| Abdominal fluid drain (paracentesis) |
$6,067 |
$6,067 |
— |
$284 | |
| Abdominal ultrasound |
$606 |
$606 |
$252 |
$100 | |
| Abdominal ultrasound (complete) |
$789 |
$789 |
$252 |
$114 | |
| Abdominal ultrasound (limited) |
$606 |
$606 |
$252 |
$86 | |
| Achilles tendon repair |
$40,576 |
$40,576 |
$1,259 |
$624 | |
| ACL knee reconstruction |
$34,886 |
$34,886 |
$1,259 |
$889 | |
| Adenoid removal (adenoidectomy) |
$8,722 |
$8,722 |
$1,330 |
$204 | |
| Albumin blood test |
$54 |
$54 |
— |
$5 | |
| Aldosterone test |
$224 |
$224 |
— |
$41 | |
| Alkaline phosphatase test |
$57 |
$57 |
— |
$5 | |
| Alpha-fetoprotein (AFP) test |
$184 |
$184 |
— |
$17 | |
| ALT liver enzyme test |
$58 |
$58 |
— |
$5 | |
| Ammonia blood test |
$160 |
$160 |
— |
$15 | |
| Amylase test |
$71 |
$71 |
— |
$6 | |
| Anal fistula repair |
$17,443 |
$17,443 |
$1,259 |
$541 | |
| Ankle fracture repair |
$29,072 |
$29,072 |
$1,259 |
$608 | |
| Antinuclear antibody (ANA) test |
$132 |
$132 |
— |
$12 | |
| Arterial blood gas (ABG) |
$200 |
$200 |
— |
$26 | |
| AST liver enzyme test |
$57 |
$57 |
— |
$5 | |
| Barium swallow study |
$515 |
$515 |
$410 |
$107 | |
| Basic metabolic panel |
$93 |
$93 |
— |
$8 | |
| Bilirubin blood test |
$55 |
$55 |
— |
$5 | |
| Blood clotting test (PT/INR) |
$44 |
$44 |
— |
$4 | |
| Blood glucose test |
$48 |
$48 |
— |
$5 | |
| Blood transfusion |
$893 |
$893 |
— |
$47 | |
| Blood type and screen |
$140 |
$140 |
— |
$10 | |
| Blood type test |
$33 |
$33 |
— |
$3 | |
| Blood type test (ABO group) |
$33 |
$33 |
— |
$3 | |
| Blood type test (Rh/D antigen) |
$33 |
$33 |
— |
$3 | |
| BNP (heart failure) test |
$373 |
$373 |
— |
$39 | |
| Breast biopsy |
$7,767 |
$7,767 |
— |
$478 | |
| Breast reconstruction |
$23,347 |
$23,347 |
$3,068 |
$1,227 | |
| Breast reduction |
$17,443 |
$17,443 |
$1,330 |
$980 | |
| Breast ultrasound |
$552 |
$552 |
— |
$92 | |
| Breast ultrasound (complete) |
$552 |
$552 |
— |
$100 | |
| Breast ultrasound (limited) |
$520 |
$520 |
— |
$84 | |
| Breathing tube insertion (intubation) |
$929 |
$929 |
$11,262 |
$133 | |
| Bunion surgery (bunionectomy) |
$23,258 |
$23,258 |
$1,259 |
$883 | |
| Burn dressing and debridement (medium) |
$1,108 |
$1,108 |
— |
$166 | |
| Burn dressing and debridement (small) |
$841 |
$841 |
$2,041 |
$93 | |
| Burn treatment |
$1,108 |
$1,108 |
$2,041 |
$129 | |
| C-reactive protein (CRP) |
$57 |
$57 |
— |
$5 | |
| CA 19-9 tumor marker test |
$229 |
$229 |
— |
$21 | |
| CA-125 ovarian marker test |
$229 |
$229 |
— |
$21 | |
| Calcium blood test |
$57 |
$57 |
— |
$5 | |
| Cardioversion |
$2,101 |
$2,101 |
— |
$155 | |
| Carotid artery ultrasound |
$1,329 |
$1,329 |
— |
$156 | |
| Carpal tunnel release |
$10,487 |
$10,487 |
$2,397 |
$483 | |
| Cataract surgery |
$8,731 |
$8,731 |
$4,994 |
$547 | |
| CEA tumor marker test |
$209 |
