| 3D mammogram (tomosynthesis) |
$117 |
$156 |
— |
$51 | |
| Abdominal fluid drain (paracentesis) |
$1,058 |
$1,410 |
— |
$284 | |
| Abdominal ultrasound |
$473 |
$630 |
— |
$100 | |
| Abdominal ultrasound (complete) |
$553 |
$737 |
— |
$114 | |
| Abdominal ultrasound (limited) |
$399 |
$532 |
— |
$86 | |
| Abscess drainage (complex or multiple) |
$554 |
$739 |
— |
$220 | |
| Abscess drainage (simple) |
$338 |
$451 |
— |
$129 | |
| Abscess incision and drainage |
$411 |
$548 |
— |
$174 | |
| Achilles tendon repair |
$3,773 |
$5,030 |
— |
$624 | |
| ACL knee reconstruction |
$5,769 |
$7,692 |
— |
$889 | |
| Acupuncture |
$68 |
$91 |
— |
$38 | |
| Acupuncture (each additional) |
$68 |
$91 |
— |
$28 | |
| Adenoid removal (adenoidectomy) |
$976 |
$1,301 |
— |
$204 | |
| Albumin blood test |
$28 |
$37 |
— |
$5 | |
| Aldosterone test |
$208 |
$277 |
— |
$41 | |
| Alkaline phosphatase test |
$30 |
$40 |
— |
$5 | |
| Allergy patch testing |
$29 |
$39 |
— |
$5 | |
| Allergy shots |
$50 |
$67 |
— |
$11 | |
| Allergy testing |
$27 |
$36 |
— |
$4 | |
| Alpha-fetoprotein (AFP) test |
$105 |
$140 |
— |
$17 | |
| ALT liver enzyme test |
$34 |
$45 |
— |
$5 | |
| Ammonia blood test |
$73 |
$97 |
— |
$15 | |
| Amylase test |
$44 |
$59 |
— |
$6 | |
| Anal fistula repair |
$1,790 |
$2,386 |
— |
$541 | |
| Ankle fracture repair |
$2,881 |
$3,841 |
— |
$608 | |
| Ankle replacement |
$8,447 |
$11,262 |
— |
$885 | |
| Annual physical (established patient) |
$261 |
$348 |
— |
— | |
| Annual physical (new patient) |
$324 |
$432 |
— |
— | |
| Anoscopy |
$225 |
$300 |
— |
$129 | |
| Antinuclear antibody (ANA) test |
$103 |
$137 |
— |
$12 | |
| Arterial blood gas (ABG) |
$92 |
$122 |
— |
$26 | |
| AST liver enzyme test |
$35 |
$46 |
— |
$5 | |
| Barium swallow study |
$383 |
$510 |
— |
$107 | |
| Bartholin cyst removal |
$440 |
$587 |
— |
$182 | |
| Basic metabolic panel |
$69 |
$92 |
— |
$8 | |
| Benign skin lesion removal |
$476 |
$635 |
— |
$171 | |
| Bilirubin blood test |
$32 |
$42 |
— |
$5 | |
| Bladder function test (urodynamics) |
$1,296 |
$1,728 |
— |
$345 | |
| Bladder scope (cystoscopy) |
$720 |
$961 |
— |
$216 | |
| Bladder tumor removal (TURBT) |
$1,807 |
$2,410 |
— |
$236 | |
| Blood clotting test (PT/INR) |
$32 |
$43 |
— |
$4 | |
| Blood crossmatch |
$169 |
$225 |
— |
— | |
| Blood glucose test |
$30 |
$40 |
— |
$5 | |
| Blood transfusion |
$681 |
$908 |
— |
$47 | |
| Blood type and screen |
$65 |
$86 |
— |
$10 | |
| Blood type test |
$33 |
$44 |
— |
$3 | |
| Blood type test (ABO group) |
$33 |
$44 |
— |
$3 | |
| Blood type test (Rh/D antigen) |
$32 |
$43 |
— |
$3 | |
| BNP (heart failure) test |
$149 |
$198 |
— |
$39 | |
| Bone density scan (DEXA) |
$547 |
$729 |
— |
$39 | |
| Bone marrow biopsy |
$1,240 |
$1,653 |
— |
$172 | |
| Bone scan (nuclear) |
$1,080 |
$1,440 |
— |
$259 | |
| Botox for migraine |
$632 |
$842 |
— |
$157 | |
| Brain shunt (VP shunt) |
$5,787 |
$7,716 |
— |
$1,023 | |
| Breast biopsy |
$2,602 |
$3,469 |
— |
$478 | |
| Breast MRI |
$4,295 |
$5,726 |
— |
$216 | |
| Breast MRI without contrast |
$4,295 |
$5,726 |
— |
$216 | |
| Breast reconstruction |
$7,823 |
$10,431 |
— |
$1,227 | |
| Breast reduction |
$7,048 |
$9,397 |
— |
$980 | |
| Breast ultrasound |
$387 |
$516 |
— |
$92 | |
| Breast ultrasound (complete) |
$450 |
$600 |
— |
$100 | |
| Breast ultrasound (limited) |
$315 |
$421 |
— |
$84 | |
| Breathing tube insertion (intubation) |
$428 |
$570 |
— |
$133 | |
| Bronchoscopy |
$1,505 |
$2,007 |
— |
$303 | |
| Bunion surgery (bunionectomy) |
$3,359 |
$4,478 |
— |
$883 | |
| Burn dressing and debridement (medium) |
$298 |
$398 |
— |
$166 | |
