| 3D mammogram (tomosynthesis) |
$107 |
$134 |
— |
$51 | |
| Abdominal fluid drain (paracentesis) |
$1,247 |
$1,559 |
— |
$284 | |
| Abdominal ultrasound |
$821 |
$1,026 |
— |
$100 | |
| Abdominal ultrasound (complete) |
$1,030 |
$1,288 |
— |
$114 | |
| Abdominal ultrasound (limited) |
$821 |
$1,026 |
— |
$86 | |
| Abscess drainage (complex or multiple) |
$350 |
$437 |
— |
$220 | |
| Abscess drainage (simple) |
$350 |
$437 |
— |
$129 | |
| Abscess incision and drainage |
$350 |
$437 |
— |
$174 | |
| Albumin blood test |
$80 |
$100 |
— |
$5 | |
| Aldosterone test |
$144 |
$181 |
— |
$41 | |
| Alkaline phosphatase test |
$104 |
$130 |
— |
$5 | |
| Allergy testing |
$53 |
$66 |
— |
$4 | |
| Alpha-fetoprotein (AFP) test |
$138 |
$173 |
— |
$17 | |
| ALT liver enzyme test |
$84 |
$105 |
— |
$5 | |
| Ammonia blood test |
$71 |
$89 |
— |
$15 | |
| Amniocentesis |
$731 |
$914 |
— |
$120 | |
| Amylase test |
$154 |
$193 |
— |
$6 | |
| Anoscopy |
$108 |
$135 |
— |
$129 | |
| Antinuclear antibody (ANA) test |
$86 |
$107 |
— |
$12 | |
| Arterial blood gas (ABG) |
$238 |
$298 |
— |
$26 | |
| AST liver enzyme test |
$111 |
$139 |
— |
$5 | |
| Barium swallow study |
$649 |
$812 |
— |
$107 | |
| Bartholin cyst removal |
$350 |
$437 |
— |
$182 | |
| Basic metabolic panel |
$183 |
$229 |
— |
$8 | |
| Bilirubin blood test |
$73 |
$92 |
— |
$5 | |
| Blood clotting test (PT/INR) |
$78 |
$98 |
— |
$4 | |
| Blood crossmatch |
$144 |
$180 |
— |
— | |
| Blood glucose test |
$76 |
$95 |
— |
$5 | |
| Blood transfusion |
$747 |
$934 |
— |
$47 | |
| Blood type and screen |
$110 |
$137 |
— |
$10 | |
| Blood type test |
$80 |
$101 |
— |
$3 | |
| Blood type test (ABO group) |
$108 |
$135 |
— |
$3 | |
| Blood type test (Rh/D antigen) |
$53 |
$66 |
— |
$3 | |
| BNP (heart failure) test |
$183 |
$229 |
— |
$39 | |
| Bone density scan (DEXA) |
$505 |
$631 |
— |
$39 | |
| Bone marrow biopsy |
$1,541 |
$1,927 |
— |
$172 | |
| Bone scan (nuclear) |
$1,601 |
$2,001 |
— |
$259 | |
| Breast biopsy |
$1,834 |
$2,293 |
— |
$478 | |
| Breast ultrasound |
$554 |
$693 |
— |
$92 | |
| Breast ultrasound (complete) |
$554 |
$693 |
— |
$100 | |
| Breast ultrasound (limited) |
$521 |
$651 |
— |
$84 | |
| Breathing tube insertion (intubation) |
$723 |
$904 |
— |
$133 | |
| Burn dressing and debridement (medium) |
$189 |
$236 |
— |
$166 | |
| Burn dressing and debridement (small) |
$350 |
$437 |
— |
$93 | |
| Burn treatment |
$269 |
$337 |
— |
$129 | |
| C-reactive protein (CRP) |
$87 |
$109 |
— |
$5 | |
| CA 19-9 tumor marker test |
$109 |
$136 |
— |
$21 | |
| CA-125 ovarian marker test |
$110 |
$137 |
— |
$21 | |
| Calcium blood test |
$86 |
$108 |
— |
$5 | |
| Cardiac ablation |
$20,607 |
$25,759 |
— |
$759 | |
| Cardiac stress test |
$1,025 |
$1,281 |
— |
$39 | |
| Cardioversion |
$1,042 |
$1,303 |
— |
$155 | |
| Carotid artery ultrasound |
$766 |
$957 |
— |
$156 | |
