| 3D mammogram (tomosynthesis) |
$27 |
$81 |
$49 |
$51 | |
| Abdominal fluid drain (paracentesis) |
$143 |
$571 |
$622 |
$284 | |
| Abdominal ultrasound |
$87 |
$173 |
$106 |
$100 | |
| Abdominal ultrasound (complete) |
$115 |
$230 |
$106 |
$114 | |
| Abdominal ultrasound (limited) |
$73 |
$146 |
$106 |
$86 | |
| Abscess drainage (complex or multiple) |
$85 |
$292 |
$400 |
$220 | |
| Abscess drainage (simple) |
$51 |
$170 |
$199 |
$129 | |
| Abscess incision and drainage |
$68 |
$186 |
$214 |
$174 | |
| Acupuncture |
$31 |
$62 |
$28 |
$38 | |
| Acupuncture (each additional) |
$25 |
$50 |
$38 |
$28 | |
| Albumin blood test |
$5 |
$20 |
$9 |
$5 | |
| Allergy shots |
$13 |
$40 |
$30 |
$11 | |
| Alpha-fetoprotein (AFP) test |
$26 |
$104 |
$50 |
$17 | |
| ALT liver enzyme test |
$8 |
$33 |
$14 |
$5 | |
| Annual physical (established patient) |
$55 |
$219 |
$90 |
— | |
| Annual physical (new patient) |
$79 |
$196 |
$87 |
— | |
| Anoscopy |
$33 |
$66 |
$129 |
$129 | |
| Aortic aneurysm repair (AAA) |
$798 |
$1,597 |
$4,665 |
$1,345 | |
| Arterial blood gas (ABG) |
$40 |
$161 |
$77 |
$26 | |
| Barium swallow study |
$141 |
$562 |
$178 |
$107 | |
| Bartholin cyst removal |
$77 |
$154 |
$201 |
$182 | |
| Bilirubin blood test |
$8 |
$20 |
$13 |
$5 | |
| Bladder function test (urodynamics) |
$113 |
$226 |
$650 |
$345 | |
| Blood glucose test |
$6 |
$24 |
$12 |
$5 | |
| BNP (heart failure) test |
$61 |
$243 |
$117 |
$39 | |
| Bone scan (nuclear) |
$263 |
$1,011 |
$402 |
$259 | |
| Botox for migraine |
$124 |
$306 |
$285 |
$157 | |
| Brain shunt (VP shunt) |
$336 |
$671 |
$1,670 |
$1,023 | |
| Breast ultrasound |
$65 |
$137 |
$92 |
$92 | |
| Breast ultrasound (complete) |
$91 |
$330 |
$106 |
$100 | |
| Breast ultrasound (limited) |
$65 |
$137 |
$88 |
$84 | |
| Breathing tube insertion (intubation) |
$51 |
$173 |
$232 |
$133 | |
| Bunion surgery (bunionectomy) |
$523 |
$1,046 |
$806 |
$883 | |
| Burn dressing and debridement (medium) |
$74 |
$148 |
$199 |
$166 | |
| Burn dressing and debridement (small) |
$43 |
$113 |
$199 |
$93 | |
| Burn treatment |
$43 |
$113 |
$199 |
$129 | |
| Capsule endoscopy |
$641 |
$1,281 |
$938 |
$802 | |
| Cardiac ablation |
$7,533 |
$29,209 |
$24,532 |
$759 | |
| Cardiac event monitor |
$168 |
$336 |
$210 |
$170 | |
| Cardiac MRI without contrast |
$142 |
$398 |
$242 |
$280 | |
| Cardiac rehabilitation |
$26 |
$51 |
$126 |
$26 | |
| Cardiac stress test |
$73 |
$146 |
$311 |
$39 | |
| Carotid artery ultrasound |
$136 |
$273 |
$159 |
$156 | |
| CEA tumor marker test |
$46 |
$182 |
$87 |
$19 | |
| Celiac disease test |
$12 |
$48 |
$23 |
$12 | |
| Cesarean section (C-section) |
$7,331 |
$29,324 |
$12,215 |
$7,552 | |
| Chemotherapy infusion |
$196 |
$661 |
$197 |
$81 | |
| Chemotherapy infusion (each additional) |
$148 |
$565 |
$71 |
$28 | |
| Chemotherapy infusion (first hour) |
$196 |
$661 |
$332 |
$133 | |
