| Abdominal fluid drain (paracentesis) |
$3,768 |
$3,768 |
$1,520 |
$284 | |
| Abdominal ultrasound |
$1,487 |
$1,487 |
$163 |
$100 | |
| Abdominal ultrasound (complete) |
$1,427 |
$1,427 |
$167 |
$114 | |
| Abdominal ultrasound (limited) |
$1,546 |
$1,546 |
$150 |
$86 | |
| Abscess drainage (complex or multiple) |
$2,352 |
$2,352 |
$714 |
$220 | |
| Abscess drainage (simple) |
$1,189 |
$1,189 |
$350 |
$129 | |
| Abscess incision and drainage |
$1,681 |
$1,681 |
$601 |
$174 | |
| Achilles tendon repair |
— |
— |
$9,287 |
$624 | |
| ACL knee reconstruction |
— |
— |
$9,287 |
$889 | |
| Albumin blood test |
$17 |
$17 |
$5 |
$5 | |
| Alkaline phosphatase test |
$17 |
$17 |
$5 |
$5 | |
| ALT liver enzyme test |
$29 |
$29 |
$7 |
$5 | |
| Ammonia blood test |
$80 |
$80 |
$18 |
$15 | |
| Amniocentesis |
$2,346 |
$2,346 |
$1,232 |
$120 | |
| Anal fistula repair |
— |
— |
$3,552 |
$541 | |
| Ankle fracture repair |
— |
— |
$9,287 |
$608 | |
| Anoscopy |
$912 |
$912 |
$213 |
$129 | |
| Antinuclear antibody (ANA) test |
$17 |
$17 |
$12 |
$12 | |
| Arterial blood gas (ABG) |
$144 |
$144 |
$33 |
$26 | |
| AST liver enzyme test |
$29 |
$29 |
$6 |
$5 | |
| Barium swallow study |
$1,070 |
$1,070 |
$251 |
$107 | |
| Bartholin cyst removal |
$1,377 |
$1,377 |
$689 |
$182 | |
| Basic metabolic panel |
$48 |
$48 |
$11 |
$8 | |
| Benign skin lesion removal |
$5,031 |
$5,031 |
$1,562 |
$171 | |
| Bilirubin blood test |
$36 |
$36 |
$6 |
$5 | |
| Bladder scope (cystoscopy) |
— |
— |
$4,612 |
$216 | |
| Bladder tumor removal (TURBT) |
— |
— |
$4,512 |
$236 | |
| Blood clotting test (PT/INR) |
$24 |
$24 |
$5 |
$4 | |
| Blood crossmatch |
$384 |
$384 |
$230 |
— | |
| Blood glucose test |
$22 |
$22 |
$5 |
$5 | |
| Blood transfusion |
$2,224 |
$2,224 |
$973 |
$47 | |
| Blood type and screen |
$210 |
$210 |
$67 |
$10 | |
| Blood type test |
$32 |
$32 |
$48 |
$3 | |
| Blood type test (ABO group) |
$32 |
$32 |
$119 |
$3 | |
| Blood type test (Rh/D antigen) |
$25 |
$25 |
$48 |
$3 | |
| BNP (heart failure) test |
$147 |
$147 |
$42 |
$39 | |
| Bone density scan (DEXA) |
$652 |
$652 |
$150 |
$39 | |
| Bone marrow biopsy |
$5,207 |
$5,207 |
$3,718 |
$172 | |
| Bone scan (nuclear) |
$1,977 |
$1,977 |
$560 |
$259 | |
| Breast biopsy |
$7,870 |
$7,870 |
$2,543 |
$478 | |
| Breast MRI |
$5,125 |
$5,125 |
$3,075 |
$216 | |
| Breast reconstruction |
— |
— |
$17,638 |
$1,227 | |
| Breast reduction |
— |
— |
$8,499 |
$980 | |
| Breast ultrasound |
$1,665 |
$1,665 |
$135 |
$92 | |
| Breast ultrasound (complete) |
$1,665 |
$1,665 |
$150 |
$100 | |
| Breast ultrasound (limited) |
$1,355 |
$1,355 |
$125 |
$84 | |
| Breathing tube insertion (intubation) |
$1,345 |
$1,345 |
$405 |
$133 | |
| Bronchoscopy |
$5,537 |
$5,537 |
$2,862 |
$303 | |
| Bunion surgery (bunionectomy) |
— |
— |
$5,615 |
$883 | |
| Burn dressing and debridement (medium) |
$1,452 |
$1,452 |
$350 |
$166 | |
| Burn dressing and debridement (small) |
$1,452 |
$1,452 |
$350 |
$93 | |
| Burn treatment |
$1,452 |
$1,452 |
$350 |
$129 | |
| C-reactive protein (CRP) |
$29 |
$29 |
$6 |
$5 | |
| CA 19-9 tumor marker test |
$12 |
$12 |
$12 |
$21 | |
| Calcium blood test |
$19 |
$19 |
$6 |
