| 3D mammogram (tomosynthesis) |
$183 |
$183 |
— |
$51 | |
| Abdominal fluid drain (paracentesis) |
$3,952 |
$3,952 |
— |
$284 | |
| Abdominal ultrasound |
$1,772 |
$1,772 |
$151 |
$100 | |
| Abdominal ultrasound (complete) |
$1,887 |
$1,887 |
$151 |
$114 | |
| Abdominal ultrasound (limited) |
$1,656 |
$1,656 |
$151 |
$86 | |
| Abscess drainage (complex or multiple) |
— |
— |
$588 |
$220 | |
| Abscess drainage (simple) |
$1,255 |
$1,255 |
$290 |
$129 | |
| Abscess incision and drainage |
$1,255 |
$1,255 |
$439 |
$174 | |
| Achilles tendon repair |
— |
— |
$13,088 |
$624 | |
| ACL knee reconstruction |
— |
— |
$23,614 |
$889 | |
| Acupuncture |
— |
— |
$42 |
$38 | |
| Adenoid removal (adenoidectomy) |
— |
— |
$10,191 |
$204 | |
| Albumin blood test |
$103 |
$103 |
$5 |
$5 | |
| Aldosterone test |
— |
— |
$41 |
$41 | |
| Alkaline phosphatase test |
$94 |
$94 |
$5 |
$5 | |
| Alpha-fetoprotein (AFP) test |
$176 |
$176 |
$17 |
$17 | |
| ALT liver enzyme test |
$112 |
$112 |
$5 |
$5 | |
| Ammonia blood test |
$411 |
$411 |
$15 |
$15 | |
| Amniocentesis |
$1,105 |
$1,105 |
— |
$120 | |
| Amylase test |
$220 |
$220 |
$6 |
$6 | |
| Anal fistula repair |
— |
— |
$6,821 |
$541 | |
| Ankle fracture repair |
— |
— |
$13,816 |
$608 | |
| Anoscopy |
— |
— |
$192 |
$129 | |
| Antinuclear antibody (ANA) test |
$102 |
$102 |
$12 |
$12 | |
| Aortic aneurysm repair (AAA) |
$15,690 |
$15,690 |
— |
$1,345 | |
| Aortic valve replacement |
$58,880 |
$58,880 |
— |
$1,603 | |
| Arterial blood gas (ABG) |
$802 |
$802 |
$26 |
$26 | |
| AST liver enzyme test |
$114 |
$114 |
$5 |
$5 | |
| Barium swallow study |
$1,497 |
$1,497 |
$254 |
$107 | |
| Bartholin cyst removal |
$956 |
$956 |
— |
$182 | |
| Basic metabolic panel |
$347 |
$347 |
$8 |
$8 | |
| Benign skin lesion removal |
— |
— |
$1,024 |
$171 | |
| Bilirubin blood test |
$123 |
$123 |
$5 |
$5 | |
| Bladder function test (urodynamics) |
$2,889 |
$2,889 |
$1,008 |
$345 | |
| Bladder scope (cystoscopy) |
— |
— |
$1,914 |
$216 | |
| Bladder tumor removal (TURBT) |
— |
— |
$7,506 |
$236 | |
| Blood clotting test (PT/INR) |
$158 |
$158 |
$4 |
$4 | |
| Blood crossmatch |
$576 |
$576 |
$246 |
— | |
| Blood glucose test |
$106 |
$106 |
$5 |
$5 | |
| Blood transfusion |
$857 |
$857 |
$638 |
$47 | |
| Blood type and screen |
$255 |
$255 |
$75 |
$10 | |
| Blood type test |
$161 |
$161 |
$123 |
$3 | |
| Blood type test (ABO group) |
$154 |
$154 |
$192 |
$3 | |
| Blood type test (Rh/D antigen) |
$161 |
$161 |
$54 |
$3 | |
| BNP (heart failure) test |
$601 |
$601 |
$39 |
$39 | |
| Bone density scan (DEXA) |
$913 |
$913 |
$151 |
$39 | |
| Bone marrow biopsy |
$5,183 |
$5,183 |
$9,374 |
$172 | |
| Bone scan (nuclear) |
$4,342 |
$4,342 |
$578 |
$259 | |
| Botox for migraine |
— |
— |
$444 |
$157 | |
| Breast biopsy |
$6,214 |
$6,214 |
$7,554 |
$478 | |
| Breast MRI |
$4,167 |
$4,167 |
$5,123 |
$216 | |
| Breast MRI without contrast |
$4,205 |
$4,205 |
$5,123 |
$216 | |
| Breast reconstruction |
— |
— |
$19,923 |
$1,227 | |
| Breast reduction |
— |
— |
$12,745 |
$980 | |
| Breast ultrasound |
$1,468 |
$1,468 |
$138 |
$92 | |
| Breast ultrasound (complete) |
$1,637 |
$1,637 |
$151 |
$100 | |
| Breast ultrasound (limited) |
$1,298 |
$1,298 |
$126 |
$84 | |
| Breathing tube insertion (intubation) |
$1,621 |
$1,621 |
$342 |
$133 | |
| Bronchoscopy |
$9,400 |
$9,400 |
$2,573 |
$303 | |
| Bunion surgery (bunionectomy) |
— |
— |
$14,525 |
$883 | |
| Burn dressing and debridement (medium) |
— |
— |
$290 |
$166 | |
| Burn dressing and debridement (small) |
— |
— |
$290 |
$93 | |
| Burn treatment |
— |
— |
$290 |
$129 | |
| C-reactive protein (CRP) |
$177 |
$177 |
$5 |
$5 | |
| CA 19-9 tumor marker test |