| CEA tumor marker test |
$493 |
$616 |
— |
$19 | |
| Central line placement |
$2,505 |
$3,132 |
— |
$238 | |
| Chemotherapy infusion |
$288 |
$360 |
— |
$81 | |
| Chemotherapy infusion (each additional) |
$170 |
$212 |
— |
$28 | |
| Chemotherapy infusion (first hour) |
$406 |
$508 |
— |
$133 | |
| Chest fluid drain (thoracentesis) |
$874 |
$1,092 |
— |
$311 | |
| Chest tube insertion |
$1,296 |
$1,620 |
— |
$143 | |
| Chest X-ray |
$377 |
$471 |
— |
$37 | |
| Chest X-ray (1 view) |
$269 |
$336 |
— |
$25 | |
| Chest X-ray (2 views) |
$317 |
$396 |
— |
$33 | |
| CK-MB heart enzyme test |
$145 |
$181 |
— |
$12 | |
| Clotting time test (PTT) |
$70 |
$87 |
— |
$6 | |
| Complete blood count (CBC) |
$101 |
$126 |
— |
$7 | |
| Complete blood count (CBC) (complete) |
$112 |
$140 |
— |
$8 | |
| Comprehensive metabolic panel |
$256 |
$321 |
— |
$11 | |
| Copper blood test |
$87 |
$109 |
— |
$12 | |
| Cortisol test |
$92 |
$115 |
— |
$16 | |
| COVID-19 PCR test |
$62 |
$78 |
— |
$51 | |
| CPAP titration study |
$238 |
$298 |
— |
$69 | |
| Creatine kinase (CK) test |
$125 |
$156 |
— |
$7 | |
| CT angiography of the chest |
$3,025 |
$3,781 |
— |
$281 | |
| CT angiography of the head |
$2,730 |
$3,412 |
— |
$274 | |
| CT scan of the abdomen |
$2,206 |
$2,757 |
— |
$230 | |
| CT scan of the abdomen and pelvis |
$3,356 |
$4,195 |
— |
$300 | |
| CT scan of the abdomen and pelvis with and without contrast |
$3,792 |
$4,740 |
— |
$338 | |
| CT scan of the abdomen and pelvis with contrast |
$3,356 |
$4,195 |
— |
$300 | |
| CT scan of the abdomen and pelvis without contrast |
$2,835 |
$3,544 |
— |
$183 | |
| CT scan of the abdomen with and without contrast |
$2,606 |
$3,257 |
— |
$259 | |
| CT scan of the abdomen with contrast |
$2,206 |
$2,757 |
— |
$230 | |
| CT scan of the abdomen without contrast |
$1,931 |
$2,414 |
— |
$136 | |
| CT scan of the arm |
$2,413 |
$3,016 |
— |
$199 | |
| CT scan of the arm with contrast |
$2,109 |
$2,636 |
— |
$199 | |
| CT scan of the arm without contrast |
$1,808 |
$2,260 |
— |
$161 | |
| CT scan of the chest |
$2,375 |
$2,969 |
— |
$167 | |
| CT scan of the chest with and without contrast |
$2,536 |
$3,170 |
— |
$196 | |
| CT scan of the chest with contrast |
$2,375 |
$2,969 |
— |
$167 | |
| CT scan of the chest without contrast |
$1,970 |
$2,463 |
— |
$133 | |
| CT scan of the head |
$2,157 |
$2,696 |
— |
$148 | |
| CT scan of the head with and without contrast |
$2,214 |
$2,768 |
— |
$173 | |
| CT scan of the head with contrast |
$2,157 |
$2,696 |
— |
$148 | |
| CT scan of the head without contrast |
$1,919 |
$2,399 |
— |
$107 | |
| CT scan of the leg |
$2,457 |
$3,071 |
— |
$166 | |
| CT scan of the leg with contrast |
$2,380 |
$2,975 |
— |
$166 | |
| CT scan of the leg without contrast |
$2,016 |
$2,520 |
— |
$130 | |
| CT scan of the lower back (lumbar spine) |
$2,778 |
$3,473 |
— |
$169 | |
