| 3D mammogram (tomosynthesis) |
$120 |
$123 |
$123 |
$51 | |
| Abdominal fluid drain (paracentesis) |
$594 |
$594 |
$267 |
$284 | |
| Abdominal ultrasound |
$352 |
$359 |
$315 |
$100 | |
| Abdominal ultrasound (complete) |
$395 |
$403 |
$403 |
$114 | |
| Abdominal ultrasound (limited) |
$309 |
$315 |
$315 |
$86 | |
| Abscess drainage (complex or multiple) |
$445 |
$445 |
$230 |
$220 | |
| Abscess drainage (simple) |
$266 |
$266 |
$136 |
$129 | |
| Abscess incision and drainage |
$445 |
$445 |
$136 |
$174 | |
| Achilles tendon repair |
$1,393 |
$1,393 |
$709 |
$624 | |
| ACL knee reconstruction |
$2,052 |
$2,052 |
$1,049 |
$889 | |
| Adenoid removal (adenoidectomy) |
$437 |
$437 |
$231 |
$204 | |
| Albumin blood test |
$5 |
$6 |
$6 |
$5 | |
| Aldosterone test |
$68 |
$70 |
$70 |
$41 | |
| Alkaline phosphatase test |
$5 |
$6 |
$6 |
$5 | |
| ALT liver enzyme test |
$5 |
$6 |
$6 |
$5 | |
| Amniocentesis |
$249 |
$249 |
$129 |
$120 | |
| Anal fistula repair |
$1,071 |
$1,071 |
$576 |
$541 | |
| Ankle fracture repair |
$1,328 |
$1,328 |
$700 |
$608 | |
| Ankle replacement |
$2,024 |
$2,024 |
$1,035 |
$885 | |
| Annual physical (established patient) |
$267 |
$267 |
$129 |
— | |
| Annual physical (new patient) |
$358 |
$358 |
$152 |
— | |
| Anoscopy |
$239 |
$239 |
$127 |
$129 | |
| Arterial blood gas (ABG) |
$22 |
$22 |
$22 |
$26 | |
| AST liver enzyme test |
$5 |
$6 |
$6 |
$5 | |
| Barium swallow study |
$395 |
$403 |
$315 |
$107 | |
| Bartholin cyst removal |
$384 |
$384 |
$201 |
$182 | |
| Benign skin lesion removal |
$358 |
$358 |
$185 |
$171 | |
| Bladder function test (urodynamics) |
$808 |
$808 |
$410 |
$345 | |
| Bladder scope (cystoscopy) |
$457 |
$457 |
$257 |
$216 | |
| Blood clotting test (PT/INR) |
$10 |
$10 |
$4 |
$4 | |
| Blood crossmatch |
$22 |
$22 |
$22 |
— | |
| Blood glucose test |
$11 |
$11 |
$11 |
$5 | |
| Blood transfusion |
$91 |
$91 |
$46 |
$47 | |
| Bone density scan (DEXA) |
$154 |
$158 |
$158 |
$39 | |
| Bone scan (nuclear) |
$598 |
$610 |
$610 |
$259 | |
| Botox for migraine |
$324 |
$324 |
$168 |
$157 | |
| Breast biopsy |
$998 |
$998 |
$528 |
$478 | |
| Breast MRI |
$1,993 |
$2,034 |
$2,034 |
$216 | |
| Breast MRI without contrast |
$1,993 |
$2,034 |
$2,034 |
$216 | |
| Breast ultrasound |
$300 |
$306 |
$306 |
$92 | |
| Breast ultrasound (complete) |
$343 |
$350 |
$350 |
$100 | |
| Breast ultrasound (limited) |
$257 |
$263 |
$263 |
$84 | |
| Breathing tube insertion (intubation) |
$291 |
$291 |
$147 |
$133 | |
| Bronchoscopy |
$565 |
$565 |
$291 |
$303 | |
| Bunion surgery (bunionectomy) |
$1,816 |
$1,816 |
$942 |
$883 | |
| Burn dressing and debridement (medium) |
$1,300 |
$1,327 |
$1,327 |
$166 | |
| Burn dressing and debridement (small) |
$180 |
$180 |
$70 |
$93 | |
| Burn treatment |
$647 |
$659 |
$70 |
$129 | |
| Calcium blood test |
$5 |
$6 |
$6 |
$5 | |
| Capsule endoscopy |
$1,450 |
$1,450 |
$782 |
$802 | |
| Cardiac MRI |
$888 |
$906 |
$906 |
$322 | |
| Cardiac MRI without contrast |
$888 |
$906 |