| Chest fluid drain (thoracentesis) |
$153 |
$612 |
$596 |
$311 | |
| Chest X-ray |
$29 |
$62 |
$74 |
$37 | |
| Chest X-ray (1 view) |
$22 |
$44 |
$73 |
$25 | |
| Chickenpox (varicella) vaccine |
$113 |
$225 |
$180 |
— | |
| Chiropractic adjustment |
$17 |
$33 |
$26 |
$38 | |
| Colon resection (colectomy) |
$308 |
$616 |
$1,735 |
$1,238 | |
| Colonoscopy |
$176 |
$381 |
$768 |
$480 | |
| Colostomy |
$277 |
$553 |
$1,542 |
$1,122 | |
| Colposcopy |
$67 |
$158 |
$304 |
$161 | |
| Complex wound repair |
$169 |
$338 |
$612 |
$390 | |
| Comprehensive eye exam |
$79 |
$158 |
$101 |
$138 | |
| Contact lens fitting |
$78 |
$155 |
$77 |
— | |
| Continuous glucose monitor setup |
$26 |
$69 |
$33 |
$35 | |
| Contraceptive implant (Nexplanon) |
$48 |
$96 |
$222 |
$115 | |
| Coronary artery bypass (CABG) |
$55,020 |
$220,078 |
$77,961 |
$36,593 | |
| Coronary CT angiography |
$272 |
$543 |
$357 |
$326 | |
| Cortisol test |
$15 |
$60 |
$36 |
$16 | |
| COVID-19 PCR test |
$79 |
$317 |
$152 |
$51 | |
| CPAP titration study |
$65 |
$130 |
$203 |
$69 | |
| Craniotomy (brain surgery) |
$3,101 |
$6,201 |
$13,464 |
$2,161 | |
| CT angiography of the chest |
$464 |
$1,772 |
$178 |
$281 | |
| CT angiography of the head |
$463 |
$1,769 |
$178 |
$274 | |
| CT scan of the abdomen and pelvis with and without contrast |
$469 |
$1,781 |
$357 |
$338 | |
| CT scan of the abdomen and pelvis with contrast |
$701 |
$2,717 |
$357 |
$300 | |
| CT scan of the abdomen with and without contrast |
$427 |
$1,642 |
$178 |
$259 | |
| CT scan of the abdomen with contrast |
$424 |
$1,636 |
$178 |
$230 | |
| CT scan of the arm |
$203 |
$405 |
$195 |
$199 | |
| CT scan of the arm with contrast |
$175 |
$351 |
$357 |
$199 | |
| CT scan of the arm without contrast |
$293 |
$1,127 |
$106 |
$161 | |
| CT scan of the chest with and without contrast |
$400 |
$1,542 |
$178 |
$196 | |
| CT scan of the chest with contrast |
$398 |
$1,538 |
$178 |
$167 | |
| CT scan of the head with and without contrast |
$451 |
$1,746 |
$178 |
$173 | |
| CT scan of the head with contrast |
$328 |
$1,258 |
$178 |
$148 | |
| CT scan of the leg |
$297 |
$1,132 |
$178 |
$166 | |
| CT scan of the leg with contrast |
$309 |
$1,183 |
$178 |
$166 | |
| CT scan of the leg without contrast |
$292 |
$1,122 |
$106 |
$130 | |
| CT scan of the lower back (lumbar spine) with and without contrast |
$312 |
$1,190 |
$178 |
$197 | |
| CT scan of the lower back (lumbar spine) with contrast |
$311 |
$1,187 |
$357 |
$169 | |
| CT scan of the neck |
$154 |
$309 |
$178 |
$183 | |
| CT scan of the neck (cervical spine) with and without contrast |
$413 |
$1,593 |
$178 |
$196 | |
| CT scan of the neck (cervical spine) with contrast |
$326 |
$1,246 |
$357 |
$168 | |
| CT scan of the neck with and without contrast |
$442 |
$1,694 |
$178 |
$220 | |
| CT scan of the neck with contrast |
$154 |
$309 |
$178 |
$183 | |
| CT scan of the neck without contrast |