| Burn dressing and debridement (small) |
$315 |
$420 |
— |
$93 | |
| Burn treatment |
$298 |
$398 |
— |
$129 | |
| C-reactive protein (CRP) |
$56 |
$75 |
— |
$5 | |
| CA 19-9 tumor marker test |
$199 |
$265 |
— |
$21 | |
| CA-125 ovarian marker test |
$163 |
$217 |
— |
$21 | |
| Calcium blood test |
$32 |
$42 |
— |
$5 | |
| Capsule endoscopy |
$3,301 |
$4,401 |
— |
$802 | |
| Cardiac ablation |
$15,256 |
$20,341 |
— |
$759 | |
| Cardiac catheterization |
$4,999 |
$6,665 |
— |
$1,049 | |
| Cardiac event monitor |
$1,337 |
$1,783 |
— |
$170 | |
| Cardiac MRI |
$3,886 |
$5,181 |
— |
$322 | |
| Cardiac MRI without contrast |
$3,153 |
$4,204 |
— |
$280 | |
| Cardiac rehabilitation |
$164 |
$218 |
— |
$26 | |
| Cardiac stress test |
$369 |
$492 |
— |
$39 | |
| Cardioversion |
$850 |
$1,134 |
— |
$155 | |
| Carotid artery surgery |
$8,834 |
$11,779 |
— |
$1,026 | |
| Carotid artery ultrasound |
$1,087 |
$1,449 |
— |
$156 | |
| Carpal tunnel release |
$2,439 |
$3,252 |
— |
$483 | |
| Cataract surgery |
$4,488 |
$5,984 |
— |
$547 | |
| CEA tumor marker test |
$130 |
$173 |
— |
$19 | |
| Celiac disease test |
$108 |
$144 |
— |
$12 | |
| Central line placement |
$2,118 |
$2,824 |
— |
$238 | |
| Cervical cerclage |
$1,067 |
$1,423 |
— |
$137 | |
| Cervical LEEP procedure |
$1,552 |
$2,069 |
— |
$325 | |
| Chalazion (eyelid cyst) removal |
$419 |
$559 |
— |
$131 | |
| Chemotherapy infusion |
$410 |
$546 |
— |
$81 | |
| Chemotherapy infusion (each additional) |
$203 |
$270 |
— |
$28 | |
| Chemotherapy infusion (first hour) |
$617 |
$822 |
— |
$133 | |
| Chest fluid drain (thoracentesis) |
$1,102 |
$1,470 |
— |
$311 | |
| Chest tube insertion |
$1,258 |
$1,677 |
— |
$143 | |
| Chest X-ray |
$173 |
$231 |
— |
$37 | |
| Chest X-ray (1 view) |
$131 |
$175 |
— |
$25 | |
| Chest X-ray (2 views) |
$147 |
$197 |
— |
$33 | |
| Chickenpox (varicella) vaccine |
$196 |
$261 |
— |
— | |
| Chiropractic adjustment |
$95 |
$126 |
— |
$38 | |
| Circumcision |
$350 |
$466 |
— |
$167 | |
| Clotting time test (PTT) |
$44 |
$58 |
— |
$6 | |
| Colon resection (colectomy) |
$5,706 |
$7,609 |
— |
$1,238 | |
| Colonoscopy |
$1,616 |
$2,154 |
— |
$480 | |
| Colostomy |
$4,613 |
$6,151 |
— |
$1,122 | |
| Colposcopy |
$598 |
$798 |
— |
$161 | |
| Complete blood count (CBC) |
$47 |
$63 |
— |
$7 | |
| Complete blood count (CBC) (complete) |
$53 |
$71 |
— |
$8 | |
| Complex wound repair |
$935 |
$1,246 |
— |
$390 | |
| Comprehensive eye exam |
$182 |
$242 |
— |
$138 | |
| Comprehensive metabolic panel |
$80 |
$106 |
— |
$11 | |
| Contact lens fitting |
$102 |
$136 |
— |
— | |
| Continuous glucose monitor setup |
$155 |
$206 |
— |
$35 | |
| Contraceptive implant (Nexplanon) |
$389 |
$518 |
— |
$115 | |
| Copper blood test |
$92 |
$123 |
— |
$12 | |
| Coronary CT angiography |
$3,208 |
$4,277 |
— |
$326 | |
| Cortisol test |
$115 |
$153 |
— |
$16 | |
| COVID-19 PCR test |
$82 |
$109 |
— |
$51 | |
| CPAP titration study |
$803 |
$1,071 |
— |
$69 | |
| Craniotomy (brain surgery) |
$12,380 |
$16,507 |
— |
$2,161 | |
| Creatine kinase (CK) test |
$40 |
$53 |
— |
$7 | |
| CT angiography of the chest |
$2,472 |
$3,296 |
— |
$281 | |
| CT angiography of the head |
$2,703 |
$3,604 |
— |
$274 | |
| CT scan of the abdomen |
$1,835 |
$2,446 |
— |
$230 | |
| CT scan of the abdomen and pelvis |
$2,515 |
$3,353 |
— |
$300 | |
| CT scan of the abdomen and pelvis with and without contrast |
$3,452 |
$4,603 |
— |
$338 | |
| CT scan of the abdomen and pelvis with contrast |
$2,515 |
$3,353 |
— |
$300 | |
| CT scan of the abdomen and pelvis without contrast |
$1,759 |
$2,345 |
— |
$183 | |
| CT scan of the abdomen with and without contrast |
