| 3D mammogram (tomosynthesis) |
— |
— |
$129 |
$51 | |
| Abdominal fluid drain (paracentesis) |
— |
— |
$2,947 |
$284 | |
| Abdominal ultrasound |
$3,027 |
$3,027 |
$1,829 |
$100 | |
| Abdominal ultrasound (complete) |
$4,064 |
$4,064 |
$1,829 |
$114 | |
| Abdominal ultrasound (limited) |
$3,027 |
$3,027 |
$1,598 |
$86 | |
| Abscess drainage (complex or multiple) |
— |
— |
$2,716 |
$220 | |
| Abscess drainage (simple) |
— |
— |
$2,716 |
$129 | |
| Abscess incision and drainage |
— |
— |
$2,716 |
$174 | |
| Achilles tendon repair |
— |
— |
$6,194 |
$624 | |
| ACL knee reconstruction |
— |
— |
$8,700 |
$889 | |
| Acupuncture |
— |
— |
$48 |
$38 | |
| Adenoid removal (adenoidectomy) |
— |
— |
$5,806 |
$204 | |
| Alkaline phosphatase test |
$297 |
$297 |
$25 |
$5 | |
| Allergy patch testing |
— |
— |
$1,677 |
$5 | |
| Allergy shots |
— |
— |
$76 |
$11 | |
| Allergy testing |
— |
— |
$1,677 |
$4 | |
| Amniocentesis |
— |
— |
$2,909 |
$120 | |
| Amylase test |
$567 |
$567 |
$31 |
$6 | |
| Anal fistula repair |
— |
— |
$4,821 |
$541 | |
| Ankle fracture repair |
— |
— |
$9,527 |
$608 | |
| Ankle replacement |
— |
— |
$15,398 |
$885 | |
| Anoscopy |
— |
— |
$2,716 |
$129 | |
| Antinuclear antibody (ANA) test |
$550 |
$550 |
$57 |
$12 | |
| Aortic aneurysm repair (AAA) |
— |
— |
$8,655 |
$1,345 | |
| Aortic valve replacement |
— |
— |
$9,449 |
$1,603 | |
| Arterial blood gas (ABG) |
$612 |
$612 |
$186 |
$26 | |
| Barium swallow study |
$3,428 |
$3,428 |
$402 |
$107 | |
| Bartholin cyst removal |
— |
— |
$2,716 |
$182 | |
| Basic metabolic panel |
$924 |
$924 |
$40 |
$8 | |
| Benign skin lesion removal |
— |
— |
$2,716 |
$171 | |
| Bladder function test (urodynamics) |
— |
— |
$1,563 |
$345 | |
| Bladder scope (cystoscopy) |
— |
— |
$2,716 |
$216 | |
| Bladder tumor removal (TURBT) |
— |
— |
$5,590 |
$236 | |
| Blood crossmatch |
$291 |
$291 |
$204 |
— | |
| Blood transfusion |
$1,503 |
$1,503 |
$2,082 |
$47 | |
| Blood type and screen |
$620 |
$620 |
$24 |
$10 | |
| Blood type test |
$194 |
$194 |
$14 |
$3 | |
| Blood type test (ABO group) |
$194 |
$194 |
$14 |
$3 | |
| Blood type test (Rh/D antigen) |
$194 |
$194 |
$14 |
$3 | |
| BNP (heart failure) test |
$681 |
$681 |
$128 |
$39 | |
| Bone density scan (DEXA) |
$1,307 |
$1,307 |
$185 |
$39 | |
| Bone marrow biopsy |
— |
— |
$3,697 |
$172 | |
| Bone scan (nuclear) |
$11,069 |
$11,069 |
$1,249 |
$259 | |
| Botox for migraine |
— |
— |
$2,716 |
$157 | |
| Brain shunt (VP shunt) |
— |
— |
$5,680 |
$1,023 | |
| Breast biopsy |
— |
— |
$4,142 |
$478 | |
| Breast MRI |
— |
— |
$533 |
$216 | |
| Breast MRI without contrast |
— |
— |
$518 |
$216 | |
| Breast reconstruction |
— |
— |
$16,626 |
$1,227 | |
| Breast reduction |
— |
— |
$8,809 |
$980 | |
| Breast ultrasound |
$1,107 |
$1,107 |
$685 |
$92 | |
| Breast ultrasound (complete) |
$1,039 |
$1,039 |
$665 |
$100 | |
| Breast ultrasound (limited) |
$1,142 |
$1,142 |
$696 |
$84 | |
| Breathing tube insertion (intubation) |
— |
— |
$2,716 |
$133 | |
| Bronchoscopy |
— |
— |
$4,765 |
$303 | |
| Bunion surgery (bunionectomy) |
— |
— |
$6,194 |
$883 | |
| Burn dressing and debridement (medium) |
— |
— |
$2,716 |
$166 | |
| Burn dressing and debridement (small) |
— |
— |
$2,716 |
$93 | |
| Burn treatment |
— |
— |
$2,716 |
$129 | |
| C-reactive protein (CRP) |
$507 |
$507 |
$25 |
$5 | |
| CA 19-9 tumor marker test |
$737 |
$737 |
$51 |
$21 | |
| CA-125 ovarian marker test |
$1,091 |
$1,091 |
