How to find a procedure price by CPT code

What a CPT code is, and where yours appears

CPT stands for Current Procedural Terminology. A CPT code is the standard code a provider uses to name a specific service on an order, an estimate, a claim, and a bill. The code never travels alone. It comes with a descriptor, a one-line definition of the service. On this site, for example, CPT 70450 is recorded with the descriptor "Computed tomography, head or brain; without contrast material" and CPT 74177 is recorded as "Computed tomography, abdomen and pelvis; with contrast material(s)". Two codes can describe services that sound alike in plain language and still be different services with different anchors, which is why the descriptor matters as much as the digits.

You will usually meet your code in one of four places. First, on the printed or electronic order from the clinician who referred you, often next to the procedure name. Second, in your patient portal, where the order or the scheduled appointment may show the code beside the service. Third, on a written estimate or Good Faith Estimate, where each expected line should carry its own code. Fourth, after service, on the itemized bill and on the explanation of benefits from a health plan, where the code is what was actually billed. The code can shift between the first and fourth documents, and a later section of this guide covers what to do when it does. For price shopping before you book, the order is the document to start from, because it records what was asked for before anyone performed anything.

If no code appears anywhere you can see, ask the ordering clinician's office one direct question: "What CPT code was ordered for this procedure?" Write the answer down with the descriptor. That office ordered the service, so it can name the code. Do not guess a code from the procedure name on a general website, including this one. The table below can confirm a code and show its anchors. It cannot tell you which code your clinician ordered.

How to read the code you have

Read the code in three parts: the digits, the descriptor, and the variants sitting next to it. The digits identify the service. The descriptor fixes the details that move the price: the body area, whether contrast is used, whether the study is complete or limited, how many views were taken, and whether a biopsy is part of the service. The variants are the nearby codes for the same kind of service with one of those details changed. The checked-in data behind this site records a variant warning for nearly every procedure, because variant mix-ups are the most common reason a quote and a bill disagree.

Three recorded examples show the pattern. Brain MRI without contrast is CPT 70551. Brain MRI without contrast followed by contrast is a different code, CPT 70553, with a higher anchor in every setting, because contrast adds scanner time and a contrast agent. CT of the head without contrast is CPT 70450; the same site data notes that with contrast is a separate code and without followed by with is a third. A complete abdominal ultrasound and a limited abdominal ultrasound, one organ or one quadrant, carry different codes and different anchors. In each case the plain-language name barely changes while the code, and the price built on it, changes a lot. Before you compare any two prices, confirm that both are for the same code and the same descriptor. If they are not, you are not looking at a price difference. You are looking at two different services.

Two more reading habits help. Codes on estimates and bills sometimes appear with a modifier, a short addition that says how the service was billed, such as the professional component marker 26 you will see in the table below. A modifier does not replace the code; the five digits still name the service. And some services are billed as a pair: a main code plus an add-on code, such as a screening mammogram with a tomosynthesis add-on. If your order or estimate shows two codes, price both. A quote that covers only the first code is incomplete.

The recorded anchors for all 30 procedures on this site

The table below is the working asset for this guide. Every row comes from the checked-in data file behind this site (src/data/procedures.json), and every figure is printed on the matching procedure page with its source. All 30 procedures recorded on this site have a CPT code recorded, so all 30 appear here. If your code is not in this table, this site has no verified anchor for it, and no figure should be borrowed from a nearby row.

How the columns are built. Hospital outpatient shows the OPPS facility anchor: the CY2026 national unadjusted facility payment from the CMS OPPS CY2026 Final Rule CMS-1834-FC, facility portion only, before wage-index adjustment, with the professional fee billed on top of it. Imaging center shows the Physician Fee Schedule (PFS) global anchor: one amount that covers the technical component and the professional component when one entity bills both, which is the usual imaging center pattern. Physician office shows the PFS nonfacility anchor, the amount recorded for a service performed in an office, where the office overhead sits inside the rate instead of billing as a separate facility fee. Facility professional shows the PFS facility anchor: the professional amount recorded when the work is done in a hospital or a surgery center (ASC) and the facility bills its own fee separately. Professional (26) shows the professional component recorded inside the global split. PFS amounts are CY2026 amounts for Michigan Locality 01, published by WPS GHA, effective January 1, 2026. Another locality will differ. All anchors were verified 2026-10-18.