$2,152 |
$2,869 |
— |
$259 | |
| CT scan of the abdomen with contrast |
$1,835 |
$2,446 |
— |
$230 | |
| CT scan of the abdomen without contrast |
$1,474 |
$1,965 |
— |
$136 | |
| CT scan of the arm |
$1,532 |
$2,042 |
— |
$199 | |
| CT scan of the arm with contrast |
$1,532 |
$2,042 |
— |
$199 | |
| CT scan of the arm without contrast |
$1,354 |
$1,805 |
— |
$161 | |
| CT scan of the chest |
$1,840 |
$2,453 |
— |
$167 | |
| CT scan of the chest with and without contrast |
$2,286 |
$3,048 |
— |
$196 | |
| CT scan of the chest with contrast |
$1,840 |
$2,453 |
— |
$167 | |
| CT scan of the chest without contrast |
$1,467 |
$1,956 |
— |
$133 | |
| CT scan of the head |
$1,499 |
$1,998 |
— |
$148 | |
| CT scan of the head with and without contrast |
$1,745 |
$2,327 |
— |
$173 | |
| CT scan of the head with contrast |
$1,499 |
$1,998 |
— |
$148 | |
| CT scan of the head without contrast |
$1,073 |
$1,431 |
— |
$107 | |
| CT scan of the leg |
$1,433 |
$1,911 |
— |
$166 | |
| CT scan of the leg with contrast |
$1,433 |
$1,911 |
— |
$166 | |
| CT scan of the leg without contrast |
$1,208 |
$1,611 |
— |
$130 | |
| CT scan of the lower back (lumbar spine) |
$2,134 |
$2,845 |
— |
$169 | |
| CT scan of the lower back (lumbar spine) with and without contrast |
$2,360 |
$3,146 |
— |
$197 | |
| CT scan of the lower back (lumbar spine) with contrast |
$2,134 |
$2,845 |
— |
$169 | |
| CT scan of the lower back (lumbar spine) without contrast |
$1,747 |
$2,329 |
— |
$130 | |
| CT scan of the neck |
$1,590 |
$2,120 |
— |
$183 | |
| CT scan of the neck (cervical spine) |
$2,231 |
$2,974 |
— |
$168 | |
| CT scan of the neck (cervical spine) with and without contrast |
$2,468 |
$3,290 |
— |
$196 | |
| CT scan of the neck (cervical spine) with contrast |
$2,231 |
$2,974 |
— |
$168 | |
| CT scan of the neck (cervical spine) without contrast |
$1,467 |
$1,956 |
— |
$131 | |
| CT scan of the neck with and without contrast |
$1,697 |
$2,263 |
— |
$220 | |
| CT scan of the neck with contrast |
$1,590 |
$2,120 |
— |
$183 | |
| CT scan of the neck without contrast |
$1,283 |
$1,710 |
— |
$150 | |
| CT scan of the pelvis |
$1,849 |
$2,465 |
— |
$226 | |
| CT scan of the pelvis with and without contrast |
$2,147 |
$2,862 |
— |
$251 | |
| CT scan of the pelvis with contrast |
$1,849 |
$2,465 |
— |
$226 | |
| CT scan of the pelvis without contrast |
$1,235 |
$1,646 |
— |
$133 | |
| CT scan of the sinuses |
$1,766 |
$2,354 |
— |
$152 | |
| CT scan of the sinuses with and without contrast |
$2,249 |
$2,999 |
— |
$184 | |
| CT scan of the sinuses with contrast |
$1,766 |
$2,354 |
— |
$152 | |
| CT scan of the sinuses without contrast |
$1,609 |
$2,145 |
— |
$128 | |
| D-dimer test |
$98 |
$131 |
— |
$10 | |
| Defibrillator (ICD) implant |
$20,905 |
$27,873 |
— |
$798 | |
| Developmental screening (child) |
$60 |
$80 |
— |
— | |
| DHEA-sulfate test |
$152 |
$202 |
— |
$22 | |
| Diagnostic mammogram |
$346 |
$461 |
— |
$140 | |
| Dialysis fistula creation |
$3,619 |
$4,825 |
— |
$601 | |
| Dilation and curettage (D&C) |
$1,263 |
$1,684 |
— |
$298 | |
| Droopy eyelid repair (ptosis) |
$4,023 |
$5,364 |
— |
$745 | |
| Drug screen (urine) |
$158 |
$211 |
— |
$17 | |
| Ear pressure test (tympanometry) |
$71 |
$95 |
— |
$16 | |
| Ear tubes (myringotomy) |
$948 |
$1,264 |
— |
$174 | |
| Eardrum repair (tympanoplasty) |
$4,529 |
$6,039 |
— |
$799 | |
| Echocardiogram |
$931 |
$1,241 |
— |
$138 | |
| Echocardiogram with and without contrast |
$818 |
$1,090 |
— |
$101 | |
| EEG (awake and asleep) |
$1,115 |
$1,486 |
— |
$482 | |
| EKG / ECG (tracing only) |
$86 |
$114 |
— |