$5 | |
| Cardiac ablation |
$79,415 |
$79,415 |
$33,618 |
$759 | |
| Cardiac catheterization |
$10,732 |
$10,732 |
$4,772 |
$1,049 | |
| Cardiac event monitor |
$631 |
$631 |
$331 |
$170 | |
| Cardiac rehabilitation |
$335 |
$335 |
$179 |
$26 | |
| Cardiac stress test |
$979 |
$979 |
$334 |
$39 | |
| Cardioversion |
$3,310 |
$3,310 |
$973 |
$155 | |
| Carotid artery ultrasound |
$1,508 |
$1,508 |
$315 |
$156 | |
| Carpal tunnel release |
$14,195 |
$14,195 |
$4,395 |
$483 | |
| CEA tumor marker test |
$18 |
$18 |
$17 |
$19 | |
| Celiac disease test |
$30 |
$30 |
$12 |
$12 | |
| Central line placement |
$10,594 |
$10,594 |
$4,061 |
$238 | |
| Cervical cerclage |
— |
— |
$4,143 |
$137 | |
| Cervical LEEP procedure |
— |
— |
$4,143 |
$325 | |
| Cesarean section (C-section) |
— |
— |
$13,882 |
$7,552 | |
| Chest fluid drain (thoracentesis) |
$3,237 |
$3,237 |
$1,204 |
$311 | |
| Chest tube insertion |
$7,806 |
$7,806 |
$3,903 |
$143 | |
| Chest X-ray |
$541 |
$541 |
$134 |
$37 | |
| Chest X-ray (1 view) |
$598 |
$598 |
$125 |
$25 | |
| Chest X-ray (2 views) |
$484 |
$484 |
$125 |
$33 | |
| CK-MB heart enzyme test |
$64 |
$64 |
$14 |
$12 | |
| Clotting time test (PTT) |
$33 |
$33 |
$7 |
$6 | |
| Colonoscopy |
— |
— |
$4,691 |
$480 | |
| Colposcopy |
— |
— |
$4,549 |
$161 | |
| Complete blood count (CBC) |
$40 |
$40 |
$9 |
$7 | |
| Complete blood count (CBC) (complete) |
$44 |
$44 |
$10 |
$8 | |
| Complex wound repair |
$4,234 |
$4,234 |
$1,905 |
$390 | |
| Comprehensive metabolic panel |
$58 |
$58 |
$13 |
$11 | |
| Copper blood test |
$17 |
$17 |
$12 |
$12 | |
| Coronary artery bypass (CABG) |
— |
— |
$58,658 |
$36,593 | |
| Coronary CT angiography |
$3,727 |
$3,727 |
$485 |
$326 | |
| Cortisol test |
$22 |
$22 |
$16 |
$16 | |
| COVID-19 PCR test |
$77 |
$77 |
$51 |
$51 | |
| CPAP titration study |
$870 |
$870 |
$315 |
$69 | |
| Creatine kinase (CK) test |
$36 |
$36 |
$7 |
$7 | |
| CT angiography of the chest |
$3,727 |
$3,727 |
$300 |
$281 | |
| CT angiography of the head |
$3,727 |
$3,727 |
$300 |
$274 | |
| CT scan of the abdomen |
$3,727 |
$3,727 |
$334 |
$230 | |
| CT scan of the abdomen and pelvis |
$7,682 |
$7,682 |
$449 |
$300 | |
| CT scan of the abdomen and pelvis with and without contrast |
$7,682 |
$7,682 |
$513 |
$338 | |
| CT scan of the abdomen and pelvis with contrast |
$7,682 |
$7,682 |
$500 |
$300 | |
| CT scan of the abdomen and pelvis without contrast |
$5,653 |
$5,653 |
$336 |
$183 | |
| CT scan of the abdomen with and without contrast |
$3,727 |
$3,727 |
$350 |
$259 | |
| CT scan of the abdomen with contrast |
$3,727 |
$3,727 |
$350 |
$230 | |
| CT scan of the abdomen without contrast |
$2,271 |
$2,271 |
$202 |
$136 | |
| CT scan of the arm |
$3,727 |
$3,727 |
$531 |
$199 | |
| CT scan of the arm with contrast |
$7,682 |
$7,682 |
$550 |
$199 | |
| CT scan of the arm without contrast |
$2,271 |
$2,271 |
$303 |
$161 | |
| CT scan of the chest |
$3,727 |
$3,727 |
$308 |
$167 | |
| CT scan of the chest with and without contrast |
$3,727 |
$3,727 |
$338 |
$196 | |
| CT scan of the chest with contrast |
$4,558 |
$4,558 |
$338 |
$167 | |
| CT scan of the chest without contrast |
$2,785 |