| CT scan of the lower back (lumbar spine) with and without contrast |
$3,083 |
$3,854 |
— |
$197 | |
| CT scan of the lower back (lumbar spine) with contrast |
$2,778 |
$3,473 |
— |
$169 | |
| CT scan of the lower back (lumbar spine) without contrast |
$2,477 |
$3,096 |
— |
$130 | |
| CT scan of the neck |
$2,066 |
$2,582 |
— |
$183 | |
| CT scan of the neck (cervical spine) |
$2,495 |
$3,119 |
— |
$168 | |
| CT scan of the neck (cervical spine) with and without contrast |
$2,767 |
$3,459 |
— |
$196 | |
| CT scan of the neck (cervical spine) with contrast |
$2,495 |
$3,119 |
— |
$168 | |
| CT scan of the neck (cervical spine) without contrast |
$2,266 |
$2,833 |
— |
$131 | |
| CT scan of the neck with and without contrast |
$2,582 |
$3,227 |
— |
$220 | |
| CT scan of the neck with contrast |
$2,066 |
$2,582 |
— |
$183 | |
| CT scan of the neck without contrast |
$1,848 |
$2,310 |
— |
$150 | |
| CT scan of the pelvis |
$2,276 |
$2,845 |
— |
$226 | |
| CT scan of the pelvis with and without contrast |
$2,711 |
$3,389 |
— |
$251 | |
| CT scan of the pelvis with contrast |
$2,276 |
$2,845 |
— |
$226 | |
| CT scan of the pelvis without contrast |
$1,981 |
$2,476 |
— |
$133 | |
| CT scan of the sinuses |
$2,087 |
$2,609 |
— |
$152 | |
| CT scan of the sinuses with and without contrast |
$2,218 |
$2,772 |
— |
$184 | |
| CT scan of the sinuses with contrast |
$2,087 |
$2,609 |
— |
$152 | |
| CT scan of the sinuses without contrast |
$1,934 |
$2,417 |
— |
$128 | |
| D-dimer test |
$126 |
$158 |
— |
$10 | |
| Defibrillator (ICD) implant |
$27,589 |
$34,486 |
— |
$798 | |
| Developmental screening (child) |
$219 |
$274 |
— |
— | |
| DHEA-sulfate test |
$94 |
$118 |
— |
$22 | |
| Diagnostic mammogram |
$322 |
$402 |
— |
$140 | |
| Drug screen (urine) |
$241 |
$302 |
— |
$17 | |
| Echocardiogram |
$1,659 |
$2,074 |
— |
$138 | |
| Echocardiogram with and without contrast |
$790 |
$987 |
— |
$101 | |
| EKG / ECG (tracing only) |
$222 |
$278 |
— |
$7 | |
| Electrocardiogram (EKG) |
$222 |
$278 |
— |
$8 | |
| Electrolyte panel |
$155 |
$194 |
— |
$7 | |
| Emergency department visit |
$648 |
$810 |
— |
$69 | |
| Emergency department visit (level 1) |
$183 |
$229 |
— |
$11 | |
| Emergency department visit (level 2) |
$380 |
$475 |
— |
$40 | |
| Emergency department visit (level 3) |
$648 |
$810 |
— |
$69 | |
| Emergency department visit (level 4) |
$1,026 |
$1,283 |
— |
$118 | |
| Emergency department visit (level 5) |
$1,707 |
$2,134 |
— |
$171 | |
| Epidural steroid injection |
$987 |
$1,234 |
— |
$275 | |
| Estradiol (estrogen) test |
$103 |
$129 |
— |
$28 | |
| Facet joint injection (spine) |
$1,262 |
$1,577 |
— |
$99 | |
| Fallopian tube X-ray (HSG) |
$698 |
$873 |
— |
$164 | |
| Fecal occult blood (stool) test |
$80 |
$100 |
— |
$10 | |
| Fecal occult blood (stool) test (guaiac, gFOBT) |
$74 |
$92 |
— |
$4 | |