$209 |
— |
$19 | |
| Celiac disease test |
$188 |
$188 |
— |
$12 | |
| Central line placement |
$8,053 |
$8,053 |
— |
$238 | |
| Cesarean section (C-section) |
— |
— |
$11,262 |
$7,552 | |
| Chest fluid drain (thoracentesis) |
$6,830 |
$6,830 |
— |
$311 | |
| Chest tube insertion |
$9,127 |
$9,127 |
— |
$143 | |
| Chest X-ray |
$427 |
$427 |
$180 |
$37 | |
| Chest X-ray (1 view) |
$520 |
$520 |
$180 |
$25 | |
| Chest X-ray (2 views) |
$427 |
$427 |
$180 |
$33 | |
| Circumcision |
$8,234 |
$8,234 |
$2,106 |
$167 | |
| CK-MB heart enzyme test |
$127 |
$127 |
— |
$12 | |
| Clotting time test (PTT) |
$66 |
$66 |
— |
$6 | |
| Colon resection (colectomy) |
$17,445 |
$17,445 |
$2,041 |
$1,238 | |
| Colonoscopy |
$11,629 |
$11,629 |
$2,106 |
$480 | |
| Colostomy |
$17,443 |
$17,443 |
$2,106 |
$1,122 | |
| Complete blood count (CBC) |
$86 |
$86 |
— |
$7 | |
| Complete blood count (CBC) (complete) |
$86 |
$86 |
— |
$8 | |
| Complex wound repair |
$7,596 |
$7,596 |
$1,259 |
$390 | |
| Comprehensive metabolic panel |
$116 |
$116 |
— |
$11 | |
| Copper blood test |
$136 |
$136 |
— |
$12 | |
| Coronary artery bypass (CABG) |
— |
— |
$11,704 |
$36,593 | |
| Cortisol test |
$179 |
$179 |
— |
$16 | |
| COVID-19 PCR test |
$654 |
$654 |
— |
$51 | |
| CPAP titration study |
$189 |
$189 |
$11,262 |
$69 | |
| Creatine kinase (CK) test |
$72 |
$72 |
— |
$7 | |
| CT angiography of the chest |
$2,622 |
$2,622 |
$450 |
$281 | |
| CT angiography of the head |
$3,238 |
$3,238 |
$450 |
$274 | |
| CT scan of the abdomen |
$1,809 |
$1,809 |
$450 |
$230 | |
| CT scan of the abdomen and pelvis |
$2,244 |
$2,244 |
$480 |
$300 | |
| CT scan of the abdomen and pelvis with and without contrast |
$2,625 |
$2,625 |
$480 |
$338 | |
| CT scan of the abdomen and pelvis with contrast |
$2,244 |
$2,244 |
$480 |
$300 | |
| CT scan of the abdomen and pelvis without contrast |
$1,504 |
$1,504 |
$480 |
$183 | |
| CT scan of the abdomen with and without contrast |
$2,081 |
$2,081 |
$450 |
$259 | |
| CT scan of the abdomen with contrast |
$1,809 |
$1,809 |
$450 |
$230 | |
| CT scan of the abdomen without contrast |
$1,161 |
$1,161 |
$450 |
$136 | |
| CT scan of the arm |
$1,889 |
$1,889 |
$450 |
$199 | |
| CT scan of the arm with contrast |
$1,665 |
$1,665 |
$480 |
$199 | |
| CT scan of the arm without contrast |
$1,357 |
$1,357 |
$450 |
$161 | |
| CT scan of the chest |
$1,705 |
$1,705 |
$450 |
$167 | |
| CT scan of the chest with and without contrast |
$2,064 |
$2,064 |
$450 |
$196 | |
| CT scan of the chest with contrast |
$1,705 |
$1,705 |
$450 |
$167 | |
| CT scan of the chest without contrast |
$1,364 |
$1,364 |
$450 |
$133 | |
| CT scan of the head |
$1,240 |
$1,240 |
$450 |
$148 | |
| CT scan of the head with and without contrast |
$1,426 |
$1,426 |
$450 |
$173 | |
| CT scan of the head with contrast |
$1,407 |
