| 3D mammogram (tomosynthesis) |
$182 |
$280 |
— |
$51 | |
| Abdominal fluid drain (paracentesis) |
$689 |
$1,060 |
— |
$284 | |
| Abdominal ultrasound |
$241 |
$371 |
— |
$100 | |
| Abdominal ultrasound (complete) |
$200 |
$308 |
— |
$114 | |
| Abdominal ultrasound (limited) |
$281 |
$433 |
— |
$86 | |
| Abscess drainage (complex or multiple) |
$1,031 |
$1,586 |
— |
$220 | |
| Abscess drainage (simple) |
$966 |
$1,486 |
— |
$129 | |
| Abscess incision and drainage |
$998 |
$1,536 |
— |
$174 | |
| ACL knee reconstruction |
$5,248 |
$8,074 |
— |
$889 | |
| Adenoid removal (adenoidectomy) |
$3,104 |
$4,775 |
— |
$204 | |
| Albumin blood test |
$20 |
$30 |
— |
$5 | |
| Aldosterone test |
$121 |
$186 |
— |
$41 | |
| Alkaline phosphatase test |
$18 |
$28 |
— |
$5 | |
| Alpha-fetoprotein (AFP) test |
$62 |
$96 |
— |
$17 | |
| ALT liver enzyme test |
$20 |
$30 |
— |
$5 | |
| Ammonia blood test |
$57 |
$87 |
— |
$15 | |
| Amniocentesis |
$332 |
$511 |
— |
$120 | |
| Amylase test |
$49 |
$76 |
— |
$6 | |
| Ankle fracture repair |
$5,496 |
$8,456 |
— |
$608 | |
| Annual physical (new patient) |
$94 |
$144 |
— |
— | |
| Anoscopy |
$102 |
$157 |
— |
$129 | |
| Antinuclear antibody (ANA) test |
$46 |
$71 |
— |
$12 | |
| Arterial blood gas (ABG) |
$81 |
$125 |
— |
$26 | |
| AST liver enzyme test |
$20 |
$30 |
— |
$5 | |
| Barium swallow study |
$173 |
$267 |
— |
$107 | |
| Bartholin cyst removal |
$213 |
$327 |
— |
$182 | |
| Basic metabolic panel |
$61 |
$94 |
— |
$8 | |
| Benign skin lesion removal |
$966 |
$1,486 |
— |
$171 | |
| Bilirubin blood test |
$18 |
$27 |
— |
$5 | |
| Blood clotting test (PT/INR) |
$15 |
$23 |
— |
$4 | |
| Blood crossmatch |
$163 |
$250 |
— |
— | |
| Blood glucose test |
$25 |
$39 |
— |
$5 | |
| Blood transfusion |
$543 |
$836 |
— |
$47 | |
| Blood type test |
$57 |
$88 |
— |
$3 | |
| Blood type test (ABO group) |
$81 |
$124 |
— |
$3 | |
| Blood type test (Rh/D antigen) |
$34 |
$52 |
— |
$3 | |
| BNP (heart failure) test |
$75 |
$116 |
— |
$39 | |
| Bone marrow biopsy |
$1,261 |
$1,940 |
— |
$172 | |
| Bone scan (nuclear) |
$418 |
$643 |
— |
$259 | |
| Breast biopsy |
$1,574 |
$2,422 |
— |
$478 | |
| Breast ultrasound |
$164 |
$252 |
— |
$92 | |
| Breast ultrasound (complete) |
$181 |
$278 |
— |
$100 | |
| Breast ultrasound (limited) |
$147 |
$226 |
— |
$84 | |
| Breathing tube insertion (intubation) |
$279 |
$429 |
— |
$133 | |
| Bronchoscopy |
$1,341 |
$2,063 |
— |
$303 | |
| Bunion surgery (bunionectomy) |
$2,921 |
$4,494 |
— |
$883 | |
| Burn dressing and debridement (medium) |
$228 |
$350 |
— |
$166 | |
| Burn dressing and debridement (small) |
$966 |
$1,486 |
— |
$93 | |
| Burn treatment |
$597 |
$918 |
— |
$129 | |
| C-reactive protein (CRP) |
$28 |
$43 |
— |
$5 | |
| CA 19-9 tumor marker test |
$66 |
$101 |
— |
$21 | |