| Fecal occult blood (stool) test (immunochemical, FIT) |
$80 |
$100 |
— |
$16 | |
| Ferritin (iron) test |
$113 |
$141 |
— |
$14 | |
| Fibrinogen test |
$127 |
$159 |
— |
$10 | |
| Flu test |
$119 |
$149 |
— |
$17 | |
| Folate (folic acid) test |
$142 |
$177 |
— |
$15 | |
| Foreign body removal (skin) |
$337 |
$421 |
— |
$157 | |
| Free T4 thyroid test |
$133 |
$166 |
— |
$9 | |
| FSH hormone test |
$76 |
$95 |
— |
$19 | |
| Gallbladder scan (HIDA) |
$1,607 |
$2,009 |
— |
$334 | |
| GGT liver test |
$78 |
$98 |
— |
$7 | |
| Glucose tolerance test |
$166 |
$208 |
— |
$8 | |
| HDL cholesterol test |
$72 |
$90 |
— |
$8 | |
| Hematocrit test |
$70 |
$87 |
— |
$2 | |
| Hemoglobin A1c (diabetes test) |
$79 |
$99 |
— |
$10 | |
| Hepatitis B test |
$81 |
$101 |
— |
$10 | |
| Hepatitis C test |
$88 |
$110 |
— |
$14 | |
| HIV test |
$186 |
$233 |
— |
$19 | |
| HIV test (antibody) |
$150 |
$187 |
— |
$14 | |
| HIV test (antigen/antibody combo) |
$223 |
$279 |
— |
$24 | |
| Holter heart monitor |
$614 |
$767 |
— |
$26 | |
| Home sleep apnea test |
$518 |
$648 |
— |
$123 | |
| Iron blood test |
$70 |
$88 |
— |
$6 | |
| IUD removal |
$255 |
$319 |
— |
$112 | |
| IV infusion therapy |
$343 |
$429 |
— |
$44 | |
| IV infusion therapy (each additional) |
$202 |
$253 |
— |
$21 | |
| IV infusion therapy (initial) |
$484 |
$605 |
— |
$67 | |
| Joint aspiration (small/intermediate) |
$311 |
$389 |
— |
$57 | |
| Joint aspiration or injection (mid-size joint) |
$311 |
$389 |
— |
$57 | |
| Joint aspiration or injection (small joint) |
$380 |
$475 |
— |
$56 | |
| Kidney scan (nuclear) |
$2,531 |
$3,164 |
— |
$172 | |
| Kidney ultrasound |
$830 |
$1,038 |
— |
$84 | |
| Kidney ultrasound (limited) |
$832 |
$1,040 |
— |
$61 | |
| Knee joint injection |
$604 |
$755 |
— |
$69 | |
| Lactate test |
$98 |
$122 |
— |
$12 | |
| LDH test |
$96 |
$120 |
— |
$6 | |
| LDL cholesterol test |
$89 |
$111 |
— |
$11 | |
| Leg vein ultrasound (Doppler) |
$843 |
$1,054 |
— |
$150 | |
| Leg vein ultrasound (Doppler) (limited) |
$843 |
$1,054 |
— |
$116 | |
| LH hormone test |
$291 |
$364 |
— |
$19 | |
| Lipase test |
$221 |
$276 |
— |
$7 | |
| Lipid (cholesterol) panel |
$203 |
$254 |
— |
$13 | |
| Liver biopsy |
$1,337 |
$1,671 |
— |
$288 | |
| Liver function panel |
$210 |
$262 |
— |
$8 | |
| Lung function test (PFT) |
$325 |
$406 |
— |
$37 | |
| Lung scan (V/Q) |
$2,586 |
$3,233 |
— |
$291 | |
| Magnesium blood test |
$77 |
$96 |
— |
$7 | |
| MRA of the brain |
$3,281 |
$4,101 |
— |
$226 | |
| MRA of the brain with contrast |
$3,281 |
$4,101 |
— |
$226 | |
| MRA of the brain without contrast |
$3,526 |
$4,407 |
— |
$328 | |
| MRA of the neck |
$2,936 |
$3,670 |
— |
$245 | |
| MRA of the neck with contrast |
$2,936 |
$3,670 |
— |
$245 | |
| MRA of the neck without contrast |
$3,883 |
$4,854 |
— |
$343 | |
| MRI of the abdomen |
$3,440 |
$4,300 |
— |
$300 | |
| MRI of the abdomen with contrast |