$1,407 |
$450 |
$148 | |
| CT scan of the head without contrast |
$1,073 |
$1,073 |
$450 |
$107 | |
| CT scan of the leg |
$1,525 |
$1,525 |
$450 |
$166 | |
| CT scan of the leg with contrast |
$1,688 |
$1,688 |
$450 |
$166 | |
| CT scan of the leg without contrast |
$1,362 |
$1,362 |
$450 |
$130 | |
| CT scan of the lower back (lumbar spine) |
$1,705 |
$1,705 |
$450 |
$169 | |
| CT scan of the lower back (lumbar spine) with and without contrast |
$2,033 |
$2,033 |
$450 |
$197 | |
| CT scan of the lower back (lumbar spine) with contrast |
$1,705 |
$1,705 |
$480 |
$169 | |
| CT scan of the lower back (lumbar spine) without contrast |
$1,361 |
$1,361 |
$450 |
$130 | |
| CT scan of the neck |
$1,743 |
$1,743 |
$450 |
$183 | |
| CT scan of the neck (cervical spine) |
$1,703 |
$1,703 |
$450 |
$168 | |
| CT scan of the neck (cervical spine) with and without contrast |
$2,033 |
$2,033 |
$450 |
$196 | |
| CT scan of the neck (cervical spine) with contrast |
$1,703 |
$1,703 |
$480 |
$168 | |
| CT scan of the neck (cervical spine) without contrast |
$1,395 |
$1,395 |
$450 |
$131 | |
| CT scan of the neck with and without contrast |
$2,076 |
$2,076 |
$450 |
$220 | |
| CT scan of the neck with contrast |
$1,743 |
$1,743 |
$450 |
$183 | |
| CT scan of the neck without contrast |
$1,450 |
$1,450 |
$450 |
$150 | |
| CT scan of the pelvis |
$1,776 |
$1,776 |
$450 |
$226 | |
| CT scan of the pelvis with and without contrast |
$1,989 |
$1,989 |
$450 |
$251 | |
| CT scan of the pelvis with contrast |
$1,776 |
$1,776 |
$450 |
$226 | |
| CT scan of the pelvis without contrast |
$1,135 |
$1,135 |
$450 |
$133 | |
| CT scan of the sinuses |
$1,784 |
$1,784 |
$450 |
$152 | |
| CT scan of the sinuses with and without contrast |
$2,144 |
$2,144 |
$450 |
$184 | |
| CT scan of the sinuses with contrast |
$1,784 |
$1,784 |
$450 |
$152 | |
| CT scan of the sinuses without contrast |
$1,482 |
$1,482 |
$450 |
$128 | |
| D-dimer test |
$112 |
$112 |
— |
$10 | |
| DHEA-sulfate test |
$182 |
$182 |
— |
$22 | |
| Dilation and curettage (D&C) |
$17,897 |
$17,897 |
$2,106 |
$298 | |
| Drug screen (urine) |
$223 |
$223 |
— |
$17 | |
| Eardrum repair (tympanoplasty) |
$23,258 |
$23,258 |
$4,030 |
$799 | |
| Echocardiogram |
$1,104 |
$1,104 |
— |
$138 | |
| Echocardiogram with and without contrast |
$1,160 |
$1,160 |
— |
$101 | |
| EKG / ECG (tracing only) |
$350 |
$350 |
$119 |
$7 | |
| Elbow replacement |
$34,886 |
$34,886 |
$4,690 |
$1,301 | |
| Electrocardiogram (EKG) |
$350 |
$350 |
$119 |
$8 | |
| Electrolyte panel |
$77 |
$77 |
— |
$7 | |
| Electromyography (EMG) |
$731 |
$731 |
— |
$141 | |
| Emergency department visit |
$1,474 |
$1,474 |
$800 |
$69 | |
| Emergency department visit (level 1) |
$462 |
$462 |
$428 |
$11 | |
| Emergency department visit (level 2) |
$837 |
$837 |
$600 |
$40 | |