$906 |
$280 | |
| Cardioversion |
$315 |
$315 |
$155 |
$155 | |
| Carotid artery ultrasound |
$444 |
$449 |
$204 |
$156 | |
| Carpal tunnel release |
$953 |
$953 |
$486 |
$483 | |
| Cataract surgery |
$1,310 |
$1,310 |
$723 |
$547 | |
| Central line placement |
$431 |
$431 |
$194 |
$238 | |
| Cervical cerclage |
$322 |
$322 |
$165 |
$137 | |
| Cervical LEEP procedure |
$717 |
$717 |
$330 |
$325 | |
| Chalazion (eyelid cyst) removal |
$267 |
$267 |
$137 |
$131 | |
| Chemotherapy infusion |
$258 |
$258 |
$126 |
$81 | |
| Chemotherapy infusion (each additional) |
$55 |
$55 |
$30 |
$28 | |
| Chemotherapy infusion (first hour) |
$258 |
$258 |
$139 |
$133 | |
| Chest fluid drain (thoracentesis) |
$636 |
$636 |
$333 |
$311 | |
| Chest tube insertion |
$319 |
$319 |
$163 |
$143 | |
| Chest X-ray |
$78 |
$79 |
$36 |
$37 | |
| Chest X-ray (1 view) |
$55 |
$55 |
$27 |
$25 | |
| Chest X-ray (2 views) |
$70 |
$70 |
$36 |
$33 | |
| Chickenpox (varicella) vaccine |
$240 |
$240 |
$145 |
— | |
| Circumcision |
$307 |
$307 |
$158 |
$167 | |
| Colon resection (colectomy) |
$2,791 |
$2,791 |
$1,439 |
$1,238 | |
| Colonoscopy |
$888 |
$888 |
$463 |
$480 | |
| Colostomy |
$2,511 |
$2,511 |
$1,286 |
$1,122 | |
| Colposcopy |
$337 |
$337 |
$174 |
$161 | |
| Comprehensive eye exam |
$280 |
$283 |
$133 |
$138 | |
| Continuous glucose monitor setup |
$70 |
$70 |
$36 |
$35 | |
| Contraceptive implant (Nexplanon) |
$230 |
$230 |
$152 |
$115 | |
| Coronary CT angiography |
$459 |
$468 |
$468 |
$326 | |
| CPAP titration study |
$403 |
$411 |
$411 |
$69 | |
| Craniotomy (brain surgery) |
$4,775 |
$4,775 |
$2,447 |
$2,161 | |
| Creatine kinase (CK) test |
$16 |
$17 |
$17 |
$7 | |
| CT angiography of the chest |
$319 |
$325 |
$325 |
$281 | |
| CT angiography of the head |
$313 |
$320 |
$320 |
$274 | |
| CT colonography (virtual colonoscopy) |
$972 |
$992 |
$992 |
$835 | |
| CT scan of the abdomen |
$254 |
$259 |
$259 |
$230 | |
| CT scan of the abdomen and pelvis |
$335 |
$342 |
$342 |
$300 | |
| CT scan of the abdomen and pelvis with and without contrast |
$383 |
$391 |
$391 |
$338 | |
| CT scan of the abdomen and pelvis with contrast |
$335 |
$342 |
$342 |
$300 | |
| CT scan of the abdomen with and without contrast |
$292 |
$298 |
$298 |
$259 | |
| CT scan of the abdomen with contrast |
$254 |
$259 |
$259 |
$230 | |
| CT scan of the abdomen without contrast |
$135 |
$138 |
$138 |
$136 | |
| CT scan of the arm |
$325 |
$325 |
$177 |
$199 | |
| CT scan of the arm with contrast |
$248 |
$254 |
$254 |
$199 | |
| CT scan of the arm without contrast |
$325 |
$325 |
$177 |
$161 | |
| CT scan of the chest |
$254 |
$259 |
$259 |
$167 | |
| CT scan of the chest with and without contrast |
$313 |
$320 |
$320 |
$196 | |
| CT scan of the chest with contrast |
$254 |
$259 |
$259 |
$167 | |
| CT scan of the chest without contrast |
$194 |
$198 |
$198 |
$133 | |
| CT scan of the head |
$162 |
$165 |
$165 |
$148 | |
| CT scan of the head with and without contrast |
$194 |
$198 |