$3,440 |
$4,300 |
— |
$300 | |
| MRI of the abdomen without contrast |
$2,880 |
$3,600 |
— |
$194 | |
| MRI of the ankle |
$4,200 |
$5,250 |
— |
$261 | |
| MRI of the ankle with contrast |
$3,014 |
$3,768 |
— |
$261 | |
| MRI of the ankle without contrast |
$2,800 |
$3,500 |
— |
$222 | |
| MRI of the brain |
$4,039 |
$5,049 |
— |
$269 | |
| MRI of the brain with contrast |
$4,039 |
$5,049 |
— |
$269 | |
| MRI of the brain without contrast |
$2,913 |
$3,641 |
— |
$195 | |
| MRI of the chest |
$3,415 |
$4,269 |
— |
$371 | |
| MRI of the chest with contrast |
$3,415 |
$4,269 |
— |
$371 | |
| MRI of the chest without contrast |
$3,878 |
$4,847 |
— |
$466 | |
| MRI of the knee |
$3,198 |
$3,998 |
— |
$315 | |
| MRI of the knee with contrast |
$3,198 |
$3,998 |
— |
$315 | |
| MRI of the knee without contrast |
$2,881 |
$3,601 |
— |
$204 | |
| MRI of the lower back (lumbar spine) |
$3,350 |
$4,188 |
— |
$270 | |
| MRI of the lower back (lumbar spine) with contrast |
$3,350 |
$4,188 |
— |
$270 | |
| MRI of the lower back (lumbar spine) without contrast |
$3,033 |
$3,791 |
— |
$192 | |
| MRI of the mid-back (thoracic spine) |
$3,752 |
$4,690 |
— |
$271 | |
| MRI of the mid-back (thoracic spine) with and without contrast |
$3,752 |
$4,690 |
— |
$319 | |
| MRI of the mid-back (thoracic spine) with contrast |
$4,972 |
$6,215 |
— |
$271 | |
| MRI of the mid-back (thoracic spine) without contrast |
$2,951 |
$3,689 |
— |
$190 | |
| MRI of the neck (cervical spine) |
$3,367 |
$4,209 |
— |
$274 | |
| MRI of the neck (cervical spine) with and without contrast |
$3,738 |
$4,673 |
— |
$318 | |
| MRI of the neck (cervical spine) with contrast |
$3,367 |
$4,209 |
— |
$274 | |
| MRI of the neck (cervical spine) without contrast |
$3,022 |
$3,778 |
— |
$191 | |
| MRI of the pelvis |
$3,382 |
$4,227 |
— |
$268 | |
| MRI of the pelvis with contrast |
$3,382 |
$4,227 |
— |
$268 | |
| MRI of the pelvis without contrast |
$2,826 |
$3,533 |
— |
$227 | |
| MRI of the shoulder |
$3,096 |
$3,870 |
— |
$313 | |
| MRI of the shoulder with contrast |
$3,096 |
$3,870 |
— |
$313 | |
| MRI of the shoulder without contrast |
$2,634 |
$3,293 |
— |
$205 | |
| MRI of the wrist |
$3,475 |
$4,344 |
— |
$330 | |
| MRI of the wrist without contrast |
$3,134 |
$3,917 |
— |
$303 | |
| Nebulizer breathing treatment |
$116 |
$145 |
— |
$9 | |
| Nuclear cardiac stress test |
$4,446 |
$5,557 |
— |
$428 | |
| Occupational therapy evaluation |
$330 |
$412 |
— |
$101 | |
| Occupational therapy evaluation (high complexity) |
$371 |
$464 |
— |
$101 | |
| Occupational therapy evaluation (low complexity) |
$309 |
$386 |
— |
$101 | |
| Occupational therapy evaluation (moderate complexity) |
$330 |
$412 |
— |
$101 | |
| Office visit (established patient) |
$250 |
$313 |
— |
$115 | |
| Office visit (new patient) |
$307 |
$384 |
— |
$177 | |
| Office visit, established patient (level 3) |
