| 3D mammogram (tomosynthesis) |
$170 |
$170 |
$108 |
$51 | |
| Abdominal fluid drain (paracentesis) |
$6,563 |
$6,563 |
$1,315 |
$284 | |
| Abdominal ultrasound |
$1,308 |
$1,308 |
$846 |
$100 | |
| Abdominal ultrasound (complete) |
$1,308 |
$1,308 |
$846 |
$114 | |
| Abdominal ultrasound (limited) |
$1,308 |
$1,308 |
$846 |
$86 | |
| Abscess drainage (complex or multiple) |
$560 |
$560 |
$430 |
$220 | |
| Abscess drainage (simple) |
$329 |
$329 |
$249 |
$129 | |
| Abscess incision and drainage |
$445 |
$445 |
$364 |
$174 | |
| Achilles tendon repair |
$1,989 |
$1,989 |
— |
$624 | |
| ACL knee reconstruction |
$3,163 |
$3,163 |
— |
$889 | |
| Adenoid removal (adenoidectomy) |
$675 |
$675 |
— |
$204 | |
| Albumin blood test |
$60 |
$60 |
$39 |
$5 | |
| Aldosterone test |
$518 |
$518 |
$335 |
$41 | |
| Alkaline phosphatase test |
$63 |
$63 |
$41 |
$5 | |
| Allergy shots |
$66 |
$66 |
$47 |
$11 | |
| Alpha-fetoprotein (AFP) test |
$215 |
$215 |
$139 |
$17 | |
| ALT liver enzyme test |
$69 |
$69 |
$45 |
$5 | |
| Ammonia blood test |
$170 |
$170 |
$110 |
$15 | |
| Amniocentesis |
$277 |
$277 |
$235 |
$120 | |
| Amylase test |
$84 |
$84 |
$54 |
$6 | |
| Anal fistula repair |
$1,563 |
$1,563 |
— |
$541 | |
| Ankle fracture repair |
$1,939 |
$1,939 |
$1,311 |
$608 | |
| Annual physical (established patient) |
$184 |
$184 |
$116 |
— | |
| Annual physical (new patient) |
$232 |
$232 |
$146 |
— | |
| Anoscopy |
$317 |
$317 |
— |
$129 | |
| Antinuclear antibody (ANA) test |
$155 |
$155 |
$100 |
$12 | |
| Arterial blood gas (ABG) |
$301 |
$301 |
$195 |
$26 | |
| AST liver enzyme test |
$68 |
$68 |
$44 |
$5 | |
| Barium swallow study |
$1,074 |
$1,074 |
$662 |
$107 | |
| Bartholin cyst removal |
$1,408 |
$1,408 |
$753 |
$182 | |
| Basic metabolic panel |
$111 |
$111 |
$72 |
$8 | |
| Benign skin lesion removal |
$487 |
$487 |
$365 |
$171 | |
| Bilirubin blood test |
$66 |
$66 |
$43 |
$5 | |
| Bladder function test (urodynamics) |
$1,051 |
$1,051 |
— |
$345 | |
| Bladder scope (cystoscopy) |
$243 |
$243 |
— |
$216 | |
| Blood clotting test (PT/INR) |
$50 |
$50 |
$29 |
$4 | |
| Blood glucose test |
$114 |
$114 |
$33 |
$5 | |
| Blood transfusion |
$2,161 |
$2,161 |
$1,450 |
$47 | |
| Blood type and screen |
$628 |
$628 |
$403 |
$10 | |
| Blood type test |
$215 |
$215 |
$156 |
$3 | |
| Blood type test (ABO group) |
$208 |
$208 |
$148 |
$3 | |
| Blood type test (Rh/D antigen) |
$222 |
$222 |
$168 |
$3 | |
| BNP (heart failure) test |
$455 |
$455 |
$294 |
$39 | |
| Bone density scan (DEXA) |
$694 |
$694 |
$449 |
$39 | |
| Bone marrow biopsy |
$353 |
$353 |
$237 |
$172 | |
| Bone scan (nuclear) |
$1,731 |
$1,731 |
$1,120 |
$259 | |
| Botox for migraine |
$495 |
$495 |
$338 |
$157 | |
| Breast biopsy |
$3,170 |
$3,170 |
$3,228 |
$478 | |
| Breast ultrasound |
$1,120 |
$1,120 |
$576 |
$92 | |
| Breast ultrasound (complete) |
$1,308 |
$1,308 |
$846 |
$100 | |
| Breast ultrasound (limited) |
$931 |
$931 |
$576 |
$84 | |
| Breathing tube insertion (intubation) |
$2,533 |
$2,533 |
$1,083 |
$133 | |
| Bunion surgery (bunionectomy) |
$2,853 |
$2,853 |
— |
$883 | |
| Burn dressing and debridement (medium) |
$1,391 |
$1,391 |
$312 |
$166 | |
| Burn dressing and debridement (small) |
$253 |
$253 |
$174 |
$93 | |
| Burn treatment |
$822 |
$822 |
$202 |
$129 | |
| CA 19-9 tumor marker test |
$265 |
$265 |
$171 |
$21 | |
| CA-125 ovarian marker test |
$241 |
$241 |
$156 |