| Emergency department visit (level 3) |
$1,474 |
$1,474 |
$800 |
$69 | |
| Emergency department visit (level 4) |
$2,317 |
$2,317 |
$1,238 |
$118 | |
| Emergency department visit (level 5) |
$3,326 |
$3,326 |
$2,036 |
$171 | |
| Epidural steroid injection |
$6,067 |
$6,067 |
— |
$275 | |
| Estradiol (estrogen) test |
$307 |
$307 |
— |
$28 | |
| Facet joint injection (spine) |
$6,067 |
$6,067 |
$3,032 |
$99 | |
| Fecal occult blood (stool) test |
$102 |
$102 |
— |
$10 | |
| Fecal occult blood (stool) test (guaiac, gFOBT) |
$30 |
$30 |
— |
$4 | |
| Fecal occult blood (stool) test (immunochemical, FIT) |
$175 |
$175 |
— |
$16 | |
| Feeding tube (PEG) placement |
$14,524 |
$14,524 |
$2,106 |
$178 | |
| Ferritin (iron) test |
$150 |
$150 |
— |
$14 | |
| Fibrinogen test |
$93 |
$93 |
— |
$10 | |
| Fibroid removal (myomectomy) |
$23,258 |
$23,258 |
$2,041 |
$914 | |
| Flu test |
$132 |
$132 |
— |
$17 | |
| Folate (folic acid) test |
$162 |
$162 |
— |
$15 | |
| Free T4 thyroid test |
$99 |
$99 |
— |
$9 | |
| FSH hormone test |
$204 |
$204 |
— |
$19 | |
| Gallbladder removal (laparoscopic) |
$23,258 |
$23,258 |
— |
$658 | |
| Ganglion cyst removal |
$5,814 |
$5,814 |
$1,259 |
$321 | |
| GGT liver test |
$79 |
$79 |
— |
$7 | |
| Glucose tolerance test |
$92 |
$92 |
— |
$8 | |
| H. pylori test |
$741 |
$741 |
— |
$67 | |
| Hammertoe repair |
$7,628 |
$7,628 |
$1,259 |
$548 | |
| Hematocrit test |
$26 |
$26 |
— |
$2 | |
| Hemoglobin A1c (diabetes test) |
$107 |
$107 |
— |
$10 | |
| Hemorrhoid removal |
$5,098 |
$5,098 |
— |
$338 | |
| Hepatitis B test |
$114 |
$114 |
— |
$10 | |
| Hepatitis C test |
$161 |
$161 |
— |
$14 | |
| Hip arthroscopy |
$40,576 |
$40,576 |
$7,414 |
$931 | |
| HIV test |
$174 |
$174 |
— |
$19 | |
| HIV test (antibody) |
$151 |
$151 |
— |
$14 | |
| HIV test (antigen/antibody combo) |
$197 |
$197 |
— |
$24 | |
| Holter heart monitor |
$555 |
$555 |
— |
$26 | |
| Hysteroscopy |
$17,443 |
$17,443 |
$1,259 |
$1,270 | |
| Inguinal hernia repair |
$20,350 |
$20,350 |
$3,269 |
$538 | |
| Iron blood test |
$71 |
$71 |
— |
$6 | |
| IV infusion therapy |
$654 |
$654 |
$29,300 |
$44 | |
| IV infusion therapy (each additional) |
$81 |
$81 |
$29,300 |
$21 | |
| IV infusion therapy (initial) |
$1,227 |
$1,227 |
$29,300 |
$67 | |
| IVC filter placement |
$31,530 |
$31,530 |
— |
$1,885 | |
| Joint aspiration (small/intermediate) |
$3,034 |
$3,034 |
$2,041 |
$57 | |
| Joint aspiration or injection (mid-size joint) |
$3,034 |
$3,034 |
$2,041 |
$57 | |
| Joint aspiration or injection (small joint) |
$3,034 |
$3,034 |
$2,041 |
$56 | |
| Kidney ultrasound |
$743 |
$743 |
$252 |
$84 | |
| Kidney ultrasound (limited) |
$743 |
$743 |
$252 |
$61 | |
| Knee arthroscopy |
$23,258 |
$23,258 |
$1,330 |
$524 | |
| Knee joint injection |
$1,668 |
$1,668 |
$2,041 |
$69 | |
| Knee replacement |
— |
— |
$11,704 |
