| 3D mammogram (tomosynthesis) |
$386 |
$773 |
$210 |
$51 | |
| Abdominal fluid drain (paracentesis) |
$1,296 |
$2,591 |
$544 |
$284 | |
| Abdominal ultrasound |
$210 |
$419 |
$88 |
$100 | |
| Abdominal ultrasound (complete) |
$210 |
$419 |
$88 |
$114 | |
| Abdominal ultrasound (limited) |
$210 |
$419 |
$88 |
$86 | |
| Abscess drainage (complex or multiple) |
$256 |
$513 |
$108 |
$220 | |
| Abscess drainage (simple) |
$192 |
$383 |
$80 |
$129 | |
| Abscess incision and drainage |
$224 |
$448 |
$108 |
$174 | |
| Albumin blood test |
$17 |
$33 |
$7 |
$5 | |
| Aldosterone test |
$90 |
$180 |
$38 |
$41 | |
| Alkaline phosphatase test |
$17 |
$33 |
$7 |
$5 | |
| Alpha-fetoprotein (AFP) test |
$43 |
$85 |
$18 |
$17 | |
| ALT liver enzyme test |
$27 |
$53 |
$11 |
$5 | |
| Ammonia blood test |
$36 |
$73 |
$13 |
$15 | |
| Amylase test |
$28 |
$56 |
$12 |
$6 | |
| Antinuclear antibody (ANA) test |
$47 |
$94 |
$20 |
$12 | |
| Arterial blood gas (ABG) |
$55 |
$111 |
$23 |
$26 | |
| AST liver enzyme test |
$21 |
$41 |
$9 |
$5 | |
| Barium swallow study |
$350 |
$700 |
$147 |
$107 | |
| Bartholin cyst removal |
$152 |
$304 |
$64 |
$182 | |
| Basic metabolic panel |
$90 |
$179 |
$38 |
$8 | |
| Benign skin lesion removal |
$869 |
$1,738 |
$365 |
$171 | |
| Bilirubin blood test |
$25 |
$49 |
$10 |
$5 | |
| Bladder scope (cystoscopy) |
$809 |
$1,617 |
$380 |
$216 | |
| Blood clotting test (PT/INR) |
$14 |
$28 |
$6 |
$4 | |
| Blood glucose test |
$17 |
$33 |
$14 |
$5 | |
| Blood transfusion |
$814 |
$1,628 |
$342 |
$47 | |
| Blood type and screen |
$282 |
$564 |
$119 |
$10 | |
| Blood type test |
$82 |
$163 |
$44 |
$3 | |
| Blood type test (ABO group) |
$106 |
$212 |
$44 |
$3 | |
| Blood type test (Rh/D antigen) |
$57 |
$115 |
$24 |
$3 | |
| BNP (heart failure) test |
$129 |
$258 |
$54 |
$39 | |
| Bone density scan (DEXA) |
$210 |
$419 |
$91 |
$39 | |
| Breast biopsy |
$3,090 |
$6,179 |
$1,298 |
$478 | |
| Breast ultrasound |
$239 |
$477 |
$102 |
$92 | |
| Breast ultrasound (complete) |
$210 |
$419 |
$88 |
$100 | |
| Breast ultrasound (limited) |
$268 |
$535 |
$112 |
$84 | |
| Breathing tube insertion (intubation) |
$309 |
$618 |
$158 |
$133 | |
| Burn dressing and debridement (medium) |
$177 |
$354 |
$74 |
$166 | |
| Burn dressing and debridement (small) |
$177 |
$354 |
$74 |
$93 | |
| Burn treatment |
$177 |
$354 |
$74 |
$129 | |
| C-reactive protein (CRP) |
$32 |
$65 |
$14 |
$5 | |
| CA 19-9 tumor marker test |
$57 |
$113 |
$24 |
$21 | |
| CA-125 ovarian marker test |
$57 |
$113 |
$24 |
$21 | |
| Calcium blood test |
$17 |
$33 |
$6 |
$5 | |
| Cardiac rehabilitation |
$100 |
$199 |
$52 |
$26 | |
| Cardioversion |
$562 |
$1,124 |
$236 |
$155 | |
| Carotid artery ultrasound |
$467 |
$934 |
$196 |
$156 | |
| CEA tumor marker test |
$65 |
$130 |
$27 |
$19 | |