$224 |
$224 |
$21 |
$21 | |
| CA-125 ovarian marker test |
$273 |
$273 |
$21 |
$21 | |
| Calcium blood test |
$112 |
$112 |
$5 |
$5 | |
| Capsule endoscopy |
$6,187 |
$6,187 |
— |
$802 | |
| Cardiac ablation |
$84,489 |
$84,489 |
— |
$759 | |
| Cardiac catheterization |
$42,910 |
$42,910 |
— |
$1,049 | |
| Cardiac MRI |
$6,585 |
$6,585 |
$504 |
$322 | |
| Cardiac MRI without contrast |
$5,936 |
$5,936 |
$345 |
$280 | |
| Cardiac rehabilitation |
$465 |
$465 |
— |
$26 | |
| Cardiac stress test |
$2,345 |
$2,345 |
$312 |
$39 | |
| Cardioversion |
$4,162 |
$4,162 |
— |
$155 | |
| Carotid artery ultrasound |
$2,178 |
$2,178 |
$248 |
$156 | |
| Carpal tunnel release |
— |
— |
$5,068 |
$483 | |
| Cataract surgery |
— |
— |
$6,446 |
$547 | |
| CEA tumor marker test |
$286 |
$286 |
$19 |
$19 | |
| Celiac disease test |
$68 |
$68 |
$12 |
$12 | |
| Central line placement |
$4,383 |
$4,383 |
— |
$238 | |
| Cervical cerclage |
— |
— |
$4,680 |
$137 | |
| Cervical LEEP procedure |
— |
— |
$5,825 |
$325 | |
| Cesarean section (C-section) |
— |
— |
$12,368 |
$7,552 | |
| Chalazion (eyelid cyst) removal |
$1,367 |
$1,367 |
— |
$131 | |
| Chemotherapy infusion |
$1,226 |
$1,226 |
$104 |
$81 | |
| Chemotherapy infusion (each additional) |
$684 |
$684 |
$104 |
$28 | |
| Chemotherapy infusion (first hour) |
$1,768 |
$1,768 |
— |
$133 | |
| Chest fluid drain (thoracentesis) |
$3,790 |
$3,790 |
— |
$311 | |
| Chest tube insertion |
$3,854 |
$3,854 |
$2,276 |
$143 | |
| Chest X-ray |
$771 |
$771 |
$126 |
$37 | |
| Chest X-ray (1 view) |
$738 |
$738 |
$126 |
$25 | |
| Chest X-ray (2 views) |
$804 |
$804 |
$126 |
$33 | |
| Chickenpox (varicella) vaccine |
— |
— |
$552 |
— | |
| Circumcision |
$484 |
$484 |
$6,455 |
$167 | |
| CK-MB heart enzyme test |
$401 |
$401 |
$12 |
$12 | |
| Clotting time test (PTT) |
$236 |
$236 |
$6 |
$6 | |
| Colonoscopy |
— |
— |
$2,997 |
$480 | |
| Colposcopy |
$3,655 |
$3,655 |
— |
$161 | |
| Complete blood count (CBC) |
$203 |
$203 |
$7 |
$7 | |
| Complete blood count (CBC) (complete) |
$217 |
$217 |
$8 |
$8 | |
| Complex wound repair |
— |
— |
$1,068 |
$390 | |
| Comprehensive eye exam |
$313 |
$313 |
$192 |
$138 | |
| Comprehensive metabolic panel |
$429 |
$429 |
$11 |
$11 | |
| Contraceptive implant (Nexplanon) |
— |
— |
$192 |
$115 | |
| Copper blood test |
— |
— |
$12 |
$12 | |
| Coronary artery bypass (CABG) |
— |
— |
$151,882 |
$36,593 | |
| Coronary CT angiography |
$5,054 |
$5,054 |
$2,793 |
$326 | |
| Cortisol test |
$283 |
$283 |
$16 |
$16 | |
| COVID-19 PCR test |
$382 |
$382 |
$51 |
$51 | |
| CPAP titration study |
$2,733 |
$2,733 |
— |
$69 | |
| Creatine kinase (CK) test |
$243 |
$243 |
$7 |
$7 | |
| CT angiography of the chest |
$6,885 |
$6,885 |
$4,642 |
$281 | |
| CT angiography of the head |
$6,173 |
$6,173 |
$4,446 |
$274 | |
| CT colonography (virtual colonoscopy) |
$2,491 |
$2,491 |
$345 |
$835 | |
| CT scan of the abdomen |
$4,755 |
$4,755 |
$1,729 |
$230 | |
| CT scan of the abdomen and pelvis |
$8,287 |
$8,287 |
$5,169 |
$300 | |
| CT scan of the abdomen and pelvis with and without contrast |
$8,994 |
$8,994 |
$5,952 |
$338 | |
| CT scan of the abdomen and pelvis with contrast |
$8,287 |
$8,287 |
$5,590 |
$300 | |
| CT scan of the abdomen and pelvis without contrast |
$6,374 |
$6,374 |
$4,585 |
$183 | |
| CT scan of the abdomen with and without contrast |
$4,989 |
$4,989 |
$2,306 |
$259 | |
| CT scan of the abdomen with contrast |
$4,755 |
$4,755 |
$1,746 |
$230 | |
| CT scan of the abdomen without contrast |
$4,058 |
$4,058 |
$1,301 |
$136 | |
| CT scan of the arm |
$7,683 |
$7,683 |
$1,243 |
$199 | |
| CT scan of the arm with contrast |
$7,683 |
$7,683 |
$504 |
$199 | |