$18,054 | |
| Lactate test |
$99 |
$99 |
— |
$12 | |
| Laminectomy (spine) |
$60,000 |
$60,000 |
$10,710 |
$1,157 | |
| LDH test |
$66 |
$66 |
— |
$6 | |
| LDL cholesterol test |
$105 |
$105 |
— |
$11 | |
| Leg artery angiogram |
$18,274 |
$18,274 |
$6,235 |
$149 | |
| Leg artery angioplasty |
$48,555 |
$48,555 |
— |
— | |
| Leg vein ultrasound (Doppler) |
$640 |
$640 |
$844 |
$150 | |
| Leg vein ultrasound (Doppler) (limited) |
$640 |
$640 |
$844 |
$116 | |
| LH hormone test |
$204 |
$204 |
— |
$19 | |
| Lipase test |
$76 |
$76 |
— |
$7 | |
| Lipid (cholesterol) panel |
$147 |
$147 |
— |
$13 | |
| Liver biopsy |
$10,784 |
$10,784 |
$2,041 |
$288 | |
| Liver function panel |
$90 |
$90 |
— |
$8 | |
| Lumpectomy (breast) |
$28,773 |
$28,773 |
$2,975 |
$750 | |
| Lung function test (PFT) |
$1,346 |
$1,346 |
— |
$37 | |
| Magnesium blood test |
$73 |
$73 |
— |
$7 | |
| Mastectomy |
$29,857 |
$29,857 |
$1,330 |
$1,021 | |
| Mastoidectomy |
$23,258 |
$23,258 |
$4,690 |
$840 | |
| Meniscus repair (knee) |
$17,443 |
$17,443 |
$1,259 |
$714 | |
| MRA of the brain |
$2,569 |
$2,569 |
$859 |
$226 | |
| MRA of the brain with contrast |
$2,522 |
$2,522 |
$859 |
$226 | |
| MRA of the brain without contrast |
$3,884 |
$3,884 |
$859 |
$328 | |
| MRA of the neck |
$2,740 |
$2,740 |
$859 |
$245 | |
| MRA of the neck with contrast |
$2,740 |
$2,740 |
$859 |
$245 | |
| MRA of the neck without contrast |
$3,892 |
$3,892 |
$859 |
$343 | |
| MRI of the abdomen |
$2,795 |
$2,795 |
$859 |
$300 | |
| MRI of the abdomen with contrast |
$2,795 |
$2,795 |
$859 |
$300 | |
| MRI of the abdomen without contrast |
$1,963 |
$1,963 |
$700 |
$194 | |
| MRI of the ankle |
$2,519 |
$2,519 |
$859 |
$261 | |
| MRI of the ankle with contrast |
$2,519 |
$2,519 |
$859 |
$261 | |
| MRI of the ankle without contrast |
$2,244 |
$2,244 |
$700 |
$222 | |
| MRI of the brain |
$2,879 |
$2,879 |
$859 |
$269 | |
| MRI of the brain with contrast |
$3,561 |
$3,561 |
$859 |
$269 | |
| MRI of the brain without contrast |
$2,785 |
$2,785 |
$700 |
$195 | |
| MRI of the chest |
$2,813 |
$2,813 |
$859 |
$371 | |
| MRI of the chest with contrast |
$2,813 |
$2,813 |
$867 |
$371 | |
| MRI of the chest without contrast |
$3,561 |
$3,561 |
$859 |
$466 | |
| MRI of the knee |
$1,839 |
$1,839 |
$859 |
$315 | |
| MRI of the knee with contrast |
$2,325 |
$2,325 |
$867 |
$315 | |
| MRI of the knee without contrast |
$1,354 |
$1,354 |
$700 |
$204 | |
| MRI of the lower back (lumbar spine) |
$1,948 |
$1,948 |
$859 |
$270 | |
| MRI of the lower back (lumbar spine) with contrast |
$2,483 |
$2,483 |
$859 |
$270 | |
| MRI of the lower back (lumbar spine) without contrast |
$1,948 |
$1,948 |
$700 |
$192 | |
| MRI of the mid-back (thoracic spine) |
$2,182 |
$2,182 |
$859 |
$271 | |
| MRI of the mid-back (thoracic spine) with and without contrast |