$7 | |
| Electrocardiogram (EKG) |
$87 |
$117 |
— |
$8 | |
| Electroencephalogram (EEG) |
$872 |
$1,163 |
— |
$448 | |
| Electrolyte panel |
$55 |
$73 |
— |
$7 | |
| Electromyography (EMG) |
$449 |
$599 |
— |
$141 | |
| Emergency department visit |
$399 |
$533 |
— |
$69 | |
| Emergency department visit (level 1) |
$158 |
$211 |
— |
$11 | |
| Emergency department visit (level 2) |
$233 |
$311 |
— |
$40 | |
| Emergency department visit (level 3) |
$399 |
$533 |
— |
$69 | |
| Emergency department visit (level 4) |
$641 |
$855 |
— |
$118 | |
| Emergency department visit (level 5) |
$957 |
$1,276 |
— |
$171 | |
| Endometrial biopsy |
$382 |
$509 |
— |
$98 | |
| Epidural steroid injection |
$1,523 |
$2,031 |
— |
$275 | |
| ERCP (bile duct endoscopy) |
$3,270 |
$4,360 |
— |
$311 | |
| Esophageal dilation |
$447 |
$596 |
— |
$522 | |
| Estradiol (estrogen) test |
$122 |
$162 |
— |
$28 | |
| Eye refraction (glasses prescription) |
$46 |
$61 |
— |
— | |
| Eyelid surgery (blepharoplasty) |
$2,228 |
$2,971 |
— |
$552 | |
| Facet joint injection (spine) |
$810 |
$1,080 |
— |
$99 | |
| Fallopian tube X-ray (HSG) |
$451 |
$601 |
— |
$164 | |
| Family therapy session |
$348 |
$464 |
— |
$110 | |
| Fecal occult blood (stool) test |
$74 |
$99 |
— |
$10 | |
| Fecal occult blood (stool) test (immunochemical, FIT) |
$74 |
$99 |
— |
$16 | |
| Feeding tube (PEG) placement |
$2,147 |
$2,863 |
— |
$178 | |
| Femoral hernia repair |
$2,454 |
$3,272 |
— |
$584 | |
| Ferritin (iron) test |
$97 |
$129 |
— |
$14 | |
| Fibrinogen test |
$75 |
$100 |
— |
$10 | |
| Fibroid removal (myomectomy) |
$3,860 |
$5,146 |
— |
$914 | |
| Flexible sigmoidoscopy |
$1,307 |
$1,742 |
— |
$323 | |
| Flu vaccine |
$23 |
$31 |
— |
— | |
| Folate (folic acid) test |
$107 |
$142 |
— |
$15 | |
| Foreign body removal (skin) |
$384 |
$513 |
— |
$157 | |
| Free T4 thyroid test |
$75 |
$100 |
— |
$9 | |
| FSH hormone test |
$110 |
$146 |
— |
$19 | |
| Gallbladder removal (laparoscopic) |
$3,860 |
$5,147 |
— |
$658 | |
| Gallbladder scan (HIDA) |
$1,795 |
$2,393 |
— |
$334 | |
| Ganglion cyst removal |
$1,679 |
$2,239 |
— |
$321 | |
| GGT liver test |
$33 |
$44 |
— |
$7 | |
| Glucose tolerance test |
$59 |
$78 |
— |
$8 | |
| Group therapy session |
$141 |
$188 |
— |
$30 | |
| H. pylori test |
$229 |
$305 |
— |
$67 | |
| Hammertoe repair |
$1,798 |
$2,397 |
— |
$548 | |
| HDL cholesterol test |
$45 |
$60 |
— |
$8 | |
| Hearing test (audiometry) |
$183 |
$244 |
— |
$36 | |
| Hematocrit test |
$26 |
$34 |
— |
$2 | |
| Hemodialysis |
$564 |
$752 |
— |
$75 | |
| Hemoglobin A1c (diabetes test) |
$57 |
$76 |
— |
$10 | |
| Hemorrhoid removal |
$824 |
$1,098 |
— |
$338 | |
| Hepatitis A vaccine |
$86 |
$115 |
— |
— | |
| Hepatitis B test |
$63 |
$84 |
— |
$10 | |
| Hepatitis B vaccine |
$47 |
$62 |
— |
— | |
| Hepatitis C test |
$108 |
$144 |
— |
$14 | |
| Hip arthroscopy |
$4,688 |
$6,250 |
— |
$931 | |
| Hip fracture repair |
$5,765 |
$7,686 |
— |
$1,120 | |
| Hip replacement |
$12,933 |
$17,244 |
— |
$1,162 | |
| HIV test |
$87 |
$116 |
— |
$19 | |
| HIV test (antibody) |
$86 |
$114 |
— |
$14 | |
| HIV test (antigen/antibody combo) |
$88 |
$117 |
— |
$24 | |
| Holter heart monitor |
$219 |
$292 |
— |
$26 | |
| Home sleep apnea test |
$729 |
$972 |
— |
$123 | |
| HPV vaccine |
$318 |
$424 |
— |
— | |
| Hydrocele repair |
$2,000 |
$2,667 |
— |
$315 | |
| Hysterectomy |
$4,662 |
$6,216 |
— |
$933 | |
| Hysteroscopy |
$2,609 |
$3,478 |
— |
$1,270 | |
| Ileostomy |
$4,014 |
$5,352 |
— |
$968 | |
| Inguinal hernia repair |
$2,275 |
$3,033 |
— |
$538 | |
| Iron blood test |
$34 |
$45 |
— |
$6 | |
| IUD insertion |
$368 |
$491 |