$198 |
$173 | |
| CT scan of the head with contrast |
$162 |
$165 |
$165 |
$148 | |
| CT scan of the leg |
$254 |
$259 |
$259 |
$166 | |
| CT scan of the leg with contrast |
$254 |
$259 |
$259 |
$166 | |
| CT scan of the leg without contrast |
$194 |
$198 |
$198 |
$130 | |
| CT scan of the lower back (lumbar spine) |
$254 |
$259 |
$259 |
$169 | |
| CT scan of the lower back (lumbar spine) with and without contrast |
$313 |
$320 |
$320 |
$197 | |
| CT scan of the lower back (lumbar spine) with contrast |
$254 |
$259 |
$259 |
$169 | |
| CT scan of the lower back (lumbar spine) without contrast |
$194 |
$198 |
$198 |
$130 | |
| CT scan of the neck |
$254 |
$259 |
$259 |
$183 | |
| CT scan of the neck (cervical spine) |
$254 |
$259 |
$259 |
$168 | |
| CT scan of the neck (cervical spine) with and without contrast |
$313 |
$320 |
$320 |
$196 | |
| CT scan of the neck (cervical spine) with contrast |
$254 |
$259 |
$259 |
$168 | |
| CT scan of the neck (cervical spine) without contrast |
$200 |
$204 |
$204 |
$131 | |
| CT scan of the neck with and without contrast |
$313 |
$320 |
$320 |
$220 | |
| CT scan of the neck with contrast |
$254 |
$259 |
$259 |
$183 | |
| CT scan of the neck without contrast |
$194 |
$198 |
$198 |
$150 | |
| CT scan of the pelvis |
$254 |
$259 |
$259 |
$226 | |
| CT scan of the pelvis with and without contrast |
$302 |
$309 |
$309 |
$251 | |
| CT scan of the pelvis with contrast |
$254 |
$259 |
$259 |
$226 | |
| CT scan of the pelvis without contrast |
$140 |
$143 |
$143 |
$133 | |
| CT scan of the sinuses |
$167 |
$171 |
$171 |
$152 | |
| CT scan of the sinuses with and without contrast |
$216 |
$220 |
$220 |
$184 | |
| CT scan of the sinuses with contrast |
$167 |
$171 |
$171 |
$152 | |
| CT scan of the sinuses without contrast |
$146 |
$149 |
$149 |
$128 | |
| Developmental screening (child) |
$26 |
$26 |
$10 |
— | |
| Diagnostic mammogram |
$515 |
$525 |
$525 |
$140 | |
| Dilation and curettage (D&C) |
$619 |
$619 |
$321 |
$298 | |
| Droopy eyelid repair (ptosis) |
$1,510 |
$1,510 |
$784 |
$745 | |
| Drug screen (urine) |
$22 |
$22 |
$104 |
$17 | |
| Ear pressure test (tympanometry) |
$33 |
$33 |
$17 |
$16 | |
| Ear tubes (myringotomy) |
$378 |
$378 |
$175 |
$174 | |
| Eardrum repair (tympanoplasty) |
$1,841 |
$1,841 |
$957 |
$799 | |
| Echocardiogram |
$160 |
$163 |
$163 |
$138 | |
| Echocardiogram without contrast |
$257 |
$263 |
$263 |
$138 | |
| EEG (awake and asleep) |
$941 |
$941 |
$489 |
$482 | |
| EKG / ECG (tracing only) |
$32 |
$33 |
$33 |
$7 | |
| Electrocardiogram (EKG) |
$30 |
$30 |
$15 |
$8 | |
| Electroencephalogram (EEG) |
$941 |
$941 |
$468 |
$448 | |
| Electromyography (EMG) |
$465 |
$474 |
$474 |
$141 | |
| Emergency department visit |
$158 |
$161 |
$126 |
$69 | |
| Emergency department visit (level 1) |
$24 |
$24 |
$16 |
$11 | |
| Emergency department visit (level 2) |
$86 |
$86 |
$46 |
$40 | |
| Emergency department visit (level 3) |
$144 |
$144 |
$74 |
$69 | |
| Emergency department visit (level 4) |