$21 | |
| Calcium blood test |
$68 |
$68 |
$36 |
$5 | |
| Cardiac rehabilitation |
$364 |
$364 |
$236 |
$26 | |
| Cardiac stress test |
$204 |
$204 |
$1,124 |
$39 | |
| Cardioversion |
$4,581 |
$4,581 |
$2,692 |
$155 | |
| Carotid artery ultrasound |
$935 |
$935 |
$591 |
$156 | |
| Carpal tunnel release |
$1,345 |
$1,345 |
— |
$483 | |
| CEA tumor marker test |
$242 |
$242 |
$157 |
$19 | |
| Celiac disease test |
$147 |
$147 |
$88 |
$12 | |
| Cervical cerclage |
$727 |
$727 |
— |
$137 | |
| Cervical LEEP procedure |
$787 |
$787 |
— |
$325 | |
| Cesarean section (C-section) |
— |
— |
$1,770 |
$7,552 | |
| Chest fluid drain (thoracentesis) |
$804 |
$804 |
$520 |
$311 | |
| Chest tube insertion |
$10,874 |
$10,874 |
$3,838 |
$143 | |
| Chest X-ray |
$471 |
$471 |
$291 |
$37 | |
| Chest X-ray (1 view) |
$449 |
$449 |
$291 |
$25 | |
| Chest X-ray (2 views) |
$493 |
$493 |
$291 |
$33 | |
| Chickenpox (varicella) vaccine |
$134 |
$134 |
$90 |
— | |
| Circumcision |
$518 |
$518 |
$308 |
$167 | |
| CK-MB heart enzyme test |
$136 |
$136 |
$88 |
$12 | |
| Clotting time test (PTT) |
$71 |
$71 |
$45 |
$6 | |
| Colon resection (colectomy) |
$4,319 |
$4,319 |
— |
$1,238 | |
| Colonoscopy |
$1,210 |
$1,210 |
— |
$480 | |
| Colostomy |
$3,854 |
$3,854 |
— |
$1,122 | |
| Colposcopy |
$452 |
$452 |
$329 |
$161 | |
| Complete blood count (CBC) |
$87 |
$87 |
$54 |
$7 | |
| Complete blood count (CBC) (complete) |
$99 |
$99 |
$64 |
$8 | |
| Complex wound repair |
$4,285 |
$4,285 |
$1,816 |
$390 | |
| Comprehensive metabolic panel |
$162 |
$162 |
$105 |
$11 | |
| Continuous glucose monitor setup |
$113 |
$113 |
— |
$35 | |
| Contraceptive implant (Nexplanon) |
$429 |
$429 |
$277 |
$115 | |
| Copper blood test |
$152 |
$152 |
$98 |
$12 | |
| Coronary artery bypass (CABG) |
— |
— |
$1,770 |
$36,593 | |
| Cortisol test |
$209 |
$209 |
$135 |
$16 | |
| COVID-19 PCR test |
$168 |
$168 |
$109 |
$51 | |
| CPAP titration study |
$976 |
$976 |
$655 |
$69 | |
| Creatine kinase (CK) test |
$136 |
$136 |
$67 |
$7 | |
| CT angiography of the chest |
$2,609 |
$2,609 |
$1,688 |
$281 | |
| CT angiography of the head |
$2,320 |
$2,320 |
$1,501 |
$274 | |
| CT scan of the abdomen |
$2,533 |
$2,533 |
$1,086 |
$230 | |
| CT scan of the abdomen and pelvis |
$5,712 |
$5,712 |
$2,481 |
$300 | |
| CT scan of the abdomen and pelvis with and without contrast |
$6,481 |
$6,481 |
$4,193 |
$338 | |
| CT scan of the abdomen and pelvis with contrast |
$5,712 |
$5,712 |
$3,696 |
$300 | |
| CT scan of the abdomen and pelvis without contrast |
$3,835 |
$3,835 |
$2,481 |
$183 | |
| CT scan of the abdomen with and without contrast |
$3,000 |
$3,000 |
$1,941 |
$259 | |
| CT scan of the abdomen with contrast |
$2,533 |
$2,533 |
$1,639 |
$230 | |
| CT scan of the abdomen without contrast |
$1,678 |
$1,678 |
$1,086 |
$136 | |
| CT scan of the arm |
$3,335 |
$3,335 |
$1,086 |
$199 | |
| CT scan of the arm with contrast |
$3,335 |
$3,335 |
$2,158 |
$199 | |
| CT scan of the arm without contrast |
$1,678 |
$1,678 |
$1,086 |
$161 | |
| CT scan of the chest |
$2,726 |
$2,726 |
$437 |
$167 | |
| CT scan of the chest with and without contrast |
$3,867 |
$3,867 |
$437 |
$196 | |
| CT scan of the chest with contrast |
$2,726 |
$2,726 |
$1,764 |
$167 | |
| CT scan of the chest without contrast |
$1,678 |
$1,678 |
$1,086 |
$133 | |
| CT scan of the head |
$2,454 |
$2,454 |
$1,086 |
$148 | |
| CT scan of the head with and without contrast |