| Central line placement |
$4,556 |
$9,111 |
$1,913 |
$238 | |
| Chest fluid drain (thoracentesis) |
$930 |
$1,860 |
$391 |
$311 | |
| Chest tube insertion |
$2,289 |
$4,578 |
$961 |
$143 | |
| Chest X-ray |
$124 |
$248 |
$73 |
$37 | |
| Chest X-ray (1 view) |
$173 |
$346 |
$73 |
$25 | |
| Chest X-ray (2 views) |
$75 |
$150 |
$32 |
$33 | |
| Circumcision |
$2,911 |
$5,822 |
$1,368 |
$167 | |
| CK-MB heart enzyme test |
$20 |
$40 |
$8 |
$12 | |
| Clotting time test (PTT) |
$21 |
$42 |
$9 |
$6 | |
| Colonoscopy |
$1,106 |
$2,211 |
$520 |
$480 | |
| Complete blood count (CBC) |
$30 |
$61 |
$13 |
$7 | |
| Complete blood count (CBC) (complete) |
$29 |
$58 |
$12 |
$8 | |
| Comprehensive metabolic panel |
$98 |
$196 |
$41 |
$11 | |
| Copper blood test |
$56 |
$112 |
$13 |
$12 | |
| Cortisol test |
$45 |
$90 |
$19 |
$16 | |
| COVID-19 PCR test |
$100 |
$200 |
$43 |
$51 | |
| CPAP titration study |
$305 |
$610 |
$128 |
$69 | |
| Creatine kinase (CK) test |
$17 |
$33 |
$7 |
$7 | |
| CT angiography of the chest |
$775 |
$1,549 |
$325 |
$281 | |
| CT angiography of the head |
$801 |
$1,602 |
$336 |
$274 | |
| CT scan of the abdomen |
$560 |
$1,120 |
$235 |
$230 | |
| CT scan of the abdomen and pelvis |
$907 |
$1,815 |
$381 |
$300 | |
| CT scan of the abdomen and pelvis with and without contrast |
$965 |
$1,929 |
$405 |
$338 | |
| CT scan of the abdomen and pelvis with contrast |
$907 |
$1,815 |
$381 |
$300 | |
| CT scan of the abdomen and pelvis without contrast |
$840 |
$1,679 |
$353 |
$183 | |
| CT scan of the abdomen with and without contrast |
$560 |
$1,120 |
$235 |
$259 | |
| CT scan of the abdomen with contrast |
$605 |
$1,210 |
$254 |
$230 | |
| CT scan of the abdomen without contrast |
$560 |
$1,119 |
$235 |
$136 | |
| CT scan of the arm |
$560 |
$1,120 |
$270 |
$199 | |
| CT scan of the arm with contrast |
$526 |
$1,052 |
$221 |
$199 | |
| CT scan of the arm without contrast |
$560 |
$1,120 |
$235 |
$161 | |
| CT scan of the chest |
$605 |
$1,210 |
$270 |
$167 | |
| CT scan of the chest with and without contrast |
$644 |
$1,287 |
$270 |
$196 | |
| CT scan of the chest with contrast |
$605 |
$1,210 |
$254 |
$167 | |
| CT scan of the chest without contrast |
$560 |
$1,120 |
$235 |
$133 | |
| CT scan of the head |
$605 |
$1,210 |
$270 |
$148 | |
| CT scan of the head with and without contrast |
$644 |
$1,287 |
$270 |
$173 | |
| CT scan of the head with contrast |
$605 |
$1,210 |
$254 |
$148 | |
| CT scan of the head without contrast |
$560 |
$1,120 |
$235 |
$107 | |
| CT scan of the leg |
$560 |
$1,120 |
$270 |
$166 | |
| CT scan of the leg with contrast |
$526 |
$1,052 |
$221 |
$166 | |
| CT scan of the leg without contrast |
$560 |
$1,120 |
$235 |
$130 | |
| CT scan of the lower back (lumbar spine) |
$605 |
$1,210 |
$270 |
$169 | |