$246 |
$246 |
$126 |
$118 | |
| Emergency department visit (level 5) |
$356 |
$356 |
$291 |
$171 | |
| Endometrial biopsy |
$209 |
$209 |
$109 |
$98 | |
| Epidural steroid injection |
$533 |
$533 |
$281 |
$275 | |
| ERCP (bile duct endoscopy) |
$721 |
$721 |
$378 |
$311 | |
| Esophageal dilation |
$389 |
$389 |
$200 |
$522 | |
| Estradiol (estrogen) test |
$41 |
$42 |
$42 |
$28 | |
| Eye refraction (glasses prescription) |
$50 |
$50 |
$20 |
— | |
| Eyelid surgery (blepharoplasty) |
$1,280 |
$1,280 |
$662 |
$552 | |
| Facet joint injection (spine) |
$188 |
$188 |
$125 |
$99 | |
| Fallopian tube X-ray (HSG) |
$486 |
$486 |
$260 |
$164 | |
| Fecal occult blood (stool) test |
$50 |
$50 |
$17 |
$10 | |
| Fecal occult blood (stool) test (immunochemical, FIT) |
$50 |
$50 |
$17 |
$16 | |
| Feeding tube (PEG) placement |
$410 |
$410 |
$210 |
$178 | |
| Femoral hernia repair |
$1,286 |
$1,286 |
$685 |
$584 | |
| Ferritin (iron) test |
$41 |
$42 |
$42 |
$14 | |
| Fibroid removal (myomectomy) |
$2,395 |
$2,395 |
$1,234 |
$914 | |
| Flexible sigmoidoscopy |
$487 |
$487 |
$206 |
$323 | |
| Flu test |
$33 |
$33 |
$14 |
$17 | |
| Folate (folic acid) test |
$41 |
$42 |
$42 |
$15 | |
| Foreign body removal (skin) |
$315 |
$315 |
$164 |
$157 | |
| FSH hormone test |
$41 |
$42 |
$42 |
$19 | |
| Gallbladder removal (laparoscopic) |
$1,461 |
$1,461 |
$715 |
$658 | |
| Gallbladder scan (HIDA) |
$1,000 |
$1,021 |
$1,021 |
$334 | |
| GGT liver test |
$5 |
$6 |
$6 |
$7 | |
| Glucose tolerance test |
$11 |
$11 |
$11 |
$8 | |
| Hammertoe repair |
$1,121 |
$1,121 |
$576 |
$548 | |
| Hearing test (audiometry) |
$75 |
$75 |
$38 |
$36 | |
| Hemodialysis |
$2,082 |
$2,124 |
$2,124 |
$75 | |
| Hemoglobin A1c (diabetes test) |
$26 |
$26 |
$10 |
$10 | |
| Hemorrhoid removal |
$660 |
$660 |
$304 |
$338 | |
| Hepatitis A vaccine |
$154 |
$154 |
$72 |
— | |
| Hepatitis B vaccine |
$126 |
$126 |
$70 |
— | |
| Hip fracture repair |
$2,585 |
$2,585 |
$1,319 |
$1,120 | |
| Hip replacement |
$2,702 |
$2,702 |
$1,379 |
$1,162 | |
| Home sleep apnea test |
$267 |
$267 |
$145 |
$123 | |
| HPV vaccine |
$515 |
$515 |
$242 |
— | |
| Hysterectomy |
$2,006 |
$2,006 |
$1,088 |
$933 | |
| Hysteroscopy |
$2,598 |
$2,598 |
$1,417 |
$1,270 | |
| Ileostomy |
$2,171 |
$2,171 |
$1,111 |
$968 | |
| Inguinal hernia repair |
$1,180 |
$1,180 |
$638 |
$538 | |
| Iron blood test |
$16 |
$17 |
$17 |
$6 | |
| IUD insertion |
$177 |
$177 |
$158 |
— | |
| IUD removal |
$228 |
$228 |
$119 |
$112 | |
| IV infusion therapy |
$125 |
$125 |
$57 |
$44 | |
| IV infusion therapy (each additional) |
$42 |
$42 |
$22 |
$21 | |
| IV infusion therapy (initial) |
$125 |
$125 |
$67 |
$67 | |
| Joint aspiration (small/intermediate) |
$113 |
$113 |
$59 |
$57 | |
| Joint aspiration or injection (mid-size joint) |
$114 |
$114 |
$59 |
$57 | |
| Joint aspiration or injection (small joint) |
$112 |
$112 |
$58 |
$56 | |
| Kidney removal (nephrectomy) |
$2,732 |
$2,732 |
$1,397 |
$1,164 | |
| Kidney scan (nuclear) |
