| 3D mammogram (tomosynthesis) |
$52 |
$75 |
— |
$51 | |
| Abdominal fluid drain (paracentesis) |
$1,824 |
$2,605 |
— |
$284 | |
| Abdominal ultrasound |
$344 |
$492 |
— |
$100 | |
| Abdominal ultrasound (complete) |
$68 |
$97 |
— |
$114 | |
| Abdominal ultrasound (limited) |
$620 |
$885 |
— |
$86 | |
| Abscess drainage (complex or multiple) |
$296 |
$405 |
— |
$220 | |
| Abscess drainage (simple) |
$190 |
$250 |
— |
$129 | |
| Abscess incision and drainage |
$284 |
$251 |
— |
$174 | |
| Achilles tendon repair |
$672 |
$960 |
— |
$624 | |
| ACL knee reconstruction |
$822 |
$1,174 |
— |
$889 | |
| Adenoid removal (adenoidectomy) |
$342 |
$489 |
— |
$204 | |
| Albumin blood test |
$58 |
$84 |
— |
$5 | |
| Aldosterone test |
$319 |
$455 |
— |
$41 | |
| Alkaline phosphatase test |
$60 |
$86 |
— |
$5 | |
| Allergy patch testing |
$19 |
$27 |
— |
$5 | |
| Allergy shots |
$29 |
$42 |
— |
$11 | |
| Allergy testing |
$23 |
$33 |
— |
$4 | |
| Alpha-fetoprotein (AFP) test |
$123 |
$176 |
— |
$17 | |
| ALT liver enzyme test |
$57 |
$82 |
— |
$5 | |
| Ammonia blood test |
$205 |
$294 |
— |
$15 | |
| Amniocentesis |
$376 |
$537 |
— |
$120 | |
| Amylase test |
$46 |
$66 |
— |
$6 | |
| Anal fistula repair |
$649 |
$660 |
— |
$541 | |
| Ankle fracture repair |
$630 |
$900 |
— |
$608 | |
| Annual physical (established patient) |
$169 |
$241 |
— |
— | |
| Anoscopy |
$143 |
$197 |
— |
$129 | |
| Antinuclear antibody (ANA) test |
$89 |
$127 |
— |
$12 | |
| Aortic aneurysm repair (AAA) |
$2,872 |
$4,103 |
— |
$1,345 | |
| Aortic valve replacement |
$3,757 |
$5,367 |
— |
$1,603 | |
| Arterial blood gas (ABG) |
$285 |
$407 |
— |
$26 | |
| AST liver enzyme test |
$54 |
$77 |
— |
$5 | |
| Barium swallow study |
$60 |
$85 |
— |
$107 | |
| Bartholin cyst removal |
$217 |
$301 |
— |
$182 | |
| Basic metabolic panel |
$78 |
$111 |
— |
$8 | |
| Benign skin lesion removal |
$334 |
$361 |
— |
$171 | |
| Bilirubin blood test |
$82 |
$118 |
— |
$5 | |
| Bladder function test (urodynamics) |
$475 |
$495 |
— |
$345 | |
| Bladder scope (cystoscopy) |
$370 |
$424 |
— |
$216 | |
| Bladder tumor removal (TURBT) |
$456 |
$598 |
— |
$236 | |
| Blood clotting test (PT/INR) |
$30 |
$43 |
— |
$4 | |
| Blood crossmatch |
$394 |
$564 |
— |
— | |
| Blood transfusion |
$1,051 |
$1,502 |
— |
$47 | |
| Blood type and screen |
$161 |
$230 |
— |
$10 | |
| Blood type test |
$91 |
$130 |
— |
$3 | |
| Blood type test (ABO group) |
$95 |
$135 |
— |
$3 | |
| Blood type test (Rh/D antigen) |
$88 |
$126 |
— |
$3 | |
| Bone marrow biopsy |
$521 |
$744 |
— |
$172 | |
| Bone scan (nuclear) |
$950 |
$1,357 |
— |
$259 | |
| Botox for migraine |
$200 |
$286 |
— |
$157 | |
| Brain shunt (VP shunt) |
$1,524 |
$2,177 |
— |
$1,023 | |
| Breast biopsy |
$1,319 |
$1,884 |
— |
$478 | |
| Breast MRI |
$2,315 |
$3,307 |
— |
$216 | |
| Breast MRI without contrast |
$2,935 |
$4,192 |
— |
$216 | |
| Breast reconstruction |
$1,550 |
$2,214 |
— |
$1,227 | |
| Breast reduction |
$1,752 |
$2,504 |
— |
$980 | |
| Breast ultrasound |
$387 |
$554 |
— |
$92 | |
| Breast ultrasound (complete) |
$387 |
$554 |
— |
$100 | |
| Breast ultrasound (limited) |
$63 |
$90 |
— |
$84 | |
| Breathing tube insertion (intubation) |
$324 |
$463 |
— |
$133 | |
| Bronchoscopy |
$589 |
$842 |
— |
$303 | |
| Bunion surgery (bunionectomy) |
$1,125 |
$1,607 |
— |
$883 | |
| Burn dressing and debridement (medium) |
$221 |
$264 |
— |
$166 | |
| Burn dressing and debridement (small) |
$137 |
$185 |
— |
$93 | |
| Burn treatment |
$177 |
$204 |
— |
$129 | |