$2,560 |
$2,560 |
$859 |
$319 | |
| MRI of the mid-back (thoracic spine) with contrast |
$2,182 |
$2,182 |
$859 |
$271 | |
| MRI of the mid-back (thoracic spine) without contrast |
$1,951 |
$1,951 |
$700 |
$190 | |
| MRI of the neck (cervical spine) |
$1,946 |
$1,946 |
$859 |
$274 | |
| MRI of the neck (cervical spine) with and without contrast |
$2,815 |
$2,815 |
$859 |
$318 | |
| MRI of the neck (cervical spine) with contrast |
$2,545 |
$2,545 |
$859 |
$274 | |
| MRI of the neck (cervical spine) without contrast |
$1,946 |
$1,946 |
$700 |
$191 | |
| MRI of the pelvis |
$2,752 |
$2,752 |
$859 |
$268 | |
| MRI of the pelvis with contrast |
$2,492 |
$2,492 |
$859 |
$268 | |
| MRI of the pelvis without contrast |
$2,752 |
$2,752 |
$700 |
$227 | |
| MRI of the shoulder |
$2,541 |
$2,541 |
$859 |
$313 | |
| MRI of the shoulder with contrast |
$2,288 |
$2,288 |
$867 |
$313 | |
| MRI of the shoulder without contrast |
$1,807 |
$1,807 |
$700 |
$205 | |
| MRI of the wrist |
$2,737 |
$2,737 |
$859 |
$330 | |
| MRI of the wrist with contrast |
$2,470 |
$2,470 |
$859 |
$330 | |
| MRI of the wrist without contrast |
$2,261 |
$2,261 |
$700 |
$303 | |
| Nebulizer breathing treatment |
$71 |
$71 |
— |
$9 | |
| Nerve conduction study |
$1,797 |
$1,797 |
— |
$118 | |
| Occupational therapy evaluation |
$180 |
$180 |
$184 |
$101 | |
| Occupational therapy evaluation (high complexity) |
$152 |
$152 |
$184 |
$101 | |
| Occupational therapy evaluation (low complexity) |
$209 |
$209 |
$184 |
$101 | |
| Occupational therapy evaluation (moderate complexity) |
$209 |
$209 |
$184 |
$101 | |
| Office visit (established patient) |
$192 |
$192 |
— |
$115 | |
| Office visit, established patient (level 3) |
$192 |
$192 |
— |
$95 | |
| Orthopedic hardware removal |
$23,258 |
$23,258 |
$1,259 |
$632 | |
| Pacemaker insertion |
— |
— |
$11,704 |
$15,506 | |
| Pap smear (cervical screening) |
$218 |
$218 |
— |
$20 | |
| Parathyroid hormone (PTH) test |
$227 |
$227 |
— |
$41 | |
| Parathyroid removal |
$33,523 |
$33,523 |
$4,030 |
$891 | |
| Pelvic ultrasound |
$615 |
$615 |
$252 |
$78 | |
| Pelvic ultrasound (complete) |
$698 |
$698 |
$252 |
$105 | |
| Pelvic ultrasound (limited) |
$532 |
$532 |
$252 |
$51 | |
| Phosphorus blood test |
$52 |
$52 |
— |
$5 | |
| Physical therapy evaluation |
$215 |
$215 |
$184 |
$98 | |
| Physical therapy evaluation (high complexity) |
$215 |
$215 |
$184 |
$98 | |
| Physical therapy evaluation (moderate complexity) |
$215 |
$215 |
$184 |
$98 | |
| Pilonidal cyst removal |
$14,536 |
$14,536 |
$1,259 |
$541 | |
| Platelet count |
$49 |
$49 |
— |
$4 | |
| Pregnancy blood test (hCG) |
$71 |
$71 |
— |
$8 | |
| Pregnancy ultrasound |
$774 |
$774 |
$252 |
$126 | |
| Pregnancy ultrasound (first trimester) |
$716 |
$716 |
$252 |
$117 | |
| Pregnancy ultrasound (second or third trimester) |
