| 3D mammogram (tomosynthesis) |
$94 |
$117 |
$102 |
$51 | |
| Abdominal fluid drain (paracentesis) |
$2,093 |
$2,616 |
$2,229 |
$284 | |
| Abdominal ultrasound |
$842 |
$1,053 |
$836 |
$100 | |
| Abdominal ultrasound (complete) |
$941 |
$1,176 |
$1,002 |
$114 | |
| Abdominal ultrasound (limited) |
$743 |
$929 |
$792 |
$86 | |
| Abscess drainage (complex or multiple) |
$852 |
$1,065 |
$907 |
$220 | |
| Abscess drainage (simple) |
$556 |
$695 |
$592 |
$129 | |
| Abscess incision and drainage |
$704 |
$880 |
$626 |
$174 | |
| Achilles tendon repair |
— |
— |
$7,501 |
$624 | |
| ACL knee reconstruction |
— |
— |
$7,501 |
$889 | |
| Acupuncture |
— |
— |
$26 |
$38 | |
| Adenoid removal (adenoidectomy) |
— |
— |
$3,405 |
$204 | |
| Allergy patch testing |
— |
— |
$1,068 |
$5 | |
| Allergy shots |
— |
— |
$48 |
$11 | |
| Allergy testing |
— |
— |
$1,068 |
$4 | |
| Amniocentesis |
— |
— |
$914 |
$120 | |
| Anal fistula repair |
— |
— |
$2,880 |
$541 | |
| Ankle fracture repair |
— |
— |
$7,501 |
$608 | |
| Ankle replacement |
— |
— |
$19,310 |
$885 | |
| Anoscopy |
$295 |
$369 |
$314 |
$129 | |
| Barium swallow study |
— |
— |
$187 |
$107 | |
| Bartholin cyst removal |
$490 |
$613 |
$522 |
$182 | |
| Basic metabolic panel |
— |
— |
$87 |
$8 | |
| Benign skin lesion removal |
— |
— |
$739 |
$171 | |
| Bladder function test (urodynamics) |
— |
— |
$701 |
$345 | |
| Bladder scope (cystoscopy) |
— |
— |
$701 |
$216 | |
| Bladder tumor removal (TURBT) |
— |
— |
$3,621 |
$236 | |
| Blood transfusion |
$937 |
$1,171 |
$998 |
$47 | |
| Bone density scan (DEXA) |
$530 |
$663 |
$565 |
$39 | |
| Bone marrow biopsy |
— |
— |
$2,353 |
$172 | |
| Bone scan (nuclear) |
$1,858 |
$2,322 |
$1,978 |
$259 | |
| Botox for migraine |
— |
— |
$310 |
$157 | |
| Breast biopsy |
— |
— |
$1,701 |
$478 | |
| Breast MRI |
— |
— |
$578 |
$216 | |
| Breast MRI without contrast |
— |
— |
$578 |
$216 | |
| Breast reconstruction |
— |
— |
$18,268 |
$1,227 | |
| Breast reduction |
— |
— |
$6,848 |
$980 | |
| Breast ultrasound |
— |
— |
$102 |
$92 | |
| Breast ultrasound (complete) |
— |
— |
$112 |
$100 | |
| Breast ultrasound (limited) |
— |
— |
$92 |
$84 | |
| Breathing tube insertion (intubation) |
$798 |
$998 |
$850 |
$133 | |
| Bronchoscopy |
— |
— |
$1,811 |
$303 | |
| Bunion surgery (bunionectomy) |
— |
— |
$7,501 |
$883 | |
| Burn dressing and debridement (medium) |
$429 |
$536 |
$457 |
$166 | |
| Burn dressing and debridement (small) |
$442 |
$553 |
$471 |
$93 | |
| Burn treatment |
$436 |
$545 |
$464 |
$129 | |
| Capsule endoscopy |
— |
— |
$984 |
$802 | |
| Cardiac ablation |
— |
— |
$25,759 |
$759 | |
| Cardiac catheterization |
— |
— |
$3,377 |
$1,049 | |
| Cardiac MRI |
— |
— |
$593 |
$322 | |
| Cardiac MRI without contrast |
— |
— |
$578 |
$280 | |
| Cardiac rehabilitation |
$319 |
$399 |
$333 |
$26 | |
| Cardiac stress test |
$1,175 |
$1,469 |
$1,252 |
$39 | |
| Cardioversion |
$1,792 |
$2,240 |
$1,908 |
$155 | |
| Carotid artery ultrasound |
$1,036 |
$1,295 |
$1,081 |
$156 | |
| Carpal tunnel release |
— |
— |
$2,050 |
$483 | |