$51 |
$21 | |
| Capsule endoscopy |
$3,563 |
$3,563 |
$2,744 |
$802 | |
| Cardiac ablation |
$139,090 |
$139,090 |
$24,283 |
$759 | |
| Cardiac catheterization |
— |
— |
$13,638 |
$1,049 | |
| Cardiac MRI |
$13,158 |
$13,158 |
$907 |
$322 | |
| Cardiac MRI without contrast |
$10,705 |
$10,705 |
$711 |
$280 | |
| Cardiac rehabilitation |
— |
— |
$212 |
$26 | |
| Cardiac stress test |
$3,616 |
$3,616 |
$1,782 |
$39 | |
| Cardioversion |
$8,714 |
$8,714 |
$4,272 |
$155 | |
| Carotid artery surgery |
— |
— |
$6,699 |
$1,026 | |
| Carotid artery ultrasound |
$5,908 |
$5,908 |
$2,600 |
$156 | |
| Carpal tunnel release |
— |
— |
$4,063 |
$483 | |
| Cataract surgery |
— |
— |
$6,719 |
$547 | |
| CEA tumor marker test |
$1,108 |
$1,108 |
$46 |
$19 | |
| Celiac disease test |
$383 |
$383 |
$36 |
$12 | |
| Central line placement |
— |
— |
$11,929 |
$238 | |
| Cervical cerclage |
— |
— |
$4,811 |
$137 | |
| Cervical LEEP procedure |
— |
— |
$4,955 |
$325 | |
| Cesarean section (C-section) |
— |
— |
$1,680 |
$7,552 | |
| Chalazion (eyelid cyst) removal |
— |
— |
$2,716 |
$131 | |
| Chemotherapy infusion |
$1,546 |
$1,546 |
$554 |
$81 | |
| Chemotherapy infusion (each additional) |
$791 |
$791 |
$418 |
$28 | |
| Chemotherapy infusion (first hour) |
$2,300 |
$2,300 |
$1,214 |
$133 | |
| Chest fluid drain (thoracentesis) |
— |
— |
$2,716 |
$311 | |
| Chest tube insertion |
— |
— |
$2,909 |
$143 | |
| Chest X-ray |
$2,147 |
$2,147 |
$245 |
$37 | |
| Chest X-ray (1 view) |
$1,741 |
$1,741 |
$222 |
$25 | |
| Chest X-ray (2 views) |
$1,909 |
$1,909 |
$222 |
$33 | |
| Chickenpox (varicella) vaccine |
$2,135 |
$2,135 |
$691 |
— | |
| Chiropractic adjustment |
— |
— |
$42 |
$38 | |
| Circumcision |
— |
— |
$3,697 |
$167 | |
| CK-MB heart enzyme test |
$224 |
$224 |
$36 |
$12 | |
| Clotting time test (PTT) |
$439 |
$439 |
$29 |
$6 | |
| Colon resection (colectomy) |
— |
— |
$7,644 |
$1,238 | |
| Colonoscopy |
— |
— |
$3,880 |
$480 | |
| Colostomy |
— |
— |
$5,680 |
$1,122 | |
| Colposcopy |
— |
— |
$2,716 |
$161 | |
| Complete blood count (CBC) |
$338 |
$338 |
$20 |
$7 | |
| Complete blood count (CBC) (complete) |
— |
— |
$8 |
$8 | |
| Complex wound repair |
— |
— |
$2,720 |
$390 | |
| Comprehensive eye exam |
— |
— |
$212 |
$138 | |
| Comprehensive metabolic panel |
$1,128 |
$1,128 |
$50 |
$11 | |
| Contraceptive implant (Nexplanon) |
— |
— |
$2,716 |
$115 | |
| Copper blood test |
$456 |
$456 |
$59 |
$12 | |
| Corneal transplant |
— |
— |
$8,580 |
$1,066 | |
| Coronary artery bypass (CABG) |
— |
— |
$1,680 |
$36,593 | |
| Coronary CT angiography |
$7,091 |
$7,091 |
$1,057 |
$326 | |
| Cortisol test |
$710 |
$710 |
$77 |
$16 | |
| COVID-19 PCR test |
$142 |
$142 |
$56 |
$51 | |
| Craniotomy (brain surgery) |
— |
— |
$9,449 |
$2,161 | |
| CT angiography of the chest |
$10,245 |
$10,245 |
$1,039 |
$281 | |
| CT angiography of the head |
$14,099 |
$14,099 |
$1,425 |
$274 | |
| CT colonography (virtual colonoscopy) |
$7,070 |
$7,070 |
$4,525 |
$835 | |
| CT scan of the abdomen |
$7,779 |
$7,779 |
$1,027 |
$230 | |
| CT scan of the abdomen and pelvis |
$15,616 |
$15,616 |
$1,039 |
$300 | |
| CT scan of the abdomen and pelvis with and without contrast |
$15,680 |
$15,680 |
$1,292 |
$338 | |
| CT scan of the abdomen and pelvis with contrast |
$15,680 |
$15,680 |
$1,141 |
$300 | |
| CT scan of the abdomen and pelvis without contrast |
$15,552 |
$15,552 |
$544 |
$183 | |
| CT scan of the abdomen with and without contrast |
