| 3D mammogram (tomosynthesis) |
$115 |
$115 |
— |
$51 | |
| Abdominal fluid drain (paracentesis) |
$300 |
$300 |
— |
$284 | |
| Abdominal ultrasound |
$93 |
$93 |
— |
$100 | |
| Abdominal ultrasound (complete) |
$105 |
$105 |
— |
$114 | |
| Abdominal ultrasound (limited) |
$80 |
$80 |
— |
$86 | |
| Abscess drainage (complex or multiple) |
$535 |
$535 |
— |
$220 | |
| Abscess drainage (simple) |
$310 |
$310 |
— |
$129 | |
| Abscess incision and drainage |
$423 |
$423 |
— |
$174 | |
| Acupuncture |
$90 |
$90 |
— |
$38 | |
| Adenoid removal (adenoidectomy) |
$658 |
$658 |
— |
$204 | |
| Allergy patch testing |
$20 |
$20 |
— |
$5 | |
| Allergy shots |
$38 |
$38 |
— |
$11 | |
| Allergy testing |
$15 |
$15 |
— |
$4 | |
| Amniocentesis |
$245 |
$245 |
— |
$120 | |
| Anal fistula repair |
$1,310 |
$1,310 |
— |
$541 | |
| Annual physical (established patient) |
$250 |
$250 |
— |
— | |
| Annual physical (new patient) |
$300 |
$300 |
— |
— | |
| Anoscopy |
$120 |
$120 |
— |
$129 | |
| Aortic aneurysm repair (AAA) |
$4,308 |
$4,308 |
— |
$1,345 | |
| Aortic valve replacement |
$5,056 |
$5,056 |
— |
$1,603 | |
| Barium swallow study |
$80 |
$80 |
— |
$107 | |
| Bartholin cyst removal |
$325 |
$325 |
— |
$182 | |
| Benign skin lesion removal |
$340 |
$340 |
— |
$171 | |
| Bladder function test (urodynamics) |
$1,005 |
$1,005 |
— |
$345 | |
| Bladder scope (cystoscopy) |
$230 |
$230 |
— |
$216 | |
| Bladder tumor removal (TURBT) |
$753 |
$753 |
— |
$236 | |
| Blood transfusion |
$130 |
$130 |
— |
$47 | |
| Bone density scan (DEXA) |
$115 |
$115 |
— |
$39 | |
| Bone marrow biopsy |
$203 |
$203 |
— |
$172 | |
| Botox for migraine |
$380 |
$380 |
— |
$157 | |
| Brain shunt (VP shunt) |
$3,210 |
$3,210 |
— |
$1,023 | |
| Breast MRI |
$205 |
$205 |
— |
$216 | |
| Breast MRI without contrast |
$205 |
$205 |
— |
$216 | |
| Breast reconstruction |
$3,420 |
$3,420 |
— |
$1,227 | |
| Breast reduction |
$3,215 |
$3,215 |
— |
$980 | |
| Breast ultrasound |
$100 |
$100 |
— |
$92 | |
| Breast ultrasound (complete) |
$198 |
$198 |
— |
$100 | |
| Breast ultrasound (limited) |
$90 |
$90 |
— |
$84 | |
| Breathing tube insertion (intubation) |
$405 |
$405 |
— |
$133 | |
| Bronchoscopy |
$370 |
$370 |
— |
$303 | |
| Bunion surgery (bunionectomy) |
$1,480 |
$1,480 |
— |
$883 | |
| Burn dressing and debridement (medium) |
$325 |
$325 |
— |
$166 | |
| Burn dressing and debridement (small) |
$208 |
$208 |
— |
$93 | |
| Burn treatment |
$250 |
$250 |
— |
$129 | |
| Capsule endoscopy |
$300 |
$300 |
— |
$802 | |
| Cardiac catheterization |
$1,920 |
$1,920 |
— |
$1,049 | |
| Cardiac event monitor |
$490 |
$490 |
— |
$170 | |
| Cardiac MRI |
$318 |
$318 |
— |
$322 | |
| Cardiac MRI without contrast |
$300 |
$300 |
— |
$280 | |
| Cardiac stress test |
$115 |
$115 |
— |
$39 | |
| Cardioversion |
$300 |
$300 |
— |
$155 | |
| Carotid artery surgery |
$3,290 |
$3,290 |
— |
