glucose, calcium, sodium, potassium, CO2, chloride, BUN, creatinine) to assess kidney function, blood sugar, and electrolyte balance. |
— | $22 | $22 | $20–$23 | $22 | -2% | 1 |
| CMP (Comprehensive Metabolic Panel) CPT 80053 Comprehensive metabolic panel — a blood test measuring 14 substances to evaluate kidney and liver function, blood sugar, electrolytes, and protein levels. |
$187 | $199 | — | — | $130 | +53% | 2 |
| Lipid Panel CPT 80061 Lipid panel — a blood test measuring cholesterol levels including total cholesterol, HDL ("good"), LDL ("bad"), and triglycerides to assess heart disease risk. |
— | $38 | $37 | $31–$46 | $31 | +23% | 2 |
| Hepatic Function Panel CPT 80076 Hepatic Function Panel — CPT code 80076 covers hepatic function panel performed in a clinical or hospital setting. |
— | $21 | $21 | $19–$23 | $23 | -9% | 1 |
| Urinalysis with Microscopy CPT 81001 Urinalysis with microscopy — a urine test that examines the physical, chemical, and microscopic properties of urine to detect infections, kidney disease, or other conditions. |
— | $8 | $8 | $7–$9 | $10 | -19% | 1 |
| Urinalysis (automated) CPT 81003 Urinalysis (automated) — CPT code 81003 covers urinalysis (automated) performed in a clinical or hospital setting. |
— | $6 | $6 | $5–$8 | $8 | -20% | 2 |
| Vitamin D Level CPT 82306 Vitamin D blood test — measures the level of vitamin D in your blood to check for deficiency. |
— | $85 | $82 | $69–$102 | $67 | +26% | 2 |
| Urine Creatinine CPT 82570 Urine Creatinine — CPT code 82570 covers urine creatinine performed in a clinical or hospital setting. |
— | $13 | $13 | $12–$14 | $13 | +2% | 1 |
| Ferritin Level CPT 82728 Ferritin Level — CPT code 82728 covers ferritin level performed in a clinical or hospital setting. |
— | $35 | $35 | $32–$38 | $31 | +12% | 1 |
| Glucose (blood sugar) CPT 82947 Blood glucose test — measures the level of sugar in your blood, used to screen for and monitor diabetes. |
— | $11 | $11 | $9–$14 | $10 | +12% | 2 |
| Hemoglobin A1C CPT 83036 Hemoglobin A1c test — a blood test that shows your average blood sugar level over the past 2-3 months, used to diagnose and monitor diabetes. |
— | $25 | $25 | $23–$27 | $22 | +13% | 1 |
| Potassium Level CPT 84132 Potassium Level — CPT code 84132 covers potassium level performed in a clinical or hospital setting. |
— | $12 | $12 | $11–$13 | $11 | +10% | 1 |
| PSA (Prostate) CPT 84153 PSA (Prostate) — CPT code 84153 covers psa (prostate) performed in a clinical or hospital setting. |
— | $47 | $47 | $43–$51 | $39 | +20% | 1 |
| Sodium Level CPT 84295 Sodium Level — CPT code 84295 covers sodium level performed in a clinical or hospital setting. |
— | $12 | $12 | $11–$13 | $12 | +3% | 1 |
| TSH (Thyroid) CPT 84443 Thyroid-stimulating hormone (TSH) test — a blood test to check how well your thyroid gland is working. |
— | $43 | $43 | $39–$46 | $36 | +19% | 1 |
| CBC (Complete Blood Count) CPT 85025 Complete blood count (CBC) with differential — a common blood test that measures red blood cells, white blood cells, platelets, and hemoglobin to evaluate overall health. |
$86 | $91 | — | — | $54 | +69% | 2 |
| PT/INR (Prothrombin Time) CPT 85610 PT/INR (Prothrombin Time) — CPT code 85610 covers pt/inr (prothrombin time) performed in a clinical or hospital setting. |
— | $12 | $12 | $10–$15 | $13 | -6% | 2 |
| TB Skin Test CPT 86580 TB Skin Test — CPT code 86580 covers tb skin test performed in a clinical or hospital setting. |
— | $44 | $28 | $24–$80 | $33 | +33% | 2 |
| Blood Type (ABO) CPT 86900 Blood Type (ABO) — CPT code 86900 covers blood type (abo) performed in a clinical or hospital setting. |
— | $8 | $8 | $7–$8 | $29 | -74% | 1 |
| Chlamydia Test CPT 87491 Chlamydia test — a laboratory test to detect the sexually transmitted infection chlamydia using genetic material from a sample. |
— | $90 | $90 | $82–$97 | $78 | +15% | 1 |
| Gonorrhea Test CPT 87591 Gonorrhea test — a laboratory test to detect the sexually transmitted infection gonorrhea using genetic material from a sample. |
— | $90 | $90 | $82–$97 | $71 | +26% | 1 |
| COVID-19 Test (PCR) CPT 87635 COVID-19 Test (PCR) — CPT code 87635 covers covid-19 test (pcr) performed in a clinical or hospital setting. |
— | $178 | $178 | $178–$178 | $135 | +32% | 1 |
| Flu Test (rapid) CPT 87804 Flu Test (rapid) — CPT code 87804 covers flu test (rapid) performed in a clinical or hospital setting. |
— | $47 | $46 | $39–$57 | $36 | +31% | 2 |
| Pap Smear (ThinPrep) CPT 88175 Pap Smear (ThinPrep) — CPT code 88175 covers pap smear (thinprep) performed in a clinical or hospital setting. |
— | $68 | $68 | $62–$73 | $52 | +31% | 1 |
| Immunization Administration CPT 90471 Immunization Administration — CPT code 90471 covers immunization administration performed in a clinical or hospital setting. |
— | $262 | $262 | $262–$262 | $141 | +86% | 1 |
| Flu Vaccine (high dose) CPT 90662 Flu Vaccine (high dose) — CPT code 90662 covers flu vaccine (high dose) performed in a clinical or hospital setting. |
— | $50 | $50 | $50–$50 | $74 | -32% | 1 |
| Psychiatric Diagnostic Evaluation CPT 90791 Psychiatric Diagnostic Evaluation — CPT code 90791 covers psychiatric diagnostic evaluation performed in a clinical or hospital setting. |
— | $50 | $50 | $50–$50 | $123 | -59% | 1 |
| Group Psychotherapy CPT 90853 Group Psychotherapy — CPT code 90853 covers group psychotherapy performed in a clinical or hospital setting. |
— | $50 | $50 | $50–$50 | $72 | -31% | 1 |
| Coronary Stent Placement CPT 92928 Coronary Stent Placement — CPT code 92928 covers coronary stent placement performed in a clinical or hospital setting. |
$30,896 | $23,310 | $23,310 | $21,420–$25,200 | $12,373 | +88% | 1 |
| EKG (12-lead) CPT 93000 EKG (12-lead) — CPT code 93000 covers ekg (12-lead) performed in a clinical or hospital setting. |
— | $60 | $60 | $60–$60 | $46 | +30% | 1 |
| EKG Interpretation CPT 93010 EKG Interpretation — CPT code 93010 covers ekg interpretation performed in a clinical or hospital setting. |
— | $38 | $38 | $38–$38 | $30 | +25% | 1 |
| Echocardiogram Complete CPT 93306 Echocardiogram Complete — CPT code 93306 covers echocardiogram complete performed in a clinical or hospital setting. |
$4,201 | $2,564 | — | — | $1,684 | +52% | 2 |
| Left Heart Catheterization CPT 93458 Left Heart Catheterization — CPT code 93458 covers left heart catheterization performed in a clinical or hospital setting. |
— | $23,310 | $23,310 | $21,420–$25,200 | $11,347 | +105% | 1 |
| Carotid Ultrasound CPT 93880 Ultrasound — carotid ultrasound. This imaging test uses sound waves to create pictures of organs and structures inside the body. |
— | $832 | $819 | $713–$964 | $563 | +48% | 2 |
| Venous Duplex Scan (legs) CPT 93971 Venous Duplex Scan (legs) — CPT code 93971 covers venous duplex scan (legs) performed in a clinical or hospital setting. |
— | $403 | $375 | $375–$441 | $351 | +15% | 1 |
| IV Push (single drug) CPT 96374 IV push medication — rapid injection of medication directly into a vein or existing IV line. |
— | $172 | $172 | $172–$172 | $150 | +15% | 1 |
| Chemotherapy Infusion (first hour) CPT 96413 Chemotherapy IV infusion, first hour — administration of cancer-fighting medication through an IV line for the initial hour. |