$2,726 |
$2,726 |
$1,764 |
$173 | |
| CT scan of the head with contrast |
$2,454 |
$2,454 |
$1,588 |
$148 | |
| CT scan of the head without contrast |
$1,678 |
$1,678 |
$1,086 |
$107 | |
| CT scan of the leg |
$2,454 |
$2,454 |
$1,086 |
$166 | |
| CT scan of the leg with contrast |
$2,454 |
$2,454 |
$1,588 |
$166 | |
| CT scan of the leg without contrast |
$1,678 |
$1,678 |
$1,086 |
$130 | |
| CT scan of the lower back (lumbar spine) |
$2,072 |
$2,072 |
$1,140 |
$169 | |
| CT scan of the lower back (lumbar spine) with and without contrast |
$2,989 |
$2,989 |
$1,934 |
$197 | |
| CT scan of the lower back (lumbar spine) with contrast |
$2,072 |
$2,072 |
$1,341 |
$169 | |
| CT scan of the lower back (lumbar spine) without contrast |
$1,762 |
$1,762 |
$1,140 |
$130 | |
| CT scan of the neck |
$2,726 |
$2,726 |
$1,193 |
$183 | |
| CT scan of the neck (cervical spine) |
$2,072 |
$2,072 |
$1,140 |
$168 | |
| CT scan of the neck (cervical spine) with and without contrast |
$2,989 |
$2,989 |
$1,934 |
$196 | |
| CT scan of the neck (cervical spine) with contrast |
$2,072 |
$2,072 |
$1,341 |
$168 | |
| CT scan of the neck (cervical spine) without contrast |
$1,762 |
$1,762 |
$1,140 |
$131 | |
| CT scan of the neck with and without contrast |
$3,000 |
$3,000 |
$1,941 |
$220 | |
| CT scan of the neck with contrast |
$2,726 |
$2,726 |
$1,764 |
$183 | |
| CT scan of the neck without contrast |
$1,844 |
$1,844 |
$1,193 |
$150 | |
| CT scan of the pelvis |
$2,726 |
$2,726 |
$976 |
$226 | |
| CT scan of the pelvis with and without contrast |
$3,000 |
$3,000 |
$1,941 |
$251 | |
| CT scan of the pelvis with contrast |
$2,726 |
$2,726 |
$1,764 |
$226 | |
| CT scan of the pelvis without contrast |
$1,509 |
$1,509 |
$976 |
$133 | |
| CT scan of the sinuses |
$2,726 |
$2,726 |
$1,193 |
$152 | |
| CT scan of the sinuses with and without contrast |
$2,945 |
$2,945 |
$1,905 |
$184 | |
| CT scan of the sinuses with contrast |
$2,726 |
$2,726 |
$1,764 |
$152 | |
| CT scan of the sinuses without contrast |
$1,844 |
$1,844 |
$1,193 |
$128 | |
| D-dimer test |
$119 |
$119 |
$77 |
$10 | |
| Developmental screening (child) |
$107 |
$107 |
$72 |
— | |
| DHEA-sulfate test |
$284 |
$284 |
$184 |
$22 | |
| Diagnostic mammogram |
$461 |
$461 |
$265 |
$140 | |
| Dilation and curettage (D&C) |
$875 |
$875 |
$613 |
$298 | |
| Drug screen (urine) |
$43 |
$43 |
$28 |
$17 | |
| Ear pressure test (tympanometry) |
$31 |
$31 |
$46 |
$16 | |
| Ear tubes (myringotomy) |
$623 |
$623 |
— |
$174 | |
| Eardrum repair (tympanoplasty) |
$2,726 |
$2,726 |
— |
$799 | |
| Echocardiogram |
$1,672 |
$1,672 |
$1,165 |
$138 | |
| Echocardiogram with and without contrast |
$1,672 |
$1,672 |
$1,142 |
$101 | |
| Echocardiogram without contrast |
$138 |
$138 |
— |
$138 | |
| EKG / ECG (tracing only) |
$133 |
$133 |
$93 |
$7 | |
| Elbow replacement |
$4,452 |
$4,452 |
— |
$1,301 | |
| Electrocardiogram (EKG) |
$42 |
$42 |
$93 |
$8 | |
| Electrolyte panel |
$91 |
$91 |
$59 |
$7 | |
| Emergency department visit |
$767 |
$767 |
$575 |
$69 | |
| Emergency department visit (level 1) |
$218 |
$218 |
$394 |
$11 | |
| Emergency department visit (level 2) |
$440 |
$440 |
$352 |
$40 | |
| Emergency department visit (level 3) |
$767 |
$767 |
$614 |
$69 | |
| Emergency department visit (level 4) |
$1,097 |
$1,097 |
$878 |
$118 | |
| Emergency department visit (level 5) |
$1,574 |
$1,574 |
$1,259 |