$2,785 |
$202 |
$133 | |
| CT scan of the head |
$3,727 |
$3,727 |
$294 |
$148 | |
| CT scan of the head with and without contrast |
$3,727 |
$3,727 |
$330 |
$173 | |
| CT scan of the head with contrast |
$3,727 |
$3,727 |
$330 |
$148 | |
| CT scan of the head without contrast |
$2,319 |
$2,319 |
$202 |
$107 | |
| CT scan of the leg |
$3,727 |
$3,727 |
$504 |
$166 | |
| CT scan of the leg with contrast |
$3,727 |
$3,727 |
$550 |
$166 | |
| CT scan of the leg without contrast |
$2,271 |
$2,271 |
$303 |
$130 | |
| CT scan of the lower back (lumbar spine) |
$3,727 |
$3,727 |
$449 |
$169 | |
| CT scan of the lower back (lumbar spine) with and without contrast |
$3,727 |
$3,727 |
$338 |
$197 | |
| CT scan of the lower back (lumbar spine) with contrast |
$7,682 |
$7,682 |
$509 |
$169 | |
| CT scan of the lower back (lumbar spine) without contrast |
$2,785 |
$2,785 |
$202 |
$130 | |
| CT scan of the neck |
$3,727 |
$3,727 |
$304 |
$183 | |
| CT scan of the neck (cervical spine) |
$3,727 |
$3,727 |
$449 |
$168 | |
| CT scan of the neck (cervical spine) with and without contrast |
$3,727 |
$3,727 |
$338 |
$196 | |
| CT scan of the neck (cervical spine) with contrast |
$7,682 |
$7,682 |
$509 |
$168 | |
| CT scan of the neck (cervical spine) without contrast |
$2,785 |
$2,785 |
$202 |
$131 | |
| CT scan of the neck with and without contrast |
$3,727 |
$3,727 |
$330 |
$220 | |
| CT scan of the neck with contrast |
$3,727 |
$3,727 |
$330 |
$183 | |
| CT scan of the neck without contrast |
$2,271 |
$2,271 |
$202 |
$150 | |
| CT scan of the pelvis |
$3,727 |
$3,727 |
$334 |
$226 | |
| CT scan of the pelvis with and without contrast |
$3,727 |
$3,727 |
$350 |
$251 | |
| CT scan of the pelvis with contrast |
$3,727 |
$3,727 |
$350 |
$226 | |
| CT scan of the pelvis without contrast |
$2,271 |
$2,271 |
$202 |
$133 | |
| CT scan of the sinuses |
$3,727 |
$3,727 |
$299 |
$152 | |
| CT scan of the sinuses with and without contrast |
$3,727 |
$3,727 |
$330 |
$184 | |
| CT scan of the sinuses with contrast |
$3,727 |
$3,727 |
$330 |
$152 | |
| CT scan of the sinuses without contrast |
$2,271 |
$2,271 |
$202 |
$128 | |
| D-dimer test |
$29 |
$29 |
$12 |
$10 | |
| DHEA-sulfate test |
$30 |
$30 |
$23 |
$22 | |
| Diagnostic mammogram |
$810 |
$810 |
$164 |
$140 | |
| Dialysis fistula creation |
— |
— |
$4,041 |
$601 | |
| Dilation and curettage (D&C) |
— |
— |
$4,143 |
$298 | |
| Drug screen (urine) |
$105 |
$105 |
$62 |
$17 | |
| Ear pressure test (tympanometry) |
$71 |
$71 |
$48 |
$16 | |
| Echocardiogram |
$4,115 |
$4,115 |
$699 |
$138 | |
| Echocardiogram with and without contrast |
$1,001 |
$1,001 |
$342 |
$101 | |
| Echocardiogram without contrast |
$852 |
$852 |
$342 |
$138 | |
| EEG (awake and asleep) |
$1,118 |
$1,118 |
$317 |
$482 | |
| EKG / ECG (tracing only) |
$631 |
$631 |
$87 |
$7 | |
| Electrocardiogram (EKG) |
$631 |
$631 |
$87 |
$8 | |
| Electroencephalogram (EEG) |
$1,118 |
$1,118 |
$317 |
$448 | |
| Electrolyte panel |
$39 |
$39 |
$9 |
$7 | |
| Electromyography (EMG) |
$1,003 |
$1,003 |
$206 |
$141 | |
| Emergency department visit |
$2,887 |
$2,887 |
$614 |
$69 | |
| Emergency department visit (level 1) |
