| 3D mammogram (tomosynthesis) |
$46 |
$115 |
$36 |
$51 | |
| Abdominal ultrasound |
$557 |
$1,392 |
$160 |
$100 | |
| Abdominal ultrasound (complete) |
$736 |
$1,840 |
$160 |
$114 | |
| Abdominal ultrasound (limited) |
$377 |
$943 |
$118 |
$86 | |
| Abscess drainage (complex or multiple) |
— |
— |
$440 |
$220 | |
| Abscess drainage (simple) |
— |
— |
$219 |
$129 | |
| Abscess incision and drainage |
— |
— |
$430 |
$174 | |
| ACL knee reconstruction |
— |
— |
$17,619 |
$889 | |
| Acupuncture |
— |
— |
$27 |
$38 | |
| Albumin blood test |
$33 |
$82 |
$5 |
$5 | |
| Aldosterone test |
$75 |
$188 |
$42 |
$41 | |
| Alkaline phosphatase test |
$66 |
$165 |
$5 |
$5 | |
| Allergy shots |
— |
— |
$51 |
$11 | |
| Alpha-fetoprotein (AFP) test |
$52 |
$129 |
$17 |
$17 | |
| ALT liver enzyme test |
$62 |
$154 |
$5 |
$5 | |
| Ammonia blood test |
$45 |
$111 |
$15 |
$15 | |
| Amniocentesis |
— |
— |
$959 |
$120 | |
| Amylase test |
$42 |
$106 |
$7 |
$6 | |
| Anoscopy |
— |
— |
$143 |
$129 | |
| Antinuclear antibody (ANA) test |
$52 |
$131 |
$12 |
$12 | |
| Arterial blood gas (ABG) |
$16 |
$40 |
$26 |
$26 | |
| AST liver enzyme test |
$67 |
$168 |
$5 |
$5 | |
| Barium swallow study |
$456 |
$1,141 |
$197 |
$107 | |
| Bartholin cyst removal |
— |
— |
$222 |
$182 | |
| Basic metabolic panel |
$45 |
$112 |
$9 |
$8 | |
| Benign skin lesion removal |
— |
— |
$756 |
$171 | |
| Bilirubin blood test |
$42 |
$105 |
$5 |
$5 | |
| Bladder function test (urodynamics) |
— |
— |
$736 |
$345 | |
| Bladder scope (cystoscopy) |
— |
— |
$739 |
$216 | |
| Bladder tumor removal (TURBT) |
— |
— |
$4,496 |
$236 | |
| Blood clotting test (PT/INR) |
$33 |
$82 |
$4 |
$4 | |
| Blood crossmatch |
$88 |
$219 |
$184 |
— | |
| Blood glucose test |
$16 |
$40 |
$5 |
$5 | |
| Blood transfusion |
— |
— |
$482 |
$47 | |
| Blood type and screen |
$52 |
$131 |
$37 |
$10 | |
| Blood type test |
$33 |
$83 |
$42 |
$3 | |
| Blood type test (ABO group) |
$51 |
$128 |
$11 |
$3 | |
| Blood type test (Rh/D antigen) |
$15 |
$37 |
$42 |
$3 | |
| BNP (heart failure) test |
$65 |
$163 |
$40 |
$39 | |
| Bone density scan (DEXA) |
$181 |
$453 |
$118 |
$39 | |
| Bone scan (nuclear) |
$2,358 |
$5,895 |
$445 |
$259 | |
| Botox for migraine |
— |
— |
$325 |
$157 | |
| Breast MRI |
$1,607 |
$4,017 |
$364 |
$216 | |
| Breast MRI without contrast |
$2,240 |
$5,599 |
$268 |
$216 | |
| Breast ultrasound |
$248 |
$619 |
$154 |
$92 | |
| Breast ultrasound (complete) |
$248 |
$619 |
$171 |
$100 | |
| Breast ultrasound (limited) |
$248 |
$619 |
$142 |
$84 | |
| Breathing tube insertion (intubation) |
— |
— |
$256 |
$133 | |
| Bronchoscopy |
— |
— |
$4,496 |
$303 | |
| Burn dressing and debridement (medium) |
— |
— |
$219 |
$166 | |
| Burn dressing and debridement (small) |
— |
— |
$219 |
$93 | |
| Burn treatment |
— |
— |
$219 |
$129 | |
| C-reactive protein (CRP) |
$125 |
$312 |
$5 |
$5 | |
| CA 19-9 tumor marker test |
$85 |
$214 |
$21 |
$21 | |
| CA-125 ovarian marker test |
$134 |
$336 |
$21 |
$21 | |
| Calcium blood test |
$71 |
$179 |
$5 |
$5 | |
| Cardiac ablation |
— |
— |
$16,572 |
$759 | |
| Cardiac catheterization |
— |
— |
$13,181 |
