| 3D mammogram (tomosynthesis) |
$26 |
$105 |
$71 |
$51 | |
| Abdominal fluid drain (paracentesis) |
$857 |
$3,428 |
$1,544 |
$284 | |
| Abdominal ultrasound |
$314 |
$1,256 |
$175 |
$100 | |
| Abdominal ultrasound (complete) |
$356 |
$1,425 |
$175 |
$114 | |
| Abdominal ultrasound (limited) |
$272 |
$1,087 |
$175 |
$86 | |
| Abscess drainage (complex or multiple) |
$147 |
$588 |
$658 |
$220 | |
| Abscess drainage (simple) |
$134 |
$535 |
$327 |
$129 | |
| Abscess incision and drainage |
$140 |
$562 |
$327 |
$174 | |
| ACL knee reconstruction |
— |
— |
$11,762 |
$889 | |
| Adenoid removal (adenoidectomy) |
— |
— |
$5,339 |
$204 | |
| Albumin blood test |
$48 |
$191 |
$9 |
$5 | |
| Aldosterone test |
$381 |
$1,524 |
$73 |
$41 | |
| Alkaline phosphatase test |
$51 |
$202 |
$9 |
$5 | |
| Alpha-fetoprotein (AFP) test |
$36 |
$145 |
$30 |
$17 | |
| ALT liver enzyme test |
$51 |
$204 |
$10 |
$5 | |
| Ammonia blood test |
$108 |
$433 |
$26 |
$15 | |
| Amniocentesis |
$347 |
$1,389 |
$1,434 |
$120 | |
| Amylase test |
$63 |
$250 |
$12 |
$6 | |
| Anal fistula repair |
— |
— |
$4,515 |
$541 | |
| Ankle fracture repair |
— |
— |
$11,762 |
$608 | |
| Anoscopy |
$79 |
$317 |
$212 |
$129 | |
| Antinuclear antibody (ANA) test |
$85 |
$340 |
$22 |
$12 | |
| Aortic aneurysm repair (AAA) |
$8,225 |
$32,899 |
$18,094 |
$1,345 | |
| Arterial blood gas (ABG) |
$89 |
$354 |
$47 |
$26 | |
| AST liver enzyme test |
$51 |
$202 |
$9 |
$5 | |
| Barium swallow study |
$147 |
$586 |
$293 |
$107 | |
| Bartholin cyst removal |
$72 |
$287 |
$331 |
$182 | |
| Basic metabolic panel |
$166 |
$665 |
$15 |
$8 | |
| Benign skin lesion removal |
$298 |
$1,194 |
$1,158 |
$171 | |
| Bilirubin blood test |
$50 |
$200 |
$9 |
$5 | |
| Bladder scope (cystoscopy) |
$326 |
$1,304 |
$1,099 |
$216 | |
| Bladder tumor removal (TURBT) |
$2,289 |
$9,155 |
$5,678 |
$236 | |
| Blood clotting test (PT/INR) |
$43 |
$172 |
$8 |
$4 | |
| Blood crossmatch |
$69 |
$276 |
$282 |
— | |
| Blood glucose test |
$38 |
$153 |
$9 |
$5 | |
| Blood transfusion |
$285 |
$1,140 |
$720 |
$47 | |
| Blood type and screen |
$75 |
$300 |
$88 |
$10 | |
| Blood type test |
$39 |
$157 |
$102 |
$3 | |
| Blood type test (ABO group) |
$39 |
$157 |
$212 |
$3 | |
| Blood type test (Rh/D antigen) |
$39 |
$157 |
$65 |
$3 | |
| BNP (heart failure) test |
$171 |
$684 |
$71 |
$39 | |
| Bone density scan (DEXA) |
$225 |
$900 |
$175 |
$39 | |
| Bone marrow biopsy |
$500 |
$1,999 |
$2,668 |
$172 | |
| Bone scan (nuclear) |
$467 |
$1,866 |
$662 |
$259 | |
| Breast biopsy |
$2,052 |
$8,206 |
$2,668 |
$478 | |
| Breast MRI |
$862 |
$3,447 |
$398 |
$216 | |
| Breast MRI without contrast |
$862 |
$3,447 |
$398 |
$216 | |
| Breast ultrasound |
$125 |
$499 |
$175 |
$92 | |
| Breast ultrasound (complete) |
$135 |
$540 |
$175 |
$100 | |
| Breast ultrasound (limited) |
$115 |
$458 |
$145 |
$84 | |
| Breathing tube insertion (intubation) |
$282 |
$1,129 |
$382 |
$133 | |
| Bronchoscopy |
— |
— |
$2,839 |
$303 | |
| Burn dressing and debridement (medium) |
$152 |
$606 |
$327 |
$166 | |
| Burn dressing and debridement (small) |
$135 |
$539 |
$327 |
$93 | |
| Burn treatment |
$152 |
$606 |
$327 |
$129 | |
| C-reactive protein (CRP) |
$41 |
$162 |
$9 |
$5 | |
| CA 19-9 tumor marker test |
$138 |
$550 |
$37 |
$21 | |
| CA-125 ovarian marker test |
$138 |
$550 |
$37 |