| CT scan of the arm without contrast |
$6,398 |
$6,398 |
$1,257 |
$161 | |
| CT scan of the chest |
$5,153 |
$5,153 |
$1,439 |
$167 | |
| CT scan of the chest with and without contrast |
$5,607 |
$5,607 |
$2,642 |
$196 | |
| CT scan of the chest with contrast |
$5,153 |
$5,153 |
$1,682 |
$167 | |
| CT scan of the chest without contrast |
$4,097 |
$4,097 |
$1,376 |
$133 | |
| CT scan of the head |
$4,869 |
$4,869 |
$1,236 |
$148 | |
| CT scan of the head with and without contrast |
$5,345 |
$5,345 |
$1,674 |
$173 | |
| CT scan of the head with contrast |
$4,869 |
$4,869 |
$254 |
$148 | |
| CT scan of the head without contrast |
$4,312 |
$4,312 |
$1,075 |
$107 | |
| CT scan of the leg |
$7,974 |
$7,974 |
$1,243 |
$166 | |
| CT scan of the leg with contrast |
$7,974 |
$7,974 |
$3,167 |
$166 | |
| CT scan of the leg without contrast |
$6,538 |
$6,538 |
$1,257 |
$130 | |
| CT scan of the lower back (lumbar spine) |
$5,824 |
$5,824 |
$1,360 |
$169 | |
| CT scan of the lower back (lumbar spine) with and without contrast |
$5,824 |
$5,824 |
$254 |
$197 | |
| CT scan of the lower back (lumbar spine) with contrast |
$6,202 |
$6,202 |
$504 |
$169 | |
| CT scan of the lower back (lumbar spine) without contrast |
$4,803 |
$4,803 |
$1,374 |
$130 | |
| CT scan of the neck |
$4,572 |
$4,572 |
$1,499 |
$183 | |
| CT scan of the neck (cervical spine) |
$5,699 |
$5,699 |
$1,365 |
$168 | |
| CT scan of the neck (cervical spine) with and without contrast |
$5,699 |
$5,699 |
$254 |
$196 | |
| CT scan of the neck (cervical spine) with contrast |
$7,056 |
$7,056 |
$504 |
$168 | |
| CT scan of the neck (cervical spine) without contrast |
$5,058 |
$5,058 |
$1,378 |
$131 | |
| CT scan of the neck with and without contrast |
$4,572 |
$4,572 |
$254 |
$220 | |
| CT scan of the neck with contrast |
$4,995 |
$4,995 |
$1,515 |
$183 | |
| CT scan of the neck without contrast |
$4,177 |
$4,177 |
$151 |
$150 | |
| CT scan of the pelvis |
$4,656 |
$4,656 |
$1,606 |
$226 | |
| CT scan of the pelvis with and without contrast |
$4,196 |
$4,196 |
$2,086 |
$251 | |
| CT scan of the pelvis with contrast |
$5,746 |
$5,746 |
$1,607 |
$226 | |
| CT scan of the pelvis without contrast |
$4,656 |
$4,656 |
$1,332 |
$133 | |
| CT scan of the sinuses |
$4,353 |
$4,353 |
$1,256 |
$152 | |
| CT scan of the sinuses with and without contrast |
$4,353 |
$4,353 |
$254 |
$184 | |
| CT scan of the sinuses with contrast |
$5,254 |
$5,254 |
$254 |
$152 | |
| CT scan of the sinuses without contrast |
$4,272 |
$4,272 |
$1,270 |
$128 | |
| D-dimer test |
$370 |
$370 |
$10 |
$10 | |
| Defibrillator (ICD) implant |
$89,176 |
$89,176 |
— |
$798 | |
| DHEA-sulfate test |
$102 |
$102 |
$22 |
$22 | |
| Diagnostic mammogram |
$803 |
$803 |
— |
$140 | |
| Dialysis fistula creation |
— |
— |
$19,728 |
$601 | |
| Dilation and curettage (D&C) |
$11,503 |
$11,503 |
$5,908 |
$298 | |
| Droopy eyelid repair (ptosis) |
— |
— |
$13,754 |
$745 | |
| Drug screen (urine) |
$781 |
$781 |
$17 |
$17 | |
| Ear pressure test (tympanometry) |
— |
— |
$54 |
$16 | |
| Ear tubes (myringotomy) |
— |
— |
$4,532 |
$174 | |
| Eardrum repair (tympanoplasty) |
— |
— |
$12,631 |
$799 | |
| Echocardiogram |
$2,776 |
$2,776 |
$345 |
$138 | |
| Echocardiogram with and without contrast |
$1,923 |
$1,923 |
$345 |
$101 | |
| Echocardiogram without contrast |
$2,776 |
$2,776 |
$345 |
$138 | |
| EEG (awake and asleep) |
$2,327 |
$2,327 |
$312 |
$482 | |
| EKG / ECG (tracing only) |
$614 |
$614 |
$85 |
$7 | |
| Elbow replacement |
— |
— |
$25,348 |
$1,301 | |
| Electrocardiogram (EKG) |
$614 |
$614 |
$85 |
$8 | |
| Electroencephalogram (EEG) |
$2,243 |
$2,243 |
$312 |
$448 | |
| Electrolyte panel |
$210 |
$210 |
$7 |