$1,026 | |
| Carotid artery ultrasound |
$105 |
$105 |
— |
$156 | |
| Carpal tunnel release |
$1,315 |
$1,315 |
— |
$483 | |
| Central line placement |
$240 |
$240 |
— |
$238 | |
| Cervical cerclage |
$465 |
$465 |
— |
$137 | |
| Cervical LEEP procedure |
$640 |
$640 |
— |
$325 | |
| Cesarean section (C-section) |
— |
— |
$22,053 |
$7,552 | |
| Chalazion (eyelid cyst) removal |
$290 |
$290 |
— |
$131 | |
| Chemotherapy infusion |
$220 |
$220 |
— |
$81 | |
| Chemotherapy infusion (each additional) |
$80 |
$80 |
— |
$28 | |
| Chemotherapy infusion (first hour) |
$360 |
$360 |
— |
$133 | |
| Chest fluid drain (thoracentesis) |
$300 |
$300 |
— |
$311 | |
| Chest tube insertion |
$445 |
$445 |
— |
$143 | |
| Chest X-ray |
$40 |
$40 |
— |
$37 | |
| Chest X-ray (1 view) |
$25 |
$25 |
— |
$25 | |
| Chest X-ray (2 views) |
$30 |
$30 |
— |
$33 | |
| Circumcision |
$566 |
$566 |
— |
$167 | |
| Colon resection (colectomy) |
$3,938 |
$3,938 |
— |
$1,238 | |
| Colonoscopy |
$570 |
$570 |
— |
$480 | |
| Colostomy |
$3,545 |
$3,545 |
— |
$1,122 | |
| Colposcopy |
$320 |
$320 |
— |
$161 | |
| Complex wound repair |
$705 |
$705 |
— |
$390 | |
| Comprehensive eye exam |
$230 |
$230 |
— |
$138 | |
| Continuous glucose monitor setup |
$95 |
$95 |
— |
$35 | |
| Contraceptive implant (Nexplanon) |
$213 |
$213 |
— |
$115 | |
| Coronary artery bypass (CABG) |
— |
— |
$76,683 |
$36,593 | |
| Coronary CT angiography |
$310 |
$310 |
— |
$326 | |
| CPAP titration study |
$105 |
$105 |
— |
$69 | |
| Craniotomy (brain surgery) |
$6,935 |
$6,935 |
— |
$2,161 | |
| CT angiography of the chest |
$240 |
$240 |
— |
$281 | |
| CT angiography of the head |
$225 |
$225 |
— |
$274 | |
| CT colonography (virtual colonoscopy) |
$305 |
$305 |
— |
$835 | |
| CT scan of the abdomen |
$165 |
$165 |
— |
$230 | |
| CT scan of the abdomen and pelvis with contrast |
$560 |
$560 |
— |
$300 | |
| CT scan of the abdomen and pelvis without contrast |
$225 |
$225 |
— |
$183 | |
| CT scan of the abdomen with contrast |
$165 |
$165 |
— |
$230 | |
| CT scan of the abdomen without contrast |
$155 |
$155 |
— |
$136 | |
| CT scan of the arm |
$150 |
$150 |
— |
$199 | |
| CT scan of the arm without contrast |
$130 |
$130 |
— |
$161 | |
| CT scan of the chest |
$165 |
$165 |
— |
$167 | |
| CT scan of the chest with and without contrast |
$370 |
$370 |
— |
$196 | |
| CT scan of the chest with contrast |
$318 |
$318 |
— |
$167 | |
| CT scan of the chest without contrast |
$140 |
$140 |
— |
$133 | |
| CT scan of the head |
$145 |
$145 |
— |
$148 | |
| CT scan of the head with and without contrast |
$165 |
$165 |
— |
$173 | |
| CT scan of the head with contrast |
$145 |
$145 |
— |
$148 | |
| CT scan of the leg |
$150 |
$150 |
— |
$166 | |
| CT scan of the leg without contrast |
$130 |
$130 |
— |
$130 | |
| CT scan of the lower back (lumbar spine) |
$160 |
$160 |
— |
$169 | |