| CT scan of the lower back (lumbar spine) with and without contrast |
$644 |
$1,287 |
$270 |
$197 | |
| CT scan of the lower back (lumbar spine) with contrast |
$605 |
$1,210 |
$284 |
$169 | |
| CT scan of the lower back (lumbar spine) without contrast |
$560 |
$1,120 |
$235 |
$130 | |
| CT scan of the neck |
$605 |
$1,210 |
$270 |
$183 | |
| CT scan of the neck (cervical spine) |
$605 |
$1,210 |
$270 |
$168 | |
| CT scan of the neck (cervical spine) with and without contrast |
$644 |
$1,287 |
$270 |
$196 | |
| CT scan of the neck (cervical spine) with contrast |
$605 |
$1,210 |
$284 |
$168 | |
| CT scan of the neck (cervical spine) without contrast |
$560 |
$1,120 |
$235 |
$131 | |
| CT scan of the neck with and without contrast |
$644 |
$1,287 |
$270 |
$220 | |
| CT scan of the neck with contrast |
$605 |
$1,210 |
$254 |
$183 | |
| CT scan of the neck without contrast |
$560 |
$1,120 |
$235 |
$150 | |
| CT scan of the pelvis |
$605 |
$1,210 |
$270 |
$226 | |
| CT scan of the pelvis with and without contrast |
$644 |
$1,287 |
$270 |
$251 | |
| CT scan of the pelvis with contrast |
$605 |
$1,210 |
$254 |
$226 | |
| CT scan of the pelvis without contrast |
$560 |
$1,120 |
$235 |
$133 | |
| CT scan of the sinuses |
$605 |
$1,210 |
$270 |
$152 | |
| CT scan of the sinuses with and without contrast |
$644 |
$1,287 |
$270 |
$184 | |
| CT scan of the sinuses with contrast |
$605 |
$1,210 |
$254 |
$152 | |
| CT scan of the sinuses without contrast |
$560 |
$1,120 |
$235 |
$128 | |
| D-dimer test |
$52 |
$104 |
$22 |
$10 | |
| DHEA-sulfate test |
$34 |
$68 |
$14 |
$22 | |
| Diagnostic mammogram |
$338 |
$676 |
$162 |
$140 | |
| Dilation and curettage (D&C) |
$4,468 |
$8,936 |
$2,100 |
$298 | |
| Drug screen (urine) |
$154 |
$308 |
$62 |
$17 | |
| Echocardiogram |
$346 |
$691 |
$249 |
$138 | |
| Echocardiogram with and without contrast |
$346 |
$691 |
$145 |
$101 | |
| Echocardiogram without contrast |
$346 |
$691 |
$145 |
$138 | |
| EEG (awake and asleep) |
$340 |
$680 |
$143 |
$482 | |
| EKG / ECG (tracing only) |
$58 |
$116 |
$24 |
$7 | |
| Electrocardiogram (EKG) |
$58 |
$116 |
$24 |
$8 | |
| Electroencephalogram (EEG) |
$340 |
$680 |
$143 |
$448 | |
| Electrolyte panel |
$84 |
$168 |
$35 |
$7 | |
| Emergency department visit |
$180 |
$359 |
$148 |
$69 | |
| Emergency department visit (level 1) |
$72 |
$143 |
$38 |
$11 | |
| Emergency department visit (level 2) |
$121 |
$243 |
$74 |
$40 | |
| Emergency department visit (level 3) |
$180 |
$359 |
$126 |
$69 | |
| Emergency department visit (level 4) |
$353 |
$705 |
$213 |
$118 | |
| Emergency department visit (level 5) |
$547 |
$1,095 |
$311 |
$171 | |
| Endometrial biopsy |
$284 |
$568 |
$133 |
$98 | |
| Estradiol (estrogen) test |
$95 |
$190 |
$40 |
$28 | |
| Fallopian tube X-ray (HSG) |
$467 |
$934 |
$196 |
