| 3D mammogram (tomosynthesis) |
$145 |
$193 |
$40 |
$51 | |
| Abdominal fluid drain (paracentesis) |
— |
— |
$11 |
$284 | |
| Abdominal ultrasound |
$1,252 |
$1,670 |
$37 |
$100 | |
| Abdominal ultrasound (complete) |
$1,632 |
$2,176 |
$49 |
$114 | |
| Abdominal ultrasound (limited) |
$1,084 |
$1,445 |
$37 |
$86 | |
| Abscess drainage (complex or multiple) |
— |
— |
$11 |
$220 | |
| Abscess drainage (simple) |
— |
— |
$10 |
$129 | |
| Abscess incision and drainage |
— |
— |
$10 |
$174 | |
| Achilles tendon repair |
— |
— |
$10 |
$624 | |
| ACL knee reconstruction |
— |
— |
$11 |
$889 | |
| Acupuncture |
— |
— |
$17 |
$38 | |
| Acupuncture (each additional) |
— |
— |
$17 |
$28 | |
| Adenoid removal (adenoidectomy) |
— |
— |
$10 |
$204 | |
| Albumin blood test |
$25 |
$33 |
$11 |
$5 | |
| Alkaline phosphatase test |
$29 |
$38 |
$11 |
$5 | |
| Allergy patch testing |
— |
— |
$3 |
$5 | |
| Allergy shots |
— |
— |
$7 |
$11 | |
| Allergy testing |
— |
— |
$2 |
$4 | |
| Alpha-fetoprotein (AFP) test |
$276 |
$368 |
$14 |
$17 | |
| ALT liver enzyme test |
$29 |
$38 |
$11 |
$5 | |
| Ammonia blood test |
$137 |
$183 |
$12 |
$15 | |
| Amniocentesis |
$2,642 |
$3,523 |
$11 |
$120 | |
| Amylase test |
$52 |
$70 |
$5 |
$6 | |
| Anal fistula repair |
— |
— |
$10 |
$541 | |
| Ankle fracture repair |
— |
— |
$10 |
$608 | |
| Ankle replacement |
— |
— |
$10 |
$885 | |
| Annual physical (established patient) |
— |
— |
$69 |
— | |
| Annual physical (new patient) |
— |
— |
$77 |
— | |
| Anoscopy |
— |
— |
$10 |
$129 | |
| Antinuclear antibody (ANA) test |
$339 |
$452 |
$10 |
$12 | |
| Aortic aneurysm repair (AAA) |
$12,614 |
$16,819 |
$11 |
$1,345 | |
| Aortic valve replacement |
— |
— |
$10 |
$1,603 | |
| Appendix removal (appendectomy) |
— |
— |
$7,319 |
$592 | |
| Arterial blood gas (ABG) |
$394 |
$525 |
$21 |
$26 | |
| AST liver enzyme test |
$29 |
$38 |
$11 |
$5 | |
| Barium swallow study |
$570 |
$760 |
$119 |
$107 | |
| Bartholin cyst removal |
— |
— |
$10 |
$182 | |
| Basic metabolic panel |
$511 |
$681 |
$8 |
$8 | |
| Benign skin lesion removal |
— |
— |
$10 |
$171 | |
| Bilirubin blood test |
$74 |
$98 |
$11 |
$5 | |
| Bladder function test (urodynamics) |
— |
— |
$10 |
$345 | |
| Bladder scope (cystoscopy) |
— |
— |
$11 |
$216 | |
| Bladder tumor removal (TURBT) |
— |
— |
$10 |
$236 | |
| Blood clotting test (PT/INR) |
$42 |
$56 |
$4 |
$4 | |
| Blood crossmatch |
$347 |
$462 |
$5 |
— | |
| Blood glucose test |
$29 |
$38 |
$8 |
$5 | |
| Blood transfusion |
$1,121 |
$1,495 |
$54 |
$47 | |
| Blood type and screen |
$95 |
$126 |
$9 |
$10 | |
| Blood type test |
$101 |
$135 |
$3 |
$3 | |
| Blood type test (ABO group) |
$145 |
$193 |
$3 |
$3 | |
| Blood type test (Rh/D antigen) |
$57 |
$76 |
$3 |
$3 | |
| BNP (heart failure) test |
$34 |
$45 |
$32 |
$39 | |
| Bone density scan (DEXA) |
$448 |
$597 |
$50 |
$39 | |
| Bone marrow biopsy |
$3,267 |
$4,357 |
$11 |
$172 | |
| Bone scan (nuclear) |
$2,056 |
$2,741 |
$374 |
$259 | |
| Botox for migraine |
— |
— |
$10 |
$157 | |
| Brain shunt (VP shunt) |
— |
— |
$10 |
$1,023 | |
| Breast biopsy |
$5,652 |
$7,536 |
$10 |
$478 | |
| Breast MRI |
$5,820 |
$7,760 |
$230 |
$216 | |
| Breast MRI without contrast |
$7,667 |
$10,222 |
$230 |
$216 | |
| Breast reconstruction |
— |
— |
$10 |
$1,227 | |
| Breast reduction |
— |
— |
$10 |
$980 | |
| Breast ultrasound |
$419 |
$558 |
$81 |
$92 | |
| Breast ultrasound (complete) |
$419 |
$558 |
$109 |
$100 | |
| Breast ultrasound (limited) |
$419 |
$558 |
$81 |
$84 | |
| Breathing tube insertion (intubation) |
— |
— |
$11 |
$133 | |
| Bronchoscopy |
$6,487 |
$8,649 |
$10 |
$303 | |
| Bunion surgery (bunionectomy) |
— |
— |
$10 |
$883 | |
| Burn dressing and debridement (medium) |
— |
— |
$10 |
$166 | |
| Burn dressing and debridement (small) |
— |
— |
$11 |
$93 | |
| Burn treatment |
— |
— |
$10 |
