| 3D mammogram (tomosynthesis) |
$93 |
$143 |
— |
$51 | |
| Abdominal ultrasound |
$325 |
$501 |
$50 |
$100 | |
| Abdominal ultrasound (complete) |
$253 |
$389 |
$52 |
$114 | |
| Abdominal ultrasound (limited) |
$398 |
$612 |
$39 |
$86 | |
| Abscess drainage (complex or multiple) |
$727 |
$1,119 |
— |
$220 | |
| Abscess drainage (simple) |
$459 |
$706 |
$115 |
$129 | |
| Abscess incision and drainage |
$633 |
$973 |
$115 |
$174 | |
| ACL knee reconstruction |
$1,748 |
$2,690 |
— |
$889 | |
| Albumin blood test |
$30 |
$47 |
— |
$5 | |
| Aldosterone test |
$167 |
$257 |
— |
$41 | |
| Alkaline phosphatase test |
$44 |
$68 |
— |
$5 | |
| Allergy shots |
$18 |
$28 |
— |
$11 | |
| Alpha-fetoprotein (AFP) test |
$123 |
$189 |
— |
$17 | |
| ALT liver enzyme test |
$24 |
$38 |
— |
$5 | |
| Ammonia blood test |
$80 |
$123 |
$14 |
$15 | |
| Amylase test |
$39 |
$61 |
$6 |
$6 | |
| Annual physical (established patient) |
$313 |
$481 |
— |
— | |
| Annual physical (new patient) |
$361 |
$556 |
— |
— | |
| Antinuclear antibody (ANA) test |
$49 |
$75 |
— |
$12 | |
| Arterial blood gas (ABG) |
$87 |
$134 |
$25 |
$26 | |
| AST liver enzyme test |
$24 |
$37 |
— |
$5 | |
| Basic metabolic panel |
$58 |
$90 |
$8 |
$8 | |
| Benign skin lesion removal |
$207 |
$319 |
— |
$171 | |
| Bilirubin blood test |
$52 |
$80 |
$5 |
$5 | |
| Blood clotting test (PT/INR) |
$23 |
$36 |
$4 |
$4 | |
| Blood crossmatch |
$53 |
$81 |
— |
— | |
| Blood glucose test |
$51 |
$78 |
— |
$5 | |
| Blood transfusion |
$448 |
$689 |
$37 |
$47 | |
| Blood type and screen |
$33 |
$50 |
— |
$10 | |
| Blood type test |
$21 |
$33 |
$3 |
$3 | |
| Blood type test (ABO group) |
$22 |
$34 |
$3 |
$3 | |
| Blood type test (Rh/D antigen) |
$21 |
$32 |
$3 |
$3 | |
| BNP (heart failure) test |
$127 |
$195 |
$37 |
$39 | |
| Breathing tube insertion (intubation) |
$415 |
$639 |
$139 |
$133 | |
| Burn dressing and debridement (medium) |
$352 |
$542 |
— |
$166 | |
| Burn dressing and debridement (small) |
$82 |
$126 |
— |
$93 | |
| Burn treatment |
$93 |
$143 |
— |
$129 | |
| C-reactive protein (CRP) |
$52 |
$81 |
$5 |
$5 | |
| CA 19-9 tumor marker test |
$106 |
$163 |
— |
$21 | |
| CA-125 ovarian marker test |
$117 |
$181 |
— |
$21 | |
| Calcium blood test |
$49 |
$76 |
$5 |
$5 | |
| Carotid artery ultrasound |
$276 |
$424 |
— |
$156 | |
| Carpal tunnel release |
$805 |
$1,238 |
— |
$483 | |
| Cataract surgery |
$2,648 |
$4,074 |
— |
$547 | |
| CEA tumor marker test |
$88 |
$136 |
— |
$19 | |
| Celiac disease test |
$93 |
$143 |
— |
$12 | |
| Central line placement |
$415 |
$639 |
— |
$238 | |
| Chest X-ray |
$127 |
$195 |
$14 |
$37 | |
| Chest X-ray (1 view) |
$96 |
$148 |
$12 |
$25 | |
| Chest X-ray (2 views) |
$127 |
$195 |
$14 |
$33 | |
| Circumcision |
$220 |
$338 |
— |
$167 | |
| CK-MB heart enzyme test |
$92 |
$141 |
— |
$12 | |
| Clotting time test (PTT) |
