| 3D mammogram (tomosynthesis) |
$243 |
$243 |
$54 |
$51 | |
| Abdominal fluid drain (paracentesis) |
$5,841 |
$5,841 |
$1,020 |
$284 | |
| Abdominal ultrasound (limited) |
$721 |
$721 |
$256 |
$86 | |
| Abscess drainage (complex or multiple) |
— |
— |
$443 |
$220 | |
| Abscess drainage (simple) |
$1,999 |
$1,999 |
$232 |
$129 | |
| Abscess incision and drainage |
$1,999 |
$1,999 |
$233 |
$174 | |
| Achilles tendon repair |
— |
— |
$7,924 |
$624 | |
| ACL knee reconstruction |
— |
— |
$7,924 |
$889 | |
| Acupuncture |
— |
— |
$27 |
$38 | |
| Adenoid removal (adenoidectomy) |
— |
— |
$3,597 |
$204 | |
| Albumin blood test |
$76 |
$76 |
$7 |
$5 | |
| Allergy patch testing |
— |
— |
$1,129 |
$5 | |
| Allergy shots |
— |
— |
$51 |
$11 | |
| Allergy testing |
— |
— |
$1,129 |
$4 | |
| Ammonia blood test |
$50 |
$50 |
$15 |
$15 | |
| Anal fistula repair |
— |
— |
$3,042 |
$541 | |
| Ankle fracture repair |
— |
— |
$7,924 |
$608 | |
| Ankle replacement |
— |
— |
$20,400 |
$885 | |
| Anoscopy |
— |
— |
$143 |
$129 | |
| Aortic valve replacement |
$61,892 |
$61,892 |
$3,008 |
$1,603 | |
| Appendix removal (appendectomy) |
— |
— |
$26,564 |
$592 | |
| Arterial blood gas (ABG) |
$172 |
$172 |
$26 |
$26 | |
| AST liver enzyme test |
$318 |
$318 |
$18 |
$5 | |
| Barium swallow study |
$4,132 |
$4,132 |
$256 |
$107 | |
| Bartholin cyst removal |
$1,026 |
$1,026 |
$227 |
$182 | |
| Basic metabolic panel |
$755 |
$755 |
$32 |
$8 | |
| Benign skin lesion removal |
$3,384 |
$3,384 |
$797 |
$171 | |
| Bladder scope (cystoscopy) |
— |
— |
$740 |
$216 | |
| Bladder tumor removal (TURBT) |
— |
— |
$3,826 |
$236 | |
| Blood crossmatch |
$1,242 |
$1,242 |
$149 |
— | |
| Blood glucose test |
$103 |
$103 |
$12 |
$5 | |
| Blood type and screen |
$70 |
$70 |
$59 |
$10 | |
| Blood type test |
$507 |
$507 |
$44 |
$3 | |
| Blood type test (ABO group) |
$585 |
$585 |
$83 |
$3 | |
| Blood type test (Rh/D antigen) |
$428 |
$428 |
$42 |
$3 | |
| BNP (heart failure) test |
$662 |
$662 |
$40 |
$39 | |
| Bone marrow biopsy |
$12,697 |
$12,697 |
$3,268 |
$172 | |
| Breast biopsy |
$18,481 |
$18,481 |
$1,895 |
$478 | |
| Breast reconstruction |
— |
— |
$19,300 |
$1,227 | |
| Breast reduction |
— |
— |
$7,234 |
$980 | |
| Breast ultrasound (limited) |
$532 |
$532 |
$99 |
$84 | |
| Bronchoscopy |
— |
— |
$1,941 |
$303 | |
| Bunion surgery (bunionectomy) |
— |
— |
$7,924 |
$883 | |
| Burn dressing and debridement (medium) |
$1,298 |
$1,298 |
$224 |
$166 | |
| Calcium blood test |
$103 |
$103 |
$6 |
$5 | |
| Capsule endoscopy |
— |
— |
$1,040 |
$802 | |
| Cardiac ablation |
$135,001 |
$135,001 |
$17,536 |
$759 | |
| Cardiac MRI |
— |
— |
$331 |
$322 | |