$7 | |
| Electromyography (EMG) |
$436 |
$436 |
$192 |
$141 | |
| Emergency department visit |
$3,093 |
$3,093 |
$395 |
$69 | |
| Emergency department visit (level 1) |
$603 |
$603 |
$122 |
$11 | |
| Emergency department visit (level 2) |
$1,527 |
$1,527 |
$222 |
$40 | |
| Emergency department visit (level 3) |
$3,093 |
$3,093 |
$395 |
$69 | |
| Emergency department visit (level 4) |
$5,214 |
$5,214 |
$603 |
$118 | |
| Emergency department visit (level 5) |
$8,003 |
$8,003 |
$861 |
$171 | |
| Epidural steroid injection |
$5,209 |
$5,209 |
$3,833 |
$275 | |
| ERCP (bile duct endoscopy) |
$7,734 |
$7,734 |
— |
$311 | |
| Esophageal dilation |
$10,254 |
$10,254 |
— |
$522 | |
| Estradiol (estrogen) test |
$272 |
$272 |
$28 |
$28 | |
| Eyelid surgery (blepharoplasty) |
— |
— |
$5,103 |
$552 | |
| Facet joint injection (spine) |
$2,156 |
$2,156 |
$2,123 |
$99 | |
| Fallopian tube X-ray (HSG) |
$1,153 |
$1,153 |
$345 |
$164 | |
| Family therapy session |
$708 |
$708 |
— |
$110 | |
| Fecal occult blood (stool) test |
$109 |
$109 |
$10 |
$10 | |
| Fecal occult blood (stool) test (guaiac, gFOBT) |
$96 |
$96 |
$4 |
$4 | |
| Fecal occult blood (stool) test (immunochemical, FIT) |
$121 |
$121 |
$16 |
$16 | |
| Feeding tube (PEG) placement |
$7,757 |
$7,757 |
— |
$178 | |
| Femoral hernia repair |
— |
— |
$5,176 |
$584 | |
| Ferritin (iron) test |
$256 |
$256 |
$14 |
$14 | |
| Fibrinogen test |
$320 |
$320 |
$10 |
$10 | |
| Flexible sigmoidoscopy |
— |
— |
$1,910 |
$323 | |
| Flu test |
— |
— |
$17 |
$17 | |
| Flu vaccine |
— |
— |
$65 |
— | |
| Folate (folic acid) test |
$231 |
$231 |
$15 |
$15 | |
| Foreign body removal (skin) |
$2,055 |
$2,055 |
$588 |
$157 | |
| Free T4 thyroid test |
$231 |
$231 |
$9 |
$9 | |
| FSH hormone test |
$248 |
$248 |
$19 |
$19 | |
| Gallbladder removal (laparoscopic) |
— |
— |
$13,419 |
$658 | |
| Gallbladder scan (HIDA) |
$3,844 |
$3,844 |
$681 |
$334 | |
| Ganglion cyst removal |
— |
— |
$5,856 |
$321 | |
| GGT liver test |
$143 |
$143 |
$7 |
$7 | |
| Glucose tolerance test |
$124 |
$124 |
$8 |
$8 | |
| Group therapy session |
$286 |
$286 |
— |
$30 | |
| H. pylori test |
$354 |
$354 |
$67 |
$67 | |
| Hammertoe repair |
— |
— |
$6,253 |
$548 | |
| HDL cholesterol test |
$136 |
$136 |
$8 |
$8 | |
| Hearing test (audiometry) |
$731 |
$731 |
— |
$36 | |
| Hematocrit test |
$104 |
$104 |
$2 |
$2 | |
| Hemoglobin A1c (diabetes test) |
$203 |
$203 |
$10 |
$10 | |
| Hepatitis A vaccine |
— |
— |
$166 |
— | |
| Hepatitis B test |
$147 |
$147 |
$10 |
$10 | |
| Hepatitis B vaccine |
$536 |
$536 |
$162 |
— | |
| Hepatitis C test |
$182 |
$182 |
$14 |
$14 | |
| Hip arthroscopy |
— |
— |
$40,632 |
$931 | |
| Hip fracture repair |
— |
— |
$10,490 |
$1,120 | |
| Hip replacement |
— |
— |
$40,905 |
$1,162 | |
| HIV test |
$244 |
$244 |
$19 |
$19 | |
| HIV test (antibody) |
$172 |
$172 |
$14 |
$14 | |
| HIV test (antigen/antibody combo) |
$316 |
$316 |
$24 |
$24 | |
| Holter heart monitor |
$848 |
$848 |
$139 |
$26 | |
| Home sleep apnea test |
— |
— |
$199 |
$123 | |
| HPV vaccine |
— |
— |
$927 |
— | |
| Hydrocele repair |
— |
— |
$15,710 |
$315 | |
| Hysterectomy |
— |
— |
$39,047 |
$933 | |
| Hysteroscopy |
— |
— |
$6,527 |
$1,270 | |
| Inguinal hernia repair |
— |
— |
$9,294 |
$538 | |
| Iron blood test |
$140 |
$140 |
$6 |
$6 | |
| IUD removal |
— |
— |
$888 |
$112 | |
| IV infusion therapy |
$902 |
$902 |
$308 |
$44 | |
| IV infusion therapy (each additional) |
$589 |
$589 |
— |
$21 | |
| IV infusion therapy (initial) |
$1,214 |
$1,214 |
$308 |
$67 | |
| IVC filter placement |
$17,462 |
$17,462 |
$8,044 |
$1,885 | |
| Joint aspiration (small/intermediate) |
$1,808 |
$1,808 |
$444 |
$57 | |