$8,086 |
$8,086 |
$1,350 |
$259 | |
| CT scan of the abdomen with contrast |
$7,779 |
$7,779 |
$1,200 |
$230 | |
| CT scan of the abdomen without contrast |
$6,872 |
$6,872 |
$441 |
$136 | |
| CT scan of the arm |
$8,554 |
$8,554 |
$4,026 |
$199 | |
| CT scan of the arm with contrast |
$8,103 |
$8,103 |
$4,565 |
$199 | |
| CT scan of the arm without contrast |
$7,366 |
$7,366 |
$3,278 |
$161 | |
| CT scan of the chest |
$8,271 |
$8,271 |
$687 |
$167 | |
| CT scan of the chest with and without contrast |
$9,530 |
$9,530 |
$729 |
$196 | |
| CT scan of the chest with contrast |
$8,271 |
$8,271 |
$595 |
$167 | |
| CT scan of the chest without contrast |
$7,424 |
$7,424 |
$438 |
$133 | |
| CT scan of the head |
$7,458 |
$7,458 |
$604 |
$148 | |
| CT scan of the head with and without contrast |
$8,104 |
$8,104 |
$604 |
$173 | |
| CT scan of the head with contrast |
$7,458 |
$7,458 |
$507 |
$148 | |
| CT scan of the head without contrast |
$7,400 |
$7,400 |
$839 |
$107 | |
| CT scan of the leg |
$8,554 |
$8,554 |
$3,250 |
$166 | |
| CT scan of the leg with contrast |
$7,828 |
$7,828 |
$3,353 |
$166 | |
| CT scan of the leg without contrast |
$7,362 |
$7,362 |
$3,152 |
$130 | |
| CT scan of the lower back (lumbar spine) |
$9,992 |
$9,992 |
$729 |
$169 | |
| CT scan of the lower back (lumbar spine) with and without contrast |
$11,418 |
$11,418 |
$729 |
$197 | |
| CT scan of the lower back (lumbar spine) with contrast |
$9,992 |
$9,992 |
$626 |
$169 | |
| CT scan of the lower back (lumbar spine) without contrast |
$9,751 |
$9,751 |
$674 |
$130 | |
| CT scan of the neck |
$7,684 |
$7,684 |
$673 |
$183 | |
| CT scan of the neck (cervical spine) |
$10,186 |
$10,186 |
$727 |
$168 | |
| CT scan of the neck (cervical spine) with and without contrast |
$10,671 |
$10,671 |
$727 |
$196 | |
| CT scan of the neck (cervical spine) with contrast |
$10,186 |
$10,186 |
$828 |
$168 | |
| CT scan of the neck (cervical spine) without contrast |
$9,989 |
$9,989 |
$677 |
$131 | |
| CT scan of the neck with and without contrast |
$8,271 |
$8,271 |
$769 |
$220 | |
| CT scan of the neck with contrast |
$7,684 |
$7,684 |
$632 |
$183 | |
| CT scan of the neck without contrast |
$7,424 |
$7,424 |
$477 |
$150 | |
| CT scan of the pelvis |
$8,024 |
$8,024 |
$909 |
$226 | |
| CT scan of the pelvis with and without contrast |
$8,113 |
$8,113 |
$1,025 |
$251 | |
| CT scan of the pelvis with contrast |
$8,024 |
$8,024 |
$909 |
$226 | |
| CT scan of the pelvis without contrast |
$7,329 |
$7,329 |
$687 |
$133 | |
| CT scan of the sinuses |
$8,891 |
$8,891 |
$524 |
$152 | |
| CT scan of the sinuses with and without contrast |
$9,887 |
$9,887 |
$662 |
$184 | |
| CT scan of the sinuses with contrast |
$8,193 |
$8,193 |
$524 |
$152 | |
| CT scan of the sinuses without contrast |
$8,891 |
$8,891 |
$467 |
$128 | |
| Defibrillator (ICD) implant |
— |
— |
$17,314 |
$798 | |
| Diagnostic mammogram |
— |
— |
$279 |
$140 | |
| Dialysis fistula creation |
— |
— |
$11,929 |
$601 | |
| Dilation and curettage (D&C) |
— |
— |
$4,821 |
$298 | |
| Droopy eyelid repair (ptosis) |
— |
— |
$5,806 |
$745 | |
| Drug screen (urine) |
$495 |
$495 |
$62 |
$17 | |
| Ear pressure test (tympanometry) |
— |
— |
$64 |
$16 | |
| Ear tubes (myringotomy) |
— |
— |
$2,947 |
$174 | |
| Eardrum repair (tympanoplasty) |
— |
— |
$9,011 |
$799 | |
| Echocardiogram |
$5,405 |
$5,405 |
$2,834 |
$138 | |
| Echocardiogram with and without contrast |
