| Abdominal fluid drain (paracentesis) |
$990 |
$1,848 |
$990 |
$284 | |
| Abdominal ultrasound |
$128 |
$720 |
$128 |
$100 | |
| Abdominal ultrasound (complete) |
$128 |
$908 |
$128 |
$114 | |
| Abdominal ultrasound (limited) |
$128 |
$532 |
$128 |
$86 | |
| Abscess drainage (simple) |
$217 |
$1,153 |
$353 |
$129 | |
| Abscess incision and drainage |
$217 |
$1,153 |
$353 |
$174 | |
| ACL knee reconstruction |
$7,936 |
$11,738 |
$7,936 |
$889 | |
| Albumin blood test |
$5 |
$83 |
$5 |
$5 | |
| Aldosterone test |
$41 |
$394 |
$41 |
$41 | |
| Alkaline phosphatase test |
$5 |
$55 |
$5 |
$5 | |
| Alpha-fetoprotein (AFP) test |
$17 |
$147 |
$17 |
$17 | |
| ALT liver enzyme test |
$5 |
$61 |
$5 |
$5 | |
| Ammonia blood test |
$15 |
$103 |
$15 |
$15 | |
| Amylase test |
$6 |
$83 |
$6 |
$6 | |
| Anal fistula repair |
$3,083 |
$5,928 |
$3,083 |
$541 | |
| Annual physical (established patient) |
$145 |
$1,251 |
$145 |
— | |
| Annual physical (new patient) |
$145 |
$1,894 |
$145 |
— | |
| Antinuclear antibody (ANA) test |
$12 |
$103 |
$12 |
$12 | |
| Appendix removal (appendectomy) |
— |
$38,277 |
$14,046 |
$592 | |
| Arterial blood gas (ABG) |
$26 |
$424 |
$26 |
$26 | |
| AST liver enzyme test |
$5 |
$61 |
$5 |
$5 | |
| Barium swallow study |
$216 |
$404 |
$216 |
$107 | |
| Benign skin lesion removal |
$779 |
$4,650 |
$839 |
$171 | |
| Bilirubin blood test |
$5 |
$61 |
$5 |
$5 | |
| Bladder scope (cystoscopy) |
$750 |
$4,597 |
$1,349 |
$216 | |
| Bladder tumor removal (TURBT) |
$3,845 |
$6,775 |
$3,845 |
$236 | |
| Blood clotting test (PT/INR) |
$4 |
$135 |
$4 |
$4 | |
| Blood glucose test |
$4 |
$58 |
$5 |
$5 | |
| Blood transfusion |
$489 |
$7,075 |
$738 |
$47 | |
| BNP (heart failure) test |
$39 |
$331 |
$39 |
$39 | |
| Bone density scan (DEXA) |
$128 |
$668 |
$128 |
$39 | |
| Bone scan (nuclear) |
$466 |
$1,280 |
$466 |
$259 | |
| Breast biopsy |
$1,799 |
$4,566 |
$1,919 |
$478 | |
| Breast reduction |
$7,130 |
$11,950 |
$7,130 |
$980 | |
| Breast ultrasound |
$116 |
$484 |
$104 |
$92 | |
| Breast ultrasound (complete) |
$128 |
$484 |
$128 |
$100 | |
| Breast ultrasound (limited) |
$104 |
$484 |
$104 |
$84 | |
| Breathing tube insertion (intubation) |
$249 |
$761 |
$416 |
$133 | |
| Bunion surgery (bunionectomy) |
$3,571 |
$8,217 |
$3,571 |
$883 | |
| CA 19-9 tumor marker test |
$21 |
$204 |
$21 |
$21 | |
| CA-125 ovarian marker test |
$21 |
$244 |
$21 |
$21 | |
| Calcium blood test |
$5 |
$61 |
$5 |
$5 | |
| Cardiac rehabilitation |
$144 |
$713 |
$144 |
$26 | |
| Cardiac stress test |
$336 |
$1,005 |
$336 |
$39 | |
| Cardioversion |
$706 |
$2,800 |
$706 |
$155 | |
| Carotid artery ultrasound |
$128 |
$803 |
$128 |
$156 | |
| Carpal tunnel release |
$2,156 |
$5,580 |
$2,156 |
$483 | |
| Cataract surgery |
$2,591 |
$4,782 |
$2,591 |
$547 | |
| CEA tumor marker test |
$19 |
$195 |
$19 |
$19 | |