$833 |
$833 |
$252 |
$136 | |
| Procalcitonin test |
$219 |
$219 |
— |
$27 | |
| Prolactin test |
$213 |
$213 |
— |
$19 | |
| Prostate test (PSA) |
$202 |
$202 |
— |
$18 | |
| Radiofrequency nerve ablation |
$12,640 |
$12,640 |
$2,687 |
$462 | |
| Rheumatoid factor test |
$62 |
$62 |
— |
$6 | |
| Rotator cuff repair |
$29,072 |
$29,072 |
$4,030 |
$792 | |
| Sacroiliac joint injection |
$6,067 |
$6,067 |
$2,041 |
$176 | |
| Scoliosis spine X-ray |
$345 |
$345 |
$252 |
$58 | |
| Scoliosis spine X-ray (1 view) |
$216 |
$216 |
$180 |
$44 | |
| Scoliosis spine X-ray (3 views) |
$432 |
$432 |
$252 |
$72 | |
| Screening colonoscopy |
$11,629 |
$11,629 |
$2,106 |
$378 | |
| Scrotal ultrasound |
$697 |
$697 |
$252 |
$99 | |
| Sedimentation rate (ESR) test |
$39 |
$39 |
— |
$3 | |
| Septoplasty (deviated septum) |
$17,443 |
$17,443 |
$1,330 |
$613 | |
| Sex hormone binding globulin test |
$179 |
$179 |
— |
$22 | |
| Shoulder arthroscopy |
$40,576 |
$40,576 |
$1,259 |
$962 | |
| Simple laceration repair (small, up to 2.5 cm) |
$1,108 |
$1,108 |
$2,041 |
$114 | |
| Simple wound stitches |
$1,108 |
$1,108 |
$2,041 |
$127 | |
| Sinus surgery (endoscopic) |
$19,590 |
$19,590 |
$1,259 |
$224 | |
| Skin biopsy |
$3,564 |
$3,564 |
— |
$121 | |
| Skin graft |
$15,792 |
$15,792 |
$2,106 |
$898 | |
| Sleep study (polysomnography) |
$3,000 |
$3,000 |
— |
$691 | |
| Small bowel resection |
$20,266 |
$20,266 |
$2,041 |
$1,136 | |
| Soft tissue ultrasound |
$201 |
$201 |
$201 |
$64 | |
| Spinal cord stimulator |
$27,000 |
$27,000 |
$18,870 |
$2,388 | |
| Spinal tap (lumbar puncture) |
$5,010 |
$5,010 |
— |
$165 | |
| Spine fracture repair (kyphoplasty) |
$69,000 |
$69,000 |
— |
$5,803 | |
| Spirometry (lung function test) |
$894 |
$894 |
— |
$30 | |
| Spirometry with bronchodilator |
$1,797 |
$1,797 |
— |
$43 | |
| Spleen removal (splenectomy) |
$29,072 |
$29,072 |
— |
$1,036 | |
| Strep throat test |
$132 |
$132 |
— |
$17 | |
| T3 thyroid test |
$140 |
$140 |
— |
$14 | |
| Testosterone test |
$284 |
$284 |
— |
$26 | |
| Thyroid test (TSH) |
$185 |
$185 |
— |
$17 | |
| Thyroid ultrasound |
$685 |
$685 |
$252 |
$109 | |
| Tonsillectomy |
$17,443 |
$17,443 |
$1,330 |
$252 | |
| Total IgE allergy test |
$181 |
$181 |
— |
$16 | |
| Total protein test |
$40 |
$40 |
— |
$4 | |
| Tracheostomy |
$18,431 |
$18,431 |
— |
$273 | |
| Transvaginal ultrasound |
$425 |
$425 |
$252 |
$118 | |
| Trigger finger release |
$13,955 |
$13,955 |
$2,106 |
$630 | |
| Trigger point injection |
$3,034 |
$3,034 |
$2,041 |
$56 | |
| Trigger point injection (1-2 muscles) |
$2,351 |
$2,351 |
$2,041 |
$52 | |
| Triglycerides test |
$63 |
$63 |
— |
$6 | |
| Troponin (heart) test |
$194 |
$194 |
— |
$12 | |
| Turbinate reduction |
$15,168 |
$15,168 |
$2,106 |
$294 | |
| Ulnar nerve surgery (elbow) |
$13,982 |
$13,982 |
$2,106 |