$129 | |
| C-reactive protein (CRP) |
$140 |
$186 |
$4 |
$5 | |
| CA 19-9 tumor marker test |
$14 |
$19 |
$17 |
$21 | |
| CA-125 ovarian marker test |
$194 |
$258 |
$17 |
$21 | |
| Calcium blood test |
$32 |
$43 |
$11 |
$5 | |
| Capsule endoscopy |
— |
— |
$1 |
$802 | |
| Cardiac ablation |
$38,858 |
$51,810 |
$1 |
$759 | |
| Cardiac catheterization |
$12,509 |
$16,679 |
$896 |
$1,049 | |
| Cardiac event monitor |
— |
— |
$105 |
$170 | |
| Cardiac MRI |
$7,606 |
$10,141 |
$107 |
$322 | |
| Cardiac MRI without contrast |
— |
— |
$107 |
$280 | |
| Cardiac rehabilitation |
$481 |
$641 |
$17 |
$26 | |
| Cardiac stress test |
$2,042 |
$2,723 |
$9 |
$39 | |
| Cardioversion |
$2,763 |
$3,684 |
$11 |
$155 | |
| Carotid artery surgery |
— |
— |
$10 |
$1,026 | |
| Carotid artery ultrasound |
$714 |
$952 |
$62 |
$156 | |
| Carpal tunnel release |
$8,678 |
$11,570 |
$11 |
$483 | |
| Cataract surgery |
— |
— |
$10 |
$547 | |
| CEA tumor marker test |
$206 |
$275 |
$16 |
$19 | |
| Celiac disease test |
$24 |
$32 |
$9 |
$12 | |
| Central line placement |
$4,326 |
$5,768 |
$11 |
$238 | |
| Cervical cerclage |
— |
— |
$11 |
$137 | |
| Cervical LEEP procedure |
— |
— |
$10 |
$325 | |
| Cesarean section (C-section) |
— |
— |
$15,934 |
$7,552 | |
| Chalazion (eyelid cyst) removal |
— |
— |
$10 |
$131 | |
| Chemotherapy infusion |
$653 |
$871 |
$40 |
$81 | |
| Chemotherapy infusion (each additional) |
$594 |
$792 |
$33 |
$28 | |
| Chemotherapy infusion (first hour) |
$713 |
$950 |
$154 |
$133 | |
| Chest fluid drain (thoracentesis) |
— |
— |
$10 |
$311 | |
| Chest tube insertion |
— |
— |
$10 |
$143 | |
| Chest X-ray |
$440 |
$587 |
$39 |
$37 | |
| Chest X-ray (1 view) |
$272 |
$362 |
$29 |
$25 | |
| Chest X-ray (2 views) |
$497 |
$662 |
$39 |
$33 | |
| Chickenpox (varicella) vaccine |
— |
— |
$201 |
— | |
| Chiropractic adjustment |
— |
— |
$14 |
$38 | |
| Circumcision |
— |
— |
$10 |
$167 | |
| CK-MB heart enzyme test |
$17 |
$22 |
$10 |
$12 | |
| Clotting time test (PTT) |
$98 |
$131 |
$5 |
$6 | |
| Colon resection (colectomy) |
— |
— |
$10 |
$1,238 | |
| Colonoscopy |
— |
— |
$10 |
$480 | |
| Colostomy |
— |
— |
$10 |
$1,122 | |
| Colposcopy |
— |
— |
$10 |
$161 | |
| Complete blood count (CBC) |
$153 |
$204 |
$6 |
$7 | |
| Complete blood count (CBC) (complete) |
$185 |
$246 |
$6 |
$8 | |
| Complex wound repair |
$903 |
$1,204 |
$11 |
$390 | |
| Comprehensive eye exam |
— |
— |
$79 |
$138 | |
| Comprehensive metabolic panel |
$669 |
$892 |
$11 |
$11 | |
| Contact lens fitting |
— |
— |
$2 |
— | |
| Continuous glucose monitor setup |
— |
— |
$17 |
$35 | |
| Contraceptive implant (Nexplanon) |
— |
— |
$10 |
$115 | |
| Copper blood test |
$10 |
$13 |
$10 |
$12 | |
| Corneal transplant |
— |
— |
$10 |
$1,066 | |
| Coronary angioplasty / stent (PCI) |
— |
— |
$5,705 |
$426 | |
| Coronary artery bypass (CABG) |
— |
— |
$90,503 |
$36,593 | |
| Coronary CT angiography |
$2,227 |
$2,969 |
$90 |
$326 | |
| Cortisol test |
$130 |
$173 |
$13 |
$16 | |
| COVID-19 PCR test |
$116 |
$155 |
$51 |
$51 | |
| CPAP titration study |
$775 |
$1,034 |
$42 |
$69 | |
| Craniotomy (brain surgery) |
— |
— |
$10 |
$2,161 | |
| Creatine kinase (CK) test |
$60 |
$79 |
$11 |
$7 | |
| CT angiography of the chest |
$3,867 |
$5,156 |
$90 |
$281 | |
| CT angiography of the head |
$3,959 |
$5,278 |
$90 |
$274 | |
| CT colonography (virtual colonoscopy) |
— |
— |
$1 |
$835 | |
| CT scan of the abdomen |
$3,338 |
$4,450 |
$52 |
$230 | |
| CT scan of the abdomen and pelvis |
$5,099 |
$6,798 |
$65 |
$300 | |
| CT scan of the abdomen and pelvis with and without contrast |
$5,099 |
$6,798 |
$154 |
$338 | |
| CT scan of the abdomen and pelvis with contrast |
$5,483 |
$7,310 |
$137 |
$300 | |
| CT scan of the abdomen and pelvis without contrast |
$3,969 |
$5,292 |
$65 |
$183 | |
| CT scan of the abdomen with and without contrast |