$21 | |
| Calcium blood test |
$51 |
$202 |
$9 |
$5 | |
| Cardiac ablation |
$12,898 |
$51,591 |
$40,391 |
$759 | |
| Cardiac catheterization |
$4,298 |
$17,193 |
$5,296 |
$1,049 | |
| Cardiac rehabilitation |
$168 |
$671 |
$207 |
$26 | |
| Cardiac stress test |
$230 |
$918 |
$513 |
$39 | |
| Cardioversion |
$196 |
$784 |
$1,077 |
$155 | |
| Carotid artery ultrasound |
$310 |
$1,238 |
$398 |
$156 | |
| Carpal tunnel release |
— |
— |
$3,215 |
$483 | |
| CEA tumor marker test |
$180 |
$720 |
$34 |
$19 | |
| Celiac disease test |
$10 |
$38 |
$21 |
$12 | |
| Central line placement |
$894 |
$3,574 |
$5,182 |
$238 | |
| Cervical cerclage |
— |
— |
$5,235 |
$137 | |
| Cervical LEEP procedure |
— |
— |
$5,235 |
$325 | |
| Cesarean section (C-section) |
— |
— |
$12,448 |
$7,552 | |
| Chemotherapy infusion |
$238 |
$953 |
$310 |
$81 | |
| Chemotherapy infusion (each additional) |
$97 |
$387 |
$117 |
$28 | |
| Chemotherapy infusion (first hour) |
$380 |
$1,518 |
$546 |
$133 | |
| Chest fluid drain (thoracentesis) |
$764 |
$3,056 |
$1,018 |
$311 | |
| Chest tube insertion |
$313 |
$1,252 |
$2,558 |
$143 | |
| Chest X-ray |
$103 |
$413 |
$149 |
$37 | |
| Chest X-ray (1 view) |
$80 |
$321 |
$145 |
$25 | |
| Chest X-ray (2 views) |
$103 |
$413 |
$145 |
$33 | |
| CK-MB heart enzyme test |
$98 |
$391 |
$21 |
$12 | |
| Clotting time test (PTT) |
$16 |
$64 |
$11 |
$6 | |
| Colon resection (colectomy) |
— |
— |
$2,813 |
$1,238 | |
| Colonoscopy |
— |
— |
$1,941 |
$480 | |
| Complete blood count (CBC) |
$40 |
$159 |
$14 |
$7 | |
| Complete blood count (CBC) (complete) |
$43 |
$171 |
$14 |
$8 | |
| Complex wound repair |
— |
— |
$1,008 |
$390 | |
| Comprehensive metabolic panel |
$173 |
$692 |
$19 |
$11 | |
| Contraceptive implant (Nexplanon) |
$108 |
$432 |
$657 |
$115 | |
| Copper blood test |
$116 |
$463 |
$22 |
$12 | |
| Coronary artery bypass (CABG) |
— |
— |
$52,092 |
$36,593 | |
| Coronary CT angiography |
$1,000 |
$3,998 |
$588 |
$326 | |
| Cortisol test |
$63 |
$250 |
$29 |
$16 | |
| COVID-19 PCR test |
$47 |
$186 |
$92 |
$51 | |
| CPAP titration study |
$142 |
$566 |
$335 |
$69 | |
| Creatine kinase (CK) test |
$63 |
$252 |
$12 |
$7 | |
| CT angiography of the chest |
$1,304 |
$5,215 |
$293 |
$281 | |
| CT angiography of the head |
$1,000 |
$3,998 |
$293 |
$274 | |
| CT colonography (virtual colonoscopy) |
$323 |
$1,292 |
$398 |
$835 | |
| CT scan of the abdomen |
$1,117 |
$4,469 |
$293 |
$230 | |
| CT scan of the abdomen and pelvis |
$1,541 |
$6,165 |
$588 |
$300 | |
| CT scan of the abdomen and pelvis with and without contrast |
$1,634 |
$6,535 |
$588 |
$338 | |
| CT scan of the abdomen and pelvis with contrast |
$1,541 |
$6,165 |
$588 |
$300 | |
| CT scan of the abdomen and pelvis without contrast |
$1,439 |
$5,755 |
$398 |
$183 | |
| CT scan of the abdomen with and without contrast |
$1,218 |
$4,871 |
$293 |
$259 | |
| CT scan of the abdomen with contrast |
$1,117 |
$4,469 |
$293 |
$230 | |
| CT scan of the abdomen without contrast |
$847 |
$3,386 |
$175 |
$136 | |
| CT scan of the arm |
$784 |
$3,135 |
$343 |
$199 | |
| CT scan of the arm with contrast |
$784 |
$3,135 |
$588 |
$199 | |
| CT scan of the arm without contrast |
$754 |
$3,014 |
$175 |
$161 | |
| CT scan of the chest |
$1,110 |
$4,440 |
$293 |
$167 | |
| CT scan of the chest with and without contrast |
$1,195 |