$435 |
$1,679 |
$106 |
$150 | |
| CT scan of the pelvis |
$155 |
$311 |
$178 |
$226 | |
| CT scan of the pelvis with and without contrast |
$352 |
$1,353 |
$178 |
$251 | |
| CT scan of the pelvis with contrast |
$203 |
$405 |
$187 |
$226 | |
| CT scan of the sinuses |
$317 |
$1,207 |
$178 |
$152 | |
| CT scan of the sinuses with and without contrast |
$317 |
$1,207 |
$178 |
$184 | |
| CT scan of the sinuses with contrast |
$313 |
$1,201 |
$178 |
$152 | |
| CT scan of the sinuses without contrast |
$307 |
$1,188 |
$106 |
$128 | |
| D-dimer test |
$16 |
$63 |
$30 |
$10 | |
| Developmental screening (child) |
$12 |
$23 |
$19 |
— | |
| Diagnostic mammogram |
$79 |
$158 |
$73 |
$140 | |
| Drug screen (urine) |
$96 |
$384 |
$155 |
$17 | |
| Ear pressure test (tympanometry) |
$12 |
$32 |
$26 |
$16 | |
| Echocardiogram |
$112 |
$223 |
$242 |
$138 | |
| Echocardiogram with and without contrast |
$85 |
$170 |
$242 |
$101 | |
| Echocardiogram without contrast |
$114 |
$227 |
$242 |
$138 | |
| EEG (awake and asleep) |
$420 |
$846 |
$327 |
$482 | |
| EKG / ECG (tracing only) |
$28 |
$107 |
$59 |
$7 | |
| Electroencephalogram (EEG) |
$375 |
$782 |
$327 |
$448 | |
| Electrolyte panel |
$34 |
$134 |
$35 |
$7 | |
| Electromyography (EMG) |
$88 |
$189 |
$129 |
$141 | |
| Emergency department visit |
$79 |
$263 |
$230 |
$69 | |
| Emergency department visit (level 1) |
$41 |
$154 |
$90 |
$11 | |
| Emergency department visit (level 2) |
$42 |
$83 |
$158 |
$40 | |
| Emergency department visit (level 3) |
$70 |
$140 |
$277 |
$69 | |
| Emergency department visit (level 4) |
$120 |
$240 |
$426 |
$118 | |
| Emergency department visit (level 5) |
$174 |
$348 |
$613 |
$171 | |
| Endometrial biopsy |
$40 |
$99 |
$201 |
$98 | |
| Estradiol (estrogen) test |
$43 |
$173 |
$83 |
$28 | |
| Eye refraction (glasses prescription) |
$14 |
$28 |
$17 |
— | |
| Fallopian tube X-ray (HSG) |
$65 |
$131 |
$209 |
$164 | |
| Family therapy session |
$83 |
$167 |
$152 |
$110 | |
| Fecal occult blood (stool) test |
$5 |
$13 |
$4 |
$10 | |
| Fecal occult blood (stool) test (immunochemical, FIT) |
$10 |
$20 |
$16 |
$16 | |
| Ferritin (iron) test |
$20 |
$81 |
$35 |
$14 | |
| Fibroid removal (myomectomy) |
$268 |
$535 |
$3,808 |
$914 | |
| Flu vaccine |
$14 |
$28 |
$23 |
— | |
| Foreign body removal (skin) |
$76 |
$213 |
$400 |
$157 | |
| Free T4 thyroid test |
$14 |
$56 |
$30 |
$9 | |
| Gallbladder scan (HIDA) |
$243 |
$930 |
$480 |
$334 | |
| GGT liver test |
$11 |
$44 |
$19 |
$7 | |
| Group therapy session |
$23 |
$46 |
$93 |
$30 | |
| Hearing test (audiometry) |
$37 |
$73 |
$29 |
$36 | |
| Hepatitis A vaccine |
$40 |
$106 |
$81 |
— | |
| Hepatitis B vaccine |
$33 |
$89 |
$68 |
— | |
| Hip arthroscopy |
$1,429 |
$2,858 |
$1,312 |
$931 | |
| Home sleep apnea test |
$109 |
$218 |
$130 |
$123 | |
| HPV vaccine |
$142 |
$378 |
$287 |
— | |
| Ileostomy |
$240 |
$479 |