| Cardiac MRI without contrast |
— |
— |
$268 |
$280 | |
| Cardiac rehabilitation |
$2,097 |
$2,097 |
$181 |
$26 | |
| Cardioversion |
$3,380 |
$3,380 |
$1,879 |
$155 | |
| Carpal tunnel release |
— |
— |
$2,166 |
$483 | |
| Cataract surgery |
— |
— |
$2,530 |
$547 | |
| CEA tumor marker test |
$656 |
$656 |
$35 |
$19 | |
| Central line placement |
$12,124 |
$12,124 |
$3,440 |
$238 | |
| Cervical cerclage |
— |
— |
$3,527 |
$137 | |
| Cervical LEEP procedure |
$22,558 |
$22,558 |
$4,357 |
$325 | |
| Cesarean section (C-section) |
— |
— |
$18,196 |
$7,552 | |
| Chalazion (eyelid cyst) removal |
— |
— |
$332 |
$131 | |
| Chemotherapy infusion |
$2,934 |
$2,934 |
$353 |
$81 | |
| Chemotherapy infusion (first hour) |
$2,916 |
$2,916 |
$363 |
$133 | |
| Chest fluid drain (thoracentesis) |
$721 |
$721 |
$706 |
$311 | |
| Chest tube insertion |
$10,262 |
$10,262 |
$1,760 |
$143 | |
| Chest X-ray |
$736 |
$736 |
$100 |
$37 | |
| Chest X-ray (1 view) |
$252 |
$252 |
$98 |
$25 | |
| Chiropractic adjustment |
— |
— |
$28 |
$38 | |
| Circumcision |
— |
— |
$2,272 |
$167 | |
| CK-MB heart enzyme test |
$501 |
$501 |
$27 |
$12 | |
| Colposcopy |
$3,429 |
$3,429 |
$579 |
$161 | |
| Complete blood count (CBC) |
$268 |
$268 |
$23 |
$7 | |
| Complete blood count (CBC) (complete) |
$70 |
$70 |
$29 |
$8 | |
| Complex wound repair |
— |
— |
$679 |
$390 | |
| Comprehensive eye exam |
— |
— |
$143 |
$138 | |
| Contraceptive implant (Nexplanon) |
$2,173 |
$2,173 |
$503 |
$115 | |
| Corneal transplant |
— |
— |
$4,462 |
$1,066 | |
| Coronary angioplasty / stent (PCI) |
— |
— |
$53,026 |
$426 | |
| Coronary artery bypass (CABG) |
— |
— |
$69,534 |
$36,593 | |
| Coronary CT angiography |
$5,333 |
$5,333 |
$499 |
$326 | |
| Cortisol test |
$188 |
$188 |
$17 |
$16 | |
| COVID-19 PCR test |
$568 |
$568 |
$51 |
$51 | |
| Creatine kinase (CK) test |
$306 |
$306 |
$12 |
$7 | |
| CT angiography of the chest |
$12,375 |
$12,375 |
$601 |
$281 | |
| CT colonography (virtual colonoscopy) |
$2,494 |
$2,494 |
$287 |
$835 | |
| CT scan of the head |
$5,389 |
$5,389 |
$314 |
$148 | |
| CT scan of the head with and without contrast |
$5,389 |
$5,389 |
$365 |
$173 | |
| CT scan of the head with contrast |
$2,723 |
$2,723 |
$269 |
$148 | |
| Defibrillator (ICD) implant |
$184,413 |
$184,413 |
$18,447 |
$798 | |
| Developmental screening (child) |
$74 |
$74 |
$14 |
— | |
| Dialysis fistula creation |
— |
— |
$3,491 |
$601 | |
| Dilation and curettage (D&C) |
$16,254 |
$16,254 |
$4,019 |
$298 | |
| Droopy eyelid repair (ptosis) |
— |
— |
$2,588 |
$745 | |
| Ear tubes (myringotomy) |
— |
— |
$1,096 |
$174 | |
| Eardrum repair (tympanoplasty) |
— |
— |
$6,562 |
$799 | |