$1,049 | |
| Cardiac event monitor |
— |
— |
$1,678 |
$170 | |
| Cardiac MRI |
$1,412 |
$3,531 |
$395 |
$322 | |
| Cardiac MRI without contrast |
$1,172 |
$2,931 |
$268 |
$280 | |
| Cardiac rehabilitation |
— |
— |
$139 |
$26 | |
| Cardiac stress test |
$1,453 |
$3,633 |
$345 |
$39 | |
| Cardioversion |
— |
— |
$721 |
$155 | |
| Carotid artery ultrasound |
$562 |
$1,405 |
$260 |
$156 | |
| CEA tumor marker test |
$99 |
$247 |
$19 |
$19 | |
| Celiac disease test |
$19 |
$48 |
$12 |
$12 | |
| Cesarean section (C-section) |
— |
— |
$9,775 |
$7,552 | |
| Chalazion (eyelid cyst) removal |
— |
— |
$329 |
$131 | |
| Chemotherapy infusion |
$149 |
$373 |
$236 |
$81 | |
| Chemotherapy infusion (each additional) |
$54 |
$136 |
$77 |
$28 | |
| Chemotherapy infusion (first hour) |
$244 |
$610 |
$360 |
$133 | |
| Chest fluid drain (thoracentesis) |
— |
— |
$681 |
$311 | |
| Chest X-ray |
$274 |
$685 |
$115 |
$37 | |
| Chest X-ray (1 view) |
$175 |
$438 |
$98 |
$25 | |
| Chest X-ray (2 views) |
$202 |
$504 |
$98 |
$33 | |
| Chickenpox (varicella) vaccine |
— |
— |
$362 |
— | |
| Chiropractic adjustment |
— |
— |
$28 |
$38 | |
| CK-MB heart enzyme test |
$187 |
$469 |
$12 |
$12 | |
| Clotting time test (PTT) |
$99 |
$248 |
$6 |
$6 | |
| Colonoscopy |
— |
— |
$1,010 |
$480 | |
| Colposcopy |
— |
— |
$337 |
$161 | |
| Complete blood count (CBC) |
$44 |
$111 |
$8 |
$7 | |
| Complete blood count (CBC) (complete) |
$67 |
$168 |
$8 |
$8 | |
| Complex wound repair |
— |
— |
$675 |
$390 | |
| Comprehensive eye exam |
— |
— |
$142 |
$138 | |
| Comprehensive metabolic panel |
$44 |
$109 |
$11 |
$11 | |
| Contraceptive implant (Nexplanon) |
— |
— |
$429 |
$115 | |
| Copper blood test |
— |
— |
$13 |
$12 | |
| Coronary artery bypass (CABG) |
— |
— |
$24,823 |
$36,593 | |
| Coronary CT angiography |
$507 |
$1,268 |
$394 |
$326 | |
| Cortisol test |
$100 |
$249 |
$16 |
$16 | |
| COVID-19 PCR test |
$85 |
$214 |
$35 |
$51 | |
| CPAP titration study |
— |
— |
$224 |
$69 | |
| Creatine kinase (CK) test |
$70 |
$175 |
$7 |
$7 | |
| CT angiography of the chest |
$1,461 |
$3,652 |
$197 |
$281 | |
| CT angiography of the head |
$2,039 |
$5,098 |
$268 |
$274 | |
| CT colonography (virtual colonoscopy) |
— |
— |
$268 |
$835 | |
| CT scan of the abdomen |
$1,310 |
$3,276 |
$197 |
$230 | |
| CT scan of the abdomen and pelvis |
$1,461 |
$3,652 |
$395 |
$300 | |
| CT scan of the abdomen and pelvis with and without contrast |
$1,461 |
$3,652 |
$395 |
$338 | |
| CT scan of the abdomen and pelvis with contrast |
$1,461 |
$3,652 |
$395 |
$300 | |
| CT scan of the abdomen and pelvis without contrast |
$1,461 |
$3,652 |
$268 |
$183 | |
| CT scan of the abdomen with and without contrast |
$1,313 |
$3,283 |
$197 |
$259 | |
| CT scan of the abdomen with contrast |
$1,310 |
$3,276 |
$197 |
$230 | |
| CT scan of the abdomen without contrast |
$924 |
$2,310 |
$118 |
$136 | |
| CT scan of the arm |
$1,421 |
$3,553 |
$351 |
$199 | |
| CT scan of the arm with contrast |
$1,421 |
$3,553 |
$521 |
$199 | |
| CT scan of the arm without contrast |
$1,421 |
$3,553 |
$171 |
$161 | |
| CT scan of the chest |
$1,287 |
$3,218 |
$197 |