$4,826 |
$4,826 |
$2,172 |
$101 | |
| Echocardiogram without contrast |
$6,675 |
$6,675 |
$2,771 |
$138 | |
| EEG (awake and asleep) |
$5,099 |
$5,099 |
$2,134 |
$482 | |
| EKG / ECG (tracing only) |
$1,257 |
$1,257 |
$603 |
$7 | |
| Elbow replacement |
— |
— |
$17,826 |
$1,301 | |
| Electrocardiogram (EKG) |
$1,257 |
$1,257 |
$603 |
$8 | |
| Electroencephalogram (EEG) |
$5,099 |
$5,099 |
$2,134 |
$448 | |
| Electromyography (EMG) |
$1,905 |
$1,905 |
$743 |
$141 | |
| Emergency department visit (level 1) |
$1,217 |
$1,217 |
$413 |
$11 | |
| Emergency department visit (level 2) |
$2,959 |
$2,959 |
$1,170 |
$40 | |
| Endometrial biopsy |
— |
— |
$2,716 |
$98 | |
| Epidural steroid injection |
— |
— |
$2,716 |
$275 | |
| ERCP (bile duct endoscopy) |
— |
— |
$5,680 |
$311 | |
| Esophageal dilation |
— |
— |
$3,189 |
$522 | |
| Esophageal variceal banding |
— |
— |
$3,697 |
$126 | |
| Eyelid surgery (blepharoplasty) |
— |
— |
$4,821 |
$552 | |
| Facet joint injection (spine) |
— |
— |
$2,909 |
$99 | |
| Fallopian tube X-ray (HSG) |
$3,735 |
$3,735 |
$518 |
$164 | |
| Family therapy session |
$896 |
$896 |
$356 |
$110 | |
| Fecal occult blood (stool) test |
$374 |
$374 |
$16 |
$10 | |
| Fecal occult blood (stool) test (immunochemical, FIT) |
— |
— |
$16 |
$16 | |
| Feeding tube (PEG) placement |
— |
— |
$4,063 |
$178 | |
| Femoral hernia repair |
— |
— |
$6,162 |
$584 | |
| Fibrinogen test |
$672 |
$672 |
$46 |
$10 | |
| Fibroid removal (myomectomy) |
— |
— |
$8,132 |
$914 | |
| Flexible sigmoidoscopy |
— |
— |
$2,716 |
$323 | |
| Flu test |
$329 |
$329 |
$66 |
$17 | |
| Foreign body removal (skin) |
— |
— |
$2,716 |
$157 | |
| Free T4 thyroid test |
$618 |
$618 |
$43 |
$9 | |
| FSH hormone test |
$953 |
$953 |
$45 |
$19 | |
| Gallbladder removal (laparoscopic) |
— |
— |
$9,252 |
$658 | |
| Ganglion cyst removal |
— |
— |
$4,821 |
$321 | |
| Glaucoma surgery |
— |
— |
$5,806 |
$984 | |
| Glucose tolerance test |
$480 |
$480 |
$13 |
$8 | |
| Group therapy session |
$424 |
$424 |
$187 |
$30 | |
| H. pylori test |
— |
— |
$67 |
$67 | |
| Hammertoe repair |
— |
— |
$5,190 |
$548 | |
| Hearing test (audiometry) |
— |
— |
$250 |
$36 | |
| Hematocrit test |
$232 |
$232 |
$11 |
$2 | |
| Hemodialysis |
— |
— |
$1,121 |
$75 | |
| Hemorrhoid removal |
— |
— |
$3,889 |
$338 | |
| Hepatitis B test |
$418 |
$418 |
$25 |
$10 | |
| Hepatitis B vaccine |
$708 |
$708 |
$225 |
— | |
| Hepatitis C test |
$418 |
$418 |
$68 |
$14 | |
| Hip arthroscopy |
— |
— |
$11,008 |
$931 | |
| Hip fracture repair |
— |
— |
$9,329 |
$1,120 | |
| Hip replacement |
— |
— |
$21,105 |
$1,162 | |
| HIV test |
$418 |
$418 |
$59 |
$19 | |
| HIV test (antibody) |
$418 |
$418 |
$65 |
$14 | |
| HIV test (antigen/antibody combo) |
— |
— |
$24 |
$24 | |
| Home sleep apnea test |
— |
— |
$2,508 |
$123 | |
| HPV vaccine |
$2,338 |
$2,338 |
$1,184 |
— | |
| Hydrocele repair |
— |
— |
$5,548 |
$315 | |
| Hysterectomy |
— |
— |
$11,402 |
$933 | |
| Hysteroscopy |
— |
— |
$6,194 |
$1,270 | |
| Ileostomy |
— |
— |
$5,680 |
$968 | |
| Incisional hernia repair |
— |
— |
$10,063 |
— | |
| Inguinal hernia repair |
— |
— |
$5,806 |
$538 | |
| IUD insertion |
— |
— |
$2,720 |
— | |
| IUD removal |
— |
— |
$2,716 |
$112 | |
| IV infusion therapy |
$1,130 |
$1,130 |
$517 |
$44 | |
| IV infusion therapy (each additional) |
$738 |
$738 |
$472 |
$21 | |
| IV infusion therapy (initial) |
$1,299 |
$1,299 |
$832 |
$67 | |