| C-reactive protein (CRP) |
$62 |
$88 |
— |
$5 | |
| CA 19-9 tumor marker test |
$144 |
$206 |
— |
$21 | |
| CA-125 ovarian marker test |
$128 |
$184 |
— |
$21 | |
| Calcium blood test |
$67 |
$95 |
— |
$5 | |
| Capsule endoscopy |
$320 |
$457 |
— |
$802 | |
| Cardiac event monitor |
$480 |
$686 |
— |
$170 | |
| Cardiac MRI |
$218 |
$311 |
— |
$322 | |
| Cardiac MRI without contrast |
$207 |
$296 |
— |
$280 | |
| Cardiac rehabilitation |
$116 |
$165 |
— |
$26 | |
| Cardiac stress test |
$691 |
$987 |
— |
$39 | |
| Cardioversion |
$937 |
$1,338 |
— |
$155 | |
| Carotid artery surgery |
$1,763 |
$2,519 |
— |
$1,026 | |
| Carotid artery ultrasound |
$499 |
$713 |
— |
$156 | |
| Carpal tunnel release |
$1,387 |
$1,508 |
— |
$483 | |
| Cataract surgery |
$1,314 |
$1,878 |
— |
$547 | |
| CEA tumor marker test |
$209 |
$299 |
— |
$19 | |
| Celiac disease test |
$116 |
$166 |
— |
$12 | |
| Central line placement |
$319 |
$541 |
— |
$238 | |
| Cervical LEEP procedure |
$501 |
$610 |
— |
$325 | |
| Chalazion (eyelid cyst) removal |
$186 |
$266 |
— |
$131 | |
| Chemotherapy infusion |
$231 |
$330 |
— |
$81 | |
| Chemotherapy infusion (each additional) |
$181 |
$259 |
— |
$28 | |
| Chemotherapy infusion (first hour) |
$632 |
$903 |
— |
$133 | |
| Chest fluid drain (thoracentesis) |
$1,455 |
$2,079 |
— |
$311 | |
| Chest tube insertion |
$1,592 |
$2,274 |
— |
$143 | |
| Chest X-ray |
$480 |
$686 |
— |
$37 | |
| Chest X-ray (1 view) |
$334 |
$478 |
— |
$25 | |
| Chest X-ray (2 views) |
$480 |
$686 |
— |
$33 | |
| Chickenpox (varicella) vaccine |
$213 |
$304 |
— |
— | |
| Chiropractic adjustment |
$58 |
$83 |
— |
$38 | |
| Circumcision |
$344 |
$482 |
— |
$167 | |
| CK-MB heart enzyme test |
$268 |
$383 |
— |
$12 | |
| Clotting time test (PTT) |
$84 |
$121 |
— |
$6 | |
| Colon resection (colectomy) |
$1,262 |
$1,803 |
— |
$1,238 | |
| Colonoscopy |
$774 |
$1,105 |
— |
$480 | |
| Colostomy |
$1,148 |
$1,640 |
— |
$1,122 | |
| Colposcopy |
$235 |
$205 |
— |
$161 | |
| Complete blood count (CBC) |
$95 |
$135 |
— |
$7 | |
| Complete blood count (CBC) (complete) |
$95 |
$135 |
— |
$8 | |
| Complex wound repair |
$626 |
$856 |
— |
$390 | |
| Comprehensive eye exam |
$199 |
$284 |
— |
$138 | |
| Comprehensive metabolic panel |
$100 |
$142 |
— |
$11 | |
| Continuous glucose monitor setup |
$67 |
$96 |
— |
$35 | |
| Copper blood test |
$127 |
$182 |
— |
$12 | |
| Corneal transplant |
$1,752 |
$2,503 |
— |
$1,066 | |
| Cortisol test |
$103 |
$148 |
— |
$16 | |
| COVID-19 PCR test |
$81 |
$79 |
— |
$51 | |
| CPAP titration study |
$645 |
$922 |
— |
$69 | |
| Craniotomy (brain surgery) |
$3,200 |
$4,572 |
— |
$2,161 | |
| Creatine kinase (CK) test |
$117 |
$167 |
— |
$7 | |
| CT angiography of the chest |
$1,387 |
$1,982 |
— |
$281 | |
| CT angiography of the head |
$1,465 |
$2,093 |
— |
$274 | |
| CT colonography (virtual colonoscopy) |
$969 |
$1,384 |
— |
$835 | |
| CT scan of the abdomen |
$2,295 |
$3,279 |
— |
$230 | |
| CT scan of the abdomen and pelvis |
$3,387 |
$4,839 |
— |
$300 | |
| CT scan of the abdomen and pelvis with and without contrast |
$4,586 |
$6,552 |
— |
$338 | |
| CT scan of the abdomen and pelvis with contrast |
$3,387 |
$4,839 |
— |
$300 | |
| CT scan of the abdomen and pelvis without contrast |
$2,800 |
$4,000 |
— |
$183 | |
| CT scan of the abdomen with and without contrast |
$3,001 |
$4,287 |
— |
$259 | |
| CT scan of the abdomen with contrast |
$2,295 |
$3,279 |
— |
$230 | |
| CT scan of the abdomen without contrast |
$1,072 |
$1,532 |
— |