$1,334 |
$968 | |
| IUD removal |
$36 |
$72 |
$248 |
$112 | |
| IV infusion therapy |
$72 |
$230 |
$119 |
$44 | |
| IV infusion therapy (each additional) |
$53 |
$191 |
$46 |
$21 | |
| IV infusion therapy (initial) |
$94 |
$315 |
$211 |
$67 | |
| IVC filter placement |
$1,143 |
$2,285 |
$5,406 |
$1,885 | |
| Kidney scan (nuclear) |
$192 |
$713 |
$538 |
$172 | |
| Kidney ultrasound |
$67 |
$134 |
$106 |
$84 | |
| Kidney ultrasound (limited) |
$47 |
$94 |
$106 |
$61 | |
| Knee replacement |
$18,635 |
$74,539 |
$26,523 |
$18,054 | |
| Lactate test |
$18 |
$72 |
$35 |
$12 | |
| Laminectomy (spine) |
$1,238 |
$2,476 |
$1,623 |
$1,157 | |
| Leg vein ultrasound (Doppler) |
$135 |
$270 |
$156 |
$150 | |
| Leg vein ultrasound (Doppler) (limited) |
$108 |
$215 |
$106 |
$116 | |
| Lipid (cholesterol) panel |
$21 |
$83 |
$40 |
$13 | |
| Liver function panel |
$13 |
$50 |
$30 |
$8 | |
| Lumbar discectomy |
$1,291 |
$2,581 |
$7,144 |
$898 | |
| Magnesium blood test |
$10 |
$41 |
$18 |
$7 | |
| MMR vaccine |
$44 |
$117 |
$83 |
— | |
| MRA of the brain with contrast |
$244 |
$918 |
$357 |
$226 | |
| MRI of the ankle with contrast |
$210 |
$766 |
$357 |
$261 | |
| MRI of the chest |
$236 |
$944 |
$380 |
$371 | |
| MRI of the chest with contrast |
$1,050 |
$4,200 |
$830 |
$371 | |
| MRI of the knee with contrast |
$278 |
$556 |
$790 |
$315 | |
| MRI of the pelvis with contrast |
$233 |
$852 |
$357 |
$268 | |
| MRI of the wrist with contrast |
$390 |
$1,558 |
$375 |
$330 | |
| Nebulizer breathing treatment |
$128 |
$512 |
$203 |
$9 | |
| Neck (cervical) spinal fusion |
$1,723 |
$3,445 |
$12,867 |
$1,410 | |
| Nerve conduction study |
$71 |
$157 |
$156 |
$118 | |
| Newborn hospital care |
$65 |
$131 |
$63 |
$58 | |
| Nuchal translucency ultrasound |
$86 |
$171 |
$106 |
$116 | |
| Nuclear cardiac stress test |
$384 |
$768 |
$966 |
$428 | |
| Occupational therapy evaluation |
$84 |
$334 |
$189 |
$101 | |
| Occupational therapy evaluation (high complexity) |
$134 |
$537 |
$258 |
$101 | |
| Occupational therapy evaluation (low complexity) |
$68 |
$211 |
$130 |
$101 | |
| Occupational therapy evaluation (moderate complexity) |
$93 |
$371 |
$178 |
$101 | |
| Office visit (established patient) |
$84 |
$199 |
$123 |
$115 | |
| Office visit (new patient) |
$106 |
$363 |
$187 |
$177 | |
| Office visit, established patient (level 3) |
$69 |
$137 |
$104 |
$95 | |
| Office visit, established patient (level 4) |
$100 |
$199 |
$151 |
$136 | |
| Office visit, new patient (level 3) |
$94 |
$188 |
$143 |
$118 | |
| Office visit, new patient (level 4) |
$116 |
$287 |
$188 |
$177 | |
| Office visit, new patient (level 5) |
$138 |
$363 |
$233 |
$237 | |
| Ovary removal (oophorectomy) |
$258 |
$516 |
$895 |
$822 | |
| Pacemaker insertion |
$21,958 |
$87,832 |
$35,479 |
$15,506 | |
| Pap smear (cervical screening) |
$11 |
$22 |
$18 |
$20 | |
| Parathyroid hormone (PTH) test |
