Prices / Houston–Pasadena–The Woodlands, TX / Hospitals

Houston Methodist The Woodlands Hospital

17201 Interstate 45 South, The Woodlands, TX 77385 · CCN 670122

Source: the hospital's standard-charges file dated 2026-04-01 (original file, json, 63 MB), checked by us on 2026-10-06. 289 of 300 common services found in it.

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Evaluation & Management

Service	Code	Cash price	Insurers pay (min – median – max)	Gross charge
Family Psychotherapy, Including Patient, 50 Min	CPT 90847	$755.00	$178.30 – $187.22 – $356.61 7 insurers	$1,510.00
Family Psychotherapy, Not Including Patient, 50 Min	CPT 90846	not published	$178.30 – $187.22 – $356.61 7 insurers	—
Group Psychotherapy	CPT 90853	$594.00	— 0 insurers	$1,188.00
Initial New Patient Preventive Medicine Evaluation (18-39 Years)	CPT 99385	not published	$310.35 – $310.35 – $310.35 1 insurers	—
Initial New Patient Preventive Medicine Evaluation (40-64 Years)	CPT 99386	not published	$377.80 – $377.80 – $377.80 1 insurers	—
New Patient Office Or Other Outpatient Visit, Typically 30 Min	CPT 99203	$272.00	$241.74 – $241.74 – $241.74 1 insurers	$544.00
New Patient Office Or Other Outpatient Visit, Typically 45 Min	CPT 99204	$313.00	$409.28 – $409.28 – $409.28 1 insurers	$626.00
New Patient Office Or Other Outpatient Visit, Typically 60 Min	CPT 99205	$336.00	$534.11 – $534.11 – $534.11 1 insurers	$672.00
Patient Office Consultation, Typically 40 Min	CPT 99243	not published	$303.61 – $303.61 – $303.61 1 insurers	—
Patient Office Consultation, Typically 60 Min	CPT 99244	not published	$488.00 – $488.00 – $488.00 1 insurers	—
Psychotherapy, 30 Min	CPT 90832	not published	$178.30 – $187.22 – $356.61 7 insurers	—
Psychotherapy, 45 Min	CPT 90834	not published	$178.30 – $187.22 – $356.61 7 insurers	—
Psychotherapy, 60 Min	CPT 90837	not published	$178.30 – $187.22 – $356.61 7 insurers	—

Laboratory & Pathology

Service	Code	Cash price	Insurers pay (min – median – max)	Gross charge
Automated Urinalysis Test	CPT 81002	$57.00	$3.48 – $5.67 – $31.63 7 insurers	$114.00
Automated Urinalysis Test	CPT 81003	$193.00	$2.25 – $3.67 – $27.70 7 insurers	$386.00
Basic Metabolic Panel	CPT 80048	$562.00	$8.46 – $8.97 – $35.19 7 insurers	$1,124.00
Blood Test, Clotting Time	CPT 85610	$134.50	$4.29 – $6.99 – $48.50 7 insurers	$269.00
Blood Test, Comprehensive Group of Blood Chemicals	CPT 80053	$572.50	$10.56 – $11.20 – $43.93 7 insurers	$1,145.00
Blood Test, Lipids (Cholesterol and Triglycerides)	CPT 80061	$12.00	$13.39 – $21.83 – $165.37 7 insurers	$981.00
Blood Test, Thyroid Stimulating Hormone (Tsh)	CPT 84443	$10.50	$16.80 – $27.38 – $207.36 7 insurers	$724.00
Coagulation Assessment Blood Test	CPT 85730	$35.00	$6.01 – $9.80 – $74.15 7 insurers	$321.00
Complete Blood Cell Count, With Differential White Blood Cells, Automated	CPT 85025	$133.00	$7.77 – $12.67 – $95.97 7 insurers	$291.00
Complete Blood Count, Automated	CPT 85027	$95.50	$6.47 – $10.55 – $79.98 7 insurers	$191.00
Kidney Function Panel Test	CPT 80069	$453.00	$8.68 – $9.20 – $36.11 7 insurers	$906.00
Liver Function Blood Test Panel	CPT 80076	$558.00	$8.17 – $8.66 – $33.99 7 insurers	$1,116.00
Manual Urinalysis Test With Examination Using Microscope	CPT 81000	$139.00	$4.02 – $6.55 – $39.03 7 insurers	$278.00
Manual Urinalysis Test With Examination Using Microscope	CPT 81001	$273.00	$3.17 – $5.17 – $39.03 7 insurers	$546.00
Obstetric Blood Test Panel	CPT 80055	$413.00	$47.81 – $50.68 – $198.89 7 insurers	$826.00
Psa (Prostate Specific Antigen)	CPT 84153	$74.00	$18.39 – $29.98 – $227.11 7 insurers	$632.00
Psa (Prostate Specific Antigen)	CPT 84154	$182.50	$18.39 – $19.50 – $76.50 7 insurers	$365.00