$34 |
$52 |
$6 |
$6 | |
| Colonoscopy |
$369 |
$568 |
— |
$480 | |
| Complete blood count (CBC) |
$37 |
$57 |
$6 |
$7 | |
| Complete blood count (CBC) (complete) |
$36 |
$56 |
— |
$8 | |
| Complex wound repair |
$1,133 |
$1,743 |
— |
$390 | |
| Comprehensive metabolic panel |
$79 |
$122 |
$10 |
$11 | |
| Contraceptive implant (Nexplanon) |
$118 |
$181 |
— |
$115 | |
| Copper blood test |
$72 |
$111 |
— |
$12 | |
| Cortisol test |
$87 |
$134 |
— |
$16 | |
| COVID-19 PCR test |
$98 |
$150 |
— |
$51 | |
| COVID-19 vaccine |
$0 |
$0 |
— |
— | |
| CPAP titration study |
$390 |
$600 |
$46 |
$69 | |
| Creatine kinase (CK) test |
$37 |
$56 |
$6 |
$7 | |
| CT angiography of the chest |
$1,216 |
$1,870 |
$116 |
$281 | |
| CT angiography of the head |
$1,342 |
$2,065 |
$112 |
$274 | |
| CT scan of the abdomen |
$1,547 |
$2,379 |
$79 |
$230 | |
| CT scan of the abdomen and pelvis |
$1,522 |
$2,341 |
— |
$300 | |
| CT scan of the abdomen and pelvis with and without contrast |
$1,729 |
$2,659 |
— |
$338 | |
| CT scan of the abdomen and pelvis with contrast |
$1,511 |
$2,325 |
— |
$300 | |
| CT scan of the abdomen and pelvis without contrast |
$1,522 |
$2,341 |
— |
$183 | |
| CT scan of the abdomen with and without contrast |
$1,729 |
$2,659 |
— |
$259 | |
| CT scan of the abdomen with contrast |
$1,547 |
$2,379 |
$82 |
$230 | |
| CT scan of the abdomen without contrast |
$1,522 |
$2,341 |
$76 |
$136 | |
| CT scan of the arm |
$1,142 |
$1,756 |
— |
$199 | |
| CT scan of the arm with contrast |
$1,142 |
$1,756 |
— |
$199 | |
| CT scan of the arm without contrast |
$996 |
$1,532 |
— |
$161 | |
| CT scan of the chest |
$1,124 |
$1,729 |
$70 |
$167 | |
| CT scan of the chest with and without contrast |
$1,265 |
$1,947 |
— |
$196 | |
| CT scan of the chest with contrast |
$1,124 |
$1,729 |
$74 |
$167 | |
| CT scan of the chest without contrast |
$761 |
$1,170 |
$69 |
$133 | |
| CT scan of the head |
$1,264 |
$1,944 |
$54 |
$148 | |
| CT scan of the head with and without contrast |
$1,577 |
$2,427 |
— |
$173 | |
| CT scan of the head with contrast |
$1,358 |
$2,089 |
— |
$148 | |
| CT scan of the head without contrast |
$1,169 |
$1,799 |
$54 |
$107 | |
| CT scan of the leg |
$1,153 |
$1,774 |
$64 |
$166 | |
| CT scan of the leg with contrast |
$1,257 |
$1,934 |
— |
$166 | |
| CT scan of the leg without contrast |
$1,049 |
$1,614 |
$64 |
$130 | |
| CT scan of the lower back (lumbar spine) |
$341 |
$525 |
$75 |
$169 | |
| CT scan of the lower back (lumbar spine) with and without contrast |
$341 |
$525 |
— |
$197 | |
| CT scan of the lower back (lumbar spine) with contrast |
$715 |
$1,099 |
$78 |
$169 | |
| CT scan of the lower back (lumbar spine) without contrast |
$204 |
$314 |
$65 |
$130 | |
| CT scan of the neck |
$1,483 |
$2,282 |
— |
$183 | |
| CT scan of the neck (cervical spine) |
$341 |
$525 |
$69 |