| CT scan of the lower back (lumbar spine) with contrast |
$160 |
$160 |
— |
$169 | |
| CT scan of the neck |
$195 |
$195 |
— |
$183 | |
| CT scan of the neck (cervical spine) |
$160 |
$160 |
— |
$168 | |
| CT scan of the neck (cervical spine) with contrast |
$160 |
$160 |
— |
$168 | |
| CT scan of the neck with and without contrast |
$210 |
$210 |
— |
$220 | |
| CT scan of the neck with contrast |
$180 |
$180 |
— |
$183 | |
| CT scan of the neck without contrast |
$303 |
$303 |
— |
$150 | |
| CT scan of the pelvis |
$150 |
$150 |
— |
$226 | |
| CT scan of the pelvis without contrast |
$140 |
$140 |
— |
$133 | |
| CT scan of the sinuses |
$145 |
$145 |
— |
$152 | |
| CT scan of the sinuses with and without contrast |
$165 |
$165 |
— |
$184 | |
| CT scan of the sinuses with contrast |
$145 |
$145 |
— |
$152 | |
| Diagnostic mammogram |
$105 |
$105 |
— |
$140 | |
| Dialysis fistula creation |
$1,925 |
$1,925 |
— |
$601 | |
| Dilation and curettage (D&C) |
$680 |
$680 |
— |
$298 | |
| Ear pressure test (tympanometry) |
$30 |
$30 |
— |
$16 | |
| Ear tubes (myringotomy) |
$430 |
$430 |
— |
$174 | |
| Eardrum repair (tympanoplasty) |
$2,560 |
$2,560 |
— |
$799 | |
| Echocardiogram |
$185 |
$185 |
— |
$138 | |
| Echocardiogram with and without contrast |
$70 |
$70 |
— |
$101 | |
| Echocardiogram without contrast |
$120 |
$120 |
— |
$138 | |
| EEG (awake and asleep) |
$1,310 |
$1,310 |
— |
$482 | |
| EKG / ECG (tracing only) |
$20 |
$20 |
— |
$7 | |
| Electrocardiogram (EKG) |
$25 |
$25 |
— |
$8 | |
| Electroencephalogram (EEG) |
$1,125 |
$1,125 |
— |
$448 | |
| Electromyography (EMG) |
$268 |
$268 |
— |
$141 | |
| Emergency department visit |
$200 |
$200 |
— |
$69 | |
| Emergency department visit (level 1) |
$35 |
$35 |
— |
$11 | |
| Emergency department visit (level 2) |
$120 |
$120 |
— |
$40 | |
| Emergency department visit (level 3) |
$200 |
$200 |
— |
$69 | |
| Emergency department visit (level 4) |
$340 |
$340 |
— |
$118 | |
| Emergency department visit (level 5) |
$490 |
$490 |
— |
$171 | |
| Endometrial biopsy |
$185 |
$185 |
— |
$98 | |
| ERCP (bile duct endoscopy) |
$995 |
$995 |
— |
$311 | |
| Esophageal dilation |
$240 |
$240 |
— |
$522 | |
| Esophageal variceal banding |
$395 |
$395 |
— |
$126 | |
| Eyelid surgery (blepharoplasty) |
$1,140 |
$1,140 |
— |
$552 | |
| Facet joint injection (spine) |
$145 |
$145 |
— |
$99 | |
| Fallopian tube X-ray (HSG) |
$110 |
$110 |
— |
$164 | |
| Family therapy session |
$285 |
$285 |
— |
$110 | |
| Feeding tube (PEG) placement |
$570 |
$570 |
— |
$178 | |
| Femoral hernia repair |
$1,823 |
$1,823 |
— |
$584 | |
| Fibroid removal (myomectomy) |
$3,008 |
$3,008 |
— |
$914 | |
| Flexible sigmoidoscopy |
$188 |
$188 |
— |
$323 | |
| Foreign body removal (skin) |
$308 |
$308 |
— |
$157 | |
| Gallbladder removal (laparoscopic) |
$2,073 |
$2,073 |
— |
$658 | |
| Ganglion cyst removal |
$985 |
$985 |
— |
$321 | |