| IVC filter placement |
— |
— |
$7,698 |
$1,885 | |
| Joint aspiration (small/intermediate) |
— |
— |
$2,716 |
$57 | |
| Joint aspiration or injection (mid-size joint) |
— |
— |
$2,716 |
$57 | |
| Joint aspiration or injection (small joint) |
— |
— |
$2,716 |
$56 | |
| Kidney biopsy |
— |
— |
$3,697 |
$492 | |
| Kidney removal (nephrectomy) |
— |
— |
$7,644 |
$1,164 | |
| Kidney scan (nuclear) |
$11,063 |
$11,063 |
$867 |
$172 | |
| Kidney stone shock-wave (lithotripsy) |
— |
— |
$9,353 |
$760 | |
| Kidney ultrasound |
$3,020 |
$3,020 |
$1,700 |
$84 | |
| Kidney ultrasound (limited) |
$3,020 |
$3,020 |
$1,595 |
$61 | |
| Knee arthroscopy |
— |
— |
$5,806 |
$524 | |
| Knee joint injection |
— |
— |
$2,716 |
$69 | |
| Knee replacement |
— |
— |
$5,339 |
$18,054 | |
| Laminectomy (spine) |
— |
— |
$10,011 |
$1,157 | |
| Laryngoscopy |
— |
— |
$2,722 |
$189 | |
| LDH test |
$314 |
$314 |
$19 |
$6 | |
| LDL cholesterol test |
— |
— |
$11 |
$11 | |
| Leg artery angiogram |
$11,812 |
$11,812 |
$3,815 |
$149 | |
| Leg artery angioplasty |
— |
— |
$9,165 |
— | |
| Leg vein ultrasound (Doppler) |
$3,449 |
$3,449 |
$2,070 |
$150 | |
| Leg vein ultrasound (Doppler) (limited) |
$3,234 |
$3,234 |
$2,070 |
$116 | |
| Lipid (cholesterol) panel |
$580 |
$580 |
$33 |
$13 | |
| Liver biopsy |
— |
— |
$3,697 |
$288 | |
| Liver function panel |
$667 |
$667 |
$39 |
$8 | |
| Lower back (lumbar) spinal fusion |
— |
— |
$78,000 |
$1,511 | |
| Lumbar discectomy |
— |
— |
$10,011 |
$898 | |
| Lumpectomy (breast) |
— |
— |
$6,719 |
$750 | |
| Lung function test (PFT) |
$504 |
$504 |
$227 |
$37 | |
| Mastectomy |
— |
— |
$9,353 |
$1,021 | |
| Mastoidectomy |
— |
— |
$8,580 |
$840 | |
| Meniscus repair (knee) |
— |
— |
$5,190 |
$714 | |
| MMR vaccine |
$772 |
$772 |
$351 |
— | |
| Mohs skin cancer surgery |
— |
— |
$2,720 |
$535 | |
| MRA of the brain |
$14,301 |
$14,301 |
$828 |
$226 | |
| MRA of the brain with contrast |
— |
— |
$626 |
$226 | |
| MRA of the brain without contrast |
$16,969 |
$16,969 |
$1,070 |
$328 | |
| MRA of the neck |
$14,287 |
$14,287 |
$828 |
$245 | |
| MRA of the neck with contrast |
— |
— |
$626 |
$245 | |
| MRA of the neck without contrast |
$16,951 |
$16,951 |
$1,119 |
$343 | |
| MRI of the abdomen |
$16,929 |
$16,929 |
$828 |
$300 | |
| MRI of the abdomen with contrast |
$16,929 |
$16,929 |
$828 |
$300 | |
| MRI of the abdomen without contrast |
$16,767 |
$16,767 |
$629 |
$194 | |
| MRI of the ankle |
$14,638 |
$14,638 |
$4,422 |
$261 | |
| MRI of the ankle with contrast |
$15,611 |
$15,611 |
$4,588 |
$261 | |
| MRI of the ankle without contrast |
$14,618 |
$14,618 |
$4,385 |
$222 | |
| MRI of the brain |
$17,586 |
$17,586 |
$828 |
$269 | |
| MRI of the brain with contrast |
$17,586 |
$17,586 |
$874 |
$269 | |
| MRI of the brain without contrast |
$15,941 |
$15,941 |
$634 |
$195 | |
| MRI of the chest |
$15,087 |
$15,087 |
$1,539 |
$371 | |
| MRI of the chest with contrast |
$14,039 |
$14,039 |
$1,539 |
$371 | |
| MRI of the chest without contrast |
$21,372 |
$21,372 |
$1,909 |
$466 | |
| MRI of the knee |
$14,638 |
$14,638 |
$3,030 |
$315 | |
| MRI of the knee with contrast |
$14,638 |
$14,638 |
$1,643 |
$315 | |
| MRI of the knee without contrast |
$14,588 |
$14,588 |
$4,376 |
$204 | |
| MRI of the lower back (lumbar spine) |
$17,197 |
$17,197 |
$828 |
$270 | |
| MRI of the lower back (lumbar spine) with contrast |
$16,938 |
$16,938 |
$828 |
$270 | |