$333 |
$340 |
$340 |
$172 | |
| Kidney stone shock-wave (lithotripsy) |
$3,470 |
$3,541 |
$3,541 |
$760 | |
| Kidney ultrasound |
$257 |
$263 |
$263 |
$84 | |
| Kidney ultrasound (limited) |
$137 |
$140 |
$140 |
$61 | |
| Knee arthroscopy |
$1,177 |
$1,177 |
$611 |
$524 | |
| Knee joint injection |
$136 |
$136 |
$70 |
$69 | |
| Laminectomy (spine) |
$2,576 |
$2,576 |
$1,421 |
$1,157 | |
| Laryngoscopy |
$519 |
$519 |
$138 |
$189 | |
| LDH test |
$11 |
$11 |
$11 |
$6 | |
| Leg vein ultrasound (Doppler) |
$385 |
$385 |
$169 |
$150 | |
| Leg vein ultrasound (Doppler) (limited) |
$246 |
$246 |
$128 |
$116 | |
| Lipase test |
$22 |
$22 |
$22 |
$7 | |
| Lumbar discectomy |
$1,970 |
$1,970 |
$1,006 |
$898 | |
| Lumpectomy (breast) |
$1,395 |
$1,395 |
$715 |
$750 | |
| Lung function test (PFT) |
$82 |
$82 |
$42 |
$37 | |
| Lung scan (V/Q) |
$804 |
$821 |
$821 |
$291 | |
| Mastectomy |
$2,027 |
$2,027 |
$1,036 |
$1,021 | |
| Meniscus repair (knee) |
$1,463 |
$1,463 |
$746 |
$714 | |
| MMR vaccine |
$125 |
$125 |
$82 |
— | |
| MRA of the brain |
$1,448 |
$1,478 |
$1,478 |
$226 | |
| MRA of the brain with contrast |
$1,432 |
$1,462 |
$1,462 |
$226 | |
| MRA of the brain without contrast |
$2,227 |
$2,272 |
$2,272 |
$328 | |
| MRA of the neck |
$1,541 |
$1,573 |
$1,573 |
$245 | |
| MRA of the neck with contrast |
$1,541 |
$1,573 |
$1,573 |
$245 | |
| MRA of the neck without contrast |
$2,242 |
$2,288 |
$2,288 |
$343 | |
| MRI of the abdomen |
$1,604 |
$1,636 |
$1,636 |
$300 | |
| MRI of the abdomen with contrast |
$1,604 |
$1,636 |
$1,636 |
$300 | |
| MRI of the abdomen without contrast |
$1,137 |
$1,160 |
$1,160 |
$194 | |
| MRI of the ankle |
$1,417 |
$1,446 |
$1,446 |
$261 | |
| MRI of the ankle with contrast |
$1,417 |
$1,446 |
$1,446 |
$261 | |
| MRI of the ankle without contrast |
$1,292 |
$1,319 |
$1,319 |
$222 | |
| MRI of the brain |
$1,012 |
$1,033 |
$1,033 |
$269 | |
| MRI of the brain with contrast |
$1,012 |
$1,033 |
$1,033 |
$269 | |
| MRI of the brain without contrast |
$685 |
$699 |
$699 |
$195 | |
| MRI of the chest |
$1,635 |
$1,668 |
$1,668 |
$371 | |
| MRI of the chest with contrast |
$1,635 |
$1,668 |
$1,668 |
$371 | |
| MRI of the chest without contrast |
$2,040 |
$2,081 |
$2,081 |
$466 | |
| MRI of the knee |
$1,308 |
$1,335 |
$1,335 |
$315 | |
| MRI of the knee with contrast |
$1,308 |
$1,335 |
$1,335 |
$315 | |
| MRI of the knee without contrast |
$732 |
$747 |
$747 |
$204 | |
| MRI of the lower back (lumbar spine) |
$1,012 |
$1,033 |
$1,033 |
$270 | |
| MRI of the lower back (lumbar spine) with contrast |
$1,012 |
$1,033 |
$1,033 |
$270 | |
| MRI of the lower back (lumbar spine) without contrast |
$654 |
$667 |
$667 |
$192 | |
| MRI of the mid-back (thoracic spine) |
$1,028 |
$1,049 |
$1,049 |
$271 | |
| MRI of the mid-back (thoracic spine) with and without contrast |
$1,168 |
$1,192 |
$1,192 |
$319 | |
| MRI of the mid-back (thoracic spine) with contrast |
$1,028 |
$1,049 |
$1,049 |
$271 | |