— |
— | |
| IUD removal |
$350 |
$467 |
— |
$112 | |
| IV infusion therapy |
$160 |
$214 |
— |
$44 | |
| IV infusion therapy (each additional) |
$80 |
$106 |
— |
$21 | |
| IV infusion therapy (initial) |
$241 |
$321 |
— |
$67 | |
| IVC filter placement |
$4,412 |
$5,883 |
— |
$1,885 | |
| Joint aspiration (small/intermediate) |
$301 |
$402 |
— |
$57 | |
| Joint aspiration or injection (mid-size joint) |
$301 |
$402 |
— |
$57 | |
| Joint aspiration or injection (small joint) |
$294 |
$392 |
— |
$56 | |
| Kidney biopsy |
$1,357 |
$1,809 |
— |
$492 | |
| Kidney removal (nephrectomy) |
$5,436 |
$7,248 |
— |
$1,164 | |
| Kidney scan (nuclear) |
$1,276 |
$1,701 |
— |
$172 | |
| Kidney stone shock-wave (lithotripsy) |
$5,012 |
$6,682 |
— |
$760 | |
| Kidney ultrasound |
$360 |
$480 |
— |
$84 | |
| Kidney ultrasound (limited) |
$278 |
$371 |
— |
$61 | |
| Knee arthroscopy |
$4,323 |
$5,764 |
— |
$524 | |
| Knee joint injection |
$661 |
$882 |
— |
$69 | |
| Lactate test |
$84 |
$113 |
— |
$12 | |
| Laminectomy (spine) |
$8,545 |
$11,394 |
— |
$1,157 | |
| Laryngoscopy |
$744 |
$993 |
— |
$189 | |
| LDH test |
$41 |
$54 |
— |
$6 | |
| Leg artery angiogram |
$1,493 |
$1,991 |
— |
$149 | |
| Leg artery angioplasty |
$12,649 |
$16,866 |
— |
— | |
| Leg vein ultrasound (Doppler) |
$1,063 |
$1,418 |
— |
$150 | |
| Leg vein ultrasound (Doppler) (limited) |
$827 |
$1,103 |
— |
$116 | |
| LH hormone test |
$109 |
$145 |
— |
$19 | |
| Lipase test |
$56 |
$75 |
— |
$7 | |
| Lipid (cholesterol) panel |
$105 |
$140 |
— |
$13 | |
| Liver biopsy |
$1,252 |
$1,669 |
— |
$288 | |
| Liver function panel |
$80 |
$106 |
— |
$8 | |
| Lumbar discectomy |
$7,882 |
$10,509 |
— |
$898 | |
| Lumpectomy (breast) |
$2,359 |
$3,145 |
— |
$750 | |
| Lung function test (PFT) |
$313 |
$417 |
— |
$37 | |
| Lung scan (V/Q) |
$1,813 |
$2,417 |
— |
$291 | |
| Magnesium blood test |
$44 |
$59 |
— |
$7 | |
| Mastectomy |
$3,804 |
$5,072 |
— |
$1,021 | |
| Meniscus repair (knee) |
$4,552 |
$6,070 |
— |
$714 | |
| MMR vaccine |
$110 |
$147 |
— |
— | |
| Mohs skin cancer surgery |
$1,347 |
$1,797 |
— |
$535 | |
| MRA of the brain |
$4,435 |
$5,913 |
— |
$226 | |
| MRA of the brain with contrast |
$4,435 |
$5,913 |
— |
$226 | |
| MRA of the brain without contrast |
$5,399 |
$7,199 |
— |
$328 | |
| MRA of the neck |
$4,447 |
$5,929 |
— |
$245 | |
| MRA of the neck with contrast |
$4,447 |
$5,929 |
— |
$245 | |
| MRA of the neck without contrast |
$5,123 |
$6,831 |
— |
$343 | |
| MRI of the abdomen |
$3,076 |
$4,101 |
— |
$300 | |
| MRI of the abdomen with contrast |
$3,076 |
$4,101 |
— |
$300 | |
| MRI of the abdomen without contrast |
$2,501 |
$3,334 |
— |
$194 | |
| MRI of the ankle |
$2,856 |
$3,809 |
— |
$261 | |
| MRI of the ankle without contrast |
$2,448 |
$3,264 |
— |
$222 | |
| MRI of the brain |
$4,169 |
$5,559 |
— |
$269 | |
| MRI of the brain with contrast |
$4,169 |
$5,559 |
— |
$269 | |
| MRI of the brain without contrast |
$3,512 |
$4,682 |
— |
$195 | |
| MRI of the chest |
$3,120 |
$4,160 |
— |
$371 | |
| MRI of the chest without contrast |
$3,404 |
$4,539 |
— |
$466 | |
| MRI of the knee |
$2,912 |
$3,883 |
— |
$315 | |
| MRI of the knee with contrast |
$2,912 |
$3,883 |
— |
$315 | |
| MRI of the knee without contrast |
$2,535 |
$3,380 |
— |
$204 | |
| MRI of the lower back (lumbar spine) |
$3,767 |
$5,023 |
— |
$270 | |
| MRI of the lower back (lumbar spine) with contrast |
$3,767 |
$5,023 |
— |
$270 | |
| MRI of the lower back (lumbar spine) without contrast |
$2,978 |
$3,970 |
— |
$192 | |
| MRI of the mid-back (thoracic spine) |
$3,721 |
$4,961 |
— |
$271 | |