$171 | |
| Endometrial biopsy |
$348 |
$348 |
$234 |
$98 | |
| Epidural steroid injection |
$2,242 |
$2,242 |
$1,337 |
$275 | |
| ERCP (bile duct endoscopy) |
$987 |
$987 |
$567 |
$311 | |
| Estradiol (estrogen) test |
$435 |
$435 |
$275 |
$28 | |
| Facet joint injection (spine) |
$418 |
$418 |
$319 |
$99 | |
| Fallopian tube X-ray (HSG) |
$1,084 |
$1,084 |
$546 |
$164 | |
| Family therapy session |
$333 |
$333 |
— |
$110 | |
| Fecal occult blood (stool) test |
$49 |
$49 |
$19 |
$10 | |
| Fecal occult blood (stool) test (guaiac, gFOBT) |
$49 |
$49 |
$11 |
$4 | |
| Fecal occult blood (stool) test (immunochemical, FIT) |
$48 |
$48 |
$31 |
$16 | |
| Feeding tube (PEG) placement |
$821 |
$821 |
— |
$178 | |
| Femoral hernia repair |
$1,983 |
$1,983 |
— |
$584 | |
| Ferritin (iron) test |
$175 |
$175 |
$113 |
$14 | |
| Fibroid removal (myomectomy) |
$3,375 |
$3,375 |
— |
$914 | |
| Flexible sigmoidoscopy |
$243 |
$243 |
— |
$323 | |
| Flu test |
$51 |
$51 |
$42 |
$17 | |
| Flu vaccine |
$55 |
$55 |
$45 |
— | |
| Folate (folic acid) test |
$158 |
$158 |
$100 |
$15 | |
| Foreign body removal (skin) |
$407 |
$407 |
$300 |
$157 | |
| Free T4 thyroid test |
$117 |
$117 |
$76 |
$9 | |
| FSH hormone test |
$237 |
$237 |
$153 |
$19 | |
| Gallbladder removal (laparoscopic) |
$2,758 |
$2,758 |
$5,543 |
$658 | |
| Gallbladder scan (HIDA) |
$1,572 |
$1,572 |
$1,005 |
$334 | |
| Ganglion cyst removal |
$989 |
$989 |
— |
$321 | |
| GGT liver test |
$93 |
$93 |
$60 |
$7 | |
| Glucose tolerance test |
$108 |
$108 |
$97 |
$8 | |
| Group therapy session |
$89 |
$89 |
— |
$30 | |
| H. pylori test |
$507 |
$507 |
$224 |
$67 | |
| Hammertoe repair |
$1,658 |
$1,658 |
— |
$548 | |
| Hearing test (audiometry) |
$105 |
$105 |
$72 |
$36 | |
| Hematocrit test |
$29 |
$29 |
$18 |
$2 | |
| Hemoglobin A1c (diabetes test) |
$124 |
$124 |
$77 |
$10 | |
| Hemorrhoid removal |
$800 |
$800 |
— |
$338 | |
| Hepatitis A vaccine |
$203 |
$203 |
$132 |
— | |
| Hepatitis B test |
$132 |
$132 |
$85 |
$10 | |
| Hepatitis B vaccine |
$100 |
$100 |
$81 |
— | |
| Hepatitis C test |
$183 |
$183 |
$118 |
$14 | |
| Hip fracture repair |
$3,871 |
$3,871 |
— |
$1,120 | |
| Hip replacement |
$4,732 |
$4,732 |
— |
$1,162 | |
| HIV test |
$281 |
$281 |
$182 |
$19 | |
| HIV test (antigen/antibody combo) |
$281 |
$281 |
$182 |
$24 | |
| Holter heart monitor |
$200 |
$200 |
$190 |
$26 | |
| Home sleep apnea test |
$1,208 |
$1,208 |
$811 |
$123 | |
| HPV vaccine |
$527 |
$527 |
$369 |
— | |
| Hydrocele repair |
$1,086 |
$1,086 |
— |
$315 | |
| Hysterectomy |
$3,325 |
$3,325 |
— |
$933 | |
| Hysteroscopy |
$1,312 |
$1,312 |
— |
$1,270 | |
| Ileostomy |
$3,405 |
$3,405 |
— |
$968 | |
| Inguinal hernia repair |
$1,753 |
$1,753 |
— |
$538 | |
| Iron blood test |
$75 |
$75 |
$48 |
$6 | |
| IUD insertion |
$305 |
$305 |
$208 |
— | |
| IUD removal |
$303 |
$303 |
$207 |
$112 | |
| IV infusion therapy |
$391 |
$391 |
$181 |
$44 | |
| IV infusion therapy (each additional) |
$207 |
$207 |
$181 |
$21 | |
| IV infusion therapy (initial) |
$574 |
$574 |
$295 |
$67 | |
| Joint aspiration (small/intermediate) |
$934 |
$934 |
$132 |
$57 | |
| Joint aspiration or injection (mid-size joint) |
$956 |
$956 |
$184 |
$57 | |
| Joint aspiration or injection (small joint) |
$911 |
$911 |
$113 |
$56 | |
| Kidney biopsy |
$8,072 |
$8,072 |
$5,223 |
$492 | |
| Kidney scan (nuclear) |
$1,766 |
$1,766 |
$1,143 |
$172 | |