| Cataract surgery |
— |
— |
$2,395 |
$547 | |
| Central line placement |
$2,311 |
$2,889 |
$2,511 |
$238 | |
| Cervical cerclage |
— |
— |
$3,339 |
$137 | |
| Cervical LEEP procedure |
— |
— |
$3,339 |
$325 | |
| Chalazion (eyelid cyst) removal |
— |
— |
$314 |
$131 | |
| Chemotherapy infusion |
— |
— |
$194 |
$81 | |
| Chemotherapy infusion (each additional) |
— |
— |
$71 |
$28 | |
| Chemotherapy infusion (first hour) |
— |
— |
$331 |
$133 | |
| Chest fluid drain (thoracentesis) |
$1,852 |
$2,315 |
$1,972 |
$311 | |
| Chest tube insertion |
$1,410 |
$1,763 |
$1,532 |
$143 | |
| Chest X-ray |
$422 |
$528 |
$392 |
$37 | |
| Chest X-ray (1 view) |
$307 |
$384 |
$327 |
$25 | |
| Chest X-ray (2 views) |
$386 |
$483 |
$403 |
$33 | |
| Chiropractic adjustment |
— |
— |
$27 |
$38 | |
| Circumcision |
— |
— |
$2,151 |
$167 | |
| Colonoscopy |
— |
— |
$1,238 |
$480 | |
| Colposcopy |
— |
— |
$319 |
$161 | |
| Complete blood count (CBC) |
— |
— |
$62 |
$7 | |
| Complete blood count (CBC) (complete) |
— |
— |
$62 |
$8 | |
| Complex wound repair |
$2,721 |
$3,401 |
$2,898 |
$390 | |
| Comprehensive eye exam |
— |
— |
$135 |
$138 | |
| Comprehensive metabolic panel |
— |
— |
$111 |
$11 | |
| Contraceptive implant (Nexplanon) |
— |
— |
$419 |
$115 | |
| Corneal transplant |
— |
— |
$4,224 |
$1,066 | |
| Coronary CT angiography |
— |
— |
$447 |
$326 | |
| COVID-19 PCR test |
— |
— |
$99 |
$51 | |
| CPAP titration study |
$502 |
$628 |
$541 |
$69 | |
| CT angiography of the chest |
$2,758 |
$3,448 |
$2,879 |
$281 | |
| CT angiography of the head |
$2,606 |
$3,258 |
$2,720 |
$274 | |
| CT colonography (virtual colonoscopy) |
— |
— |
$254 |
$835 | |
| CT scan of the abdomen |
$2,364 |
$2,955 |
$2,170 |
$230 | |
| CT scan of the abdomen and pelvis |
$4,016 |
$5,020 |
$3,911 |
$300 | |
| CT scan of the abdomen and pelvis with and without contrast |
$4,289 |
$5,361 |
$4,476 |
$338 | |
| CT scan of the abdomen and pelvis with contrast |
$4,016 |
$5,020 |
$4,192 |
$300 | |
| CT scan of the abdomen and pelvis without contrast |
$3,476 |
$4,345 |
$3,628 |
$183 | |
| CT scan of the abdomen with and without contrast |
$2,674 |
$3,342 |
$2,791 |
$259 | |
| CT scan of the abdomen with contrast |
$2,364 |
$2,955 |
$2,467 |
$230 | |
| CT scan of the abdomen without contrast |
$1,929 |
$2,411 |
$2,013 |
$136 | |
| CT scan of the arm |
$1,948 |
$2,435 |
$1,917 |
$199 | |
| CT scan of the arm with contrast |
$2,151 |
$2,689 |
$2,245 |
$199 | |
| CT scan of the arm without contrast |
$1,745 |
$2,181 |
$1,821 |
$161 | |
| CT scan of the chest |
$2,297 |
$2,871 |
$2,210 |
$167 | |
| CT scan of the chest with and without contrast |
$2,644 |
$3,305 |
$2,760 |
$196 | |
| CT scan of the chest with contrast |
$2,297 |
$2,871 |
$2,397 |
$167 | |
| CT scan of the chest without contrast |
$1,965 |
$2,456 |
$2,051 |
$133 | |
| CT scan of the head |
$2,047 |
$2,559 |
$2,096 |
$148 | |
| CT scan of the head with and without contrast |
$2,363 |
$2,954 |
$2,467 |
$173 | |
| CT scan of the head with contrast |
$2,047 |
$2,559 |
$2,137 |
$148 | |