| MRI of the mid-back (thoracic spine) with and without contrast |
$4,456 |
$5,941 |
— |
$319 | |
| MRI of the mid-back (thoracic spine) with contrast |
$3,721 |
$4,961 |
— |
$271 | |
| MRI of the mid-back (thoracic spine) without contrast |
$3,154 |
$4,205 |
— |
$190 | |
| MRI of the neck (cervical spine) |
$3,834 |
$5,112 |
— |
$274 | |
| MRI of the neck (cervical spine) with and without contrast |
$4,292 |
$5,722 |
— |
$318 | |
| MRI of the neck (cervical spine) with contrast |
$3,834 |
$5,112 |
— |
$274 | |
| MRI of the neck (cervical spine) without contrast |
$2,947 |
$3,929 |
— |
$191 | |
| MRI of the pelvis |
$3,266 |
$4,354 |
— |
$268 | |
| MRI of the pelvis with contrast |
$3,266 |
$4,354 |
— |
$268 | |
| MRI of the pelvis without contrast |
$2,952 |
$3,936 |
— |
$227 | |
| MRI of the shoulder |
$2,918 |
$3,890 |
— |
$313 | |
| MRI of the shoulder with contrast |
$2,918 |
$3,890 |
— |
$313 | |
| MRI of the shoulder without contrast |
$2,580 |
$3,440 |
— |
$205 | |
| MRI of the wrist |
$2,906 |
$3,875 |
— |
$330 | |
| MRI of the wrist without contrast |
$2,449 |
$3,265 |
— |
$303 | |
| Nebulizer breathing treatment |
$180 |
$240 |
— |
$9 | |
| Neck (cervical) spinal fusion |
$9,024 |
$12,032 |
— |
$1,410 | |
| Nerve conduction study |
$777 |
$1,036 |
— |
$118 | |
| Newborn hospital care |
$233 |
$311 |
— |
$58 | |
| Nuclear cardiac stress test |
$2,125 |
$2,833 |
— |
$428 | |
| Occupational therapy evaluation |
$194 |
$259 |
— |
$101 | |
| Occupational therapy evaluation (high complexity) |
$258 |
$344 |
— |
$101 | |
| Occupational therapy evaluation (low complexity) |
$192 |
$256 |
— |
$101 | |
| Occupational therapy evaluation (moderate complexity) |
$194 |
$259 |
— |
$101 | |
| Office visit (established patient) |
$135 |
$180 |
— |
$115 | |
| Office visit (new patient) |
$224 |
$298 |
— |
$177 | |
| Office visit, established patient (level 3) |
$120 |
$160 |
— |
$95 | |
| Office visit, established patient (level 4) |
$172 |
$229 |
— |
$136 | |
| Office visit, new patient (level 3) |
$181 |
$242 |
— |
$118 | |
| Office visit, new patient (level 4) |
$278 |
$371 |
— |
$177 | |
| Office visit, new patient (level 5) |
$329 |
$439 |
— |
$237 | |
| Orthopedic hardware removal |
$1,572 |
$2,096 |
— |
$632 | |
| Ovarian cyst removal |
$3,929 |
$5,239 |
— |
$698 | |
| Ovary removal (oophorectomy) |
$2,839 |
$3,785 |
— |
$822 | |
| Pap smear (cervical screening) |
$81 |
$108 |
— |
$20 | |
| Parathyroid hormone (PTH) test |
$272 |
$363 |
— |
$41 | |
| Parathyroid removal |
$5,559 |
$7,412 |
— |
$891 | |
| Pelvic ultrasound |
$338 |
$451 |
— |
$78 | |
| Pelvic ultrasound (complete) |
$465 |
$620 |
— |
$105 | |
| Pelvic ultrasound (limited) |
$261 |
$348 |
— |
$51 | |
| PET scan |
$5,966 |
$7,954 |
— |
— | |
| Phosphorus blood test |
$27 |
$36 |
— |
$5 | |
| Physical therapy evaluation |
$203 |
$270 |
— |
$98 | |
| Physical therapy evaluation (high complexity) |
$217 |
$289 |
— |
$98 | |
| Physical therapy evaluation (moderate complexity) |
$203 |
$270 |
— |
$98 | |
| Pilonidal cyst removal |
$1,458 |
$1,944 |
— |
$541 | |
| Platelet count |
$31 |
$41 |
— |
$4 | |
| Pneumonia vaccine |
$128 |
$171 |
— |
— | |
| Pregnancy ultrasound |
$582 |
$777 |
— |
$126 | |
| Pregnancy ultrasound (first trimester) |
$571 |
$761 |
— |
$117 | |
| Pregnancy ultrasound (second or third trimester) |
$594 |
$792 |
— |
$136 | |
| Procalcitonin test |
$135 |
$180 |
— |
$27 | |
| Prolactin test |
$149 |
$199 |
— |
$19 | |
| Prostate removal (prostatectomy) |
$7,314 |
$9,752 |
— |
$1,063 | |
| Prostate surgery (TURP) |
$4,097 |
$5,463 |
— |
$526 | |
| Prostate test (PSA) |
$116 |
$155 |
— |
$18 | |