$3,935 |
$5,246 |
$90 |
$259 | |
| CT scan of the abdomen with contrast |
$3,338 |
$4,450 |
$90 |
$230 | |
| CT scan of the abdomen without contrast |
$2,092 |
$2,789 |
$52 |
$136 | |
| CT scan of the arm |
$3,310 |
$4,413 |
$55 |
$199 | |
| CT scan of the arm with contrast |
$3,310 |
$4,413 |
$92 |
$199 | |
| CT scan of the arm without contrast |
$2,444 |
$3,258 |
$55 |
$161 | |
| CT scan of the chest |
$3,361 |
$4,481 |
$53 |
$167 | |
| CT scan of the chest with and without contrast |
$4,027 |
$5,369 |
$87 |
$196 | |
| CT scan of the chest with contrast |
$3,361 |
$4,481 |
$72 |
$167 | |
| CT scan of the chest without contrast |
$2,473 |
$3,297 |
$53 |
$133 | |
| CT scan of the head |
$3,080 |
$4,107 |
$43 |
$148 | |
| CT scan of the head with and without contrast |
$3,286 |
$4,381 |
$73 |
$173 | |
| CT scan of the head with contrast |
$3,080 |
$4,107 |
$61 |
$148 | |
| CT scan of the head without contrast |
$2,675 |
$3,566 |
$43 |
$107 | |
| CT scan of the leg |
$3,317 |
$4,422 |
$53 |
$166 | |
| CT scan of the leg with contrast |
$3,317 |
$4,422 |
$72 |
$166 | |
| CT scan of the leg without contrast |
$2,340 |
$3,120 |
$53 |
$130 | |
| CT scan of the lower back (lumbar spine) |
$1,966 |
$2,621 |
$53 |
$169 | |
| CT scan of the lower back (lumbar spine) with and without contrast |
$3,799 |
$5,065 |
$87 |
$197 | |
| CT scan of the lower back (lumbar spine) with contrast |
$1,966 |
$2,621 |
$72 |
$169 | |
| CT scan of the lower back (lumbar spine) without contrast |
$1,966 |
$2,621 |
$53 |
$130 | |
| CT scan of the neck |
$3,080 |
$4,107 |
$55 |
$183 | |
| CT scan of the neck (cervical spine) |
$2,346 |
$3,128 |
$53 |
$168 | |
| CT scan of the neck (cervical spine) with and without contrast |
$4,166 |
$5,555 |
$87 |
$196 | |
| CT scan of the neck (cervical spine) with contrast |
$1,394 |
$1,858 |
$71 |
$168 | |
| CT scan of the neck (cervical spine) without contrast |
$2,346 |
$3,128 |
$53 |
$131 | |
| CT scan of the neck with and without contrast |
$3,286 |
$4,381 |
$90 |
$220 | |
| CT scan of the neck with contrast |
$3,080 |
$4,107 |
$76 |
$183 | |
| CT scan of the neck without contrast |
$1,948 |
$2,597 |
$55 |
$150 | |
| CT scan of the pelvis |
$3,323 |
$4,430 |
$52 |
$226 | |
| CT scan of the pelvis with and without contrast |
$4,027 |
$5,369 |
$90 |
$251 | |
| CT scan of the pelvis with contrast |
$3,323 |
$4,430 |
$90 |
$226 | |
| CT scan of the pelvis without contrast |
$2,459 |
$3,278 |
$52 |
$133 | |
| CT scan of the sinuses |
$2,825 |
$3,767 |
$55 |
$152 | |
| CT scan of the sinuses with and without contrast |
$3,464 |
$4,619 |
$79 |
$184 | |
| CT scan of the sinuses with contrast |
$2,825 |
$3,767 |
$63 |
$152 | |
| CT scan of the sinuses without contrast |
$1,966 |
$2,621 |
$55 |
$128 | |
| D-dimer test |
$179 |
$238 |
$8 |
$10 | |
| Defibrillator (ICD) implant |
$82,910 |
$110,546 |
$11 |
$798 | |
| DHEA-sulfate test |
$230 |
$306 |
$18 |
$22 | |
| Diagnostic mammogram |
$799 |
$1,065 |
$91 |
$140 | |
| Dialysis fistula creation |
— |
— |
$10 |
$601 | |
| Dilation and curettage (D&C) |
— |
— |
$10 |
$298 | |
| Droopy eyelid repair (ptosis) |
— |
— |
$10 |
$745 | |
| Drug screen (urine) |
$246 |
$329 |
$49 |
$17 | |
| Ear pressure test (tympanometry) |
— |
— |
$11 |
$16 | |
| Ear tubes (myringotomy) |
— |
— |
$10 |
$174 | |
| Eardrum repair (tympanoplasty) |
— |
— |
$10 |
$799 | |
| Echocardiogram |
$1,580 |
$2,107 |
$46 |
$138 | |
| Echocardiogram with and without contrast |
$817 |
$1,089 |
$46 |
$101 | |
| Echocardiogram without contrast |
$1,310 |
$1,746 |
$58 |
$138 | |
| EEG (awake and asleep) |
$2,027 |
$2,703 |
$245 |
$482 | |
| EKG / ECG (tracing only) |
$216 |
$288 |
$5 |
$7 | |
| Elbow replacement |
— |
— |
$10 |
$1,301 | |
| Electrocardiogram (EKG) |
$216 |
$288 |
$5 |
$8 | |
| Electroencephalogram (EEG) |
$1,823 |
$2,431 |