$136 | |
| CT scan of the arm |
$2,041 |
$2,916 |
— |
$199 | |
| CT scan of the arm with contrast |
$2,406 |
$3,437 |
— |
$199 | |
| CT scan of the arm without contrast |
$2,041 |
$2,916 |
— |
$161 | |
| CT scan of the chest with and without contrast |
$1,332 |
$1,903 |
— |
$196 | |
| CT scan of the chest with contrast |
$1,197 |
$1,711 |
— |
$167 | |
| CT scan of the chest without contrast |
$125 |
$178 |
— |
$133 | |
| CT scan of the head |
$1,776 |
$2,538 |
— |
$148 | |
| CT scan of the head with and without contrast |
$1,290 |
$1,843 |
— |
$173 | |
| CT scan of the head with contrast |
$1,029 |
$1,471 |
— |
$148 | |
| CT scan of the head without contrast |
$1,776 |
$2,538 |
— |
$107 | |
| CT scan of the leg |
$1,939 |
$2,771 |
— |
$166 | |
| CT scan of the leg with contrast |
$2,406 |
$3,437 |
— |
$166 | |
| CT scan of the leg without contrast |
$1,939 |
$2,771 |
— |
$130 | |
| CT scan of the lower back (lumbar spine) |
$1,074 |
$1,534 |
— |
$169 | |
| CT scan of the lower back (lumbar spine) with and without contrast |
$1,326 |
$1,895 |
— |
$197 | |
| CT scan of the lower back (lumbar spine) with contrast |
$1,197 |
$1,710 |
— |
$169 | |
| CT scan of the lower back (lumbar spine) without contrast |
$1,069 |
$1,528 |
— |
$130 | |
| CT scan of the neck |
$1,548 |
$2,211 |
— |
$183 | |
| CT scan of the neck (cervical spine) |
$1,074 |
$1,534 |
— |
$168 | |
| CT scan of the neck (cervical spine) with and without contrast |
$1,326 |
$1,895 |
— |
$196 | |
| CT scan of the neck (cervical spine) with contrast |
$1,197 |
$1,710 |
— |
$168 | |
| CT scan of the neck (cervical spine) without contrast |
$1,069 |
$1,528 |
— |
$131 | |
| CT scan of the neck with and without contrast |
$2,475 |
$3,536 |
— |
$220 | |
| CT scan of the neck with contrast |
$1,207 |
$1,724 |
— |
$183 | |
| CT scan of the neck without contrast |
$828 |
$1,183 |
— |
$150 | |
| CT scan of the pelvis |
$2,041 |
$2,916 |
— |
$226 | |
| CT scan of the pelvis with and without contrast |
$1,388 |
$1,984 |
— |
$251 | |
| CT scan of the pelvis with contrast |
$2,337 |
$3,339 |
— |
$226 | |
| CT scan of the pelvis without contrast |
$1,066 |
$1,523 |
— |
$133 | |
| CT scan of the sinuses |
$945 |
$1,350 |
— |
$152 | |
| CT scan of the sinuses with and without contrast |
$1,114 |
$1,591 |
— |
$184 | |
| CT scan of the sinuses with contrast |
$1,006 |
$1,438 |
— |
$152 | |
| CT scan of the sinuses without contrast |
$933 |
$1,333 |
— |
$128 | |
| D-dimer test |
$149 |
$213 |
— |
$10 | |
| Developmental screening (child) |
$18 |
$26 |
— |
— | |
| DHEA-sulfate test |
$135 |
$194 |
— |
$22 | |
| Diagnostic mammogram |
$506 |
$723 |
— |
$140 | |
| Dialysis fistula creation |
$876 |
$1,252 |
— |
$601 | |
| Dilation and curettage (D&C) |
$392 |
$561 |
— |
$298 | |
| Droopy eyelid repair (ptosis) |
$1,075 |
$1,536 |
— |
$745 | |
| Ear pressure test (tympanometry) |
$38 |
$43 |
— |
$16 | |
| Ear tubes (myringotomy) |
$288 |
$411 |
— |
$174 | |
| Eardrum repair (tympanoplasty) |
$1,377 |
$1,967 |
— |
$799 | |
| Echocardiogram |
$444 |
$634 |
— |
$138 | |
| Echocardiogram with and without contrast |
$444 |
$634 |
— |
$101 | |
| Echocardiogram without contrast |
$980 |
$1,400 |
— |
$138 | |
| EEG (awake and asleep) |
$487 |
$695 |
— |
$482 | |
| EKG / ECG (tracing only) |
$143 |
$145 |
— |
$7 | |
| Elbow replacement |
$2,308 |
$3,298 |
— |
$1,301 | |
| Electrocardiogram (EKG) |
$109 |
$145 |
— |
$8 | |
| Electroencephalogram (EEG) |
$487 |
$695 |
— |
$448 | |
| Electrolyte panel |
$67 |
$95 |
— |
$7 | |