| MRI of the lower back (lumbar spine) without contrast |
$17,197 |
$17,197 |
$622 |
$192 | |
| MRI of the mid-back (thoracic spine) |
$17,740 |
$17,740 |
$828 |
$271 | |
| MRI of the mid-back (thoracic spine) with and without contrast |
$20,924 |
$20,924 |
$1,034 |
$319 | |
| MRI of the mid-back (thoracic spine) with contrast |
$16,938 |
$16,938 |
$828 |
$271 | |
| MRI of the mid-back (thoracic spine) without contrast |
$17,740 |
$17,740 |
$617 |
$190 | |
| MRI of the neck (cervical spine) |
$16,938 |
$16,938 |
$828 |
$274 | |
| MRI of the neck (cervical spine) with and without contrast |
$19,965 |
$19,965 |
$1,032 |
$318 | |
| MRI of the neck (cervical spine) with contrast |
$16,938 |
$16,938 |
$828 |
$274 | |
| MRI of the neck (cervical spine) without contrast |
$16,930 |
$16,930 |
$618 |
$191 | |
| MRI of the pelvis |
$18,683 |
$18,683 |
$852 |
$268 | |
| MRI of the pelvis with contrast |
$18,683 |
$18,683 |
$872 |
$268 | |
| MRI of the pelvis without contrast |
$17,090 |
$17,090 |
$740 |
$227 | |
| MRI of the shoulder |
$14,602 |
$14,602 |
$3,023 |
$313 | |
| MRI of the shoulder with contrast |
$14,772 |
$14,772 |
$4,432 |
$313 | |
| MRI of the shoulder without contrast |
$14,602 |
$14,602 |
$4,381 |
$205 | |
| MRI of the wrist |
$15,839 |
$15,839 |
$3,033 |
$330 | |
| MRI of the wrist with contrast |
$14,638 |
$14,638 |
$1,721 |
$330 | |
| MRI of the wrist without contrast |
$14,651 |
$14,651 |
$4,395 |
$303 | |
| Nebulizer breathing treatment |
$934 |
$934 |
$420 |
$9 | |
| Neck (cervical) spinal fusion |
— |
— |
$21,105 |
$1,410 | |
| Nerve conduction study |
$797 |
$797 |
$380 |
$118 | |
| Newborn hospital care |
— |
— |
$212 |
$58 | |
| Nuchal translucency ultrasound |
$1,521 |
$1,521 |
$358 |
$116 | |
| Nuclear cardiac stress test |
$19,939 |
$19,939 |
$2,938 |
$428 | |
| Occupational therapy evaluation |
$621 |
$621 |
$359 |
$101 | |
| Occupational therapy evaluation (high complexity) |
$621 |
$621 |
$368 |
$101 | |
| Occupational therapy evaluation (low complexity) |
$575 |
$575 |
$289 |
$101 | |
| Occupational therapy evaluation (moderate complexity) |
$621 |
$621 |
$368 |
$101 | |
| Office visit (established patient) |
$1,668 |
$1,668 |
$1,084 |
$115 | |
| Office visit, new patient (level 3) |
$1,698 |
$1,698 |
$1,086 |
$118 | |
| Orthopedic hardware removal |
— |
— |
$5,079 |
$632 | |
| Ovarian cyst removal |
— |
— |
$7,976 |
$698 | |
| Ovary removal (oophorectomy) |
— |
— |
$7,650 |
$822 | |
| Pacemaker insertion |
— |
— |
$4,253 |
$15,506 | |
| Pap smear (cervical screening) |
$197 |
$197 |
$27 |
$20 | |
| Parathyroid removal |
— |
— |
$9,391 |
$891 | |
| Pelvic ultrasound |
$2,135 |
$2,135 |
$1,127 |
$78 | |
| Pelvic ultrasound (complete) |
$2,174 |
$2,174 |
$978 |
$105 | |
| Pelvic ultrasound (limited) |
$2,135 |
$2,135 |
$1,127 |
$51 | |
| PET scan |
$32,907 |
$32,907 |
$14,479 |
— | |
| Physical therapy evaluation |
$632 |
$632 |
$348 |
$98 | |
| Physical therapy evaluation (high complexity) |
$632 |
$632 |
$368 |
$98 | |
| Physical therapy evaluation (moderate complexity) |
$632 |
$632 |
$368 |
$98 | |
| Pilonidal cyst removal |
— |
— |
$5,079 |
$541 | |
| Pneumonia vaccine |
$315 |
$315 |
$201 |
— | |
| Pregnancy blood test (hCG) |
$496 |
$496 |
$36 |
$8 | |
| Pregnancy ultrasound |
$2,848 |
$2,848 |
$1,402 |
$126 | |
| Pregnancy ultrasound (first trimester) |
$2,848 |
$2,848 |
$1,504 |
$117 | |
| Pregnancy ultrasound (second or third trimester) |
$2,888 |
$2,888 |
$1,300 |