$206 |
$448 | |
| Electrolyte panel |
$244 |
$325 |
$5 |
$7 | |
| Electromyography (EMG) |
$695 |
$927 |
$38 |
$141 | |
| Emergency department visit |
$1,516 |
$2,021 |
$179 |
$69 | |
| Emergency department visit (level 1) |
$427 |
$569 |
$130 |
$11 | |
| Emergency department visit (level 2) |
$891 |
$1,189 |
$282 |
$40 | |
| Emergency department visit (level 3) |
$1,566 |
$2,088 |
$473 |
$69 | |
| Emergency department visit (level 4) |
$2,831 |
$3,775 |
$812 |
$118 | |
| Emergency department visit (level 5) |
$3,760 |
$5,013 |
$1,171 |
$171 | |
| Endometrial biopsy |
— |
— |
$10 |
$98 | |
| Epidural steroid injection |
— |
— |
$11 |
$275 | |
| ERCP (bile duct endoscopy) |
— |
— |
$10 |
$311 | |
| Esophageal dilation |
— |
— |
$10 |
$522 | |
| Esophageal variceal banding |
— |
— |
$10 |
$126 | |
| Estradiol (estrogen) test |
$128 |
$171 |
$23 |
$28 | |
| Eye refraction (glasses prescription) |
— |
— |
$8 |
— | |
| Eyelid surgery (blepharoplasty) |
— |
— |
$10 |
$552 | |
| Facet joint injection (spine) |
$1,808 |
$2,410 |
$11 |
$99 | |
| Fallopian tube X-ray (HSG) |
$1,517 |
$2,023 |
$11 |
$164 | |
| Family therapy session |
— |
— |
$18 |
$110 | |
| Fecal occult blood (stool) test |
$87 |
$116 |
$4 |
$10 | |
| Fecal occult blood (stool) test (guaiac, gFOBT) |
$84 |
$112 |
$4 |
$4 | |
| Fecal occult blood (stool) test (immunochemical, FIT) |
$98 |
$131 |
$13 |
$16 | |
| Feeding tube (PEG) placement |
— |
— |
$10 |
$178 | |
| Femoral hernia repair |
— |
— |
$10 |
$584 | |
| Ferritin (iron) test |
$527 |
$702 |
$11 |
$14 | |
| Fibrinogen test |
$208 |
$278 |
$8 |
$10 | |
| Fibroid removal (myomectomy) |
— |
— |
$10 |
$914 | |
| Flexible sigmoidoscopy |
— |
— |
$10 |
$323 | |
| Flu test |
— |
— |
$14 |
$17 | |
| Flu vaccine |
$35 |
$47 |
$22 |
— | |
| Folate (folic acid) test |
$197 |
$263 |
$12 |
$15 | |
| Foreign body removal (skin) |
— |
— |
$10 |
$157 | |
| Free T4 thyroid test |
$182 |
$242 |
$7 |
$9 | |
| FSH hormone test |
$148 |
$198 |
$15 |
$19 | |
| Gallbladder removal (laparoscopic) |
— |
— |
$10 |
$658 | |
| Gallbladder scan (HIDA) |
$1,927 |
$2,569 |
$377 |
$334 | |
| Ganglion cyst removal |
— |
— |
$10 |
$321 | |
| GGT liver test |
$194 |
$258 |
$11 |
$7 | |
| Glaucoma surgery |
— |
— |
$10 |
$984 | |
| Glucose tolerance test |
$255 |
$341 |
$4 |
$8 | |
| Group therapy session |
— |
— |
$9 |
$30 | |
| H. pylori test |
$258 |
$344 |
$55 |
$67 | |
| Hammertoe repair |
— |
— |
$10 |
$548 | |
| HDL cholesterol test |
$56 |
$75 |
$7 |
$8 | |
| Hearing test (audiometry) |
— |
— |
$23 |
$36 | |
| Hematocrit test |
$61 |
$82 |
$2 |
$2 | |
| Hemodialysis |
— |
— |
$45 |
$75 | |
| Hemoglobin A1c (diabetes test) |
$108 |
$145 |
$8 |
$10 | |
| Hemorrhoid removal |
— |
— |
$10 |
$338 | |
| Hepatitis A vaccine |
$124 |
$165 |
$89 |
— | |
| Hepatitis B test |
— |
— |
$9 |
$10 | |
| Hepatitis B vaccine |
$61 |
$81 |
$76 |
— | |
| Hepatitis C test |
$96 |
$129 |
$12 |
$14 | |
| Hip arthroscopy |
— |
— |
$11 |
$931 | |
| Hip fracture repair |
— |
— |
$10 |
$1,120 | |
| Hip replacement |
— |
— |
$10 |
$1,162 | |
| HIV test |
$190 |
$254 |
$12 |
$19 | |
| HIV test (antibody) |
$107 |
$142 |
$11 |
$14 | |
| HIV test (antigen/antibody combo) |
$274 |
$365 |
$20 |
$24 | |
| Holter heart monitor |
$1,391 |
$1,854 |
$12 |
$26 | |
| Home sleep apnea test |
$1,157 |
$1,543 |
$36 |
$123 | |
| HPV vaccine |
— |
— |
$338 |
— | |
| Hydrocele repair |
— |
— |
$10 |
$315 | |
| Hysterectomy |
— |
— |
$10 |
$933 | |
| Hysteroscopy |
— |
— |
$10 |
$1,270 | |
| Ileostomy |
— |
— |
$10 |
$968 | |
| Incisional hernia repair |
— |
— |
$6,861 |
— | |
| Inguinal hernia repair |
— |
— |
$10 |
$538 | |
| Iron blood test |
$41 |
$54 |
$5 |
$6 | |
| IUD insertion |
— |
— |
$10 |
— | |
| IUD removal |
— |
— |
$10 |
$112 | |
| IV infusion therapy |
$366 |
$488 |
$63 |
$44 | |
| IV infusion therapy (each additional) |