| MRI of the mid-back (thoracic spine) without contrast |
$654 |
$667 |
$667 |
$190 | |
| MRI of the neck (cervical spine) |
$1,028 |
$1,049 |
$1,049 |
$274 | |
| MRI of the neck (cervical spine) with and without contrast |
$1,152 |
$1,176 |
$1,176 |
$318 | |
| MRI of the neck (cervical spine) with contrast |
$1,028 |
$1,049 |
$1,049 |
$274 | |
| MRI of the neck (cervical spine) without contrast |
$654 |
$667 |
$667 |
$191 | |
| MRI of the pelvis |
$1,417 |
$1,446 |
$1,597 |
$268 | |
| MRI of the pelvis with contrast |
$1,417 |
$1,446 |
$1,446 |
$268 | |
| MRI of the pelvis without contrast |
$1,323 |
$1,350 |
$1,350 |
$227 | |
| MRI of the shoulder |
$1,292 |
$1,319 |
$1,319 |
$313 | |
| MRI of the shoulder with contrast |
$1,292 |
$1,319 |
$1,319 |
$313 | |
| MRI of the shoulder without contrast |
$732 |
$747 |
$747 |
$205 | |
| MRI of the wrist |
$1,401 |
$1,430 |
$1,430 |
$330 | |
| MRI of the wrist with contrast |
$1,401 |
$1,430 |
$1,430 |
$330 | |
| MRI of the wrist without contrast |
$1,308 |
$1,335 |
$1,335 |
$303 | |
| Neck (cervical) spinal fusion |
$3,173 |
$3,173 |
$1,731 |
$1,410 | |
| Nerve conduction study |
$273 |
$273 |
$119 |
$118 | |
| Newborn hospital care |
$134 |
$134 |
$82 |
$58 | |
| Nuchal translucency ultrasound |
$234 |
$234 |
$123 |
$116 | |
| Nuclear cardiac stress test |
$1,128 |
$1,151 |
$1,151 |
$428 | |
| Occupational therapy evaluation |
$212 |
$212 |
$106 |
$101 | |
| Occupational therapy evaluation (high complexity) |
$183 |
$187 |
$187 |
$101 | |
| Occupational therapy evaluation (low complexity) |
$212 |
$212 |
$106 |
$101 | |
| Occupational therapy evaluation (moderate complexity) |
$212 |
$212 |
$106 |
$101 | |
| Office visit (established patient) |
$261 |
$264 |
$121 |
$115 | |
| Office visit (new patient) |
$347 |
$347 |
$177 |
$177 | |
| Office visit, established patient (level 3) |
$189 |
$189 |
$96 |
$95 | |
| Office visit, established patient (level 4) |
$265 |
$265 |
$136 |
$136 | |
| Office visit, new patient (level 3) |
$232 |
$232 |
$121 |
$118 | |
| Office visit, new patient (level 4) |
$347 |
$347 |
$182 |
$177 | |
| Office visit, new patient (level 5) |
$458 |
$458 |
$233 |
$237 | |
| Orthopedic hardware removal |
$1,250 |
$1,250 |
$647 |
$632 | |
| Ovarian cyst removal |
$1,608 |
$1,608 |
$825 |
$698 | |
| Ovary removal (oophorectomy) |
$2,505 |
$2,505 |
$1,288 |
$822 | |
| Parathyroid removal |
$2,038 |
$2,038 |
$1,044 |
$891 | |
| Pelvic ultrasound |
$169 |
$170 |
$112 |
$78 | |
| Pelvic ultrasound (complete) |
$218 |
$218 |
$112 |
$105 | |
| Pelvic ultrasound (limited) |
$104 |
$104 |
$52 |
$51 | |
| PET scan |
$4,560 |
$4,653 |
$4,653 |
— | |
| Phosphorus blood test |
$5 |
$6 |
$6 |
$5 | |
| Physical therapy evaluation |
$207 |
$207 |
$105 |
$98 | |
| Physical therapy evaluation (high complexity) |
$198 |
$202 |
$202 |
$98 | |
| Physical therapy evaluation (moderate complexity) |
$207 |
$207 |
$105 |
$98 | |
| Pilonidal cyst removal |
$1,021 |
$1,021 |
$490 |
$541 | |
| Pneumonia vaccine |
$76 |