$168 | |
| CT scan of the neck (cervical spine) with and without contrast |
$341 |
$525 |
— |
$196 | |
| CT scan of the neck (cervical spine) with contrast |
$715 |
$1,099 |
$78 |
$168 | |
| CT scan of the neck (cervical spine) without contrast |
$204 |
$314 |
$64 |
$131 | |
| CT scan of the neck with and without contrast |
$1,570 |
$2,415 |
— |
$220 | |
| CT scan of the neck with contrast |
$1,483 |
$2,282 |
— |
$183 | |
| CT scan of the neck without contrast |
$1,220 |
$1,876 |
— |
$150 | |
| CT scan of the pelvis |
$973 |
$1,496 |
$71 |
$226 | |
| CT scan of the pelvis with and without contrast |
$1,156 |
$1,779 |
— |
$251 | |
| CT scan of the pelvis with contrast |
$1,160 |
$1,784 |
— |
$226 | |
| CT scan of the pelvis without contrast |
$789 |
$1,214 |
$71 |
$133 | |
| CT scan of the sinuses |
$1,423 |
$2,189 |
$72 |
$152 | |
| CT scan of the sinuses with and without contrast |
$1,634 |
$2,514 |
— |
$184 | |
| CT scan of the sinuses with contrast |
$1,423 |
$2,189 |
$73 |
$152 | |
| CT scan of the sinuses without contrast |
$1,189 |
$1,830 |
$55 |
$128 | |
| D-dimer test |
$102 |
$157 |
— |
$10 | |
| Developmental screening (child) |
$17 |
$27 |
— |
— | |
| DHEA-sulfate test |
$90 |
$138 |
— |
$22 | |
| Drug screen (urine) |
$42 |
$65 |
$19 |
$17 | |
| Echocardiogram |
$852 |
$1,311 |
$92 |
$138 | |
| EKG / ECG (tracing only) |
$112 |
$173 |
$7 |
$7 | |
| Electrocardiogram (EKG) |
$112 |
$173 |
$7 |
$8 | |
| Electrolyte panel |
$51 |
$78 |
— |
$7 | |
| Emergency department visit |
$211 |
$324 |
$71 |
$69 | |
| Emergency department visit (level 1) |
$83 |
$128 |
$22 |
$11 | |
| Emergency department visit (level 2) |
$101 |
$155 |
$42 |
$40 | |
| Emergency department visit (level 3) |
$211 |
$324 |
$71 |
$69 | |
| Emergency department visit (level 4) |
$359 |
$552 |
$120 |
$118 | |
| Emergency department visit (level 5) |
$527 |
$811 |
$175 |
$171 | |
| Estradiol (estrogen) test |
$130 |
$200 |
— |
$28 | |
| Family therapy session |
$549 |
$845 |
— |
$110 | |
| Fecal occult blood (stool) test |
$27 |
$42 |
$4 |
$10 | |
| Fecal occult blood (stool) test (guaiac, gFOBT) |
$27 |
$42 |
$4 |
$4 | |
| Feeding tube (PEG) placement |
$1,556 |
$2,394 |
— |
$178 | |
| Ferritin (iron) test |
$63 |
$97 |
$13 |
$14 | |
| Fibrinogen test |
$37 |
$57 |
— |
$10 | |
| Flu test |
$33 |
$50 |
— |
$17 | |
| Folate (folic acid) test |
$83 |
$128 |
$14 |
$15 | |
| Foreign body removal (skin) |
$124 |
$190 |
— |
$157 | |
| Free T4 thyroid test |
$50 |
$78 |
— |
$9 | |
| FSH hormone test |
$104 |
$160 |
$18 |
$19 | |
| Gallbladder removal (laparoscopic) |
$1,259 |
$1,937 |
— |
$658 | |
| Ganglion cyst removal |
$592 |
$911 |
— |
$321 | |
| GGT liver test |
$49 |
$76 |
— |
$7 | |
| Glucose tolerance test |
$135 |
$208 |
$12 |
$8 | |
| Group therapy session |
$478 |
$735 |
— |
$30 | |
| H. pylori test |
$188 |