| Echocardiogram with and without contrast |
$1,517 |
$1,517 |
$274 |
$101 | |
| Echocardiogram without contrast |
— |
— |
$268 |
$138 | |
| EKG / ECG (tracing only) |
$391 |
$391 |
$65 |
$7 | |
| Elbow replacement |
— |
— |
$20,400 |
$1,301 | |
| Electrocardiogram (EKG) |
$391 |
$391 |
$65 |
$8 | |
| Electrolyte panel |
$39 |
$39 |
$7 |
$7 | |
| Endometrial biopsy |
$1,671 |
$1,671 |
$338 |
$98 | |
| Epidural steroid injection |
$8,070 |
$8,070 |
$1,357 |
$275 | |
| ERCP (bile duct endoscopy) |
— |
— |
$4,220 |
$311 | |
| Esophageal dilation |
— |
— |
$1,564 |
$522 | |
| Esophageal variceal banding |
— |
— |
$2,104 |
$126 | |
| Estradiol (estrogen) test |
$295 |
$295 |
$34 |
$28 | |
| Eyelid surgery (blepharoplasty) |
— |
— |
$2,029 |
$552 | |
| Facet joint injection (spine) |
$7,876 |
$7,876 |
$1,277 |
$99 | |
| Fallopian tube X-ray (HSG) |
$2,090 |
$2,090 |
$274 |
$164 | |
| Family therapy session |
$788 |
$788 |
$178 |
$110 | |
| Fecal occult blood (stool) test (guaiac, gFOBT) |
$257 |
$257 |
$7 |
$4 | |
| Feeding tube (PEG) placement |
— |
— |
$2,104 |
$178 | |
| Femoral hernia repair |
— |
— |
$3,915 |
$584 | |
| Fibrinogen test |
$386 |
$386 |
$21 |
$10 | |
| Flexible sigmoidoscopy |
— |
— |
$1,011 |
$323 | |
| Flu test |
— |
— |
$17 |
$17 | |
| Folate (folic acid) test |
$195 |
$195 |
$15 |
$15 | |
| Foreign body removal (skin) |
— |
— |
$443 |
$157 | |
| Free T4 thyroid test |
$354 |
$354 |
$33 |
$9 | |
| FSH hormone test |
$133 |
$133 |
$19 |
$19 | |
| Gallbladder removal (laparoscopic) |
— |
— |
$6,472 |
$658 | |
| Gallbladder scan (HIDA) |
$4,993 |
$4,993 |
$653 |
$334 | |
| Ganglion cyst removal |
— |
— |
$1,775 |
$321 | |
| GGT liver test |
$98 |
$98 |
$11 |
$7 | |
| Glaucoma surgery |
— |
— |
$2,530 |
$984 | |
| Glucose tolerance test |
$339 |
$339 |
$14 |
$8 | |
| Group therapy session |
— |
— |
$103 |
$30 | |
| Hammertoe repair |
— |
— |
$3,599 |
$548 | |
| HDL cholesterol test |
$409 |
$409 |
$21 |
$8 | |
| Hemoglobin A1c (diabetes test) |
$349 |
$349 |
$16 |
$10 | |
| Hemorrhoid removal |
— |
— |
$2,012 |
$338 | |
| Hepatitis A vaccine |
$591 |
$591 |
$140 |
— | |
| Hepatitis B test |
$70 |
$70 |
$18 |
$10 | |
| Hepatitis B vaccine |
$1,211 |
$1,211 |
$105 |
— | |
| Hepatitis C test |
$43 |
$43 |
$19 |
$14 | |
| Hip arthroscopy |
— |
— |
$7,924 |
$931 | |
| Hip replacement |
— |
— |
$14,273 |
$1,162 | |
| HIV test |
$828 |
$828 |
$36 |
$19 | |
| Home sleep apnea test |
$1,198 |
$1,198 |
$176 |
$123 | |
| HPV vaccine |
$2,431 |
$2,431 |
$392 |
— | |
| Hydrocele repair |
— |
— |
$3,915 |
$315 | |
| Hysterectomy |
— |
— |
$11,549 |
$933 | |
| Hysteroscopy |
— |
— |
$3,527 |
$1,270 | |
| Inguinal hernia repair |
— |
— |