| CA-125 ovarian marker test |
$38 |
$59 |
— |
$21 | |
| Calcium blood test |
$20 |
$30 |
— |
$5 | |
| Cardiac stress test |
$287 |
$442 |
— |
$39 | |
| Cardioversion |
$340 |
$523 |
— |
$155 | |
| Carotid artery ultrasound |
$430 |
$662 |
— |
$156 | |
| Carpal tunnel release |
$1,724 |
$2,653 |
— |
$483 | |
| Cataract surgery |
$1,724 |
$2,653 |
— |
$547 | |
| CEA tumor marker test |
$66 |
$101 |
— |
$19 | |
| Central line placement |
$1,225 |
$1,884 |
— |
$238 | |
| Cervical cerclage |
$2,497 |
$3,841 |
— |
$137 | |
| Cesarean section (C-section) |
$11,121 |
$17,109 |
— |
$7,552 | |
| Chemotherapy infusion |
$163 |
$251 |
— |
$81 | |
| Chemotherapy infusion (each additional) |
$84 |
$129 |
— |
$28 | |
| Chemotherapy infusion (first hour) |
$242 |
$373 |
— |
$133 | |
| Chest fluid drain (thoracentesis) |
$2,350 |
$3,616 |
— |
$311 | |
| Chest tube insertion |
$1,234 |
$1,898 |
— |
$143 | |
| Chest X-ray |
$94 |
$144 |
— |
$37 | |
| Chest X-ray (1 view) |
$81 |
$125 |
— |
$25 | |
| Chest X-ray (2 views) |
$88 |
$135 |
— |
$33 | |
| Circumcision |
$1,284 |
$1,976 |
— |
$167 | |
| Clotting time test (PTT) |
$20 |
$31 |
— |
$6 | |
| Colon resection (colectomy) |
$1,772 |
$2,726 |
— |
$1,238 | |
| Colonoscopy |
$1,724 |
$2,653 |
— |
$480 | |
| Complete blood count (CBC) |
$21 |
$32 |
— |
$7 | |
| Complete blood count (CBC) (complete) |
$22 |
$34 |
— |
$8 | |
| Complex wound repair |
$966 |
$1,486 |
— |
$390 | |
| Comprehensive metabolic panel |
$92 |
$141 |
— |
$11 | |
| Contraceptive implant (Nexplanon) |
$966 |
$1,486 |
— |
$115 | |
| Copper blood test |
$37 |
$57 |
— |
$12 | |
| Coronary CT angiography |
$489 |
$752 |
— |
$326 | |
| Cortisol test |
$58 |
$89 |
— |
$16 | |
| CPAP titration study |
$190 |
$293 |
— |
$69 | |
| Creatine kinase (CK) test |
$29 |
$45 |
— |
$7 | |
| CT angiography of the chest |
$794 |
$1,221 |
— |
$281 | |
| CT angiography of the head |
$716 |
$1,102 |
— |
$274 | |
| CT scan of the abdomen |
$494 |
$760 |
— |
$230 | |
| CT scan of the abdomen and pelvis |
$516 |
$794 |
— |
$300 | |
| CT scan of the abdomen and pelvis with and without contrast |
$649 |
$998 |
— |
$338 | |
| CT scan of the abdomen and pelvis with contrast |
$516 |
$794 |
— |
$300 | |
| CT scan of the abdomen and pelvis without contrast |
$390 |
$600 |
— |
$183 | |
| CT scan of the abdomen with and without contrast |
$593 |
$913 |
— |
$259 | |
| CT scan of the abdomen with contrast |
$494 |
$760 |
— |
$230 | |
| CT scan of the abdomen without contrast |
$413 |
$636 |
— |
$136 | |
| CT scan of the arm |
$421 |
$647 |
— |
$199 | |
| CT scan of the arm with contrast |
$421 |
$647 |
— |
$199 | |
| CT scan of the arm without contrast |
$372 |
$572 |
— |
$161 | |
| CT scan of the chest |
$497 |
$764 |
— |
$167 | |
| CT scan of the chest with and without contrast |
$794 |
$1,221 |
— |