$164 | |
| Fecal occult blood (stool) test |
$7 |
$13 |
$3 |
$10 | |
| Fecal occult blood (stool) test (guaiac, gFOBT) |
$7 |
$13 |
$3 |
$4 | |
| Feeding tube (PEG) placement |
$2,436 |
$4,872 |
$1,145 |
$178 | |
| Ferritin (iron) test |
$37 |
$74 |
$16 |
$14 | |
| Fibrinogen test |
$25 |
$50 |
$11 |
$10 | |
| Flexible sigmoidoscopy |
$692 |
$1,383 |
$325 |
$323 | |
| Flu test |
$31 |
$63 |
$13 |
$17 | |
| Folate (folic acid) test |
$42 |
$84 |
$18 |
$15 | |
| Foreign body removal (skin) |
$330 |
$659 |
$138 |
$157 | |
| Free T4 thyroid test |
$25 |
$49 |
$10 |
$9 | |
| FSH hormone test |
$70 |
$140 |
$29 |
$19 | |
| Gallbladder removal (laparoscopic) |
$5,631 |
$11,263 |
$3,463 |
$658 | |
| Ganglion cyst removal |
$2,297 |
$4,594 |
$1,080 |
$321 | |
| GGT liver test |
$29 |
$58 |
$12 |
$7 | |
| Glucose tolerance test |
$25 |
$50 |
$16 |
$8 | |
| H. pylori test |
$104 |
$208 |
$44 |
$67 | |
| HDL cholesterol test |
$30 |
$60 |
$13 |
$8 | |
| Hematocrit test |
$10 |
$20 |
$4 |
$2 | |
| Hemoglobin A1c (diabetes test) |
$43 |
$86 |
$18 |
$10 | |
| Hepatitis B test |
$37 |
$73 |
$14 |
$10 | |
| Hepatitis C test |
$25 |
$50 |
$11 |
$14 | |
| HIV test |
$41 |
$82 |
$19 |
$19 | |
| HIV test (antibody) |
$46 |
$91 |
$19 |
$14 | |
| HIV test (antigen/antibody combo) |
$36 |
$72 |
$15 |
$24 | |
| Hysterectomy |
$3,186 |
$6,371 |
$1,338 |
$933 | |
| Hysteroscopy |
$2,645 |
$5,290 |
$1,243 |
$1,270 | |
| Incisional hernia repair |
$4,125 |
$8,250 |
$1,733 |
— | |
| Iron blood test |
$21 |
$42 |
$9 |
$6 | |
| IUD removal |
$284 |
$568 |
$133 |
$112 | |
| IV infusion therapy |
$106 |
$212 |
$70 |
$44 | |
| IV infusion therapy (each additional) |
$45 |
$89 |
$19 |
$21 | |
| IV infusion therapy (initial) |
$168 |
$336 |
$87 |
$67 | |
| Joint aspiration (small/intermediate) |
$261 |
$522 |
$110 |
$57 | |
| Joint aspiration or injection (mid-size joint) |
$261 |
$522 |
$110 |
$57 | |
| Joint aspiration or injection (small joint) |
$261 |
$522 |
$110 |
$56 | |
| Kidney ultrasound |
$210 |
$419 |
$88 |
$84 | |
| Knee joint injection |
$243 |
$486 |
$102 |
$69 | |
| Lactate test |
$27 |
$53 |
$11 |
$12 | |
| LDH test |
$28 |
$56 |
$11 |
$6 | |
| LDL cholesterol test |
$10 |
$19 |
$4 |
$11 | |
| Leg vein ultrasound (Doppler) |
$539 |
$1,078 |
$257 |
$150 | |
| Leg vein ultrasound (Doppler) (limited) |
$611 |
$1,223 |
$257 |
$116 | |
| LH hormone test |
$21 |
$42 |
$12 |
$19 | |
| Lipase test |
$22 |
$43 |
$9 |
$7 | |
| Lipid (cholesterol) panel |
$47 |
$94 |
$20 |
$13 | |
| Liver biopsy |
$3,090 |
$6,179 |
$1,298 |
$288 | |
| Liver function panel |
$101 |
$202 |
$42 |
$8 | |
| Lumpectomy (breast) |
$4,224 |
$8,448 |
$1,985 |
$750 | |
| Lung function test (PFT) |
$127 |
$255 |
$73 |
$37 | |
| Magnesium blood test |
$22 |
$44 |
$8 |
$7 | |
| MRA of the brain |