One gap in the data is stated plainly, because the table would mislead without it. The checked-in data records no separate ASC facility payment figure for any of the 30 procedures. A surgery center does charge a facility fee, and that fee is a real layer of an ASC bill, but no verified ASC facility amount is published in the site's data, so the table has no ASC dollar column and invents none. For an ASC booking, the recorded figures you can use are the PFS facility professional anchor, which is the professional layer inside that setting, plus the all-in cash price the center itself gives you in writing. Treat any ASC quote that names only the professional figure as incomplete, the same way you would treat a hospital quote that names only its facility figure.

A cell that reads "Not recorded" means the checked-in data publishes no anchor of that type for that code. It does not mean the layer costs nothing. It means this site has not verified a figure for that layer, and the facility's written quote is the source for it.

Procedure	CPT	Hospital outpatient: OPPS facility anchor	Imaging center: PFS global anchor	Physician office: PFS nonfacility anchor	Facility setting (hospital or ASC): PFS facility professional anchor	Professional component (26)
MRI Without Contrast	70551	$243.77	$192.65	Not recorded	Not recorded	$69.04
MRI With Contrast	70553	$356.43	$312.34	Not recorded	Not recorded	$107.27
CT Abdomen and Pelvis	74177	$356.43	$294.96	Not recorded	Not recorded	$85.62
CT Head	70450	$106.81	$105.23	Not recorded	Not recorded	$40.21
Ultrasound Abdomen	76700	$106.81	$112.60	Not recorded	Not recorded	$37.99
Screening Mammogram	77067	Not recorded	$123.91	Not recorded	Not recorded	$35.67
Colonoscopy	45378	Not recorded	Not recorded	$378.46	$172.49	Not recorded
Upper Endoscopy (EGD)	43235	Not recorded	Not recorded	$319.52	$114.85	Not recorded
X-Ray Chest	71046	Not recorded	$32.64	Not recorded	Not recorded	$10.16
Echocardiogram	93306	Not recorded	$193.43	Not recorded	Not recorded	$67.97
MRI Lumbar Spine	72148	$243.77	$189.10	Not recorded	Not recorded	$69.69
MRI Knee	73721	$243.77	$200.97	Not recorded	Not recorded	$63.82
CT Chest	71250	$106.81	$130.87	Not recorded	Not recorded	$50.38
CT Abdomen and Pelvis Without Contrast	74176	$243.77	$181.27	Not recorded	Not recorded	$81.19
Ultrasound Pelvis	76856	$106.81	$103.52	Not recorded	Not recorded	$33.01
Ultrasound Transvaginal	76830	$106.81	$115.68	Not recorded	Not recorded	$33.01
Ultrasound Abdomen Limited	76705	$106.81	$84.80	Not recorded	Not recorded	$27.83
Diagnostic Mammogram	77066	Not recorded	$154.56	Not recorded	Not recorded	$47.39
DXA Bone Density	77080	$106.81	$38.75	Not recorded	Not recorded	$9.50
Ultrasound Thyroid and Neck	76536	$106.81	$106.36	Not recorded	Not recorded	$26.83
X-Ray Lumbar Spine	72100	$106.81	$39.73	Not recorded	Not recorded	$10.80
Echocardiogram Limited	93308	$243.77	$99.23	Not recorded	Not recorded	$24.94
Sleep Study (Polysomnography)	95810	$877.34	$659.23	Not recorded	Not recorded	$120.89
Colonoscopy With Biopsy	45380	$1,222.56	Not recorded	$477.34	$185.64	Not recorded
Upper Endoscopy (EGD) With Biopsy	43239	$926.63	Not recorded	$413.41	$128.48	Not recorded
Carpal Tunnel Release	64721	$1,995.02	Not recorded	$495.26	$437.89	Not recorded
Cataract Surgery	66984	$2,357.81	Not recorded	Not recorded	$467.80	Not recorded
Knee Arthroscopy (Meniscectomy)	29881	$3,342.87	Not recorded	Not recorded	$539.38	Not recorded
Physical Therapy Evaluation	97161	Not recorded	Not recorded	$96.48	$96.48	Not recorded
Cardiovascular Stress Test	93015	Not recorded	Not recorded	$72.73	$72.73	Not recorded