| Electromyography (EMG) |
$128 |
$183 |
— |
$141 | |
| Emergency department visit |
$202 |
$288 |
— |
$69 | |
| Emergency department visit (level 1) |
$71 |
$101 |
— |
$11 | |
| Emergency department visit (level 2) |
$99 |
$141 |
— |
$40 | |
| Emergency department visit (level 3) |
$159 |
$227 |
— |
$69 | |
| Emergency department visit (level 4) |
$244 |
$348 |
— |
$118 | |
| Emergency department visit (level 5) |
$334 |
$477 |
— |
$171 | |
| Endometrial biopsy |
$203 |
$196 |
— |
$98 | |
| Epidural steroid injection |
$1,926 |
$2,751 |
— |
$275 | |
| ERCP (bile duct endoscopy) |
$677 |
$967 |
— |
$311 | |
| Esophageal dilation |
$264 |
$377 |
— |
$522 | |
| Esophageal variceal banding |
$355 |
$507 |
— |
$126 | |
| Estradiol (estrogen) test |
$144 |
$206 |
— |
$28 | |
| Eyelid surgery (blepharoplasty) |
$1,155 |
$1,185 |
— |
$552 | |
| Facet joint injection (spine) |
$1,048 |
$1,497 |
— |
$99 | |
| Fallopian tube X-ray (HSG) |
$168 |
$240 |
— |
$164 | |
| Family therapy session |
$187 |
$267 |
— |
$110 | |
| Fecal occult blood (stool) test |
$20 |
$29 |
— |
$10 | |
| Fecal occult blood (stool) test (guaiac, gFOBT) |
$20 |
$29 |
— |
$4 | |
| Feeding tube (PEG) placement |
$396 |
$566 |
— |
$178 | |
| Femoral hernia repair |
$555 |
$793 |
— |
$584 | |
| Ferritin (iron) test |
$61 |
$87 |
— |
$14 | |
| Fibrinogen test |
$110 |
$158 |
— |
$10 | |
| Fibroid removal (myomectomy) |
$1,443 |
$2,061 |
— |
$914 | |
| Flexible sigmoidoscopy |
$284 |
$405 |
— |
$323 | |
| Flu test |
$29 |
$42 |
— |
$17 | |
| Flu vaccine |
$14 |
$20 |
— |
— | |
| Folate (folic acid) test |
$83 |
$119 |
— |
$15 | |
| Foreign body removal (skin) |
$274 |
$225 |
— |
$157 | |
| Free T4 thyroid test |
$122 |
$175 |
— |
$9 | |
| FSH hormone test |
$212 |
$303 |
— |
$19 | |
| Gallbladder removal (laparoscopic) |
$711 |
$1,016 |
— |
$658 | |
| Gallbladder scan (HIDA) |
$2,157 |
$3,082 |
— |
$334 | |
| Ganglion cyst removal |
$945 |
$1,657 |
— |
$321 | |
| GGT liver test |
$67 |
$96 |
— |
$7 | |
| Glaucoma surgery |
$1,896 |
$2,709 |
— |
$984 | |
| Glucose tolerance test |
$143 |
$205 |
— |
$8 | |
| Group therapy session |
$54 |
$77 |
— |
$30 | |
| Hammertoe repair |
$823 |
$1,176 |
— |
$548 | |
| HDL cholesterol test |
$80 |
$114 |
— |
$8 | |
| Hearing test (audiometry) |
$89 |
$101 |
— |
$36 | |
| Hematocrit test |
$28 |
$40 |
— |
$2 | |
| Hemodialysis |
$151 |
$216 |
— |
$75 | |
| Hemoglobin A1c (diabetes test) |
$26 |
$38 |
— |
$10 | |
| Hemorrhoid removal |
$380 |
$513 |
— |
$338 | |
| Hepatitis A vaccine |
$94 |
$134 |
— |
— | |
| Hepatitis B test |
$139 |
$198 |
— |
$10 | |
| Hepatitis B vaccine |
$62 |
$89 |
— |
— | |
| Hepatitis C test |
$83 |
$119 |
— |
$14 | |
| Hip fracture repair |
$569 |
$813 |
— |
$1,120 | |
| Hip replacement |
$1,870 |
$2,671 |
— |
$1,162 | |
| Holter heart monitor |
$50 |
$71 |
— |
$26 | |
| HPV vaccine |
$291 |
$415 |
— |
— | |
| Hydrocele repair |
$564 |
$806 |
— |
$315 | |
| Hysterectomy |
$1,047 |
$1,496 |
— |
$933 | |
| Hysteroscopy |
$1,050 |
$2,080 |
— |
$1,270 | |
| Ileostomy |
$1,008 |
$1,440 |
— |
$968 | |
| Inguinal hernia repair |
$848 |
$1,212 |
— |
$538 | |
| Iron blood test |
$60 |
$86 |
— |
$6 | |
| IUD removal |
$167 |
$190 |
— |
$112 | |
| IV infusion therapy |
$263 |
$375 |
— |
$44 | |
| IV infusion therapy (each additional) |
$142 |
$202 |
— |
$21 | |
| IV infusion therapy (initial) |
$467 |
$668 |
— |
$67 | |
| IVC filter placement |
$2,681 |
$3,831 |
— |
$1,885 | |
| Kidney biopsy |
$1,162 |
$1,660 |
— |
$492 | |