$117 |
$156 |
$52 |
$21 | |
| IV infusion therapy (initial) |
$497 |
$662 |
$154 |
$67 | |
| IVC filter placement |
$14,894 |
$19,858 |
$11 |
$1,885 | |
| Joint aspiration (small/intermediate) |
$1,409 |
$1,879 |
$11 |
$57 | |
| Joint aspiration or injection (mid-size joint) |
$1,409 |
$1,879 |
$11 |
$57 | |
| Joint aspiration or injection (small joint) |
— |
— |
$10 |
$56 | |
| Kidney biopsy |
— |
— |
$11 |
$492 | |
| Kidney removal (nephrectomy) |
— |
— |
$10 |
$1,164 | |
| Kidney scan (nuclear) |
$1,604 |
$2,139 |
$200 |
$172 | |
| Kidney stone shock-wave (lithotripsy) |
— |
— |
$10 |
$760 | |
| Kidney ultrasound |
$1,623 |
$2,164 |
$21 |
$84 | |
| Kidney ultrasound (limited) |
$1,381 |
$1,841 |
$21 |
$61 | |
| Knee arthroscopy |
— |
— |
$11 |
$524 | |
| Knee joint injection |
$1,280 |
$1,707 |
$11 |
$69 | |
| Knee replacement |
— |
— |
$7,520 |
$18,054 | |
| Lactate test |
$176 |
$235 |
$10 |
$12 | |
| Laminectomy (spine) |
— |
— |
$10 |
$1,157 | |
| Laryngoscopy |
— |
— |
$10 |
$189 | |
| LDH test |
$47 |
$62 |
$11 |
$6 | |
| LDL cholesterol test |
$35 |
$47 |
$9 |
$11 | |
| Leg artery angiogram |
$9,452 |
$12,603 |
$112 |
$149 | |
| Leg artery angioplasty |
$17,343 |
$23,124 |
$11 |
— | |
| Leg vein ultrasound (Doppler) |
$1,112 |
$1,483 |
$61 |
$150 | |
| Leg vein ultrasound (Doppler) (limited) |
$729 |
$972 |
$61 |
$116 | |
| LH hormone test |
$98 |
$131 |
$15 |
$19 | |
| Lipase test |
$82 |
$109 |
$6 |
$7 | |
| Lipid (cholesterol) panel |
$593 |
$790 |
$13 |
$13 | |
| Liver biopsy |
$4,180 |
$5,573 |
$11 |
$288 | |
| Liver function panel |
$121 |
$161 |
$8 |
$8 | |
| Lumbar discectomy |
— |
— |
$10 |
$898 | |
| Lumpectomy (breast) |
— |
— |
$10 |
$750 | |
| Lung function test (PFT) |
$556 |
$742 |
$13 |
$37 | |
| Lung scan (V/Q) |
$6,159 |
$8,212 |
$412 |
$291 | |
| Mastectomy |
— |
— |
$10 |
$1,021 | |
| Mastoidectomy |
— |
— |
$10 |
$840 | |
| Meniscus repair (knee) |
— |
— |
$11 |
$714 | |
| MMR vaccine |
$142 |
$189 |
$104 |
— | |
| Mohs skin cancer surgery |
— |
— |
$10 |
$535 | |
| MRA of the brain |
$4,576 |
$6,101 |
$101 |
$226 | |
| MRA of the brain with contrast |
$6,224 |
$8,299 |
$109 |
$226 | |
| MRA of the brain without contrast |
$7,437 |
$9,916 |
$165 |
$328 | |
| MRA of the neck |
$4,576 |
$6,101 |
$102 |
$245 | |
| MRA of the neck with contrast |
$7,687 |
$10,249 |
$112 |
$245 | |
| MRA of the neck without contrast |
$4,576 |
$6,101 |
$165 |
$343 | |
| MRI of the abdomen |
$4,614 |
$6,152 |
$81 |
$300 | |
| MRI of the abdomen with contrast |
— |
— |
$140 |
$300 | |
| MRI of the abdomen without contrast |
$3,911 |
$5,215 |
$81 |
$194 | |
| MRI of the ankle |
$6,144 |
$8,192 |
$101 |
$261 | |
| MRI of the ankle with contrast |
$5,090 |
$6,786 |
$118 |
$261 | |
| MRI of the ankle without contrast |
$6,144 |
$8,192 |
$101 |
$222 | |
| MRI of the brain |
$4,566 |
$6,089 |
$81 |
$269 | |
| MRI of the brain with contrast |
$4,391 |
$5,855 |
$119 |
$269 | |
| MRI of the brain without contrast |
$4,451 |
$5,935 |
$81 |
$195 | |
| MRI of the chest |
$5,946 |
$7,928 |
$116 |
$371 | |
| MRI of the chest with contrast |
— |
— |
$184 |
$371 | |
| MRI of the chest without contrast |
$6,560 |
$8,746 |
$185 |
$466 | |
| MRI of the knee |
$6,551 |
$8,735 |
$89 |
$315 | |
| MRI of the knee with contrast |
$6,877 |
$9,169 |
$149 |
$315 | |
| MRI of the knee without contrast |
$6,226 |
$8,301 |
$89 |
$204 | |
| MRI of the lower back (lumbar spine) |
$4,891 |
$6,521 |
$78 |
$270 | |
| MRI of the lower back (lumbar spine) with contrast |
$3,875 |
$5,167 |
$118 |
$270 | |
| MRI of the lower back (lumbar spine) without contrast |
$4,891 |
$6,521 |
$78 |
$192 | |
| MRI of the mid-back (thoracic spine) |
$4,891 |
$6,521 |
$77 |
$271 | |
| MRI of the mid-back (thoracic spine) with and without contrast |
$6,764 |
$9,018 |
$135 |
$319 | |