$167 | |
| CT scan of the chest with and without contrast |
$1,461 |
$3,652 |
$197 |
$196 | |
| CT scan of the chest with contrast |
$1,214 |
$3,034 |
$197 |
$167 | |
| CT scan of the chest without contrast |
$1,287 |
$3,218 |
$118 |
$133 | |
| CT scan of the head |
$1,461 |
$3,652 |
$197 |
$148 | |
| CT scan of the head with and without contrast |
$1,461 |
$3,652 |
$197 |
$173 | |
| CT scan of the head with contrast |
$1,461 |
$3,652 |
$197 |
$148 | |
| CT scan of the head without contrast |
$1,274 |
$3,184 |
$118 |
$107 | |
| CT scan of the leg |
$1,152 |
$2,881 |
$204 |
$166 | |
| CT scan of the leg with contrast |
$1,152 |
$2,881 |
$287 |
$166 | |
| CT scan of the leg without contrast |
$1,152 |
$2,881 |
$171 |
$130 | |
| CT scan of the lower back (lumbar spine) |
$1,374 |
$3,434 |
$306 |
$169 | |
| CT scan of the lower back (lumbar spine) with and without contrast |
$1,635 |
$4,088 |
$197 |
$197 | |
| CT scan of the lower back (lumbar spine) with contrast |
$1,374 |
$3,434 |
$395 |
$169 | |
| CT scan of the lower back (lumbar spine) without contrast |
$1,246 |
$3,115 |
$118 |
$130 | |
| CT scan of the neck |
$1,110 |
$2,775 |
$197 |
$183 | |
| CT scan of the neck (cervical spine) |
$1,418 |
$3,545 |
$306 |
$168 | |
| CT scan of the neck (cervical spine) with and without contrast |
$1,687 |
$4,218 |
$197 |
$196 | |
| CT scan of the neck (cervical spine) with contrast |
$1,418 |
$3,545 |
$395 |
$168 | |
| CT scan of the neck (cervical spine) without contrast |
$1,382 |
$3,456 |
$118 |
$131 | |
| CT scan of the neck with and without contrast |
$1,110 |
$2,775 |
$197 |
$220 | |
| CT scan of the neck with contrast |
$1,043 |
$2,607 |
$197 |
$183 | |
| CT scan of the neck without contrast |
$1,110 |
$2,775 |
$118 |
$150 | |
| CT scan of the pelvis |
$1,293 |
$3,233 |
$197 |
$226 | |
| CT scan of the pelvis with and without contrast |
$1,293 |
$3,233 |
$197 |
$251 | |
| CT scan of the pelvis with contrast |
$1,383 |
$3,457 |
$197 |
$226 | |
| CT scan of the pelvis without contrast |
$1,009 |
$2,523 |
$118 |
$133 | |
| CT scan of the sinuses |
$1,338 |
$3,344 |
$197 |
$152 | |
| CT scan of the sinuses with and without contrast |
$1,593 |
$3,982 |
$197 |
$184 | |
| CT scan of the sinuses with contrast |
$1,338 |
$3,344 |
$197 |
$152 | |
| CT scan of the sinuses without contrast |
$1,197 |
$2,992 |
$118 |
$128 | |
| D-dimer test |
$56 |
$140 |
$10 |
$10 | |
| Defibrillator (ICD) implant |
— |
— |
$39,146 |
$798 | |
| DHEA-sulfate test |
$112 |
$279 |
$23 |
$22 | |
| Diagnostic mammogram |
$346 |
$865 |
$112 |
$140 | |
| Drug screen (urine) |
$78 |
$195 |
$62 |
$17 | |
| Ear pressure test (tympanometry) |
— |
— |
$43 |
$16 | |
| Ear tubes (myringotomy) |
— |
— |
$561 |
$174 | |
| Echocardiogram |
$1,841 |
$4,602 |
$416 |
$138 | |
| Echocardiogram with and without contrast |
$1,210 |
$3,026 |
$268 |
$101 | |
| Echocardiogram without contrast |
— |
— |
$268 |
$138 | |
| EEG (awake and asleep) |
— |
— |
$343 |
$482 | |
| EKG / ECG (tracing only) |
— |
— |
$66 |
$7 | |
| Electrocardiogram (EKG) |
— |
— |
$66 |
$8 | |
| Electroencephalogram (EEG) |
— |
— |
$343 |
$448 | |