| Joint aspiration or injection (mid-size joint) |
$1,808 |
$1,808 |
$444 |
$57 | |
| Joint aspiration or injection (small joint) |
$1,801 |
$1,801 |
$444 |
$56 | |
| Kidney biopsy |
$4,356 |
$4,356 |
$8,409 |
$492 | |
| Kidney scan (nuclear) |
$4,467 |
$4,467 |
$785 |
$172 | |
| Kidney stone shock-wave (lithotripsy) |
— |
— |
$11,176 |
$760 | |
| Kidney ultrasound |
$1,498 |
$1,498 |
$151 |
$84 | |
| Kidney ultrasound (limited) |
$1,330 |
$1,330 |
$151 |
$61 | |
| Knee arthroscopy |
— |
— |
$7,889 |
$524 | |
| Knee joint injection |
$1,922 |
$1,922 |
$901 |
$69 | |
| Knee replacement |
— |
— |
$76,307 |
$18,054 | |
| Lactate test |
$333 |
$333 |
$12 |
$12 | |
| Laminectomy (spine) |
— |
— |
$30,046 |
$1,157 | |
| Laryngoscopy |
$1,102 |
$1,102 |
$2,573 |
$189 | |
| LDH test |
$157 |
$157 |
$6 |
$6 | |
| LDL cholesterol test |
$129 |
$129 |
$11 |
$11 | |
| Leg artery angiogram |
$10,621 |
$10,621 |
— |
$149 | |
| Leg artery angioplasty |
$47,766 |
$47,766 |
— |
— | |
| Leg vein ultrasound (Doppler) |
$2,459 |
$2,459 |
$248 |
$150 | |
| Leg vein ultrasound (Doppler) (limited) |
$2,046 |
$2,046 |
$151 |
$116 | |
| LH hormone test |
$327 |
$327 |
$19 |
$19 | |
| Lipase test |
$266 |
$266 |
$7 |
$7 | |
| Lipid (cholesterol) panel |
$343 |
$343 |
$13 |
$13 | |
| Liver biopsy |
$4,749 |
$4,749 |
$2,388 |
$288 | |
| Liver function panel |
$309 |
$309 |
$8 |
$8 | |
| Lower back (lumbar) spinal fusion |
— |
— |
$168,809 |
$1,511 | |
| Lumbar discectomy |
— |
— |
$28,671 |
$898 | |
| Lumpectomy (breast) |
— |
— |
$12,454 |
$750 | |
| Lung function test (PFT) |
$1,051 |
$1,051 |
$426 |
$37 | |
| Lung scan (V/Q) |
$4,562 |
$4,562 |
$785 |
$291 | |
| Magnesium blood test |
$219 |
$219 |
$7 |
$7 | |
| Mastectomy |
— |
— |
$9,599 |
$1,021 | |
| Mastoidectomy |
— |
— |
$8,558 |
$840 | |
| Meniscus repair (knee) |
— |
— |
$7,755 |
$714 | |
| MMR vaccine |
— |
— |
$319 |
— | |
| Mohs skin cancer surgery |
— |
— |
$1,068 |
$535 | |
| MRA of the brain |
$6,437 |
$6,437 |
$3,016 |
$226 | |
| MRA of the brain with contrast |
$6,437 |
$6,437 |
$504 |
$226 | |
| MRA of the brain without contrast |
$7,839 |
$7,839 |
$504 |
$328 | |
| MRA of the neck |
$5,978 |
$5,978 |
$504 |
$245 | |
| MRA of the neck with contrast |
$5,978 |
$5,978 |
$504 |
$245 | |
| MRA of the neck without contrast |
$8,824 |
$8,824 |
$3,556 |
$343 | |
| MRI of the abdomen |
$5,540 |
$5,540 |
$4,263 |
$300 | |
| MRI of the abdomen with contrast |
$5,386 |
$5,386 |
$504 |
$300 | |
| MRI of the abdomen without contrast |
$5,540 |
$5,540 |
$3,782 |
$194 | |
| MRI of the ankle |
$10,040 |
$10,040 |
$2,813 |
$261 | |
| MRI of the ankle with contrast |
$10,124 |
$10,124 |
$504 |
$261 | |
| MRI of the ankle without contrast |
$6,744 |
$6,744 |
$2,842 |
$222 | |
| MRI of the brain |
$7,192 |
$7,192 |
$3,322 |
$269 | |
| MRI of the brain with contrast |
$7,192 |
$7,192 |
$504 |
$269 | |
| MRI of the brain without contrast |
$5,481 |
$5,481 |
$2,881 |
$195 | |
| MRI of the chest |
$6,294 |
$6,294 |
$425 |
$371 | |
| MRI of the chest with contrast |
$6,294 |
$6,294 |
— |
$371 | |
| MRI of the chest without contrast |
$8,053 |
$8,053 |
$504 |
$466 | |
| MRI of the knee |
$7,678 |
$7,678 |
$2,795 |
$315 | |
| MRI of the knee with contrast |
$7,678 |
$7,678 |
— |
$315 | |
| MRI of the knee without contrast |
$7,464 |
$7,464 |
$2,795 |
$204 | |
| MRI of the lower back (lumbar spine) |
$8,076 |
$8,076 |
$3,227 |
$270 | |
| MRI of the lower back (lumbar spine) with contrast |
$8,076 |
$8,076 |
$504 |
$270 | |
| MRI of the lower back (lumbar spine) without contrast |
$5,217 |
$5,217 |
$2,800 |
$192 | |
| MRI of the mid-back (thoracic spine) |
$6,508 |
$6,508 |
$3,228 |
$271 | |