— | $621 | $621 | $621–$621 | $439 | +41% | 1 |
| PT - Ultrasound Therapy CPT 97035 Ultrasound — pt - ultrasound therapy. This imaging test uses sound waves to create pictures of organs and structures inside the body. |
— | $61 | $61 | $61–$61 | $47 | +30% | 1 |
| PT Evaluation - Moderate Complexity CPT 97162 Physical therapy evaluation, moderate complexity — initial assessment by a physical therapist for a condition requiring moderate clinical decision-making. |
— | $375 | $375 | $375–$375 | $249 | +51% | 1 |
| PT Evaluation - High Complexity CPT 97163 Physical therapy evaluation, high complexity — comprehensive initial assessment by a physical therapist for a complex condition. |
— | $375 | $375 | $375–$375 | $226 | +66% | 1 |
| Supplies and Materials CPT 99070 Supplies and Materials — CPT code 99070 covers supplies and materials performed in a clinical or hospital setting. |
— | $50 | $50 | $50–$50 | $45 | +11% | 1 |
| New Patient Visit - Moderate Complexity CPT 99203 Office visit for a new patient with a low complexity medical problem. Typically 30-44 minutes for initial evaluation, history, and treatment planning. |
— | $336 | $336 | $336–$336 | $215 | +56% | 1 |
| New Patient Visit - High Complexity CPT 99204 Office visit for a new patient with a moderate to high complexity medical problem. Typically 45-59 minutes for comprehensive evaluation. |
— | $569 | $569 | $569–$569 | $352 | +62% | 1 |
| Office Visit - Moderate Complexity (Level 4) CPT 99214 Office visit for an established patient with a moderate to high complexity medical problem. Typically 30-39 minutes with your doctor for evaluation and management. |
— | $347 | $347 | $347–$347 | $218 | +59% | 1 |
| ER Visit - Minor Problem CPT 99281 Emergency department visit for a minor, self-limited problem requiring minimal evaluation. |
— | $1,495 | $1,402 | $1,402–$1,649 | $750 | +99% | 1 |
| ER Visit - Low Complexity CPT 99282 Emergency department visit for a low to moderate severity problem requiring a brief evaluation. |
— | $1,495 | $1,402 | $1,402–$1,649 | $817 | +83% | 1 |
| ER Visit - Moderate Complexity CPT 99283 Emergency department visit for a moderate severity problem requiring an expanded evaluation. |
$561 | $573 | — | — | $807 | -29% | 2 |
| ER Visit - High Complexity CPT 99284 Emergency department visit for a high severity problem requiring urgent evaluation, but not an immediate threat to life. |
$1,547 | $958 | — | — | $1,251 | -23% | 2 |
| ER Visit - Immediate Threat to Life CPT 99285 Emergency department visit for a severe, potentially life-threatening problem requiring immediate and comprehensive evaluation. |
$1,760 | $1,690 | — | — | $1,901 | -11% | 2 |
| Critical Care - First Hour CPT 99291 Critical care, first 30-74 minutes — intensive medical care for a critically ill or injured patient whose condition requires constant attention from the physician. |
$1,886 | $2,000 | — | — | $2,406 | -17% | 2 |
| Preventive Visit - Established (18-39) CPT 99395 Preventive Visit - Established (18-39) — CPT code 99395 covers preventive visit - established (18-39) performed in a clinical or hospital setting. |
— | $396 | $396 | $396–$396 | $272 | +45% | 1 |
| Triamcinolone Injection CPT J3301 HCPCS Level II code J3301 — Triamcinolone Injection. Healthcare Common Procedure Coding System code for triamcinolone injection. |
— | $50 | $50 | $50–$50 | $33 | +52% | 1 |
| Wound Care Supplies CPT A6250 HCPCS Level II code A6250 — Wound Care Supplies. Healthcare Common Procedure Coding System code for wound care supplies. |
— | $50 | $50 | $50–$50 | $44 | +14% | 1 |
| Excision of Benign Skin Lesion (0.5 cm or less) CPT 11400 Excision of benign lesion, trunk/arms/legs |
— | $135 | $135 | $50–$221 | $495 | -73% | 1 |
| Excision of Benign Skin Lesion (0.6-1.0 cm) CPT 11401 Excision of benign lesion, trunk/arms/legs, 0.6-1.0 cm |
— | $50 | $50 | $50–$50 | $340 | -85% | 1 |
| Excision Benign Lesion - Face (0.5 cm) CPT 11440 Excision of benign lesion, face/ears/eyelids/nose/lips |
— | $242 | $242 | $242–$242 | $525 | -54% | 1 |
| Excision Malignant Lesion (0.5 cm or less) CPT 11600 Excision of malignant lesion, trunk/arms/legs |
— | $188 | $188 | $50–$325 | $489 | -62% | 1 |
| Destruction Malignant Lesion (trunk) CPT 17260 Destruction of malignant lesion, trunk, any method |
— | $234 | $234 | $50–$418 | $333 | -30% | 1 |
| Tendon Sheath Injection CPT 20550 Injection of tendon sheath, ligament, or trigger point |
— | $62 | $62 | $62–$62 | $241 | -74% | 1 |
| Closed Treatment Distal Radius Fracture CPT 25600 Closed treatment of distal radial fracture without manipulation |
— | $50 | $50 | $50–$50 | $315 | -84% | 1 |
| Knee Manipulation Under Anesthesia CPT 27570 Manipulation of knee joint under general anesthesia |
— | $3,239 | $3,239 | $3,239–$3,239 | $1,778 | +82% | 1 |
| Endoscopic Carpal Tunnel Release CPT 29848 Endoscopy of wrist, carpal tunnel release |
— | $1,645 | $1,645 | $50–$3,239 | $1,698 | -3% | 1 |
| Knee Arthroscopy with Meniscus Repair CPT 29882 Arthroscopy, knee, surgical, meniscus repair |
— | $6,543 | $6,543 | $6,543–$6,543 | $3,424 | +91% | 1 |
| ACL Reconstruction (Knee Ligament Repair) CPT 29888 Arthroscopically aided anterior cruciate ligament repair/augmentation |
— | $14,297 | $14,297 | $14,297–$14,297 | $6,676 | +114% | 1 |
| Esophagoscopy (diagnostic) CPT 43191 Esophagoscopy, flexible, diagnostic |
— | $1,886 | $1,886 | $50–$3,722 | $1,602 | +18% | 1 |
| EGD with Stent Placement CPT 43210 Esophagogastroduodenoscopy with stent placement |
— | $20,107 | $20,107 | $20,107–$20,107 | $8,175 | +146% | 1 |
| EGD with Foreign Body Removal CPT 43247 Upper GI endoscopy with removal of foreign body |
— | $50 | $50 | $50–$50 | $590 | -92% | 1 |
| Sigmoidoscopy with Biopsy CPT 45331 Sigmoidoscopy, flexible, with biopsy |
— | $938 | $938 | $50–$1,826 | $856 | +10% | 1 |
| CT Chest Low Dose (Lung Screening) CPT 71271 CT chest for lung cancer screening, low dose |
— | $293 | $293 | $293–$293 | $189 | +55% | 1 |
| MRI Cervical Spine with/without Contrast CPT 72156 MRI cervical spine without contrast, then with contrast |
— | $1,772 | $1,772 | $1,772–$1,772 | $1,093 | +62% | 1 |
| CT Pelvis without Contrast CPT 72192 CT pelvis without contrast |
— | $520 | $520 | $520–$520 | $348 | +49% | 1 |
| Clavicle X-Ray CPT 73000 Radiologic examination of clavicle |
— | $332 | $332 | $305–$359 | $191 | +74% | 1 |
| Humerus X-Ray CPT 73060 Radiologic examination of humerus, minimum 2 views |
— | $332 | $332 | $305–$359 | $173 | +92% | 1 |
| Elbow X-Ray CPT 73070 Radiologic examination of elbow, 2 views |
— | $332 | $332 | $305–$359 | $189 | +76% | 1 |
| Elbow X-Ray (3+ views) CPT 73080 Radiologic examination of elbow, complete, minimum 3 views |
— | $332 | $332 | $305–$359 | $174 | +91% | 1 |
| Wrist X-Ray CPT 73100 Radiologic examination of wrist, 2 views |
— | $332 | $332 | $305–$359 | $189 | +76% | 1 |
| Wrist X-Ray (3+ views) CPT 73110 Radiologic examination of wrist, complete, minimum 3 views |
— | $332 | $332 | $305–$359 | $192 | +73% | 1 |
| Hip X-Ray (2-3 views) CPT 73502 Radiologic examination of hip, 2-3 views |
— | $296 | $305 | $226–$359 | $173 | +71% | 2 |