$136 | |
| Procalcitonin test |
$690 |
$690 |
$66 |
$27 | |
| Prostate biopsy |
— |
— |
$4,821 |
— | |
| Prostate removal (prostatectomy) |
— |
— |
$9,449 |
$1,063 | |
| Prostate surgery (TURP) |
— |
— |
$7,080 |
$526 | |
| Prostate test (PSA) |
$586 |
$586 |
$45 |
$18 | |
| Psychotherapy session |
$770 |
$770 |
$256 |
$140 | |
| Pterygium removal (eye) |
— |
— |
$4,063 |
$540 | |
| Pulmonary rehabilitation |
— |
— |
$98 |
$87 | |
| Radiofrequency nerve ablation |
— |
— |
$3,835 |
$462 | |
| Retina scan (OCT) |
— |
— |
$98 |
$33 | |
| Retinal (fundus) photography |
— |
— |
$205 |
$37 | |
| Retinal detachment repair |
— |
— |
$6,699 |
$966 | |
| Rheumatoid factor test |
$449 |
$449 |
$29 |
$6 | |
| Rotator cuff repair |
— |
— |
$10,011 |
$792 | |
| Routine eye exam |
— |
— |
$212 |
$88 | |
| RSV vaccine |
— |
— |
$1,149 |
— | |
| Sacroiliac joint injection |
— |
— |
$2,720 |
$176 | |
| Screening colonoscopy |
— |
— |
$2,909 |
$378 | |
| Screening mammogram |
— |
— |
$236 |
$126 | |
| Scrotal ultrasound |
$2,810 |
$2,810 |
$1,265 |
$99 | |
| Semen analysis |
$228 |
$228 |
$29 |
$12 | |
| Septoplasty (deviated septum) |
— |
— |
$5,806 |
$613 | |
| Sex hormone binding globulin test |
$195 |
$195 |
$53 |
$22 | |
| Shoulder arthroscopy |
— |
— |
$8,700 |
$962 | |
| Shoulder replacement |
— |
— |
$25,730 |
$1,300 | |
| Simple laceration repair (small, up to 2.5 cm) |
— |
— |
$2,716 |
$114 | |
| Simple wound stitches |
— |
— |
$2,125 |
$127 | |
| Sinus surgery (endoscopic) |
— |
— |
$6,194 |
$224 | |
| Skin biopsy |
— |
— |
$2,716 |
$121 | |
| Skin biopsy (punch) |
— |
— |
$2,716 |
$121 | |
| Skin cancer lesion removal |
— |
— |
$2,716 |
$240 | |
| Skin graft |
— |
— |
$4,955 |
$898 | |
| Skin lesion freezing (cryotherapy) |
— |
— |
$2,720 |
$36 | |
| Skin tag removal |
— |
— |
$2,716 |
$92 | |
| Sleep study (polysomnography) |
$19,820 |
$19,820 |
$5,405 |
$691 | |
| Small bowel resection |
— |
— |
$5,680 |
$1,136 | |
| Soft tissue ultrasound |
$2,725 |
$2,725 |
$1,487 |
$64 | |
| Speech therapy |
$1,122 |
$1,122 |
$572 |
$76 | |
| Spinal cord stimulator |
— |
— |
$10,524 |
$2,388 | |
| Spinal tap (lumbar puncture) |
— |
— |
$2,716 |
$165 | |
| Spine fracture repair (kyphoplasty) |
— |
— |
$9,329 |
$5,803 | |
| Spirometry (lung function test) |
$676 |
$676 |
$294 |
$30 | |
| Spirometry with bronchodilator |
$344 |
$344 |
$160 |
$43 | |
| Spleen removal (splenectomy) |
— |
— |
$9,329 |
$1,036 | |
| Stomach removal (gastrectomy) |
— |
— |
$5,680 |
$1,595 | |
| Strabismus (eye muscle) surgery |
— |
— |
$5,806 |
$475 | |
| Strep throat test |
$195 |
$195 |
$51 |
$17 | |
| Stress echocardiogram |
$5,116 |
$5,116 |
$2,172 |
$209 | |
| Stress echocardiogram (complete) |
$5,116 |
$5,116 |
$2,123 |
$233 | |
| Swallow study |
$1,825 |
$1,825 |
$928 |
$85 | |
| T3 thyroid test |
$557 |
$557 |
$34 |
$14 | |
| Tdap (tetanus) vaccine |
$317 |
$317 |
$119 |
— | |
| Testicle removal (orchiectomy) |
— |
— |
$5,364 |
$306 | |
| Thyroid removal (thyroidectomy) |
— |
— |
$9,391 |
$1,004 | |
| Thyroid ultrasound |
$3,064 |
$3,064 |
$1,725 |
$109 | |
| Thyroid uptake scan |
$4,445 |
$4,445 |
$651 |
$145 | |
| Tilt table test |
$4,620 |
$4,620 |
$2,720 |
$168 | |
| Tonsillectomy |
— |
— |
$6,447 |
$252 | |
| Tracheostomy |
— |
— |
$4,954 |
$273 | |
| Transesophageal echocardiogram (TEE) |
$9,320 |
$9,320 |
$3,705 |
$239 | |
| Transesophageal echocardiogram (TEE) with and without contrast |
$9,320 |