$199 |
$249 |
— |
$95 | |
| Office visit, established patient (level 4) |
$302 |
$377 |
— |
$136 | |
| Office visit, new patient (level 3) |
$242 |
$302 |
— |
$118 | |
| Office visit, new patient (level 4) |
$372 |
$465 |
— |
$177 | |
| Pap smear (cervical screening) |
$182 |
$228 |
— |
$20 | |
| Parathyroid hormone (PTH) test |
$136 |
$170 |
— |
$41 | |
| Pelvic ultrasound |
$686 |
$858 |
— |
$78 | |
| Pelvic ultrasound (complete) |
$898 |
$1,123 |
— |
$105 | |
| Pelvic ultrasound (limited) |
$474 |
$592 |
— |
$51 | |
| Phosphorus blood test |
$88 |
$110 |
— |
$5 | |
| Physical therapy evaluation |
$330 |
$412 |
— |
$98 | |
| Physical therapy evaluation (high complexity) |
$371 |
$464 |
— |
$98 | |
| Physical therapy evaluation (moderate complexity) |
$330 |
$412 |
— |
$98 | |
| Platelet count |
$75 |
$94 |
— |
$4 | |
| Pregnancy blood test (hCG) |
$115 |
$144 |
— |
$8 | |
| Pregnancy ultrasound |
$718 |
$898 |
— |
$126 | |
| Pregnancy ultrasound (first trimester) |
$604 |
$755 |
— |
$117 | |
| Pregnancy ultrasound (second or third trimester) |
$833 |
$1,041 |
— |
$136 | |
| Procalcitonin test |
$122 |
$152 |
— |
$27 | |
| Prolactin test |
$112 |
$140 |
— |
$19 | |
| Prostate test (PSA) |
$192 |
$240 |
— |
$18 | |
| Rheumatoid factor test |
$134 |
$167 |
— |
$6 | |
| Sacroiliac joint injection |
$1,059 |
$1,324 |
— |
$176 | |
| Scoliosis spine X-ray |
$318 |
$398 |
— |
$58 | |
| Scoliosis spine X-ray (1 view) |
$295 |
$369 |
— |
$44 | |
| Scoliosis spine X-ray (3 views) |
$342 |
$427 |
— |
$72 | |
| Screening mammogram |
$312 |
$390 |
— |
$126 | |
| Scrotal ultrasound |
$862 |
$1,078 |
— |
$99 | |
| Sedimentation rate (ESR) test |
$99 |
$124 |
— |
$3 | |
| Semen analysis |
$82 |
$103 |
— |
$12 | |
| Sex hormone binding globulin test |
$175 |
$219 |
— |
$22 | |
| Simple laceration repair (small, up to 2.5 cm) |
$380 |
$475 |
— |
$114 | |
| Simple wound stitches |
$386 |
$482 |
— |
$127 | |
| Skin biopsy |
$514 |
$643 |
— |
$121 | |
| Skin tag removal |
$259 |
$324 |
— |
$92 | |
| Sleep study (polysomnography) |
$4,767 |
$5,959 |
— |
$691 | |
| Soft tissue ultrasound |
$474 |
$592 |
— |
$64 | |
| Speech therapy |
$111 |
$139 |
— |
$76 | |
| Spinal tap (lumbar puncture) |
$788 |
$985 |
— |
$165 | |
| Spirometry (lung function test) |
$325 |
$406 |
— |
$30 | |
| Spirometry with bronchodilator |
$395 |
$494 |
— |
$43 | |
| Strep throat test |
$90 |
$112 |
— |
$17 | |
| Stress echocardiogram |
$2,089 |
$2,612 |
— |
$209 | |
| Stress echocardiogram (complete) |
$2,144 |
$2,680 |
— |
$233 | |
| Swallow study |
$413 |
$516 |
— |
$85 | |
| T3 thyroid test |
$80 |
$100 |
— |
$14 | |
| Testosterone test |
$96 |
$120 |
— |
$26 | |
| Thyroid test (TSH) |
$189 |
$236 |
— |
$17 | |
| Thyroid ultrasound |
$797 |
$996 |
— |
$109 | |
| Thyroid uptake scan |
$1,216 |
$1,521 |
— |
$145 | |
| Total IgE allergy test |