$905 |
$905 |
$135 |
$11 | |
| Emergency department visit (level 2) |
$1,641 |
$1,641 |
$246 |
$40 | |
| Emergency department visit (level 3) |
$2,887 |
$2,887 |
$437 |
$69 | |
| Emergency department visit (level 4) |
$4,614 |
$4,614 |
$667 |
$118 | |
| Emergency department visit (level 5) |
$6,693 |
$6,693 |
$952 |
$171 | |
| Epidural steroid injection |
$3,077 |
$3,077 |
$1,207 |
$275 | |
| ERCP (bile duct endoscopy) |
— |
— |
$4,934 |
$311 | |
| Estradiol (estrogen) test |
$17 |
$17 |
$17 |
$28 | |
| Eyelid surgery (blepharoplasty) |
— |
— |
$4,830 |
$552 | |
| Facet joint injection (spine) |
$4,270 |
$4,270 |
$1,843 |
$99 | |
| Fallopian tube X-ray (HSG) |
$1,378 |
$1,378 |
$501 |
$164 | |
| Fecal occult blood (stool) test |
$26 |
$26 |
$16 |
$10 | |
| Fecal occult blood (stool) test (guaiac, gFOBT) |
$24 |
$24 |
$5 |
$4 | |
| Fecal occult blood (stool) test (immunochemical, FIT) |
$28 |
$28 |
$17 |
$16 | |
| Feeding tube (PEG) placement |
$13,131 |
$13,131 |
$4,319 |
$178 | |
| Ferritin (iron) test |
$40 |
$40 |
$14 |
$14 | |
| Fibrinogen test |
$31 |
$31 |
$10 |
$10 | |
| Fibroid removal (myomectomy) |
— |
— |
$50,000 |
$914 | |
| Flexible sigmoidoscopy |
— |
— |
$4,649 |
$323 | |
| Flu test |
$91 |
$91 |
$18 |
$17 | |
| Folate (folic acid) test |
$9 |
$9 |
$9 |
$15 | |
| Foreign body removal (skin) |
$2,794 |
$2,794 |
$906 |
$157 | |
| Free T4 thyroid test |
$27 |
$27 |
$9 |
$9 | |
| FSH hormone test |
$54 |
$54 |
$19 |
$19 | |
| Gallbladder removal (laparoscopic) |
— |
— |
$7,737 |
$658 | |
| Gallbladder scan (HIDA) |
$4,954 |
$4,954 |
$698 |
$334 | |
| Ganglion cyst removal |
— |
— |
$4,757 |
$321 | |
| GGT liver test |
$21 |
$21 |
$7 |
$7 | |
| Glucose tolerance test |
$71 |
$71 |
$14 |
$8 | |
| Group therapy session |
$291 |
$291 |
$162 |
$30 | |
| H. pylori test |
$77 |
$77 |
$67 |
$67 | |
| Hammertoe repair |
— |
— |
$4,188 |
$548 | |
| Hearing test (audiometry) |
$311 |
$311 |
$165 |
$36 | |
| Hematocrit test |
$13 |
$13 |
$3 |
$2 | |
| Hemodialysis |
$2,898 |
$2,898 |
$1,007 |
$75 | |
| Hemoglobin A1c (diabetes test) |
$31 |
$31 |
$10 |
$10 | |
| Hemorrhoid removal |
— |
— |
$3,954 |
$338 | |
| Hepatitis B test |
$7 |
$7 |
$7 |
$10 | |
| Hepatitis C test |
$42 |
$42 |
$14 |
$14 | |
| Hip arthroscopy |
— |
— |
$9,287 |
$931 | |
| Hip replacement |
— |
— |
$16,432 |
$1,162 | |
| HIV test |
$26 |
$26 |
$19 |
$19 | |
| HIV test (antibody) |
$19 |
$19 |
$14 |
$14 | |
| HIV test (antigen/antibody combo) |
$33 |
$33 |
$24 |
$24 | |
| Holter heart monitor |
$1,278 |
$1,278 |
$171 |
$26 | |
| Hydrocele repair |
— |
— |
$4,582 |
$315 | |
| Hysterectomy |
— |
— |
$50,000 |
$933 | |
| Hysteroscopy |
— |
— |
$4,143 |
$1,270 | |
| Inguinal hernia repair |
$18,138 |
$18,138 |
$4,605 |
$538 | |
| Iron blood test |
$36 |
$36 |
$6 |
$6 | |
| IUD insertion |
— |
— |
$686 |
— | |
| IUD removal |
$2,280 |
$2,280 |
$1,083 |
$112 | |
| IV infusion therapy |
$674 |
$674 |
$225 |
$44 | |
| IV infusion therapy (each additional) |
$253 |
$253 |
$69 |
$21 | |
| IV infusion therapy (initial) |
$1,298 |
$1,298 |
$312 |
$67 | |
| Joint aspiration (small/intermediate) |
$1,450 |
$1,450 |
$589 |
$57 | |