$3,915 |
$538 | |
| Iron blood test |
$196 |
$196 |
$7 |
$6 | |
| IUD insertion |
$1,246 |
$1,246 |
$707 |
— | |
| IUD removal |
$2,586 |
$2,586 |
$841 |
$112 | |
| IV infusion therapy (initial) |
$2,717 |
$2,717 |
$244 |
$67 | |
| IVC filter placement |
$59,044 |
$59,044 |
$7,693 |
$1,885 | |
| Joint aspiration (small/intermediate) |
$1,948 |
$1,948 |
$345 |
$57 | |
| Joint aspiration or injection (mid-size joint) |
$1,948 |
$1,948 |
$352 |
$57 | |
| Joint aspiration or injection (small joint) |
$1,948 |
$1,948 |
$345 |
$56 | |
| Kidney biopsy |
$4,263 |
$4,263 |
$1,858 |
$492 | |
| Kidney stone shock-wave (lithotripsy) |
— |
— |
$3,826 |
$760 | |
| Kidney ultrasound |
$825 |
$825 |
$120 |
$84 | |
| Kidney ultrasound (limited) |
$721 |
$721 |
$120 |
$61 | |
| Knee arthroscopy |
— |
— |
$3,599 |
$524 | |
| Knee joint injection |
$1,948 |
$1,948 |
$352 |
$69 | |
| Knee replacement |
— |
— |
$35,504 |
$18,054 | |
| Lactate test |
$810 |
$810 |
$14 |
$12 | |
| Laminectomy (spine) |
— |
— |
$7,924 |
$1,157 | |
| Laryngoscopy |
$5,828 |
$5,828 |
$766 |
$189 | |
| LDH test |
$124 |
$124 |
$9 |
$6 | |
| Leg artery angiogram |
$18,437 |
$18,437 |
$3,440 |
$149 | |
| Leg artery angioplasty |
— |
— |
$9,406 |
— | |
| Leg vein ultrasound (Doppler) (limited) |
$721 |
$721 |
$613 |
$116 | |
| LH hormone test |
$838 |
$838 |
$21 |
$19 | |
| Lipid (cholesterol) panel |
$200 |
$200 |
$22 |
$13 | |
| Liver biopsy |
$14,735 |
$14,735 |
$2,907 |
$288 | |
| Liver function panel |
$48 |
$48 |
$30 |
$8 | |
| Lower back (lumbar) spinal fusion |
— |
— |
$90,496 |
$1,511 | |
| Lumbar discectomy |
— |
— |
$7,924 |
$898 | |
| Lumpectomy (breast) |
— |
— |
$5,719 |
$750 | |
| Lung scan (V/Q) |
$2,900 |
$2,900 |
$611 |
$291 | |
| Magnesium blood test |
$172 |
$172 |
$13 |
$7 | |
| Mastectomy |
— |
— |
$7,234 |
$1,021 | |
| Mastoidectomy |
— |
— |
$6,562 |
$840 | |
| Meniscus repair (knee) |
— |
— |
$3,599 |
$714 | |
| MMR vaccine |
$440 |
$440 |
$330 |
— | |
| Mohs skin cancer surgery |
— |
— |
$679 |
$535 | |
| MRA of the brain |
$4,149 |
$4,149 |
$402 |
$226 | |
| MRA of the brain with contrast |
— |
— |
$396 |
$226 | |
| MRA of the brain without contrast |
$3,340 |
$3,340 |
$400 |
$328 | |
| MRA of the neck |
$4,957 |
$4,957 |
$537 |
$245 | |
| MRA of the neck with contrast |
$2,976 |
$2,976 |
$396 |
$245 | |
| MRA of the neck without contrast |
$8,042 |
$8,042 |
$875 |
$343 | |
| MRI of the abdomen without contrast |
$17,923 |
$17,923 |
$774 |
$194 | |
| MRI of the ankle |
$19,031 |
$19,031 |
$864 |
$261 | |
| MRI of the ankle with contrast |
$11,024 |
$11,024 |
$757 |
$261 | |
| MRI of the brain |
$15,168 |
$15,168 |
$978 |
$269 | |
| MRI of the brain with contrast |