| Kidney ultrasound |
$1,032 |
$1,032 |
$567 |
$84 | |
| Kidney ultrasound (limited) |
$876 |
$876 |
$567 |
$61 | |
| Knee arthroscopy |
$2,022 |
$2,022 |
— |
$524 | |
| Knee joint injection |
$1,305 |
$1,305 |
$403 |
$69 | |
| Knee replacement |
— |
— |
$1,770 |
$18,054 | |
| Lactate test |
$136 |
$136 |
$88 |
$12 | |
| Laryngoscopy |
$399 |
$399 |
$279 |
$189 | |
| LDH test |
$71 |
$71 |
$46 |
$6 | |
| LDL cholesterol test |
$136 |
$136 |
$88 |
$11 | |
| Leg vein ultrasound (Doppler) |
$955 |
$955 |
$591 |
$150 | |
| Leg vein ultrasound (Doppler) (limited) |
$675 |
$675 |
$540 |
$116 | |
| LH hormone test |
$236 |
$236 |
$153 |
$19 | |
| Lipase test |
$90 |
$90 |
$58 |
$7 | |
| Lipid (cholesterol) panel |
$171 |
$171 |
$111 |
$13 | |
| Liver biopsy |
$8,072 |
$8,072 |
$5,223 |
$288 | |
| Liver function panel |
$116 |
$116 |
$75 |
$8 | |
| Lumbar discectomy |
$3,219 |
$3,219 |
— |
$898 | |
| Lumpectomy (breast) |
$2,464 |
$2,464 |
— |
$750 | |
| Lung function test (PFT) |
$300 |
$300 |
$384 |
$37 | |
| Lung scan (V/Q) |
$1,766 |
$1,766 |
$1,143 |
$291 | |
| Magnesium blood test |
$78 |
$78 |
$50 |
$7 | |
| Mastectomy |
$3,535 |
$3,535 |
— |
$1,021 | |
| Meniscus repair (knee) |
$2,565 |
$2,565 |
— |
$714 | |
| MMR vaccine |
$163 |
$163 |
$106 |
— | |
| MRA of the brain |
$1,763 |
$1,763 |
$1,056 |
$226 | |
| MRA of the brain with contrast |
$1,632 |
$1,632 |
$1,056 |
$226 | |
| MRA of the brain without contrast |
$1,763 |
$1,763 |
$1,141 |
$328 | |
| MRA of the neck |
$1,632 |
$1,632 |
$1,056 |
$245 | |
| MRA of the neck with contrast |
$1,632 |
$1,632 |
$1,056 |
$245 | |
| MRA of the neck without contrast |
$3,040 |
$3,040 |
$1,967 |
$343 | |
| MRI of the abdomen |
$3,040 |
$3,040 |
$1,183 |
$300 | |
| MRI of the abdomen with contrast |
$3,646 |
$3,646 |
$2,359 |
$300 | |
| MRI of the abdomen without contrast |
$1,828 |
$1,828 |
$1,183 |
$194 | |
| MRI of the ankle |
$1,875 |
$1,875 |
$1,183 |
$261 | |
| MRI of the ankle with contrast |
$1,875 |
$1,875 |
$1,213 |
$261 | |
| MRI of the ankle without contrast |
$1,828 |
$1,828 |
$1,183 |
$222 | |
| MRI of the brain |
$2,258 |
$2,258 |
$1,183 |
$269 | |
| MRI of the brain with contrast |
$2,258 |
$2,258 |
$1,461 |
$269 | |
| MRI of the brain without contrast |
$1,828 |
$1,828 |
$1,183 |
$195 | |
| MRI of the chest |
$2,760 |
$2,760 |
$1,075 |
$371 | |
| MRI of the chest with contrast |
$2,760 |
$2,760 |
$1,786 |
$371 | |
| MRI of the chest without contrast |
$3,363 |
$3,363 |
$2,176 |
$466 | |
| MRI of the knee |
$2,760 |
$2,760 |
$1,420 |
$315 | |
| MRI of the knee with contrast |
$2,760 |
$2,760 |
$1,786 |
$315 | |
| MRI of the knee without contrast |
$2,195 |
$2,195 |
$1,420 |
$204 | |
| MRI of the lower back (lumbar spine) |
$2,064 |
$2,064 |
$1,183 |
$270 | |
| MRI of the lower back (lumbar spine) with contrast |
$2,064 |
$2,064 |
$1,335 |
$270 | |
| MRI of the lower back (lumbar spine) without contrast |
$1,828 |
$1,828 |
$1,183 |
$192 | |
| MRI of the mid-back (thoracic spine) |
$2,064 |
$2,064 |
$1,183 |
$271 | |
| MRI of the mid-back (thoracic spine) with and without contrast |
$3,040 |
$3,040 |
$1,967 |
$319 | |
| MRI of the mid-back (thoracic spine) with contrast |
$2,064 |
$2,064 |
$1,335 |
$271 | |
| MRI of the mid-back (thoracic spine) without contrast |
$1,828 |
$1,828 |
$1,183 |
$190 | |
| MRI of the neck (cervical spine) |
$2,064 |
$2,064 |
$1,183 |
$274 | |