$1,169 |
$2,337 |
$491 |
$226 | |
| MRA of the neck |
$1,169 |
$2,337 |
$491 |
$245 | |
| MRA of the neck with contrast |
$1,169 |
$2,337 |
$491 |
$245 | |
| MRI of the abdomen |
$1,129 |
$2,258 |
$491 |
$300 | |
| MRI of the abdomen without contrast |
$1,090 |
$2,180 |
$458 |
$194 | |
| MRI of the ankle |
$941 |
$1,882 |
$395 |
$261 | |
| MRI of the ankle without contrast |
$941 |
$1,882 |
$395 |
$222 | |
| MRI of the brain |
$1,129 |
$2,258 |
$491 |
$269 | |
| MRI of the brain without contrast |
$1,090 |
$2,180 |
$458 |
$195 | |
| MRI of the chest |
$1,169 |
$2,337 |
$491 |
$371 | |
| MRI of the chest without contrast |
$1,169 |
$2,337 |
$491 |
$466 | |
| MRI of the knee |
$1,055 |
$2,109 |
$491 |
$315 | |
| MRI of the knee without contrast |
$941 |
$1,882 |
$395 |
$204 | |
| MRI of the lower back (lumbar spine) |
$1,169 |
$2,337 |
$518 |
$270 | |
| MRI of the lower back (lumbar spine) with contrast |
$1,169 |
$2,337 |
$491 |
$270 | |
| MRI of the lower back (lumbar spine) without contrast |
$1,362 |
$2,724 |
$572 |
$192 | |
| MRI of the mid-back (thoracic spine) |
$1,169 |
$2,337 |
$491 |
$271 | |
| MRI of the mid-back (thoracic spine) with and without contrast |
$1,169 |
$2,337 |
$491 |
$319 | |
| MRI of the mid-back (thoracic spine) with contrast |
$1,169 |
$2,337 |
$491 |
$271 | |
| MRI of the mid-back (thoracic spine) without contrast |
$1,090 |
$2,180 |
$458 |
$190 | |
| MRI of the neck (cervical spine) |
$1,169 |
$2,337 |
$491 |
$274 | |
| MRI of the neck (cervical spine) with and without contrast |
$1,169 |
$2,337 |
$491 |
$318 | |
| MRI of the neck (cervical spine) with contrast |
$1,169 |
$2,337 |
$491 |
$274 | |
| MRI of the neck (cervical spine) without contrast |
$1,090 |
$2,180 |
$458 |
$191 | |
| MRI of the pelvis |
$1,169 |
$2,337 |
$491 |
$268 | |
| MRI of the shoulder |
$941 |
$1,882 |
$444 |
$313 | |
| MRI of the shoulder with contrast |
$941 |
$1,882 |
$395 |
$313 | |
| MRI of the shoulder without contrast |
$941 |
$1,882 |
$395 |
$205 | |
| Newborn hospital care |
$115 |
$231 |
$67 |
$58 | |
| Nuchal translucency ultrasound |
$210 |
$419 |
$88 |
$116 | |
| Occupational therapy evaluation |
$145 |
$289 |
$61 |
$101 | |
| Occupational therapy evaluation (high complexity) |
$145 |
$289 |
$61 |
$101 | |
| Occupational therapy evaluation (low complexity) |
$145 |
$289 |
$61 |
$101 | |
| Occupational therapy evaluation (moderate complexity) |
$145 |
$289 |
$61 |
$101 | |
| Office visit (established patient) |
$126 |
$252 |
$56 |
$115 | |
| Office visit (new patient) |
$148 |
$297 |
$62 |
$177 | |
| Office visit, established patient (level 3) |
$119 |
$237 |
$50 |
$95 | |
| Office visit, established patient (level 4) |
$134 |
$267 |
$56 |
$136 | |
| Office visit, new patient (level 3) |
$134 |
$267 |
$56 |
$118 | |
