CPT 91120
Test - Miscellaneous
Retired code25 hospitals with prices
This code is retired. Some hospitals still list it.
What Washington hospitals publish for this code
Medicaid managed care: Rate for an Apple Health managed-care plan. Applies only to members of that plan.
| Hospital | Medicaid managed care rates (lowest – highest) | Cash price | List price (before discounts) |
|---|---|---|---|
| Capital Medical Center | $102 – $151 | — | — |
| Deaconess Medical Center | $93.19 – $98.68 | — | — |
| Island Hospital | — | — | — |
| Kadlec Regional Medical Center | — | — | — |
| Legacy Salmon Creek Medical Center | — | $870 | $1,339 |
| Mary Bridge Children's Hospital | $96.39 – $104 | — | — |
| MultiCare Auburn Medical Center | $94.65 – $102 | — | — |
| MultiCare Covington Medical Center | $94.65 – $102 | — | — |
| MultiCare Good Samaritan Hospital | $96.84 – $105 | — | — |
| MultiCare Valley Hospital | $92.53 – $97.97 | — | — |
| Overlake Hospital Medical Center & Clinics | — | — | — |
| Prov Sacred HRT Med Ctr & Childs Hosp. | — | $232 – $690 | $331 – $986 |
| Providence Centralia Hospital | — | — | — |
| Providence Holy Family Hospital | — | — | — |
| Providence Regional Medical Center Everett | — | — | — |
| Providence St Mary Medical Center | — | — | — |
| Providence St Peter Hospital | — | — | — |
| Swedish Edmonds Hospital | — | — | — |
| Swedish Issaquah | — | $248 – $456 | $517 – $950 |
| Swedish Medical Center | — | $248 – $456 | $517 – $950 |
| Swedish Medical Center / Cherry Hill | — | $248 – $456 | $517 – $950 |
| Tacoma General Allenmore Hospital | $96.87 – $105 | — | — |
| University of Washington Medical Ctr | — | — | — |
| Virginia Mason Medical Center | — | $373 | $732 |
| Yakima Valley Memorial | $92.57 – $108 | — | — |
Medicare (traditional) reference
CMS publishes no national amount for this code.