| MRI of the neck (cervical spine) with and without contrast |
$3,040 |
$3,040 |
$1,967 |
$318 | |
| MRI of the neck (cervical spine) with contrast |
$2,064 |
$2,064 |
$1,335 |
$274 | |
| MRI of the neck (cervical spine) without contrast |
$1,828 |
$1,828 |
$1,183 |
$191 | |
| MRI of the pelvis |
$1,862 |
$1,862 |
$1,183 |
$268 | |
| MRI of the pelvis with contrast |
$1,862 |
$1,862 |
$1,205 |
$268 | |
| MRI of the pelvis without contrast |
$1,828 |
$1,828 |
$1,183 |
$227 | |
| MRI of the shoulder |
$3,646 |
$3,646 |
$1,420 |
$313 | |
| MRI of the shoulder with contrast |
$3,646 |
$3,646 |
$2,359 |
$313 | |
| MRI of the shoulder without contrast |
$2,195 |
$2,195 |
$1,420 |
$205 | |
| MRI of the wrist |
$2,853 |
$2,853 |
$1,420 |
$330 | |
| MRI of the wrist with contrast |
$2,853 |
$2,853 |
$1,846 |
$330 | |
| MRI of the wrist without contrast |
$2,195 |
$2,195 |
$1,420 |
$303 | |
| Nebulizer breathing treatment |
$577 |
$577 |
$387 |
$9 | |
| Neck (cervical) spinal fusion |
$5,680 |
$5,680 |
— |
$1,410 | |
| Nerve conduction study |
$317 |
$317 |
$266 |
$118 | |
| Newborn hospital care |
$198 |
$198 |
— |
$58 | |
| Nuclear cardiac stress test |
$4,758 |
$4,758 |
$3,078 |
$428 | |
| Occupational therapy evaluation |
$626 |
$626 |
$405 |
$101 | |
| Occupational therapy evaluation (high complexity) |
$626 |
$626 |
$405 |
$101 | |
| Occupational therapy evaluation (low complexity) |
$628 |
$628 |
$406 |
$101 | |
| Occupational therapy evaluation (moderate complexity) |
$626 |
$626 |
$405 |
$101 | |
| Office visit (established patient) |
$122 |
$122 |
$180 |
$115 | |
| Office visit (new patient) |
$229 |
$229 |
$201 |
$177 | |
| Office visit, established patient (level 3) |
$99 |
$99 |
$167 |
$95 | |
| Office visit, established patient (level 4) |
$145 |
$145 |
$190 |
$136 | |
| Office visit, new patient (level 3) |
$173 |
$173 |
$167 |
$118 | |
| Office visit, new patient (level 4) |
$229 |
$229 |
$207 |
$177 | |
| Office visit, new patient (level 5) |
$285 |
$285 |
$265 |
$237 | |
| Orthopedic hardware removal |
$1,913 |
$1,913 |
— |
$632 | |
| Ovarian cyst removal |
$2,399 |
$2,399 |
— |
$698 | |
| Ovary removal (oophorectomy) |
$2,682 |
$2,682 |
— |
$822 | |
| Pacemaker insertion |
— |
— |
$1,770 |
$15,506 | |
| Pap smear (cervical screening) |
$340 |
$340 |
$220 |
$20 | |
| Parathyroid hormone (PTH) test |
$478 |
$478 |
$309 |
$41 | |
| Parathyroid removal |
$3,286 |
$3,286 |
— |
$891 | |
| Pelvic ultrasound |
$1,308 |
$1,308 |
$812 |
$78 | |
| Pelvic ultrasound (complete) |
$1,308 |
$1,308 |
$810 |
$105 | |
| Pelvic ultrasound (limited) |
$1,308 |
$1,308 |
$846 |
$51 | |
| Phosphorus blood test |
$56 |
$56 |
$36 |
$5 | |
| Physical therapy evaluation |
$298 |
$298 |
$193 |
$98 | |
| Physical therapy evaluation (high complexity) |
$298 |
$298 |
$193 |
$98 | |
| Physical therapy evaluation (moderate complexity) |
$298 |
$298 |
$193 |
$98 | |
| Pilonidal cyst removal |
$1,301 |
$1,301 |
$602 |
$541 | |
| Platelet count |
$47 |
$47 |
$30 |
$4 | |
| Pneumonia vaccine |
$330 |
$330 |
$214 |
— | |
| Pregnancy blood test (hCG) |
$97 |
$97 |
$63 |
$8 | |
| Pregnancy ultrasound |
$1,308 |
$1,308 |
$846 |
$126 | |
| Pregnancy ultrasound (first trimester) |
$1,308 |
$1,308 |
$846 |
$117 | |
| Pregnancy ultrasound (second or third trimester) |
$1,308 |
$1,308 |
$846 |
$136 | |
| Procalcitonin test |
$115 |
$115 |
$74 |
$27 | |
| Prolactin test |
$247 |
$247 |
$160 |
$19 | |