| Office visit, new patient (level 4) |
$148 |
$297 |
$62 |
$177 | |
| Office visit, new patient (level 5) |
$163 |
$327 |
$69 |
$237 | |
| Ovarian cyst removal |
$3,784 |
$7,568 |
$1,778 |
$698 | |
| Pap smear (cervical screening) |
$43 |
$86 |
$18 |
$20 | |
| Parathyroid hormone (PTH) test |
$74 |
$148 |
$42 |
$41 | |
| Pelvic ultrasound |
$210 |
$419 |
$88 |
$78 | |
| Pelvic ultrasound (complete) |
$210 |
$419 |
$88 |
$105 | |
| Pelvic ultrasound (limited) |
$210 |
$419 |
$88 |
$51 | |
| Phosphorus blood test |
$17 |
$33 |
$7 |
$5 | |
| Physical therapy evaluation |
$116 |
$233 |
$49 |
$98 | |
| Physical therapy evaluation (high complexity) |
$116 |
$233 |
$49 |
$98 | |
| Physical therapy evaluation (moderate complexity) |
$116 |
$233 |
$49 |
$98 | |
| Platelet count |
$8 |
$15 |
$3 |
$4 | |
| Pneumonia vaccine |
$234 |
$468 |
$98 |
— | |
| Pregnancy blood test (hCG) |
$28 |
$56 |
$12 |
$8 | |
| Pregnancy ultrasound |
$210 |
$419 |
$88 |
$126 | |
| Pregnancy ultrasound (first trimester) |
$210 |
$419 |
$88 |
$117 | |
| Pregnancy ultrasound (second or third trimester) |
$210 |
$419 |
$88 |
$136 | |
| Procalcitonin test |
$150 |
$300 |
$63 |
$27 | |
| Prolactin test |
$110 |
$220 |
$46 |
$19 | |
| Prostate test (PSA) |
$31 |
$63 |
$16 |
$18 | |
| Psychiatric evaluation |
$151 |
$301 |
$63 |
$188 | |
| Rheumatoid factor test |
$11 |
$23 |
$7 |
$6 | |
| Scoliosis spine X-ray |
$191 |
$383 |
$88 |
$58 | |
| Scoliosis spine X-ray (1 view) |
$173 |
$346 |
$73 |
$44 | |
| Scoliosis spine X-ray (3 views) |
$210 |
$419 |
$88 |
$72 | |
| Screening colonoscopy |
$970 |
$1,940 |
$407 |
$378 | |
| Screening mammogram |
$386 |
$773 |
$162 |
$126 | |
| Scrotal ultrasound |
$210 |
$419 |
$88 |
$99 | |
| Sedimentation rate (ESR) test |
$10 |
$20 |
$4 |
$3 | |
| Semen analysis |
$22 |
$44 |
$11 |
$12 | |
| Sex hormone binding globulin test |
$14 |
$28 |
$14 |
$22 | |
| Simple laceration repair (small, up to 2.5 cm) |
$101 |
$201 |
$42 |
$114 | |
| Simple wound stitches |
$101 |
$201 |
$42 |
$127 | |
| Soft tissue ultrasound |
$210 |
$419 |
$88 |
$64 | |
| Speech therapy |
$121 |
$241 |
$51 |
$76 | |
| Spinal tap (lumbar puncture) |
$425 |
$850 |
$415 |
$165 | |
| Spirometry (lung function test) |
$81 |
$162 |
$34 |
$30 | |
| Spirometry with bronchodilator |
$174 |
$348 |
$73 |
$43 | |
| Stress echocardiogram |
$755 |
$1,509 |
$317 |
$209 | |
| Stress echocardiogram (complete) |
$755 |
$1,509 |
$317 |
$233 | |
| Swallow study |
$132 |
$265 |
$56 |
$85 | |
| T3 thyroid test |
$71 |
$143 |
$30 |
$14 | |
| Testosterone test |
$110 |
$221 |
$42 |
$26 | |
| Thyroid test (TSH) |
$39 |
$77 |
$16 |
$17 | |
| Thyroid ultrasound |
$3,620 |
$7,240 |
$1,520 |
$109 | |
| Total IgE allergy test |
$29 |
$58 |
$18 |
$16 | |
| Total protein test |
$18 |
$37 |
$8 |
$4 | |