$4,779 |
$293 |
$196 | |
| CT scan of the chest with contrast |
$1,110 |
$4,440 |
$293 |
$167 | |
| CT scan of the head |
$795 |
$3,178 |
$293 |
$148 | |
| CT scan of the head with and without contrast |
$1,010 |
$4,038 |
$293 |
$173 | |
| CT scan of the head with contrast |
$795 |
$3,178 |
$293 |
$148 | |
| CT scan of the head without contrast |
$758 |
$3,032 |
$175 |
$107 | |
| CT scan of the leg |
$784 |
$3,135 |
$293 |
$166 | |
| CT scan of the leg with contrast |
$784 |
$3,135 |
$293 |
$166 | |
| CT scan of the leg without contrast |
$773 |
$3,091 |
$175 |
$130 | |
| CT scan of the lower back (lumbar spine) |
$891 |
$3,564 |
$343 |
$169 | |
| CT scan of the lower back (lumbar spine) with and without contrast |
$891 |
$3,564 |
$293 |
$197 | |
| CT scan of the lower back (lumbar spine) with contrast |
$928 |
$3,713 |
$588 |
$169 | |
| CT scan of the lower back (lumbar spine) without contrast |
$841 |
$3,363 |
$175 |
$130 | |
| CT scan of the neck |
$917 |
$3,669 |
$293 |
$183 | |
| CT scan of the neck (cervical spine) |
$979 |
$3,915 |
$343 |
$168 | |
| CT scan of the neck (cervical spine) with and without contrast |
$891 |
$3,564 |
$293 |
$196 | |
| CT scan of the neck (cervical spine) with contrast |
$1,021 |
$4,084 |
$588 |
$168 | |
| CT scan of the neck (cervical spine) without contrast |
$979 |
$3,915 |
$175 |
$131 | |
| CT scan of the neck with and without contrast |
$1,054 |
$4,215 |
$293 |
$220 | |
| CT scan of the neck with contrast |
$917 |
$3,669 |
$293 |
$183 | |
| CT scan of the neck without contrast |
$799 |
$3,195 |
$175 |
$150 | |
| CT scan of the pelvis |
$1,044 |
$4,174 |
$293 |
$226 | |
| CT scan of the pelvis with and without contrast |
$1,214 |
$4,855 |
$293 |
$251 | |
| CT scan of the pelvis with contrast |
$1,044 |
$4,174 |
$293 |
$226 | |
| CT scan of the pelvis without contrast |
$927 |
$3,707 |
$175 |
$133 | |
| CT scan of the sinuses |
$615 |
$2,460 |
$293 |
$152 | |
| CT scan of the sinuses with and without contrast |
$692 |
$2,767 |
$293 |
$184 | |
| CT scan of the sinuses with contrast |
$615 |
$2,460 |
$293 |
$152 | |
| CT scan of the sinuses without contrast |
$583 |
$2,330 |
$175 |
$128 | |
| D-dimer test |
$63 |
$250 |
$18 |
$10 | |
| Defibrillator (ICD) implant |
$20,744 |
$82,974 |
$52,787 |
$798 | |
| DHEA-sulfate test |
$212 |
$846 |
$40 |
$22 | |
| Diagnostic mammogram |
$171 |
$682 |
$265 |
$140 | |
| Dialysis fistula creation |
— |
— |
$5,182 |
$601 | |
| Dilation and curettage (D&C) |
— |
— |
$5,235 |
$298 | |
| Drug screen (urine) |
$18 |
$73 |
$31 |
$17 | |
| Ear tubes (myringotomy) |
— |
— |
$2,439 |
$174 | |
| Eardrum repair (tympanoplasty) |
— |
— |
$9,740 |
$799 | |
| Echocardiogram |
$452 |
$1,809 |
$458 |
$138 | |
| Echocardiogram with and without contrast |
$189 |
$756 |
$398 |
$101 | |
| Echocardiogram without contrast |
$452 |
$1,809 |
$398 |
$138 | |
| EEG (awake and asleep) |
$291 |
$1,162 |
$513 |
$482 | |
| EKG / ECG (tracing only) |
$63 |
$253 |
$98 |
$7 | |
| Electrocardiogram (EKG) |
$63 |
$253 |
$98 |
$8 | |
| Electroencephalogram (EEG) |
$265 |
$1,061 |
$513 |
$448 | |
| Electrolyte panel |
$121 |
$484 |
$13 |
$7 | |
| Electromyography (EMG) |
$166 |
$665 |
$212 |
$141 | |
| Emergency department visit |
$190 |
$761 |
$456 |
$69 | |
| Emergency department visit (level 1) |
$90 |
$360 |
$145 |
$11 | |