| CT scan of the head without contrast |
$1,863 |
$2,329 |
$1,945 |
$107 | |
| CT scan of the leg |
$1,925 |
$2,407 |
$1,924 |
$166 | |
| CT scan of the leg with contrast |
$2,099 |
$2,624 |
$2,191 |
$166 | |
| CT scan of the leg without contrast |
$1,751 |
$2,189 |
$1,828 |
$130 | |
| CT scan of the lower back (lumbar spine) |
$2,216 |
$2,770 |
$2,194 |
$169 | |
| CT scan of the lower back (lumbar spine) with and without contrast |
— |
— |
$447 |
$197 | |
| CT scan of the lower back (lumbar spine) with contrast |
$2,434 |
$3,043 |
$2,541 |
$169 | |
| CT scan of the lower back (lumbar spine) without contrast |
$1,997 |
$2,496 |
$2,084 |
$130 | |
| CT scan of the neck |
$2,211 |
$2,764 |
$2,024 |
$183 | |
| CT scan of the neck (cervical spine) |
$2,224 |
$2,780 |
$2,194 |
$168 | |
| CT scan of the neck (cervical spine) with and without contrast |
— |
— |
$447 |
$196 | |
| CT scan of the neck (cervical spine) with contrast |
$2,451 |
$3,064 |
$2,558 |
$168 | |
| CT scan of the neck (cervical spine) without contrast |
$1,997 |
$2,496 |
$2,084 |
$131 | |
| CT scan of the neck with and without contrast |
$2,640 |
$3,300 |
$2,756 |
$220 | |
| CT scan of the neck with contrast |
$2,211 |
$2,764 |
$2,308 |
$183 | |
| CT scan of the neck without contrast |
$1,799 |
$2,249 |
$1,878 |
$150 | |
| CT scan of the pelvis |
$1,859 |
$2,324 |
$1,885 |
$226 | |
| CT scan of the pelvis with and without contrast |
— |
— |
$447 |
$251 | |
| CT scan of the pelvis with contrast |
$2,002 |
$2,503 |
$2,090 |
$226 | |
| CT scan of the pelvis without contrast |
$1,715 |
$2,144 |
$1,790 |
$133 | |
| CT scan of the sinuses |
$2,044 |
$2,555 |
$2,061 |
$152 | |
| CT scan of the sinuses with and without contrast |
— |
— |
$447 |
$184 | |
| CT scan of the sinuses with contrast |
$2,211 |
$2,764 |
$2,308 |
$152 | |
| CT scan of the sinuses without contrast |
$1,876 |
$2,345 |
$1,958 |
$128 | |
| Defibrillator (ICD) implant |
— |
— |
$33,665 |
$798 | |
| Diagnostic mammogram |
$523 |
$654 |
$516 |
$140 | |
| Dialysis fistula creation |
— |
— |
$3,305 |
$601 | |
| Dilation and curettage (D&C) |
— |
— |
$3,339 |
$298 | |
| Droopy eyelid repair (ptosis) |
— |
— |
$2,450 |
$745 | |
| Ear pressure test (tympanometry) |
— |
— |
$41 |
$16 | |
| Ear tubes (myringotomy) |
— |
— |
$1,045 |
$174 | |
| Eardrum repair (tympanoplasty) |
— |
— |
$6,211 |
$799 | |
| Echocardiogram |
$1,636 |
$2,045 |
$1,152 |
$138 | |
| Echocardiogram with and without contrast |
$992 |
$1,240 |
$1,056 |
$101 | |
| Echocardiogram without contrast |
— |
— |
$254 |
$138 | |
| EEG (awake and asleep) |
— |
— |
$327 |
$482 | |
| EKG / ECG (tracing only) |
$261 |
$326 |
$272 |
$7 | |
| Elbow replacement |
— |
— |
$19,310 |
$1,301 | |
| Electrocardiogram (EKG) |
$195 |
$244 |
$150 |
$8 | |
| Electroencephalogram (EEG) |
— |
— |
$327 |
$448 | |
| Electromyography (EMG) |
— |
— |
$135 |
$141 | |
| Emergency department visit |
$888 |
$1,110 |
$871 |
$69 | |
| Emergency department visit (level 1) |
$315 |
$394 |
$336 |
$11 | |
| Emergency department visit (level 2) |
$502 |
$627 |
$534 |