Sources for every figure in the table: CMS Physician Fee Schedule CY2026 via WPS GHA, Michigan Locality 01, and CMS OPPS CY2026 Final Rule CMS-1834-FC, as recorded per procedure in src/data/procedures.json, verified 2026-10-18. Method: Procedure Price Method v1.0. The columns sit side by side on purpose. This site never adds payment layers into a total that no source published, because a real bill runs through wage adjustments, plan contracts, and facility cash pricing that the anchors do not capture.

Step by step: from the code on your order to a price in writing

1. Copy the code and descriptor exactly. Take both from the order, the portal, or the ordering office, including any add-on code. Write down who gave you the code and on what date.
2. Find the row and open the procedure page. Match your code in the table above, then open the linked procedure page. The page prints the descriptor, what the anchor includes, what it excludes, and the variant codes that could replace yours if the plan changes. Three pages used often with this guide are MRI without contrast (CPT 70551), CT head (CPT 70450), and CT abdomen and pelvis (CPT 74177). For an endoscopy, start at colonoscopy (CPT 45378), where anesthesia and pathology sit outside the procedure anchor.
3. Note the anchors for the settings open to you. If your clinician can send you to either a hospital outpatient department or a freestanding center, write down both columns for your code. The gap between those two columns is the setting lever, and it is usually larger than any difference you will talk a single facility into.
4. Ask each facility for the all-in cash price for that code in that setting. Use the wording in the next section. One sentence, used the same way at every facility, makes the answers comparable.
5. If you are uninsured or paying for yourself, ask for the written price as a Good Faith Estimate. The estimate form carries a federal dispute protection that a phone quote does not. The Good Faith Estimates and the No Surprises Act guide covers who qualifies, what the estimate must list, and the timing rules.
6. Book only after the chosen price is in writing, with the code, the setting, the inclusions, and the day-of-change rule named. A verbal number with no code attached is not a confirmed price.
7. After service, match the bill to the estimate code by code. If a provider billed at least $400 more than its own Good Faith Estimate, the Good Faith Estimate Checker totals both documents, flags the changed lines, and applies that $400 test for one provider at a time, using only numbers you type in.

The facility fee: same code, different setting, different price

The worked example below uses only recorded anchors, for brain MRI without contrast, CPT 70551. At an imaging center, the recorded PFS global anchor is $192.65: $69.04 professional plus $123.61 technical, in one amount, because one entity bills both parts. In a hospital outpatient department, the recorded OPPS facility anchor for the same code is $243.77, and that figure is the facility portion only. The professional fee bills on top of it. Read those two figures side by side and the structure is clear even before any cash price enters the picture: the hospital facility layer alone sits above the entire imaging center global amount, and the hospital total has a second layer still to come.

That is the facility fee in practice. It is not a charge for a different scan. The code, the scanner work, and the reading are the same service in both rows. What changes is the billing identity of the building. A hospital outpatient department, including a department that sits off the hospital campus, bills a facility layer under OPPS and a professional layer under the PFS. A freestanding imaging center usually bills one global amount. An office folds its overhead into the nonfacility rate. A surgery center bills its own facility fee beside the PFS facility professional amount. Four settings, one code, four billing structures. This is why the first question on any quote is not the number. It is which setting the number belongs to, and which layers it includes.

The hospital outpatient vs imaging center guide walks through this split for 11 imaging procedures in more depth, and the facility-type pages describe how each setting bills. Use them after you have your row in the table above, when you want to understand why two settings quote so far apart for the same code. The hospital's own published row for your code is the other half of that homework: How to use a hospital's published prices explains how to find the transparency posting and read its discounted cash price and negotiated charge columns before any call is made.