| Emergency department visit (level 2) |
$135 |
$540 |
$261 |
$40 | |
| Emergency department visit (level 3) |
$190 |
$761 |
$456 |
$69 | |
| Emergency department visit (level 4) |
$275 |
$1,098 |
$701 |
$118 | |
| Emergency department visit (level 5) |
$367 |
$1,466 |
$1,009 |
$171 | |
| Endometrial biopsy |
$83 |
$331 |
$331 |
$98 | |
| Epidural steroid injection |
$449 |
$1,798 |
$1,140 |
$275 | |
| ERCP (bile duct endoscopy) |
$1,351 |
$5,402 |
$6,264 |
$311 | |
| Esophageal dilation |
— |
— |
$1,544 |
$522 | |
| Estradiol (estrogen) test |
$262 |
$1,047 |
$50 |
$28 | |
| Facet joint injection (spine) |
$191 |
$763 |
$1,151 |
$99 | |
| Fallopian tube X-ray (HSG) |
$722 |
$2,889 |
$398 |
$164 | |
| Family therapy session |
$164 |
$656 |
$265 |
$110 | |
| Fecal occult blood (stool) test |
$18 |
$70 |
$22 |
$10 | |
| Fecal occult blood (stool) test (guaiac, gFOBT) |
$24 |
$96 |
$8 |
$4 | |
| Fecal occult blood (stool) test (immunochemical, FIT) |
$11 |
$44 |
$29 |
$16 | |
| Feeding tube (PEG) placement |
$702 |
$2,807 |
$3,123 |
$178 | |
| Femoral hernia repair |
— |
— |
$5,810 |
$584 | |
| Ferritin (iron) test |
$130 |
$521 |
$25 |
$14 | |
| Fibrinogen test |
$80 |
$321 |
$18 |
$10 | |
| Fibroid removal (myomectomy) |
— |
— |
$2,188 |
$914 | |
| Flexible sigmoidoscopy |
— |
— |
$1,501 |
$323 | |
| Flu test |
$43 |
$172 |
$30 |
$17 | |
| Flu vaccine |
$5 |
$18 |
$11 |
— | |
| Folate (folic acid) test |
$110 |
$438 |
$26 |
$15 | |
| Foreign body removal (skin) |
$259 |
$1,034 |
$658 |
$157 | |
| Free T4 thyroid test |
$25 |
$98 |
$16 |
$9 | |
| FSH hormone test |
$176 |
$703 |
$33 |
$19 | |
| Gallbladder removal (laparoscopic) |
— |
— |
$9,606 |
$658 | |
| Gallbladder scan (HIDA) |
$570 |
$2,279 |
$886 |
$334 | |
| Ganglion cyst removal |
— |
— |
$2,635 |
$321 | |
| GGT liver test |
$69 |
$276 |
$13 |
$7 | |
| Glucose tolerance test |
$33 |
$131 |
$23 |
$8 | |
| Group therapy session |
$107 |
$426 |
$152 |
$30 | |
| HDL cholesterol test |
$77 |
$306 |
$15 |
$8 | |
| Hematocrit test |
$23 |
$93 |
$4 |
$2 | |
| Hemodialysis |
$347 |
$1,389 |
$1,152 |
$75 | |
| Hemoglobin A1c (diabetes test) |
$93 |
$370 |
$17 |
$10 | |
| Hemorrhoid removal |
— |
— |
$1,501 |
$338 | |
| Hepatitis B test |
$81 |
$322 |
$19 |
$10 | |
| Hepatitis C test |
$102 |
$406 |
$26 |
$14 | |
| Hip arthroscopy |
— |
— |
$11,762 |
$931 | |
| Hip replacement |
— |
— |
$21,184 |
$1,162 | |
| HIV test |
$32 |
$128 |
$25 |
$19 | |
| HIV test (antibody) |
$38 |
$152 |
$25 |
$14 | |
| HIV test (antigen/antibody combo) |
$26 |
$104 |
$43 |
$24 | |
| Holter heart monitor |
$219 |
$877 |
$212 |
$26 | |
| Home sleep apnea test |
$127 |
$509 |
$258 |
$123 | |
| Hydrocele repair |
— |
— |
$5,810 |
$315 | |
| Hysterectomy |
— |
— |
$17,141 |
$933 | |
| Hysteroscopy |
— |
— |
$5,235 |
$1,270 | |
| Inguinal hernia repair |
— |
— |
$5,810 |
$538 | |
| Iron blood test |
$63 |
$250 |
$12 |
$6 | |
| IUD insertion |
— |
— |
$242 |
— | |
| IUD removal |
$83 |
$331 |
$501 |
$112 | |
| IV infusion therapy |
$116 |
$463 |
$116 |
$44 | |
| IV infusion therapy (each additional) |
$32 |
$126 |
$76 |
$21 | |
| IV infusion therapy (initial) |
$200 |
$800 |
$347 |
$67 | |
| IVC filter placement |
$2,561 |
$10,243 |
$8,900 |
$1,885 | |
| Joint aspiration (small/intermediate) |
$193 |
$774 |
$486 |
$57 | |