| Group therapy session |
$70 |
$70 |
— |
$30 | |
| Hammertoe repair |
$1,130 |
$1,130 |
— |
$548 | |
| Hearing test (audiometry) |
$90 |
$90 |
— |
$36 | |
| Hemodialysis |
$195 |
$195 |
— |
$75 | |
| Hemorrhoid removal |
$790 |
$790 |
— |
$338 | |
| Hepatitis A vaccine |
$180 |
$180 |
— |
— | |
| Hip fracture repair |
$3,630 |
$3,630 |
— |
$1,120 | |
| Hip replacement |
$3,795 |
$3,795 |
— |
$1,162 | |
| Holter heart monitor |
$80 |
$80 |
— |
$26 | |
| Home sleep apnea test |
$280 |
$280 |
— |
$123 | |
| HPV vaccine |
$380 |
$380 |
— |
— | |
| Hydrocele repair |
$979 |
$979 |
— |
$315 | |
| Hysterectomy |
$2,960 |
$2,960 |
— |
$933 | |
| Hysteroscopy |
$670 |
$670 |
— |
$1,270 | |
| Ileostomy |
$3,060 |
$3,060 |
— |
$968 | |
| Inguinal hernia repair |
$1,673 |
$1,673 |
— |
$538 | |
| IUD removal |
$193 |
$193 |
— |
$112 | |
| IV infusion therapy |
$60 |
$60 |
— |
$44 | |
| IV infusion therapy (each additional) |
$60 |
$60 |
— |
$21 | |
| IV infusion therapy (initial) |
$175 |
$175 |
— |
$67 | |
| Joint aspiration (small/intermediate) |
$105 |
$105 |
— |
$57 | |
| Joint aspiration or injection (mid-size joint) |
$105 |
$105 |
— |
$57 | |
| Joint aspiration or injection (small joint) |
$105 |
$105 |
— |
$56 | |
| Kidney biopsy |
$355 |
$355 |
— |
$492 | |
| Kidney removal (nephrectomy) |
$3,705 |
$3,705 |
— |
$1,164 | |
| Kidney scan (nuclear) |
$155 |
$155 |
— |
$172 | |
| Kidney stone shock-wave (lithotripsy) |
$1,635 |
$1,635 |
— |
$760 | |
| Kidney ultrasound |
$100 |
$100 |
— |
$84 | |
| Kidney ultrasound (limited) |
$125 |
$125 |
— |
$61 | |
| Knee joint injection |
$135 |
$135 |
— |
$69 | |
| Knee replacement |
— |
— |
$39,969 |
$18,054 | |
| Laminectomy (spine) |
$3,698 |
$3,698 |
— |
$1,157 | |
| Laryngoscopy |
$205 |
$205 |
— |
$189 | |
| Leg artery angioplasty |
$1,285 |
$1,285 |
— |
— | |
| Leg vein ultrasound (Doppler) |
$218 |
$218 |
— |
$150 | |
| Leg vein ultrasound (Doppler) (limited) |
$203 |
$203 |
— |
$116 | |
| Liver biopsy |
$245 |
$245 |
— |
$288 | |
| Lumbar discectomy |
$2,815 |
$2,815 |
— |
$898 | |
| Lumpectomy (breast) |
$2,350 |
$2,350 |
— |
$750 | |
| Lung function test (PFT) |
$55 |
$55 |
— |
$37 | |
| Lung scan (V/Q) |
$498 |
$498 |
— |
$291 | |
| Mastectomy |
$3,203 |
$3,203 |
— |
$1,021 | |
| Mastoidectomy |
$2,715 |
$2,715 |
— |
$840 | |
| Mohs skin cancer surgery |
$768 |
$768 |
— |
$535 | |
| MRA of the brain with contrast |
$410 |
$410 |
— |
$226 | |
| MRA of the neck with contrast |
$195 |
$195 |
— |
$245 | |
| MRI of the abdomen |
$225 |
$225 |
— |
$300 | |
| MRI of the abdomen with contrast |
$225 |
$225 |
— |
$300 | |
| MRI of the abdomen without contrast |
$190 |
$190 |
— |
$194 | |
| MRI of the ankle with contrast |
$210 |
$210 |
— |
$261 | |
| MRI of the brain |
$230 |
$230 |
— |
$269 | |
| MRI of the brain with contrast |
$230 |
$230 |
— |
$269 | |
| MRI of the brain without contrast |
$190 |