| Femur X-Ray CPT 73552 Radiologic examination of femur, minimum 2 views |
— | $296 | $305 | $226–$359 | $171 | +73% | 2 |
| Knee X-Ray (3 views) CPT 73562 Radiologic examination of knee, 3 views |
— | $332 | $332 | $305–$359 | $191 | +74% | 1 |
| Tibia/Fibula X-Ray CPT 73590 Radiologic examination of tibia and fibula, 2 views |
— | $332 | $332 | $305–$359 | $189 | +76% | 1 |
| Foot X-Ray (2 views) CPT 73620 Radiologic examination of foot, 2 views |
— | $332 | $332 | $305–$359 | $188 | +76% | 1 |
| Foot X-Ray (3+ views) CPT 73630 Radiologic examination of foot, complete, minimum 3 views |
— | $332 | $332 | $305–$359 | $190 | +75% | 1 |
| MRI Knee with/without Contrast CPT 73723 MRI any joint of lower extremity without then with contrast |
— | $1,772 | $1,772 | $1,772–$1,772 | $1,103 | +61% | 1 |
| Abdomen X-Ray (1 view) CPT 74018 Radiologic examination of abdomen, single anteroposterior view |
— | $332 | $332 | $305–$359 | $197 | +68% | 1 |
| Abdomen X-Ray (2 views) CPT 74019 Radiologic examination of abdomen, 2 views |
— | $378 | $375 | $317–$441 | $226 | +67% | 2 |
| MRI Abdomen without Contrast CPT 74181 MRI abdomen without contrast |
— | $1,081 | $1,081 | $1,081–$1,081 | $616 | +76% | 1 |
| MRI Abdomen with/without Contrast CPT 74183 MRI abdomen without contrast, then with contrast |
— | $1,772 | $1,772 | $1,772–$1,772 | $1,084 | +63% | 1 |
| Thyroid Ultrasound CPT 76536 Ultrasound of head and neck, thyroid, real time with image |
— | $408 | $408 | $375–$441 | $273 | +49% | 1 |
| Chest Ultrasound CPT 76604 Ultrasound of chest, real time with image documentation |
— | $408 | $408 | $375–$441 | $250 | +63% | 1 |
| Retroperitoneal Ultrasound (complete) CPT 76770 Ultrasound, retroperitoneal, complete |
— | $408 | $408 | $375–$441 | $267 | +53% | 1 |
| Retroperitoneal Ultrasound (limited) CPT 76775 Ultrasound, retroperitoneal, limited |
— | $408 | $408 | $375–$441 | $258 | +58% | 1 |
| OB Ultrasound (limited) CPT 76815 Ultrasound, pregnant uterus, limited |
— | $378 | $375 | $317–$441 | $223 | +69% | 2 |
| Transvaginal OB Ultrasound CPT 76817 Ultrasound, pregnant uterus, transvaginal |
— | $378 | $375 | $317–$441 | $223 | +69% | 2 |
| Pelvic Ultrasound (limited) CPT 76857 Ultrasound, pelvic, limited or follow-up |
— | $408 | $408 | $375–$441 | $259 | +58% | 1 |
| Scrotal Ultrasound CPT 76870 Ultrasound, scrotum and contents |
— | $408 | $408 | $375–$441 | $261 | +56% | 1 |
| Extremity Ultrasound (complete) CPT 76881 Ultrasound, complete joint, real time |
— | $408 | $408 | $375–$441 | $254 | +61% | 1 |
| Extremity Ultrasound (limited) CPT 76882 Ultrasound, limited, joint or focal evaluation |
— | $408 | $408 | $375–$441 | $229 | +78% | 1 |
| Bone Age Study CPT 77072 Bone age studies |
— | $408 | $408 | $375–$441 | $231 | +77% | 1 |
| Bone Length Studies CPT 77073 Bone length studies |
— | $378 | $375 | $317–$441 | $208 | +82% | 2 |
| Bone Survey (complete) CPT 77075 Radiologic examination, osseous survey, complete |
— | $408 | $408 | $375–$441 | $233 | +75% | 1 |
| DEXA Scan (Bone Density) CPT 77080 DXA bone density study, axial skeleton |
— | $408 | $408 | $375–$441 | $250 | +63% | 1 |
| DEXA Scan (Peripheral) CPT 77081 DXA bone density study, appendicular skeleton |
— | $243 | $305 | $66–$359 | $136 | +79% | 2 |
| DEXA Body Composition CPT 77085 DXA bone density study, body composition |
— | $378 | $375 | $317–$441 | $216 | +75% | 2 |
| Bone Scan (whole body) CPT 78306 Bone imaging, whole body |
— | $1,245 | $1,364 | $766–$1,604 | $700 | +78% | 2 |
| Nuclear Stress Test (Planar MPI) CPT 78451 Myocardial perfusion imaging, planar, single study |
— | $5,068 | $5,068 | $4,657–$5,478 | $2,833 | +79% | 1 |
| Renal Function Panel CPT 80069 Renal function panel blood test |
— | $22 | $22 | $20–$24 | $22 | +1% | 1 |
| Acute Hepatitis Panel CPT 80074 Acute hepatitis panel blood test |
— | $136 | $132 | $112–$165 | $102 | +33% | 2 |
| Urinalysis (non-automated, with microscopy) CPT 81000 Urinalysis by dip stick or tablet reagent, non-automated, with microscopy |
— | $10 | $10 | $9–$11 | $8 | +28% | 1 |
| Urinalysis (non-automated, without microscopy) CPT 81002 Urinalysis without microscopy, non-automated |
— | $9 | $9 | $8–$10 | $9 | -1% | 1 |
| Albumin Level CPT 82040 Albumin, serum, plasma or whole blood |
— | $13 | $13 | $12–$14 | $11 | +15% | 1 |
| Amylase Level CPT 82150 Amylase test |
— | $19 | $18 | $15–$22 | $14 | +32% | 2 |
| Bilirubin Total CPT 82247 Bilirubin, total |
— | $12 | $12 | $12–$12 | $10 | +18% | 1 |
| Bilirubin Direct CPT 82248 Bilirubin, direct |
— | $14 | $14 | $12–$17 | $15 | -4% | 2 |
| Calcium Level CPT 82310 Calcium, total |
— | $13 | $13 | $12–$14 | $14 | -6% | 1 |
| CO2/Bicarbonate Level CPT 82374 Carbon dioxide (bicarbonate) |
— | $12 | $12 | $11–$13 | $12 | +4% | 1 |
| Cholesterol Total CPT 82465 Cholesterol, serum or whole blood, total |
— | $12 | $12 | $10–$15 | $14 | -11% | 2 |
| CK/CPK (Creatine Kinase) CPT 82550 Creatine kinase (CK, CPK), total |
— | $19 | $18 | $15–$23 | $17 | +9% | 2 |
| CK-MB (Heart) CPT 82553 Creatine kinase (CK), MB fraction |
— | $30 | $30 | $27–$32 | $25 | +18% | 1 |
| Creatinine Level CPT 82565 Creatinine; blood |
— | $13 | $13 | $12–$14 | $10 | +31% | 1 |
| Vitamin B12 Level CPT 82607 Cyanocobalamin (Vitamin B-12) |
— | $39 | $39 | $35–$42 | $31 | +24% | 1 |
| Estradiol Level CPT 82670 Estradiol |
— | $80 | $77 | $66–$97 | $59 | +35% | 2 |
| Folic Acid Level CPT 82746 Folic acid, serum |
— | $38 | $38 | $35–$41 | $29 | +30% | 1 |
| IgA Level CPT 82784 Gammaglobulin IgA |
— | $24 | $24 | $22–$26 | $19 | +25% | 1 |
| Blood Gas Panel (ABG) CPT 82803 Gases, blood, any combination of pH, pCO2, pO2 |
— | $67 | $67 | $61–$72 | $49 | +36% | 1 |
| Glucose (point of care) CPT 82962 Glucose, blood by glucose monitoring device |
— | $8 | $8 | $8–$9 | $7 | +20% | 1 |
| FSH (Follicle Stimulating Hormone) CPT 83001 Gonadotropin, follicle stimulating hormone (FSH) |
— | $47 | $47 | $44–$51 | $36 | +32% | 1 |
| LH (Luteinizing Hormone) CPT 83002 Gonadotropin, luteinizing hormone (LH) |
— | $47 | $47 | $43–$51 | $37 | +28% | 1 |
| Iron Level CPT 83540 Iron |
— | $18 | $18 | $15–$22 | $19 | -3% | 2 |
| Iron Binding Capacity (TIBC) CPT 83550 Iron binding capacity, total |
— | $25 | $24 | $21–$30 | $22 | +13% | 2 |
| LDH (Lactate Dehydrogenase) CPT 83615 Lactate dehydrogenase (LD, LDH) |
— | $15 | $15 | $14–$17 | $12 | +29% | 1 |
| Lipase Level CPT 83690 Lipase |
— | $20 | $19 | $16–$24 | $19 | +4% | 2 |
| Magnesium Level CPT 83735 Magnesium |
— | $19 | $19 | $16–$23 | $19 | +1% | 2 |
| BNP (Brain Natriuretic Peptide) CPT 83880 Natriuretic peptide (BNP) |
— | $112 | $108 | $92–$136 | $81 | +38% | 2 |
| Parathyroid Hormone (PTH) CPT 83970 Parathormone (parathyroid hormone, PTH) |
— | $105 | $105 | $97–$114 | $80 | +32% | 1 |
| Alkaline Phosphatase CPT 84075 Phosphatase, alkaline |
— | $15 | $14 | $12–$18 | $12 | +23% | 2 |
| Phosphorus Level CPT 84100 Phosphorus inorganic (phosphate) |
— | $12 | $12 | $11–$13 | $10 | +21% | 1 |
| Prealbumin Level CPT 84134 Prealbumin |
— | $37 | $37 | $34–$40 | $29 | +28% | 1 |
| Progesterone Level CPT 84144 Progesterone |
— | $53 | $53 | $49–$58 | $42 | +27% | 1 |