| Joint aspiration or injection (mid-size joint) |
$1,450 |
$1,450 |
$589 |
$57 | |
| Joint aspiration or injection (small joint) |
$1,450 |
$1,450 |
$589 |
$56 | |
| Kidney biopsy |
$5,207 |
$5,207 |
$2,543 |
$492 | |
| Kidney scan (nuclear) |
$2,182 |
$2,182 |
$726 |
$172 | |
| Kidney ultrasound |
$1,133 |
$1,133 |
$161 |
$84 | |
| Kidney ultrasound (limited) |
$881 |
$881 |
$150 |
$61 | |
| Knee arthroscopy |
— |
— |
$4,188 |
$524 | |
| Knee joint injection |
$1,450 |
$1,450 |
$589 |
$69 | |
| Knee replacement |
— |
— |
$31,589 |
$18,054 | |
| Lactate test |
$64 |
$64 |
$14 |
$12 | |
| Laminectomy (spine) |
— |
— |
$9,287 |
$1,157 | |
| Laryngoscopy |
$1,331 |
$1,331 |
$820 |
$189 | |
| LDH test |
$33 |
$33 |
$6 |
$6 | |
| LDL cholesterol test |
$32 |
$32 |
$11 |
$11 | |
| Leg artery angiogram |
$17,145 |
$17,145 |
$4,061 |
$149 | |
| Leg artery angioplasty |
$32,344 |
$32,344 |
$13,578 |
— | |
| Leg vein ultrasound (Doppler) |
$969 |
$969 |
$305 |
$150 | |
| Leg vein ultrasound (Doppler) (limited) |
$969 |
$969 |
$170 |
$116 | |
| Lipase test |
$23 |
$23 |
$7 |
$7 | |
| Lipid (cholesterol) panel |
$41 |
$41 |
$13 |
$13 | |
| Liver biopsy |
$6,817 |
$6,817 |
$2,985 |
$288 | |
| Liver function panel |
$45 |
$45 |
$10 |
$8 | |
| Lower back (lumbar) spinal fusion |
— |
— |
$61,557 |
$1,511 | |
| Lumbar discectomy |
— |
— |
$9,287 |
$898 | |
| Lumpectomy (breast) |
— |
— |
$6,414 |
$750 | |
| Lung function test (PFT) |
$936 |
$936 |
$478 |
$37 | |
| Lung scan (V/Q) |
$4,079 |
$4,079 |
$729 |
$291 | |
| Magnesium blood test |
$9 |
$9 |
$7 |
$7 | |
| Mastectomy |
— |
— |
$8,499 |
$1,021 | |
| Meniscus repair (knee) |
— |
— |
$4,188 |
$714 | |
| MMR vaccine |
$651 |
$651 |
$391 |
— | |
| MRA of the brain |
$7,505 |
$7,505 |
$454 |
$226 | |
| MRA of the brain with contrast |
$7,505 |
$7,505 |
$507 |
$226 | |
| MRA of the brain without contrast |
$7,505 |
$7,505 |
$531 |
$328 | |
| MRA of the neck |
$7,505 |
$7,505 |
$475 |
$245 | |
| MRA of the neck with contrast |
$7,505 |
$7,505 |
$507 |
$245 | |
| MRA of the neck without contrast |
$7,505 |
$7,505 |
$531 |
$343 | |
| MRI of the abdomen |
$7,505 |
$7,505 |
$507 |
$300 | |
| MRI of the abdomen with contrast |
$7,505 |
$7,505 |
$507 |
$300 | |
| MRI of the abdomen without contrast |
$4,690 |
$4,690 |
$445 |
$194 | |
| MRI of the ankle |
$7,505 |
$7,505 |
$770 |
$261 | |
| MRI of the ankle with contrast |
$7,505 |
$7,505 |
$958 |
$261 | |
| MRI of the ankle without contrast |
$4,690 |
$4,690 |
$674 |
$222 | |
| MRI of the brain |
$7,505 |
$7,505 |
$597 |
$269 | |
| MRI of the brain with contrast |
$7,505 |
$7,505 |
$651 |
$269 | |
| MRI of the brain without contrast |
$5,195 |
$5,195 |
$445 |
$195 | |
| MRI of the chest |
$7,505 |
$7,505 |
$1,003 |
$371 | |
| MRI of the chest with contrast |
$14,581 |
$14,581 |
$1,037 |
$371 | |
| MRI of the chest without contrast |
$7,505 |
$7,505 |
$585 |
$466 | |
| MRI of the knee |
$7,505 |
$7,505 |
$1,006 |
$315 | |
| MRI of the knee with contrast |
$14,581 |
$14,581 |
$1,092 |
$315 | |
| MRI of the knee without contrast |
$4,690 |
$4,690 |
$674 |
$204 | |
| MRI of the lower back (lumbar spine) |
$7,505 |
$7,505 |
$597 |
$270 | |