| Joint aspiration or injection (mid-size joint) |
$266 |
$1,065 |
$486 |
$57 | |
| Joint aspiration or injection (small joint) |
$121 |
$482 |
$486 |
$56 | |
| Kidney biopsy |
$631 |
$2,525 |
$2,668 |
$492 | |
| Kidney scan (nuclear) |
$644 |
$2,577 |
$886 |
$172 | |
| Kidney stone shock-wave (lithotripsy) |
— |
— |
$5,678 |
$760 | |
| Kidney ultrasound |
$234 |
$937 |
$175 |
$84 | |
| Kidney ultrasound (limited) |
$244 |
$977 |
$175 |
$61 | |
| Knee arthroscopy |
— |
— |
$5,342 |
$524 | |
| Knee joint injection |
$429 |
$1,715 |
$486 |
$69 | |
| Knee replacement |
— |
— |
$24,637 |
$18,054 | |
| Lactate test |
$286 |
$1,143 |
$21 |
$12 | |
| Laminectomy (spine) |
— |
— |
$11,762 |
$1,157 | |
| Laryngoscopy |
$126 |
$505 |
$320 |
$189 | |
| LDH test |
$56 |
$225 |
$11 |
$6 | |
| LDL cholesterol test |
$39 |
$157 |
$19 |
$11 | |
| Leg artery angiogram |
$1,423 |
$5,693 |
$5,182 |
$149 | |
| Leg artery angioplasty |
$9,468 |
$37,873 |
$10,679 |
— | |
| Leg vein ultrasound (Doppler) |
$305 |
$1,221 |
$398 |
$150 | |
| Leg vein ultrasound (Doppler) (limited) |
$249 |
$995 |
$175 |
$116 | |
| LH hormone test |
$168 |
$671 |
$33 |
$19 | |
| Lipase test |
$16 |
$62 |
$12 |
$7 | |
| Lipid (cholesterol) panel |
$98 |
$390 |
$24 |
$13 | |
| Liver biopsy |
$669 |
$2,677 |
$2,668 |
$288 | |
| Liver function panel |
$146 |
$582 |
$15 |
$8 | |
| Lumbar discectomy |
— |
— |
$11,762 |
$898 | |
| Lumpectomy (breast) |
— |
— |
$6,305 |
$750 | |
| Lung function test (PFT) |
$197 |
$788 |
$389 |
$37 | |
| Lung scan (V/Q) |
$800 |
$3,199 |
$886 |
$291 | |
| Magnesium blood test |
$27 |
$109 |
$12 |
$7 | |
| Mastectomy |
— |
— |
$10,737 |
$1,021 | |
| Meniscus repair (knee) |
— |
— |
$5,342 |
$714 | |
| MRA of the brain |
$947 |
$3,787 |
$588 |
$226 | |
| MRA of the brain with contrast |
$963 |
$3,852 |
$588 |
$226 | |
| MRA of the neck |
$1,002 |
$4,006 |
$588 |
$245 | |
| MRA of the neck with contrast |
$1,002 |
$4,006 |
$588 |
$245 | |
| MRA of the neck without contrast |
$1,519 |
$6,074 |
$588 |
$343 | |
| MRI of the abdomen |
$1,289 |
$5,156 |
$588 |
$300 | |
| MRI of the abdomen with contrast |
$1,289 |
$5,156 |
$588 |
$300 | |
| MRI of the abdomen without contrast |
$1,128 |
$4,512 |
$398 |
$194 | |
| MRI of the ankle |
$1,050 |
$4,198 |
$588 |
$261 | |
| MRI of the ankle with contrast |
$1,050 |
$4,198 |
$588 |
$261 | |
| MRI of the ankle without contrast |
$932 |
$3,728 |
$398 |
$222 | |
| MRI of the brain |
$950 |
$3,801 |
$588 |
$269 | |
| MRI of the brain with contrast |
$950 |
$3,801 |
$588 |
$269 | |
| MRI of the brain without contrast |
$919 |
$3,675 |
$398 |
$195 | |
| MRI of the chest |
$1,171 |
$4,683 |
$588 |
$371 | |
| MRI of the chest without contrast |
$1,466 |
$5,862 |
$588 |
$466 | |
| MRI of the knee |
$1,026 |
$4,102 |
$759 |
$315 | |
| MRI of the knee with contrast |
$1,026 |
$4,102 |
$1,301 |
$315 | |
| MRI of the knee without contrast |
$1,025 |
$4,100 |
$398 |
$204 | |
| MRI of the lower back (lumbar spine) |
$1,191 |
$4,765 |
$588 |
$270 | |
| MRI of the lower back (lumbar spine) with contrast |
$1,191 |
$4,765 |
$588 |
$270 | |
| MRI of the lower back (lumbar spine) without contrast |
$1,132 |
$4,528 |
$398 |
$192 | |
| MRI of the mid-back (thoracic spine) |
$1,505 |
$6,021 |
$588 |
$271 | |
| MRI of the mid-back (thoracic spine) with and without contrast |
$1,637 |