| Electrolyte panel |
$31 |
$79 |
$7 |
$7 | |
| Electromyography (EMG) |
— |
— |
$142 |
$141 | |
| Emergency department visit |
$752 |
$1,880 |
$617 |
$69 | |
| Emergency department visit (level 1) |
$284 |
$711 |
$303 |
$11 | |
| Emergency department visit (level 2) |
$408 |
$1,019 |
$501 |
$40 | |
| Emergency department visit (level 3) |
$752 |
$1,880 |
$537 |
$69 | |
| Emergency department visit (level 4) |
$1,386 |
$3,465 |
$1,860 |
$118 | |
| Emergency department visit (level 5) |
$1,778 |
$4,445 |
$1,860 |
$171 | |
| Endometrial biopsy |
— |
— |
$222 |
$98 | |
| Epidural steroid injection |
— |
— |
$763 |
$275 | |
| ERCP (bile duct endoscopy) |
— |
— |
$4,496 |
$311 | |
| Esophageal variceal banding |
— |
— |
$4,496 |
$126 | |
| Estradiol (estrogen) test |
$236 |
$590 |
$29 |
$28 | |
| Facet joint injection (spine) |
— |
— |
$981 |
$99 | |
| Fallopian tube X-ray (HSG) |
$552 |
$1,380 |
$268 |
$164 | |
| Family therapy session |
— |
— |
$176 |
$110 | |
| Fecal occult blood (stool) test |
$46 |
$114 |
$16 |
$10 | |
| Fecal occult blood (stool) test (guaiac, gFOBT) |
$35 |
$88 |
$4 |
$4 | |
| Fecal occult blood (stool) test (immunochemical, FIT) |
$56 |
$140 |
$16 |
$16 | |
| Feeding tube (PEG) placement |
— |
— |
$4,496 |
$178 | |
| Ferritin (iron) test |
$151 |
$378 |
$14 |
$14 | |
| Fibrinogen test |
$52 |
$130 |
$10 |
$10 | |
| Flexible sigmoidoscopy |
— |
— |
$1,010 |
$323 | |
| Flu test |
$17 |
$43 |
$17 |
$17 | |
| Flu vaccine |
$29 |
$72 |
$33 |
— | |
| Folate (folic acid) test |
$105 |
$262 |
$15 |
$15 | |
| Foreign body removal (skin) |
— |
— |
$440 |
$157 | |
| Free T4 thyroid test |
$157 |
$392 |
$9 |
$9 | |
| FSH hormone test |
$194 |
$485 |
$19 |
$19 | |
| Gallbladder scan (HIDA) |
$2,188 |
$5,469 |
$596 |
$334 | |
| GGT liver test |
$47 |
$117 |
$7 |
$7 | |
| Glucose tolerance test |
$37 |
$94 |
$13 |
$8 | |
| Group therapy session |
— |
— |
$101 |
$30 | |
| H. pylori test |
$28 |
$70 |
$68 |
$67 | |
| HDL cholesterol test |
$46 |
$114 |
$8 |
$8 | |
| Hearing test (audiometry) |
— |
— |
$172 |
$36 | |
| Hematocrit test |
$16 |
$40 |
$2 |
$2 | |
| Hemodialysis |
— |
— |
$771 |
$75 | |
| Hemoglobin A1c (diabetes test) |
$207 |
$518 |
$10 |
$10 | |
| Hemorrhoid removal |
— |
— |
$1,005 |
$338 | |
| Hepatitis A vaccine |
— |
— |
$119 |
— | |
| Hepatitis B test |
$32 |
$81 |
$11 |
$10 | |
| Hepatitis B vaccine |
— |
— |
$116 |
— | |
| Hepatitis C test |
$41 |
$102 |
$15 |
$14 | |
| Hip arthroscopy |
— |
— |
$5,994 |
$931 | |
| Hip replacement |
— |
— |
$27,970 |
$1,162 | |
| HIV test |
$51 |
$127 |
$24 |
$19 | |
| HIV test (antibody) |
$25 |
$62 |
$14 |
$14 | |
| HIV test (antigen/antibody combo) |
$76 |
$191 |
$25 |
$24 | |
| Holter heart monitor |
— |
— |
$139 |
$26 | |
| Home sleep apnea test |
— |
— |
$168 |
$123 | |
| HPV vaccine |
— |
— |
$609 |
— | |
| Hysterectomy |
— |
— |
$28,358 |
$933 | |
| Iron blood test |
$64 |
$159 |
$7 |
$6 | |
| IUD removal |
— |
— |
$335 |
$112 | |
| IV infusion therapy |
— |
— |
$169 |
$44 | |
| IV infusion therapy (each additional) |
— |
— |
$51 |
$21 | |
| IV infusion therapy (initial) |
— |
— |
$232 |
$67 | |