$196 | |
| CT scan of the chest with contrast |
$497 |
$764 |
— |
$167 | |
| CT scan of the chest without contrast |
$425 |
$654 |
— |
$133 | |
| CT scan of the head |
$410 |
$630 |
— |
$148 | |
| CT scan of the head with and without contrast |
$807 |
$1,242 |
— |
$173 | |
| CT scan of the head with contrast |
$410 |
$630 |
— |
$148 | |
| CT scan of the head without contrast |
$333 |
$513 |
— |
$107 | |
| CT scan of the leg |
$486 |
$747 |
— |
$166 | |
| CT scan of the leg with contrast |
$486 |
$747 |
— |
$166 | |
| CT scan of the leg without contrast |
$437 |
$672 |
— |
$130 | |
| CT scan of the lower back (lumbar spine) |
$481 |
$740 |
— |
$169 | |
| CT scan of the lower back (lumbar spine) with and without contrast |
$579 |
$890 |
— |
$197 | |
| CT scan of the lower back (lumbar spine) with contrast |
$481 |
$740 |
— |
$169 | |
| CT scan of the lower back (lumbar spine) without contrast |
$426 |
$656 |
— |
$130 | |
| CT scan of the neck |
$409 |
$629 |
— |
$183 | |
| CT scan of the neck (cervical spine) |
$495 |
$761 |
— |
$168 | |
| CT scan of the neck (cervical spine) with and without contrast |
$579 |
$890 |
— |
$196 | |
| CT scan of the neck (cervical spine) with contrast |
$495 |
$761 |
— |
$168 | |
| CT scan of the neck (cervical spine) without contrast |
$425 |
$654 |
— |
$131 | |
| CT scan of the neck with and without contrast |
$520 |
$800 |
— |
$220 | |
| CT scan of the neck with contrast |
$409 |
$629 |
— |
$183 | |
| CT scan of the neck without contrast |
$376 |
$578 |
— |
$150 | |
| CT scan of the pelvis |
$477 |
$734 |
— |
$226 | |
| CT scan of the pelvis with and without contrast |
$569 |
$876 |
— |
$251 | |
| CT scan of the pelvis with contrast |
$477 |
$734 |
— |
$226 | |
| CT scan of the pelvis without contrast |
$419 |
$644 |
— |
$133 | |
| CT scan of the sinuses |
$518 |
$797 |
— |
$152 | |
| CT scan of the sinuses with and without contrast |
$518 |
$797 |
— |
$184 | |
| CT scan of the sinuses with contrast |
$429 |
$660 |
— |
$152 | |
| CT scan of the sinuses without contrast |
$527 |
$810 |
— |
$128 | |
| D-dimer test |
$30 |
$46 |
— |
$10 | |
| DHEA-sulfate test |
$69 |
$106 |
— |
$22 | |
| Diagnostic mammogram |
$174 |
$268 |
— |
$140 | |
| Dilation and curettage (D&C) |
$2,769 |
$4,260 |
— |
$298 | |
| Drug screen (urine) |
$62 |
$95 |
— |
$17 | |
| Ear tubes (myringotomy) |
$1,724 |
$2,653 |
— |
$174 | |
| Echocardiogram |
$243 |
$374 |
— |
$138 | |
| Echocardiogram with and without contrast |
$217 |
$334 |
— |
$101 | |
| Echocardiogram without contrast |
$243 |
$374 |
— |
$138 | |
| EEG (awake and asleep) |
$494 |
$760 |
— |
$482 | |
| EKG / ECG (tracing only) |
$90 |
$138 |
— |
$7 | |
| Electrocardiogram (EKG) |
$59 |
$90 |
— |
$8 | |
| Electroencephalogram (EEG) |
$494 |
$760 |
— |
$448 | |
| Electrolyte panel |
$31 |
$48 |
— |