$88 |
$110 |
— |
$16 | |
| Total protein test |
$76 |
$95 |
— |
$4 | |
| Transvaginal ultrasound |
$711 |
$889 |
— |
$118 | |
| Trigger point injection |
$423 |
$529 |
— |
$56 | |
| Trigger point injection (1-2 muscles) |
$370 |
$463 |
— |
$52 | |
| Triglycerides test |
$67 |
$84 |
— |
$6 | |
| Troponin (heart) test |
$203 |
$254 |
— |
$12 | |
| Upper GI series (barium) |
$1,034 |
$1,293 |
— |
$128 | |
| Uric acid (gout) test |
$106 |
$132 |
— |
$5 | |
| Urinalysis |
$59 |
$74 |
— |
$3 | |
| Urine microalbumin test |
$50 |
$62 |
— |
$5 | |
| Urine pregnancy test |
$73 |
$92 |
— |
$9 | |
| Vaccine administration |
$70 |
$88 |
— |
$19 | |
| Vaccine administration (each additional) |
$70 |
$88 |
— |
$16 | |
| Vitamin B12 test |
$119 |
$149 |
— |
$15 | |
| Vitamin D test |
$145 |
$181 |
— |
$30 | |
| Wound debridement |
$580 |
$725 |
— |
$186 | |
| X-ray of the abdomen |
$383 |
$479 |
— |
$36 | |
| X-ray of the ankle |
$354 |
$443 |
— |
$37 | |
| X-ray of the collarbone |
$316 |
$395 |
— |
$33 | |
| X-ray of the elbow |
$389 |
$486 |
— |
$33 | |
| X-ray of the facial bones |
$581 |
$726 |
— |
$39 | |
| X-ray of the foot |
$378 |
$472 |
— |
$34 | |
| X-ray of the forearm |
$324 |
$405 |
— |
$29 | |
| X-ray of the hand |
$350 |
$437 |
— |
$38 | |
| X-ray of the hip |
$469 |
$586 |
— |
$49 | |
| X-ray of the hip (1 view) |
$330 |
$412 |
— |
$34 | |
| X-ray of the hip (3 views) |
$469 |
$586 |
— |
$49 | |
| X-ray of the hip (4 views) |
$510 |
$638 |
— |
$63 | |
| X-ray of the knee |
$463 |
$579 |
— |
$42 | |
| X-ray of the knee (2 views) |
$430 |
$538 |
— |
$34 | |
| X-ray of the knee (3 views) |
$463 |
$579 |
— |
$42 | |
| X-ray of the knee (4+ views) |
$463 |
$579 |
— |
$49 | |
| X-ray of the lower back (lumbar spine) |
$471 |
$589 |
— |
$47 | |
| X-ray of the lower back (lumbar spine) (2 views) |
$471 |
$589 |
— |
$40 | |
| X-ray of the lower back (lumbar spine) (4+ views) |
$542 |
$678 |
— |
$53 | |
| X-ray of the lower leg |
$356 |
$445 |
— |
$31 | |
| X-ray of the mid-back (thoracic spine) |
$459 |
$574 |
— |
$36 | |
| X-ray of the mid-back (thoracic spine) (2 views) |
$459 |
$574 |
— |
$33 | |
| X-ray of the mid-back (thoracic spine) (3 views) |
$527 |
$659 |
— |
$39 | |
| X-ray of the neck (cervical spine) |
$468 |
$585 |
— |
$47 | |
| X-ray of the neck (cervical spine) (3 views) |
$468 |
$585 |
— |
$40 | |
| X-ray of the pelvis |
$324 |
$405 |
— |
$36 | |
| X-ray of the pelvis (1 view) |
$324 |
$405 |
— |
$28 | |
| X-ray of the ribs |
$526 |
$657 |
— |
$42 | |
| X-ray of the ribs (2 views) |
$423 |
$529 |
— |
$36 | |
| X-ray of the ribs (3 views) |
$526 |
$657 |
— |
$42 | |
| X-ray of the shoulder |
$413 |
$516 |
— |
$36 | |
| X-ray of the skull |
$485 |
$607 |
— |
$40 | |
| X-ray of the upper arm |
$354 |
$442 |
— |
$32 | |
| X-ray of the wrist |
$345 |
$431 |
— |
$43 | |
| Zinc blood test |
$86 |
$108 |
— |
$11 | |