Medicine & Surgery

Service	Code	Cash price	Insurers pay (min – median – max)	Gross charge
Biopsy of Large Bowel Using An Endoscope	CPT 45380	$895.50	$1,202.09 – $2,344.08 – $5,545.00 10 insurers	$1,791.00
Biopsy of Prostate Gland	CPT 55700	$3,039.50	$2,214.47 – $3,772.00 – $5,545.00 7 insurers	$6,079.00
Biopsy of The Esophagus, Stomach, and/Or Upper Small Bowel Using An Endoscope	CPT 43239	$591.50	$911.12 – $1,822.24 – $5,545.00 10 insurers	$1,183.00
Cardiac Valve and Other Major Cardiothoracic Procedures With Cardiac Catheterization With Mcc	MS-DRG 216	not published	$9,936.00 – $75,966.15 – $171,746.00 16 insurers	—
Cervical Spinal Fusion Without Cc Or Mcc	MS-DRG 473	not published	$17,717.17 – $19,223.13 – $37,438.03 15 insurers	—
Diagnostic Examination of Esophagus, Stomach, and/Or Upper Small Bowel Using An Endoscope	CPT 43235	$658.00	$911.12 – $1,776.68 – $4,138.00 10 insurers	$1,316.00
Diagnostic Examination of Large Bowel Using An Endoscope	CPT 45378	$866.00	$934.20 – $1,868.39 – $5,545.00 10 insurers	$1,732.00
Electrocardiogram, Routine, With Interpretation and Report	CPT 93000	not published	$71.97 – $71.97 – $71.97 1 insurers	—
Injection of Substance Into Spinal Canal of Lower Back Or Sacrum Using Imaging Guidance	CPT 62322	$3,031.50	$888.50 – $1,275.10 – $7,542.00 7 insurers	$6,063.00
Injection of Substance Into Spinal Canal of Lower Back Or Sacrum Using Imaging Guidance	CPT 62323	$1,675.50	$709.10 – $1,155.83 – $7,542.00 7 insurers	$3,351.00
Injections of Anesthetic and/Or Steroid Drug Into Lower Or Sacral Spine Nerve Root Using Imaging Guidance	CPT 64483	$4,482.00	$888.50 – $1,732.58 – $4,138.00 10 insurers	$8,964.00
Insertion of Catheter Into Left Heart For Diagnosis	CPT 93452	$8,192.00	$3,256.70 – $5,308.43 – $17,455.00 7 insurers	$16,384.00
Major Joint Replacement Or Reattachment of Lower Extremity Without Mcc	MS-DRG 470	not published	$13,998.54 – $15,398.39 – $88,050.00 16 insurers	—
Removal of 1 Or More Breast Growth, Open Procedure	CPT 19120	not published	$2,537.60 – $4,129.94 – $7,866.55 10 insurers	—
Removal of Cataract With Insertion of Lens	CPT 66984	not published	$2,318.34 – $4,636.68 – $12,189.00 10 insurers	—
Removal of Gallbladder Using An Endoscope	CPT 47562	not published	$6,073.08 – $7,466.00 – $12,146.15 7 insurers	—
Removal of One Knee Cartilage Using An Endoscope	CPT 29881	not published	$3,127.85 – $4,128.00 – $8,126.00 9 insurers	—
Removal of Polyps Or Growths of Large Bowel Using An Endoscope	CPT 45385	$653.00	$1,202.09 – $2,344.08 – $5,545.00 10 insurers	$1,306.00
Removal of Recurring Cataract In Lens Capsule Using Laser	CPT 66821	not published	$552.50 – $1,105.01 – $5,545.00 10 insurers	—
Removal of Tonsils and Adenoid Glands Patient Younger Than Age 12	CPT 42820	not published	$2,537.60 – $6,036.01 – $11,893.61 10 insurers	—
Repair of Groin Hernia Patient Age 5 Years Or Older	CPT 49505	$7,802.00	$3,127.85 – $4,201.00 – $8,341.00 10 insurers	$15,604.00
Routine Obstetric Care For Cesarean Delivery, Including Pre- and Post-Delivery Care	CPT 59510	not published	$5,770.94 – $7,316.00 – $7,542.00 2 insurers	—
Routine Obstetric Care For Vaginal Delivery After Prior Cesarean Delivery Including Pre- and Post-Delivery Care	CPT 59610	not published	$5,461.72 – $7,316.00 – $7,542.00 2 insurers	—
Routine Obstetric Care For Vaginal Delivery, Including Pre- and Post-Delivery Care	CPT 59400	not published	$5,205.04 – $7,316.00 – $7,542.00 2 insurers	—
Shaving of Shoulder Bone Using An Endoscope	CPT 29826	not published	$2,537.60 – $4,004.00 – $8,126.00 5 insurers	—
Sleep Study	CPT 95810	$6,192.00	$862.65 – $914.42 – $1,725.31 7 insurers	$12,384.00
Spinal Fusion Except Cervical Without Mcc	MS-DRG 460	not published	$55,654.95 – $55,654.95 – $55,654.95 1 insurers	—
Surgical Removal of Prostate and Surrounding Lymph Nodes Using An Endoscope	CPT 55866	not published	$7,316.00 – $11,318.97 – $21,356.54 7 insurers	—
Ultrasound Examination of Lower Large Bowel Using An Endoscope	CPT 45391	$808.00	$1,202.09 – $2,344.08 – $5,545.00 10 insurers	$1,616.00
Uterine and Adnexa Procedures For Non-Malignancy Without Cc Or Mcc	MS-DRG 743	not published	$9,004.09 – $9,769.44 – $18,153.11 15 insurers	—

Radiology

Service	Code	Cash price	Insurers pay (min – median – max)	Gross charge
Abdominal Ultrasound of Pregnant Uterus (>= 14 Weeks 0 Days) Single Or First Fetus	CPT 76805	$2,316.50	$105.02 – $204.79 – $753.34 7 insurers	$4,633.00
Ct Scan, Head Or Brain, Without Contrast	CPT 70450	$1,120.00	$105.02 – $141.78 – $813.70 7 insurers	$2,240.00
Ct Scan of Abdomen and Pelvis With Contrast	CPT 74177	$2,362.00	$350.46 – $473.13 – $2,772.23 7 insurers	$4,724.00
Ct Scan, Pelvis, With Contrast	CPT 72193	$1,124.00	$176.20 – $237.87 – $1,322.92 7 insurers	$2,248.00
Mammography of Both Breasts	CPT 77066	$1,762.95	$104.89 – $141.60 – $476.67 7 insurers	$3,525.90
Mammography of One Breast	CPT 77065	$905.00	$85.33 – $115.20 – $372.48 7 insurers	$1,810.00
Mammography, Screening, Bilateral	CPT 77067	$715.50	$82.98 – $112.03 – $393.90 7 insurers	$1,431.00
Mri Scan of Brain Before and After Contrast	CPT 70553	$1,615.50	$350.46 – $473.13 – $2,772.23 7 insurers	$3,231.00
Mri Scan of Leg Joint	CPT 73721	$1,243.50	$239.69 – $323.58 – $1,691.87 7 insurers	$2,487.00
Mri Scan of Lower Spinal Canal	CPT 72148	$1,056.00	$239.69 – $323.58 – $1,691.87 7 insurers	$2,112.00
Ultrasound of Abdomen	CPT 76700	$2,661.50	$105.02 – $204.79 – $707.10 7 insurers	$5,323.00
Ultrasound Pelvis Through Vagina	CPT 76830	$1,492.50	$105.02 – $204.79 – $549.05 7 insurers	$2,985.00
X-Ray, Lower Back, Minimum Four Views	CPT 72110	$1,152.00	$105.02 – $155.94 – $443.84 7 insurers	$2,304.00