$6,549 |
$588 |
$319 | |
| MRI of the mid-back (thoracic spine) with contrast |
$1,505 |
$6,021 |
$588 |
$271 | |
| MRI of the mid-back (thoracic spine) without contrast |
$1,132 |
$4,528 |
$398 |
$190 | |
| MRI of the neck (cervical spine) |
$1,251 |
$5,002 |
$588 |
$274 | |
| MRI of the neck (cervical spine) with and without contrast |
$1,719 |
$6,876 |
$588 |
$318 | |
| MRI of the neck (cervical spine) with contrast |
$1,251 |
$5,002 |
$588 |
$274 | |
| MRI of the neck (cervical spine) without contrast |
$1,132 |
$4,528 |
$398 |
$191 | |
| MRI of the pelvis |
$1,042 |
$4,169 |
$588 |
$268 | |
| MRI of the pelvis with contrast |
$1,042 |
$4,169 |
$588 |
$268 | |
| MRI of the pelvis without contrast |
$911 |
$3,643 |
$398 |
$227 | |
| MRI of the shoulder |
$1,026 |
$4,102 |
$759 |
$313 | |
| MRI of the shoulder with contrast |
$1,026 |
$4,102 |
$1,301 |
$313 | |
| MRI of the shoulder without contrast |
$930 |
$3,721 |
$398 |
$205 | |
| MRI of the wrist |
$1,000 |
$3,998 |
$588 |
$330 | |
| MRI of the wrist with contrast |
$1,026 |
$4,102 |
$588 |
$330 | |
| MRI of the wrist without contrast |
$930 |
$3,721 |
$398 |
$303 | |
| Nebulizer breathing treatment |
$63 |
$251 |
$335 |
$9 | |
| Neck (cervical) spinal fusion |
— |
— |
$21,184 |
$1,410 | |
| Nerve conduction study |
$496 |
$1,985 |
$513 |
$118 | |
| Nuclear cardiac stress test |
$2,549 |
$10,196 |
$2,149 |
$428 | |
| Occupational therapy evaluation |
$224 |
$895 |
$492 |
$101 | |
| Occupational therapy evaluation (high complexity) |
$224 |
$895 |
$492 |
$101 | |
| Occupational therapy evaluation (low complexity) |
$224 |
$895 |
$492 |
$101 | |
| Occupational therapy evaluation (moderate complexity) |
$224 |
$895 |
$492 |
$101 | |
| Office visit (established patient) |
$264 |
$1,055 |
$292 |
$115 | |
| Office visit (new patient) |
$122 |
$489 |
$279 |
$177 | |
| Office visit, established patient (level 3) |
$222 |
$887 |
$266 |
$95 | |
| Office visit, established patient (level 4) |
$306 |
$1,222 |
$299 |
$136 | |
| Office visit, new patient (level 3) |
$93 |
$372 |
$223 |
$118 | |
| Office visit, new patient (level 4) |
$122 |
$489 |
$268 |
$177 | |
| Office visit, new patient (level 5) |
$149 |
$595 |
$397 |
$237 | |
| Orthopedic hardware removal |
— |
— |
$4,712 |
$632 | |
| Ovarian cyst removal |
— |
— |
$8,127 |
$698 | |
| Pacemaker insertion |
— |
— |
$28,355 |
$15,506 | |
| Pap smear (cervical screening) |
$25 |
$98 |
$41 |
$20 | |
| Parathyroid hormone (PTH) test |
$178 |
$712 |
$74 |
$41 | |
| Parathyroid removal |
— |
— |
$9,740 |
$891 | |
| Pelvic ultrasound |
$210 |
$842 |
$175 |
$78 | |
| Pelvic ultrasound (complete) |
$261 |
$1,045 |
$175 |
$105 | |
| Pelvic ultrasound (limited) |
$160 |
$638 |
$175 |
$51 | |
| PET scan |
$3,090 |
$12,361 |
$2,401 |
— | |
| Phosphorus blood test |
$43 |
$173 |
$9 |
$5 | |
| Physical therapy evaluation |
$224 |
$895 |
$492 |
$98 | |
| Physical therapy evaluation (high complexity) |
$224 |
$895 |
$492 |
$98 | |
| Physical therapy evaluation (moderate complexity) |
$224 |
$895 |
$492 |
$98 | |
| Pilonidal cyst removal |
— |
— |
$4,712 |
$541 | |
| Platelet count |
$41 |
$165 |
$8 |
$4 | |
| Pregnancy blood test (hCG) |
$72 |
$287 |
$14 |
$8 | |
| Pregnancy ultrasound |
$288 |
$1,154 |
$175 |
$126 | |
| Pregnancy ultrasound (first trimester) |
$180 |
$719 |
$175 |