$20 |
$78 |
$37 |
$41 | |
| Pelvic ultrasound |
$61 |
$122 |
$106 |
$78 | |
| Pelvic ultrasound (complete) |
$88 |
$177 |
$106 |
$105 | |
| Pelvic ultrasound (limited) |
$38 |
$77 |
$106 |
$51 | |
| PET scan |
$525 |
$1,987 |
$1,459 |
— | |
| Physical therapy evaluation |
$93 |
$371 |
$208 |
$98 | |
| Physical therapy evaluation (high complexity) |
$129 |
$517 |
$248 |
$98 | |
| Physical therapy evaluation (moderate complexity) |
$93 |
$371 |
$178 |
$98 | |
| Pneumonia vaccine |
$144 |
$288 |
$182 |
— | |
| Pregnancy blood test (hCG) |
$15 |
$58 |
$50 |
$8 | |
| Pregnancy ultrasound |
$102 |
$203 |
$106 |
$126 | |
| Pregnancy ultrasound (first trimester) |
$93 |
$186 |
$106 |
$117 | |
| Pregnancy ultrasound (second or third trimester) |
$111 |
$221 |
$106 |
$136 | |
| Prolactin test |
$30 |
$120 |
$58 |
$19 | |
| Psychiatric evaluation |
$133 |
$271 |
$163 |
$188 | |
| Psychotherapy session |
$88 |
$234 |
$161 |
$140 | |
| Pulmonary rehabilitation |
$79 |
$240 |
$62 |
$87 | |
| Retina scan (OCT) |
$18 |
$35 |
$23 |
$33 | |
| Retinal (fundus) photography |
$29 |
$57 |
$129 |
$37 | |
| Retinal detachment repair |
$1,139 |
$2,277 |
$1,434 |
$966 | |
| Routine eye exam |
$49 |
$97 |
$57 |
$88 | |
| RSV vaccine |
$203 |
$406 |
$325 |
— | |
| Scoliosis spine X-ray |
$54 |
$126 |
$90 |
$58 | |
| Scoliosis spine X-ray (1 view) |
$32 |
$117 |
$88 |
$44 | |
| Scoliosis spine X-ray (3 views) |
$63 |
$126 |
$106 |
$72 | |
| Screening colonoscopy |
$339 |
$1,354 |
$912 |
$378 | |
| Screening mammogram |
$67 |
$232 |
$164 |
$126 | |
| Scrotal ultrasound |
$85 |
$169 |
$106 |
$99 | |
| Sex hormone binding globulin test |
$34 |
$134 |
$64 |
$22 | |
| Shingles vaccine |
$99 |
$265 |
$201 |
— | |
| Simple laceration repair (small, up to 2.5 cm) |
$45 |
$89 |
$199 |
$114 | |
| Simple wound stitches |
$46 |
$103 |
$199 |
$127 | |
| Skin biopsy |
$47 |
$155 |
$214 |
$121 | |
| Skin biopsy (punch) |
$49 |
$194 |
$236 |
$121 | |
| Skin cancer lesion removal |
$93 |
$246 |
$415 |
$240 | |
| Skin graft |
$448 |
$896 |
$2,002 |
$898 | |
| Skin tag removal |
$37 |
$122 |
$117 |
$92 | |
| Sleep study (polysomnography) |
$412 |
$988 |
$800 |
$691 | |
| Small bowel resection |
$282 |
$563 |
$1,573 |
$1,136 | |
| Speech therapy |
$157 |
$626 |
$300 |
$76 | |
| Spine fracture repair (kyphoplasty) |
$1,296 |
$2,591 |
$7,144 |
$5,803 | |
| Stomach removal (gastrectomy) |
$335 |
$669 |
$2,130 |
$1,595 | |
| Stress echocardiogram |
$165 |
$331 |
$371 |
$209 | |
| Stress echocardiogram (complete) |
$189 |
$378 |
$548 |
$233 | |
| Swallow study |
$196 |
$784 |
$376 |
$85 | |
| Tdap (tetanus) vaccine |
$23 |
$60 |
$39 |
— | |
| Testosterone test |
$27 |
$106 |
$70 |
$26 | |
| Thyroid ultrasound |
$96 |
$192 |
$106 |
$109 | |
| Thyroid uptake scan |
$180 |
$719 |
$402 |
$145 | |
| Transesophageal echocardiogram (TEE) |
$232 |
$464 |
$548 |
$239 | |