$15,168 |
$15,168 |
$839 |
$269 | |
| MRI of the brain without contrast |
$11,798 |
$11,798 |
$552 |
$195 | |
| MRI of the chest |
$17,699 |
$17,699 |
$1,279 |
$371 | |
| MRI of the chest with contrast |
$17,699 |
$17,699 |
$1,244 |
$371 | |
| MRI of the knee |
$18,997 |
$18,997 |
$905 |
$315 | |
| MRI of the knee with contrast |
$16,544 |
$16,544 |
$1,216 |
$315 | |
| MRI of the knee without contrast |
$18,997 |
$18,997 |
$732 |
$204 | |
| MRI of the shoulder |
$16,641 |
$16,641 |
$907 |
$313 | |
| MRI of the shoulder with contrast |
$12,772 |
$12,772 |
$1,086 |
$313 | |
| MRI of the shoulder without contrast |
$16,641 |
$16,641 |
$716 |
$205 | |
| MRI of the wrist |
$17,464 |
$17,464 |
$899 |
$330 | |
| MRI of the wrist with contrast |
$17,464 |
$17,464 |
$859 |
$330 | |
| MRI of the wrist without contrast |
$16,641 |
$16,641 |
$751 |
$303 | |
| Nebulizer breathing treatment |
$1,560 |
$1,560 |
$246 |
$9 | |
| Neck (cervical) spinal fusion |
— |
— |
$14,273 |
$1,410 | |
| Newborn hospital care |
— |
— |
$143 |
$58 | |
| Nuchal translucency ultrasound |
$3,352 |
$3,352 |
$217 |
$116 | |
| Occupational therapy evaluation |
$1,093 |
$1,093 |
$111 |
$101 | |
| Occupational therapy evaluation (high complexity) |
$1,375 |
$1,375 |
$152 |
$101 | |
| Occupational therapy evaluation (low complexity) |
$838 |
$838 |
$108 |
$101 | |
| Occupational therapy evaluation (moderate complexity) |
$1,093 |
$1,093 |
$121 |
$101 | |
| Office visit, established patient (level 3) |
$1,531 |
$1,531 |
$190 |
$95 | |
| Office visit, new patient (level 5) |
$2,811 |
$2,811 |
$253 |
$237 | |
| Orthopedic hardware removal |
— |
— |
$3,175 |
$632 | |
| Ovarian cyst removal |
— |
— |
$5,476 |
$698 | |
| Pacemaker insertion |
— |
— |
$37,093 |
$15,506 | |
| Pap smear (cervical screening) |
$315 |
$315 |
$27 |
$20 | |
| Parathyroid removal |
— |
— |
$6,562 |
$891 | |
| Pelvic ultrasound |
$1,998 |
$1,998 |
$224 |
$78 | |
| Pelvic ultrasound (complete) |
$3,274 |
$3,274 |
$377 |
$105 | |
| Pelvic ultrasound (limited) |
$721 |
$721 |
$120 |
$51 | |
| Physical therapy evaluation |
$1,093 |
$1,093 |
$106 |
$98 | |
| Physical therapy evaluation (high complexity) |
$1,375 |
$1,375 |
$137 |
$98 | |
| Physical therapy evaluation (moderate complexity) |
$1,093 |
$1,093 |
$109 |
$98 | |
| Pilonidal cyst removal |
— |
— |
$3,175 |
$541 | |
| Platelet count |
$358 |
$358 |
$16 |
$4 | |
| Pneumonia vaccine |
$1,021 |
$1,021 |
$136 |
— | |
| Pregnancy ultrasound (second or third trimester) |
$4,549 |
$4,549 |
$249 |
$136 | |
| Prolactin test |
$182 |
$182 |
$20 |
$19 | |
| Prostate biopsy |
— |
— |
$2,272 |
— | |
| Prostate removal (prostatectomy) |
— |