Inpatient (volume)

Service	Code	Cash price	Insurers pay (min – median – max)	Gross charge
Acute Myocardial Infarction, Discharged Alive With Cc	MS-DRG 281	not published	$4,308.32 – $7,137.07 – $13,959.74 15 insurers	—
Acute Myocardial Infarction, Discharged Alive With Mcc	MS-DRG 280	not published	$4,308.32 – $12,456.28 – $24,857.36 15 insurers	—
Alcohol, Drug Abuse Or Dependence Without Rehabilitation Therapy Without Mcc	MS-DRG 897	not published	$6,406.72 – $6,727.06 – $12,813.44 14 insurers	—
Bronchitis and Asthma With Cc/Mcc	MS-DRG 202	not published	$7,048.26 – $7,647.37 – $14,639.70 15 insurers	—
Cardiac Arrhythmia and Conduction Disorders With Cc	MS-DRG 309	not published	$4,308.32 – $5,712.91 – $11,330.61 15 insurers	—
Cardiac Arrhythmia and Conduction Disorders With Mcc	MS-DRG 308	not published	$4,308.32 – $9,349.39 – $18,291.47 15 insurers	—
Cardiac Arrhythmia and Conduction Disorders Without Cc/Mcc	MS-DRG 310	not published	$4,108.34 – $4,395.92 – $8,473.07 15 insurers	—
Cellulitis With Mcc	MS-DRG 602	not published	$10,314.76 – $11,191.52 – $22,632.31 15 insurers	—
Cellulitis Without Mcc	MS-DRG 603	not published	$6,320.35 – $6,857.58 – $13,460.71 15 insurers	—
Chest Pain	MS-DRG 313	not published	$4,308.32 – $5,591.00 – $11,009.57 15 insurers	—
Chronic Obstructive Pulmonary Disease With Cc	MS-DRG 191	not published	$6,117.88 – $6,637.90 – $13,010.21 15 insurers	—
Chronic Obstructive Pulmonary Disease With Mcc	MS-DRG 190	not published	$8,038.88 – $8,722.19 – $17,006.71 15 insurers	—
Circulatory Disorders Except Ami, With Cardiac Catheterization With Mcc	MS-DRG 286	not published	$9,936.00 – $17,183.00 – $33,518.22 16 insurers	—
Circulatory Disorders Except Ami, With Cardiac Catheterization Without Mcc	MS-DRG 287	not published	$7,766.00 – $9,707.50 – $26,952.00 16 insurers	—
Cirrhosis and Alcoholic Hepatitis With Mcc	MS-DRG 432	not published	$14,283.76 – $15,497.88 – $29,668.61 15 insurers	—
Combined Anterior and Posterior Spinal Fusion With Cc	MS-DRG 454	not published	$93,059.50 – $93,059.50 – $93,059.50 1 insurers	—
Craniotomy and Endovascular Intracranial Procedures With Mcc	MS-DRG 025	not published	$32,996.62 – $36,296.28 – $123,913.00 16 insurers	—
Degenerative Nervous System Disorders Without Mcc	MS-DRG 057	not published	$9,402.52 – $10,201.74 – $20,741.09 15 insurers	—
Diabetes With Cc	MS-DRG 638	not published	$6,503.96 – $7,056.80 – $13,890.08 15 insurers	—
Diabetes With Mcc	MS-DRG 637	not published	$10,426.52 – $11,312.78 – $22,054.21 15 insurers	—
Endovascular Cardiac Valve Replacement and Supplement Procedures With Mcc	MS-DRG 266	not published	$9,936.00 – $47,588.72 – $171,746.00 16 insurers	—
Endovascular Cardiac Valve Replacement and Supplement Procedures Without Mcc	MS-DRG 267	not published	$9,936.00 – $36,968.93 – $171,746.00 16 insurers	—
Esophagitis, Gastroenteritis and Miscellaneous Digestive Disorders With Mcc	MS-DRG 391	not published	$9,204.39 – $9,986.77 – $19,452.47 15 insurers	—
Esophagitis, Gastroenteritis and Miscellaneous Digestive Disorders Without Mcc	MS-DRG 392	not published	$5,657.77 – $6,138.68 – $11,952.90 15 insurers	—
Extensive O.R. Procedures Unrelated To Principal Diagnosis With Mcc	MS-DRG 981	not published	$34,049.65 – $36,943.88 – $72,125.19 15 insurers	—
Fractures of Hip and Pelvis Without Mcc	MS-DRG 536	not published	$5,860.97 – $6,359.16 – $12,280.27 15 insurers	—
Fracture, Sprain, Strain and Dislocation Except Femur, Hip, Pelvis and Thigh Without Mcc	MS-DRG 563	not published	$6,498.88 – $7,051.29 – $13,626.55 15 insurers	—
Gastrointestinal Hemorrhage With Cc	MS-DRG 378	not published	$7,117.20 – $7,722.16 – $14,968.52 15 insurers	—
Gastrointestinal Hemorrhage With Mcc	MS-DRG 377	not published	$13,266.29 – $14,393.93 – $27,534.82 15 insurers	—
Gastrointestinal Obstruction With Cc	MS-DRG 389	not published	$5,731.79 – $6,219.00 – $12,139.43 15 insurers	—
Gastrointestinal Obstruction With Mcc	MS-DRG 388	not published	$10,717.53 – $11,628.52 – $22,260.17 15 insurers	—
Gastrointestinal Obstruction Without Cc/Mcc	MS-DRG 390	not published	$3,947.95 – $4,283.53 – $8,505.19 15 insurers	—
Heart Failure and Shock With Mcc	MS-DRG 291	not published	$4,308.32 – $9,969.06 – $19,759.89 15 insurers	—
Hip and Femur Procedures Except Major Joint With Cc	MS-DRG 481	not published	$15,200.35 – $16,492.38 – $31,569.60 15 insurers	—
Hip and Femur Procedures Except Major Joint With Mcc	MS-DRG 480	not published	$21,135.34 – $22,931.84 – $44,867.51 15 insurers	—
Hip Replacement With Principal Diagnosis of Hip Fracture Without Mcc	MS-DRG 522	not published	$15,368.72 – $16,905.59 – $88,050.00 16 insurers	—
Hypertension Without Mcc	MS-DRG 305	not published	$4,308.32 – $5,863.56 – $11,464.50 15 insurers	—
Infectious and Parasitic Diseases With O.R. Procedures With Cc	MS-DRG 854	not published	$14,500.75 – $15,733.31 – $31,011.21 15 insurers	—
Infectious and Parasitic Diseases With O.R. Procedures With Mcc	MS-DRG 853	not published	$35,840.74 – $38,887.20 – $76,064.35 15 insurers	—
Intracranial Hemorrhage Or Cerebral Infarction With Cc Or Tpa In 24 Hours	MS-DRG 065	not published	$7,332.02 – $8,065.22 – $55,441.00 16 insurers	—
Intracranial Hemorrhage Or Cerebral Infarction With Mcc	MS-DRG 064	not published	$14,594.37 – $16,053.81 – $55,441.00 16 insurers	—
Intracranial Hemorrhage Or Cerebral Infarction Without Cc/Mcc	MS-DRG 066	not published	$4,966.87 – $5,463.56 – $55,441.00 16 insurers	—
Kidney and Ureter Procedures For Non-Neoplasm With Cc	MS-DRG 660	not published	$9,591.93 – $10,407.25 – $20,477.87 15 insurers	—
Kidney and Urinary Tract Infections With Mcc	MS-DRG 689	not published	$8,420.61 – $9,136.36 – $17,868.50 15 insurers	—