| Central line placement |
$3,574 |
$6,468 |
$3,574 |
$238 | |
| Cervical LEEP procedure |
$3,392 |
$7,697 |
$3,392 |
$325 | |
| Chest fluid drain (thoracentesis) |
$694 |
$562 |
$694 |
$311 | |
| Chest tube insertion |
$1,785 |
$3,082 |
$1,785 |
$143 | |
| Chest X-ray |
$104 |
$461 |
$104 |
$37 | |
| Chest X-ray (1 view) |
$104 |
$406 |
$104 |
$25 | |
| Chest X-ray (2 views) |
$104 |
$435 |
$104 |
$33 | |
| Chickenpox (varicella) vaccine |
$82 |
$847 |
$163 |
— | |
| CK-MB heart enzyme test |
$12 |
$129 |
$14 |
$12 | |
| Clotting time test (PTT) |
$6 |
$88 |
$6 |
$6 | |
| Colonoscopy |
$1,299 |
$4,914 |
$1,299 |
$480 | |
| Colposcopy |
$350 |
$1,564 |
$763 |
$161 | |
| Complete blood count (CBC) |
$7 |
$100 |
$7 |
$7 | |
| Complete blood count (CBC) (complete) |
$8 |
$106 |
$8 |
$8 | |
| Contraceptive implant (Nexplanon) |
$453 |
$5,383 |
$485 |
$115 | |
| Copper blood test |
$12 |
$55 |
$12 |
$12 | |
| Coronary CT angiography |
$216 |
$2,676 |
$216 |
$326 | |
| Cortisol test |
$16 |
$331 |
$16 |
$16 | |
| CPAP titration study |
$230 |
$638 |
$230 |
$69 | |
| Creatine kinase (CK) test |
$7 |
$106 |
$7 |
$7 | |
| CT angiography of the chest |
$216 |
$2,907 |
$216 |
$281 | |
| CT angiography of the head |
$216 |
$2,567 |
$219 |
$274 | |
| CT scan of the abdomen |
$216 |
$1,505 |
$216 |
$230 | |
| CT scan of the abdomen and pelvis |
$442 |
$3,015 |
$302 |
$300 | |
| CT scan of the abdomen and pelvis with and without contrast |
$442 |
$3,015 |
$442 |
$338 | |
| CT scan of the abdomen and pelvis with contrast |
$442 |
$3,015 |
$442 |
$300 | |
| CT scan of the abdomen with and without contrast |
$216 |
$1,255 |
$257 |
$259 | |
| CT scan of the abdomen with contrast |
$216 |
$1,505 |
$216 |
$230 | |
| CT scan of the abdomen without contrast |
$128 |
$1,505 |
$141 |
$136 | |
| CT scan of the arm |
$285 |
$1,071 |
$222 |
$199 | |
| CT scan of the arm with contrast |
$442 |
$933 |
$442 |
$199 | |
| CT scan of the arm without contrast |
$128 |
$1,208 |
$141 |
$161 | |
| CT scan of the chest |
$216 |
$1,505 |
$216 |
$167 | |
| CT scan of the chest with and without contrast |
$216 |
$1,007 |
$257 |
$196 | |
| CT scan of the chest with contrast |
$216 |
$1,505 |
$216 |
$167 | |
| CT scan of the chest without contrast |
$128 |
$1,505 |
$141 |
$133 | |
| CT scan of the head |
$216 |
$933 |
$216 |
$148 | |
| CT scan of the head with and without contrast |
$216 |
$933 |
$219 |
$173 | |
| CT scan of the head with contrast |
$216 |
$933 |
$216 |
$148 | |
| CT scan of the head without contrast |
$128 |
$1,626 |
$128 |
$107 | |
| CT scan of the leg |
$172 |
$1,071 |
$216 |
$166 | |
| CT scan of the leg with contrast |
$216 |
$933 |
$216 |
$166 | |
| CT scan of the leg without contrast |
$128 |
$1,208 |
$141 |
$130 | |
| CT scan of the lower back (lumbar spine) |
$285 |
$1,256 |
$224 |
$169 | |
| CT scan of the lower back (lumbar spine) with contrast |