— |
$11,549 |
$1,063 | |
| Prostate surgery (TURP) |
— |
— |
$5,639 |
$526 | |
| Psychiatric evaluation |
$788 |
$788 |
$361 |
$188 | |
| Psychotherapy session |
— |
— |
$178 |
$140 | |
| Pterygium removal (eye) |
— |
— |
$2,588 |
$540 | |
| Pulmonary rehabilitation |
$1,473 |
$1,473 |
$147 |
$87 | |
| Radiofrequency nerve ablation |
$15,751 |
$15,751 |
$2,241 |
$462 | |
| Retina scan (OCT) |
— |
— |
$66 |
$33 | |
| Retinal (fundus) photography |
— |
— |
$143 |
$37 | |
| Retinal detachment repair |
— |
— |
$4,462 |
$966 | |
| Rheumatoid factor test |
— |
— |
$6 |
$6 | |
| Rotator cuff repair |
— |
— |
$7,924 |
$792 | |
| Routine eye exam |
— |
— |
$143 |
$88 | |
| RSV vaccine |
$1,334 |
$1,334 |
$271 |
— | |
| Scoliosis spine X-ray (1 view) |
$501 |
$501 |
$96 |
$44 | |
| Screening colonoscopy |
— |
— |
$1,011 |
$378 | |
| Scrotal ultrasound |
$721 |
$721 |
$186 |
$99 | |
| Semen analysis |
— |
— |
$12 |
$12 | |
| Septoplasty (deviated septum) |
— |
— |
$3,597 |
$613 | |
| Sex hormone binding globulin test |
$279 |
$279 |
$25 |
$22 | |
| Shingles vaccine |
$934 |
$934 |
$190 |
— | |
| Shoulder arthroscopy |
— |
— |
$7,924 |
$962 | |
| Shoulder replacement |
— |
— |
$20,400 |
$1,300 | |
| Simple laceration repair (small, up to 2.5 cm) |
$1,043 |
$1,043 |
$224 |
$114 | |
| Sinus surgery (endoscopic) |
— |
— |
$7,565 |
$224 | |
| Skin biopsy |
$1,950 |
$1,950 |
$703 |
$121 | |
| Skin biopsy (punch) |
— |
— |
$443 |
$121 | |
| Skin cancer lesion removal |
— |
— |
$769 |
$240 | |
| Skin graft |
— |
— |
$3,030 |
$898 | |
| Skin lesion freezing (cryotherapy) |
— |
— |
$220 |
$36 | |
| Skin tag removal |
$1,038 |
$1,038 |
$253 |
$92 | |
| Soft tissue ultrasound |
$721 |
$721 |
$118 |
$64 | |
| Speech therapy |
$928 |
$928 |
$119 |
$76 | |
| Spinal cord stimulator |
— |
— |
$7,280 |
$2,388 | |
| Spinal tap (lumbar puncture) |
$3,434 |
$3,434 |
$985 |
$165 | |
| Spine fracture repair (kyphoplasty) |
$62,767 |
$62,767 |
$8,664 |
$5,803 | |
| Spirometry (lung function test) |
$1,420 |
$1,420 |
$243 |
$30 | |
| Spleen removal (splenectomy) |
— |
— |
$11,549 |
$1,036 | |
| Strabismus (eye muscle) surgery |
— |
— |
$3,374 |
$475 | |
| Strep throat test |
$307 |
$307 |
$17 |
$17 | |
| Stress echocardiogram (complete) |
— |
— |
$608 |
$233 | |
| Swallow study |
$547 |
$547 |
$90 |
$85 | |
| Tdap (tetanus) vaccine |
$582 |
$582 |
$118 |
— | |
| Testicle removal (orchiectomy) |
— |
— |
$3,826 |
$306 | |
| Thyroid removal (thyroidectomy) |
— |
— |
$6,516 |
$1,004 | |
| Thyroid test (TSH) |
$252 |
$252 |
$25 |
$17 | |
| Thyroid ultrasound |
$721 |
$721 |
$287 |
$109 | |
| Tilt table test |
$2,780 |
$2,780 |
$1,858 |
$168 | |
| Tonsillectomy |
