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Hospital bill prices by code: what Medicare pays

For each common code on a hospital bill: Medicare's average allowed amount, the average amount billed, and how to question the line. National averages, office setting, CMS 2024 data.

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Blood and lab tests

ServiceMedicareBilled
CPT 80053: Comprehensive metabolic panel (CMP)$10.33$61.45
CPT 80048: Basic metabolic panel (BMP)$8.27$47.97
CPT 85025: CBC with differential$7.59$37.12
CPT 85027: CBC without differential$6.33$31.99
CPT 80061: Lipid panel (cholesterol)$13.09$96.06
CPT 80076: Liver function panel$7.99$44.28
CPT 84484: Troponin test$12.17$101.34
CPT 83690: Lipase test$6.73$46.08
CPT 83605: Lactic acid test$11.31$64.38
CPT 83735: Magnesium test$6.55$38.22
CPT 85610: PT/INR clotting test$4.19$27.41
CPT 85730: PTT clotting test$5.88$44.98
CPT 83880: BNP test$38.41$170.55
CPT 87040: Blood culture$10.09$87.62
CPT 87086: Urine culture$7.90$51.07
CPT 81001: Urinalysis with microscopy$3.10$31.94
CPT 81003: Automated urinalysis$2.19$15.18
CPT 83036: Hemoglobin A1c test$9.49$58.04
CPT 84443: TSH thyroid test$16.44$95.90
CPT 82947: Glucose test$3.83$22.94
CPT 84132: Potassium test$4.63$22.03
CPT 82565: Creatinine test$4.89$22.73
CPT 86900: Blood type test (ABO)$2.92$35.81
CPT 86901: Rh blood type test$2.92$37.53
CPT 86850: Antibody screen$9.54$68.75
CPT 87635: COVID-19 PCR test$50.06$126.56
CPT 87426: COVID-19 antigen test$34.30$97.92
CPT 87804: Rapid flu test$16.07$43.91
CPT 87880: Rapid strep test$16.03$45.06
CPT 36415: Blood draw (venipuncture)$8.49$21.82
CPT 88305: Tissue pathology exam$57.93$185.12
CPT 88342: Special tissue stain$82.90$219.63

Imaging

ServiceMedicareBilled
CPT 70450: CT scan of the head without contrast$76.05$563.09
CPT 70470: CT scan of the head with and without contrast$118.33$743.83
CPT 70486: CT scan of the face without contrast$103.39$588.40
CPT 71045: Chest X-ray, 1 view$14.40$41.07
CPT 71046: Chest X-ray, 2 views$23.13$89.42
CPT 71250: CT scan of the chest without contrast$97.80$671.96
CPT 71260: CT scan of the chest with contrast$84.20$704.47
CPT 72125: CT scan of the neck spine without contrast$92.71$719.89
CPT 73030: Shoulder X-ray$28.42$108.39
CPT 73110: Wrist X-ray$33.75$118.50
CPT 73130: Hand X-ray$30.74$108.28
CPT 73560: Knee X-ray, 1 or 2 views$27.08$92.90
CPT 73562: Knee X-ray, 3 views$34.38$122.52
CPT 73590: Lower leg X-ray$22.91$84.48
CPT 73610: Ankle X-ray$29.92$104.39
CPT 73630: Foot X-ray$29.78$95.28
CPT 74176: CT scan of the abdomen and pelvis without contrast$136.21$813.89
CPT 74177: CT scan of the abdomen and pelvis with contrast$200.77$1,075.40
CPT 74018: Abdominal X-ray, 1 view$19.43$67.28
CPT 76700: Complete abdominal ultrasound$98.56$336.81
CPT 76705: Limited abdominal ultrasound$63.10$266.02
CPT 76770: Kidney and retroperitoneal ultrasound$85.56$316.42
CPT 76856: Complete pelvic ultrasound$91.72$328.46
CPT 76830: Transvaginal ultrasound$104.70$349.29
CPT 76801: Pregnancy ultrasound, first trimester$98.73$365.98
CPT 76805: Pregnancy ultrasound, after 14 weeks$114.65$387.30
CPT 76815: Limited pregnancy ultrasound$68.19$267.60
CPT 77067: Screening mammogram$92.58$333.50
CPT 77063: 3D screening mammogram (add-on)$40.12$162.08
CPT 70551: MRI of the brain without contrast$155.06$1,290.96
CPT 70553: MRI of the brain with and without contrast$229.98$1,918.76
CPT 72148: MRI of the lower back without contrast$144.78$1,235.09

Heart tests

ServiceMedicareBilled
CPT 93005: EKG tracing only$6.14$55.92
CPT 93000: EKG with interpretation$14.20$69.03
CPT 93306: Echocardiogram (heart ultrasound)$173.10$690.55
CPT 93880: Carotid artery ultrasound$170.09$531.14

Injections and IV

ServiceMedicareBilled
CPT 96374: IV push, first drug$36.52$154.04
CPT 96375: IV push, each additional drug$14.94$81.45
CPT 96365: IV infusion, first hour$60.45$222.72
CPT 96366: IV infusion, each additional hour$19.46$89.59
CPT 96360: IV hydration, first hour$31.69$166.48
CPT 96361: IV hydration, each additional hour$12.35$73.00
CPT 96372: Injection into a muscle or under the skin$13.42$55.33
CPT 90471: Vaccine administration$18.79$49.99

Drugs and vaccines

ServiceMedicareBilled
CPT 90715: Tdap vaccine$37.48$87.91
CPT 90686: Flu vaccine$21.42$37.68
CPT J1885: Ketorolac (Toradol) injection, per 15 mg$0.65$13.23
CPT J2405: Ondansetron (Zofran) injection, per 1 mg$0.09$6.57
CPT J0696: Ceftriaxone injection, per 250 mg$0.45$16.56
CPT J1100: Dexamethasone injection, per 1 mg$0.11$4.56
CPT J3010: Fentanyl injection, per 0.1 mg$0.90$11.02
CPT J2270: Morphine injection, up to 10 mg$4.16$33.57
CPT J7030: Saline IV bag, 1000 cc$2.58$19.69
CPT J7120: Lactated Ringer's IV bag, up to 1000 cc$2.40$25.55
CPT J0131: IV acetaminophen, per 10 mg$0.05$4.04
CPT J1170: Hydromorphone injection, up to 4 mg$3.56$13.04
CPT J2550: Promethazine injection, up to 50 mg$3.20$15.52

Visits

ServiceMedicareBilled
CPT 99213: Office visit, established patient, low complexity$85.37$189.25
CPT 99214: Office visit, established patient, moderate complexity$119.71$276.45
CPT 99203: Office visit, new patient, low complexity$105.33$267.25
CPT 99204: Office visit, new patient, moderate complexity$160.28$410.82

Procedures

ServiceMedicareBilled
CPT 12001: Simple wound repair, small$79.16$286.74
CPT 12002: Simple wound repair, medium$95.18$322.81
CPT 12011: Simple wound repair of the face$86.09$315.55
CPT 10060: Abscess drainage$120.51$249.63
CPT 20610: Large joint injection or aspiration$66.41$281.20
CPT 29125: Forearm and hand splint$62.14$221.96