| MRI of the mid-back (thoracic spine) with and without contrast |
$8,406 |
$8,406 |
$4,658 |
$319 | |
| MRI of the mid-back (thoracic spine) with contrast |
$6,508 |
$6,508 |
$504 |
$271 | |
| MRI of the mid-back (thoracic spine) without contrast |
$5,458 |
$5,458 |
$2,803 |
$190 | |
| MRI of the neck (cervical spine) |
$6,480 |
$6,480 |
$3,059 |
$274 | |
| MRI of the neck (cervical spine) with and without contrast |
$8,560 |
$8,560 |
$4,835 |
$318 | |
| MRI of the neck (cervical spine) with contrast |
$6,480 |
$6,480 |
$504 |
$274 | |
| MRI of the neck (cervical spine) without contrast |
$5,265 |
$5,265 |
$2,657 |
$191 | |
| MRI of the pelvis |
$5,735 |
$5,735 |
$3,307 |
$268 | |
| MRI of the pelvis with contrast |
$5,220 |
$5,220 |
$504 |
$268 | |
| MRI of the pelvis without contrast |
$5,735 |
$5,735 |
$2,861 |
$227 | |
| MRI of the shoulder |
$7,576 |
$7,576 |
$2,733 |
$313 | |
| MRI of the shoulder with contrast |
$7,576 |
$7,576 |
— |
$313 | |
| MRI of the shoulder without contrast |
$7,291 |
$7,291 |
$2,761 |
$205 | |
| MRI of the wrist |
$6,684 |
$6,684 |
$2,853 |
$330 | |
| MRI of the wrist with contrast |
$5,882 |
$5,882 |
$504 |
$330 | |
| MRI of the wrist without contrast |
$6,684 |
$6,684 |
$2,882 |
$303 | |
| Nebulizer breathing treatment |
$685 |
$685 |
— |
$9 | |
| Neck (cervical) spinal fusion |
— |
— |
$18,560 |
$1,410 | |
| Nerve conduction study |
$261 |
$261 |
$312 |
$118 | |
| Newborn hospital care |
— |
— |
$192 |
$58 | |
| Nuchal translucency ultrasound |
$769 |
$769 |
$151 |
$116 | |
| Nuclear cardiac stress test |
$9,698 |
$9,698 |
— |
$428 | |
| Occupational therapy evaluation |
$624 |
$624 |
$106 |
$101 | |
| Occupational therapy evaluation (high complexity) |
$646 |
$646 |
$106 |
$101 | |
| Occupational therapy evaluation (low complexity) |
$508 |
$508 |
$106 |
$101 | |
| Occupational therapy evaluation (moderate complexity) |
$624 |
$624 |
$128 |
$101 | |
| Orthopedic hardware removal |
— |
— |
$6,166 |
$632 | |
| Ovarian cyst removal |
— |
— |
$30,940 |
$698 | |
| Pacemaker insertion |
— |
— |
$86,669 |
$15,506 | |
| Pap smear (cervical screening) |
$89 |
$89 |
$20 |
$20 | |
| Parathyroid hormone (PTH) test |
$400 |
$400 |
$41 |
$41 | |
| Parathyroid removal |
— |
— |
$29,992 |
$891 | |
| Pelvic ultrasound |
$1,270 |
$1,270 |
$151 |
$78 | |
| Pelvic ultrasound (complete) |
$1,596 |
$1,596 |
$151 |
$105 | |
| Pelvic ultrasound (limited) |
$944 |
$944 |
$151 |
$51 | |
| PET scan |
$10,766 |
$10,766 |
$5,348 |
— | |
| Phosphorus blood test |
$142 |
$142 |
$5 |
$5 | |
| Physical therapy evaluation |
$558 |
$558 |
$121 |
$98 | |
| Physical therapy evaluation (high complexity) |
$629 |
$629 |
$121 |
$98 | |
| Physical therapy evaluation (moderate complexity) |
$558 |
$558 |
$103 |
$98 | |
| Pilonidal cyst removal |
— |
— |
$15,586 |
$541 | |
| Platelet count |
$148 |
$148 |
$4 |
$4 | |
| Pneumonia vaccine |
— |
— |
$307 |
— | |
| Pregnancy blood test (hCG) |
$296 |
$296 |
$8 |
$8 | |
| Pregnancy ultrasound |
$1,552 |
$1,552 |
$151 |
$126 | |
| Pregnancy ultrasound (first trimester) |
$1,625 |
$1,625 |
$151 |
$117 | |
| Pregnancy ultrasound (second or third trimester) |
$1,479 |
$1,479 |
$151 |
$136 | |
| Procalcitonin test |
$625 |
$625 |
$27 |
$27 | |
| Prolactin test |
$262 |
$262 |
$19 |
$19 | |
| Prostate biopsy |
$9,221 |
$9,221 |
$12,839 |
— | |
| Prostate removal (prostatectomy) |
— |
— |
$65,254 |
$1,063 | |
| Prostate surgery (TURP) |
— |
— |
$23,515 |
$526 | |
| Prostate test (PSA) |
$242 |
$242 |
$18 |
$18 | |
| Psychiatric evaluation |
$597 |
$597 |
— |
$188 | |
| Psychotherapy session |
$634 |
$634 |
— |
$140 | |
| Pterygium removal (eye) |
$7,608 |
$7,608 |
— |
$540 | |