| MRI of the lower back (lumbar spine) with contrast |
$7,505 |
$7,505 |
$651 |
$270 | |
| MRI of the lower back (lumbar spine) without contrast |
$4,690 |
$4,690 |
$445 |
$192 | |
| MRI of the mid-back (thoracic spine) |
$7,505 |
$7,505 |
$597 |
$271 | |
| MRI of the mid-back (thoracic spine) with and without contrast |
$7,505 |
$7,505 |
$651 |
$319 | |
| MRI of the mid-back (thoracic spine) with contrast |
$7,505 |
$7,505 |
$651 |
$271 | |
| MRI of the mid-back (thoracic spine) without contrast |
$4,690 |
$4,690 |
$445 |
$190 | |
| MRI of the neck (cervical spine) |
$7,505 |
$7,505 |
$597 |
$274 | |
| MRI of the neck (cervical spine) with and without contrast |
$7,505 |
$7,505 |
$651 |
$318 | |
| MRI of the neck (cervical spine) with contrast |
$7,505 |
$7,505 |
$651 |
$274 | |
| MRI of the neck (cervical spine) without contrast |
$5,253 |
$5,253 |
$445 |
$191 | |
| MRI of the pelvis |
$7,505 |
$7,505 |
$507 |
$268 | |
| MRI of the pelvis with contrast |
$7,505 |
$7,505 |
$651 |
$268 | |
| MRI of the pelvis without contrast |
$4,690 |
$4,690 |
$347 |
$227 | |
| MRI of the shoulder |
$7,505 |
$7,505 |
$1,003 |
$313 | |
| MRI of the shoulder with contrast |
$14,581 |
$14,581 |
$1,092 |
$313 | |
| MRI of the shoulder without contrast |
$4,690 |
$4,690 |
$674 |
$205 | |
| MRI of the wrist |
$7,505 |
$7,505 |
$770 |
$330 | |
| MRI of the wrist with contrast |
$7,505 |
$7,505 |
$958 |
$330 | |
| MRI of the wrist without contrast |
$4,690 |
$4,690 |
$674 |
$303 | |
| Nebulizer breathing treatment |
$870 |
$870 |
$315 |
$9 | |
| Neck (cervical) spinal fusion |
— |
— |
$16,432 |
$1,410 | |
| Nuchal translucency ultrasound |
$1,868 |
$1,868 |
$152 |
$116 | |
| Nuclear cardiac stress test |
$6,414 |
$6,414 |
$1,798 |
$428 | |
| Occupational therapy evaluation |
$957 |
$957 |
$176 |
$101 | |
| Occupational therapy evaluation (high complexity) |
$957 |
$957 |
$176 |
$101 | |
| Occupational therapy evaluation (low complexity) |
$957 |
$957 |
$167 |
$101 | |
| Occupational therapy evaluation (moderate complexity) |
$957 |
$957 |
$195 |
$101 | |
| Orthopedic hardware removal |
— |
— |
$3,718 |
$632 | |
| Ovarian cyst removal |
— |
— |
$6,402 |
$698 | |
| Pacemaker insertion |
— |
— |
$25,289 |
$15,506 | |
| Pap smear (cervical screening) |
$34 |
$34 |
$27 |
$20 | |
| Parathyroid hormone (PTH) test |
$59 |
$59 |
$41 |
$41 | |
| Pelvic ultrasound |
$942 |
$942 |
$154 |
$78 | |
| Pelvic ultrasound (complete) |
$1,161 |
$1,161 |
$154 |
$105 | |
| Pelvic ultrasound (limited) |
$723 |
$723 |
$150 |
$51 | |
| Phosphorus blood test |
$14 |
$14 |
$5 |
$5 | |
| Physical therapy evaluation |
$1,032 |
$1,032 |
$167 |
$98 | |
| Physical therapy evaluation (high complexity) |
$1,032 |
$1,032 |
$187 |
$98 | |
| Physical therapy evaluation (moderate complexity) |
$1,032 |
$1,032 |
$163 |
$98 | |
| Pilonidal cyst removal |
— |
— |
$3,718 |
$541 | |
| Platelet count |
$25 |
$25 |
$5 |
$4 | |
| Pregnancy blood test (hCG) |
$41 |
$41 |
$9 |
$8 | |
| Pregnancy ultrasound |
$1,482 |
$1,482 |
$153 |
$126 | |
| Pregnancy ultrasound (first trimester) |
$1,345 |
$1,345 |
$150 |
$117 | |
| Pregnancy ultrasound (second or third trimester) |