| Prolactin Level CPT 84146 Prolactin |
— | $50 | $50 | $45–$54 | $37 | +34% | 1 |
| Testosterone Total CPT 84403 Testosterone, total |
— | $74 | $71 | $61–$89 | $56 | +32% | 2 |
| Thyroxine Total (T4) CPT 84436 Thyroxine, total |
— | $18 | $18 | $16–$19 | $14 | +25% | 1 |
| Free Thyroxine (Free T4) CPT 84439 Thyroxine, free |
— | $23 | $23 | $21–$25 | $18 | +28% | 1 |
| Transferrin Level CPT 84466 Transferrin |
— | $33 | $33 | $30–$35 | $27 | +21% | 1 |
| Triglycerides CPT 84478 Triglycerides |
— | $15 | $15 | $13–$16 | $12 | +22% | 1 |
| T3 (Triiodothyronine) Total CPT 84480 Triiodothyronine T3, total |
— | $41 | $39 | $33–$49 | $33 | +23% | 2 |
| Free T3 CPT 84481 Triiodothyronine T3, free |
— | $48 | $47 | $40–$59 | $38 | +27% | 2 |
| Troponin (Cardiac) CPT 84484 Troponin, quantitative |
— | $32 | $32 | $29–$34 | $24 | +33% | 1 |
| BUN (Blood Urea Nitrogen) CPT 84520 Urea nitrogen, blood (BUN) |
— | $11 | $11 | $9–$14 | $10 | +13% | 2 |
| Uric Acid Level CPT 84550 Uric acid, blood |
— | $12 | $12 | $11–$12 | $10 | +16% | 1 |
| CBC (Automated) CPT 85027 Complete blood count, automated |
— | $17 | $17 | $15–$18 | $14 | +18% | 1 |
| D-Dimer CPT 85379 Fibrin degradation products, D-dimer |
— | $26 | $26 | $24–$28 | $21 | +24% | 1 |
| Sed Rate (ESR) CPT 85652 Sedimentation rate, erythrocyte; automated |
— | $7 | $7 | $6–$7 | $6 | +15% | 1 |
| PTT (Partial Thromboplastin Time) CPT 85730 Thromboplastin time, partial (PTT) |
— | $15 | $15 | $14–$17 | $16 | -4% | 1 |
| Allergen Specific IgE CPT 86003 Allergen specific IgE; quantitative or semiquantitative, each allergen |
— | $13 | $13 | $12–$14 | $11 | +21% | 1 |
| C-Reactive Protein (CRP) CPT 86140 C-reactive protein |
— | $15 | $14 | $12–$18 | $11 | +35% | 2 |
| Cyclic Citrullinated Peptide (CCP) CPT 86200 Cyclic citrullinated peptide (CCP), antibody |
— | $33 | $33 | $30–$36 | $28 | +18% | 1 |
| Nuclear Antigen Antibody (ENA) CPT 86235 Extractable nuclear antigen (ENA) antibody |
— | $51 | $49 | $42–$62 | $40 | +28% | 2 |
| CA 125 Tumor Marker CPT 86300 Immunoassay for tumor antigen, CA 125 |
— | $59 | $57 | $49–$72 | $45 | +32% | 2 |
| CA 19-9 Tumor Marker CPT 86304 Immunoassay for tumor antigen, CA 19-9 |
— | $59 | $57 | $49–$72 | $46 | +29% | 2 |
| Rheumatoid Factor CPT 86431 Rheumatoid factor, quantitative |
— | $15 | $15 | $13–$16 | $16 | -9% | 1 |
| TB Blood Test (QuantiFERON) CPT 86480 Tuberculosis test, cell mediated immunity antigen response |
— | $158 | $158 | $145–$171 | $121 | +31% | 1 |
| Syphilis Test (RPR/VDRL) CPT 86592 Syphilis test, non-treponemal antibody; qualitative |
— | $11 | $11 | $10–$12 | $8 | +37% | 1 |
| Helicobacter Pylori Antibody CPT 86677 Antibody, Helicobacter pylori |
— | $43 | $43 | $40–$47 | $33 | +30% | 1 |
| Herpes Simplex Antibody CPT 86695 Antibody, herpes simplex, type specific |
— | $34 | $34 | $31–$36 | $26 | +30% | 1 |
| Hepatitis A Antibody CPT 86696 Antibody, hepatitis A |
— | $49 | $49 | $45–$53 | $38 | +30% | 1 |
| Hepatitis B Core Antibody CPT 86704 Hepatitis B core antibody (HBcAb); total |
— | $31 | $31 | $28–$33 | $24 | +28% | 1 |
| Hepatitis B Surface Antibody CPT 86706 Hepatitis B surface antibody (HBsAb) |
— | $27 | $27 | $25–$30 | $22 | +25% | 1 |
| Rubella Antibody CPT 86762 Antibody, rubella |
— | $37 | $37 | $34–$40 | $30 | +22% | 1 |
| Rubeola (Measles) Antibody CPT 86765 Antibody, rubeola |
— | $37 | $36 | $30–$45 | $30 | +23% | 2 |
| Varicella Antibody (Chickenpox) CPT 86787 Antibody, varicella-zoster |
— | $33 | $33 | $30–$36 | $24 | +37% | 1 |
| Hepatitis C Antibody CPT 86803 Hepatitis C antibody |
— | $36 | $36 | $34–$39 | $30 | +22% | 1 |
| Antibody Screen (RBC) CPT 86850 Antibody screen, RBC, each serum technique |
— | $25 | $25 | $23–$27 | $25 | avg | 1 |
| Rh Blood Type CPT 86901 Blood typing, Rh (D) |
— | $8 | $8 | $7–$8 | $11 | -31% | 1 |
| Bacterial Culture CPT 87070 Culture, bacterial; any other source except urine, blood or stool |
— | $22 | $22 | $20–$24 | $17 | +29% | 1 |
| Bacterial Culture (aerobic isolate) CPT 87077 Culture, bacterial; aerobic isolate, additional methods |
— | $21 | $21 | $19–$22 | $16 | +29% | 1 |
| Culture, presumptive (screen) CPT 87081 Culture, presumptive, pathogenic organisms, screening only |
— | $19 | $18 | $16–$23 | $19 | avg | 2 |
| Urine Culture CPT 87086 Culture, bacterial; quantitative colony count, urine |
— | $23 | $22 | $19–$28 | $21 | +10% | 2 |
| Chlamydia Culture CPT 87110 Culture, chlamydia |
— | $50 | $50 | $46–$54 | $37 | +35% | 1 |
| Antibiotic Sensitivity (MIC) CPT 87186 Susceptibility studies, antimicrobial agent; microdilution or agar dilution |
— | $22 | $22 | $20–$24 | $17 | +30% | 1 |
| Gram Stain CPT 87205 Smear, primary source with interpretation; Gram or Giemsa stain |
— | $12 | $12 | $10–$15 | $15 | -19% | 2 |
| Hepatitis B Surface Antigen CPT 87340 Infectious agent antigen detection; hepatitis B surface antigen (HBsAg) |
— | $26 | $26 | $24–$29 | $20 | +32% | 1 |
| HIV-1/HIV-2 Antibody Test CPT 87389 HIV-1 and HIV-2, single result, immunoassay |
— | $62 | $62 | $57–$66 | $46 | +34% | 1 |
| Flu Test (PCR/molecular) CPT 87502 Infectious agent detection, influenza, multiplex reverse transcription |
— | $274 | $265 | $225–$331 | $188 | +46% | 2 |
| Mycobacterium TB Detection CPT 87580 Infectious agent detection, Mycobacterium tuberculosis, amplified probe |
— | $51 | $51 | $47–$55 | $40 | +28% | 1 |
| HPV High-Risk Test CPT 87624 Infectious agent detection, human papillomavirus (HPV), high-risk types |
— | $90 | $90 | $82–$97 | $68 | +32% | 1 |
| Strep Test (rapid) CPT 87880 Infectious agent antigen detection, Streptococcus, group A |
— | $42 | $42 | $39–$46 | $34 | +24% | 1 |
| Laceration Repair - Simple (2.5 cm or less) CPT 12001 Simple repair of superficial wounds, scalp/neck/extremities |
— | $234 | $234 | $50–$418 | $348 | -33% | 1 |
| Laceration Repair - Simple (7.6-12.5 cm) CPT 12004 Simple repair of superficial wounds, 7.6-12.5 cm |
— | $234 | $234 | $50–$418 | $371 | -37% | 1 |
| Laceration Repair - Intermediate (2.5 cm or less) CPT 12031 Repair, intermediate, wounds of scalp/trunk/extremities |
— | $218 | $218 | $50–$386 | $388 | -44% | 1 |
| Laceration Repair - Intermediate Face (2.5 cm) CPT 12051 Repair, intermediate, wounds of face, 2.5 cm or less |
— | $218 | $218 | $50–$386 | $393 | -45% | 1 |
| Short Arm Splint CPT 29125 Application of short arm splint, forearm to hand |
— | $50 | $50 | $50–$50 | $245 | -80% | 1 |
| Anterior Nasal Packing (nosebleed) CPT 30901 Control nasal hemorrhage, anterior, simple |
— | $155 | $155 | $50–$261 | $254 | -39% | 1 |
| Anterior Nasal Packing (complex) CPT 30903 Control nasal hemorrhage, anterior, complex |
— | $155 | $155 | $50–$261 | $297 | -48% | 1 |
| Endotracheal Intubation CPT 31500 Intubation, endotracheal, emergency procedure |
— | $268 | $268 | $50–$487 | $368 | -27% | 1 |
| Venipuncture (age 3+) CPT 36410 Venipuncture, age 3 years or older, necessitating physician skill |
— | $23 | $23 | $21–$25 | $20 | +17% | 1 |
| IV Push (each additional) CPT 96375 Therapeutic, prophylactic, or diagnostic injection; each additional sequential IV push |
— | $74 | $74 | $74–$74 | $61 | +21% | 1 |