What to ask billing, with the code in hand

A CPT code turns a general price question into a specific one, and billing offices answer specific questions with specific numbers. Use the same core sentence at every facility: "What is the all-in cash price for CPT [your code] performed in [setting], including the professional fee, the facility fee, anesthesia, and pathology if they apply? Please list what is included and what would bill separately." Then add the code-specific follow-ups:

• "Is the code I gave you the code you will bill if nothing changes? If the plan changes on the day, what code will be billed instead, and what is the price for that code?"
• "Is your price a global price, a facility-only price, or a professional-only price? Who bills the other layers?"
• "Does this setting bill as a hospital outpatient department, a surgery center, an imaging center, or an office for this code?"
• "Are there add-on codes expected with this service, and are they inside the price you just gave me?"
• "Can you send the price in writing with the CPT code, the setting, and the inclusions listed, and tell me how long it stays valid?"

The cash price guide gives the full call checklist built around that first sentence, including how to record who quoted you and how to compare two quotes layer by layer. The billing questions checklist covers the same call from the setting and day-of-change side. Bring your code, your row from the table above, and those two checklists, and the call stays short.

When the code on the estimate differs from the code billed

A code change between documents has three common causes, and each one calls for a different response. The first is a plan change on the day. The clearest recorded example on this site is colonoscopy. A diagnostic colonoscopy is CPT 45378, with a recorded PFS nonfacility anchor of $378.46 and a facility professional anchor of $172.49. If a biopsy is taken, the billed code becomes CPT 45380, colonoscopy with biopsy, recorded at $477.34 nonfacility and $185.64 facility professional, plus a pathology layer for the tissue sample. The service genuinely changed, so the code and the price changed with it. Your protection is the day-of-change question asked before service: get the changed-code price in writing at booking, not as a surprise on the bill.

The second cause is a scope correction: the order expected one study and a different study was the right record of what was performed, for example a limited ultrasound billed instead of the complete study that was estimated, or the reverse. Ask the billing office to name the code on the estimate, the code on the bill, and the reason for the swap, in writing. A scope correction should be explainable in one sentence tied to what was actually done.

The third cause is a plain coding or clerical error: a code for a service you did not receive, a duplicate line, or a code that matches nothing in your visit. That one is the provider's to fix. The itemized bill guide gives the line-by-line procedure for duplicates, quantities, dates, and services not received. In all three cases, keep the estimate and the bill together and compare them code by code before you pay. If you were uninsured or self-pay and you hold a Good Faith Estimate, run that provider's estimate lines and bill lines through the Good Faith Estimate Checker. It flags lines that changed, were added, or are missing, and tests the difference against the $400 dispute threshold published by CMS. A changed code that was explained and priced in advance will show up as a changed line you already knew about. A changed code nobody mentioned is the line to raise on the call.

What the anchors cannot do

An anchor is not a quote, a prediction, or a ceiling. The PFS figures here are one locality, Michigan Locality 01, and a facility in another locality works from a different PFS amount. The OPPS figures are national unadjusted rates, and a real hospital payment is adjusted before it is final. Cash prices are set by each facility and are published nowhere in the Medicare files this site draws from, which is why this site publishes no self-pay range it cannot verify. Use the anchors for the two jobs they do well: judging whether a quote is in a plausible range for its layer, and seeing how much of a quote is the setting rather than the service. The price itself comes from one place only, the facility, in writing, before service.

This guide also stays on the billing side of the line, like everything on this site. It does not say whether a procedure should happen, which setting is medically right for you, or how to read a result. Those questions belong to your clinician. What it gives you is the code-based route to a complete price, so the money conversation is finished before the appointment, not started by the bill.

CPT code price questions

Data and rules cited

All procedure names, CPT codes, descriptors, and anchor figures on this page come from the checked-in data file src/data/procedures.json on this site: CMS Physician Fee Schedule CY2026 via WPS GHA, Michigan Locality 01, effective January 1, 2026, and CMS Hospital Outpatient Prospective Payment System (OPPS) CY2026 Final Rule CMS-1834-FC, verified 2026-10-18. The $400 Good Faith Estimate dispute threshold and the patient-provider dispute process are published by the Centers for Medicare and Medicaid Services on its No Surprises Act consumer pages, as covered in the Good Faith Estimate guide on this site. Method: Procedure Price Method v1.0.

This page is general educational information about medical billing. It is not medical, legal, or financial advice for your situation. For a dispute or a billing decision with a deadline, use the CMS pages linked from the Good Faith Estimate guide or a qualified advisor. Confirm your price in writing before service.