$290 |
$64 |
$67 | |
| Hammertoe repair |
$703 |
$1,082 |
— |
$548 | |
| HDL cholesterol test |
$41 |
$64 |
$8 |
$8 | |
| Hematocrit test |
$27 |
$42 |
— |
$2 | |
| Hemoglobin A1c (diabetes test) |
$40 |
$61 |
— |
$10 | |
| Hepatitis A vaccine |
$16 |
$25 |
— |
— | |
| Hepatitis B test |
$42 |
$65 |
— |
$10 | |
| Hepatitis B vaccine |
$49 |
$75 |
— |
— | |
| Hepatitis C test |
$76 |
$116 |
— |
$14 | |
| HIV test |
$49 |
$75 |
— |
$19 | |
| HIV test (antibody) |
$76 |
$117 |
— |
$14 | |
| HIV test (antigen/antibody combo) |
$22 |
$34 |
— |
$24 | |
| Holter heart monitor |
$182 |
$280 |
— |
$26 | |
| HPV vaccine |
$201 |
$310 |
— |
— | |
| Inguinal hernia repair |
$1,001 |
$1,540 |
— |
$538 | |
| Iron blood test |
$25 |
$38 |
$6 |
$6 | |
| IUD removal |
$98 |
$150 |
— |
$112 | |
| IV infusion therapy |
$105 |
$162 |
— |
$44 | |
| IV infusion therapy (each additional) |
$76 |
$117 |
— |
$21 | |
| IV infusion therapy (initial) |
$133 |
$205 |
— |
$67 | |
| Joint aspiration (small/intermediate) |
$55 |
$85 |
— |
$57 | |
| Joint aspiration or injection (mid-size joint) |
$62 |
$95 |
— |
$57 | |
| Joint aspiration or injection (small joint) |
$49 |
$75 |
— |
$56 | |
| Kidney ultrasound |
$373 |
$573 |
$41 |
$84 | |
| Kidney ultrasound (limited) |
$373 |
$573 |
$38 |
$61 | |
| Knee arthroscopy |
$1,010 |
$1,553 |
— |
$524 | |
| Knee joint injection |
$78 |
$120 |
— |
$69 | |
| Lactate test |
$77 |
$119 |
$11 |
$12 | |
| LDH test |
$28 |
$43 |
$6 |
$6 | |
| LDL cholesterol test |
$44 |
$68 |
— |
$11 | |
| Leg vein ultrasound (Doppler) |
$496 |
$763 |
$45 |
$150 | |
| Leg vein ultrasound (Doppler) (limited) |
$378 |
$581 |
— |
$116 | |
| LH hormone test |
$103 |
$159 |
— |
$19 | |
| Lipase test |
$38 |
$59 |
$7 |
$7 | |
| Lipid (cholesterol) panel |
$62 |
$95 |
$13 |
$13 | |
| Liver function panel |
$51 |
$78 |
— |
$8 | |
| Lung function test (PFT) |
$114 |
$175 |
— |
$37 | |
| Magnesium blood test |
$37 |
$58 |
$6 |
$7 | |
| Meniscus repair (knee) |
$3,918 |
$6,028 |
— |
$714 | |
| MMR vaccine |
$42 |
$65 |
— |
— | |
| MRA of the brain |
$1,750 |
$2,693 |
$77 |
$226 | |
| MRA of the brain with contrast |
$1,888 |
$2,905 |
$76 |
$226 | |
| MRA of the brain without contrast |
$1,750 |
$2,693 |
— |
$328 | |
| MRA of the neck |
$1,846 |
$2,840 |
$97 |
$245 | |
| MRA of the neck with contrast |
$1,855 |
$2,854 |
$97 |
$245 | |
| MRA of the neck without contrast |
$1,846 |
$2,840 |
$115 |
$343 | |
| MRI of the abdomen |
$1,409 |
$2,168 |
$140 |
$300 | |
| MRI of the abdomen with contrast |
$1,071 |
$1,648 |
— |
$300 | |
| MRI of the abdomen without contrast |
$1,083 |
$1,666 |
— |
$194 | |
| MRI of the ankle |
$1,679 |
$2,584 |
$137 |
$261 | |
| MRI of the ankle with contrast |
$1,377 |
$2,119 |
— |
$261 | |
| MRI of the ankle without contrast |
$1,475 |
$2,269 |
— |
$222 | |
| MRI of the brain |
$1,751 |