| Pulmonary rehabilitation |
$473 |
$473 |
$85 |
$87 | |
| Radiofrequency nerve ablation |
$6,488 |
$6,488 |
$2,823 |
$462 | |
| Retina scan (OCT) |
$276 |
$276 |
$85 |
$33 | |
| Retinal (fundus) photography |
$592 |
$592 |
$192 |
$37 | |
| Rheumatoid factor test |
$126 |
$126 |
$6 |
$6 | |
| Rotator cuff repair |
— |
— |
$13,565 |
$792 | |
| Routine eye exam |
$295 |
$295 |
$192 |
$88 | |
| RSV vaccine |
$1,788 |
$1,788 |
— |
— | |
| Scoliosis spine X-ray |
$698 |
$698 |
$138 |
$58 | |
| Scoliosis spine X-ray (1 view) |
$575 |
$575 |
$126 |
$44 | |
| Scoliosis spine X-ray (3 views) |
$820 |
$820 |
$151 |
$72 | |
| Screening colonoscopy |
— |
— |
$2,596 |
$378 | |
| Screening mammogram |
$602 |
$602 |
— |
$126 | |
| Scrotal ultrasound |
$1,538 |
$1,538 |
$151 |
$99 | |
| Sedimentation rate (ESR) test |
$125 |
$125 |
$3 |
$3 | |
| Semen analysis |
$253 |
$253 |
$12 |
$12 | |
| Septoplasty (deviated septum) |
— |
— |
$6,905 |
$613 | |
| Sex hormone binding globulin test |
$184 |
$184 |
$22 |
$22 | |
| Shoulder arthroscopy |
— |
— |
$15,665 |
$962 | |
| Shoulder replacement |
— |
— |
$25,348 |
$1,300 | |
| Simple laceration repair (small, up to 2.5 cm) |
$1,194 |
$1,194 |
$290 |
$114 | |
| Simple wound stitches |
$1,194 |
$1,194 |
$290 |
$127 | |
| Sinus surgery (endoscopic) |
— |
— |
$10,203 |
$224 | |
| Skin biopsy |
$1,121 |
$1,121 |
$588 |
$121 | |
| Skin biopsy (punch) |
$1,121 |
$1,121 |
$588 |
$121 | |
| Skin cancer lesion removal |
— |
— |
$1,024 |
$240 | |
| Skin graft |
— |
— |
$4,053 |
$898 | |
| Skin lesion freezing (cryotherapy) |
— |
— |
$901 |
$36 | |
| Skin tag removal |
— |
— |
$290 |
$92 | |
| Soft tissue ultrasound |
$847 |
$847 |
$151 |
$64 | |
| Speech therapy |
$578 |
$578 |
$84 |
$76 | |
| Spinal cord stimulator |
$17,127 |
$17,127 |
— |
$2,388 | |
| Spinal tap (lumbar puncture) |
$3,056 |
$3,056 |
$1,020 |
$165 | |
| Spine fracture repair (kyphoplasty) |
$26,959 |
$26,959 |
$10,490 |
$5,803 | |
| Spirometry (lung function test) |
$653 |
$653 |
$312 |
$30 | |
| Spirometry with bronchodilator |
$1,449 |
$1,449 |
$539 |
$43 | |
| Strabismus (eye muscle) surgery |
— |
— |
$6,672 |
$475 | |
| Strep throat test |
— |
— |
$17 |
$17 | |
| Stress echocardiogram |
$4,326 |
$4,326 |
$790 |
$209 | |
| Stress echocardiogram (complete) |
$4,168 |
$4,168 |
$790 |
$233 | |
| Swallow study |
$826 |
$826 |
$67 |
$85 | |
| T3 thyroid test |
$191 |
$191 |
$14 |
$14 | |
| Tdap (tetanus) vaccine |
$381 |
$381 |
$90 |
— | |
| Testicle removal (orchiectomy) |
— |
— |
$5,096 |
$306 | |
| Testosterone test |
$141 |
$141 |
$26 |
$26 | |
| Thyroid removal (thyroidectomy) |
— |
— |
$33,434 |
$1,004 | |
| Thyroid test (TSH) |
$313 |
$313 |
$17 |
$17 | |
| Thyroid ultrasound |
$1,368 |
$1,368 |
$151 |
$109 | |
| Thyroid uptake scan |
$2,107 |
$2,107 |
$578 |
$145 | |
| Tilt table test |
$4,199 |
$4,199 |
$539 |
$168 | |
| Tonsillectomy |
— |
— |
$7,113 |
$252 | |
| Total IgE allergy test |
$185 |
$185 |
$16 |
$16 | |
| Total protein test |
$56 |
$56 |
$4 |
$4 | |
| Tracheostomy |
$9,513 |
$9,513 |
$4,793 |
$273 | |
| Transesophageal echocardiogram (TEE) |
$5,466 |
$5,466 |
$790 |
$239 | |
| Transesophageal echocardiogram (TEE) with and without contrast |
$5,451 |
$5,451 |
$790 |
$239 | |
| Transvaginal ultrasound |
$1,310 |
$1,310 |
$151 |
$118 | |
| Trigger finger release |
— |
— |
$4,556 |
$630 | |
| Trigger point injection |
$1,549 |
$1,549 |
$895 |
$56 | |
| Trigger point injection (1-2 muscles) |
$1,556 |
$1,556 |
$444 |
$52 | |
| Triglycerides test |
$162 |
$162 |
$6 |
$6 | |
| Troponin (heart) test |
$492 |
$492 |
$12 |
$12 | |
| Tubal ligation |
— |
— |
$13,419 |
$333 | |
| Turbinate reduction |
— |
— |
$6,915 |