$442 |
$1,007 |
$442 |
$169 | |
| CT scan of the neck |
$216 |
$1,118 |
$216 |
$183 | |
| CT scan of the neck with and without contrast |
$216 |
$1,007 |
$257 |
$220 | |
| CT scan of the neck with contrast |
$216 |
$1,208 |
$216 |
$183 | |
| CT scan of the neck without contrast |
$128 |
$1,118 |
$141 |
$150 | |
| CT scan of the pelvis |
$216 |
$1,255 |
$216 |
$226 | |
| CT scan of the pelvis with and without contrast |
$216 |
$1,255 |
$257 |
$251 | |
| CT scan of the pelvis with contrast |
$216 |
$1,255 |
$216 |
$226 | |
| CT scan of the pelvis without contrast |
$128 |
$1,505 |
$141 |
$133 | |
| CT scan of the sinuses |
$172 |
$1,007 |
$210 |
$152 | |
| CT scan of the sinuses with contrast |
$216 |
$1,007 |
$216 |
$152 | |
| CT scan of the sinuses without contrast |
$128 |
$1,007 |
$128 |
$128 | |
| Developmental screening (child) |
$162 |
$642 |
$234 |
— | |
| DHEA-sulfate test |
$22 |
$135 |
$22 |
$22 | |
| Diagnostic mammogram |
$123 |
$1,112 |
$138 |
$140 | |
| Dialysis fistula creation |
$3,574 |
$6,644 |
$3,574 |
$601 | |
| Drug screen (urine) |
$37 |
$397 |
$62 |
$17 | |
| Echocardiogram |
$442 |
$1,347 |
$280 |
$138 | |
| Echocardiogram with and without contrast |
$280 |
$1,005 |
$280 |
$101 | |
| EEG (awake and asleep) |
$336 |
$718 |
$336 |
$482 | |
| EKG / ECG (tracing only) |
$69 |
$330 |
$69 |
$7 | |
| Electrocardiogram (EKG) |
$69 |
$330 |
$69 |
$8 | |
| Electroencephalogram (EEG) |
$336 |
$718 |
$336 |
$448 | |
| Electrolyte panel |
$7 |
$65 |
$7 |
$7 | |
| Emergency department visit |
$294 |
$2,226 |
$461 |
$69 | |
| Emergency department visit (level 1) |
$90 |
$1,293 |
$205 |
$11 | |
| Emergency department visit (level 2) |
$168 |
$1,817 |
$216 |
$40 | |
| Emergency department visit (level 3) |
$294 |
$2,226 |
$294 |
$69 | |
| Emergency department visit (level 4) |
$458 |
$3,727 |
$458 |
$118 | |
| Emergency department visit (level 5) |
$658 |
$5,785 |
$658 |
$171 | |
| Endometrial biopsy |
$214 |
$1,372 |
$666 |
$98 | |
| ERCP (bile duct endoscopy) |
$3,912 |
$5,047 |
$3,761 |
$311 | |
| Estradiol (estrogen) test |
$28 |
$254 |
$28 |
$28 | |
| Eyelid surgery (blepharoplasty) |
$2,071 |
$18,789 |
$2,496 |
$552 | |
| Family therapy session |
$175 |
$1,172 |
$227 |
$110 | |
| Fecal occult blood (stool) test |
$4 |
$61 |
$4 |
$10 | |
| Fecal occult blood (stool) test (guaiac, gFOBT) |
$4 |
$61 |
$4 |
$4 | |
| Feeding tube (PEG) placement |
$2,089 |
$6,513 |
$2,089 |
$178 | |
| Ferritin (iron) test |
$14 |
$141 |
$14 |
$14 | |
| Fibrinogen test |
$10 |
$103 |
$10 |
$10 | |
| Flexible sigmoidoscopy |
$997 |
$6,300 |
$1,004 |
$323 | |
| Flu test |
$17 |
$279 |
$17 |
$17 | |
| Flu vaccine |
— |
$23 |
$21 |
— | |
| Folate (folic acid) test |
$15 |
$141 |
$15 |
$15 | |
| Foreign body removal (skin) |
$448 |
$2,015 |
$448 |
$157 | |
| Free T4 thyroid test |
$9 |
$113 |