| MRI of the mid-back (thoracic spine) with contrast |
— |
— |
$120 |
$271 | |
| MRI of the mid-back (thoracic spine) without contrast |
$4,891 |
$6,521 |
$77 |
$190 | |
| MRI of the neck (cervical spine) |
$7,172 |
$9,563 |
$77 |
$274 | |
| MRI of the neck (cervical spine) with and without contrast |
$10,229 |
$13,639 |
$134 |
$318 | |
| MRI of the neck (cervical spine) with contrast |
$7,409 |
$9,879 |
$121 |
$274 | |
| MRI of the neck (cervical spine) without contrast |
$6,935 |
$9,246 |
$77 |
$191 | |
| MRI of the pelvis |
$5,269 |
$7,025 |
$101 |
$268 | |
| MRI of the pelvis with contrast |
— |
— |
$119 |
$268 | |
| MRI of the pelvis without contrast |
$4,590 |
$6,121 |
$101 |
$227 | |
| MRI of the shoulder |
$6,876 |
$9,168 |
$89 |
$313 | |
| MRI of the shoulder with contrast |
$7,754 |
$10,339 |
$148 |
$313 | |
| MRI of the shoulder without contrast |
$5,997 |
$7,996 |
$89 |
$205 | |
| MRI of the wrist |
$7,181 |
$9,574 |
$116 |
$330 | |
| MRI of the wrist with contrast |
$8,364 |
$11,152 |
$160 |
$330 | |
| MRI of the wrist without contrast |
$5,997 |
$7,996 |
$116 |
$303 | |
| Nebulizer breathing treatment |
$398 |
$531 |
$6 |
$9 | |
| Neck (cervical) spinal fusion |
— |
— |
$10 |
$1,410 | |
| Nerve conduction study |
$1,441 |
$1,921 |
$23 |
$118 | |
| Newborn hospital care |
— |
— |
$26 |
$58 | |
| Nuchal translucency ultrasound |
$923 |
$1,231 |
$97 |
$116 | |
| Nuclear cardiac stress test |
$5,717 |
$7,622 |
$578 |
$428 | |
| Occupational therapy evaluation |
$554 |
$738 |
$66 |
$101 | |
| Occupational therapy evaluation (high complexity) |
$644 |
$859 |
$66 |
$101 | |
| Occupational therapy evaluation (low complexity) |
$149 |
$198 |
$66 |
$101 | |
| Occupational therapy evaluation (moderate complexity) |
$554 |
$738 |
$66 |
$101 | |
| Office visit (established patient) |
— |
— |
$46 |
$115 | |
| Office visit (new patient) |
— |
— |
$62 |
$177 | |
| Office visit, established patient (level 3) |
— |
— |
$46 |
$95 | |
| Office visit, established patient (level 4) |
— |
— |
$63 |
$136 | |
| Office visit, new patient (level 3) |
— |
— |
$62 |
$118 | |
| Office visit, new patient (level 4) |
— |
— |
$82 |
$177 | |
| Office visit, new patient (level 5) |
— |
— |
$100 |
$237 | |
| Orthopedic hardware removal |
— |
— |
$10 |
$632 | |
| Ovarian cyst removal |
— |
— |
$10 |
$698 | |
| Ovary removal (oophorectomy) |
— |
— |
$10 |
$822 | |
| Pacemaker insertion |
— |
— |
$8,254 |
$15,506 | |
| Pap smear (cervical screening) |
$155 |
$206 |
$17 |
$20 | |
| Parathyroid hormone (PTH) test |
$128 |
$170 |
$34 |
$41 | |
| Parathyroid removal |
— |
— |
$10 |
$891 | |
| Pelvic ultrasound |
$1,080 |
$1,440 |
$17 |
$78 | |
| Pelvic ultrasound (complete) |
$1,409 |
$1,879 |
$45 |
$105 | |
| Pelvic ultrasound (limited) |
$751 |
$1,001 |
$17 |
$51 | |
| PET scan |
$6,981 |
$9,308 |
$1,480 |
— | |
| Phosphorus blood test |
$71 |
$95 |
$11 |
$5 | |
| Physical therapy evaluation |
$163 |
$218 |
$64 |
$98 | |
| Physical therapy evaluation (high complexity) |
$189 |
$252 |
$64 |
$98 | |
| Physical therapy evaluation (moderate complexity) |
$137 |
$183 |
$64 |
$98 | |
| Pilonidal cyst removal |
— |
— |
$10 |
$541 | |
| Platelet count |
$107 |
$143 |
$4 |
$4 | |
| Pneumonia vaccine |
$158 |
$211 |
$128 |
— | |
| Pregnancy blood test (hCG) |
$107 |
$143 |
$6 |
$8 | |
| Pregnancy ultrasound |
$1,335 |
$1,780 |
$109 |
$126 | |
| Pregnancy ultrasound (first trimester) |
$1,335 |
$1,780 |
$109 |
$117 | |
| Pregnancy ultrasound (second or third trimester) |
$1,340 |
$1,786 |
$109 |
$136 | |
| Procalcitonin test |
$266 |
$355 |
$22 |
$27 | |
| Prolactin test |
$80 |
$106 |
$16 |
$19 | |
| Prostate biopsy |
$2,011 |
$2,681 |
$11 |
— | |
| Prostate removal (prostatectomy) |
— |
— |
$10 |
$1,063 | |
| Prostate surgery (TURP) |
— |
— |
$10 |
$526 | |
| Prostate test (PSA) |
$137 |
$183 |
$15 |
$18 | |