$117 | |
| Pregnancy ultrasound (second or third trimester) |
$397 |
$1,588 |
$175 |
$136 | |
| Procalcitonin test |
$206 |
$822 |
$49 |
$27 | |
| Prolactin test |
$184 |
$735 |
$35 |
$19 | |
| Prostate biopsy |
— |
— |
$3,373 |
— | |
| Prostate surgery (TURP) |
— |
— |
$8,370 |
$526 | |
| Prostate test (PSA) |
$138 |
$550 |
$33 |
$18 | |
| Psychiatric evaluation |
$110 |
$439 |
$265 |
$188 | |
| Psychotherapy session |
$138 |
$550 |
$265 |
$140 | |
| Pulmonary rehabilitation |
$55 |
$220 |
$98 |
$87 | |
| Radiofrequency nerve ablation |
$808 |
$3,230 |
$3,215 |
$462 | |
| Rheumatoid factor test |
$53 |
$212 |
$11 |
$6 | |
| Rotator cuff repair |
— |
— |
$11,762 |
$792 | |
| Scoliosis spine X-ray |
$105 |
$419 |
$175 |
$58 | |
| Scoliosis spine X-ray (1 view) |
$99 |
$397 |
$145 |
$44 | |
| Scoliosis spine X-ray (3 views) |
$110 |
$440 |
$175 |
$72 | |
| Screening mammogram |
$136 |
$545 |
$300 |
$126 | |
| Scrotal ultrasound |
$163 |
$652 |
$175 |
$99 | |
| Sedimentation rate (ESR) test |
$33 |
$133 |
$8 |
$3 | |
| Septoplasty (deviated septum) |
— |
— |
$5,339 |
$613 | |
| Sex hormone binding globulin test |
$52 |
$208 |
$39 |
$22 | |
| Shoulder replacement |
— |
— |
$30,278 |
$1,300 | |
| Simple laceration repair (small, up to 2.5 cm) |
$83 |
$331 |
$327 |
$114 | |
| Simple wound stitches |
$83 |
$331 |
$327 |
$127 | |
| Sinus surgery (endoscopic) |
— |
— |
$11,081 |
$224 | |
| Skin biopsy |
$155 |
$618 |
$408 |
$121 | |
| Skin biopsy (punch) |
$149 |
$595 |
$658 |
$121 | |
| Skin cancer lesion removal |
— |
— |
$1,158 |
$240 | |
| Skin graft |
— |
— |
$6,028 |
$898 | |
| Skin lesion freezing (cryotherapy) |
$100 |
$401 |
$324 |
$36 | |
| Skin tag removal |
$68 |
$272 |
$327 |
$92 | |
| Sleep study (polysomnography) |
$1,468 |
$5,871 |
$1,675 |
$691 | |
| Small bowel resection |
— |
— |
$1,424 |
$1,136 | |
| Soft tissue ultrasound |
$134 |
$536 |
$175 |
$64 | |
| Speech therapy |
$271 |
$1,085 |
$597 |
$76 | |
| Spinal cord stimulator |
$2,907 |
$11,629 |
$10,805 |
$2,388 | |
| Spinal tap (lumbar puncture) |
$277 |
$1,109 |
$1,140 |
$165 | |
| Spine fracture repair (kyphoplasty) |
$5,771 |
$23,082 |
$11,762 |
$5,803 | |
| Spirometry (lung function test) |
$175 |
$698 |
$258 |
$30 | |
| Spirometry with bronchodilator |
$220 |
$878 |
$513 |
$43 | |
| Strep throat test |
$101 |
$402 |
$30 |
$17 | |
| Stress echocardiogram |
$313 |
$1,252 |
$903 |
$209 | |
| Swallow study |
$180 |
$719 |
$395 |
$85 | |
| T3 thyroid test |
$134 |
$537 |
$26 |
$14 | |
| Testicle removal (orchiectomy) |
— |
— |
$5,678 |
$306 | |
| Testosterone test |
$69 |
$275 |
$46 |
$26 | |
| Thyroid removal (thyroidectomy) |
— |
— |
$9,606 |
$1,004 | |
| Thyroid test (TSH) |
$89 |
$357 |
$30 |
$17 | |
| Thyroid ultrasound |
$220 |
$881 |
$175 |
$109 | |
| Thyroid uptake scan |
$388 |
$1,552 |
$662 |
$145 | |
| Tilt table test |
$383 |
$1,530 |
$874 |
$168 | |
| Tonsillectomy |
— |
— |
$5,411 |
$252 | |
| Total IgE allergy test |
$129 |
$514 |
$30 |
$16 | |
| Total protein test |
$51 |
$204 |
$7 |
$4 | |
| Transesophageal echocardiogram (TEE) |
$677 |
$2,706 |
$903 |
$239 | |
| Transesophageal echocardiogram (TEE) with and without contrast |
$677 |
$2,706 |
$903 |
$239 | |
| Transvaginal ultrasound |
$158 |
$631 |
$175 |
$118 | |
| Trigger point injection |
$185 |
$739 |
$486 |
$56 | |