$9 |
$9 | |
| FSH hormone test |
$19 |
$195 |
$19 |
$19 | |
| Gallbladder removal (laparoscopic) |
$6,253 |
$7,975 |
$6,253 |
$658 | |
| Gallbladder scan (HIDA) |
$536 |
$1,350 |
$466 |
$334 | |
| Ganglion cyst removal |
$1,721 |
$6,323 |
$1,721 |
$321 | |
| GGT liver test |
$7 |
$43 |
$7 |
$7 | |
| Glucose tolerance test |
$13 |
$94 |
$13 |
$8 | |
| Group therapy session |
$91 |
$418 |
$91 |
$30 | |
| Hammertoe repair |
$3,571 |
$6,046 |
$3,571 |
$548 | |
| HDL cholesterol test |
$8 |
$61 |
$8 |
$8 | |
| Hearing test (audiometry) |
$174 |
$669 |
$174 |
$36 | |
| Hemoglobin A1c (diabetes test) |
$10 |
$103 |
$10 |
$10 | |
| Hepatitis A vaccine |
$82 |
$530 |
$82 |
— | |
| Hepatitis B test |
$10 |
$103 |
$13 |
$10 | |
| Hepatitis B vaccine |
— |
$50 |
$66 |
— | |
| Hepatitis C test |
$14 |
$226 |
$14 |
$14 | |
| HIV test |
$19 |
$197 |
$23 |
$19 | |
| HIV test (antibody) |
$14 |
$204 |
$16 |
$14 | |
| HIV test (antigen/antibody combo) |
$24 |
$189 |
$24 |
$24 | |
| Holter heart monitor |
$139 |
$415 |
$139 |
$26 | |
| Hydrocele repair |
$4,249 |
$6,493 |
$3,545 |
$315 | |
| Hysteroscopy |
$3,392 |
$11,440 |
$3,718 |
$1,270 | |
| Inguinal hernia repair |
$4,249 |
$9,811 |
$4,249 |
$538 | |
| Iron blood test |
$6 |
$61 |
$6 |
$6 | |
| IUD removal |
$350 |
$5,415 |
$350 |
$112 | |
| IV infusion therapy |
$248 |
$6,060 |
$412 |
$44 | |
| IV infusion therapy (initial) |
$248 |
$6,060 |
$412 |
$67 | |
| Joint aspiration (small/intermediate) |
$326 |
$2,001 |
$452 |
$57 | |
| Joint aspiration or injection (mid-size joint) |
$326 |
$2,245 |
$452 |
$57 | |
| Joint aspiration or injection (small joint) |
$326 |
$1,757 |
$452 |
$56 | |
| Kidney biopsy |
$1,799 |
$4,443 |
$1,799 |
$492 | |
| Kidney scan (nuclear) |
$605 |
$1,648 |
$605 |
$172 | |
| Kidney stone shock-wave (lithotripsy) |
$3,786 |
$9,006 |
$3,596 |
$760 | |
| Kidney ultrasound |
$128 |
$532 |
$128 |
$84 | |
| Kidney ultrasound (limited) |
$128 |
$532 |
$128 |
$61 | |
| Knee arthroscopy |
$3,571 |
$6,451 |
$3,571 |
$524 | |
| Knee joint injection |
$326 |
$1,335 |
$452 |
$69 | |
| Knee replacement |
— |
$56,986 |
$22,572 |
$18,054 | |
| Lactate test |
$12 |
$105 |
$12 |
$12 | |
| LDH test |
$6 |
$112 |
$6 |
$6 | |
| Leg artery angiogram |
$3,574 |
$8,483 |
$3,574 |
$149 | |
| Leg vein ultrasound (Doppler) |
$204 |
$856 |
$200 |
$150 | |
| Leg vein ultrasound (Doppler) (limited) |
$128 |
$908 |
$128 |
$116 | |
| LH hormone test |
$19 |
$168 |
$19 |
$19 | |
| Lipase test |
$7 |
$83 |
$7 |
$7 | |
| Lipid (cholesterol) panel |
$13 |
$147 |
$13 |
$13 | |
| Liver biopsy |
$1,799 |
$9,532 |
$1,799 |
$288 | |
| Lumpectomy (breast) |
$4,124 |
$16,199 |
$4,124 |
$750 | |
| Lung function test (PFT) |
$174 |
$938 |
$174 |
$37 | |
| Lung scan (V/Q) |
$605 |
$1,704 |
$605 |
$291 | |
| Magnesium blood test |
$7 |
$76 |
$7 |
$7 | |
| MMR vaccine |
$66 |
$517 |