| Joint aspiration (small/intermediate) |
— |
— |
$325 |
$57 | |
| Joint aspiration or injection (mid-size joint) |
— |
— |
$325 |
$57 | |
| Joint aspiration or injection (small joint) |
— |
— |
$325 |
$56 | |
| Kidney scan (nuclear) |
$2,626 |
$6,566 |
$596 |
$172 | |
| Kidney stone shock-wave (lithotripsy) |
— |
— |
$10,520 |
$760 | |
| Kidney ultrasound |
$347 |
$867 |
$118 |
$84 | |
| Kidney ultrasound (limited) |
$428 |
$1,070 |
$118 |
$61 | |
| Knee arthroscopy |
— |
— |
$17,619 |
$524 | |
| Knee joint injection |
— |
— |
$325 |
$69 | |
| Knee replacement |
— |
— |
$16,907 |
$18,054 | |
| Lactate test |
$58 |
$145 |
$12 |
$12 | |
| Laryngoscopy |
— |
— |
$215 |
$189 | |
| LDH test |
$25 |
$62 |
$6 |
$6 | |
| LDL cholesterol test |
$52 |
$130 |
$11 |
$11 | |
| Leg artery angiogram |
— |
— |
$6,833 |
$149 | |
| Leg vein ultrasound (Doppler) |
$497 |
$1,242 |
$260 |
$150 | |
| Leg vein ultrasound (Doppler) (limited) |
$389 |
$972 |
$118 |
$116 | |
| LH hormone test |
$204 |
$509 |
$19 |
$19 | |
| Lipase test |
$60 |
$150 |
$7 |
$7 | |
| Lipid (cholesterol) panel |
$82 |
$206 |
$14 |
$13 | |
| Liver function panel |
$46 |
$114 |
$8 |
$8 | |
| Lung function test (PFT) |
— |
— |
$335 |
$37 | |
| Lung scan (V/Q) |
$1,427 |
$3,567 |
$596 |
$291 | |
| Magnesium blood test |
$12 |
$31 |
$7 |
$7 | |
| Meniscus repair (knee) |
— |
— |
$17,619 |
$714 | |
| MMR vaccine |
$76 |
$190 |
$188 |
— | |
| Mohs skin cancer surgery |
— |
— |
$675 |
$535 | |
| MRA of the brain |
$1,155 |
$2,888 |
$395 |
$226 | |
| MRA of the brain with contrast |
$1,155 |
$2,888 |
$395 |
$226 | |
| MRA of the brain without contrast |
$2,009 |
$5,023 |
$395 |
$328 | |
| MRA of the neck |
$1,155 |
$2,888 |
$395 |
$245 | |
| MRA of the neck with contrast |
$1,155 |
$2,888 |
$395 |
$245 | |
| MRA of the neck without contrast |
$2,009 |
$5,023 |
$395 |
$343 | |
| MRI of the abdomen |
$1,067 |
$2,667 |
$395 |
$300 | |
| MRI of the abdomen with contrast |
$1,334 |
$3,334 |
$395 |
$300 | |
| MRI of the abdomen without contrast |
$1,010 |
$2,524 |
$268 |
$194 | |
| MRI of the ankle |
$1,141 |
$2,852 |
$455 |
$261 | |
| MRI of the ankle with contrast |
$1,210 |
$3,024 |
$576 |
$261 | |
| MRI of the ankle without contrast |
$1,010 |
$2,524 |
$390 |
$222 | |
| MRI of the brain |
$1,010 |
$2,524 |
$395 |
$269 | |
| MRI of the brain with contrast |
$1,010 |
$2,524 |
$395 |
$269 | |
| MRI of the brain without contrast |
$895 |
$2,238 |
$268 |
$195 | |
| MRI of the chest |
$1,334 |
$3,334 |
$614 |
$371 | |
| MRI of the chest with contrast |
$1,334 |
$3,334 |
$875 |
$371 | |
| MRI of the chest without contrast |
$1,334 |
$3,334 |
$395 |
$466 | |
| MRI of the knee |
$1,010 |
$2,524 |
$767 |
$315 | |
| MRI of the knee with contrast |
$1,010 |
$2,524 |
$901 |
$315 | |
| MRI of the knee without contrast |
$1,010 |
$2,524 |
$390 |
$204 | |
| MRI of the lower back (lumbar spine) |
$1,010 |
$2,524 |
$395 |
$270 | |
| MRI of the lower back (lumbar spine) with contrast |
$1,278 |
$3,195 |
$395 |
$270 | |
| MRI of the lower back (lumbar spine) without contrast |
$1,010 |
$2,524 |
$268 |
$192 | |
| MRI of the mid-back (thoracic spine) |
$1,010 |