| Immunization Admin (through age 18) CPT 90460 Immunization administration through 18 years of age, first or only component |
— | $63 | $63 | $63–$63 | $45 | +39% | 1 |
| Immunization Admin (each additional) CPT 90472 Immunization administration, each additional vaccine |
— | $56 | $56 | $56–$56 | $37 | +52% | 1 |
| Hepatitis A & B Vaccine (combo) CPT 90636 Hepatitis A and hepatitis B vaccine, adult dosage |
— | $50 | $50 | $50–$50 | $132 | -62% | 1 |
| Rotavirus Vaccine CPT 90681 Rotavirus vaccine, human, attenuated |
— | $50 | $50 | $50–$50 | $110 | -55% | 1 |
| Hepatitis B Vaccine (adult) CPT 90746 Hepatitis B vaccine, adult dosage |
— | $50 | $50 | $50–$50 | $83 | -40% | 1 |
| Preventive Visit - New Adolescent (12-17) CPT 99384 Initial comprehensive preventive visit, adolescent (12-17) |
— | $450 | $450 | $450–$450 | $280 | +61% | 1 |
| Preventive Visit - Established Child (5-11) CPT 99393 Periodic comprehensive preventive visit, late childhood (5-11) |
— | $339 | $339 | $339–$339 | $211 | +61% | 1 |
| Mastopexy (Breast Lift) CPT 19316 Mastopexy |
— | $6,284 | $6,284 | $50–$12,517 | $3,983 | +58% | 1 |
| Vulvectomy (partial) CPT 56620 Vulvectomy, simple, partial |
— | $3,010 | $3,010 | $50–$5,970 | $2,432 | +24% | 1 |
| Colposcopy (diagnostic) CPT 57420 Colposcopy of entire vagina, with cervix if present |
— | $100 | $100 | $50–$151 | $269 | -63% | 1 |
| LEEP Procedure (cervix) CPT 57460 Colposcopy with loop electrode excision procedure of cervix |
— | $263 | $263 | $50–$475 | $1,084 | -76% | 1 |
| Vaginal Hysterectomy CPT 58260 Vaginal hysterectomy, for uterus 250g or less |
— | $50 | $50 | $50–$50 | $2,332 | -98% | 1 |
| Vaginal Hysterectomy with Tube/Ovary Removal CPT 58262 Vaginal hysterectomy with removal of tube(s) and/or ovary(s) |
— | $5,129 | $5,129 | $50–$10,209 | $3,907 | +31% | 1 |
| Hysteroscopy (diagnostic) CPT 58555 Hysteroscopy, diagnostic, separate procedure |
— | $5,970 | $5,970 | $5,970–$5,970 | $3,326 | +80% | 1 |
| Hysteroscopy with Ablation CPT 58563 Hysteroscopy, surgical, with endometrial ablation |
— | $10,209 | $10,209 | $10,209–$10,209 | $5,554 | +84% | 1 |
| Amniocentesis CPT 59000 Amniocentesis, diagnostic |
— | $103 | $103 | $50–$157 | $395 | -74% | 1 |
| Soft Tissue Excision (back/flank) CPT 21931 Excision, tumor, soft tissue of back or flank, subcutaneous |
— | $1,665 | $1,665 | $50–$3,281 | $1,599 | +4% | 1 |
| Bone Marrow Aspiration CPT 38220 Diagnostic bone marrow aspiration(s) |
— | $292 | $292 | $292–$292 | $638 | -54% | 1 |
| Bone Marrow Biopsy CPT 38221 Diagnostic bone marrow biopsy(ies) |
— | $159 | $159 | $50–$267 | $579 | -73% | 1 |
| Lymph Node Biopsy/Excision (superficial) CPT 38500 Biopsy or excision of lymph node(s), superficial |
— | $50 | $50 | $50–$50 | $1,660 | -97% | 1 |
| Lymph Node Biopsy/Excision (deep) CPT 38510 Biopsy or excision of lymph node(s), deep cervical |
— | $3,645 | $3,645 | $50–$7,241 | $2,778 | +31% | 1 |
| Lip Biopsy CPT 40490 Biopsy of lip, vermilion |
— | $121 | $121 | $50–$191 | $287 | -58% | 1 |
| Lysis of Abdominal Adhesions (open) CPT 44005 Enterolysis, freeing of intestinal adhesion |
— | $1,393 | $1,393 | $50–$2,736 | $1,528 | -9% | 1 |
| Partial Colectomy CPT 44140 Colectomy, partial, with anastomosis |
— | $1,701 | $1,701 | $50–$3,352 | $1,845 | -8% | 1 |
| Laparoscopic Partial Colectomy CPT 44204 Laparoscopic partial colectomy with anastomosis |
— | $50 | $50 | $50–$50 | $2,292 | -98% | 1 |
| Liver Biopsy (needle) CPT 47000 Biopsy of liver, needle, percutaneous |
— | $3,281 | $3,281 | $3,281–$3,281 | $1,926 | +70% | 1 |
| Diagnostic Laparoscopy CPT 49320 Laparoscopy, abdomen, diagnostic |
— | $50 | $50 | $50–$50 | $2,865 | -98% | 1 |
| Cystoscopy with Lithotripsy CPT 52353 Cystourethroscopy, with lithotripsy |
— | $5,082 | $5,082 | $50–$10,114 | $3,543 | +43% | 1 |
| Lumbar Puncture (spinal tap) CPT 62270 Lumbar puncture (spinal tap), diagnostic |
— | $50 | $50 | $50–$50 | $439 | -89% | 1 |
| Crisis Psychotherapy (first 60 min) CPT 90839 Psychotherapy for crisis, first 60 minutes |
— | $50 | $50 | $50–$50 | $96 | -48% | 1 |
| TMS Treatment (Transcranial Magnetic Stimulation) CPT 90867 Therapeutic repetitive transcranial magnetic stimulation treatment |
— | $798 | $798 | $798–$798 | $582 | +37% | 1 |
| Psychological Test Administration (first 30 min) CPT 96136 Psychological or neuropsychological test administration, first 30 minutes |
— | $100 | $100 | $100–$100 | $88 | +13% | 1 |
| Psychological Test Administration (additional 30 min) CPT 96137 Psychological or neuropsychological test administration, each additional 30 min |
— | $86 | $86 | $86–$86 | $67 | +28% | 1 |
| Tooth Extraction (surgical) CPT D7210 Extraction, erupted tooth requiring removal of bone and/or sectioning |
— | $50 | $50 | $50–$50 | $49 | +2% | 1 |
| Cervical Epidural Injection CPT 62320 Injection, including indwelling catheter placement, cervical or thoracic |
— | $772 | $772 | $50–$1,494 | $751 | +3% | 1 |
| Peripheral Nerve Block CPT 64450 Injection, anesthetic agent; other peripheral nerve or branch |
— | $83 | $83 | $50–$116 | $508 | -84% | 1 |
| Facet Joint Injection - Cervical (first level) CPT 64490 Injection, diagnostic or therapeutic agent, paravertebral facet joint, cervical or thoracic, first level |
— | $995 | $995 | $50–$1,941 | $856 | +16% | 1 |
| Pacemaker Insertion (ventricular) CPT 33207 Insertion of new or replacement of permanent pacemaker, ventricular |
— | $12,276 | $12,276 | $50–$24,502 | $9,176 | +34% | 1 |
| Coronary Angioplasty (single vessel) CPT 92920 Percutaneous transluminal coronary angioplasty, single vessel |
— | $23,310 | $23,310 | $21,420–$25,200 | $12,675 | +84% | 1 |
| Transesophageal Echocardiogram (TEE) CPT 93312 Echocardiography, transesophageal, real-time with image documentation |
— | $604 | $604 | $604–$604 | $409 | +48% | 1 |
| Doppler Echocardiography (complete) CPT 93320 Doppler echocardiography, pulsed wave and/or continuous wave, complete |
— | $155 | $155 | $155–$155 | $97 | +60% | 1 |
| Right Heart Catheterization CPT 93451 Right heart catheterization |
— | $15,557 | $21,420 | $50–$25,200 | $8,347 | +86% | 2 |
| Coronary Angiography CPT 93454 Catheter placement in coronary artery for coronary angiography |
— | $15,401 | $18,177 | $50–$25,200 | $7,237 | +113% | 2 |
| Ankle-Brachial Index (ABI) CPT 93922 Limited bilateral noninvasive physiologic studies of upper or lower extremity arteries |
— | $443 | $443 | $407–$479 | $296 | +50% | 1 |
| Complete Bilateral Extremity Study CPT 93923 Complete bilateral noninvasive physiologic studies of upper or lower extremity arteries |
— | $534 | $510 | $493–$600 | $313 | +71% | 2 |
| Lower Extremity Arterial Duplex CPT 93925 Duplex scan of lower extremity arteries, complete bilateral study |
— | $892 | $892 | $819–$964 | $537 | +66% | 1 |
| Venous Duplex Scan (complete) CPT 93970 Duplex scan of extremity veins, complete bilateral study |
— | $842 | $819 | $710–$964 | $621 | +36% | 2 |
| Aorta/IVC/Iliac Duplex Scan CPT 93978 Duplex scan of aorta, inferior vena cava, iliac vasculature |
— | $838 | $819 | $660–$964 | $493 | +70% | 2 |
| Cytopathology (fluids) CPT 88104 Cytopathology, fluids, washings or brushings, smears with interpretation |
— | $110 | $110 | $101–$119 | $74 | +49% | 1 |