$76 |
$133 |
— | |
| Pregnancy ultrasound |
$278 |
$278 |
$139 |
$126 | |
| Pregnancy ultrasound (first trimester) |
$241 |
$241 |
$125 |
$117 | |
| Pregnancy ultrasound (second or third trimester) |
$278 |
$278 |
$145 |
$136 | |
| Prostate removal (prostatectomy) |
$2,451 |
$2,451 |
$1,253 |
$1,063 | |
| Radiofrequency nerve ablation |
$899 |
$899 |
$472 |
$462 | |
| Retina scan (OCT) |
$67 |
$67 |
$43 |
$33 | |
| Retinal (fundus) photography |
$76 |
$76 |
$39 |
$37 | |
| Rotator cuff repair |
$2,252 |
$2,252 |
$1,151 |
$792 | |
| Routine eye exam |
$182 |
$182 |
$90 |
$88 | |
| Sacroiliac joint injection |
$340 |
$340 |
$175 |
$176 | |
| Scoliosis spine X-ray |
$172 |
$175 |
$175 |
$58 | |
| Scoliosis spine X-ray (1 view) |
$120 |
$123 |
$123 |
$44 | |
| Scoliosis spine X-ray (3 views) |
$223 |
$228 |
$228 |
$72 | |
| Screening colonoscopy |
$702 |
$702 |
$363 |
$378 | |
| Screening mammogram |
$481 |
$490 |
$490 |
$126 | |
| Scrotal ultrasound |
$172 |
$175 |
$175 |
$99 | |
| Septoplasty (deviated septum) |
$1,399 |
$1,399 |
$728 |
$613 | |
| Shingles vaccine |
$361 |
$361 |
$165 |
— | |
| Shoulder replacement |
$3,033 |
$3,033 |
$1,549 |
$1,300 | |
| Simple laceration repair (small, up to 2.5 cm) |
$196 |
$196 |
$88 |
$114 | |
| Simple wound stitches |
$218 |
$218 |
$113 |
$127 | |
| Sinus surgery (endoscopic) |
$546 |
$546 |
$280 |
$224 | |
| Skin biopsy |
$256 |
$256 |
$134 |
$121 | |
| Skin biopsy (punch) |
$256 |
$256 |
$134 |
$121 | |
| Skin cancer lesion removal |
$544 |
$544 |
$298 |
$240 | |
| Skin graft |
$1,790 |
$1,790 |
$933 |
$898 | |
| Skin lesion freezing (cryotherapy) |
$78 |
$78 |
$13 |
$36 | |
| Skin tag removal |
$193 |
$193 |
$99 |
$92 | |
| Sleep study (polysomnography) |
$1,368 |
$1,368 |
$699 |
$691 | |
| Small bowel resection |
$2,564 |
$2,564 |
$1,312 |
$1,136 | |
| Soft tissue ultrasound |
$51 |
$53 |
$53 |
$64 | |
| Speech therapy |
$158 |
$158 |
$80 |
$76 | |
| Spinal tap (lumbar puncture) |
$306 |
$306 |
$142 |
$165 | |
| Spine fracture repair (kyphoplasty) |
$11,191 |
$11,191 |
$6,035 |
$5,803 | |
| Spirometry (lung function test) |
$57 |
$57 |
$29 |
$30 | |
| Spirometry with bronchodilator |
$82 |
$82 |
$42 |
$43 | |
| Strabismus (eye muscle) surgery |
$1,142 |
$1,142 |
$695 |
$475 | |
| Strep throat test |
$54 |
$54 |
$12 |
$17 | |
| Stress echocardiogram |
$160 |
$163 |
$163 |
$209 | |
| Swallow study |
$176 |
$176 |
$90 |
$85 | |
| Tdap (tetanus) vaccine |
$60 |
$60 |
$39 |
— | |
| Testosterone test |
$41 |
$42 |
$42 |
$26 | |
| Thyroid removal (thyroidectomy) |
$2,337 |
$2,337 |
$1,280 |
$1,004 | |
| Thyroid ultrasound |
$228 |
$228 |
$118 |
$109 | |
| Thyroid uptake scan |
$412 |
$420 |
$420 |
$145 | |
| Tonsillectomy |
$614 |
$614 |
$314 |
$252 | |
| Total protein test |
$5 |
$6 |
$6 |
$4 | |
| Tracheostomy |
$628 |
$628 |
$323 |
$273 | |
| Transvaginal ultrasound |
$245 |
$245 |
$128 |
$118 | |
| Trigger point injection |
$117 |
$117 |
$65 |
$56 | |
| Trigger point injection (1-2 muscles) |