$40 | |
| Emergency department visit (level 3) |
$888 |
$1,110 |
$946 |
$69 | |
| Emergency department visit (level 4) |
$1,411 |
$1,764 |
$1,503 |
$118 | |
| Emergency department visit (level 5) |
$2,053 |
$2,566 |
$2,186 |
$171 | |
| Endometrial biopsy |
— |
— |
$211 |
$98 | |
| Epidural steroid injection |
— |
— |
$727 |
$275 | |
| ERCP (bile duct endoscopy) |
— |
— |
$3,995 |
$311 | |
| Esophageal dilation |
— |
— |
$1,488 |
$522 | |
| Esophageal variceal banding |
— |
— |
$1,992 |
$126 | |
| Eyelid surgery (blepharoplasty) |
— |
— |
$1,921 |
$552 | |
| Facet joint injection (spine) |
— |
— |
$935 |
$99 | |
| Fallopian tube X-ray (HSG) |
— |
— |
$254 |
$164 | |
| Family therapy session |
$540 |
$675 |
$575 |
$110 | |
| Feeding tube (PEG) placement |
— |
— |
$1,992 |
$178 | |
| Femoral hernia repair |
— |
— |
$3,706 |
$584 | |
| Flexible sigmoidoscopy |
— |
— |
$957 |
$323 | |
| Foreign body removal (skin) |
$858 |
$1,073 |
$914 |
$157 | |
| Gallbladder removal (laparoscopic) |
— |
— |
$6,126 |
$658 | |
| Gallbladder scan (HIDA) |
$1,854 |
$2,318 |
$1,936 |
$334 | |
| Ganglion cyst removal |
— |
— |
$1,680 |
$321 | |
| Glaucoma surgery |
— |
— |
$2,395 |
$984 | |
| Group therapy session |
$1,400 |
$1,750 |
$1,491 |
$30 | |
| Hammertoe repair |
— |
— |
$3,407 |
$548 | |
| Hearing test (audiometry) |
— |
— |
$164 |
$36 | |
| Hemodialysis |
— |
— |
$735 |
$75 | |
| Hemoglobin A1c (diabetes test) |
— |
— |
$58 |
$10 | |
| Hemorrhoid removal |
— |
— |
$1,918 |
$338 | |
| Hepatitis B vaccine |
$80 |
$100 |
$87 |
— | |
| Hip arthroscopy |
— |
— |
$7,501 |
$931 | |
| Hip replacement |
— |
— |
$13,510 |
$1,162 | |
| Holter heart monitor |
$552 |
$690 |
$576 |
$26 | |
| Home sleep apnea test |
— |
— |
$113 |
$123 | |
| Hydrocele repair |
— |
— |
$3,706 |
$315 | |
| Hysterectomy |
— |
— |
$10,932 |
$933 | |
| Hysteroscopy |
— |
— |
$3,339 |
$1,270 | |
| Inguinal hernia repair |
— |
— |
$3,706 |
$538 | |
| IUD removal |
$434 |
$543 |
$463 |
$112 | |
| IV infusion therapy |
$368 |
$461 |
$203 |
$44 | |
| IV infusion therapy (each additional) |
$117 |
$146 |
$131 |
$21 | |
| IV infusion therapy (initial) |
$620 |
$775 |
$660 |
$67 | |
| IVC filter placement |
— |
— |
$5,676 |
$1,885 | |
| Joint aspiration (small/intermediate) |
$662 |
$828 |
$705 |
$57 | |
| Joint aspiration or injection (mid-size joint) |
$658 |
$822 |
$700 |
$57 | |
| Joint aspiration or injection (small joint) |
$666 |
$833 |
$710 |
$56 | |
| Kidney biopsy |
— |
— |
$1,701 |
$492 | |
| Kidney scan (nuclear) |
— |
— |
$565 |
$172 | |
| Kidney stone shock-wave (lithotripsy) |
— |
— |
$3,621 |
$760 | |
| Kidney ultrasound |
$410 |
$513 |
$436 |
$84 | |
| Kidney ultrasound (limited) |
$399 |
$499 |
$425 |
$61 | |
| Knee arthroscopy |
— |
— |
$3,407 |
$524 | |
| Knee joint injection |
$277 |
$346 |
$577 |
$69 | |
| Laminectomy (spine) |
— |
— |
$7,501 |
$1,157 | |
| Laryngoscopy |
— |
— |
$1,007 |
$189 | |
| Leg artery angiogram |
— |
— |
$3,305 |
$149 | |
| Leg artery angioplasty |
— |
— |
$8,947 |
— | |
| Leg vein ultrasound (Doppler) |
$1,061 |