$7 | |
| Emergency department visit |
$268 |
$412 |
— |
$69 | |
| Emergency department visit (level 1) |
$101 |
$155 |
— |
$11 | |
| Emergency department visit (level 2) |
$185 |
$284 |
— |
$40 | |
| Emergency department visit (level 3) |
$268 |
$412 |
— |
$69 | |
| Emergency department visit (level 4) |
$345 |
$531 |
— |
$118 | |
| Emergency department visit (level 5) |
$436 |
$670 |
— |
$171 | |
| Epidural steroid injection |
$966 |
$1,486 |
— |
$275 | |
| Estradiol (estrogen) test |
$60 |
$92 |
— |
$28 | |
| Facet joint injection (spine) |
$966 |
$1,486 |
— |
$99 | |
| Fallopian tube X-ray (HSG) |
$264 |
$406 |
— |
$164 | |
| Family therapy session |
— |
$0 |
— |
$110 | |
| Fecal occult blood (stool) test |
$14 |
$21 |
— |
$10 | |
| Fecal occult blood (stool) test (guaiac, gFOBT) |
$14 |
$21 |
— |
$4 | |
| Feeding tube (PEG) placement |
$1,724 |
$2,653 |
— |
$178 | |
| Ferritin (iron) test |
$49 |
$75 |
— |
$14 | |
| Fibrinogen test |
$26 |
$40 |
— |
$10 | |
| Flexible sigmoidoscopy |
$1,211 |
$1,863 |
— |
$323 | |
| Flu test |
$49 |
$76 |
— |
$17 | |
| Folate (folic acid) test |
$53 |
$82 |
— |
$15 | |
| Free T4 thyroid test |
$49 |
$76 |
— |
$9 | |
| FSH hormone test |
$58 |
$89 |
— |
$19 | |
| Gallbladder removal (laparoscopic) |
$3,916 |
$6,025 |
— |
$658 | |
| Gallbladder scan (HIDA) |
$560 |
$862 |
— |
$334 | |
| Ganglion cyst removal |
$3,104 |
$4,775 |
— |
$321 | |
| GGT liver test |
$26 |
$40 |
— |
$7 | |
| Glucose tolerance test |
$39 |
$60 |
— |
$8 | |
| Group therapy session |
— |
$0 |
— |
$30 | |
| Hammertoe repair |
$2,921 |
$4,494 |
— |
$548 | |
| HDL cholesterol test |
$28 |
$43 |
— |
$8 | |
| Hematocrit test |
$15 |
$23 |
— |
$2 | |
| Hemoglobin A1c (diabetes test) |
$31 |
$48 |
— |
$10 | |
| Hemorrhoid removal |
$1,555 |
$2,393 |
— |
$338 | |
| Hepatitis B test |
$34 |
$53 |
— |
$10 | |
| Hepatitis C test |
$42 |
$64 |
— |
$14 | |
| HIV test |
$56 |
$86 |
— |
$19 | |
| HIV test (antibody) |
$55 |
$85 |
— |
$14 | |
| HIV test (antigen/antibody combo) |
$57 |
$87 |
— |
$24 | |
| Holter heart monitor |
$127 |
$196 |
— |
$26 | |
| Hydrocele repair |
$2,892 |
$4,450 |
— |
$315 | |
| Hysterectomy |
$4,017 |
$6,180 |
— |
$933 | |
| Hysteroscopy |
$2,769 |
$4,260 |
— |
$1,270 | |
| Inguinal hernia repair |
$3,233 |
$4,974 |
— |
$538 | |
| Iron blood test |
$26 |
$40 |
— |
$6 | |
| IUD removal |
$966 |
$1,486 |
— |
$112 | |
| IV infusion therapy |
$92 |
$141 |
— |
$44 | |
| IV infusion therapy (each additional) |
$61 |
$94 |
— |
$21 | |
| IV infusion therapy (initial) |
$122 |
$188 |
— |
$67 | |
| Joint aspiration (small/intermediate) |
$533 |
$821 |
— |
$57 | |
| Joint aspiration or injection (mid-size joint) |
$101 |
$155 |
— |
$57 | |
| Joint aspiration or injection (small joint) |
$966 |
$1,486 |
— |
$56 | |
| Kidney biopsy |
$449 |
$690 |