Kidney and Urinary Tract Infections Without Mcc	MS-DRG 690	not published	$5,874.76 – $6,374.12 – $12,276.98 15 insurers	—
Laparoscopic Cholecystectomy Without C.D.E. With Cc	MS-DRG 418	not published	$12,276.39 – $13,319.89 – $25,114.81 15 insurers	—
Major Gastrointestinal Disorders and Peritoneal Infections With Cc	MS-DRG 372	not published	$7,409.67 – $8,039.50 – $15,858.59 15 insurers	—
Major Small and Large Bowel Procedures With Cc	MS-DRG 330	not published	$17,397.12 – $18,875.88 – $36,091.50 15 insurers	—
Major Small and Large Bowel Procedures With Mcc	MS-DRG 329	not published	$33,358.03 – $36,193.46 – $69,539.73 15 insurers	—
Major Small and Large Bowel Procedures Without Cc/Mcc	MS-DRG 331	not published	$12,213.26 – $13,251.39 – $25,439.48 15 insurers	—
Medical Back Problems Without Mcc	MS-DRG 552	not published	$6,976.41 – $7,569.41 – $14,702.25 15 insurers	—
Miscellaneous Disorders of Nutrition, Metabolism, Fluids and Electrolytes With Mcc	MS-DRG 640	not published	$9,692.81 – $10,516.70 – $20,111.23 15 insurers	—
Miscellaneous Disorders of Nutrition, Metabolism, Fluids and Electrolytes Without Mcc	MS-DRG 641	not published	$5,647.61 – $6,127.66 – $11,889.00 15 insurers	—
Organic Disturbances and Intellectual Disability	MS-DRG 884	not published	$11,676.22 – $12,260.03 – $23,352.44 14 insurers	—
Other Cerebrovascular Disorders With Cc	MS-DRG 071	not published	$7,445.96 – $8,078.87 – $16,155.29 15 insurers	—
Other Cerebrovascular Disorders With Mcc	MS-DRG 070	not published	$12,081.90 – $13,108.86 – $27,227.24 15 insurers	—
Other Circulatory System Diagnoses With Mcc	MS-DRG 314	not published	$4,308.32 – $16,192.16 – $32,612.60 15 insurers	—
Other Digestive System Diagnoses With Cc	MS-DRG 394	not published	$6,790.63 – $7,367.83 – $14,255.05 15 insurers	—
Other Digestive System Diagnoses With Mcc	MS-DRG 393	not published	$11,606.55 – $12,593.11 – $25,078.46 15 insurers	—
Other Disorders of Nervous System With Cc	MS-DRG 092	not published	$7,424.19 – $8,055.25 – $16,032.95 15 insurers	—
Other Kidney and Urinary Tract Diagnoses With Cc	MS-DRG 699	not published	$7,366.13 – $7,992.25 – $15,531.47 15 insurers	—
Other Kidney and Urinary Tract Diagnoses With Mcc	MS-DRG 698	not published	$12,006.42 – $13,026.97 – $25,455.55 15 insurers	—
Other Vascular Procedures With Mcc	MS-DRG 252	not published	$7,754.97 – $27,087.62 – $51,949.98 15 insurers	—
Percutaneous and Other Intracardiac Procedures Without Mcc	MS-DRG 274	not published	$9,936.00 – $25,919.30 – $49,308.77 15 insurers	—
Percutaneous Cardiovascular Procedures With Intraluminal Device With Mcc Or 4+ Arteries/	MS-DRG 321	not published	$9,936.00 – $21,423.96 – $43,738.56 15 insurers	—
Percutaneous Cardiovascular Procedures With Intraluminal Device Without Mcc	MS-DRG 322	not published	$9,936.00 – $13,882.10 – $41,144.45 15 insurers	—
Peripheral Vascular Disorders With Cc	MS-DRG 300	not published	$4,308.32 – $8,289.43 – $16,234.41 15 insurers	—
Permanent Cardiac Pacemaker Implant With Cc	MS-DRG 243	not published	$9,936.00 – $17,010.96 – $104,352.00 16 insurers	—
Poisoning and Toxic Effects of Drugs With Mcc	MS-DRG 917	not published	$11,382.30 – $12,349.80 – $24,831.62 15 insurers	—
Psychoses	MS-DRG 885	not published	$10,136.95 – $10,643.80 – $20,273.90 14 insurers	—
Pulmonary Edema and Respiratory Failure	MS-DRG 189	not published	$8,965.63 – $9,727.71 – $18,744.88 15 insurers	—
Pulmonary Embolism With Mcc Or Acute Cor Pulmonale	MS-DRG 175	not published	$9,968.58 – $10,815.91 – $21,346.65 15 insurers	—
Pulmonary Embolism Without Mcc	MS-DRG 176	not published	$5,842.10 – $6,338.68 – $12,409.35 15 insurers	—
Red Blood Cell Disorders With Mcc	MS-DRG 811	not published	$10,191.38 – $11,057.65 – $21,355.77 15 insurers	—
Red Blood Cell Disorders Without Mcc	MS-DRG 812	not published	$6,663.62 – $7,230.03 – $13,976.40 15 insurers	—
Renal Failure With Cc	MS-DRG 683	not published	$6,355.92 – $6,896.17 – $13,705.67 15 insurers	—
Renal Failure With Mcc	MS-DRG 682	not published	$10,748.01 – $11,661.59 – $22,834.67 15 insurers	—
Respiratory Infections and Inflammations With Cc	MS-DRG 178	not published	$7,083.09 – $7,685.16 – $15,024.36 15 insurers	—
Respiratory Infections and Inflammations With Mcc	MS-DRG 177	not published	$11,340.93 – $12,304.91 – $25,810.73 15 insurers	—
Respiratory System Diagnosis With Ventilator Support <=96 Hours	MS-DRG 208	not published	$19,948.05 – $21,643.64 – $41,138.32 15 insurers	—
Revision of Hip Or Knee Replacement With Cc	MS-DRG 467	not published	$25,593.48 – $28,152.83 – $88,050.00 16 insurers	—
Seizures With Mcc	MS-DRG 100	not published	$14,055.88 – $15,461.47 – $45,575.00 16 insurers	—
Seizures Without Mcc	MS-DRG 101	not published	$6,550.41 – $7,205.45 – $45,575.00 16 insurers	—
Septicemia Or Severe Sepsis With Mv >96 Hours	MS-DRG 870	not published	$50,160.79 – $54,424.46 – $105,970.95 15 insurers	—
Septicemia Or Severe Sepsis Without Mv >96 Hours With Mcc	MS-DRG 871	not published	$14,097.24 – $15,295.51 – $30,165.26 15 insurers	—
Septicemia Or Severe Sepsis Without Mv >96 Hours Without Mcc	MS-DRG 872	not published	$7,426.36 – $8,057.61 – $15,669.93 15 insurers	—
Signs and Symptoms Without Mcc	MS-DRG 948	not published	$5,809.44 – $6,303.24 – $12,187.22 15 insurers	—
Simple Pneumonia and Pleurisy With Cc	MS-DRG 194	not published	$5,848.63 – $6,345.76 – $12,509.77 15 insurers	—
Simple Pneumonia and Pleurisy With Mcc	MS-DRG 193	not published	$9,538.95 – $10,349.76 – $20,184.22 15 insurers	—
Syncope and Collapse	MS-DRG 312	not published	$4,308.32 – $6,768.21 – $13,194.97 15 insurers	—
Transient Ischemia Without Thrombolytic	MS-DRG 069	not published	$5,797.11 – $6,289.87 – $12,152.22 15 insurers	—