$294 | |
| Turning a breech baby (version) |
$2,750 |
$2,750 |
$4,680 |
$94 | |
| Ulnar nerve surgery (elbow) |
— |
— |
$5,068 |
$575 | |
| Umbilical hernia repair |
— |
— |
$12,530 |
— | |
| Upper GI endoscopy (EGD) |
— |
— |
$2,728 |
$371 | |
| Upper GI series (barium) |
$1,651 |
$1,651 |
$254 |
$128 | |
| Ureteral stent placement |
$15,748 |
$15,748 |
$7,443 |
$373 | |
| Ureteroscopy (stone removal) |
— |
— |
$22,335 |
$365 | |
| Uric acid (gout) test |
$125 |
$125 |
$5 |
$5 | |
| Urinalysis |
$114 |
$114 |
$3 |
$3 | |
| Urine microalbumin test |
$120 |
$120 |
$5 |
$5 | |
| Urine pregnancy test |
$190 |
$190 |
$9 |
$9 | |
| UV light therapy (skin) |
— |
— |
$85 |
$106 | |
| Vaccine administration |
$177 |
$177 |
$104 |
$19 | |
| Vaccine administration (each additional) |
$150 |
$150 |
— |
$16 | |
| Vaginal delivery |
— |
— |
$9,201 |
$5,487 | |
| Varicocele repair |
— |
— |
$18,825 |
$327 | |
| Varicose vein ablation |
$12,293 |
$12,293 |
— |
$1,018 | |
| Vasectomy |
— |
— |
$6,455 |
$347 | |
| Visual field test |
$576 |
$576 |
$192 |
$64 | |
| Vitamin B12 test |
$228 |
$228 |
$15 |
$15 | |
| Vitamin D test |
$277 |
$277 |
$30 |
$30 | |
| Vocal cord injection |
— |
— |
$5,390 |
$211 | |
| Wart removal |
— |
— |
$290 |
$121 | |
| Weight-loss (bariatric) surgery |
— |
— |
$18,644 |
$11,645 | |
| Wound debridement |
— |
— |
$828 |
$186 | |
| Wrist fracture repair |
— |
— |
$19,345 |
$735 | |
| X-ray of the abdomen |
$879 |
$879 |
$151 |
$36 | |
| X-ray of the ankle |
$1,300 |
$1,300 |
$126 |
$37 | |
| X-ray of the collarbone |
$1,154 |
$1,154 |
$126 |
$33 | |
| X-ray of the elbow |
$1,265 |
$1,265 |
$126 |
$33 | |
| X-ray of the facial bones |
$840 |
$840 |
$138 |
$39 | |
| X-ray of the foot |
$1,377 |
$1,377 |
$126 |
$34 | |
| X-ray of the forearm |
$1,368 |
$1,368 |
$126 |
$29 | |
| X-ray of the hand |
$1,329 |
$1,329 |
$126 |
$38 | |
| X-ray of the hip |
$768 |
$768 |
$126 |
$49 | |
| X-ray of the hip (1 view) |
$685 |
$685 |
$126 |
$34 | |
| X-ray of the hip (3 views) |
$768 |
$768 |
$126 |
$49 | |
| X-ray of the hip (4 views) |
$1,048 |
$1,048 |
$151 |
$63 | |
| X-ray of the knee |
$1,431 |
$1,431 |
$126 |
$42 | |
| X-ray of the knee (2 views) |
$1,064 |
$1,064 |
$126 |
$34 | |
| X-ray of the knee (3 views) |
$1,431 |
$1,431 |
$126 |
$42 | |
| X-ray of the knee (4+ views) |
$1,537 |
$1,537 |
$151 |
$49 | |
| X-ray of the lower back (lumbar spine) |
$1,059 |
$1,059 |
$151 |
$47 | |
| X-ray of the lower back (lumbar spine) (2 views) |
$966 |
$966 |
$151 |
$40 | |
| X-ray of the lower back (lumbar spine) (4+ views) |
$1,151 |
$1,151 |
$151 |
$53 | |
| X-ray of the lower leg |
$1,215 |
$1,215 |
$126 |
$31 | |
| X-ray of the mid-back (thoracic spine) |
$956 |
$956 |
$151 |
$36 | |
| X-ray of the mid-back (thoracic spine) (2 views) |
$932 |
$932 |
$151 |
$33 | |
| X-ray of the mid-back (thoracic spine) (3 views) |
$980 |
$980 |
$151 |
$39 | |
| X-ray of the neck (cervical spine) |
$1,020 |
$1,020 |
$138 |
$47 | |
| X-ray of the neck (cervical spine) (3 views) |
$864 |
$864 |
$126 |
$40 | |
| X-ray of the pelvis |
$830 |
$830 |
$151 |
$36 | |
| X-ray of the pelvis (1 view) |
$770 |
$770 |
$151 |
$28 | |
| X-ray of the ribs |
$1,049 |
$1,049 |
$151 |
$42 | |
| X-ray of the ribs (2 views) |
$803 |
$803 |
$126 |
$36 | |
| X-ray of the ribs (3 views) |
$1,074 |
$1,074 |
$151 |
$42 | |
| X-ray of the shoulder |
$1,335 |
$1,335 |
$126 |
$36 | |
| X-ray of the skull |
$1,019 |
$1,019 |
$151 |
$40 | |
| X-ray of the upper arm |
$919 |
$919 |
$126 |
$32 | |
| X-ray of the wrist |
$1,294 |
$1,294 |
$126 |
$43 | |
| YAG laser capsulotomy (eye) |
$3,867 |
$3,867 |
$1,514 |
$335 | |
| Zinc blood test |
— |
— |
$11 |
$11 | |