$9,320 |
$4,101 |
$239 | |
| Transvaginal ultrasound |
$2,338 |
$2,338 |
$1,234 |
$118 | |
| Trigger finger release |
— |
— |
$4,063 |
$630 | |
| Trigger point injection |
— |
— |
$2,716 |
$56 | |
| Trigger point injection (1-2 muscles) |
— |
— |
$2,716 |
$52 | |
| Tubal ligation |
— |
— |
$7,697 |
$333 | |
| Turbinate reduction |
— |
— |
$4,954 |
$294 | |
| Turning a breech baby (version) |
— |
— |
$4,821 |
$94 | |
| Ulnar nerve surgery (elbow) |
— |
— |
$4,063 |
$575 | |
| Umbilical hernia repair |
— |
— |
$10,063 |
— | |
| Upper GI endoscopy (EGD) |
— |
— |
$2,947 |
$371 | |
| Upper GI series (barium) |
$4,447 |
$4,447 |
$437 |
$128 | |
| Ureteral stent placement |
— |
— |
$5,364 |
$373 | |
| Ureteroscopy (stone removal) |
— |
— |
$7,962 |
$365 | |
| Urine pregnancy test |
$288 |
$288 |
$41 |
$9 | |
| UV light therapy (skin) |
— |
— |
$98 |
$106 | |
| Vaccine administration |
$84 |
$84 |
$38 |
$19 | |
| Vaccine administration (each additional) |
$80 |
$80 |
$36 |
$16 | |
| Vaginal delivery |
— |
— |
$1,680 |
$5,487 | |
| Varicocele repair |
— |
— |
$5,806 |
$327 | |
| Varicose vein ablation |
— |
— |
$5,680 |
$1,018 | |
| Vasectomy |
— |
— |
$4,063 |
$347 | |
| Visual field test |
— |
— |
$205 |
$64 | |
| Vitrectomy (eye) |
— |
— |
$6,699 |
$814 | |
| Vocal cord injection |
— |
— |
$5,680 |
$211 | |
| Wart removal |
— |
— |
$2,716 |
$121 | |
| Weight-loss (bariatric) surgery |
— |
— |
$5,093 |
$11,645 | |
| Whipple procedure (pancreas) |
— |
— |
$5,680 |
$2,871 | |
| Wound debridement |
— |
— |
$2,716 |
$186 | |
| Wrist fracture repair |
— |
— |
$10,011 |
$735 | |
| X-ray of the abdomen |
$2,075 |
$2,075 |
$245 |
$36 | |
| X-ray of the ankle |
$1,916 |
$1,916 |
$843 |
$37 | |
| X-ray of the collarbone |
$1,800 |
$1,800 |
$581 |
$33 | |
| X-ray of the elbow |
$1,900 |
$1,900 |
$855 |
$33 | |
| X-ray of the foot |
$1,894 |
$1,894 |
$852 |
$34 | |
| X-ray of the forearm |
$1,694 |
$1,694 |
$745 |
$29 | |
| X-ray of the hand |
$1,813 |
$1,813 |
$798 |
$38 | |
| X-ray of the knee |
$2,759 |
$2,759 |
$897 |
$42 | |
| X-ray of the knee (2 views) |
$1,848 |
$1,848 |
$769 |
$34 | |
| X-ray of the knee (3 views) |
$2,103 |
$2,103 |
$925 |
$42 | |
| X-ray of the knee (4+ views) |
$2,759 |
$2,759 |
$1,214 |
$49 | |
| X-ray of the lower back (lumbar spine) |
$3,266 |
$3,266 |
$278 |
$47 | |
| X-ray of the lower back (lumbar spine) (2 views) |
$2,875 |
$2,875 |
$274 |
$40 | |
| X-ray of the lower back (lumbar spine) (4+ views) |
$3,657 |
$3,657 |
$278 |
$53 | |
| X-ray of the lower leg |
$1,967 |
$1,967 |
$866 |
$31 | |
| X-ray of the mid-back (thoracic spine) (2 views) |
$2,644 |
$2,644 |
$274 |
$33 | |
| X-ray of the neck (cervical spine) |
$3,201 |
$3,201 |
$287 |
$47 | |
| X-ray of the neck (cervical spine) (3 views) |
$2,595 |
$2,595 |
$222 |
$40 | |
| X-ray of the pelvis |
$2,088 |
$2,088 |
$274 |
$36 | |
| X-ray of the pelvis (1 view) |
$1,927 |
$1,927 |
$274 |
$28 | |
| X-ray of the ribs |
$2,428 |
$2,428 |
$557 |
$42 | |
| X-ray of the ribs (2 views) |
$1,895 |
$1,895 |
$557 |
$36 | |
| X-ray of the ribs (3 views) |
$2,428 |
$2,428 |
$714 |
$42 | |
| X-ray of the shoulder |
$2,014 |
$2,014 |
$886 |
$36 | |
| X-ray of the skull |
$2,381 |
$2,381 |
$274 |
$40 | |
| X-ray of the upper arm |
$1,941 |
$1,941 |
$854 |
$32 | |
| X-ray of the wrist |
$1,889 |
$1,889 |
$831 |
$43 | |
| YAG laser capsulotomy (eye) |
— |
— |
$2,716 |
$335 | |
| Zinc blood test |
$525 |
$525 |
$28 |
$11 | |