— |
$492 | |
| Kidney scan (nuclear) |
$351 |
$540 |
— |
$172 | |
| Kidney ultrasound |
$217 |
$334 |
— |
$84 | |
| Kidney ultrasound (limited) |
$217 |
$334 |
— |
$61 | |
| Knee arthroscopy |
$3,621 |
$5,570 |
— |
$524 | |
| Knee joint injection |
$311 |
$478 |
— |
$69 | |
| Knee replacement |
— |
$0 |
— |
$18,054 | |
| Lactate test |
$36 |
$55 |
— |
$12 | |
| LDH test |
$22 |
$34 |
— |
$6 | |
| LDL cholesterol test |
$31 |
$48 |
— |
$11 | |
| Leg vein ultrasound (Doppler) |
$433 |
$666 |
— |
$150 | |
| Leg vein ultrasound (Doppler) (limited) |
$353 |
$543 |
— |
$116 | |
| LH hormone test |
$54 |
$83 |
— |
$19 | |
| Lipase test |
$31 |
$48 |
— |
$7 | |
| Lipid (cholesterol) panel |
$53 |
$82 |
— |
$13 | |
| Liver biopsy |
$764 |
$1,176 |
— |
$288 | |
| Liver function panel |
$37 |
$57 |
— |
$8 | |
| Lower back (lumbar) spinal fusion |
— |
$0 |
— |
$1,511 | |
| Lumpectomy (breast) |
$5,232 |
$8,049 |
— |
$750 | |
| Lung function test (PFT) |
$208 |
$320 |
— |
$37 | |
| Lung scan (V/Q) |
$554 |
$852 |
— |
$291 | |
| Magnesium blood test |
$28 |
$43 |
— |
$7 | |
| Mastectomy |
$5,338 |
$8,212 |
— |
$1,021 | |
| Meniscus repair (knee) |
$2,980 |
$4,584 |
— |
$714 | |
| MRA of the brain |
$1,046 |
$1,609 |
— |
$226 | |
| MRA of the brain with contrast |
$622 |
$957 |
— |
$226 | |
| MRA of the brain without contrast |
$1,138 |
$1,750 |
— |
$328 | |
| MRA of the neck |
$727 |
$1,118 |
— |
$245 | |
| MRA of the neck with contrast |
$697 |
$1,073 |
— |
$245 | |
| MRA of the neck without contrast |
$1,290 |
$1,985 |
— |
$343 | |
| MRI of the abdomen |
$818 |
$1,259 |
— |
$300 | |
| MRI of the abdomen with contrast |
$818 |
$1,259 |
— |
$300 | |
| MRI of the abdomen without contrast |
$732 |
$1,126 |
— |
$194 | |
| MRI of the ankle |
$1,359 |
$2,091 |
— |
$261 | |
| MRI of the ankle with contrast |
$1,359 |
$2,091 |
— |
$261 | |
| MRI of the ankle without contrast |
$1,065 |
$1,639 |
— |
$222 | |
| MRI of the brain |
$891 |
$1,371 |
— |
$269 | |
| MRI of the brain with contrast |
$891 |
$1,371 |
— |
$269 | |
| MRI of the brain without contrast |
$694 |
$1,067 |
— |
$195 | |
| MRI of the chest |
$1,036 |
$1,594 |
— |
$371 | |
| MRI of the chest without contrast |
$1,327 |
$2,041 |
— |
$466 | |
| MRI of the knee |
$1,359 |
$2,091 |
— |
$315 | |
| MRI of the knee with contrast |
$1,359 |
$2,091 |
— |
$315 | |
| MRI of the knee without contrast |
$1,065 |
$1,639 |
— |
$204 | |
| MRI of the lower back (lumbar spine) |
$1,051 |
$1,617 |
— |
$270 | |
| MRI of the lower back (lumbar spine) with contrast |
$891 |
$1,371 |
— |
$270 | |
| MRI of the lower back (lumbar spine) without contrast |
$1,051 |
$1,617 |
— |
$192 | |
| MRI of the mid-back (thoracic spine) |
$1,061 |
$1,632 |
— |
$271 | |
| MRI of the mid-back (thoracic spine) with and without contrast |
$1,214 |
$1,868 |