| Trigger point injection (1-2 muscles) |
$135 |
$539 |
$486 |
$52 | |
| Triglycerides test |
$56 |
$222 |
$10 |
$6 | |
| Troponin (heart) test |
$83 |
$330 |
$22 |
$12 | |
| Tubal ligation |
— |
— |
$9,606 |
$333 | |
| Turbinate reduction |
— |
— |
$5,339 |
$294 | |
| Upper GI endoscopy (EGD) |
— |
— |
$1,544 |
$371 | |
| Upper GI series (barium) |
$283 |
$1,132 |
$293 |
$128 | |
| Ureteral stent placement |
— |
— |
$5,678 |
$373 | |
| Ureteroscopy (stone removal) |
— |
— |
$8,370 |
$365 | |
| Uric acid (gout) test |
$41 |
$165 |
$8 |
$5 | |
| Urinalysis |
$7 |
$26 |
$4 |
$3 | |
| Urine microalbumin test |
$31 |
$123 |
$9 |
$5 | |
| Urine pregnancy test |
$66 |
$262 |
$16 |
$9 | |
| Vaccine administration |
$32 |
$126 |
$110 |
$19 | |
| Vaccine administration (each additional) |
$32 |
$126 |
$81 |
$16 | |
| Vaginal delivery |
— |
— |
$9,246 |
$5,487 | |
| Varicose vein ablation |
$2,040 |
$8,161 |
$5,182 |
$1,018 | |
| Vitamin B12 test |
$143 |
$572 |
$27 |
$15 | |
| Vitamin D test |
$305 |
$1,220 |
$53 |
$30 | |
| Wart removal |
$51 |
$205 |
$327 |
$121 | |
| Weight-loss (bariatric) surgery |
— |
— |
$21,079 |
$11,645 | |
| Wound debridement |
$281 |
$1,125 |
$658 |
$186 | |
| Wrist fracture repair |
— |
— |
$11,762 |
$735 | |
| X-ray of the abdomen |
$89 |
$355 |
$175 |
$36 | |
| X-ray of the ankle |
$61 |
$243 |
$145 |
$37 | |
| X-ray of the collarbone |
$55 |
$218 |
$145 |
$33 | |
| X-ray of the elbow |
$61 |
$243 |
$145 |
$33 | |
| X-ray of the facial bones |
$56 |
$225 |
$145 |
$39 | |
| X-ray of the foot |
$64 |
$255 |
$145 |
$34 | |
| X-ray of the forearm |
$48 |
$191 |
$145 |
$29 | |
| X-ray of the hand |
$81 |
$322 |
$145 |
$38 | |
| X-ray of the hip |
$129 |
$514 |
$145 |
$49 | |
| X-ray of the hip (1 view) |
$66 |
$263 |
$145 |
$34 | |
| X-ray of the hip (3 views) |
$129 |
$514 |
$145 |
$49 | |
| X-ray of the hip (4 views) |
$142 |
$569 |
$175 |
$63 | |
| X-ray of the knee |
$81 |
$322 |
$145 |
$42 | |
| X-ray of the knee (2 views) |
$61 |
$243 |
$145 |
$34 | |
| X-ray of the knee (3 views) |
$89 |
$357 |
$145 |
$42 | |
| X-ray of the knee (4+ views) |
$81 |
$322 |
$175 |
$49 | |
| X-ray of the lower back (lumbar spine) |
$97 |
$389 |
$175 |
$47 | |
| X-ray of the lower back (lumbar spine) (2 views) |
$71 |
$283 |
$175 |
$40 | |
| X-ray of the lower back (lumbar spine) (4+ views) |
$124 |
$494 |
$175 |
$53 | |
| X-ray of the lower leg |
$61 |
$243 |
$145 |
$31 | |
| X-ray of the mid-back (thoracic spine) |
$91 |
$364 |
$175 |
$36 | |
| X-ray of the mid-back (thoracic spine) (2 views) |
$65 |
$260 |
$175 |
$33 | |
| X-ray of the mid-back (thoracic spine) (3 views) |
$117 |
$468 |
$175 |
$39 | |
| X-ray of the neck (cervical spine) |
$112 |
$446 |
$175 |
$47 | |
| X-ray of the neck (cervical spine) (3 views) |
$75 |
$298 |
$145 |
$40 | |
| X-ray of the pelvis |
$70 |
$282 |
$175 |
$36 | |
| X-ray of the pelvis (1 view) |
$44 |
$177 |
$175 |
$28 | |
| X-ray of the ribs |
$79 |
$315 |
$175 |
$42 | |
| X-ray of the ribs (2 views) |
$79 |
$315 |
$145 |
$36 | |
| X-ray of the ribs (3 views) |
$79 |
$315 |
$175 |
$42 | |
| X-ray of the shoulder |
$81 |
$322 |
$145 |
$36 | |
| X-ray of the skull |
$86 |
$342 |
$175 |
$40 | |
| X-ray of the upper arm |
$61 |
$243 |
$145 |
$32 | |
| X-ray of the wrist |
$81 |
$322 |
$145 |
$43 | |
| Zinc blood test |
$90 |
$358 |
$21 |
$11 | |