$575 | |
| Upper GI endoscopy (EGD) |
$11,629 |
$11,629 |
$2,074 |
$371 | |
| Upper GI series (barium) |
$726 |
$726 |
$410 |
$128 | |
| Uric acid (gout) test |
$50 |
$50 |
— |
$5 | |
| Urinalysis |
$35 |
$35 |
— |
$3 | |
| Urine microalbumin test |
$64 |
$64 |
— |
$5 | |
| Urine pregnancy test |
$96 |
$96 |
— |
$9 | |
| Vaccine administration |
$225 |
$225 |
— |
$19 | |
| Vaccine administration (each additional) |
$47 |
$47 |
— |
$16 | |
| Vaginal delivery |
— |
— |
$11,262 |
$5,487 | |
| Vasectomy |
$8,234 |
$8,234 |
$2,106 |
$347 | |
| Vitamin B12 test |
$166 |
$166 |
— |
$15 | |
| Vitamin D test |
$326 |
$326 |
— |
$30 | |
| Weight-loss (bariatric) surgery |
— |
— |
$11,704 |
$11,645 | |
| Wrist fracture repair |
$40,576 |
$40,576 |
$4,030 |
$735 | |
| X-ray of the abdomen |
$520 |
$520 |
$229 |
$36 | |
| X-ray of the ankle |
$288 |
$288 |
$180 |
$37 | |
| X-ray of the collarbone |
$165 |
$165 |
$172 |
$33 | |
| X-ray of the elbow |
$191 |
$191 |
$180 |
$33 | |
| X-ray of the facial bones |
$206 |
$206 |
$206 |
$39 | |
| X-ray of the foot |
$481 |
$481 |
$180 |
$34 | |
| X-ray of the forearm |
$357 |
$357 |
$180 |
$29 | |
| X-ray of the hand |
$520 |
$520 |
$180 |
$38 | |
| X-ray of the hip |
$164 |
$164 |
$172 |
$49 | |
| X-ray of the hip (1 view) |
$164 |
$164 |
$164 |
$34 | |
| X-ray of the hip (3 views) |
$520 |
$520 |
$180 |
$49 | |
| X-ray of the knee |
$520 |
$520 |
$180 |
$42 | |
| X-ray of the knee (2 views) |
$520 |
$520 |
$180 |
$34 | |
| X-ray of the knee (3 views) |
$520 |
$520 |
$180 |
$42 | |
| X-ray of the knee (4+ views) |
$250 |
$250 |
$250 |
$49 | |
| X-ray of the lower back (lumbar spine) |
$575 |
$575 |
$252 |
$47 | |
| X-ray of the lower back (lumbar spine) (2 views) |
$362 |
$362 |
$228 |
$40 | |
| X-ray of the lower back (lumbar spine) (4+ views) |
$629 |
$629 |
$252 |
$53 | |
| X-ray of the lower leg |
$158 |
$158 |
$169 |
$31 | |
| X-ray of the mid-back (thoracic spine) |
$318 |
$318 |
$231 |
$36 | |
| X-ray of the mid-back (thoracic spine) (2 views) |
$356 |
$356 |
$222 |
$33 | |
| X-ray of the mid-back (thoracic spine) (3 views) |
$318 |
$318 |
$231 |
$39 | |
| X-ray of the neck (cervical spine) |
$481 |
$481 |
$180 |
$47 | |
| X-ray of the neck (cervical spine) (3 views) |
$342 |
$342 |
$180 |
$40 | |
| X-ray of the pelvis |
$275 |
$275 |
$252 |
$36 | |
| X-ray of the pelvis (1 view) |
$275 |
$275 |
$252 |
$28 | |
| X-ray of the ribs |
$224 |
$224 |
$224 |
$42 | |
| X-ray of the ribs (2 views) |
$184 |
$184 |
$180 |
$36 | |
| X-ray of the ribs (3 views) |
$224 |
$224 |
$224 |
$42 | |
| X-ray of the shoulder |
$520 |
$520 |
$180 |
$36 | |
| X-ray of the skull |
$240 |
$240 |
$232 |
$40 | |
| X-ray of the upper arm |
$520 |
$520 |
$180 |
$32 | |
| X-ray of the wrist |
$520 |
$520 |
$180 |
$43 | |
| Zinc blood test |
$125 |
$125 |
— |
$11 | |