| Kidney removal (nephrectomy) |
$1,410 |
$2,014 |
— |
$1,164 | |
| Kidney scan (nuclear) |
$947 |
$1,354 |
— |
$172 | |
| Kidney stone shock-wave (lithotripsy) |
$2,369 |
$3,384 |
— |
$760 | |
| Kidney ultrasound |
$486 |
$694 |
— |
$84 | |
| Kidney ultrasound (limited) |
$486 |
$694 |
— |
$61 | |
| Knee arthroscopy |
$491 |
$701 |
— |
$524 | |
| Knee joint injection |
$248 |
$200 |
— |
$69 | |
| Lactate test |
$314 |
$448 |
— |
$12 | |
| Laminectomy (spine) |
$1,891 |
$2,701 |
— |
$1,157 | |
| Laryngoscopy |
$327 |
$468 |
— |
$189 | |
| LDH test |
$56 |
$80 |
— |
$6 | |
| LDL cholesterol test |
$65 |
$93 |
— |
$11 | |
| Leg vein ultrasound (Doppler) |
$504 |
$720 |
— |
$150 | |
| Leg vein ultrasound (Doppler) (limited) |
$504 |
$720 |
— |
$116 | |
| LH hormone test |
$218 |
$311 |
— |
$19 | |
| Lipase test |
$67 |
$96 |
— |
$7 | |
| Lipid (cholesterol) panel |
$59 |
$84 |
— |
$13 | |
| Liver biopsy |
$2,078 |
$2,969 |
— |
$288 | |
| Liver function panel |
$86 |
$123 |
— |
$8 | |
| Lumbar discectomy |
$1,708 |
$2,440 |
— |
$898 | |
| Lumpectomy (breast) |
$894 |
$1,277 |
— |
$750 | |
| Lung function test (PFT) |
$78 |
$81 |
— |
$37 | |
| Lung scan (V/Q) |
$1,708 |
$2,440 |
— |
$291 | |
| Magnesium blood test |
$88 |
$126 |
— |
$7 | |
| Mastectomy |
$1,102 |
$1,574 |
— |
$1,021 | |
| Mastoidectomy |
$1,530 |
$2,185 |
— |
$840 | |
| Meniscus repair (knee) |
$891 |
$1,273 |
— |
$714 | |
| MMR vaccine |
$116 |
$165 |
— |
— | |
| Mohs skin cancer surgery |
$876 |
$1,251 |
— |
$535 | |
| MRA of the brain |
$3,015 |
$4,307 |
— |
$226 | |
| MRA of the brain with contrast |
$1,620 |
$2,314 |
— |
$226 | |
| MRA of the brain without contrast |
$1,728 |
$2,468 |
— |
$328 | |
| MRA of the neck |
$1,584 |
$2,263 |
— |
$245 | |
| MRA of the neck with contrast |
$1,621 |
$2,315 |
— |
$245 | |
| MRA of the neck without contrast |
$1,728 |
$2,468 |
— |
$343 | |
| MRI of the abdomen |
$2,432 |
$3,474 |
— |
$300 | |
| MRI of the abdomen with contrast |
$1,365 |
$1,950 |
— |
$300 | |
| MRI of the abdomen without contrast |
$2,432 |
$3,474 |
— |
$194 | |
| MRI of the ankle |
$2,951 |
$4,215 |
— |
$261 | |
| MRI of the ankle with contrast |
$2,951 |
$4,215 |
— |
$261 | |
| MRI of the ankle without contrast |
$2,805 |
$4,007 |
— |
$222 | |
| MRI of the brain |
$2,970 |
$4,243 |
— |
$269 | |
| MRI of the brain with contrast |
$2,970 |
$4,243 |
— |
$269 | |
| MRI of the brain without contrast |
$1,493 |
$2,132 |
— |
$195 | |
| MRI of the chest |
$2,396 |
$3,422 |
— |
$371 | |
| MRI of the chest with contrast |
$1,415 |
$2,021 |
— |
$371 | |
| MRI of the chest without contrast |
$3,303 |
$4,718 |
— |
$466 | |
| MRI of the knee |
$3,035 |
$4,335 |
— |
$315 | |
| MRI of the knee with contrast |
$3,035 |
$4,335 |
— |
$315 | |
| MRI of the knee without contrast |
$2,903 |
$4,147 |
— |
$204 | |
| MRI of the lower back (lumbar spine) |
$2,913 |
$4,161 |
— |
$270 | |
| MRI of the lower back (lumbar spine) with contrast |
$1,600 |
$2,285 |
— |
$270 | |
| MRI of the lower back (lumbar spine) without contrast |
$2,913 |
$4,161 |
— |
$192 | |
| MRI of the mid-back (thoracic spine) |
$2,431 |
$3,473 |
— |
$271 | |
| MRI of the mid-back (thoracic spine) with and without contrast |
$1,771 |
$2,530 |
— |
$319 | |
| MRI of the mid-back (thoracic spine) with contrast |
$1,357 |
$1,939 |
— |
$271 | |
| MRI of the mid-back (thoracic spine) without contrast |
$2,431 |
$3,473 |
— |
$190 | |
| MRI of the neck (cervical spine) |
$2,822 |
$4,032 |
— |
$274 | |
| MRI of the neck (cervical spine) with and without contrast |