$94 |
— | |
| MRA of the brain |
$280 |
$4,433 |
$397 |
$226 | |
| MRA of the neck |
$280 |
$2,957 |
$397 |
$245 | |
| MRI of the abdomen |
$361 |
$2,736 |
$505 |
$300 | |
| MRI of the abdomen without contrast |
$280 |
$2,218 |
$504 |
$194 | |
| MRI of the ankle |
$363 |
$2,735 |
$505 |
$261 | |
| MRI of the ankle without contrast |
$283 |
$2,512 |
$504 |
$222 | |
| MRI of the brain |
$442 |
$4,582 |
$505 |
$269 | |
| MRI of the brain with contrast |
$442 |
$4,774 |
$505 |
$269 | |
| MRI of the brain without contrast |
$280 |
$3,991 |
$504 |
$195 | |
| MRI of the knee |
$363 |
$3,390 |
$505 |
$315 | |
| MRI of the knee without contrast |
$283 |
$3,330 |
$504 |
$204 | |
| MRI of the lower back (lumbar spine) |
$361 |
$5,126 |
$505 |
$270 | |
| MRI of the lower back (lumbar spine) without contrast |
$280 |
$5,324 |
$503 |
$192 | |
| MRI of the mid-back (thoracic spine) |
$361 |
$5,126 |
$505 |
$271 | |
| MRI of the mid-back (thoracic spine) with and without contrast |
$442 |
$4,928 |
$505 |
$319 | |
| MRI of the mid-back (thoracic spine) without contrast |
$280 |
$5,324 |
$503 |
$190 | |
| MRI of the neck (cervical spine) |
$361 |
$3,499 |
$505 |
$274 | |
| MRI of the neck (cervical spine) with and without contrast |
$442 |
$3,450 |
$505 |
$318 | |
| MRI of the neck (cervical spine) without contrast |
$280 |
$3,548 |
$503 |
$191 | |
| MRI of the pelvis |
$361 |
$3,917 |
$505 |
$268 | |
| MRI of the pelvis without contrast |
$280 |
$3,694 |
$503 |
$227 | |
| MRI of the shoulder |
$280 |
$3,330 |
$504 |
$313 | |
| MRI of the shoulder without contrast |
$280 |
$3,330 |
$504 |
$205 | |
| MRI of the wrist |
$361 |
$3,204 |
$505 |
$330 | |
| MRI of the wrist without contrast |
$280 |
$2,957 |
$504 |
$303 | |
| Nebulizer breathing treatment |
$230 |
$466 |
$230 |
$9 | |
| Nuclear cardiac stress test |
$1,592 |
$4,558 |
$1,592 |
$428 | |
| Office visit (established patient) |
$129 |
$983 |
$153 |
$115 | |
| Office visit (new patient) |
$198 |
$1,485 |
$198 |
$177 | |
| Office visit, established patient (level 3) |
$107 |
$847 |
$139 |
$95 | |
| Office visit, established patient (level 4) |
$151 |
$1,118 |
$174 |
$136 | |
| Office visit, new patient (level 3) |
$135 |
$1,118 |
$150 |
$118 | |
| Office visit, new patient (level 4) |
$198 |
$1,485 |
$198 |
$177 | |
| Office visit, new patient (level 5) |
$261 |
$1,692 |
$269 |
$237 | |
| Orthopedic hardware removal |
$3,099 |
$5,419 |
$3,099 |
$632 | |
| Pap smear (cervical screening) |
$20 |
$156 |
$20 |
$20 | |
| Parathyroid hormone (PTH) test |
$41 |
$615 |
$41 |
$41 | |
| Pelvic ultrasound |
$128 |
$532 |
$128 |
$78 | |
| Pelvic ultrasound (complete) |
$128 |
$532 |
$128 |
$105 | |
| Phosphorus blood test |
$5 |
$88 |
$5 |
$5 | |
| Physical therapy evaluation |
$117 |
$669 |
$119 |
$98 | |
| Physical therapy evaluation (high complexity) |
$117 |
$708 |
$152 |