$2,524 |
$395 |
$271 | |
| MRI of the mid-back (thoracic spine) with and without contrast |
$1,010 |
$2,524 |
$395 |
$319 | |
| MRI of the mid-back (thoracic spine) with contrast |
$1,263 |
$3,157 |
$395 |
$271 | |
| MRI of the mid-back (thoracic spine) without contrast |
$1,010 |
$2,524 |
$268 |
$190 | |
| MRI of the neck (cervical spine) |
$1,252 |
$3,130 |
$395 |
$274 | |
| MRI of the neck (cervical spine) with and without contrast |
$1,539 |
$3,848 |
$395 |
$318 | |
| MRI of the neck (cervical spine) with contrast |
$1,252 |
$3,130 |
$395 |
$274 | |
| MRI of the neck (cervical spine) without contrast |
$1,010 |
$2,524 |
$268 |
$191 | |
| MRI of the pelvis |
$1,067 |
$2,667 |
$395 |
$268 | |
| MRI of the pelvis with contrast |
$1,067 |
$2,667 |
$395 |
$268 | |
| MRI of the pelvis without contrast |
$1,010 |
$2,524 |
$268 |
$227 | |
| MRI of the shoulder |
$1,343 |
$3,357 |
$633 |
$313 | |
| MRI of the shoulder with contrast |
$1,343 |
$3,357 |
$899 |
$313 | |
| MRI of the shoulder without contrast |
$1,010 |
$2,524 |
$390 |
$205 | |
| MRI of the wrist |
$1,266 |
$3,166 |
$455 |
$330 | |
| MRI of the wrist with contrast |
$1,343 |
$3,357 |
$576 |
$330 | |
| MRI of the wrist without contrast |
$1,010 |
$2,524 |
$390 |
$303 | |
| Nebulizer breathing treatment |
— |
— |
$224 |
$9 | |
| Nerve conduction study |
— |
— |
$335 |
$118 | |
| Newborn hospital care |
— |
— |
$142 |
$58 | |
| Nuchal translucency ultrasound |
$288 |
$720 |
$118 |
$116 | |
| Nuclear cardiac stress test |
$4,978 |
$12,444 |
$3,044 |
$428 | |
| Occupational therapy evaluation |
$152 |
$380 |
$119 |
$101 | |
| Occupational therapy evaluation (high complexity) |
$152 |
$380 |
$119 |
$101 | |
| Occupational therapy evaluation (low complexity) |
$152 |
$380 |
$119 |
$101 | |
| Occupational therapy evaluation (moderate complexity) |
$152 |
$380 |
$119 |
$101 | |
| Office visit (established patient) |
— |
— |
$66 |
$115 | |
| Office visit (new patient) |
— |
— |
$135 |
$177 | |
| Office visit, established patient (level 3) |
— |
— |
$51 |
$95 | |
| Office visit, established patient (level 4) |
— |
— |
$81 |
$136 | |
| Office visit, new patient (level 3) |
— |
— |
$95 |
$118 | |
| Office visit, new patient (level 4) |
— |
— |
$135 |
$177 | |
| Office visit, new patient (level 5) |
— |
— |
$171 |
$237 | |
| Pacemaker insertion |
— |
— |
$14,996 |
$15,506 | |
| Pap smear (cervical screening) |
— |
— |
$27 |
$20 | |
| Parathyroid hormone (PTH) test |
$139 |
$347 |
$42 |
$41 | |
| Pelvic ultrasound |
$477 |
$1,192 |
$118 |
$78 | |
| Pelvic ultrasound (complete) |
$698 |
$1,745 |
$118 |
$105 | |
| Pelvic ultrasound (limited) |
$255 |
$638 |
$118 |
$51 | |
| PET scan |
— |
— |
$3,354 |
— | |
| Phosphorus blood test |
$37 |
$93 |
$5 |
$5 | |
| Physical therapy evaluation |
$196 |
$490 |
$116 |
$98 | |
| Physical therapy evaluation (high complexity) |
$196 |
$490 |
$116 |
$98 | |
| Physical therapy evaluation (moderate complexity) |
$196 |
$490 |
$116 |
$98 | |
| Platelet count |
$64 |
$159 |
$5 |
$4 | |
| Pneumonia vaccine |
— |
— |
$220 |
— | |
| Pregnancy blood test (hCG) |
$105 |
$263 |
$8 |
$8 | |