$1,326 |
$988 |
$150 | |
| Leg vein ultrasound (Doppler) (limited) |
$878 |
$1,098 |
$936 |
$116 | |
| Lipid (cholesterol) panel |
— |
— |
$70 |
$13 | |
| Liver biopsy |
— |
— |
$1,701 |
$288 | |
| Lumbar discectomy |
— |
— |
$7,501 |
$898 | |
| Lumpectomy (breast) |
— |
— |
$5,434 |
$750 | |
| Lung function test (PFT) |
$471 |
$589 |
$362 |
$37 | |
| Lung scan (V/Q) |
$2,066 |
$2,582 |
$2,200 |
$291 | |
| Mastectomy |
— |
— |
$6,848 |
$1,021 | |
| Mastoidectomy |
— |
— |
$6,211 |
$840 | |
| Meniscus repair (knee) |
— |
— |
$3,407 |
$714 | |
| Mohs skin cancer surgery |
— |
— |
$643 |
$535 | |
| MRA of the brain |
$3,235 |
$4,044 |
$3,505 |
$226 | |
| MRA of the brain with contrast |
$3,182 |
$3,977 |
$3,321 |
$226 | |
| MRA of the brain without contrast |
$3,830 |
$4,788 |
$3,998 |
$328 | |
| MRA of the neck |
$3,708 |
$4,635 |
$3,707 |
$245 | |
| MRA of the neck with contrast |
— |
— |
$608 |
$245 | |
| MRA of the neck without contrast |
$3,708 |
$4,635 |
$3,870 |
$343 | |
| MRI of the abdomen |
$3,328 |
$4,160 |
$3,082 |
$300 | |
| MRI of the abdomen with contrast |
— |
— |
$608 |
$300 | |
| MRI of the abdomen without contrast |
$2,805 |
$3,506 |
$2,928 |
$194 | |
| MRI of the ankle |
$3,207 |
$4,009 |
$3,346 |
$261 | |
| MRI of the ankle with contrast |
$3,207 |
$4,009 |
$3,348 |
$261 | |
| MRI of the ankle without contrast |
$2,974 |
$3,718 |
$3,105 |
$222 | |
| MRI of the brain |
$3,406 |
$4,257 |
$3,469 |
$269 | |
| MRI of the brain with contrast |
$3,406 |
$4,257 |
$3,555 |
$269 | |
| MRI of the brain without contrast |
$3,083 |
$3,854 |
$3,218 |
$195 | |
| MRI of the chest |
$2,727 |
$3,409 |
$2,726 |
$371 | |
| MRI of the chest with contrast |
— |
— |
$830 |
$371 | |
| MRI of the chest without contrast |
— |
— |
$608 |
$466 | |
| MRI of the knee |
$3,164 |
$3,955 |
$3,302 |
$315 | |
| MRI of the knee with contrast |
$3,164 |
$3,955 |
$3,302 |
$315 | |
| MRI of the knee without contrast |
$2,974 |
$3,718 |
$3,105 |
$204 | |
| MRI of the lower back (lumbar spine) |
$3,377 |
$4,221 |
$3,232 |
$270 | |
| MRI of the lower back (lumbar spine) with contrast |
$3,377 |
$4,221 |
$3,525 |
$270 | |
| MRI of the lower back (lumbar spine) without contrast |
$2,873 |
$3,591 |
$2,998 |
$192 | |
| MRI of the mid-back (thoracic spine) |
$3,461 |
$4,326 |
$3,348 |
$271 | |
| MRI of the mid-back (thoracic spine) with and without contrast |
$4,034 |
$5,043 |
$4,211 |
$319 | |
| MRI of the mid-back (thoracic spine) with contrast |
$3,461 |
$4,326 |
$3,612 |
$271 | |
| MRI of the mid-back (thoracic spine) without contrast |
$2,976 |
$3,720 |
$3,106 |
$190 | |
| MRI of the neck (cervical spine) |
$3,478 |
$4,347 |
$3,329 |
$274 | |
| MRI of the neck (cervical spine) with and without contrast |
$4,034 |
$5,043 |
$4,211 |
$318 | |
| MRI of the neck (cervical spine) with contrast |
$3,478 |
$4,347 |
$3,630 |
$274 | |
| MRI of the neck (cervical spine) without contrast |
$2,959 |
$3,699 |
$3,089 |
$191 | |
| MRI of the pelvis |
$3,291 |
$4,114 |
$3,015 |
$268 | |
| MRI of the pelvis with contrast |
— |
— |
$608 |
$268 | |