$2,694 |
— |
$269 | |
| MRI of the brain with contrast |
$1,751 |
$2,694 |
— |
$269 | |
| MRI of the brain without contrast |
$1,149 |
$1,768 |
— |
$195 | |
| MRI of the chest |
$1,674 |
$2,575 |
— |
$371 | |
| MRI of the chest with contrast |
$1,069 |
$1,644 |
— |
$371 | |
| MRI of the chest without contrast |
$2,339 |
$3,598 |
— |
$466 | |
| MRI of the knee |
$1,490 |
$2,292 |
— |
$315 | |
| MRI of the knee with contrast |
$1,490 |
$2,292 |
— |
$315 | |
| MRI of the knee without contrast |
$1,475 |
$2,269 |
— |
$204 | |
| MRI of the lower back (lumbar spine) |
$1,379 |
$2,121 |
$88 |
$270 | |
| MRI of the lower back (lumbar spine) with contrast |
$1,788 |
$2,750 |
— |
$270 | |
| MRI of the lower back (lumbar spine) without contrast |
$970 |
$1,492 |
$88 |
$192 | |
| MRI of the mid-back (thoracic spine) |
$1,970 |
$3,030 |
$94 |
$271 | |
| MRI of the mid-back (thoracic spine) with and without contrast |
$2,100 |
$3,232 |
— |
$319 | |
| MRI of the mid-back (thoracic spine) with contrast |
$2,100 |
$3,232 |
— |
$271 | |
| MRI of the mid-back (thoracic spine) without contrast |
$1,839 |
$2,829 |
$94 |
$190 | |
| MRI of the neck (cervical spine) |
$1,649 |
$2,537 |
$88 |
$274 | |
| MRI of the neck (cervical spine) with and without contrast |
$2,238 |
$3,444 |
— |
$318 | |
| MRI of the neck (cervical spine) with contrast |
$1,684 |
$2,591 |
— |
$274 | |
| MRI of the neck (cervical spine) without contrast |
$1,614 |
$2,483 |
$88 |
$191 | |
| MRI of the pelvis |
$1,646 |
$2,533 |
— |
$268 | |
| MRI of the pelvis with contrast |
$1,646 |
$2,533 |
— |
$268 | |
| MRI of the pelvis without contrast |
$1,497 |
$2,304 |
— |
$227 | |
| MRI of the shoulder |
$1,616 |
$2,486 |
— |
$313 | |
| MRI of the shoulder with contrast |
$1,616 |
$2,486 |
— |
$313 | |
| MRI of the shoulder without contrast |
$1,520 |
$2,338 |
— |
$205 | |
| MRI of the wrist |
$1,616 |
$2,486 |
— |
$330 | |
| MRI of the wrist with contrast |
$1,616 |
$2,486 |
— |
$330 | |
| MRI of the wrist without contrast |
$1,520 |
$2,338 |
— |
$303 | |
| Nebulizer breathing treatment |
$153 |
$236 |
$16 |
$9 | |
| Occupational therapy evaluation |
$88 |
$136 |
— |
$101 | |
| Occupational therapy evaluation (high complexity) |
$88 |
$136 |
— |
$101 | |
| Occupational therapy evaluation (low complexity) |
$88 |
$136 |
— |
$101 | |
| Occupational therapy evaluation (moderate complexity) |
$88 |
$136 |
— |
$101 | |
| Office visit (established patient) |
$205 |
$315 |
— |
$115 | |
| Office visit (new patient) |
$312 |
$480 |
— |
$177 | |
| Office visit, established patient (level 3) |
$169 |
$260 |
— |
$95 | |
| Office visit, established patient (level 4) |
$241 |
$370 |
— |
$136 | |
| Office visit, new patient (level 3) |
$208 |
$320 |
— |
$118 | |
| Office visit, new patient (level 4) |
$312 |
$480 |
— |
$177 | |
| Office visit, new patient (level 5) |