$1,618 |
$1,618 |
$167 |
$136 | |
| Procalcitonin test |
$116 |
$116 |
$31 |
$27 | |
| Prostate biopsy |
$6,626 |
$6,626 |
$4,261 |
— | |
| Prostate test (PSA) |
$33 |
$33 |
$18 |
$18 | |
| Psychiatric evaluation |
$2,546 |
$2,546 |
$273 |
$188 | |
| Psychotherapy session |
$520 |
$520 |
$258 |
$140 | |
| Radiofrequency nerve ablation |
$6,498 |
$6,498 |
$3,340 |
$462 | |
| Rheumatoid factor test |
$34 |
$34 |
$8 |
$6 | |
| Rotator cuff repair |
— |
— |
$9,287 |
$792 | |
| Sacroiliac joint injection |
$790 |
$790 |
$590 |
$176 | |
| Scoliosis spine X-ray |
$568 |
$568 |
$134 |
$58 | |
| Scoliosis spine X-ray (1 view) |
$484 |
$484 |
$125 |
$44 | |
| Scoliosis spine X-ray (3 views) |
$652 |
$652 |
$150 |
$72 | |
| Screening mammogram |
$810 |
$810 |
$143 |
$126 | |
| Scrotal ultrasound |
$1,026 |
$1,026 |
$150 |
$99 | |
| Sedimentation rate (ESR) test |
$20 |
$20 |
$4 |
$3 | |
| Sex hormone binding globulin test |
$12 |
$12 |
$10 |
$22 | |
| Shoulder arthroscopy |
— |
— |
$9,287 |
$962 | |
| Shoulder replacement |
— |
— |
$22,441 |
$1,300 | |
| Simple laceration repair (small, up to 2.5 cm) |
$1,452 |
$1,452 |
$739 |
$114 | |
| Simple wound stitches |
$1,452 |
$1,452 |
$739 |
$127 | |
| Skin biopsy |
$2,975 |
$2,975 |
$1,059 |
$121 | |
| Skin cancer lesion removal |
— |
— |
$4,613 |
$240 | |
| Skin graft |
$13,847 |
$13,847 |
$2,829 |
$898 | |
| Skin tag removal |
$1,452 |
$1,452 |
$739 |
$92 | |
| Small bowel resection |
— |
— |
$50,000 |
$1,136 | |
| Soft tissue ultrasound |
$450 |
$450 |
$150 |
$64 | |
| Speech therapy |
$226 |
$226 |
$84 |
$76 | |
| Spinal cord stimulator |
— |
— |
$8,157 |
$2,388 | |
| Spinal tap (lumbar puncture) |
$3,742 |
$3,742 |
$1,183 |
$165 | |
| Spirometry (lung function test) |
$646 |
$646 |
$332 |
$30 | |
| Spirometry with bronchodilator |
$1,225 |
$1,225 |
$535 |
$43 | |
| Spleen removal (splenectomy) |
— |
— |
$13,605 |
$1,036 | |
| Strep throat test |
$91 |
$91 |
$18 |
$17 | |
| Stress echocardiogram |
$4,115 |
$4,115 |
$783 |
$209 | |
| Stress echocardiogram (complete) |
$4,115 |
$4,115 |
$783 |
$233 | |
| Swallow study |
$371 |
$371 |
$111 |
$85 | |
| T3 thyroid test |
$78 |
$78 |
$18 |
$14 | |
| Tdap (tetanus) vaccine |
$650 |
$650 |
$390 |
— | |
| Testosterone test |
$30 |
$30 |
$26 |
$26 | |
| Thyroid removal (thyroidectomy) |
— |
— |
$7,737 |
$1,004 | |
| Thyroid test (TSH) |
$56 |
$56 |
$18 |
$17 | |
| Thyroid ultrasound |
$1,025 |
$1,025 |
$154 |
$109 | |
| Thyroid uptake scan |
$2,810 |
$2,810 |
$586 |
$145 | |
| Tilt table test |
$1,807 |
$1,807 |
$547 |
$168 | |
| Total IgE allergy test |
$10 |
$10 |
$10 |
$16 | |
| Total protein test |
$13 |
$13 |
$4 |
$4 | |
| Transesophageal echocardiogram (TEE) |
$4,115 |
$4,115 |
$783 |
$239 | |
| Transesophageal echocardiogram (TEE) with and without contrast |
$4,115 |
$4,115 |
$783 |
$239 | |
| Transvaginal ultrasound |
$1,161 |
$1,161 |
$153 |
$118 | |
| Trigger finger release |
— |
— |
$4,757 |
$630 | |
| Trigger point injection |
$967 |
$967 |
$555 |
$56 | |
| Trigger point injection (1-2 muscles) |
$1,540 |
$1,540 |
$525 |
$52 | |
| Triglycerides test |
$32 |
$32 |
$6 |
$6 | |
| Troponin (heart) test |
$69 |