| MRI of the pelvis without contrast |
$2,744 |
$3,430 |
$2,864 |
$227 | |
| MRI of the shoulder |
$3,234 |
$4,043 |
$3,376 |
$313 | |
| MRI of the shoulder with contrast |
$3,234 |
$4,043 |
$3,376 |
$313 | |
| MRI of the shoulder without contrast |
$3,041 |
$3,801 |
$3,174 |
$205 | |
| MRI of the wrist |
$3,266 |
$4,082 |
$3,544 |
$330 | |
| MRI of the wrist with contrast |
$3,266 |
$4,082 |
$3,408 |
$330 | |
| MRI of the wrist without contrast |
$3,222 |
$4,028 |
$3,363 |
$303 | |
| Nebulizer breathing treatment |
$168 |
$210 |
$147 |
$9 | |
| Neck (cervical) spinal fusion |
— |
— |
$13,510 |
$1,410 | |
| Nerve conduction study |
— |
— |
$327 |
$118 | |
| Newborn hospital care |
— |
— |
$135 |
$58 | |
| Nuchal translucency ultrasound |
— |
— |
$112 |
$116 | |
| Nuclear cardiac stress test |
$3,842 |
$4,803 |
$4,011 |
$428 | |
| Occupational therapy evaluation |
$290 |
$362 |
$302 |
$101 | |
| Occupational therapy evaluation (high complexity) |
$303 |
$379 |
$329 |
$101 | |
| Occupational therapy evaluation (low complexity) |
$269 |
$336 |
$292 |
$101 | |
| Occupational therapy evaluation (moderate complexity) |
$290 |
$362 |
$315 |
$101 | |
| Office visit (established patient) |
$224 |
$280 |
$218 |
$115 | |
| Office visit (new patient) |
$269 |
$336 |
$236 |
$177 | |
| Office visit, established patient (level 3) |
$194 |
$242 |
$210 |
$95 | |
| Office visit, established patient (level 4) |
$254 |
$317 |
$275 |
$136 | |
| Office visit, new patient (level 3) |
$203 |
$254 |
$221 |
$118 | |
| Office visit, new patient (level 4) |
$269 |
$336 |
$292 |
$177 | |
| Office visit, new patient (level 5) |
$328 |
$410 |
$356 |
$237 | |
| Orthopedic hardware removal |
— |
— |
$3,005 |
$632 | |
| Ovarian cyst removal |
— |
— |
$5,183 |
$698 | |
| Pap smear (cervical screening) |
$84 |
$105 |
$79 |
$20 | |
| Parathyroid removal |
— |
— |
$6,211 |
$891 | |
| Pelvic ultrasound |
$591 |
$739 |
$476 |
$78 | |
| Pelvic ultrasound (complete) |
$772 |
$965 |
$822 |
$105 | |
| Pelvic ultrasound (limited) |
$410 |
$513 |
$437 |
$51 | |
| PET scan |
— |
— |
$1,532 |
— | |
| Physical therapy evaluation |
$304 |
$380 |
$302 |
$98 | |
| Physical therapy evaluation (high complexity) |
$341 |
$426 |
$370 |
$98 | |
| Physical therapy evaluation (moderate complexity) |
$304 |
$380 |
$330 |
$98 | |
| Pilonidal cyst removal |
— |
— |
$3,005 |
$541 | |
| Pneumonia vaccine |
$125 |
$156 |
$137 |
— | |
| Pregnancy ultrasound |
$426 |
$533 |
$445 |
$126 | |
| Pregnancy ultrasound (first trimester) |
$426 |
$533 |
$454 |
$117 | |
| Pregnancy ultrasound (second or third trimester) |
— |
— |
$112 |
$136 | |
| Prostate biopsy |
— |
— |
$2,151 |
— | |
| Prostate removal (prostatectomy) |
— |
— |
$10,932 |
$1,063 | |
| Prostate surgery (TURP) |
— |
— |
$5,338 |
$526 | |
| Psychiatric evaluation |
— |
— |
$169 |
$188 | |
| Psychotherapy session |
$524 |
$655 |
$355 |
$140 | |
| Pterygium removal (eye) |
— |
— |
$2,450 |
$540 | |
| Pulmonary rehabilitation |
$166 |
$207 |
$176 |
$87 | |
| Radiofrequency nerve ablation |
— |
— |
$2,050 |
$462 | |