$410 |
$630 |
— |
$237 | |
| Orthopedic hardware removal |
$774 |
$1,191 |
— |
$632 | |
| Pap smear (cervical screening) |
$103 |
$158 |
$19 |
$20 | |
| Parathyroid hormone (PTH) test |
$175 |
$269 |
$39 |
$41 | |
| Pelvic ultrasound |
$368 |
$566 |
$37 |
$78 | |
| Pelvic ultrasound (complete) |
$456 |
$702 |
$44 |
$105 | |
| Pelvic ultrasound (limited) |
$280 |
$430 |
$32 |
$51 | |
| Phosphorus blood test |
$29 |
$45 |
$5 |
$5 | |
| Physical therapy evaluation |
$88 |
$136 |
$96 |
$98 | |
| Physical therapy evaluation (high complexity) |
$88 |
$136 |
$96 |
$98 | |
| Physical therapy evaluation (moderate complexity) |
$88 |
$136 |
$96 |
$98 | |
| Pilonidal cyst removal |
$3,058 |
$4,704 |
— |
$541 | |
| Pneumonia vaccine |
$61 |
$94 |
— |
— | |
| Pregnancy ultrasound |
$328 |
$505 |
$65 |
$126 | |
| Pregnancy ultrasound (first trimester) |
$328 |
$505 |
$65 |
$117 | |
| Pregnancy ultrasound (second or third trimester) |
$439 |
$676 |
— |
$136 | |
| Procalcitonin test |
$192 |
$295 |
$26 |
$27 | |
| Prolactin test |
$98 |
$151 |
$18 |
$19 | |
| Prostate test (PSA) |
$98 |
$151 |
— |
$18 | |
| Psychotherapy session |
$496 |
$763 |
— |
$140 | |
| Rotator cuff repair |
$1,929 |
$2,967 |
— |
$792 | |
| Sacroiliac joint injection |
$150 |
$231 |
— |
$176 | |
| Scoliosis spine X-ray |
$169 |
$261 |
— |
$58 | |
| Scoliosis spine X-ray (1 view) |
$169 |
$261 |
— |
$44 | |
| Screening mammogram |
$190 |
$293 |
$49 |
$126 | |
| Scrotal ultrasound |
$401 |
$618 |
$41 |
$99 | |
| Sedimentation rate (ESR) test |
$27 |
$42 |
$4 |
$3 | |
| Semen analysis |
$46 |
$71 |
— |
$12 | |
| Sex hormone binding globulin test |
$42 |
$65 |
— |
$22 | |
| Shingles vaccine |
$226 |
$347 |
— |
— | |
| Shoulder arthroscopy |
$1,867 |
$2,872 |
— |
$962 | |
| Simple laceration repair (small, up to 2.5 cm) |
$165 |
$253 |
— |
$114 | |
| Simple wound stitches |
$168 |
$259 |
— |
$127 | |
| Skin biopsy |
$95 |
$146 |
— |
$121 | |
| Skin biopsy (punch) |
$99 |
$153 |
— |
$121 | |
| Skin cancer lesion removal |
$1,307 |
$2,011 |
— |
$240 | |
| Skin lesion freezing (cryotherapy) |
$43 |
$66 |
— |
$36 | |
| Skin tag removal |
$117 |
$180 |
— |
$92 | |
| Soft tissue ultrasound |
$208 |
$321 |
$29 |
$64 | |
| Spirometry (lung function test) |
$114 |
$175 |
— |
$30 | |
| Strep throat test |
$37 |
$57 |
$16 |
$17 | |
| Swallow study |
$194 |
$298 |
— |
$85 | |
| T3 thyroid test |
$79 |
$121 |
$13 |
$14 | |
| Tdap (tetanus) vaccine |
$47 |
$73 |
$44 |
— | |
| Testosterone test |
$119 |
$183 |
— |
$26 | |
| Thyroid test (TSH) |
$78 |
$121 |
$16 |
$17 | |
| Thyroid ultrasound |
$755 |
$1,162 |
$34 |
$109 | |
| Total IgE allergy test |
$28 |
$43 |
— |
$16 | |
| Total protein test |
$39 |
$61 |
$3 |
$4 | |
| Transvaginal ultrasound |
$401 |
$616 |
— |
$118 | |
| Trigger finger release |
$539 |
$829 |
— |
$630 | |
| Trigger point injection |