— |
$319 | |
| MRI of the mid-back (thoracic spine) with contrast |
$902 |
$1,388 |
— |
$271 | |
| MRI of the mid-back (thoracic spine) without contrast |
$1,061 |
$1,632 |
— |
$190 | |
| MRI of the neck (cervical spine) |
$904 |
$1,390 |
— |
$274 | |
| MRI of the neck (cervical spine) with and without contrast |
$1,355 |
$2,084 |
— |
$318 | |
| MRI of the neck (cervical spine) with contrast |
$904 |
$1,390 |
— |
$274 | |
| MRI of the neck (cervical spine) without contrast |
$694 |
$1,067 |
— |
$191 | |
| MRI of the pelvis |
$877 |
$1,349 |
— |
$268 | |
| MRI of the pelvis with contrast |
$877 |
$1,349 |
— |
$268 | |
| MRI of the pelvis without contrast |
$743 |
$1,143 |
— |
$227 | |
| MRI of the shoulder |
$1,065 |
$1,639 |
— |
$313 | |
| MRI of the shoulder with contrast |
$970 |
$1,493 |
— |
$313 | |
| MRI of the shoulder without contrast |
$1,065 |
$1,639 |
— |
$205 | |
| MRI of the wrist |
$1,065 |
$1,639 |
— |
$330 | |
| MRI of the wrist with contrast |
$942 |
$1,449 |
— |
$330 | |
| MRI of the wrist without contrast |
$1,065 |
$1,639 |
— |
$303 | |
| Nebulizer breathing treatment |
$143 |
$220 |
— |
$9 | |
| Nuclear cardiac stress test |
$823 |
$1,266 |
— |
$428 | |
| Occupational therapy evaluation |
$125 |
$192 |
— |
$101 | |
| Occupational therapy evaluation (high complexity) |
$138 |
$213 |
— |
$101 | |
| Occupational therapy evaluation (low complexity) |
$111 |
$170 |
— |
$101 | |
| Occupational therapy evaluation (moderate complexity) |
$125 |
$192 |
— |
$101 | |
| Office visit (new patient) |
$113 |
$174 |
— |
$177 | |
| Office visit, new patient (level 3) |
$73 |
$113 |
— |
$118 | |
| Office visit, new patient (level 4) |
$113 |
$174 |
— |
$177 | |
| Office visit, new patient (level 5) |
$141 |
$217 |
— |
$237 | |
| Orthopedic hardware removal |
$1,724 |
$2,653 |
— |
$632 | |
| Pap smear (cervical screening) |
$121 |
$186 |
— |
$20 | |
| Parathyroid hormone (PTH) test |
$124 |
$190 |
— |
$41 | |
| Pelvic ultrasound |
$216 |
$333 |
— |
$78 | |
| Pelvic ultrasound (complete) |
$292 |
$449 |
— |
$105 | |
| Pelvic ultrasound (limited) |
$140 |
$216 |
— |
$51 | |
| Phosphorus blood test |
$20 |
$30 |
— |
$5 | |
| Physical therapy evaluation |
$118 |
$181 |
— |
$98 | |
| Physical therapy evaluation (high complexity) |
$131 |
$201 |
— |
$98 | |
| Physical therapy evaluation (moderate complexity) |
$118 |
$181 |
— |
$98 | |
| Pilonidal cyst removal |
$2,126 |
$3,270 |
— |
$541 | |
| Platelet count |
$21 |
$33 |
— |
$4 | |
| Pneumonia vaccine |
$259 |
$399 |
— |
— | |
| Pregnancy blood test (hCG) |
$29 |
$44 |
— |
$8 | |
| Pregnancy ultrasound |
$247 |
$380 |
— |
$126 | |
| Pregnancy ultrasound (first trimester) |
$228 |
$351 |
— |
$117 | |
| Pregnancy ultrasound (second or third trimester) |
$266 |
$409 |
— |
$136 | |
| Prolactin test |
$58 |
$89 |
— |