| Psychiatric evaluation |
— |
— |
$110 |
$188 | |
| Psychotherapy session |
— |
— |
$68 |
$140 | |
| Pterygium removal (eye) |
— |
— |
$10 |
$540 | |
| Pulmonary rehabilitation |
— |
— |
$49 |
$87 | |
| Radiofrequency nerve ablation |
$4,365 |
$5,821 |
$11 |
$462 | |
| Retina scan (OCT) |
— |
— |
$10 |
$33 | |
| Retinal (fundus) photography |
— |
— |
$11 |
$37 | |
| Retinal detachment repair |
— |
— |
$10 |
$966 | |
| Rheumatoid factor test |
— |
— |
$5 |
$6 | |
| Rotator cuff repair |
— |
— |
$10 |
$792 | |
| Routine eye exam |
— |
— |
$53 |
$88 | |
| RSV vaccine |
$551 |
$735 |
$337 |
— | |
| Sacroiliac joint injection |
— |
— |
$10 |
$176 | |
| Scoliosis spine X-ray |
$237 |
$317 |
$54 |
$58 | |
| Scoliosis spine X-ray (1 view) |
$194 |
$258 |
$51 |
$44 | |
| Scoliosis spine X-ray (3 views) |
$281 |
$375 |
$92 |
$72 | |
| Screening colonoscopy |
— |
— |
$11 |
$378 | |
| Screening mammogram |
$562 |
$749 |
$97 |
$126 | |
| Scrotal ultrasound |
$1,351 |
$1,801 |
$44 |
$99 | |
| Sedimentation rate (ESR) test |
$32 |
$43 |
$2 |
$3 | |
| Semen analysis |
$196 |
$261 |
$10 |
$12 | |
| Septoplasty (deviated septum) |
— |
— |
$10 |
$613 | |
| Sex hormone binding globulin test |
— |
— |
$18 |
$22 | |
| Shingles vaccine |
$200 |
$267 |
$236 |
— | |
| Shoulder arthroscopy |
— |
— |
$11 |
$962 | |
| Shoulder replacement |
— |
— |
$10 |
$1,300 | |
| Simple laceration repair (small, up to 2.5 cm) |
— |
— |
$11 |
$114 | |
| Simple wound stitches |
— |
— |
$11 |
$127 | |
| Sinus surgery (endoscopic) |
— |
— |
$10 |
$224 | |
| Skin biopsy |
— |
— |
$11 |
$121 | |
| Skin biopsy (punch) |
— |
— |
$11 |
$121 | |
| Skin cancer lesion removal |
— |
— |
$10 |
$240 | |
| Skin graft |
— |
— |
$10 |
$898 | |
| Skin lesion freezing (cryotherapy) |
— |
— |
$10 |
$36 | |
| Skin tag removal |
— |
— |
$10 |
$92 | |
| Sleep study (polysomnography) |
$11,924 |
$15,899 |
$318 |
$691 | |
| Small bowel resection |
— |
— |
$10 |
$1,136 | |
| Soft tissue ultrasound |
$539 |
$718 |
$53 |
$64 | |
| Speech therapy |
$338 |
$451 |
$49 |
$76 | |
| Spinal cord stimulator |
$11,747 |
$15,662 |
$11 |
$2,388 | |
| Spinal tap (lumbar puncture) |
$1,096 |
$1,462 |
$11 |
$165 | |
| Spine fracture repair (kyphoplasty) |
$19,835 |
$26,447 |
$11 |
$5,803 | |
| Spirometry (lung function test) |
$371 |
$495 |
$13 |
$30 | |
| Spirometry with bronchodilator |
$889 |
$1,185 |
$19 |
$43 | |
| Spleen removal (splenectomy) |
— |
— |
$10 |
$1,036 | |
| Stomach removal (gastrectomy) |
— |
— |
$10 |
$1,595 | |
| Strabismus (eye muscle) surgery |
— |
— |
$10 |
$475 | |
| Strep throat test |
$158 |
$211 |
$14 |
$17 | |
| Stress echocardiogram |
$4,922 |
$6,563 |
$72 |
$209 | |
| Stress echocardiogram (complete) |
— |
— |
$93 |
$233 | |
| Swallow study |
$488 |
$651 |
$55 |
$85 | |
| T3 thyroid test |
$302 |
$402 |
$12 |
$14 | |
| Tdap (tetanus) vaccine |
$63 |
$84 |
$53 |
— | |
| Testicle removal (orchiectomy) |
— |
— |
$10 |
$306 | |
| Testosterone test |
$99 |
$132 |
$21 |
$26 | |
| Thyroid removal (thyroidectomy) |
— |
— |
$10 |
$1,004 | |
| Thyroid test (TSH) |
$243 |
$325 |
$14 |
$17 | |
| Thyroid ultrasound |
$1,409 |
$1,879 |
$109 |
$109 | |
| Thyroid uptake scan |
$1,956 |
$2,608 |
$127 |
$145 | |
| Tilt table test |
$3,653 |
$4,871 |
$1 |
$168 | |
| Tonsillectomy |
— |
— |
$10 |
$252 | |
| Total IgE allergy test |
$41 |
$55 |
$14 |
$16 | |
| Total protein test |
$61 |
$82 |
$11 |
$4 | |
| Tracheostomy |
— |
— |
$10 |
$273 | |
| Transesophageal echocardiogram (TEE) |
$1,985 |
$2,647 |
$80 |
$239 | |
| Transesophageal echocardiogram (TEE) with and without contrast |
$1,985 |
$2,647 |
$80 |
$239 | |
| Transvaginal ultrasound |
$1,124 |
$1,499 |
$109 |
$118 | |
| Trigger finger release |
$6,227 |
$8,303 |
$11 |
$630 | |
| Trigger point injection |
$1,273 |
$1,698 |
$11 |
$56 | |
| Trigger point injection (1-2 muscles) |