| Cytopathology (concentration technique) CPT 88108 Cytopathology, concentration technique, smears and interpretation |
— | $115 | $116 | $105–$124 | $78 | +47% | 2 |
| Cytopathology (selective cellular enhancement) CPT 88112 Cytopathology, selective cellular enhancement technique with interpretation |
— | $103 | $103 | $95–$111 | $82 | +26% | 1 |
| Pap Smear - Physician Interpretation CPT 88141 Cytopathology, cervical or vaginal, requiring interpretation by physician |
— | $77 | $64 | $54–$112 | $55 | +39% | 2 |
| Pap Smear - ThinPrep (automated) CPT 88142 Cytopathology, cervical or vaginal, collected in preservative fluid, automated thin layer |
— | $52 | $52 | $48–$56 | $39 | +33% | 1 |
| Cytopathology (smears, any source) CPT 88160 Cytopathology, smears, any other source, screening and interpretation |
— | $129 | $129 | $119–$139 | $81 | +59% | 1 |
| Flow Cytometry (first marker) CPT 88184 Flow cytometry, cell surface, cytoplasmic, or nuclear marker, first marker |
— | $192 | $192 | $177–$208 | $162 | +19% | 1 |
| Flow Cytometry (each additional marker) CPT 88185 Flow cytometry, each additional marker |
— | $61 | $61 | $56–$66 | $50 | +23% | 1 |
| Surgical Pathology (gross only) CPT 88300 Level I surgical pathology, gross examination only |
— | $47 | $33 | $28–$80 | $35 | +33% | 2 |
| Surgical Pathology (gross & micro) CPT 88302 Level II surgical pathology, gross and microscopic examination |
— | $68 | $68 | $62–$73 | $50 | +35% | 1 |
| Surgical Pathology (Level III) CPT 88304 Level III surgical pathology |
— | $81 | $81 | $75–$88 | $67 | +21% | 1 |
| Surgical Pathology (Level IV) CPT 88305 Level IV surgical pathology, each specimen |
— | $90 | $90 | $83–$97 | $73 | +23% | 1 |
| Surgical Pathology (Level V) CPT 88307 Level V surgical pathology, each specimen |
— | $541 | $541 | $497–$585 | $409 | +32% | 1 |
| Surgical Pathology (Level VI) CPT 88309 Level VI surgical pathology, each specimen |
— | $1,234 | $826 | $702–$2,174 | $775 | +59% | 2 |
| Special Stain (Group I) CPT 88312 Special stain including interpretation and report, Group I |
— | $206 | $205 | $171–$241 | $130 | +58% | 2 |
| Immunohistochemistry (first antibody) CPT 88342 Immunohistochemistry, each antibody, per specimen, first stain |
— | $171 | $171 | $157–$184 | $127 | +34% | 1 |
| PT - Traction (mechanical) CPT 97012 Application of modality, traction, mechanical |
— | $66 | $66 | $66–$66 | $44 | +49% | 1 |
| PT - Electrical Stimulation (attended) CPT 97014 Application of modality, electrical stimulation, attended |
— | $66 | $66 | $66–$66 | $45 | +46% | 1 |
| PT - Electrical Stimulation (manual) CPT 97032 Application of modality, electrical stimulation, manual |
— | $66 | $66 | $66–$66 | $43 | +53% | 1 |
| PT - Neuromuscular Re-education CPT 97112 Therapeutic procedure, neuromuscular reeducation |
— | $155 | $155 | $155–$155 | $94 | +65% | 1 |
| PT - Aquatic Therapy CPT 97113 Therapeutic procedure, aquatic therapy with therapeutic exercises |
— | $172 | $172 | $172–$172 | $105 | +64% | 1 |
| PT - Massage Therapy CPT 97124 Therapeutic procedure, massage, including effleurage and petrissage |
— | $127 | $127 | $127–$127 | $76 | +67% | 1 |
| Orthotic/Prosthetic Checkout CPT 97763 Orthotic/prosthetic management, subsequent encounter |
— | $224 | $224 | $224–$224 | $146 | +53% | 1 |
| Medical Nutrition Therapy (follow-up) CPT 97803 Medical nutrition therapy, re-assessment and intervention, individual |
— | $128 | $128 | $128–$128 | $78 | +64% | 1 |
| OT Evaluation - Low Complexity CPT 97165 Occupational therapy evaluation, low complexity |
— | $404 | $404 | $404–$404 | $242 | +67% | 1 |
| Evaluation of Speech Fluency CPT 92521 Evaluation of speech fluency (stuttering, cluttering) |
— | $502 | $502 | $502–$502 | $307 | +64% | 1 |
| Subsequent Hospital Care - Low CPT 99231 Subsequent hospital inpatient or observation care, low complexity |
— | $174 | $174 | $174–$174 | $111 | +56% | 1 |
| Hospital Discharge Day (>30 min) CPT 99239 Hospital inpatient or observation discharge day management, more than 30 min |
— | $472 | $472 | $472–$472 | $292 | +62% | 1 |
| Morphine Injection CPT J2270 Injection, morphine sulfate, up to 10 mg |
— | $50 | $50 | $50–$50 | $34 | +47% | 1 |
| Fentanyl Injection CPT J3010 Injection, fentanyl citrate, 0.1 mg |
— | $50 | $50 | $50–$50 | $29 | +72% | 1 |
| Bronchospasm Evaluation CPT 94060 Bronchodilation responsiveness, spirometry before and after bronchodilator |
— | $205 | $205 | $205–$205 | $165 | +24% | 1 |
| CPAP Initiation CPT 94660 Continuous positive airway pressure ventilation (CPAP), initiation and management |
— | $798 | $798 | $798–$798 | $433 | +84% | 1 |
| Lung Volume Test (Plethysmography) CPT 94726 Plethysmography for determination of lung volumes and capacity |
— | $1,098 | $1,098 | $1,098–$1,098 | $563 | +95% | 1 |
| Sleep Study with CPAP CPT 95811 Polysomnography with CPAP titration |
— | $2,285 | $2,285 | $2,285–$2,285 | $1,564 | +46% | 1 |
| Refraction (eyeglass prescription) CPT 92015 Determination of refractive state |
— | $86 | $86 | $86–$86 | $62 | +39% | 1 |
| Visual Field Exam CPT 92083 Visual field examination, unilateral or bilateral, with interpretation |
— | $473 | $473 | $473–$473 | $186 | +154% | 1 |
| Corneal Topography (IOL calculation) CPT 92136 Ophthalmic biometry by partial coherence interferometry with IOL power calculation |
— | $473 | $473 | $473–$473 | $236 | +101% | 1 |
| Intravitreal Injection CPT 67028 Intravitreal injection of a pharmacologic agent |
— | $82 | $82 | $50–$113 | $264 | -69% | 1 |
| Allergy Antigen Preparation (multi-dose) CPT 95165 Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy, multi-dose vials |
— | $165 | $165 | $165–$165 | $93 | +78% | 1 |
| Major Hip and Knee Joint Replacement without MCC CPT 469 Total hip or knee replacement without major complications |
— | $34,200 | $41,277 | $1,201–$53,045 | $35,734 | -4% | 2 |
| Major Hip and Knee Joint Replacement without CC/MCC CPT 470 Total hip or knee replacement without complications or comorbidities |
— | $21,305 | $25,142 | $1,201–$33,733 | $22,617 | -6% | 2 |
| Major Hip and Knee Joint Replacement with MCC CPT 468 Total hip or knee replacement with major complications |
— | $44,452 | $44,452 | $40,846–$48,057 | $38,169 | +16% | 1 |
| Hip and Femur Procedures without MCC CPT 480 Hip fracture repair or femur procedures without major complications |
— | $37,984 | $37,984 | $34,904–$41,063 | $37,429 | +1% | 1 |
| Hip and Femur Procedures without CC/MCC CPT 481 Hip fracture repair or femur procedures without complications |
— | $27,318 | $27,318 | $25,103–$29,532 | $27,330 | avg | 1 |
| Hip and Femur Procedures with MCC CPT 479 Hip fracture repair or femur procedures with major complications |
— | $24,245 | $24,245 | $22,279–$26,210 | $23,215 | +4% | 1 |
| Cervical Spinal Fusion without CC/MCC CPT 473 Cervical spine fusion surgery without complications |
— | $23,005 | $28,198 | $1,201–$34,422 | $26,101 | -12% | 2 |
| Cervical Spinal Fusion without MCC CPT 472 Cervical spine fusion without major complications |
— | $38,425 | $38,425 | $35,309–$41,540 | $37,738 | +2% | 1 |
| Cervical Spinal Fusion with MCC CPT 471 Cervical spine fusion with major complications |