— |
— |
$5,058 |
$252 | |
| Total IgE allergy test |
$156 |
$156 |
$17 |
$16 | |
| Total protein test |
$29 |
$29 |
$4 |
$4 | |
| Tracheostomy |
— |
— |
$3,597 |
$273 | |
| Trigger finger release |
— |
— |
$1,775 |
$630 | |
| Trigger point injection |
$1,421 |
$1,421 |
$365 |
$56 | |
| Trigger point injection (1-2 muscles) |
$1,421 |
$1,421 |
$365 |
$52 | |
| Troponin (heart) test |
$722 |
$722 |
$37 |
$12 | |
| Tubal ligation |
— |
— |
$6,472 |
$333 | |
| Turbinate reduction |
— |
— |
$3,597 |
$294 | |
| Turning a breech baby (version) |
$11,242 |
$11,242 |
$2,888 |
$94 | |
| Ulnar nerve surgery (elbow) |
— |
— |
$2,166 |
$575 | |
| Ureteral stent placement |
— |
— |
$3,826 |
$373 | |
| Ureteroscopy (stone removal) |
— |
— |
$5,639 |
$365 | |
| Urinalysis |
$155 |
$155 |
$5 |
$3 | |
| UV light therapy (skin) |
— |
— |
$66 |
$106 | |
| Vaccine administration |
$24 |
$24 |
$38 |
$19 | |
| Vaccine administration (each additional) |
$24 |
$24 |
$18 |
$16 | |
| Vaginal delivery |
— |
— |
$12,478 |
$5,487 | |
| Varicocele repair |
— |
— |
$3,826 |
$327 | |
| Vasectomy |
— |
— |
$2,272 |
$347 | |
| Visual field test |
— |
— |
$143 |
$64 | |
| Vitamin B12 test |
$218 |
$218 |
$16 |
$15 | |
| Vitamin D test |
$173 |
$173 |
$61 |
$30 | |
| Vitrectomy (eye) |
— |
— |
$4,462 |
$814 | |
| Vocal cord injection |
— |
— |
$4,090 |
$211 | |
| Wart removal |
— |
— |
$220 |
$121 | |
| Weight-loss (bariatric) surgery |
— |
— |
$29,917 |
$11,645 | |
| Wound debridement |
$2,760 |
$2,760 |
$749 |
$186 | |
| Wrist fracture repair |
— |
— |
$7,924 |
$735 | |
| X-ray of the abdomen |
$799 |
$799 |
$112 |
$36 | |
| X-ray of the ankle |
$520 |
$520 |
$204 |
$37 | |
| X-ray of the foot |
$1,811 |
$1,811 |
$148 |
$34 | |
| X-ray of the hip |
$939 |
$939 |
$100 |
$49 | |
| X-ray of the hip (1 view) |
$736 |
$736 |
$96 |
$34 | |
| X-ray of the hip (4 views) |
$1,141 |
$1,141 |
$120 |
$63 | |
| X-ray of the knee |
$1,475 |
$1,475 |
$180 |
$42 | |
| X-ray of the knee (2 views) |
$617 |
$617 |
$100 |
$34 | |
| X-ray of the knee (3 views) |
$1,426 |
$1,426 |
$100 |
$42 | |
| X-ray of the lower leg |
$1,073 |
$1,073 |
$180 |
$31 | |
| X-ray of the mid-back (thoracic spine) (2 views) |
$1,199 |
$1,199 |
$118 |
$33 | |
| X-ray of the pelvis |
$928 |
$928 |
$118 |
$36 | |
| X-ray of the pelvis (1 view) |
$838 |
$838 |
$118 |
$28 | |
| X-ray of the ribs |
$928 |
$928 |
$120 |
$42 | |
| X-ray of the ribs (3 views) |
$928 |
$928 |
$116 |
$42 | |
| X-ray of the skull |
$1,217 |
$1,217 |
$120 |
$40 | |
| X-ray of the upper arm |
$569 |
$569 |
$100 |
$32 | |
| X-ray of the wrist |
$2,580 |
$2,580 |
$190 |
$43 | |
| YAG laser capsulotomy (eye) |
— |
— |
$609 |
$335 | |