| Pregnancy ultrasound |
$263 |
$659 |
$118 |
$126 | |
| Pregnancy ultrasound (first trimester) |
$232 |
$580 |
$118 |
$117 | |
| Pregnancy ultrasound (second or third trimester) |
$295 |
$737 |
$118 |
$136 | |
| Procalcitonin test |
$94 |
$235 |
$28 |
$27 | |
| Prolactin test |
$219 |
$548 |
$20 |
$19 | |
| Prostate test (PSA) |
$77 |
$194 |
$19 |
$18 | |
| Psychiatric evaluation |
— |
— |
$176 |
$188 | |
| Psychotherapy session |
— |
— |
$176 |
$140 | |
| Pulmonary rehabilitation |
— |
— |
$65 |
$87 | |
| Retina scan (OCT) |
— |
— |
$65 |
$33 | |
| Retinal (fundus) photography |
— |
— |
$142 |
$37 | |
| Rheumatoid factor test |
$9 |
$22 |
$6 |
$6 | |
| Rotator cuff repair |
— |
— |
$17,619 |
$792 | |
| Routine eye exam |
— |
— |
$142 |
$88 | |
| RSV vaccine |
— |
— |
$607 |
— | |
| Scoliosis spine X-ray |
$214 |
$535 |
$118 |
$58 | |
| Scoliosis spine X-ray (1 view) |
$161 |
$402 |
$98 |
$44 | |
| Scoliosis spine X-ray (3 views) |
$267 |
$667 |
$118 |
$72 | |
| Screening mammogram |
$415 |
$1,038 |
$137 |
$126 | |
| Scrotal ultrasound |
$570 |
$1,425 |
$118 |
$99 | |
| Sedimentation rate (ESR) test |
$9 |
$22 |
$4 |
$3 | |
| Semen analysis |
$10 |
$24 |
$12 |
$12 | |
| Sex hormone binding globulin test |
$158 |
$395 |
$22 |
$22 | |
| Shingles vaccine |
— |
— |
$332 |
— | |
| Shoulder arthroscopy |
— |
— |
$17,619 |
$962 | |
| Simple laceration repair (small, up to 2.5 cm) |
— |
— |
$219 |
$114 | |
| Simple wound stitches |
— |
— |
$219 |
$127 | |
| Sinus surgery (endoscopic) |
— |
— |
$4,496 |
$224 | |
| Skin biopsy |
— |
— |
$442 |
$121 | |
| Skin biopsy (punch) |
— |
— |
$440 |
$121 | |
| Skin cancer lesion removal |
— |
— |
$756 |
$240 | |
| Skin lesion freezing (cryotherapy) |
— |
— |
$219 |
$36 | |
| Skin tag removal |
— |
— |
$219 |
$92 | |
| Sleep study (polysomnography) |
— |
— |
$4,091 |
$691 | |
| Soft tissue ultrasound |
$146 |
$366 |
$118 |
$64 | |
| Speech therapy |
$101 |
$252 |
$76 |
$76 | |
| Spinal tap (lumbar puncture) |
— |
— |
$763 |
$165 | |
| Spirometry (lung function test) |
— |
— |
$172 |
$30 | |
| Spirometry with bronchodilator |
— |
— |
$343 |
$43 | |
| Strep throat test |
$72 |
$179 |
$17 |
$17 | |
| Stress echocardiogram |
$2,435 |
$6,087 |
$607 |
$209 | |
| Stress echocardiogram (complete) |
$2,435 |
$6,087 |
$607 |
$233 | |
| Swallow study |
— |
— |
$84 |
$85 | |
| T3 thyroid test |
$150 |
$374 |
$15 |
$14 | |
| Tdap (tetanus) vaccine |
$55 |
$138 |
$64 |
— | |
| Testosterone test |
$76 |
$190 |
$26 |
$26 | |
| Thyroid test (TSH) |
$132 |
$330 |
$17 |
$17 | |
| Thyroid ultrasound |
$485 |
$1,213 |
$118 |
$109 | |
| Thyroid uptake scan |
$1,149 |
$2,873 |
$445 |
$145 | |
| Tilt table test |
— |
— |
$585 |
$168 | |
| Total IgE allergy test |
$89 |
$222 |
$17 |
$16 | |
| Total protein test |
$40 |
$99 |
$4 |
$4 | |
| Transesophageal echocardiogram (TEE) |
— |
— |
$607 |
$239 | |
| Transesophageal echocardiogram (TEE) with and without contrast |
— |
— |
$607 |
$239 | |
| Transvaginal ultrasound |
$393 |
$983 |
$118 |
$118 | |
| Trigger point injection |
— |
— |
$325 |
$56 | |
| Trigger point injection (1-2 muscles) |
— |
— |
$325 |
$52 | |
| Triglycerides test |
