CPT Code Lookup: What It Means and What It Costs
Your bill and cost estimate are full of five-digit CPT codes like 99204, 72148, or 45378. Each one names a specific service and largely sets the price. Look yours up to see what it is, in plain English, and what it typically costs.
Look up a CPT code
Enter the CPT code from your bill or estimate (for example 99204, 72148, or 45378) to see what it is and what it typically costs. Nothing is saved.
Common codes
Established patient office visit, level 3
A routine follow-up visit with a doctor you have seen before, for a straightforward problem (about 20-29 minutes).
Typical self-pay (cash)
$90 to $180
With insurance
Your copay or coinsurance, often $20 to $60.
Tip: The most common office-visit code. A telehealth version is usually cheaper.
Established patient office visit, level 4
A follow-up visit for a more complex or worsening problem, or one needing more decision-making (about 30-39 minutes).
Typical self-pay (cash)
$120 to $250
With insurance
Your copay or coinsurance.
Tip: Higher level than 99213 because the visit was more involved.
New patient office visit, level 4
A first visit with a new doctor for a moderately complex problem needing a detailed workup (about 45-59 minutes).
Typical self-pay (cash)
$170 to $350
With insurance
Your copay or coinsurance, then any tests are billed separately.
Tip: A very commonly searched code. If billed at a hospital-owned clinic, watch for a separate facility fee.
Emergency department visit, high complexity
The facility charge for a serious ER visit (the highest routine level). This is separate from the doctor and any tests.
Typical self-pay (cash)
$1,000 to $3,000+ (facility fee alone)
With insurance
Your ER copay plus deductible and coinsurance, up to your out-of-pocket max.
Tip: The ER facility fee is the biggest driver of a high ER bill.
Comprehensive metabolic panel (CMP)
A common blood panel checking kidney and liver function, blood sugar, and electrolytes.
Typical self-pay (cash)
$10 to $60
With insurance
Often $0 to a small coinsurance; frequently applied to your deductible.
Tip: Far cheaper at a standalone lab (Quest, Labcorp) than a hospital.
Routine blood draw (venipuncture)
The charge for drawing the blood sample itself, separate from the tests run on it.
Typical self-pay (cash)
$3 to $25
With insurance
Usually a few dollars or bundled.
Tip: A small add-on line you will see alongside any blood test.
MRI of the lower (lumbar) spine, without contrast
An MRI of your lower back, commonly ordered for back pain, sciatica, or leg numbness.
Typical self-pay (cash)
$300 to $800 (imaging center) up to $2,000+ (hospital)
With insurance
Deductible plus coinsurance; often needs prior authorization.
Tip: Shopping a standalone imaging center can cut this by more than half.
MRI of the brain, with and without contrast
A brain MRI done both with and without contrast dye, often for headaches, dizziness, or neurologic symptoms.
Typical self-pay (cash)
$400 to $1,200 (imaging center); more at a hospital
With insurance
Deductible plus coinsurance; usually needs prior authorization.
Tip: The without-contrast-only version (CPT 70551) is cheaper.
Screening mammogram (bilateral)
A routine screening mammogram of both breasts for someone with no symptoms.
Typical self-pay (cash)
$100 to $250
With insurance
$0 as a covered preventive service in-network under the ACA.
Tip: If it is billed as diagnostic (CPT 77066), the $0 benefit does not apply.
Colonoscopy (diagnostic)
A colonoscopy done to evaluate symptoms such as bleeding or a change in bowel habits.
Typical self-pay (cash)
$1,000 to $3,000 (surgery center); more at a hospital
With insurance
Deductible plus coinsurance. A routine SCREENING colonoscopy is $0 in-network.
Tip: If a polyp is removed during a screening colonoscopy, coding can shift and a bill may appear.
Cost ranges are national estimates for 2026 and vary widely by location, facility, and your plan. CPT is a registered trademark of the American Medical Association. This tool is general cost information, not medical, billing, or coding advice.
Why the CPT code decides your price
A CPT code identifies exactly what was done, and the price follows the code. The catch is that the same code can cost wildly different amounts depending on where it is performed. An MRI of the lower back (CPT 72148) might be $300 at a standalone imaging center and over $2,000 at a hospital. A comprehensive metabolic panel (CPT 80053) can be $15 at an independent lab and ten times that at a hospital. The difference is almost always the facility fee.
That is why knowing the CPT code is powerful: it lets you compare the identical service across facilities, and it lets you check that your bill matches the care you actually received. To turn the code into a real number for your ZIP and insurance, use the free cost estimator.
A CPT code on your bill looks wrong?
Upcoding, unbundling, and duplicate CPT codes are common and can inflate a bill by hundreds or thousands of dollars. Send us the itemized bill. CareRoute Bill Defense checks each code against the care you received, disputes the errors, and negotiates down what is left.
Have us review the billFree to submit. You only pay if we save you money.
Frequently asked questions
What is a CPT code?
A CPT (Current Procedural Terminology) code is a five-character code that identifies a specific medical service, such as an office visit, lab test, imaging study, or surgery. Doctors and hospitals put CPT codes on your bill and on the claim sent to your insurer, and the code largely determines the price. CPT is maintained by the American Medical Association.
Does the CPT code on my bill tell me the price?
It tells you what was done, which is the biggest driver of price, but the same code can cost very different amounts depending on where it was performed and who is paying. For example, an MRI (CPT 72148) can cost $300 at a standalone imaging center and over $2,000 at a hospital. Use the CPT code to compare prices across facilities and to check that you were billed for what actually happened.
Why is the same CPT code so much cheaper at one place than another?
The main reason is the facility fee. Hospitals and hospital-owned clinics add a facility charge that standalone imaging centers, labs, and surgery centers do not, so the identical procedure under the same CPT code can cost several times more at a hospital. For shoppable services like imaging and labs, calling a few outpatient facilities for their cash price often saves hundreds to thousands of dollars.
What is the difference between a CPT code and a diagnosis (ICD) code?
A CPT code describes what was done (the procedure or service). A diagnosis code, called an ICD-10 code, describes why it was done (your condition). Insurers look at both together to decide coverage. A mismatch, for example a screening service coded with a diagnostic reason, is a common cause of a surprise bill and is often fixable.
The CPT code on my bill does not match what happened. What can I do?
Request an itemized bill and compare each CPT code to the care you actually received. Upcoding (billing a higher-level code than warranted), unbundling (charging separately for services that should be one code), and duplicate codes are common and reviewable. If something looks off, you can dispute it with the provider, or send the itemized bill to CareRoute Bill Defense to review and negotiate.
Related
Sources & references
Cost ranges are national estimates for 2026 and vary widely by location, facility, and your specific plan. CPT is a registered trademark of the American Medical Association; codes are referenced here for identification and educational purposes only. This is general cost information, not medical, billing, or coding advice. Last updated: September 2026.