| Psychiatric evaluation |
$450 |
$601 |
— |
$188 | |
| Psychotherapy session |
$330 |
$440 |
— |
$140 | |
| Pulmonary rehabilitation |
$248 |
$330 |
— |
$87 | |
| Radiofrequency nerve ablation |
$2,457 |
$3,277 |
— |
$462 | |
| Retina scan (OCT) |
$197 |
$263 |
— |
$33 | |
| Retinal (fundus) photography |
$170 |
$226 |
— |
$37 | |
| Rotator cuff repair |
$4,489 |
$5,985 |
— |
$792 | |
| Routine eye exam |
$148 |
$197 |
— |
$88 | |
| RSV vaccine |
$282 |
$376 |
— |
— | |
| Sacroiliac joint injection |
$907 |
$1,210 |
— |
$176 | |
| Scoliosis spine X-ray |
$307 |
$409 |
— |
$58 | |
| Scoliosis spine X-ray (1 view) |
$290 |
$386 |
— |
$44 | |
| Scoliosis spine X-ray (3 views) |
$324 |
$432 |
— |
$72 | |
| Screening colonoscopy |
$1,540 |
$2,053 |
— |
$378 | |
| Screening mammogram |
$410 |
$547 |
— |
$126 | |
| Scrotal ultrasound |
$632 |
$842 |
— |
$99 | |
| Sedimentation rate (ESR) test |
$35 |
$47 |
— |
$3 | |
| Semen analysis |
$87 |
$116 |
— |
$12 | |
| Septoplasty (deviated septum) |
$3,302 |
$4,403 |
— |
$613 | |
| Sex hormone binding globulin test |
$153 |
$204 |
— |
$22 | |
| Shingles vaccine |
$169 |
$225 |
— |
— | |
| Shoulder arthroscopy |
$4,740 |
$6,320 |
— |
$962 | |
| Shoulder replacement |
$8,429 |
$11,239 |
— |
$1,300 | |
| Simple laceration repair (small, up to 2.5 cm) |
$306 |
$409 |
— |
$114 | |
| Simple wound stitches |
$314 |
$418 |
— |
$127 | |
| Sinus surgery (endoscopic) |
$2,281 |
$3,041 |
— |
$224 | |
| Skin biopsy |
$230 |
$307 |
— |
$121 | |
| Skin biopsy (punch) |
$230 |
$307 |
— |
$121 | |
| Skin cancer lesion removal |
$647 |
$863 |
— |
$240 | |
| Skin graft |
$2,357 |
$3,142 |
— |
$898 | |
| Skin lesion freezing (cryotherapy) |
$114 |
$152 |
— |
$36 | |
| Skin tag removal |
$222 |
$296 |
— |
$92 | |
| Sleep study (polysomnography) |
$3,084 |
$4,112 |
— |
$691 | |
| Small bowel resection |
$4,757 |
$6,342 |
— |
$1,136 | |
| Soft tissue ultrasound |
$272 |
$362 |
— |
$64 | |
| Speech therapy |
$155 |
$207 |
— |
$76 | |
| Spinal cord stimulator |
$5,757 |
$7,676 |
— |
$2,388 | |
| Spinal tap (lumbar puncture) |
$725 |
$967 |
— |
$165 | |
| Spine fracture repair (kyphoplasty) |
$9,116 |
$12,154 |
— |
$5,803 | |
| Spirometry (lung function test) |
$219 |
$292 |
— |
$30 | |
| Spirometry with bronchodilator |
$432 |
$577 |
— |
$43 | |
| Spleen removal (splenectomy) |
$5,294 |
$7,058 |
— |
$1,036 | |
| Strabismus (eye muscle) surgery |
$4,041 |
$5,388 |
— |
$475 | |
| Stress echocardiogram |
$1,982 |
$2,643 |
— |
$209 | |
| Stress echocardiogram (complete) |
$1,982 |
$2,643 |
— |
$233 | |
| Swallow study |
$457 |
$609 |
— |
$85 | |
| T3 thyroid test |
$100 |
$133 |
— |
$14 | |
| Tdap (tetanus) vaccine |
$49 |
$65 |
— |
— | |
| Testicle removal (orchiectomy) |
$1,708 |
$2,277 |
— |
$306 | |
| Testosterone test |
$133 |
$178 |
— |
$26 | |
| Thyroid removal (thyroidectomy) |
$6,283 |
$8,378 |
— |
$1,004 | |
| Thyroid test (TSH) |
$108 |
$144 |
— |
$17 | |
| Thyroid ultrasound |
$389 |
$519 |
— |
$109 | |
| Thyroid uptake scan |
$954 |
$1,272 |
— |
$145 | |
| Tonsillectomy |
$1,425 |
$1,900 |
— |
$252 | |
| Total IgE allergy test |
$88 |
$117 |
— |
$16 | |
| Total protein test |
$29 |
$39 |
— |
$4 | |
| Tracheostomy |
$1,796 |
$2,394 |
— |
$273 | |
| Transesophageal echocardiogram (TEE) |
$2,147 |
$2,863 |
— |
$239 | |
| Transesophageal echocardiogram (TEE) with and without contrast |
$2,121 |
$2,828 |
— |
$239 | |
| Transvaginal ultrasound |
$521 |
$695 |
— |
$118 | |
| Trigger finger release |
$2,051 |
$2,735 |
— |
$630 | |
| Trigger point injection |
$343 |
$457 |
— |
$56 | |
| Trigger point injection (1-2 muscles) |
$485 |
$647 |
— |