$1,350 |
$1,800 |
$11 |
$52 | |
| Triglycerides test |
$8 |
$11 |
$11 |
$6 | |
| Troponin (heart) test |
$34 |
$45 |
$10 |
$12 | |
| Tubal ligation |
— |
— |
$10 |
$333 | |
| Turbinate reduction |
— |
— |
$10 |
$294 | |
| Turning a breech baby (version) |
— |
— |
$10 |
$94 | |
| Ulnar nerve surgery (elbow) |
— |
— |
$10 |
$575 | |
| Umbilical hernia repair |
— |
— |
$6,861 |
— | |
| Upper GI endoscopy (EGD) |
— |
— |
$10 |
$371 | |
| Upper GI series (barium) |
$1,376 |
$1,835 |
$141 |
$128 | |
| Ureteral stent placement |
— |
— |
$11 |
$373 | |
| Ureteroscopy (stone removal) |
— |
— |
$10 |
$365 | |
| Uric acid (gout) test |
$70 |
$93 |
$11 |
$5 | |
| Urinalysis |
$83 |
$110 |
$2 |
$3 | |
| Urine microalbumin test |
$65 |
$86 |
$4 |
$5 | |
| Urine pregnancy test |
$161 |
$214 |
$7 |
$9 | |
| UV light therapy (skin) |
— |
— |
$62 |
$106 | |
| Vaccine administration |
$71 |
$95 |
$19 |
$19 | |
| Vaccine administration (each additional) |
$46 |
$61 |
$19 |
$16 | |
| Vaginal delivery |
— |
— |
$5,523 |
$5,487 | |
| Varicocele repair |
— |
— |
$10 |
$327 | |
| Varicose vein ablation |
— |
— |
$10 |
$1,018 | |
| Vasectomy |
— |
— |
$10 |
$347 | |
| Visual field test |
— |
— |
$23 |
$64 | |
| Vitamin B12 test |
$210 |
$280 |
$12 |
$15 | |
| Vitamin D test |
$149 |
$198 |
$24 |
$30 | |
| Vitrectomy (eye) |
— |
— |
$10 |
$814 | |
| Vocal cord injection |
— |
— |
$10 |
$211 | |
| Wart removal |
— |
— |
$10 |
$121 | |
| Weight-loss (bariatric) surgery |
— |
— |
$24,755 |
$11,645 | |
| Well-child visit |
— |
— |
$65 |
— | |
| Whipple procedure (pancreas) |
— |
— |
$10 |
$2,871 | |
| Wound debridement |
— |
— |
$11 |
$186 | |
| Wrist fracture repair |
— |
— |
$10 |
$735 | |
| X-ray of the abdomen |
$706 |
$941 |
$37 |
$36 | |
| X-ray of the ankle |
$466 |
$621 |
$47 |
$37 | |
| X-ray of the collarbone |
$500 |
$666 |
$41 |
$33 | |
| X-ray of the elbow |
$466 |
$621 |
$41 |
$33 | |
| X-ray of the facial bones |
$417 |
$556 |
$39 |
$39 | |
| X-ray of the foot |
$466 |
$621 |
$43 |
$34 | |
| X-ray of the forearm |
$450 |
$600 |
$36 |
$29 | |
| X-ray of the hand |
$489 |
$652 |
$48 |
$38 | |
| X-ray of the hip |
$276 |
$369 |
$43 |
$49 | |
| X-ray of the hip (1 view) |
$206 |
$274 |
$41 |
$34 | |
| X-ray of the hip (3 views) |
$347 |
$463 |
$62 |
$49 | |
| X-ray of the hip (4 views) |
$392 |
$522 |
$79 |
$63 | |
| X-ray of the knee |
$460 |
$613 |
$46 |
$42 | |
| X-ray of the knee (2 views) |
$448 |
$597 |
$43 |
$34 | |
| X-ray of the knee (3 views) |
$460 |
$613 |
$53 |
$42 | |
| X-ray of the knee (4+ views) |
$615 |
$820 |
$61 |
$49 | |
| X-ray of the lower back (lumbar spine) |
$584 |
$779 |
$51 |
$47 | |
| X-ray of the lower back (lumbar spine) (2 views) |
$584 |
$779 |
$48 |
$40 | |
| X-ray of the lower back (lumbar spine) (4+ views) |
$809 |
$1,078 |
$66 |
$53 | |
| X-ray of the lower leg |
$416 |
$554 |
$40 |
$31 | |
| X-ray of the mid-back (thoracic spine) |
$410 |
$546 |
$41 |
$36 | |
| X-ray of the mid-back (thoracic spine) (2 views) |
$443 |
$590 |
$39 |
$33 | |
| X-ray of the mid-back (thoracic spine) (3 views) |
$377 |
$502 |
$48 |
$39 | |
| X-ray of the neck (cervical spine) |
$392 |
$522 |
$51 |
$47 | |
| X-ray of the neck (cervical spine) (3 views) |
$392 |
$522 |
$48 |
$40 | |
| X-ray of the pelvis |
$427 |
$569 |
$34 |
$36 | |
| X-ray of the pelvis (1 view) |
$427 |
$569 |
$33 |
$28 | |
| X-ray of the ribs |
$392 |
$522 |
$46 |
$42 | |
| X-ray of the ribs (2 views) |
$491 |
$654 |
$43 |
$36 | |
| X-ray of the ribs (3 views) |
$392 |
$522 |
$49 |
$42 | |
| X-ray of the shoulder |
$575 |
$767 |
$43 |
$36 | |
| X-ray of the skull |
$575 |
$767 |
$47 |
$40 | |
| X-ray of the upper arm |
$416 |
$554 |
$41 |
$32 | |
| X-ray of the wrist |
$479 |
$638 |
$55 |
$43 | |
| YAG laser capsulotomy (eye) |
— |
— |
$10 |
$335 | |
| Zinc blood test |
$26 |
$34 |
$9 |
$11 | |