| Prostate biopsy |
$6,144 |
$6,144 |
$3,975 |
— | |
| Prostate test (PSA) |
$214 |
$214 |
$138 |
$18 | |
| Psychiatric evaluation |
$435 |
$435 |
— |
$188 | |
| Psychotherapy session |
$227 |
$227 |
— |
$140 | |
| Pulmonary rehabilitation |
$190 |
$190 |
$127 |
$87 | |
| Radiofrequency nerve ablation |
$11,170 |
$11,170 |
$2,716 |
$462 | |
| Rotator cuff repair |
$2,713 |
$2,713 |
— |
$792 | |
| Sacroiliac joint injection |
$501 |
$501 |
$401 |
$176 | |
| Scoliosis spine X-ray |
$629 |
$629 |
$407 |
$58 | |
| Scoliosis spine X-ray (3 views) |
$629 |
$629 |
$407 |
$72 | |
| Screening colonoscopy |
$552 |
$552 |
— |
$378 | |
| Screening mammogram |
$415 |
$415 |
$269 |
$126 | |
| Scrotal ultrasound |
$1,308 |
$1,308 |
$846 |
$99 | |
| Sedimentation rate (ESR) test |
$55 |
$55 |
$36 |
$3 | |
| Semen analysis |
$155 |
$155 |
$100 |
$12 | |
| Septoplasty (deviated septum) |
$1,942 |
$1,942 |
— |
$613 | |
| Shoulder replacement |
$4,662 |
$4,662 |
— |
$1,300 | |
| Simple laceration repair (small, up to 2.5 cm) |
$472 |
$472 |
$322 |
$114 | |
| Simple wound stitches |
$409 |
$409 |
$258 |
$127 | |
| Sinus surgery (endoscopic) |
$1,630 |
$1,630 |
— |
$224 | |
| Skin biopsy |
$372 |
$372 |
$254 |
$121 | |
| Skin biopsy (punch) |
$372 |
$372 |
$250 |
$121 | |
| Skin cancer lesion removal |
$739 |
$739 |
$493 |
$240 | |
| Skin graft |
$2,622 |
$2,622 |
— |
$898 | |
| Skin lesion freezing (cryotherapy) |
$169 |
$169 |
$155 |
$36 | |
| Skin tag removal |
$1,435 |
$1,435 |
$230 |
$92 | |
| Sleep study (polysomnography) |
$4,814 |
$4,814 |
$3,115 |
$691 | |
| Small bowel resection |
$3,944 |
$3,944 |
— |
$1,136 | |
| Soft tissue ultrasound |
$931 |
$931 |
$602 |
$64 | |
| Speech therapy |
$302 |
$302 |
$195 |
$76 | |
| Spinal cord stimulator |
$19,418 |
$19,418 |
$7,068 |
$2,388 | |
| Spinal tap (lumbar puncture) |
$1,559 |
$1,559 |
$1,009 |
$165 | |
| Spine fracture repair (kyphoplasty) |
$27,328 |
$27,328 |
$9,982 |
$5,803 | |
| Spirometry (lung function test) |
$491 |
$491 |
$331 |
$30 | |
| Spirometry with bronchodilator |
$109 |
$109 |
$499 |
$43 | |
| Strep throat test |
$53 |
$53 |
$34 |
$17 | |
| Stress echocardiogram |
$3,799 |
$3,799 |
$2,659 |
$209 | |
| Stress echocardiogram (complete) |
$3,799 |
$3,799 |
$2,659 |
$233 | |
| Swallow study |
$332 |
$332 |
$215 |
$85 | |
| T3 thyroid test |
$181 |
$181 |
$117 |
$14 | |
| Tdap (tetanus) vaccine |
$120 |
$120 |
$60 |
— | |
| Testicle removal (orchiectomy) |
$1,049 |
$1,049 |
— |
$306 | |
| Testosterone test |
$329 |
$329 |
$213 |
$26 | |
| Thyroid removal (thyroidectomy) |
$3,684 |
$3,684 |
— |
$1,004 | |
| Thyroid test (TSH) |
$215 |
$215 |
$98 |
$17 | |
| Thyroid ultrasound |
$1,252 |
$1,252 |
$810 |
$109 | |
| Thyroid uptake scan |
$1,377 |
$1,377 |
$1,005 |
$145 | |
| Tonsillectomy |
$871 |
$871 |
— |
$252 | |
| Total IgE allergy test |
$64 |
$64 |
$41 |
$16 | |
| Total protein test |
$41 |
$41 |
$33 |
$4 | |
| Tracheostomy |
$1,307 |
$1,307 |
— |
$273 | |
| Transesophageal echocardiogram (TEE) |
$3,024 |
$3,024 |
$2,108 |
$239 | |
| Transesophageal echocardiogram (TEE) with and without contrast |
$3,024 |
$3,024 |
$2,108 |
$239 | |
| Transvaginal ultrasound |
$1,308 |
$1,308 |
$846 |
$118 | |
| Trigger finger release |
$1,248 |
$1,248 |
— |
$630 | |
| Trigger point injection |
$1,320 |
$1,320 |
$382 |
$56 | |
| Trigger point injection (1-2 muscles) |
$1,754 |
$1,754 |
$390 |
$52 | |