$1,706 |
$2,437 |
— |
$318 | |
| MRI of the neck (cervical spine) with contrast |
$1,552 |
$2,217 |
— |
$274 | |
| MRI of the neck (cervical spine) without contrast |
$2,822 |
$4,032 |
— |
$191 | |
| MRI of the pelvis |
$1,311 |
$1,873 |
— |
$268 | |
| MRI of the pelvis with contrast |
$1,402 |
$2,003 |
— |
$268 | |
| MRI of the pelvis without contrast |
$1,277 |
$1,825 |
— |
$227 | |
| MRI of the shoulder |
$3,093 |
$4,419 |
— |
$313 | |
| MRI of the shoulder with contrast |
$3,093 |
$4,419 |
— |
$313 | |
| MRI of the shoulder without contrast |
$2,899 |
$4,142 |
— |
$205 | |
| MRI of the wrist |
$2,553 |
$3,647 |
— |
$330 | |
| MRI of the wrist with contrast |
$2,553 |
$3,647 |
— |
$330 | |
| MRI of the wrist without contrast |
$2,432 |
$3,474 |
— |
$303 | |
| Nebulizer breathing treatment |
$100 |
$144 |
— |
$9 | |
| Neck (cervical) spinal fusion |
$2,599 |
$3,713 |
— |
$1,410 | |
| Nerve conduction study |
$158 |
$225 |
— |
$118 | |
| Newborn hospital care |
$116 |
$166 |
— |
$58 | |
| Nuchal translucency ultrasound |
$100 |
$143 |
— |
$116 | |
| Nuclear cardiac stress test |
$2,508 |
$3,583 |
— |
$428 | |
| Occupational therapy evaluation |
$247 |
$353 |
— |
$101 | |
| Occupational therapy evaluation (high complexity) |
$247 |
$353 |
— |
$101 | |
| Occupational therapy evaluation (low complexity) |
$247 |
$353 |
— |
$101 | |
| Occupational therapy evaluation (moderate complexity) |
$247 |
$353 |
— |
$101 | |
| Office visit (established patient) |
$144 |
$205 |
— |
$115 | |
| Office visit (new patient) |
$228 |
$325 |
— |
$177 | |
| Office visit, established patient (level 3) |
$144 |
$205 |
— |
$95 | |
| Office visit, established patient (level 4) |
$172 |
$245 |
— |
$136 | |
| Office visit, new patient (level 3) |
$182 |
$260 |
— |
$118 | |
| Office visit, new patient (level 4) |
$228 |
$325 |
— |
$177 | |
| Office visit, new patient (level 5) |
$287 |
$410 |
— |
$237 | |
| Orthopedic hardware removal |
$516 |
$1,751 |
— |
$632 | |
| Ovarian cyst removal |
$748 |
$1,069 |
— |
$698 | |
| Ovary removal (oophorectomy) |
$789 |
$1,127 |
— |
$822 | |
| Pap smear (cervical screening) |
$145 |
$208 |
— |
$20 | |
| Parathyroid hormone (PTH) test |
$168 |
$241 |
— |
$41 | |
| Parathyroid removal |
$1,002 |
$1,431 |
— |
$891 | |
| Pelvic ultrasound |
$566 |
$809 |
— |
$78 | |
| Pelvic ultrasound (complete) |
$423 |
$605 |
— |
$105 | |
| Pelvic ultrasound (limited) |
$566 |
$809 |
— |
$51 | |
| PET scan |
$2,435 |
$3,479 |
— |
— | |
| Phosphorus blood test |
$67 |
$95 |
— |
$5 | |
| Physical therapy evaluation |
$248 |
$354 |
— |
$98 | |
| Physical therapy evaluation (high complexity) |
$248 |
$354 |
— |
$98 | |
| Physical therapy evaluation (moderate complexity) |
$248 |
$354 |
— |
$98 | |
| Pilonidal cyst removal |
$596 |
$573 |
— |
$541 | |
| Platelet count |
$47 |
$68 |
— |
$4 | |
| Pneumonia vaccine |
$255 |
$220 |
— |
— | |
| Pregnancy blood test (hCG) |
$130 |
$185 |
— |
$8 | |
| Pregnancy ultrasound |
$437 |
$624 |
— |
$126 | |
| Pregnancy ultrasound (first trimester) |
$437 |
$624 |
— |
$117 | |
| Pregnancy ultrasound (second or third trimester) |
$443 |
$633 |
— |
$136 | |
| Procalcitonin test |
$50 |
$72 |
— |
$27 | |
| Prolactin test |
$242 |
$346 |
— |
$19 | |
| Prostate biopsy |
$421 |
$469 |
— |
— | |
| Prostate removal (prostatectomy) |
$2,248 |
$3,211 |
— |
$1,063 | |
| Prostate surgery (TURP) |
$1,385 |
$1,979 |
— |
$526 | |
| Prostate test (PSA) |
$225 |
$321 |
— |
$18 | |
| Psychiatric evaluation |
$198 |
$283 |