Outpatient/professional (volume)

Service	Code	Cash price	Insurers pay (min – median – max)	Gross charge
3d Radiographic Procedure	CPT 76376	$1,109.00	$52.79 – $63.16 – $65.08 2 insurers	$2,218.00
Advance Care Planning, First 30 Minutes	CPT 99497	not published	$102.05 – $108.18 – $245.04 7 insurers	—
Annual Wellness Visit, Includes A Personalized Prevention Plan of Service (Pps), Subsequent Visit	HCPCS G0439	not published	$136.89 – $143.73 – $273.78 7 insurers	—
Aspiration and/Or Injection of Fluid From Large Joint	CPT 20610	$1,337.00	$45.32 – $601.28 – $7,542.00 8 insurers	$2,674.00
Calculation of Radiation Therapy Dose	CPT 77300	$942.00	$132.19 – $144.47 – $480.59 7 insurers	$1,884.00
Cell Examination of Specimen, Selective Cellular Enhancement Technique	CPT 88112	$97.00	$52.35 – $55.49 – $205.80 7 insurers	$194.00
Collection of Venous Blood By Venipuncture Or Urine Sample By Catheterization From An Individual In A Skilled Nursing Facility (Snf) Or By A Laboratory On Behalf of A Home Health Agency (Hha)	HCPCS G0471	not published	$11.34 – $12.02 – $22.68 7 insurers	—
Colorectal Cancer Screening; Colonoscopy On Individual At High Risk	HCPCS G0105	$547.00	$934.20 – $1,845.04 – $4,074.00 9 insurers	$1,094.00
Colorectal Cancer Screening; Colonoscopy On Individual Not Meeting Criteria For High Risk	HCPCS G0121	$782.00	$934.20 – $1,845.04 – $4,074.00 9 insurers	$1,564.00
Complete Ultrasound Scan Behind Abdominal Cavity	CPT 76770	$2,295.50	$105.02 – $204.79 – $707.10 7 insurers	$4,591.00
Continuous Intraoperative Neurophysiology Monitoring, From Outside The Operating Room (Remote Or Nearby), Per Patient, (Attention Directed Exclusively To One Patient) Each 15 Minutes (List In Addition To Primary Procedure)	HCPCS G0453	not published	$139.44 – $2,374.72 – $4,610.00 2 insurers	—
Critical Care, Each Additional 30 Minutes	CPT 99292	$634.50	— 0 insurers	$1,269.00
Critical Care, First 30-74 Minutes	CPT 99291	$4,149.00	$829.79 – $871.28 – $1,659.59 7 insurers	$8,298.00
Ct Guidance For Insertion of Radiation Therapy Fields	CPT 77014	$519.50	$284.31 – $292.97 – $305.40 2 insurers	$1,039.00
Ct Scan of Abdomen and Pelvis Before and After Contrast	CPT 74178	$2,840.50	$350.46 – $473.13 – $2,772.23 7 insurers	$5,681.00
Ct Scan of Abdomen and Pelvis Without Contrast	CPT 74176	$2,147.00	$239.69 – $323.58 – $1,691.87 7 insurers	$4,294.00
Ct Scan of Blood Vessels of Abdomen and Pelvis With Contrast	CPT 74174	$2,336.50	$350.46 – $473.13 – $2,108.88 7 insurers	$4,673.00
Ct Scan of Blood Vessels of Chest With Contrast	CPT 71275	$1,141.00	$176.20 – $237.87 – $1,322.92 7 insurers	$2,282.00
Ct Scan of Blood Vessels of Head With Contrast	CPT 70496	$1,397.00	$176.20 – $237.87 – $1,322.92 7 insurers	$2,794.00
Ct Scan of Blood Vessels of Neck With Contrast	CPT 70498	$1,504.00	$176.20 – $237.87 – $1,322.92 7 insurers	$3,008.00
Ct Scan of Chest With Contrast	CPT 71260	$1,197.50	$176.20 – $237.87 – $1,322.92 7 insurers	$2,395.00
Ct Scan of Chest Without Contrast	CPT 71250	$1,088.50	$105.02 – $141.78 – $813.70 7 insurers	$2,177.00
Ct Scan of Face Without Contrast	CPT 70486	$1,300.50	$105.02 – $141.78 – $813.70 7 insurers	$2,601.00
Ct Scan of Leg Without Contrast	CPT 73700	$876.50	$105.02 – $141.78 – $813.70 7 insurers	$1,753.00
Ct Scan of Lower Spine Without Contrast	CPT 72131	$1,224.50	$105.02 – $141.78 – $813.70 7 insurers	$2,449.00
Ct Scan of Upper Spine Without Contrast	CPT 72125	$1,291.00	$105.02 – $141.78 – $813.70 7 insurers	$2,582.00
Design and Construction of Complex Radiation Treatment Device	CPT 77334	$2,745.50	$253.62 – $394.94 – $1,162.08 7 insurers	$5,491.00
Destruction of Lower Or Sacral Spinal Facet Joint Nerves Using Imaging Guidance, Single Facet Joint	CPT 64635	$6,118.00	$1,961.62 – $3,197.45 – $7,542.00 7 insurers	$12,236.00
Destruction of Precancer Skin Growth, 2-14 Growths	CPT 17003	$714.50	$211.00 – $2,956.00 – $7,542.00 4 insurers	$1,429.00
Dexamethasone, Lacrimal Ophthalmic Insert, 0.1 Mg	HCPCS J1096	not published	$102.94 – $167.78 – $654.67 7 insurers	—
Diagnostic Digital Breast Tomosynthesis, Unilateral Or Bilateral (List Separately In Addition To 77065 Or 77066)	HCPCS G0279	$63.50	$12.51 – $13.27 – $99.91 7 insurers	$127.00