$109 |
$109 |
$56 |
$52 | |
| Triglycerides test |
$5 |
$6 |
$6 |
$6 | |
| Turbinate reduction |
$616 |
$616 |
$312 |
$294 | |
| Turning a breech baby (version) |
$2,021 |
$2,062 |
$2,062 |
$94 | |
| Upper GI endoscopy (EGD) |
$679 |
$679 |
$400 |
$371 | |
| Upper GI series (barium) |
$412 |
$420 |
$420 |
$128 | |
| Uric acid (gout) test |
$5 |
$6 |
$6 |
$5 | |
| Urine pregnancy test |
$17 |
$17 |
$8 |
$9 | |
| Vaccine administration |
$31 |
$31 |
$22 |
$19 | |
| Vaccine administration (each additional) |
$31 |
$31 |
$16 |
$16 | |
| Varicose vein ablation |
$2,132 |
$2,132 |
$1,136 |
$1,018 | |
| Visual field test |
$131 |
$131 |
$67 |
$64 | |
| Vitamin B12 test |
$41 |
$42 |
$42 |
$15 | |
| Vitamin D test |
$41 |
$42 |
$42 |
$30 | |
| Vocal cord injection |
$513 |
$513 |
$262 |
$211 | |
| Wart removal |
$236 |
$236 |
$122 |
$121 | |
| Well-child visit |
$231 |
$231 |
$114 |
— | |
| Wound debridement |
$483 |
$483 |
$150 |
$186 | |
| X-ray of the abdomen |
$73 |
$74 |
$38 |
$36 | |
| X-ray of the ankle |
$76 |
$76 |
$39 |
$37 | |
| X-ray of the collarbone |
$69 |
$69 |
$35 |
$33 | |
| X-ray of the elbow |
$68 |
$68 |
$35 |
$33 | |
| X-ray of the facial bones |
$97 |
$97 |
$51 |
$39 | |
| X-ray of the foot |
$71 |
$71 |
$37 |
$34 | |
| X-ray of the forearm |
$62 |
$62 |
$31 |
$29 | |
| X-ray of the hand |
$78 |
$78 |
$40 |
$38 | |
| X-ray of the hip |
$100 |
$100 |
$51 |
$49 | |
| X-ray of the hip (1 view) |
$70 |
$70 |
$35 |
$34 | |
| X-ray of the hip (3 views) |
$100 |
$100 |
$51 |
$49 | |
| X-ray of the knee |
$99 |
$99 |
$44 |
$42 | |
| X-ray of the knee (2 views) |
$71 |
$71 |
$37 |
$34 | |
| X-ray of the knee (3 views) |
$85 |
$85 |
$44 |
$42 | |
| X-ray of the knee (4+ views) |
$99 |
$99 |
$51 |
$49 | |
| X-ray of the lower back (lumbar spine) |
$102 |
$103 |
$43 |
$47 | |
| X-ray of the lower back (lumbar spine) (2 views) |
$83 |
$83 |
$43 |
$40 | |
| X-ray of the lower back (lumbar spine) (4+ views) |
$154 |
$158 |
$158 |
$53 | |
| X-ray of the lower leg |
$66 |
$66 |
$34 |
$31 | |
| X-ray of the mid-back (thoracic spine) |
$82 |
$82 |
$35 |
$36 | |
| X-ray of the mid-back (thoracic spine) (2 views) |
$69 |
$69 |
$35 |
$33 | |
| X-ray of the mid-back (thoracic spine) (3 views) |
$82 |
$82 |
$42 |
$39 | |
| X-ray of the neck (cervical spine) |
$108 |
$109 |
$42 |
$47 | |
| X-ray of the neck (cervical spine) (3 views) |
$83 |
$83 |
$42 |
$40 | |
| X-ray of the pelvis |
$88 |
$88 |
$43 |
$36 | |
| X-ray of the pelvis (1 view) |
$59 |
$59 |
$30 |
$28 | |
| X-ray of the ribs |
$91 |
$91 |
$45 |
$42 | |
| X-ray of the ribs (2 views) |
$77 |
$77 |
$39 |
$36 | |
| X-ray of the ribs (3 views) |
$88 |
$88 |
$45 |
$42 | |
| X-ray of the shoulder |
$73 |
$73 |
$37 |
$36 | |
| X-ray of the skull |
$129 |
$131 |
$131 |
$40 | |
| X-ray of the thigh bone |
$51 |
$53 |
$53 |
— | |
| X-ray of the upper arm |
$67 |
$67 |
$34 |
$32 | |
| X-ray of the wrist |
$87 |
$87 |
$44 |
$43 | |
| YAG laser capsulotomy (eye) |
$681 |
$681 |
$353 |
$335 | |