$67 |
$103 |
— |
$56 | |
| Trigger point injection (1-2 muscles) |
$298 |
$459 |
— |
$52 | |
| Triglycerides test |
$36 |
$55 |
— |
$6 | |
| Troponin (heart) test |
$96 |
$148 |
$12 |
$12 | |
| Ulnar nerve surgery (elbow) |
$1,091 |
$1,678 |
— |
$575 | |
| Upper GI endoscopy (EGD) |
$254 |
$391 |
— |
$371 | |
| Uric acid (gout) test |
$29 |
$44 |
$4 |
$5 | |
| Urinalysis |
$43 |
$66 |
$2 |
$3 | |
| Urine microalbumin test |
$27 |
$41 |
— |
$5 | |
| Urine pregnancy test |
$16 |
$25 |
$8 |
$9 | |
| Vaccine administration |
$47 |
$72 |
$20 |
$19 | |
| Vaccine administration (each additional) |
$23 |
$35 |
— |
$16 | |
| Vitamin B12 test |
$36 |
$55 |
$14 |
$15 | |
| Vitamin D test |
$143 |
$221 |
$28 |
$30 | |
| Wart removal |
$111 |
$170 |
— |
$121 | |
| Well-child visit |
$270 |
$415 |
— |
— | |
| Wound debridement |
$141 |
$217 |
— |
$186 | |
| X-ray of the abdomen |
$109 |
$167 |
$12 |
$36 | |
| X-ray of the ankle |
$151 |
$233 |
— |
$37 | |
| X-ray of the collarbone |
$191 |
$294 |
— |
$33 | |
| X-ray of the elbow |
$206 |
$317 |
— |
$33 | |
| X-ray of the facial bones |
$227 |
$349 |
— |
$39 | |
| X-ray of the foot |
$101 |
$156 |
— |
$34 | |
| X-ray of the forearm |
$191 |
$294 |
$10 |
$29 | |
| X-ray of the hand |
$206 |
$317 |
$11 |
$38 | |
| X-ray of the hip |
$106 |
$163 |
$12 |
$49 | |
| X-ray of the hip (1 view) |
$106 |
$163 |
$12 |
$34 | |
| X-ray of the hip (3 views) |
$106 |
$163 |
— |
$49 | |
| X-ray of the knee |
$97 |
$149 |
$12 |
$42 | |
| X-ray of the knee (2 views) |
$97 |
$149 |
$11 |
$34 | |
| X-ray of the knee (3 views) |
$104 |
$160 |
$13 |
$42 | |
| X-ray of the knee (4+ views) |
$120 |
$185 |
— |
$49 | |
| X-ray of the lower back (lumbar spine) |
$158 |
$243 |
$17 |
$47 | |
| X-ray of the lower back (lumbar spine) (2 views) |
$176 |
$270 |
— |
$40 | |
| X-ray of the lower back (lumbar spine) (4+ views) |
$158 |
$243 |
$17 |
$53 | |
| X-ray of the lower leg |
$210 |
$323 |
$11 |
$31 | |
| X-ray of the mid-back (thoracic spine) |
$265 |
$407 |
— |
$36 | |
| X-ray of the mid-back (thoracic spine) (2 views) |
$241 |
$371 |
— |
$33 | |
| X-ray of the mid-back (thoracic spine) (3 views) |
$288 |
$443 |
— |
$39 | |
| X-ray of the neck (cervical spine) |
$103 |
$159 |
— |
$47 | |
| X-ray of the neck (cervical spine) (3 views) |
$103 |
$159 |
— |
$40 | |
| X-ray of the pelvis |
$118 |
$182 |
$11 |
$36 | |
| X-ray of the pelvis (1 view) |
$118 |
$182 |
$11 |
$28 | |
| X-ray of the ribs |
$114 |
$175 |
$14 |
$42 | |
| X-ray of the ribs (2 views) |
$114 |
$175 |
$14 |
$36 | |
| X-ray of the ribs (3 views) |
$320 |
$492 |
— |
$42 | |
| X-ray of the shoulder |
$151 |
$233 |
$13 |
$36 | |
| X-ray of the skull |
$251 |
$387 |
— |
$40 | |
| X-ray of the upper arm |
$201 |
$309 |
— |
$32 | |
| X-ray of the wrist |
$101 |
$156 |
— |
$43 | |
| Zinc blood test |
$66 |
$102 |
— |
$11 | |