| Transvaginal ultrasound |
$210 |
$419 |
$88 |
$118 | |
| Trigger point injection |
$371 |
$742 |
$156 |
$56 | |
| Trigger point injection (1-2 muscles) |
$371 |
$742 |
$156 |
$52 | |
| Triglycerides test |
$33 |
$66 |
$14 |
$6 | |
| Troponin (heart) test |
$47 |
$94 |
$20 |
$12 | |
| Tubal ligation |
$7,818 |
$15,636 |
$3,675 |
$333 | |
| Umbilical hernia repair |
$4,775 |
$9,550 |
$2,006 |
— | |
| Upper GI endoscopy (EGD) |
$1,006 |
$2,011 |
$473 |
$371 | |
| Upper GI series (barium) |
$350 |
$700 |
$147 |
$128 | |
| Uric acid (gout) test |
$21 |
$42 |
$9 |
$5 | |
| Urinalysis |
$14 |
$29 |
$8 |
$3 | |
| Urine microalbumin test |
$25 |
$50 |
$8 |
$5 | |
| Urine pregnancy test |
$28 |
$56 |
$12 |
$9 | |
| Vaccine administration |
$53 |
$105 |
$22 |
$19 | |
| Vitamin B12 test |
$24 |
$48 |
$10 |
$15 | |
| Vitamin D test |
$150 |
$301 |
$32 |
$30 | |
| Wound debridement |
$471 |
$942 |
$221 |
$186 | |
| X-ray of the abdomen |
$191 |
$383 |
$88 |
$36 | |
| X-ray of the ankle |
$173 |
$346 |
$73 |
$37 | |
| X-ray of the collarbone |
$173 |
$346 |
$73 |
$33 | |
| X-ray of the elbow |
$173 |
$346 |
$73 |
$33 | |
| X-ray of the facial bones |
$210 |
$419 |
$88 |
$39 | |
| X-ray of the foot |
$173 |
$346 |
$73 |
$34 | |
| X-ray of the forearm |
$173 |
$346 |
$73 |
$29 | |
| X-ray of the hand |
$262 |
$524 |
$110 |
$38 | |
| X-ray of the hip |
$173 |
$346 |
$73 |
$49 | |
| X-ray of the hip (3 views) |
$173 |
$346 |
$73 |
$49 | |
| X-ray of the knee |
$173 |
$346 |
$88 |
$42 | |
| X-ray of the knee (2 views) |
$173 |
$346 |
$73 |
$34 | |
| X-ray of the knee (3 views) |
$173 |
$346 |
$90 |
$42 | |
| X-ray of the knee (4+ views) |
$210 |
$419 |
$88 |
$49 | |
| X-ray of the lower back (lumbar spine) |
$210 |
$419 |
$88 |
$47 | |
| X-ray of the lower back (lumbar spine) (2 views) |
$210 |
$419 |
$88 |
$40 | |
| X-ray of the lower back (lumbar spine) (4+ views) |
$210 |
$419 |
$88 |
$53 | |
| X-ray of the lower leg |
$173 |
$346 |
$73 |
$31 | |
| X-ray of the mid-back (thoracic spine) |
$210 |
$419 |
$88 |
$36 | |
| X-ray of the mid-back (thoracic spine) (2 views) |
$210 |
$419 |
$88 |
$33 | |
| X-ray of the neck (cervical spine) |
$191 |
$383 |
$88 |
$47 | |
| X-ray of the neck (cervical spine) (3 views) |
$173 |
$346 |
$73 |
$40 | |
| X-ray of the pelvis |
$210 |
$419 |
$88 |
$36 | |
| X-ray of the pelvis (1 view) |
$210 |
$419 |
$88 |
$28 | |
| X-ray of the ribs |
$210 |
$419 |
$88 |
$42 | |
| X-ray of the ribs (2 views) |
$173 |
$346 |
$73 |
$36 | |
| X-ray of the ribs (3 views) |
$210 |
$419 |
$88 |
$42 | |
| X-ray of the shoulder |
$173 |
$346 |
$73 |
$36 | |
| X-ray of the skull |
$210 |
$419 |
$88 |
$40 | |
| X-ray of the upper arm |
$173 |
$346 |
$73 |
$32 | |
| X-ray of the wrist |
$173 |
$346 |
$73 |
$43 | |
| Zinc blood test |
$54 |
$108 |
$23 |
$11 | |