$98 | |
| Physical therapy evaluation (moderate complexity) |
$117 |
$669 |
$152 |
$98 | |
| Pilonidal cyst removal |
$3,099 |
$6,316 |
$3,099 |
$541 | |
| Pneumonia vaccine |
— |
$173 |
$72 |
— | |
| Pregnancy blood test (hCG) |
$8 |
$83 |
$8 |
$8 | |
| Pregnancy ultrasound |
$128 |
$532 |
$128 |
$126 | |
| Pregnancy ultrasound (first trimester) |
$128 |
$532 |
$128 |
$117 | |
| Pregnancy ultrasound (second or third trimester) |
$128 |
$532 |
$128 |
$136 | |
| Prolactin test |
$19 |
$218 |
$19 |
$19 | |
| Prostate biopsy |
$2,225 |
$10,043 |
$2,402 |
— | |
| Prostate surgery (TURP) |
$5,641 |
$8,718 |
$5,641 |
$526 | |
| Prostate test (PSA) |
$18 |
$118 |
$18 |
$18 | |
| Psychiatric evaluation |
$175 |
$976 |
$213 |
$188 | |
| Psychotherapy session |
$175 |
$807 |
$175 |
$140 | |
| Rheumatoid factor test |
$6 |
$61 |
$6 |
$6 | |
| Rotator cuff repair |
$7,936 |
$11,366 |
$7,936 |
$792 | |
| Scoliosis spine X-ray |
$116 |
$660 |
$104 |
$58 | |
| Scoliosis spine X-ray (1 view) |
$104 |
$496 |
$104 |
$44 | |
| Scoliosis spine X-ray (3 views) |
$128 |
$823 |
$128 |
$72 | |
| Screening colonoscopy |
$997 |
$4,252 |
$1,004 |
$378 | |
| Screening mammogram |
$114 |
$814 |
$114 |
$126 | |
| Scrotal ultrasound |
$128 |
$532 |
$128 |
$99 | |
| Sedimentation rate (ESR) test |
$4 |
$61 |
$4 |
$3 | |
| Sex hormone binding globulin test |
$21 |
$213 |
$21 |
$22 | |
| Simple laceration repair (small, up to 2.5 cm) |
$217 |
$857 |
$470 |
$114 | |
| Simple wound stitches |
$217 |
$857 |
$470 |
$127 | |
| Skin biopsy |
$448 |
$1,363 |
$679 |
$121 | |
| Skin biopsy (punch) |
$448 |
$1,363 |
$679 |
$121 | |
| Skin graft |
$2,071 |
$6,241 |
$2,071 |
$898 | |
| Skin lesion freezing (cryotherapy) |
$217 |
$606 |
$353 |
$36 | |
| Skin tag removal |
$217 |
$7,202 |
$418 |
$92 | |
| Soft tissue ultrasound |
$128 |
$668 |
$128 |
$64 | |
| Spinal tap (lumbar puncture) |
$773 |
$1,210 |
$773 |
$165 | |
| Spirometry (lung function test) |
$174 |
$772 |
$174 |
$30 | |
| Spirometry with bronchodilator |
$336 |
$1,714 |
$336 |
$43 | |
| Strep throat test |
$17 |
$72 |
$17 |
$17 | |
| Stress echocardiogram |
$604 |
$1,689 |
$604 |
$209 | |
| Stress echocardiogram (complete) |
$604 |
$1,689 |
$604 |
$233 | |
| T3 thyroid test |
$14 |
$147 |
$14 |
$14 | |
| Tdap (tetanus) vaccine |
$66 |
$494 |
$82 |
— | |
| Testosterone test |
$26 |
$276 |
$26 |
$26 | |
| Thyroid test (TSH) |
$17 |
$245 |
$17 |
$17 | |
| Thyroid ultrasound |
$128 |
$532 |
$128 |
$109 | |
| Thyroid uptake scan |
$466 |
$875 |
$466 |
$145 | |
| Total IgE allergy test |
$16 |
$156 |
$16 |
$16 | |
| Total protein test |
$4 |
$61 |
$5 |
$4 | |
| Transvaginal ultrasound |
$128 |
$532 |
$128 |
$118 | |
| Trigger finger release |
$1,721 |
$5,726 |
$1,721 |
$630 | |
| Trigger point injection |
$326 |
$1,757 |
$452 |
$56 | |
| Trigger point injection (1-2 muscles) |
$326 |