| Retina scan (OCT) |
— |
— |
$62 |
$33 | |
| Retinal (fundus) photography |
— |
— |
$135 |
$37 | |
| Retinal detachment repair |
— |
— |
$4,224 |
$966 | |
| Rotator cuff repair |
— |
— |
$7,501 |
$792 | |
| Routine eye exam |
— |
— |
$135 |
$88 | |
| Scoliosis spine X-ray |
$390 |
$488 |
$359 |
$58 | |
| Scoliosis spine X-ray (1 view) |
$319 |
$399 |
$340 |
$44 | |
| Scoliosis spine X-ray (3 views) |
$462 |
$577 |
$492 |
$72 | |
| Screening colonoscopy |
— |
— |
$1,143 |
$378 | |
| Screening mammogram |
$487 |
$609 |
$509 |
$126 | |
| Scrotal ultrasound |
$614 |
$768 |
$654 |
$99 | |
| Semen analysis |
$56 |
$70 |
$61 |
$12 | |
| Septoplasty (deviated septum) |
— |
— |
$3,405 |
$613 | |
| Shoulder arthroscopy |
— |
— |
$7,501 |
$962 | |
| Shoulder replacement |
— |
— |
$19,310 |
$1,300 | |
| Simple laceration repair (small, up to 2.5 cm) |
$470 |
$587 |
$500 |
$114 | |
| Simple wound stitches |
$481 |
$602 |
$512 |
$127 | |
| Sinus surgery (endoscopic) |
— |
— |
$7,269 |
$224 | |
| Skin biopsy |
— |
— |
$420 |
$121 | |
| Skin biopsy (punch) |
— |
— |
$420 |
$121 | |
| Skin cancer lesion removal |
— |
— |
$739 |
$240 | |
| Skin graft |
— |
— |
$2,882 |
$898 | |
| Skin lesion freezing (cryotherapy) |
— |
— |
$209 |
$36 | |
| Skin tag removal |
— |
— |
$209 |
$92 | |
| Sleep study (polysomnography) |
— |
— |
$1,068 |
$691 | |
| Soft tissue ultrasound |
$238 |
$298 |
$254 |
$64 | |
| Speech therapy |
$306 |
$383 |
$333 |
$76 | |
| Spinal cord stimulator |
— |
— |
$6,891 |
$2,388 | |
| Spinal tap (lumbar puncture) |
$1,302 |
$1,628 |
$1,387 |
$165 | |
| Spine fracture repair (kyphoplasty) |
— |
— |
$7,501 |
$5,803 | |
| Spirometry (lung function test) |
$312 |
$390 |
$332 |
$30 | |
| Spirometry with bronchodilator |
$630 |
$788 |
$671 |
$43 | |
| Spleen removal (splenectomy) |
— |
— |
$10,932 |
$1,036 | |
| Strabismus (eye muscle) surgery |
— |
— |
$3,205 |
$475 | |
| Stress echocardiogram |
— |
— |
$576 |
$209 | |
| Stress echocardiogram (complete) |
— |
— |
$576 |
$233 | |
| Swallow study |
$341 |
$426 |
$370 |
$85 | |
| Tdap (tetanus) vaccine |
$81 |
$101 |
$88 |
— | |
| Testicle removal (orchiectomy) |
— |
— |
$3,621 |
$306 | |
| Thyroid removal (thyroidectomy) |
— |
— |
$6,169 |
$1,004 | |
| Thyroid test (TSH) |
— |
— |
$74 |
$17 | |
| Thyroid ultrasound |
$426 |
$533 |
$454 |
$109 | |
| Thyroid uptake scan |
$1,317 |
$1,646 |
$1,374 |
$145 | |
| Tilt table test |
— |
— |
$557 |
$168 | |
| Tonsillectomy |
— |
— |
$4,808 |
$252 | |
| Tracheostomy |
— |
— |
$3,405 |
$273 | |
| Transesophageal echocardiogram (TEE) |
— |
— |
$576 |
$239 | |
| Transesophageal echocardiogram (TEE) with and without contrast |
— |
— |
$576 |
$239 | |
| Transvaginal ultrasound |
$379 |
$474 |
$404 |
$118 | |
| Trigger finger release |
— |
— |
$1,680 |
$630 | |
| Trigger point injection |
$706 |
$883 |
$737 |
$56 | |
| Trigger point injection (1-2 muscles) |
$706 |
$883 |
$752 |
$52 | |
| Tubal ligation |
— |
— |
$6,126 |
$333 | |
| Turbinate reduction |
— |
— |
$3,405 |
$294 | |
| Turning a breech baby (version) |
— |
— |
$3,339 |