— | $62,979 | $62,979 | $57,872–$68,085 | $60,477 | +4% | 1 |
| Bilateral or Multiple Major Joint Procedures CPT 461 Bilateral joint replacement or multiple major joint procedures |
— | $70,913 | $68,673 | $66,193–$77,874 | $69,950 | +1% | 2 |
| Coronary Bypass without MCC CPT 236 CABG surgery without major complications |
— | $67,758 | $67,758 | $62,262–$73,254 | $61,028 | +11% | 1 |
| Coronary Bypass with MCC CPT 235 CABG surgery with major complications |
— | $94,931 | $94,931 | $87,231–$102,630 | $86,442 | +10% | 1 |
| Heart Failure and Shock with MCC CPT 291 Inpatient treatment for heart failure with major complications |
— | $12,411 | $15,171 | $1,201–$18,102 | $13,010 | -5% | 2 |
| Heart Failure and Shock with CC CPT 292 Inpatient treatment for heart failure with complications |
— | $8,305 | $10,023 | $1,201–$11,971 | $8,661 | -4% | 2 |
| Heart Failure and Shock without CC/MCC CPT 293 Inpatient treatment for heart failure without complications |
— | $7,383 | $7,383 | $6,784–$7,981 | $6,885 | +7% | 1 |
| Cardiac Valve Procedures with CC CPT 216 Heart valve repair or replacement with complications |
— | $158,247 | $158,247 | $145,412–$171,082 | $139,560 | +13% | 1 |
| Vaginal Delivery with OR Procedures CPT 768 Vaginal delivery requiring operating room procedures |
— | $10,217 | $10,217 | $1,201–$19,232 | $10,629 | -4% | 1 |
| Respiratory Infections and Inflammations with MCC CPT 177 Pneumonia or respiratory infections with major complications |
— | $15,123 | $18,629 | $1,201–$22,034 | $16,001 | -5% | 2 |
| Respiratory Infections and Inflammations with CC CPT 178 Pneumonia or respiratory infections with complications |
— | $9,508 | $11,535 | $1,201–$13,762 | $9,940 | -4% | 2 |
| Simple Pneumonia and Pleurisy with MCC CPT 193 Uncomplicated pneumonia with major complications |
— | $17,143 | $17,143 | $15,753–$18,533 | $16,014 | +7% | 1 |
| Simple Pneumonia and Pleurisy with CC CPT 194 Uncomplicated pneumonia with complications |
— | $10,511 | $10,511 | $9,659–$11,363 | $9,691 | +8% | 1 |
| Simple Pneumonia and Pleurisy without CC/MCC CPT 195 Uncomplicated pneumonia without complications |
— | $6,184 | $7,336 | $1,201–$8,862 | $6,420 | -4% | 2 |
| Major Small and Large Bowel Procedures with MCC CPT 329 Bowel resection or major intestinal surgery with major complications |
— | $59,950 | $59,950 | $55,089–$64,811 | $56,004 | +7% | 1 |
| Major Small and Large Bowel Procedures with CC CPT 330 Bowel resection or major intestinal surgery with complications |
— | $22,707 | $27,913 | $1,201–$33,801 | $24,563 | -8% | 2 |
| Major Small and Large Bowel Procedures without CC/MCC CPT 331 Bowel resection without complications |
— | $21,950 | $21,950 | $20,170–$23,729 | $20,845 | +5% | 1 |
| GI Hemorrhage with MCC CPT 377 Gastrointestinal bleeding with major complications |
— | $23,842 | $23,842 | $21,909–$25,775 | $22,207 | +7% | 1 |
| GI Hemorrhage with CC CPT 378 Gastrointestinal bleeding with complications |
— | $9,521 | $11,528 | $1,201–$13,828 | $9,963 | -4% | 2 |
| Intracranial Hemorrhage or Cerebral Infarction with MCC CPT 064 Stroke with major complications |
— | $19,115 | $23,452 | $1,201–$28,355 | $19,807 | -3% | 2 |
| Intracranial Hemorrhage or Cerebral Infarction with CC CPT 065 Stroke with complications |
— | $13,177 | $13,177 | $12,108–$14,245 | $12,305 | +7% | 1 |
| Intracranial Hemorrhage or Cerebral Infarction without CC/MCC CPT 066 Stroke without complications |
— | $6,736 | $8,046 | $1,201–$9,650 | $6,999 | -4% | 2 |
| Renal Failure with MCC CPT 682 Acute or chronic kidney failure with major complications |
— | $19,316 | $19,316 | $17,750–$20,882 | $18,051 | +7% | 1 |
| Renal Failure with CC CPT 683 Acute or chronic kidney failure with complications |
— | $11,423 | $11,423 | $10,496–$12,349 | $10,277 | +11% | 1 |
| Renal Failure without CC/MCC CPT 684 Acute or chronic kidney failure without complications |
— | $7,830 | $7,830 | $7,195–$8,464 | $7,317 | +7% | 1 |
| Septicemia or Severe Sepsis with MV >96 Hours CPT 870 Severe sepsis requiring extended ventilator support |
— | $90,147 | $90,147 | $82,838–$97,456 | $82,818 | +9% | 1 |
| Septicemia or Severe Sepsis without MV >96 Hours with MCC CPT 871 Sepsis with major complications |
— | $25,335 | $25,335 | $23,281–$27,389 | $23,331 | +9% | 1 |
| Septicemia or Severe Sepsis without MV >96 Hours without MCC CPT 872 Sepsis without major complications |
— | $13,347 | $13,347 | $12,264–$14,429 | $12,729 | +5% | 1 |
| Rehabilitation with CC/MCC CPT 945 Inpatient rehabilitation with complications |
— | $20,198 | $20,198 | $18,560–$21,835 | $17,626 | +15% | 1 |
| Rehabilitation without CC/MCC CPT 946 Inpatient rehabilitation without complications |
— | $10,372 | $13,744 | $1,201–$16,170 | $10,321 | avg | 2 |
| Hip Replacement with Hip Fracture with MCC CPT 521 Hip replacement after hip fracture with major complications |
— | $31,867 | $38,037 | $1,201–$50,194 | $33,758 | -6% | 2 |
| Hip Replacement with Hip Fracture without MCC CPT 522 Hip replacement after hip fracture without major complications |
— | $30,892 | $31,477 | $24,165–$37,034 | $28,356 | +9% | 2 |
| Respiratory System Diagnosis with Ventilator Support >96 Hours CPT 207 Extended ventilator support for respiratory failure |
— | $60,796 | $75,627 | $1,201–$90,729 | $65,066 | -7% | 2 |
| Respiratory System Diagnosis with Ventilator Support ≤96 Hours CPT 208 Short-term ventilator support for respiratory failure |
— | $35,850 | $35,850 | $32,943–$38,757 | $33,406 | +7% | 1 |
| Heart Failure and Shock w MCC MS-DRG 291 Medicare Severity Diagnosis Related Group DRG-291 — Heart Failure and Shock w MCC. Inpatient hospital payment classification for cases involving heart failure and shock w mcc. |
— | $8,028 | — | — | $18,378 | -56% | 1 |
| Cardiac Arrhythmia/Conduction Disorders w CC MS-DRG 309 Medicare Severity Diagnosis Related Group DRG-309 — Cardiac Arrhythmia/Conduction Disorders w CC. Inpatient hospital payment classification for cases involving cardiac arrhythmia/conduction disorders w cc. |
— | $4,893 | — | — | $6,547 | -25% | 1 |
| Percutaneous Intracardiac Procedures w/o MCC MS-DRG 274 Medicare Severity Diagnosis Related Group DRG-274 — Percutaneous Intracardiac Procedures w/o MCC. Inpatient hospital payment classification for cases involving percutaneous intracardiac procedures w/o mcc. |
— | $23,431 | — | — | $25,078 | -7% | 1 |
| Percutaneous Cardiovascular Proc w Drug-Eluting Stent w/o MCC MS-DRG 247 Medicare Severity Diagnosis Related Group DRG-247 — Percutaneous Cardiovascular Proc w Drug-Eluting Stent w/o MCC. Inpatient hospital payment classification for cases involving percutaneous cardiovascular proc w drug-eluting stent w/o mcc. |
— | $13,282 | — | — | $16,963 | -22% | 1 |
| Septorhinoplasty (Nose Job with Septal Repair) CPT 30420 Septorhinoplasty (Nose Job with Septal Repair) — CPT code 30420 covers septorhinoplasty (nose job with septal repair) performed in a clinical or hospital setting. |
— | $5,821 | $5,821 | $50–$11,593 | $4,210 | +38% | 1 |
| Revision Rhinoplasty - Minor (Nose Job Revision) CPT 30430 Revision Rhinoplasty - Minor (Nose Job Revision) — CPT code 30430 covers revision rhinoplasty - minor (nose job revision) performed in a clinical or hospital setting. |