$1,757 |
$452 |
$52 | |
| Triglycerides test |
$6 |
$61 |
$6 |
$6 | |
| Troponin (heart) test |
$12 |
$61 |
$12 |
$12 | |
| Upper GI endoscopy (EGD) |
$990 |
$4,864 |
$1,546 |
$371 | |
| Upper GI series (barium) |
$216 |
$1,086 |
$216 |
$128 | |
| Ureteral stent placement |
$3,845 |
$6,716 |
$3,845 |
$373 | |
| Ureteroscopy (stone removal) |
$5,641 |
$7,076 |
$5,641 |
$365 | |
| Uric acid (gout) test |
$5 |
$61 |
$5 |
$5 | |
| Urine microalbumin test |
$5 |
$59 |
$6 |
$5 | |
| Urine pregnancy test |
$9 |
$119 |
$9 |
$9 | |
| Vaccine administration |
$81 |
$279 |
$76 |
$19 | |
| Vaccine administration (each additional) |
$81 |
$177 |
$57 |
$16 | |
| Varicocele repair |
$3,845 |
$6,034 |
$3,489 |
$327 | |
| Vitamin B12 test |
$15 |
$113 |
$15 |
$15 | |
| Vitamin D test |
$30 |
$226 |
$30 |
$30 | |
| Wart removal |
$217 |
$691 |
$428 |
$121 | |
| Well-child visit |
$50 |
$1,251 |
$100 |
— | |
| Wound debridement |
$572 |
$4,351 |
$916 |
$186 | |
| X-ray of the abdomen |
$128 |
$435 |
$104 |
$36 | |
| X-ray of the ankle |
$104 |
$228 |
$104 |
$37 | |
| X-ray of the collarbone |
$104 |
$228 |
$104 |
$33 | |
| X-ray of the elbow |
$104 |
$228 |
$104 |
$33 | |
| X-ray of the facial bones |
$128 |
$359 |
$128 |
$39 | |
| X-ray of the foot |
$104 |
$228 |
$104 |
$34 | |
| X-ray of the forearm |
$104 |
$228 |
$104 |
$29 | |
| X-ray of the hand |
$104 |
$228 |
$104 |
$38 | |
| X-ray of the hip |
$104 |
$496 |
$104 |
$49 | |
| X-ray of the hip (1 view) |
$104 |
$496 |
$104 |
$34 | |
| X-ray of the hip (3 views) |
$104 |
$496 |
$104 |
$49 | |
| X-ray of the hip (4 views) |
$128 |
$823 |
$128 |
$63 | |
| X-ray of the knee |
$104 |
$282 |
$104 |
$42 | |
| X-ray of the knee (2 views) |
$104 |
$228 |
$104 |
$34 | |
| X-ray of the knee (3 views) |
$104 |
$282 |
$104 |
$42 | |
| X-ray of the knee (4+ views) |
$128 |
$333 |
$128 |
$49 | |
| X-ray of the lower back (lumbar spine) |
$128 |
$359 |
$128 |
$47 | |
| X-ray of the lower back (lumbar spine) (4+ views) |
$128 |
$359 |
$128 |
$53 | |
| X-ray of the lower leg |
$104 |
$425 |
$104 |
$31 | |
| X-ray of the mid-back (thoracic spine) |
$128 |
$263 |
$128 |
$36 | |
| X-ray of the mid-back (thoracic spine) (2 views) |
$128 |
$263 |
$128 |
$33 | |
| X-ray of the neck (cervical spine) |
$104 |
$306 |
$104 |
$47 | |
| X-ray of the neck (cervical spine) (3 views) |
$104 |
$306 |
$104 |
$40 | |
| X-ray of the pelvis |
$128 |
$325 |
$128 |
$36 | |
| X-ray of the pelvis (1 view) |
$128 |
$325 |
$128 |
$28 | |
| X-ray of the ribs |
$128 |
$359 |
$128 |
$42 | |
| X-ray of the ribs (3 views) |
$128 |
$359 |
$128 |
$42 | |
| X-ray of the shoulder |
$104 |
$285 |
$104 |
$36 | |
| X-ray of the skull |
$128 |
$321 |
$128 |
$40 | |
| X-ray of the upper arm |
$104 |
$228 |
$104 |
$32 | |
| X-ray of the wrist |
$104 |
$285 |
$104 |
$43 | |
| Zinc blood test |
$11 |
$128 |
$11 |
$11 | |