$19 | |
| Prostate biopsy |
— |
$0 |
— |
— | |
| Prostate removal (prostatectomy) |
— |
$0 |
— |
$1,063 | |
| Prostate test (PSA) |
$62 |
$96 |
— |
$18 | |
| Psychotherapy session |
— |
$0 |
— |
$140 | |
| Rheumatoid factor test |
$28 |
$43 |
— |
$6 | |
| Rotator cuff repair |
$5,248 |
$8,074 |
— |
$792 | |
| Scoliosis spine X-ray |
$95 |
$146 |
— |
$58 | |
| Scoliosis spine X-ray (1 view) |
$70 |
$107 |
— |
$44 | |
| Scoliosis spine X-ray (3 views) |
$120 |
$184 |
— |
$72 | |
| Screening colonoscopy |
$1,724 |
$2,653 |
— |
$378 | |
| Screening mammogram |
$212 |
$326 |
— |
$126 | |
| Scrotal ultrasound |
$190 |
$293 |
— |
$99 | |
| Sedimentation rate (ESR) test |
$18 |
$28 |
— |
$3 | |
| Semen analysis |
$58 |
$89 |
— |
$12 | |
| Simple laceration repair (small, up to 2.5 cm) |
$966 |
$1,486 |
— |
$114 | |
| Simple wound stitches |
$966 |
$1,486 |
— |
$127 | |
| Skin biopsy |
$966 |
$1,486 |
— |
$121 | |
| Skin biopsy (punch) |
$966 |
$1,486 |
— |
$121 | |
| Skin cancer lesion removal |
$558 |
$858 |
— |
$240 | |
| Skin graft |
$3,058 |
$4,705 |
— |
$898 | |
| Skin lesion freezing (cryotherapy) |
$966 |
$1,486 |
— |
$36 | |
| Skin tag removal |
$161 |
$248 |
— |
$92 | |
| Sleep study (polysomnography) |
$1,119 |
$1,722 |
— |
$691 | |
| Small bowel resection |
$1,724 |
$2,653 |
— |
$1,136 | |
| Soft tissue ultrasound |
$145 |
$223 |
— |
$64 | |
| Speech therapy |
$101 |
$155 |
— |
$76 | |
| Spinal tap (lumbar puncture) |
$417 |
$641 |
— |
$165 | |
| Spine fracture repair (kyphoplasty) |
$4,039 |
$6,214 |
— |
$5,803 | |
| Spirometry (lung function test) |
$152 |
$234 |
— |
$30 | |
| Spirometry with bronchodilator |
$263 |
$405 |
— |
$43 | |
| Spleen removal (splenectomy) |
$3,575 |
$5,500 |
— |
$1,036 | |
| Stomach removal (gastrectomy) |
$4,525 |
$6,962 |
— |
$1,595 | |
| Strep throat test |
$35 |
$54 |
— |
$17 | |
| Swallow study |
$176 |
$271 |
— |
$85 | |
| T3 thyroid test |
$49 |
$76 |
— |
$14 | |
| Tdap (tetanus) vaccine |
$88 |
$136 |
— |
— | |
| Testosterone test |
$82 |
$126 |
— |
$26 | |
| Thyroid removal (thyroidectomy) |
$5,318 |
$8,182 |
— |
$1,004 | |
| Thyroid test (TSH) |
$49 |
$75 |
— |
$17 | |
| Thyroid ultrasound |
$268 |
$413 |
— |
$109 | |
| Thyroid uptake scan |
$242 |
$373 |
— |
$145 | |
| Tonsillectomy |
$3,104 |
$4,775 |
— |
$252 | |
| Total IgE allergy test |
$46 |
$71 |
— |
$16 | |
| Total protein test |
$26 |
$40 |
— |
$4 | |
| Transvaginal ultrasound |
$180 |
$277 |
— |
$118 | |
| Trigger finger release |
$1,724 |
$2,653 |
— |
$630 | |
| Trigger point injection |
$88 |
$135 |
— |
$56 | |
| Trigger point injection (1-2 muscles) |
$88 |
$135 |
— |
$52 | |
| Triglycerides test |
$20 |
$30 |
— |
$6 | |
| Troponin (heart) test |
$63 |
$97 |
— |
$12 | |
| Tubal ligation |
$4,138 |
$6,366 |
— |
$333 | |
| Turning a breech baby (version) |