| Triglycerides test |
$73 |
$73 |
$47 |
$6 | |
| Troponin (heart) test |
$145 |
$145 |
$94 |
$12 | |
| Tubal ligation |
$1,179 |
$1,179 |
— |
$333 | |
| Turbinate reduction |
$1,307 |
$1,307 |
— |
$294 | |
| Turning a breech baby (version) |
$333 |
$333 |
— |
$94 | |
| Ulnar nerve surgery (elbow) |
$1,858 |
$1,858 |
— |
$575 | |
| Upper GI endoscopy (EGD) |
$526 |
$526 |
— |
$371 | |
| Upper GI series (barium) |
$1,125 |
$1,125 |
$728 |
$128 | |
| Uric acid (gout) test |
$60 |
$60 |
$39 |
$5 | |
| Urinalysis |
$37 |
$37 |
$20 |
$3 | |
| Urine microalbumin test |
$69 |
$69 |
$44 |
$5 | |
| Urine pregnancy test |
$97 |
$97 |
$22 |
$9 | |
| Vaccine administration |
$80 |
$80 |
$82 |
$19 | |
| Vaccine administration (each additional) |
$18 |
$18 |
$28 |
$16 | |
| Vaginal delivery |
— |
— |
$1,770 |
$5,487 | |
| Vasectomy |
$809 |
$809 |
$566 |
$347 | |
| Vitamin B12 test |
$169 |
$169 |
$107 |
$15 | |
| Vitamin D test |
$377 |
$377 |
$244 |
$30 | |
| Vocal cord injection |
$1,025 |
$1,025 |
— |
$211 | |
| Wart removal |
$888 |
$888 |
$250 |
$121 | |
| Weight-loss (bariatric) surgery |
— |
— |
$1,770 |
$11,645 | |
| Well-child visit |
$154 |
$154 |
$100 |
— | |
| Wound debridement |
$3,541 |
$3,541 |
$441 |
$186 | |
| Wrist fracture repair |
$2,405 |
$2,405 |
— |
$735 | |
| X-ray of the abdomen |
$694 |
$694 |
$320 |
$36 | |
| X-ray of the ankle |
$493 |
$493 |
$319 |
$37 | |
| X-ray of the collarbone |
$493 |
$493 |
$319 |
$33 | |
| X-ray of the elbow |
$493 |
$493 |
$319 |
$33 | |
| X-ray of the facial bones |
$572 |
$572 |
$291 |
$39 | |
| X-ray of the foot |
$493 |
$493 |
$319 |
$34 | |
| X-ray of the forearm |
$493 |
$493 |
$319 |
$29 | |
| X-ray of the hand |
$493 |
$493 |
$319 |
$38 | |
| X-ray of the hip |
$449 |
$449 |
$291 |
$49 | |
| X-ray of the hip (1 view) |
$449 |
$449 |
$291 |
$34 | |
| X-ray of the hip (3 views) |
$449 |
$449 |
$291 |
$49 | |
| X-ray of the hip (4 views) |
$629 |
$629 |
$407 |
$63 | |
| X-ray of the knee |
$493 |
$493 |
$319 |
$42 | |
| X-ray of the knee (2 views) |
$493 |
$493 |
$319 |
$34 | |
| X-ray of the knee (3 views) |
$493 |
$493 |
$319 |
$42 | |
| X-ray of the knee (4+ views) |
$629 |
$629 |
$407 |
$49 | |
| X-ray of the lower back (lumbar spine) |
$694 |
$694 |
$449 |
$47 | |
| X-ray of the lower back (lumbar spine) (2 views) |
$694 |
$694 |
$449 |
$40 | |
| X-ray of the lower back (lumbar spine) (4+ views) |
$694 |
$694 |
$449 |
$53 | |
| X-ray of the lower leg |
$449 |
$449 |
$291 |
$31 | |
| X-ray of the mid-back (thoracic spine) |
$694 |
$694 |
$449 |
$36 | |
| X-ray of the mid-back (thoracic spine) (2 views) |
$694 |
$694 |
$449 |
$33 | |
| X-ray of the mid-back (thoracic spine) (3 views) |
$694 |
$694 |
$449 |
$39 | |
| X-ray of the neck (cervical spine) |
$594 |
$594 |
$319 |
$47 | |
| X-ray of the neck (cervical spine) (3 views) |
$493 |
$493 |
$319 |
$40 | |
| X-ray of the pelvis |
$598 |
$598 |
$367 |
$36 | |
| X-ray of the pelvis (1 view) |
$629 |
$629 |
$407 |
$28 | |
| X-ray of the ribs |
$493 |
$493 |
$319 |
$42 | |
| X-ray of the ribs (2 views) |
$493 |
$493 |
$319 |
$36 | |
| X-ray of the ribs (3 views) |
$694 |
$694 |
$449 |
$42 | |
| X-ray of the shoulder |
$493 |
$493 |
$319 |
$36 | |
| X-ray of the skull |
$631 |
$631 |
$367 |
$40 | |
| X-ray of the upper arm |
$493 |
$493 |
$319 |
$32 | |
| X-ray of the wrist |
$493 |
$493 |
$319 |
$43 | |
| Zinc blood test |
$146 |
$146 |
$94 |
$11 | |