— | $50 | $50 | $50–$50 | $2,073 | -98% | 1 |
| Revision Rhinoplasty - Intermediate (Nose Job Revision) CPT 30435 Revision Rhinoplasty - Intermediate (Nose Job Revision) — CPT code 30435 covers revision rhinoplasty - intermediate (nose job revision) performed in a clinical or hospital setting. |
— | $50 | $50 | $50–$50 | $2,551 | -98% | 1 |
| Body Contouring - Leg Lift CPT 15833 Body Contouring - Leg Lift — CPT code 15833 covers body contouring - leg lift performed in a clinical or hospital setting. |
— | $2,796 | $2,796 | $50–$5,542 | $2,263 | +24% | 1 |
| Body Contouring - Hip Lift CPT 15834 Body Contouring - Hip Lift — CPT code 15834 covers body contouring - hip lift performed in a clinical or hospital setting. |
— | $5,542 | $5,542 | $5,542–$5,542 | $3,484 | +59% | 1 |
| Body Contouring - Forearm/Hand CPT 15837 Body Contouring - Forearm/Hand — CPT code 15837 covers body contouring - forearm/hand performed in a clinical or hospital setting. |
— | $2,796 | $2,796 | $50–$5,542 | $2,263 | +24% | 1 |
| Body Contouring - Other Area CPT 15839 Body Contouring - Other Area — CPT code 15839 covers body contouring - other area performed in a clinical or hospital setting. |
— | $2,796 | $2,796 | $50–$5,542 | $2,078 | +35% | 1 |
| Upper Eyelid Surgery (Blepharoplasty) CPT 15822 Upper Eyelid Surgery (Blepharoplasty) — CPT code 15822 covers upper eyelid surgery (blepharoplasty) performed in a clinical or hospital setting. |
— | $3,878 | $3,878 | $3,878–$3,878 | $2,745 | +41% | 1 |
| Liposuction - Head and Neck CPT 15876 Liposuction - Head and Neck — CPT code 15876 covers liposuction - head and neck performed in a clinical or hospital setting. |
— | $3,583 | $3,583 | $50–$7,116 | $2,803 | +28% | 1 |
| Neck Lift (with Platysmal Tightening) CPT 15825 Neck Lift (with Platysmal Tightening) — CPT code 15825 covers neck lift (with platysmal tightening) performed in a clinical or hospital setting. |
— | $50 | $50 | $50–$50 | $1,320 | -96% | 1 |
| Ear Pinning (Otoplasty) CPT 69300 Ear Pinning (Otoplasty) — CPT code 69300 covers ear pinning (otoplasty) performed in a clinical or hospital setting. |
— | $3,155 | $3,155 | $50–$6,260 | $2,562 | +23% | 1 |
| Chin Reshaping with Bone Graft CPT 21123 Chin Reshaping with Bone Graft — CPT code 21123 covers chin reshaping with bone graft performed in a clinical or hospital setting. |
— | $3,155 | $3,155 | $50–$6,260 | $2,598 | +21% | 1 |
| Embryo Culture (IVF Lab) CPT 89250 Embryo Culture (IVF Lab) — CPT code 89250 covers embryo culture (ivf lab) performed in a clinical or hospital setting. |
— | $220 | $89 | $75–$497 | $591 | -63% | 2 |
| Assisted Embryo Hatching (IVF) CPT 89253 Assisted Embryo Hatching (IVF) — CPT code 89253 covers assisted embryo hatching (ivf) performed in a clinical or hospital setting. |
— | $402 | $402 | $369–$434 | $336 | +20% | 1 |
| Egg/Embryo Freezing (Cryopreservation) CPT 89258 Egg/Embryo Freezing (Cryopreservation) — CPT code 89258 covers egg/embryo freezing (cryopreservation) performed in a clinical or hospital setting. |
— | $1,983 | $1,983 | $1,822–$2,144 | $1,375 | +44% | 1 |
| IVF Fertilization (Oocyte Insemination) CPT 89268 IVF Fertilization (Oocyte Insemination) — CPT code 89268 covers ivf fertilization (oocyte insemination) performed in a clinical or hospital setting. |
— | $402 | $402 | $369–$434 | $342 | +17% | 1 |
| Extended Embryo Culture (IVF) CPT 89272 Extended Embryo Culture (IVF) — CPT code 89272 covers extended embryo culture (ivf) performed in a clinical or hospital setting. |
— | $1,983 | $1,983 | $1,822–$2,144 | $1,417 | +40% | 1 |
| Circumcision (Surgical, Older Child/Adult) CPT 54160 Circumcision (Surgical, Older Child/Adult) — CPT code 54160 covers circumcision (surgical, older child/adult) performed in a clinical or hospital setting. |
— | $690 | $690 | $50–$1,330 | $569 | +21% | 1 |
| Complex Bunionectomy CPT 28299 Complex Bunionectomy — CPT code 28299 covers complex bunionectomy performed in a clinical or hospital setting. |
— | $7,173 | $7,173 | $50–$14,297 | $5,235 | +37% | 1 |
| ACDF - Cervical Disc Fusion (Single Level) CPT 22551 Cervical spinal fusion (neck) — surgery to permanently join two or more vertebrae in the neck using bone grafts and hardware, typically to treat herniated discs or spinal instability. |
— | $14,246 | $14,246 | $50–$28,443 | $10,164 | +40% | 1 |
| Tonsillectomy (Under Age 12) CPT 42825 Tonsillectomy (Under Age 12) — CPT code 42825 covers tonsillectomy (under age 12) performed in a clinical or hospital setting. |
— | $5,821 | $5,821 | $50–$11,593 | $4,579 | +27% | 1 |
| Sinus Surgery - Maxillary Antrostomy CPT 31267 Sinus Surgery - Maxillary Antrostomy — CPT code 31267 covers sinus surgery - maxillary antrostomy performed in a clinical or hospital setting. |
— | $13,002 | $13,002 | $13,002–$13,002 | $9,102 | +43% | 1 |
Prices are typical ranges based on The Heart Hospital Baylor Plano's published transparency data, including actual allowed amounts calculated from insurer remittance (ERA) data per CMS v3.0 requirements. Your actual cost depends on your specific plan, deductible status, and clinical details.
Search all procedures at The Heart Hospital Baylor Plano →
Insurance Plans with Negotiated Rates
Taven has payer-specific negotiated rate data from 2 insurers at The Heart Hospital Baylor Plano. The "Avg Negotiated" rate in the table above represents the average across all payers. Individual payer rates may be higher or lower.
Cigna Healthcare
Humana
Negotiated rates vary by insurance plan. The prices shown are aggregated from this hospital's publicly filed machine-readable file. Your actual rate depends on your specific insurance plan and network tier. Use our price comparison tool to see payer-specific breakdowns.
Your Billing Rights
Under the No Surprises Act and hospital price transparency rules, you have the right to receive a Good Faith Estimate before scheduled care, protection from surprise out-of-network bills in emergencies, and access to the hospital's published pricing data.
Nearby Hospitals in Dallas, TX
Compare prices at other hospitals in the same area.
Texas Health Dallas
28.0 mi
Dallas, TX
105 procedures
Methodist Hospital For Surgery
20.4 mi
Addison, TX
4/5 ★
449 procedures
Children'S Medical Center Of Dallas
29.7 mi
Dallas, TX
Baylor Scott and White Heart and Vascular Hospital
32.8 mi
Dallas, TX
761 procedures
Childrens Medical Ctr of Dallas
29.6 mi
Dallas, TX
619 procedures
Baylor University Medical Center
32.5 mi
Dallas, TX
3/5 ★
538 procedures
Parkland Health and Hospital System
29.5 mi
Dallas, TX
2/5 ★
774 procedures
Baylor Scott and White All Saints Medical Center
32.8 mi
Fort Worth, TX
4/5 ★
623 procedures
▸ Technical Details
Type
Acute Care Hospitals
Ownership
Proprietary
Medicare Provider #
450893
Emergency Services
Yes
Metro Area
Dallas, TX
Procedures Tracked
419
Have a bill from The Heart Hospital Baylor Plano?
Upload it and we'll break down every charge, check for errors, and find savings.
Review your bill for free →Compare The Heart Hospital Baylor Plano with Nearby Hospitals
See how prices stack up against other hospitals in Dallas, TX.
Compare hospitals →