$52 | |
| Triglycerides test |
$32 |
$43 |
— |
$6 | |
| Troponin (heart) test |
$83 |
$111 |
— |
$12 | |
| Tubal ligation |
$2,663 |
$3,550 |
— |
$333 | |
| Turbinate reduction |
$1,993 |
$2,657 |
— |
$294 | |
| Turning a breech baby (version) |
$2,112 |
$2,816 |
— |
$94 | |
| Ulnar nerve surgery (elbow) |
$3,574 |
$4,765 |
— |
$575 | |
| Upper GI endoscopy (EGD) |
$1,412 |
$1,883 |
— |
$371 | |
| Upper GI series (barium) |
$596 |
$794 |
— |
$128 | |
| Ureteral stent placement |
$1,719 |
$2,292 |
— |
$373 | |
| Ureteroscopy (stone removal) |
$4,163 |
$5,551 |
— |
$365 | |
| Uric acid (gout) test |
$32 |
$42 |
— |
$5 | |
| Urinalysis |
$29 |
$39 |
— |
$3 | |
| Urine microalbumin test |
$51 |
$69 |
— |
$5 | |
| Urine pregnancy test |
$38 |
$51 |
— |
$9 | |
| UV light therapy (skin) |
$135 |
$180 |
— |
$106 | |
| Vaccine administration |
$31 |
$42 |
— |
$19 | |
| Vaccine administration (each additional) |
$27 |
$36 |
— |
$16 | |
| Varicocele repair |
$2,998 |
$3,997 |
— |
$327 | |
| Varicose vein ablation |
$5,353 |
$7,138 |
— |
$1,018 | |
| Vasectomy |
$1,352 |
$1,802 |
— |
$347 | |
| Visual field test |
$236 |
$314 |
— |
$64 | |
| Vitamin B12 test |
$113 |
$151 |
— |
$15 | |
| Vitamin D test |
$181 |
$241 |
— |
$30 | |
| Vitrectomy (eye) |
$4,178 |
$5,570 |
— |
$814 | |
| Vocal cord injection |
$2,029 |
$2,705 |
— |
$211 | |
| Wart removal |
$243 |
$324 |
— |
$121 | |
| Well-child visit |
$203 |
$270 |
— |
— | |
| Wound debridement |
$510 |
$681 |
— |
$186 | |
| Wrist fracture repair |
$3,316 |
$4,421 |
— |
$735 | |
| X-ray of the abdomen |
$195 |
$260 |
— |
$36 | |
| X-ray of the ankle |
$156 |
$208 |
— |
$37 | |
| X-ray of the collarbone |
$164 |
$219 |
— |
$33 | |
| X-ray of the elbow |
$158 |
$211 |
— |
$33 | |
| X-ray of the facial bones |
$204 |
$272 |
— |
$39 | |
| X-ray of the foot |
$158 |
$210 |
— |
$34 | |
| X-ray of the forearm |
$151 |
$201 |
— |
$29 | |
| X-ray of the hand |
$143 |
$190 |
— |
$38 | |
| X-ray of the hip |
$224 |
$299 |
— |
$49 | |
| X-ray of the hip (1 view) |
$186 |
$248 |
— |
$34 | |
| X-ray of the hip (3 views) |
$224 |
$299 |
— |
$49 | |
| X-ray of the hip (4 views) |
$288 |
$384 |
— |
$63 | |
| X-ray of the knee |
$162 |
$216 |
— |
$42 | |
| X-ray of the knee (2 views) |
$155 |
$206 |
— |
$34 | |
| X-ray of the knee (3 views) |
$162 |
$216 |
— |
$42 | |
| X-ray of the knee (4+ views) |
$210 |
$280 |
— |
$49 | |
| X-ray of the lower back (lumbar spine) |
$216 |
$288 |
— |
$47 | |
| X-ray of the lower back (lumbar spine) (2 views) |
$188 |
$250 |
— |
$40 | |
| X-ray of the lower back (lumbar spine) (4+ views) |
$244 |
$325 |
— |
$53 | |
| X-ray of the lower leg |
$135 |
$180 |
— |
$31 | |
| X-ray of the mid-back (thoracic spine) |
$243 |
$324 |
— |
$36 | |
| X-ray of the mid-back (thoracic spine) (2 views) |
$219 |
$292 |
— |
$33 | |
| X-ray of the mid-back (thoracic spine) (3 views) |
$267 |
$356 |
— |
$39 | |
| X-ray of the neck (cervical spine) |
$216 |
$288 |
— |
$47 | |
| X-ray of the neck (cervical spine) (3 views) |
$155 |
$207 |
— |
$40 | |
| X-ray of the pelvis |
$210 |
$281 |
— |
$36 | |
| X-ray of the pelvis (1 view) |
$203 |
$270 |
— |
$28 | |
| X-ray of the ribs |
$213 |
$284 |
— |
$42 | |
| X-ray of the ribs (2 views) |
$176 |
$234 |
— |
$36 | |
| X-ray of the ribs (3 views) |
$213 |
$284 |
— |
$42 | |
| X-ray of the shoulder |
$167 |
$222 |
— |
$36 | |
| X-ray of the skull |
$227 |
$303 |
— |
$40 | |
| X-ray of the upper arm |
$170 |
$227 |
— |
$32 | |
| X-ray of the wrist |
$159 |
$212 |
— |
$43 | |
| YAG laser capsulotomy (eye) |
$1,083 |
$1,444 |
— |
$335 | |
| Zinc blood test |
$101 |
$134 |
— |
$11 | |