Diagnostic Exam of Bladder and Urethra Using An Endoscope	CPT 52000	$467.50	$700.47 – $1,400.95 – $4,138.00 10 insurers	$935.00
Dxa Bone Density Measurement of Hip, Pelvis, Spine	CPT 77080	$638.00	$105.02 – $113.97 – $210.04 7 insurers	$1,276.00
Electrocardiogram (Ecg) 1 To 3 Leads With Review By Physician Only	CPT 93042	not published	$22.50 – $22.50 – $22.50 1 insurers	—
Emergency Department Visit With High Level of Medical Decision Making	CPT 99285	$2,491.50	$598.24 – $628.16 – $1,196.49 7 insurers	$4,983.00
Emergency Department Visit With Low Level of Medical Decision Making	CPT 99283	$1,217.50	$274.22 – $287.93 – $548.44 7 insurers	$2,435.00
Emergency Department Visit With Moderate Level of Medical Decision Making	CPT 99284	$1,951.00	$419.16 – $440.12 – $838.33 7 insurers	$3,902.00
Established Patient Office Or Other Outpatient Visit With High Level of Medical Decision Making, If Using Time, 40 Minutes Or More	CPT 99215	$309.50	$351.94 – $351.94 – $351.94 1 insurers	$619.00
Established Patient Office Or Other Outpatient Visit With Low Level Od Decision Making, If Using Time, 20 Minutes Or More	CPT 99213	$204.50	$161.93 – $161.93 – $161.93 1 insurers	$409.00
Established Patient Office Or Other Outpatient Visit With Moderate Level of Decision Making, If Using Time, 30 Minutes Or More	CPT 99214	$289.00	$249.63 – $249.63 – $249.63 1 insurers	$578.00
Established Patient Office Or Other Outpatient Visit With Straightforward Medical Decision Making, If Using Time, 10 Minutes Or More	CPT 99212	$164.00	$80.96 – $80.96 – $80.96 1 insurers	$328.00
Evaluation of Fine Needle Aspirate With Interpretation and Report	CPT 88173	$153.00	$52.35 – $85.33 – $205.80 7 insurers	$371.00
Evaluation of Single, Dual, Multiple Lead Or Leadless Pacemaker System, Remote Up To 90 Days	CPT 93294	not published	$97.81 – $97.81 – $97.81 1 insurers	—
Exercise Or Drug-Induced Heart Stress Test With Electrocardiogram (Ecg) With Review By Physician	CPT 93018	not published	$47.24 – $47.24 – $47.24 1 insurers	—
Exercise Or Drug-Induced Heart Stress Test With Electrocardiogram (Ecg) With Supervision By Physician	CPT 93016	not published	$70.82 – $70.82 – $70.82 1 insurers	—
Hemodialysis Procedure With Physician Evaluation	CPT 90935	$851.00	$689.44 – $723.91 – $1,378.88 7 insurers	$1,710.00
Hospital Discharge Day Management, 30 Minutes Or Less	CPT 99238	not published	$231.63 – $231.63 – $231.63 1 insurers	—
Hospital Discharge Day Management, More Than 30 Minutes	CPT 99239	not published	$339.58 – $339.58 – $339.58 1 insurers	—
Imaging For Evaluation of Swallowing Function	CPT 74230	$1,176.00	$176.20 – $343.59 – $721.59 7 insurers	$2,352.00
Immunologic Analysis Technique On Serum (Immunofixation)	CPT 86334	$328.50	$22.34 – $36.41 – $275.82 7 insurers	$657.00
Initial Hospital Care With Moderate Level of Medical Decision Making, If Using Time, At Least 75 Minutes	CPT 99223	not published	$640.91 – $640.91 – $640.91 1 insurers	—
Initial Hospital Care With Straightforward Or Low-Level Medical Decision Making, If Using Time, At Least 55 Minutes	CPT 99222	not published	$434.02 – $434.02 – $434.02 1 insurers	—
Initial Hospital Care With Straightforward Or Low Level of Medical Decision Making, Per Day, If Using Time, At Least 40 Minutes	CPT 99221	not published	$321.58 – $321.58 – $321.58 1 insurers	—
Injection of Anesthetic Agent and/Or Steroid Into Thigh Nerve (Femoral Nerve)	CPT 64447	$2,845.50	$70.61 – $1,382.74 – $7,542.00 8 insurers	$5,691.00
Injection of Lower Or Sacral Spine Facet Joint Using Imaging Guidance, Single Level	CPT 64493	$3,207.00	$888.50 – $1,448.26 – $7,542.00 7 insurers	$6,414.00
Insertion of Artery Tube For Blood Sampling Or Infusion Through Skin	CPT 36620	$652.00	$2,956.00 – $5,963.00 – $7,542.00 3 insurers	$1,304.00
Insertion of Non-Tunneled Central Venous Tube For Infusion (5 Years Or Older)	CPT 36556	$3,709.00	$1,650.09 – $3,235.31 – $6,343.74 10 insurers	$7,418.00
Insertion of Tube In Left Lower Heart Chamber and Coronary Artery For Diagnosis With Review By Radiologist	CPT 93458	$5,950.50	$3,256.70 – $5,308.43 – $17,455.00 7 insurers	$11,901.00
Instillation, Bupivacaine and Meloxicam, 1 Mg/0.03 Mg	HCPCS C9088	not published	$1.81 – $1.93 – $4.55 3 insurers	—
Limited Ultrasound Scan of 1 Breast	CPT 76642	$1,458.00	$87.42 – $118.02 – $316.05 7 insurers	$2,916.00