$36 |
$90 |
$6 |
$6 | |
| Troponin (heart) test |
$90 |
$224 |
$13 |
$12 | |
| Upper GI endoscopy (EGD) |
— |
— |
$4,496 |
$371 | |
| Upper GI series (barium) |
$222 |
$555 |
$197 |
$128 | |
| Ureteral stent placement |
— |
— |
$4,496 |
$373 | |
| Uric acid (gout) test |
$40 |
$100 |
$5 |
$5 | |
| Urinalysis |
$32 |
$81 |
$3 |
$3 | |
| Urine microalbumin test |
$28 |
$71 |
$6 |
$5 | |
| Urine pregnancy test |
$9 |
$23 |
$9 |
$9 | |
| UV light therapy (skin) |
— |
— |
$65 |
$106 | |
| Vaccine administration |
— |
— |
$78 |
$19 | |
| Vaginal delivery |
— |
— |
$8,989 |
$5,487 | |
| Visual field test |
— |
— |
$142 |
$64 | |
| Vitamin B12 test |
$117 |
$292 |
$15 |
$15 | |
| Vitamin D test |
$72 |
$180 |
$30 |
$30 | |
| Vocal cord injection |
— |
— |
$4,496 |
$211 | |
| Wart removal |
— |
— |
$219 |
$121 | |
| Weight-loss (bariatric) surgery |
— |
— |
$13,982 |
$11,645 | |
| Wound debridement |
— |
— |
$658 |
$186 | |
| X-ray of the abdomen |
$232 |
$580 |
$118 |
$36 | |
| X-ray of the ankle |
$606 |
$1,516 |
$115 |
$37 | |
| X-ray of the collarbone |
$267 |
$667 |
$115 |
$33 | |
| X-ray of the elbow |
$762 |
$1,905 |
$115 |
$33 | |
| X-ray of the facial bones |
$399 |
$997 |
$116 |
$39 | |
| X-ray of the foot |
$550 |
$1,376 |
$115 |
$34 | |
| X-ray of the forearm |
$548 |
$1,370 |
$115 |
$29 | |
| X-ray of the hand |
$600 |
$1,501 |
$115 |
$38 | |
| X-ray of the hip |
$161 |
$402 |
$133 |
$49 | |
| X-ray of the hip (1 view) |
$161 |
$402 |
$98 |
$34 | |
| X-ray of the hip (3 views) |
$161 |
$402 |
$108 |
$49 | |
| X-ray of the hip (4 views) |
$267 |
$667 |
$133 |
$63 | |
| X-ray of the knee |
$548 |
$1,370 |
$125 |
$42 | |
| X-ray of the knee (2 views) |
$527 |
$1,318 |
$115 |
$34 | |
| X-ray of the knee (3 views) |
$548 |
$1,370 |
$115 |
$42 | |
| X-ray of the knee (4+ views) |
$721 |
$1,802 |
$139 |
$49 | |
| X-ray of the lower back (lumbar spine) |
$345 |
$862 |
$118 |
$47 | |
| X-ray of the lower back (lumbar spine) (2 views) |
$227 |
$567 |
$118 |
$40 | |
| X-ray of the lower back (lumbar spine) (4+ views) |
$463 |
$1,157 |
$118 |
$53 | |
| X-ray of the lower leg |
$588 |
$1,470 |
$115 |
$31 | |
| X-ray of the mid-back (thoracic spine) |
$227 |
$568 |
$118 |
$36 | |
| X-ray of the mid-back (thoracic spine) (2 views) |
$227 |
$568 |
$118 |
$33 | |
| X-ray of the mid-back (thoracic spine) (3 views) |
— |
— |
$117 |
$39 | |
| X-ray of the neck (cervical spine) |
$254 |
$636 |
$117 |
$47 | |
| X-ray of the neck (cervical spine) (3 views) |
$91 |
$228 |
$98 |
$40 | |
| X-ray of the pelvis |
$362 |
$906 |
$118 |
$36 | |
| X-ray of the pelvis (1 view) |
$282 |
$706 |
$118 |
$28 | |
| X-ray of the ribs |
$131 |
$328 |
$118 |
$42 | |
| X-ray of the ribs (2 views) |
$129 |
$323 |
$98 |
$36 | |
| X-ray of the ribs (3 views) |
$363 |
$907 |
$118 |
$42 | |
| X-ray of the shoulder |
$580 |
$1,451 |
$115 |
$36 | |
| X-ray of the skull |
$355 |
$889 |
$118 |
$40 | |
| X-ray of the upper arm |
$566 |
$1,416 |
$115 |
$32 | |
| X-ray of the wrist |
$637 |
$1,593 |
$115 |
$43 | |
| YAG laser capsulotomy (eye) |
— |
— |
$605 |
$335 | |
| Zinc blood test |
— |
— |
$12 |
$11 | |