— |
$188 | |
| Psychotherapy session |
$149 |
$213 |
— |
$140 | |
| Pterygium removal (eye) |
$783 |
$1,119 |
— |
$540 | |
| Pulmonary rehabilitation |
$156 |
$223 |
— |
$87 | |
| Radiofrequency nerve ablation |
$2,120 |
$3,029 |
— |
$462 | |
| Retinal (fundus) photography |
$38 |
$54 |
— |
$37 | |
| Retinal detachment repair |
$2,007 |
$2,867 |
— |
$966 | |
| Rheumatoid factor test |
$74 |
$105 |
— |
$6 | |
| Rotator cuff repair |
$960 |
$1,372 |
— |
$792 | |
| Routine eye exam |
$120 |
$172 |
— |
$88 | |
| RSV vaccine |
$470 |
$500 |
— |
— | |
| Sacroiliac joint injection |
$272 |
$389 |
— |
$176 | |
| Scoliosis spine X-ray |
$408 |
$582 |
— |
$58 | |
| Scoliosis spine X-ray (1 view) |
$408 |
$582 |
— |
$44 | |
| Screening colonoscopy |
$649 |
$927 |
— |
$378 | |
| Screening mammogram |
$550 |
$786 |
— |
$126 | |
| Scrotal ultrasound |
$422 |
$603 |
— |
$99 | |
| Sedimentation rate (ESR) test |
$54 |
$78 |
— |
$3 | |
| Semen analysis |
$72 |
$103 |
— |
$12 | |
| Septoplasty (deviated septum) |
$915 |
$1,307 |
— |
$613 | |
| Sex hormone binding globulin test |
$96 |
$137 |
— |
$22 | |
| Shingles vaccine |
$322 |
$425 |
— |
— | |
| Shoulder arthroscopy |
$1,041 |
$1,487 |
— |
$962 | |
| Simple laceration repair (small, up to 2.5 cm) |
$236 |
$303 |
— |
$114 | |
| Simple wound stitches |
$242 |
$328 |
— |
$127 | |
| Sinus surgery (endoscopic) |
$528 |
$755 |
— |
$224 | |
| Skin biopsy |
$169 |
$229 |
— |
$121 | |
| Skin biopsy (punch) |
$177 |
$193 |
— |
$121 | |
| Skin cancer lesion removal |
$377 |
$519 |
— |
$240 | |
| Skin graft |
$1,400 |
$1,999 |
— |
$898 | |
| Skin lesion freezing (cryotherapy) |
$74 |
$62 |
— |
$36 | |
| Skin tag removal |
$161 |
$185 |
— |
$92 | |
| Small bowel resection |
$1,164 |
$1,662 |
— |
$1,136 | |
| Soft tissue ultrasound |
$600 |
$857 |
— |
$64 | |
| Speech therapy |
$127 |
$182 |
— |
$76 | |
| Spinal cord stimulator |
$7,022 |
$10,032 |
— |
$2,388 | |
| Spinal tap (lumbar puncture) |
$992 |
$949 |
— |
$165 | |
| Spine fracture repair (kyphoplasty) |
$7,846 |
$11,208 |
— |
$5,803 | |
| Spirometry (lung function test) |
$56 |
$70 |
— |
$30 | |
| Spirometry with bronchodilator |
$100 |
$106 |
— |
$43 | |
| Spleen removal (splenectomy) |
$1,569 |
$2,241 |
— |
$1,036 | |
| Stomach removal (gastrectomy) |
$2,151 |
$3,073 |
— |
$1,595 | |
| Strabismus (eye muscle) surgery |
$931 |
$1,331 |
— |
$475 | |
| Strep throat test |
$68 |
$60 |
— |
$17 | |
| Stress echocardiogram |
$2,059 |
$2,941 |
— |
$209 | |
| Stress echocardiogram (complete) |
$2,059 |
$2,941 |
— |
$233 | |
| Swallow study |
$242 |
$346 |
— |
$85 | |
| T3 thyroid test |
$83 |
$119 |
— |
$14 | |
| Tdap (tetanus) vaccine |
$68 |
$73 |
— |
— | |
| Testicle removal (orchiectomy) |
$359 |
$513 |
— |
$306 | |
| Testosterone test |
$135 |
$194 |
— |
$26 | |
| Thyroid removal (thyroidectomy) |
$1,051 |
$1,502 |
— |
$1,004 | |
| Thyroid test (TSH) |
$181 |
$258 |
— |
$17 | |
| Thyroid ultrasound |
$740 |
$1,058 |
— |
$109 | |
| Thyroid uptake scan |
$1,245 |
$1,778 |
— |
$145 | |
| Tilt table test |
$172 |
$246 |
— |
$168 | |
| Tonsillectomy |
$442 |
$631 |
— |
$252 | |
| Total IgE allergy test |
$103 |
$147 |
— |
$16 | |
| Total protein test |
$54 |
$77 |
— |
$4 | |
| Tracheostomy |
$639 |
$912 |
— |
$273 | |
| Transesophageal echocardiogram (TEE) |
$248 |
$354 |
— |
$239 | |
| Transesophageal echocardiogram (TEE) with and without contrast |
$194 |
$277 |
— |
$239 | |
| Transvaginal ultrasound |
$306 |
$438 |
— |
$118 | |
| Trigger finger release |
$1,250 |
$1,210 |