Limited Ultrasound Scan of Abdomen	CPT 76705	$1,980.50	$105.02 – $204.79 – $509.56 7 insurers	$3,961.00
Low Dose Ct Scan of Chest For Lung Cancer Screening	CPT 71271	$1,188.00	$105.02 – $141.78 – $409.58 7 insurers	$2,376.00
Microscopic Genetic Analysis of Tumor, Manual	CPT 88360	$147.00	$171.15 – $181.42 – $596.96 7 insurers	$358.00
Mri Scan of Abdomen Before and After Contrast	CPT 74183	$1,225.00	$350.46 – $473.13 – $2,772.23 7 insurers	$2,450.00
Mri Scan of Brain Without Contrast	CPT 70551	$1,335.50	$239.69 – $323.58 – $1,691.87 7 insurers	$2,671.00
Mri Scan of Upper Spinal Canal Without Contrast	CPT 72141	$1,407.50	$239.69 – $323.58 – $1,691.87 7 insurers	$2,815.00
Nuclear Medicine Studies of Heart Muscle At Rest and With Stress and Spect	CPT 78452	$8,153.00	$1,300.55 – $1,370.27 – $2,601.10 7 insurers	$16,306.00
Nuclear Medicine Study From Skull Base To Mid-Thigh With Ct Scan	CPT 78815	$4,707.00	$1,436.46 – $1,522.66 – $9,986.93 7 insurers	$9,414.00
Pathology Examination of Tissue Using A Microscope, Intermediate Complexity	CPT 88305	$126.00	$52.35 – $85.33 – $205.80 7 insurers	$2,500.00
Pathology Examination of Tissue Using A Microscope, Moderately High Complexity	CPT 88307	$271.50	$256.90 – $370.88 – $1,178.99 7 insurers	$614.00
Pathology Examination of Tissue Using A Microscope, Moderately Low Complexity	CPT 88304	$105.00	$52.35 – $85.33 – $205.80 7 insurers	$210.00
Phenylephrine 10.16 Mg/Ml and Ketorolac 2.88 Mg/Ml Ophthalmic Irrigation Solution, 1 Ml	HCPCS J1097	not published	$96.91 – $173.47 – $580.08 7 insurers	—
Preparation of Tissue For Examination By Removing Any Calcium Present	CPT 88311	$36.50	$31.14 – $32.06 – $37.48 2 insurers	$73.00
Prolonged Hospital Inpatient Or Observation Care Evaluation and Management Service(S) Beyond The Total Time For The Primary Service (When The Primary Service Has Been Selected Using Time On The Date of The Primary Service); Each Additional 15 Minutes By Th	HCPCS G0316	not published	$101.21 – $101.21 – $101.21 1 insurers	—
Protein Measurement, Serum	CPT 84165	$61.00	$10.74 – $17.51 – $132.57 7 insurers	$122.00
Psychiatric Diagnostic Evaluation With Medical Services	CPT 90792	$968.50	$178.30 – $187.22 – $356.61 7 insurers	$1,937.00
Radiation Treatment Management, 5 Treatment Sessions	CPT 77427	not published	$761.37 – $784.55 – $892.17 2 insurers	—
Removal of Fingernails Or Toenails, 6 Or More Nails	CPT 11721	$357.50	$59.26 – $115.56 – $7,542.00 8 insurers	$715.00
Removal of Skin and Tissue, 20.0 Sq Cm Or Less	CPT 11042	$1,999.50	$408.37 – $816.74 – $5,545.00 10 insurers	$3,999.00
Removal of Skin and Tissue, Each Additional 20.0 Sq Cm Or Less	CPT 11045	$1,295.00	$4,610.00 – $7,316.00 – $7,542.00 2 insurers	$2,590.00
Replacement of Knee Joint, Both Sides of Knee	CPT 27447	not published	$7,316.00 – $13,898.50 – $25,794.37 7 insurers	—
Replacement of Thigh Bone and Hip Joint With Prosthesis	CPT 27130	not published	$7,316.00 – $13,898.50 – $25,794.37 7 insurers	—
Routine Electrocardiogram (Ecg) Using At Least 12 Leads With Interpretation and Report Only	CPT 93010	not published	$26.99 – $26.99 – $26.99 1 insurers	—
Screening 3d Breast Mammography	CPT 77063	$63.00	$23.22 – $31.35 – $99.91 7 insurers	$126.00
Special Stained Specimen Slides To Examine Tissue, Each Additional Procedure	CPT 88341	$73.50	$268.36 – $268.36 – $268.36 1 insurers	$213.00
Special Stained Specimen Slides To Examine Tissue Including Interpretation and Report	CPT 88313	$48.50	$31.14 – $137.66 – $267.31 7 insurers	$115.00
Special Stained Specimen Slides To Examine Tissue, Initial Procedure	CPT 88342	$90.00	$105.41 – $176.28 – $596.96 7 insurers	$273.00
Special Stained Specimen Slides To Identify Organisms Including Interpretation and Report	CPT 88312	$46.50	$37.40 – $53.92 – $205.80 7 insurers	$93.00
Stereoscopic X-Ray Guidance For Localization of Target Volume For The Delivery of Radiation Therapy	HCPCS G6002	not published	$259.17 – $259.17 – $259.17 1 insurers	—
Subsequent Hospital Care With Moderate Levelof Medical Decision Making, If Using Time, At Least 35 Minutes	CPT 99232	not published	$230.51 – $230.51 – $230.51 1 insurers	—
