Fairview Hospital

Cash prices

1. Comprehensive metabolic panel (CMP) blood test

   CPT 80053

   Facility fee only
   $96.90
   US typical $100

   Doctor fees are billed separately.
2. Chest X-ray (1 view)

   CPT 71045

   Scan only
   $250
   US typical $191

   The radiologist read is billed separately.
3. TSH (thyroid) test

   CPT 84443

   Facility fee only
   $52.73
   US typical $71

   Doctor fees are billed separately.
4. Hemoglobin A1c (diabetes) test

   CPT 83036

   Facility fee only
   $39.90
   US typical $51

   Doctor fees are billed separately.
5. Prothrombin time (PT/INR) clotting test

   CPT 85610

   Facility fee only
   $16.67
   US typical $27.20

   Doctor fees are billed separately.
6. Chest X-ray (2 views)

   CPT 71046

   Scan only
   $250
   US typical $219

   The radiologist read is billed separately.
7. Magnesium test

   CPT 83735

   Facility fee only
   $58
   US typical $34.43

   Doctor fees are billed separately.
8. Potassium blood test

   CPT 84132

   Facility fee only
   $39.79
   US typical $33

   Doctor fees are billed separately.
9. Lipid panel (cholesterol) blood test

   CPT 80061

   Doctor fee only
   $69.35
   US typical $71.50
10. Free T4 (thyroid hormone) test

    CPT 84439

    Facility fee only
    $94.19
    US typical $56.70

    Doctor fees are billed separately.
11. Uric acid blood test

    CPT 84550

    Facility fee only
    $39.11
    US typical $39

    Doctor fees are billed separately.
12. X-ray of abdomen, 1 view

    CPT 74018

    Scan only
    $258
    US typical $209

    The radiologist read is billed separately.
13. Partial thromboplastin time (PTT) clotting test

    CPT 85730

    Facility fee only
    $18.91
    US typical $37.50

    Doctor fees are billed separately.
14. Phosphorus test

    CPT 84100

    Facility fee only
    $41.08
    US typical $35.40

    Doctor fees are billed separately.
15. Liver function (hepatic) panel

    CPT 80076

    Facility fee only
    $95.67
    US typical $81.60

    Doctor fees are billed separately.
16. Hemoglobin blood test

    CPT 85018

    Doctor fee only
    $10.45
    US typical $20
17. X-ray of pelvis, 1-2 views

    CPT 72170

    Scan only
    $270
    US typical $223

    The radiologist read is billed separately.
18. Creatine kinase (CK) test, total

    CPT 82550

    Facility fee only
    $56.46
    US typical $44.20

    Doctor fees are billed separately.
19. Creatinine blood test

    CPT 82565

    Facility fee only
    $44.27
    US typical $33

    Doctor fees are billed separately.
20. Lactic acid (lactate) test

    CPT 83605

    Facility fee only
    $92.38
    US typical $67

    Doctor fees are billed separately.
21. Bacterial culture, aerobic (not urine, blood, or stool)

    CPT 87070

    Facility fee only
    $27.03
    US typical $55.80

    Doctor fees are billed separately.
22. Iron test

    CPT 83540

    Facility fee only
    $21.49
    US typical $42.10

    Doctor fees are billed separately.
23. Vitamin B12 test

    CPT 82607

    Facility fee only
    $129
    US typical $75.60

    Doctor fees are billed separately.
24. Ferritin test

    CPT 82728

    Facility fee only
    $118
    US typical $76.85

    Doctor fees are billed separately.
25. Troponin test, quantitative

    CPT 84484

    Facility fee only
    $152
    US typical $89.50

    Doctor fees are billed separately.
26. BNP heart failure blood test (natriuretic peptide)

    CPT 83880

    Facility fee only
    $208
    US typical $135

    Doctor fees are billed separately.
27. Lipase test

    CPT 83690

    Facility fee only
    $59.56
    US typical $56.61

    Doctor fees are billed separately.
28. Creatinine test, urine or other non-blood sample

    CPT 82570

    Facility fee only
    $18.71
    US typical $26

    Doctor fees are billed separately.
29. Ultrasound of abdomen (complete)

    CPT 76700

    Scan only
    $688
    US typical $617

    The radiologist read is billed separately.
30. Amylase test

    CPT 82150

    Facility fee only
    $56.11
    US typical $44.50

    Doctor fees are billed separately.
31. X-ray of neck spine (cervical), 2-3 views

    CPT 72040

    Read only
    $76.95
    US typical $255
32. Folic acid (folate) blood test

    CPT 82746

    Facility fee only
    $127
    US typical $76.80

    Doctor fees are billed separately.
33. X-ray of lower back spine (lumbosacral), 2-3 views

    CPT 72100

    Scan only
    $450
    US typical $279

    The radiologist read is billed separately.
34. LDH (lactate dehydrogenase) test

    CPT 83615

    Facility fee only
    $52.29
    US typical $34.81

    Doctor fees are billed separately.
35. Blood infection test (bacterial culture)

    CPT 87040

    Facility fee only
    $89.36
    US typical $96.19

    Doctor fees are billed separately.
36. Gram stain smear for bacteria or fungi

    CPT 87205

    Facility fee only
    $16.70
    US typical $35.40

    Doctor fees are billed separately.
37. Direct bilirubin blood test

    CPT 82248

    Facility fee only
    $43.42
    US typical $38.35

    Doctor fees are billed separately.
38. Total calcium blood test

    CPT 82310

    Facility fee only
    $44.60
    US typical $36

    Doctor fees are billed separately.
39. C-reactive protein (CRP) blood test

    CPT 86140

    Facility fee only
    $60.59
    US typical $43.16

    Doctor fees are billed separately.
40. Vitamin D test

    CPT 82306

    Facility fee only
    $164
    US typical $101

    Doctor fees are billed separately.
41. Sodium blood test

    CPT 84295

    Facility fee only
    $41.63
    US typical $33.15

    Doctor fees are billed separately.
42. Total bilirubin blood test

    CPT 82247

    Facility fee only
    $43.42
    US typical $32.90

    Doctor fees are billed separately.
43. Total cortisol test

    CPT 82533

    Facility fee only
    $141
    US typical $74.10

    Doctor fees are billed separately.
44. Parathyroid hormone (PTH) blood test

    CPT 83970

    Facility fee only
    $357
    US typical $156

    Doctor fees are billed separately.
45. CT scan of head/brain (no contrast)

    CPT 70450

    Scan only
    $1,020
    US typical $1,078

    The radiologist read is billed separately.
46. Albumin blood test

    CPT 82040

    Facility fee only
    $42.95
    US typical $25.60

    Doctor fees are billed separately.
47. Ammonia blood test

    CPT 82140

    Facility fee only
    $126
    US typical $78

    Doctor fees are billed separately.
48. Hematocrit blood test

    CPT 85014

    Facility fee only
    $22.74
    US typical $21

    Doctor fees are billed separately.
49. Ultrasound of abdomen (limited)

    CPT 76705

    Scan only
    $252
    US typical $460

    The radiologist read is billed separately.
50. Total testosterone blood test

    CPT 84403

    Facility fee only
    $223
    US typical $91.35

    Doctor fees are billed separately.

Prices are published cash prices with their source and the date we last checked. Confirm with the provider before you book. Hospital prices for a billing code are often the facility charge only.