— |
$630 | |
| Trigger point injection |
$99 |
$125 |
— |
$56 | |
| Triglycerides test |
$64 |
$92 |
— |
$6 | |
| Troponin (heart) test |
$266 |
$381 |
— |
$12 | |
| Tubal ligation |
$581 |
$830 |
— |
$333 | |
| Turbinate reduction |
$662 |
$945 |
— |
$294 | |
| Ulnar nerve surgery (elbow) |
$705 |
$1,007 |
— |
$575 | |
| Upper GI endoscopy (EGD) |
$571 |
$816 |
— |
$371 | |
| Upper GI series (barium) |
$1,244 |
$1,777 |
— |
$128 | |
| Ureteral stent placement |
$1,169 |
$1,114 |
— |
$373 | |
| Ureteroscopy (stone removal) |
$870 |
$829 |
— |
$365 | |
| Uric acid (gout) test |
$54 |
$77 |
— |
$5 | |
| Urine microalbumin test |
$77 |
$110 |
— |
$5 | |
| Urine pregnancy test |
$17 |
$25 |
— |
$9 | |
| UV light therapy (skin) |
$116 |
$165 |
— |
$106 | |
| Vaccine administration |
$30 |
$35 |
— |
$19 | |
| Vaccine administration (each additional) |
$21 |
$30 |
— |
$16 | |
| Varicocele repair |
$592 |
$846 |
— |
$327 | |
| Varicose vein ablation |
$3,088 |
$4,201 |
— |
$1,018 | |
| Vasectomy |
$848 |
$986 |
— |
$347 | |
| Visual field test |
$43 |
$61 |
— |
$64 | |
| Vitamin B12 test |
$82 |
$118 |
— |
$15 | |
| Vitamin D test |
$187 |
$268 |
— |
$30 | |
| Vitrectomy (eye) |
$1,704 |
$2,434 |
— |
$814 | |
| Wart removal |
$179 |
$231 |
— |
$121 | |
| Well-child visit |
$144 |
$127 |
— |
— | |
| Whipple procedure (pancreas) |
$4,613 |
$6,590 |
— |
$2,871 | |
| Wrist fracture repair |
$753 |
$1,075 |
— |
$735 | |
| X-ray of the abdomen |
$603 |
$862 |
— |
$36 | |
| X-ray of the ankle |
$448 |
$641 |
— |
$37 | |
| X-ray of the collarbone |
$409 |
$584 |
— |
$33 | |
| X-ray of the elbow |
$436 |
$623 |
— |
$33 | |
| X-ray of the facial bones |
$706 |
$1,009 |
— |
$39 | |
| X-ray of the foot |
$448 |
$641 |
— |
$34 | |
| X-ray of the forearm |
$416 |
$594 |
— |
$29 | |
| X-ray of the hand |
$428 |
$612 |
— |
$38 | |
| X-ray of the hip |
$578 |
$825 |
— |
$49 | |
| X-ray of the hip (1 view) |
$552 |
$789 |
— |
$34 | |
| X-ray of the hip (3 views) |
$578 |
$825 |
— |
$49 | |
| X-ray of the hip (4 views) |
$312 |
$446 |
— |
$63 | |
| X-ray of the knee |
$428 |
$612 |
— |
$42 | |
| X-ray of the knee (2 views) |
$382 |
$546 |
— |
$34 | |
| X-ray of the knee (3 views) |
$428 |
$612 |
— |
$42 | |
| X-ray of the knee (4+ views) |
$608 |
$868 |
— |
$49 | |
| X-ray of the lower back (lumbar spine) |
$547 |
$782 |
— |
$47 | |
| X-ray of the lower back (lumbar spine) (2 views) |
$469 |
$670 |
— |
$40 | |
| X-ray of the lower back (lumbar spine) (4+ views) |
$547 |
$782 |
— |
$53 | |
| X-ray of the lower leg |
$416 |
$594 |
— |
$31 | |
| X-ray of the mid-back (thoracic spine) |
$457 |
$652 |
— |
$36 | |
| X-ray of the mid-back (thoracic spine) (2 views) |
$457 |
$652 |
— |
$33 | |
| X-ray of the mid-back (thoracic spine) (3 views) |
$486 |
$694 |
— |
$39 | |
| X-ray of the neck (cervical spine) |
$339 |
$485 |
— |
$47 | |
| X-ray of the neck (cervical spine) (3 views) |
$339 |
$485 |
— |
$40 | |
| X-ray of the pelvis |
$365 |
$521 |
— |
$36 | |
| X-ray of the pelvis (1 view) |
$365 |
$521 |
— |
$28 | |
| X-ray of the ribs |
$547 |
$781 |
— |
$42 | |
| X-ray of the ribs (2 views) |
$429 |
$613 |
— |
$36 | |
| X-ray of the ribs (3 views) |
$665 |
$950 |
— |
$42 | |
| X-ray of the shoulder |
$600 |
$857 |
— |
$36 | |
| X-ray of the skull |
$592 |
$846 |
— |
$40 | |
| X-ray of the upper arm |
$600 |
$857 |
— |
$32 | |
| X-ray of the wrist |
$523 |
$747 |
— |
$43 | |
| YAG laser capsulotomy (eye) |
$466 |
$666 |
— |
$335 | |
| Zinc blood test |
$95 |
$135 |
— |
$11 | |