| Transesophageal echocardiogram (TEE) with and without contrast |
$180 |
$360 |
$548 |
$239 | |
| Transvaginal ultrasound |
$101 |
$203 |
$106 |
$118 | |
| Trigger finger release |
$293 |
$606 |
$1,580 |
$630 | |
| Triglycerides test |
$6 |
$23 |
$10 |
$6 | |
| Troponin (heart) test |
$16 |
$64 |
$35 |
$12 | |
| Upper GI series (barium) |
$87 |
$307 |
$178 |
$128 | |
| Urinalysis |
$4 |
$14 |
$11 |
$3 | |
| Urine microalbumin test |
$5 |
$21 |
$11 |
$5 | |
| Vaccine administration |
$19 |
$46 |
$40 |
$19 | |
| Vaccine administration (each additional) |
$15 |
$30 |
$23 |
$16 | |
| Vaginal delivery |
$5,039 |
$20,156 |
$7,884 |
$5,487 | |
| Visual field test |
$37 |
$73 |
$42 |
$64 | |
| Vitamin D test |
$30 |
$120 |
$46 |
$30 | |
| Wart removal |
$45 |
$110 |
$199 |
$121 | |
| Weight-loss (bariatric) surgery |
$9,650 |
$38,599 |
$18,999 |
$11,645 | |
| Well-child visit |
$67 |
$172 |
$80 |
— | |
| Whipple procedure (pancreas) |
$718 |
$1,435 |
$4,002 |
$2,871 | |
| X-ray of the abdomen |
$30 |
$60 |
$59 |
$36 | |
| X-ray of the ankle |
$32 |
$65 |
$88 |
$37 | |
| X-ray of the collarbone |
$29 |
$57 |
$88 |
$33 | |
| X-ray of the elbow |
$29 |
$57 |
$88 |
$33 | |
| X-ray of the facial bones |
$33 |
$67 |
$88 |
$39 | |
| X-ray of the foot |
$30 |
$60 |
$88 |
$34 | |
| X-ray of the forearm |
$26 |
$51 |
$88 |
$29 | |
| X-ray of the hand |
$33 |
$67 |
$88 |
$38 | |
| X-ray of the hip |
$37 |
$74 |
$76 |
$49 | |
| X-ray of the hip (1 view) |
$29 |
$58 |
$84 |
$34 | |
| X-ray of the hip (3 views) |
$42 |
$85 |
$84 |
$49 | |
| X-ray of the hip (4 views) |
$48 |
$95 |
$39 |
$63 | |
| X-ray of the knee |
$42 |
$84 |
$88 |
$42 | |
| X-ray of the knee (2 views) |
$53 |
$202 |
$88 |
$34 | |
| X-ray of the knee (3 views) |
$53 |
$203 |
$88 |
$42 | |
| X-ray of the knee (4+ views) |
$42 |
$84 |
$106 |
$49 | |
| X-ray of the lower back (lumbar spine) |
$40 |
$79 |
$106 |
$47 | |
| X-ray of the lower back (lumbar spine) (2 views) |
$34 |
$69 |
$106 |
$40 | |
| X-ray of the lower back (lumbar spine) (4+ views) |
$46 |
$92 |
$106 |
$53 | |
| X-ray of the lower leg |
$28 |
$56 |
$88 |
$31 | |
| X-ray of the mid-back (thoracic spine) |
$31 |
$62 |
$106 |
$36 | |
| X-ray of the mid-back (thoracic spine) (2 views) |
$28 |
$57 |
$106 |
$33 | |
| X-ray of the mid-back (thoracic spine) (3 views) |
$34 |
$68 |
$106 |
$39 | |
| X-ray of the neck (cervical spine) |
$40 |
$81 |
$88 |
$47 | |
| X-ray of the neck (cervical spine) (3 views) |
$34 |
$69 |
$88 |
$40 | |
| X-ray of the pelvis |
$29 |
$58 |
$106 |
$36 | |
| X-ray of the ribs |
$33 |
$67 |
$88 |
$42 | |
| X-ray of the ribs (2 views) |
$31 |
$63 |
$88 |
$36 | |
| X-ray of the ribs (3 views) |
$36 |
$72 |
$106 |
$42 | |
| X-ray of the shoulder |
$30 |
$60 |
$88 |
$36 | |
| X-ray of the skull |
$34 |
$68 |
$106 |
$40 | |
| X-ray of the upper arm |
$28 |
$57 |
$88 |
$32 | |
| X-ray of the wrist |
$37 |
$75 |
$88 |
$43 | |