$69 |
$16 |
$12 | |
| Tubal ligation |
— |
— |
$7,737 |
$333 | |
| Turning a breech baby (version) |
$9,301 |
$9,301 |
$4,287 |
$94 | |
| Ulnar nerve surgery (elbow) |
— |
— |
$4,812 |
$575 | |
| Upper GI endoscopy (EGD) |
— |
— |
$4,645 |
$371 | |
| Upper GI series (barium) |
$1,070 |
$1,070 |
$251 |
$128 | |
| Uric acid (gout) test |
$25 |
$25 |
$6 |
$5 | |
| Urinalysis |
$15 |
$15 |
$3 |
$3 | |
| Urine microalbumin test |
$6 |
$6 |
$5 |
$5 | |
| Urine pregnancy test |
$47 |
$47 |
$10 |
$9 | |
| Vaccine administration |
$317 |
$317 |
$119 |
$19 | |
| Vaccine administration (each additional) |
$251 |
$251 |
$127 |
$16 | |
| Vaginal delivery |
— |
— |
$10,972 |
$5,487 | |
| Vasectomy |
— |
— |
$4,834 |
$347 | |
| Vitamin B12 test |
$9 |
$9 |
$9 |
$15 | |
| Vitamin D test |
$21 |
$21 |
$21 |
$30 | |
| Wart removal |
$1,452 |
$1,452 |
$321 |
$121 | |
| Weight-loss (bariatric) surgery |
— |
— |
$19,771 |
$11,645 | |
| Wound debridement |
$3,514 |
$3,514 |
$1,467 |
$186 | |
| Wrist fracture repair |
— |
— |
$9,287 |
$735 | |
| X-ray of the abdomen |
$652 |
$652 |
$137 |
$36 | |
| X-ray of the ankle |
$484 |
$484 |
$125 |
$37 | |
| X-ray of the collarbone |
$484 |
$484 |
$125 |
$33 | |
| X-ray of the elbow |
$484 |
$484 |
$125 |
$33 | |
| X-ray of the facial bones |
$568 |
$568 |
$134 |
$39 | |
| X-ray of the foot |
$484 |
$484 |
$125 |
$34 | |
| X-ray of the forearm |
$484 |
$484 |
$125 |
$29 | |
| X-ray of the hand |
$484 |
$484 |
$125 |
$38 | |
| X-ray of the hip |
$484 |
$484 |
$134 |
$49 | |
| X-ray of the hip (1 view) |
$484 |
$484 |
$125 |
$34 | |
| X-ray of the hip (3 views) |
$484 |
$484 |
$125 |
$49 | |
| X-ray of the hip (4 views) |
$652 |
$652 |
$150 |
$63 | |
| X-ray of the knee |
$484 |
$484 |
$134 |
$42 | |
| X-ray of the knee (2 views) |
$484 |
$484 |
$125 |
$34 | |
| X-ray of the knee (3 views) |
$484 |
$484 |
$125 |
$42 | |
| X-ray of the knee (4+ views) |
$652 |
$652 |
$150 |
$49 | |
| X-ray of the lower back (lumbar spine) |
$652 |
$652 |
$150 |
$47 | |
| X-ray of the lower back (lumbar spine) (2 views) |
$652 |
$652 |
$150 |
$40 | |
| X-ray of the lower back (lumbar spine) (4+ views) |
$652 |
$652 |
$150 |
$53 | |
| X-ray of the lower leg |
$484 |
$484 |
$125 |
$31 | |
| X-ray of the mid-back (thoracic spine) |
$652 |
$652 |
$150 |
$36 | |
| X-ray of the mid-back (thoracic spine) (2 views) |
$652 |
$652 |
$150 |
$33 | |
| X-ray of the mid-back (thoracic spine) (3 views) |
$652 |
$652 |
$150 |
$39 | |
| X-ray of the neck (cervical spine) |
$568 |
$568 |
$134 |
$47 | |
| X-ray of the neck (cervical spine) (3 views) |
$484 |
$484 |
$125 |
$40 | |
| X-ray of the pelvis |
$652 |
$652 |
$150 |
$36 | |
| X-ray of the pelvis (1 view) |
$652 |
$652 |
$150 |
$28 | |
| X-ray of the ribs |
$568 |
$568 |
$134 |
$42 | |
| X-ray of the ribs (2 views) |
$484 |
$484 |
$125 |
$36 | |
| X-ray of the ribs (3 views) |
$652 |
$652 |
$150 |
$42 | |
| X-ray of the shoulder |
$484 |
$484 |
$125 |
$36 | |
| X-ray of the skull |
$652 |
$652 |
$150 |
$40 | |
| X-ray of the upper arm |
$484 |
$484 |
$125 |
$32 | |
| X-ray of the wrist |
$484 |
$484 |
$125 |
$43 | |
| Zinc blood test |
$60 |
$60 |
$12 |
$11 | |