Subsequent Hospital Care With Moderate Levelof Medical Decision Making, If Using Time, At Least 50 Minutes	CPT 99233	not published	$329.44 – $329.44 – $329.44 1 insurers	—
Subsequent Hospital Care With Straightforward Or Low Level of Medical Decision Making, Per Day, If Using Time, At Least 25 Minutes	CPT 99231	not published	$124.80 – $124.80 – $124.80 1 insurers	—
Test To Determine Lung Volumes Using Sensors	CPT 94726	$819.00	$374.86 – $397.35 – $789.67 7 insurers	$1,638.00
Test To Examine How Well The Lungs Exchange Gases	CPT 94729	$961.50	$146.17 – $146.17 – $146.17 1 insurers	$1,923.00
Test To Measure Expiratory Airflow and Volume Changes Before and After Medication Administration	CPT 94060	$843.50	$147.30 – $389.85 – $749.72 7 insurers	$1,687.00
Ultrasonic Guidance For Blood Vessel Access	CPT 76937	$1,647.00	$78.49 – $96.37 – $99.31 2 insurers	$3,294.00
Ultrasonic Guidance For Needle Placement	CPT 76942	$2,232.50	$99.91 – $111.74 – $115.14 2 insurers	$4,465.00
Ultrasound of Both Sides of Head and Neck Blood Flow	CPT 93880	$1,411.50	$239.69 – $254.07 – $512.74 7 insurers	$2,823.00
Ultrasound of Heart Blood Flow, Valves and Chambers	CPT 93320	$558.00	$111.32 – $111.32 – $111.32 1 insurers	$1,116.00
Ultrasound of Heart Blood Flow, Valves and Chambers, Follow-Up	CPT 93321	$408.00	$61.84 – $61.84 – $61.84 1 insurers	$816.00
Ultrasound of Heart, Follow-Up	CPT 93308	$822.00	$230.51 – $249.28 – $479.38 7 insurers	$1,644.00
Ultrasound of Heart With Color-Depicted Blood Flow, Rate and Valve Function	CPT 93325	$554.00	$69.70 – $69.70 – $69.70 1 insurers	$1,108.00
Ultrasound of Heart With Color-Depicted Blood Flow, Rate, Direction and Valve Function	CPT 93306	$3,340.00	$422.79 – $570.86 – $1,097.81 7 insurers	$6,680.00
Ultrasound of Heart With Probe In Esophagus, With Report	CPT 93312	$2,192.00	$434.02 – $570.86 – $1,097.81 7 insurers	$4,384.00
Ultrasound Scan of Head and Neck Soft Tissue	CPT 76536	$1,710.00	$105.02 – $204.79 – $509.56 7 insurers	$3,420.00
Ultrasound Study of Arm Or Leg Veins With Compression and Maneuvers	CPT 93970	$3,446.00	$239.69 – $254.07 – $510.49 7 insurers	$6,892.00
Ultrasound Study of One Arm Or Leg Veins With Compression and Maneuvers	CPT 93971	$2,334.00	$105.02 – $111.32 – $312.59 7 insurers	$4,668.00
Use of A Drug To Induce Depression of Consciousness By Physician Performing A Procedure (5 Years Or Older), Initial 15 Minutes	CPT 99152	$803.50	$39.34 – $39.34 – $39.34 1 insurers	$1,607.00
Visit Complexity Inherent To Evaluation and Management Associated With Medical Care Services That Serve As The Continuing Focal Point For All Needed Health Care Services and/Or With Medical Care Services That Are Part of Ongoing Care Related To A Patient'S	HCPCS G2211	not published	$55.10 – $55.10 – $55.10 1 insurers	—
X-Ray of Abdomen, 1 View	CPT 74018	$706.00	$82.35 – $90.92 – $316.05 7 insurers	$1,412.00
X-Ray of Ankle, Minimum of 3 Views	CPT 73610	$736.50	$87.42 – $111.16 – $316.05 7 insurers	$1,473.00
X-Ray of Chest, 1 View	CPT 71045	$944.50	$66.98 – $90.92 – $316.05 7 insurers	$1,889.00
X-Ray of Chest, 2 Views	CPT 71046	$998.00	$87.42 – $92.26 – $316.05 7 insurers	$1,996.00
X-Ray of Foot, Minimum of 3 Views	CPT 73630	$763.50	$87.42 – $103.29 – $316.05 7 insurers	$1,527.00
X-Ray of Hand, Minimum of 3 Views	CPT 73130	$695.00	$87.42 – $115.14 – $316.05 7 insurers	$1,390.00
X-Ray of Hip, 2-3 Views	CPT 73502	$654.50	$87.42 – $117.97 – $316.05 7 insurers	$1,309.00
X-Ray of Knee, 1-2 Views	CPT 73560	$598.00	$87.42 – $103.29 – $316.05 7 insurers	$1,196.00
X-Ray of Knee, 3 Views	CPT 73562	$732.00	$87.42 – $125.66 – $316.05 7 insurers	$1,464.00
X-Ray of Knee, 4 Or More Views	CPT 73564	$904.50	$105.02 – $144.09 – $443.84 7 insurers	$1,809.00
X-Ray of Lower and Sacral Spine, 2-3 Views	CPT 72100	$732.00	$105.02 – $115.14 – $443.84 7 insurers	$1,464.00
X-Ray of Lower Leg, 2 Views	CPT 73590	$782.50	$87.42 – $95.37 – $316.05 7 insurers	$1,565.00
X-Ray of Pelvis, 1-2 Views	CPT 72170	$596.00	$75.92 – $112.37 – $443.84 7 insurers	$1,192.00
X-Ray of Shoulder, Minimum of 2 Views	CPT 73030	$798.00	$87.42 – $101.95 – $316.05 7 insurers	$1,596.00
X-Ray of Thigh Bone, Minimum 2 Views	CPT 73552	$612.00	$87.42 – $98.80 – $316.05 7 insurers	$1,224.00
X-Ray of Wrist, Minimum of 3 Views	CPT 73110	$714.00	$87.42 – $130.94 – $316.05 7 insurers	$1,428.00