$1,828 |
$2,812 |
— |
$94 | |
| Ulnar nerve surgery (elbow) |
$1,724 |
$2,653 |
— |
$575 | |
| Upper GI endoscopy (EGD) |
$1,724 |
$2,653 |
— |
$371 | |
| Upper GI series (barium) |
$183 |
$281 |
— |
$128 | |
| Uric acid (gout) test |
$20 |
$30 |
— |
$5 | |
| Urine microalbumin test |
$44 |
$67 |
— |
$5 | |
| Urine pregnancy test |
$29 |
$44 |
— |
$9 | |
| Vaccine administration |
$44 |
$68 |
— |
$19 | |
| Vaginal delivery |
$7,831 |
$12,047 |
— |
$5,487 | |
| Vasectomy |
$1,755 |
$2,700 |
— |
$347 | |
| Vitamin B12 test |
$49 |
$76 |
— |
$15 | |
| Vitamin D test |
$86 |
$133 |
— |
$30 | |
| Wart removal |
$966 |
$1,486 |
— |
$121 | |
| Wound debridement |
$966 |
$1,486 |
— |
$186 | |
| Wrist fracture repair |
$4,366 |
$6,717 |
— |
$735 | |
| X-ray of the abdomen |
$138 |
$213 |
— |
$36 | |
| X-ray of the ankle |
$252 |
$387 |
— |
$37 | |
| X-ray of the collarbone |
$64 |
$99 |
— |
$33 | |
| X-ray of the elbow |
$127 |
$196 |
— |
$33 | |
| X-ray of the facial bones |
$194 |
$299 |
— |
$39 | |
| X-ray of the foot |
$122 |
$187 |
— |
$34 | |
| X-ray of the forearm |
$59 |
$91 |
— |
$29 | |
| X-ray of the hand |
$181 |
$278 |
— |
$38 | |
| X-ray of the hip |
$181 |
$279 |
— |
$49 | |
| X-ray of the hip (1 view) |
$58 |
$89 |
— |
$34 | |
| X-ray of the hip (3 views) |
$181 |
$279 |
— |
$49 | |
| X-ray of the hip (4 views) |
$195 |
$300 |
— |
$63 | |
| X-ray of the knee |
$125 |
$192 |
— |
$42 | |
| X-ray of the knee (2 views) |
$156 |
$240 |
— |
$34 | |
| X-ray of the knee (3 views) |
$111 |
$170 |
— |
$42 | |
| X-ray of the knee (4+ views) |
$125 |
$192 |
— |
$49 | |
| X-ray of the lower back (lumbar spine) |
$104 |
$161 |
— |
$47 | |
| X-ray of the lower back (lumbar spine) (2 views) |
$99 |
$153 |
— |
$40 | |
| X-ray of the lower back (lumbar spine) (4+ views) |
$109 |
$168 |
— |
$53 | |
| X-ray of the lower leg |
$70 |
$107 |
— |
$31 | |
| X-ray of the mid-back (thoracic spine) |
$141 |
$217 |
— |
$36 | |
| X-ray of the mid-back (thoracic spine) (2 views) |
$84 |
$129 |
— |
$33 | |
| X-ray of the mid-back (thoracic spine) (3 views) |
$198 |
$304 |
— |
$39 | |
| X-ray of the neck (cervical spine) |
$80 |
$123 |
— |
$47 | |
| X-ray of the neck (cervical spine) (3 views) |
$82 |
$126 |
— |
$40 | |
| X-ray of the pelvis |
$131 |
$202 |
— |
$36 | |
| X-ray of the pelvis (1 view) |
$64 |
$98 |
— |
$28 | |
| X-ray of the ribs |
$116 |
$178 |
— |
$42 | |
| X-ray of the ribs (2 views) |
$116 |
$178 |
— |
$36 | |
| X-ray of the ribs (3 views) |
$224 |
$344 |
— |
$42 | |
| X-ray of the shoulder |
$179 |
$275 |
— |
$36 | |
| X-ray of the skull |
$194 |
$299 |
— |
$40 | |
| X-ray of the upper arm |
$64 |
$99 |
— |
$32 | |
| X-ray of the wrist |
$164 |
$252 |
— |
$43 | |
| YAG laser capsulotomy (eye) |
— |
$0 |
— |
$335 | |
| Zinc blood test |
$31 |
$48 |
— |
$11 | |