$190 |
— |
$195 | |
| MRI of the chest with contrast |
$225 |
$225 |
— |
$371 | |
| MRI of the chest without contrast |
$295 |
$295 |
— |
$466 | |
| MRI of the lower back (lumbar spine) |
$235 |
$235 |
— |
$270 | |
| MRI of the lower back (lumbar spine) with contrast |
$235 |
$235 |
— |
$270 | |
| MRI of the lower back (lumbar spine) without contrast |
$195 |
$195 |
— |
$192 | |
| MRI of the mid-back (thoracic spine) |
$230 |
$230 |
— |
$271 | |
| MRI of the mid-back (thoracic spine) with and without contrast |
$618 |
$618 |
— |
$319 | |
| MRI of the mid-back (thoracic spine) with contrast |
$230 |
$230 |
— |
$271 | |
| MRI of the mid-back (thoracic spine) without contrast |
$195 |
$195 |
— |
$190 | |
| MRI of the neck (cervical spine) |
$235 |
$235 |
— |
$274 | |
| MRI of the neck (cervical spine) with and without contrast |
$615 |
$615 |
— |
$318 | |
| MRI of the neck (cervical spine) with contrast |
$235 |
$235 |
— |
$274 | |
| MRI of the neck (cervical spine) without contrast |
$195 |
$195 |
— |
$191 | |
| MRI of the pelvis |
$225 |
$225 |
— |
$268 | |
| MRI of the pelvis with contrast |
$225 |
$225 |
— |
$268 | |
| MRI of the pelvis without contrast |
$190 |
$190 |
— |
$227 | |
| MRI of the wrist with contrast |
$210 |
$210 |
— |
$330 | |
| Nebulizer breathing treatment |
$25 |
$25 |
— |
$9 | |
| Neck (cervical) spinal fusion |
$4,550 |
$4,550 |
— |
$1,410 | |
| Nerve conduction study |
$215 |
$215 |
— |
$118 | |
| Newborn hospital care |
$183 |
$183 |
— |
$58 | |
| Nuchal translucency ultrasound |
$320 |
$320 |
— |
$116 | |
| Nuclear cardiac stress test |
$713 |
$713 |
— |
$428 | |
| Office visit (established patient) |
$185 |
$185 |
— |
$115 | |
| Office visit (new patient) |
$375 |
$375 |
— |
$177 | |
| Office visit, established patient (level 3) |
$185 |
$185 |
— |
$95 | |
| Office visit, established patient (level 4) |
$270 |
$270 |
— |
$136 | |
| Office visit, new patient (level 3) |
$230 |
$230 |
— |
$118 | |
| Office visit, new patient (level 4) |
$375 |
$375 |
— |
$177 | |
| Office visit, new patient (level 5) |
$510 |
$510 |
— |
$237 | |
| Orthopedic hardware removal |
$1,238 |
$1,238 |
— |
$632 | |
| Ovarian cyst removal |
$2,255 |
$2,255 |
— |
$698 | |
| Ovary removal (oophorectomy) |
$2,563 |
$2,563 |
— |
$822 | |
| Pacemaker insertion |
— |
— |
$42,036 |
$15,506 | |
| Pap smear (cervical screening) |
— |
— |
$25 |
$20 | |
| Parathyroid removal |
$2,875 |
$2,875 |
— |
$891 | |
| Pelvic ultrasound |
$90 |
$90 |
— |
$78 | |
| Pelvic ultrasound (complete) |
$90 |
$90 |
— |
$105 | |
| Pelvic ultrasound (limited) |
$65 |
$65 |
— |
$51 | |
| Physical therapy evaluation |
$280 |
$280 |
— |
$98 | |
| Physical therapy evaluation (high complexity) |
$280 |
$280 |
— |
$98 | |
| Physical therapy evaluation (moderate complexity) |
$280 |
$280 |
— |
$98 | |
| Pilonidal cyst removal |
$948 |
$948 |
— |
$541 | |
| Pregnancy ultrasound |
