UP Health System - Bell

Cash prices

1. Blood type test (ABO)

   CPT 86900

   Facility fee only
   $33.96
   US typical $58

   Doctor fees are billed separately.
2. ALT liver enzyme test (SGPT)

   CPT 84460

   Facility fee only
   $40.66
   US typical $35

   Doctor fees are billed separately.
3. BUN kidney function blood test (urea nitrogen)

   CPT 84520

   Facility fee only
   $33.35
   US typical $30

   Doctor fees are billed separately.
4. CT scan of abdomen and pelvis (with contrast)

   CPT 74177

   Scan only
   $2,264
   US typical $2,362

   The radiologist read is billed separately.
5. Vancomycin drug level test

   CPT 80202

   Facility fee only
   $109
   US typical $101

   Doctor fees are billed separately.
6. AST liver enzyme test (SGOT)

   CPT 84450

   Facility fee only
   $40.43
   US typical $36

   Doctor fees are billed separately.
7. X-ray of knee (1-2 views)

   CPT 73560

   Scan only
   $104
   US typical $210

   The radiologist read is billed separately.
8. X-ray of neck soft tissue

   CPT 70360

   Scan only
   $106
   US typical $206

   The radiologist read is billed separately.
9. X-ray of sacrum and tailbone, at least 2 views

   CPT 72220

   Scan only
   $127
   US typical $233

   The radiologist read is billed separately.
10. Total T4 (thyroxine) thyroid test

    CPT 84436

    Facility fee only
    $48.70
    US typical $43

    Doctor fees are billed separately.
11. PSA (prostate-specific antigen) test

    CPT 84153

    Facility fee only
    $97.31
    US typical $75.95

    Doctor fees are billed separately.
12. X-ray of forearm, 2 views

    CPT 73090

    Scan only
    $110
    US typical $214

    The radiologist read is billed separately.
13. CT scan of abdomen and pelvis (no contrast)

    CPT 74176

    Scan only
    $1,760
    US typical $1,857

    The radiologist read is billed separately.
14. Blood glucose (sugar) test

    CPT 82947

    Facility fee only
    $34.04
    US typical $27

    Doctor fees are billed separately.
15. Urine sodium test

    CPT 84300

    Facility fee only
    $16.55
    US typical $31.20

    Doctor fees are billed separately.
16. Hepatitis C antibody test

    CPT 86803

    Facility fee only
    $104
    US typical $68.60

    Doctor fees are billed separately.
17. Rh blood type test (Rh D)

    CPT 86901

    Facility fee only
    $36.51
    US typical $40

    Doctor fees are billed separately.
18. Kidney function blood panel

    CPT 80069

    Facility fee only
    $102
    US typical $83.86

    Doctor fees are billed separately.
19. Ultrasound of head and neck soft tissue (e.g., thyroid)

    CPT 76536

    Scan only
    $452
    US typical $478

    The radiologist read is billed separately.
20. Pregnancy hormone (hCG) blood test, quantitative

    CPT 84702

    Facility fee only
    $96.94
    US typical $71.68

    Doctor fees are billed separately.
21. CT scan of chest (with contrast)

    CPT 71260

    Scan only
    $998
    US typical $1,433

    The radiologist read is billed separately.
22. GGT liver enzyme test

    CPT 82977

    Facility fee only
    $49.42
    US typical $40.80

    Doctor fees are billed separately.
23. X-ray of collarbone (clavicle)

    CPT 73000

    Scan only
    $113
    US typical $216

    The radiologist read is billed separately.
24. CT scan of lower back spine (lumbar), without contrast

    CPT 72131

    Scan only
    $646
    US typical $1,237

    The radiologist read is billed separately.
25. X-ray of hand, 3 or more views

    CPT 73130

    Scan only
    $121
    US typical $239

    The radiologist read is billed separately.
26. CT scan of chest (no contrast)

    CPT 71250

    Scan only
    $895
    US typical $1,095

    The radiologist read is billed separately.
27. CT scan of neck spine (cervical), without contrast

    CPT 72125

    Scan only
    $607
    US typical $1,265

    The radiologist read is billed separately.
28. X-ray of abdomen, 2 views

    CPT 74019

    Scan only
    $250
    US typical $269

    The radiologist read is billed separately.
29. X-ray of lower spine (4+ views)

    CPT 72110

    Scan only
    $214
    US typical $365

    The radiologist read is billed separately.
30. Total protein urine test

    CPT 84156

    Facility fee only
    $38.78
    US typical $30

    Doctor fees are billed separately.
31. Ultrasound of scrotum and testicles

    CPT 76870

    Scan only
    $461
    US typical $491

    The radiologist read is billed separately.
32. Valproic acid drug level test

    CPT 80164

    Facility fee only
    $95.62
    US typical $81.04

    Doctor fees are billed separately.
33. Pelvic ultrasound (complete)

    CPT 76856

    Scan only
    $423
    US typical $519

    The radiologist read is billed separately.
34. Hepatitis B surface antigen test (HBsAg)

    CPT 87340

    Facility fee only
    $55.57
    US typical $53.12

    Doctor fees are billed separately.
35. Physical therapy: therapeutic exercise (15 min)

    CPT 97110

    Facility fee only
    $42.30
    US typical $88.80

    Doctor fees are billed separately.
36. Follicle stimulating hormone (FSH) test

    CPT 83001

    Facility fee only
    $133
    US typical $89.70

    Doctor fees are billed separately.
37. Prolactin blood test

    CPT 84146

    Facility fee only
    $139
    US typical $94.76

    Doctor fees are billed separately.
38. Urine osmolality test

    CPT 83935

    Facility fee only
    $52.96
    US typical $46.15

    Doctor fees are billed separately.
39. Carcinoembryonic antigen (CEA) tumor marker test

    CPT 82378

    Facility fee only
    $120
    US typical $97

    Doctor fees are billed separately.
40. Free T3 thyroid hormone test

    CPT 84481

    Facility fee only
    $102
    US typical $88.84

    Doctor fees are billed separately.
41. CT scan of pelvis, without contrast

    CPT 72192

    Scan only
    $908
    US typical $1,140

    The radiologist read is billed separately.
42. X-ray of shoulder

    CPT 73030

    Scan only
    $127
    US typical $246

    The radiologist read is billed separately.
43. CT scan of neck soft tissue, with contrast

    CPT 70491

    Scan only
    $968
    US typical $1,356

    The radiologist read is billed separately.
44. X-ray of ankle (3+ views)

    CPT 73610

    Scan only
    $108
    US typical $243

    The radiologist read is billed separately.
45. X-ray of upper arm (humerus), 2 or more views

    CPT 73060

    Scan only
    $124
    US typical $218

    The radiologist read is billed separately.
46. CT scan of face and sinuses, without contrast

    CPT 70486

    Scan only
    $735
    US typical $1,044

    The radiologist read is billed separately.
47. X-ray of foot, 3 or more views

    CPT 73630

    Scan only
    $118
    US typical $239

    The radiologist read is billed separately.
48. Total T3 thyroid hormone test

    CPT 84480

    Facility fee only
    $102
    US typical $72.86

    Doctor fees are billed separately.
49. CT scan of abdomen, with contrast

    CPT 74160

    Scan only
    $1,241
    US typical $1,455

    The radiologist read is billed separately.
50. Alkaline phosphatase (ALP) test

    CPT 84075

    Facility fee only
    $39.71
    US typical $30.75

    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.