$94 | |
| Ulnar nerve surgery (elbow) |
— |
— |
$2,050 |
$575 | |
| Upper GI endoscopy (EGD) |
— |
— |
$1,135 |
$371 | |
| Upper GI series (barium) |
— |
— |
$187 |
$128 | |
| Ureteral stent placement |
— |
— |
$3,621 |
$373 | |
| Ureteroscopy (stone removal) |
— |
— |
$5,338 |
$365 | |
| Urinalysis |
$10 |
$12 |
$10 |
$3 | |
| UV light therapy (skin) |
— |
— |
$62 |
$106 | |
| Vaccine administration |
$81 |
$101 |
$67 |
$19 | |
| Vaccine administration (each additional) |
$65 |
$81 |
$61 |
$16 | |
| Varicocele repair |
— |
— |
$3,621 |
$327 | |
| Varicose vein ablation |
— |
— |
$3,305 |
$1,018 | |
| Vasectomy |
— |
— |
$2,151 |
$347 | |
| Visual field test |
— |
— |
$135 |
$64 | |
| Vitrectomy (eye) |
— |
— |
$4,224 |
$814 | |
| Vocal cord injection |
— |
— |
$3,871 |
$211 | |
| Wart removal |
— |
— |
$209 |
$121 | |
| Wound debridement |
— |
— |
$531 |
$186 | |
| Wrist fracture repair |
— |
— |
$7,501 |
$735 | |
| X-ray of the abdomen |
$438 |
$547 |
$415 |
$36 | |
| X-ray of the ankle |
$514 |
$642 |
$547 |
$37 | |
| X-ray of the collarbone |
$366 |
$457 |
$389 |
$33 | |
| X-ray of the elbow |
$438 |
$547 |
$466 |
$33 | |
| X-ray of the facial bones |
$453 |
$566 |
$377 |
$39 | |
| X-ray of the foot |
$438 |
$548 |
$467 |
$34 | |
| X-ray of the forearm |
$391 |
$489 |
$417 |
$29 | |
| X-ray of the hand |
$506 |
$632 |
$538 |
$38 | |
| X-ray of the hip |
$350 |
$438 |
$340 |
$49 | |
| X-ray of the hip (1 view) |
$293 |
$366 |
$312 |
$34 | |
| X-ray of the hip (3 views) |
$350 |
$438 |
$373 |
$49 | |
| X-ray of the hip (4 views) |
$470 |
$587 |
$500 |
$63 | |
| X-ray of the knee |
$533 |
$666 |
$518 |
$42 | |
| X-ray of the knee (2 views) |
$446 |
$558 |
$475 |
$34 | |
| X-ray of the knee (3 views) |
$533 |
$666 |
$567 |
$42 | |
| X-ray of the knee (4+ views) |
$641 |
$801 |
$682 |
$49 | |
| X-ray of the lower back (lumbar spine) |
$536 |
$670 |
$500 |
$47 | |
| X-ray of the lower back (lumbar spine) (2 views) |
$444 |
$555 |
$473 |
$40 | |
| X-ray of the lower back (lumbar spine) (4+ views) |
$627 |
$784 |
$668 |
$53 | |
| X-ray of the lower leg |
$533 |
$666 |
$567 |
$31 | |
| X-ray of the mid-back (thoracic spine) |
$468 |
$585 |
$456 |
$36 | |
| X-ray of the mid-back (thoracic spine) (2 views) |
$406 |
$507 |
$432 |
$33 | |
| X-ray of the mid-back (thoracic spine) (3 views) |
$530 |
$662 |
$564 |
$39 | |
| X-ray of the neck (cervical spine) |
$528 |
$660 |
$508 |
$47 | |
| X-ray of the neck (cervical spine) (3 views) |
$451 |
$564 |
$481 |
$40 | |
| X-ray of the pelvis |
$404 |
$505 |
$395 |
$36 | |
| X-ray of the pelvis (1 view) |
$351 |
$439 |
$374 |
$28 | |
| X-ray of the ribs |
$503 |
$629 |
$479 |
$42 | |
| X-ray of the ribs (2 views) |
$413 |
$516 |
$440 |
$36 | |
| X-ray of the ribs (3 views) |
$503 |
$629 |
$536 |
$42 | |
| X-ray of the shoulder |
$530 |
$663 |
$565 |
$36 | |
| X-ray of the skull |
$591 |
$739 |
$476 |
$40 | |
| X-ray of the upper arm |
$533 |
$666 |
$567 |
$32 | |
| X-ray of the wrist |
$510 |
$638 |
$544 |
$43 | |
| YAG laser capsulotomy (eye) |
— |
— |
$576 |
$335 | |