$233 |
$233 |
— |
$126 | |
| Pregnancy ultrasound (first trimester) |
$233 |
$233 |
— |
$117 | |
| Pregnancy ultrasound (second or third trimester) |
$258 |
$258 |
— |
$136 | |
| Prostate biopsy |
$365 |
$365 |
— |
— | |
| Prostate removal (prostatectomy) |
$3,355 |
$3,355 |
— |
$1,063 | |
| Prostate surgery (TURP) |
$2,070 |
$2,070 |
— |
$526 | |
| Psychiatric evaluation |
$425 |
$425 |
— |
$188 | |
| Psychotherapy session |
$250 |
$250 |
— |
$140 | |
| Retinal (fundus) photography |
$105 |
$105 |
— |
$37 | |
| Routine eye exam |
$133 |
$133 |
— |
$88 | |
| Scoliosis spine X-ray |
$45 |
$45 |
— |
$58 | |
| Scoliosis spine X-ray (1 view) |
$35 |
$35 |
— |
$44 | |
| Scoliosis spine X-ray (3 views) |
$45 |
$45 |
— |
$72 | |
| Screening colonoscopy |
$3,905 |
$3,905 |
$3,585 |
$378 | |
| Screening mammogram |
$100 |
$100 |
— |
$126 | |
| Scrotal ultrasound |
$188 |
$188 |
— |
$99 | |
| Septoplasty (deviated septum) |
$1,945 |
$1,945 |
— |
$613 | |
| Simple laceration repair (small, up to 2.5 cm) |
$133 |
$133 |
— |
$114 | |
| Simple wound stitches |
$135 |
$135 |
— |
$127 | |
| Sinus surgery (endoscopic) |
$760 |
$760 |
— |
$224 | |
| Skin biopsy |
$148 |
$148 |
— |
$121 | |
| Skin biopsy (punch) |
$135 |
$135 |
— |
$121 | |
| Skin cancer lesion removal |
$465 |
$465 |
— |
$240 | |
| Skin graft |
$2,060 |
$2,060 |
— |
$898 | |
| Skin lesion freezing (cryotherapy) |
$85 |
$85 |
— |
$36 | |
| Skin tag removal |
$225 |
$225 |
— |
$92 | |
| Sleep study (polysomnography) |
$330 |
$330 |
— |
$691 | |
| Small bowel resection |
$3,635 |
$3,635 |
— |
$1,136 | |
| Soft tissue ultrasound |
$90 |
$90 |
— |
$64 | |
| Spinal cord stimulator |
$1,185 |
$1,185 |
— |
$2,388 | |
| Spinal tap (lumbar puncture) |
$195 |
$195 |
— |
$165 | |
| Spine fracture repair (kyphoplasty) |
$1,433 |
$1,433 |
— |
$5,803 | |
| Spirometry (lung function test) |
$53 |
$53 |
— |
$30 | |
| Spirometry with bronchodilator |
$73 |
$73 |
— |
$43 | |
| Spleen removal (splenectomy) |
$3,170 |
$3,170 |
— |
$1,036 | |
| Stomach removal (gastrectomy) |
$4,330 |
$4,330 |
— |
$1,595 | |
| Stress echocardiogram |
$370 |
$370 |
— |
$209 | |
| Stress echocardiogram (complete) |
$438 |
$438 |
— |
$233 | |
| Swallow study |
$195 |
$195 |
— |
$85 | |
| Testicle removal (orchiectomy) |
$950 |
$950 |
— |
$306 | |
| Thyroid removal (thyroidectomy) |
$3,280 |
$3,280 |
— |
$1,004 | |
| Thyroid ultrasound |
$198 |
$198 |
— |
$109 | |
| Tilt table test |
$355 |
$355 |
— |
$168 | |
| Tonsillectomy |
$823 |
$823 |
— |
$252 | |
| Tracheostomy |
$885 |
$885 |
— |
$273 | |
| Transesophageal echocardiogram (TEE) |
$660 |
$660 |
— |
$239 | |
| Transesophageal echocardiogram (TEE) with and without contrast |
$473 |
$473 |
— |
$239 | |
| Transvaginal ultrasound |
$90 |
$90 |
— |
$118 | |
| Trigger finger release |
$885 |
$885 |
— |
$630 | |
| Trigger point injection |
$113 |
$113 |
— |
$56 | |
| Trigger point injection (1-2 muscles) |
$105 |
$105 |
— |
$52 | |
| Tubal ligation |
$1,085 |
$1,085 |
— |
$333 | |
| Turbinate reduction |
$515 |
$515 |
— |
$294 | |
| Turning a breech baby (version) |
$315 |
$315 |
— |
$94 | |
| Upper GI endoscopy (EGD) |
$370 |
$370 |
— |
$371 | |
| Upper GI series (barium) |
$110 |
$110 |
— |
$128 | |
| Ureteral stent placement |
$440 |
$440 |
— |
$373 | |
| Ureteroscopy (stone removal) |
$1,165 |
$1,165 |
— |
$365 | |
| Urinalysis |
$8 |
$8 |
— |
$3 | |
| Vaccine administration |
$53 |
$53 |
— |
$19 | |
| Vaccine administration (each additional) |
$45 |
$45 |
— |
$16 | |
| Vaginal delivery |
— |
— |
$14,668 |
$5,487 | |
| Varicocele repair |
$1,015 |
$1,015 |
— |
$327 | |
| Vasectomy |
$665 |
$665 |
— |
$347 | |
| Visual field test |
$180 |
$180 |
— |
$64 | |
| Vocal cord injection |
$715 |
$715 |
— |
$211 | |
| Wart removal |
$223 |
$223 |
— |
$121 | |
| Weight-loss (bariatric) surgery |
— |
— |
$38,081 |
$11,645 | |
| Whipple procedure (pancreas) |
$9,255 |
$9,255 |
— |
$2,871 | |
| Wound debridement |
$310 |
$310 |
— |
$186 | |
| X-ray of the abdomen |
$35 |
$35 |
— |
$36 | |
| X-ray of the ankle |
$68 |
$68 |
— |
$37 | |
| X-ray of the collarbone |
$25 |
$25 |
— |
$33 | |
| X-ray of the elbow |
$58 |
$58 |
— |
$33 | |
| X-ray of the facial bones |
$35 |
$35 |
— |
$39 | |
| X-ray of the forearm |
$55 |
$55 |
— |
$29 | |
| X-ray of the hand |
$68 |
$68 |
— |
$38 | |
| X-ray of the hip |
$35 |
$35 |
— |
$49 | |
| X-ray of the hip (1 view) |
$63 |
$63 |
— |
$34 | |
| X-ray of the hip (3 views) |
$30 |
$30 |
— |
$49 | |
| X-ray of the hip (4 views) |
$40 |
$40 |
— |
$63 | |
| X-ray of the knee |
$35 |
$35 |
— |
$42 | |
| X-ray of the knee (2 views) |
$25 |
$25 |
— |
$34 | |
| X-ray of the knee (3 views) |
$73 |
$73 |
— |
$42 | |
| X-ray of the knee (4+ views) |
$35 |
$35 |
— |
$49 | |
| X-ray of the lower back (lumbar spine) |
$35 |
$35 |
— |
$47 | |
| X-ray of the lower back (lumbar spine) (2 views) |
$30 |
$30 |
— |
$40 | |
| X-ray of the lower back (lumbar spine) (4+ views) |
$93 |
$93 |
— |
$53 | |
| X-ray of the lower leg |
$25 |
$25 |
— |
$31 | |
| X-ray of the mid-back (thoracic spine) |
$30 |
$30 |
— |
$36 | |
| X-ray of the mid-back (thoracic spine) (2 views) |
$30 |
$30 |
— |
$33 | |
| X-ray of the neck (cervical spine) |
$40 |
$40 |
— |
$47 | |
| X-ray of the neck (cervical spine) (3 views) |
$70 |
$70 |
— |
$40 | |
| X-ray of the pelvis |
$60 |
$60 |
— |
$36 | |
| X-ray of the pelvis (1 view) |
$55 |
$55 |
— |
$28 | |
| X-ray of the ribs |
$35 |
$35 |
— |
$42 | |
| X-ray of the ribs (2 views) |
$30 |
$30 |
— |
$36 | |
| X-ray of the ribs (3 views) |
$35 |
$35 |
— |
$42 | |
| X-ray of the shoulder |
$63 |
$63 |
— |
$36 | |
| X-ray of the skull |
$33 |
$33 |
— |
$40 | |
| X-ray of the upper arm |
$25 |
$25 |
— |
$32 | |
| YAG laser capsulotomy (eye) |
$875 |
$875 |
— |
$335 | |