| Abdominal ultrasound |
$1,772 |
$1,772 |
— |
$100 | |
| Abdominal ultrasound (complete) |
$1,887 |
$1,887 |
— |
$114 | |
| Abdominal ultrasound (limited) |
$1,656 |
$1,656 |
— |
$86 | |
| Abscess drainage (simple) |
$1,255 |
$1,255 |
— |
$129 | |
| Abscess incision and drainage |
$1,255 |
$1,255 |
— |
$174 | |
| Achilles tendon repair |
— |
— |
$13,400 |
$624 | |
| ACL knee reconstruction |
— |
— |
$22,793 |
$889 | |
| Adenoid removal (adenoidectomy) |
— |
— |
$11,803 |
$204 | |
| Albumin blood test |
$97 |
$97 |
— |
$5 | |
| Alkaline phosphatase test |
$94 |
$94 |
— |
$5 | |
| Alpha-fetoprotein (AFP) test |
$176 |
$176 |
— |
$17 | |
| ALT liver enzyme test |
$112 |
$112 |
— |
$5 | |
| Ammonia blood test |
$387 |
$387 |
— |
$15 | |
| Amylase test |
$220 |
$220 |
— |
$6 | |
| Anal fistula repair |
— |
— |
$6,425 |
$541 | |
| Ankle fracture repair |
— |
— |
$14,616 |
$608 | |
| Antinuclear antibody (ANA) test |
$98 |
$98 |
— |
$12 | |
| Arterial blood gas (ABG) |
$755 |
$755 |
— |
$26 | |
| AST liver enzyme test |
$114 |
$114 |
— |
$5 | |
| Basic metabolic panel |
$383 |
$383 |
— |
$8 | |
| Bilirubin blood test |
$123 |
$123 |
— |
$5 | |
| Bladder scope (cystoscopy) |
— |
— |
$1,793 |
$216 | |
| Bladder tumor removal (TURBT) |
— |
— |
$7,449 |
$236 | |
| Blood clotting test (PT/INR) |
$158 |
$158 |
— |
$4 | |
| Blood glucose test |
$102 |
$102 |
— |
$5 | |
| BNP (heart failure) test |
$566 |
$566 |
— |
$39 | |
| Bone marrow biopsy |
— |
— |
$9,672 |
$172 | |
| Bone scan (nuclear) |
$4,089 |
$4,089 |
— |
$259 | |
| Breast biopsy |
— |
— |
$6,797 |
$478 | |
| Breast MRI |
— |
— |
$5,193 |
$216 | |
| Breast MRI without contrast |
— |
— |
$5,123 |
$216 | |
| Breast reduction |
— |
— |
$12,711 |
$980 | |
| Breast ultrasound |
$1,468 |
$1,468 |
— |
$92 | |
| Breast ultrasound (complete) |
$1,637 |
$1,637 |
— |
$100 | |
| Breast ultrasound (limited) |
$1,298 |
$1,298 |
— |
$84 | |
| Bunion surgery (bunionectomy) |
— |
— |
$20,945 |
$883 | |
| C-reactive protein (CRP) |
$177 |
$177 |
— |
$5 | |
| CA 19-9 tumor marker test |
$212 |
$212 |
— |
$21 | |
| CA-125 ovarian marker test |
$257 |
$257 |
— |
$21 | |
| Calcium blood test |
$110 |
$110 |
— |
$5 | |
| Carotid artery ultrasound |
$2,747 |
$2,747 |
— |
$156 | |
| Carpal tunnel release |
— |
— |
$4,903 |
$483 | |
| Cataract surgery |
— |
— |
$6,257 |
$547 | |
| Cervical LEEP procedure |
— |
— |
$5,694 |
$325 | |
| Chest X-ray |
$771 |
$771 |
— |
$37 | |
| Chest X-ray (1 view) |
$738 |
$738 |
— |
$25 | |
| Chest X-ray (2 views) |
$804 |
$804 |
— |
$33 | |
| Circumcision |
— |
— |
$6,146 |
$167 | |
| CK-MB heart enzyme test |
$377 |
$377 |
— |
$12 | |
| Clotting time test (PTT) |
$221 |
$221 |
— |
$6 | |
| Colonoscopy |
— |
— |
$2,855 |
$480 | |
| Complete blood count (CBC) |
$198 |
$198 |
— |
$7 | |
| Complete blood count (CBC) (complete) |
$217 |
$217 |
— |
$8 | |
| Comprehensive metabolic panel |
$471 |
$471 |
— |
$11 | |
| Coronary artery bypass (CABG) |
— |
— |
$180,605 |
$36,593 | |
| Coronary CT angiography |
— |
— |
$2,793 |
$326 | |
| Cortisol test |
$283 |
$283 |
— |
$16 | |
| COVID-19 PCR test |
$360 |
$360 |
— |
$51 | |
| Creatine kinase (CK) test |
$243 |
$243 |
— |
$7 | |
| CT angiography of the chest |
— |
— |
$4,642 |
$281 | |
| CT angiography of the head |
— |
— |
$4,446 |
$274 | |
| CT scan of the abdomen |
— |
— |
$1,729 |
$230 | |
| CT scan of the abdomen and pelvis |
$8,287 |
$8,287 |
$5,169 |
$300 | |
| CT scan of the abdomen and pelvis with and without contrast |
— |
— |
$5,952 |
$338 | |
| CT scan of the abdomen and pelvis with contrast |
$8,287 |
$8,287 |
$5,590 |
$300 | |
| CT scan of the abdomen and pelvis without contrast |
— |
— |
$4,585 |
$183 | |
| CT scan of the abdomen with and without contrast |
— |
— |
$2,345 |
$259 | |
| CT scan of the abdomen with contrast |
— |
— |
$1,773 |
$230 | |
| CT scan of the abdomen without contrast |
— |
— |
$1,322 |
$136 | |
| CT scan of the arm |
— |
— |
$1,280 |
$199 | |
| CT scan of the arm without contrast |
— |
— |
$1,280 |
$161 | |
| CT scan of the chest |
$5,153 |
$5,153 |
$1,517 |
$167 | |
| CT scan of the chest with contrast |
$5,153 |
$5,153 |
$1,710 |
$167 | |
| CT scan of the chest without contrast |
— |
— |
$1,401 |
$133 | |
| CT scan of the head |
$4,869 |
$4,869 |
$1,184 |
$148 | |
| CT scan of the head with and without contrast |
$5,345 |
$5,345 |
$1,700 |
$173 | |
| CT scan of the head with contrast |
$4,869 |
$4,869 |
— |
$148 | |
| CT scan of the head without contrast |
$4,312 |
$4,312 |
$1,092 |
$107 | |
| CT scan of the leg |
$4,106 |
$4,106 |
$1,280 |
$166 | |
| CT scan of the leg without contrast |
$4,106 |
$4,106 |
$1,280 |
$130 | |
| CT scan of the lower back (lumbar spine) |
— |
— |
$1,396 |
$169 | |
| CT scan of the lower back (lumbar spine) without contrast |
— |
— |
$1,396 |
$130 | |
| CT scan of the neck |
— |
— |
$1,539 |
$183 | |
| CT scan of the neck (cervical spine) |
$5,058 |
$5,058 |
$1,402 |
$168 | |
| CT scan of the neck (cervical spine) without contrast |
$5,058 |
$5,058 |
$1,402 |
$131 | |
| CT scan of the neck with contrast |
— |
— |
$1,539 |
$183 | |
| CT scan of the pelvis |
— |
— |
$1,590 |
$226 | |
| CT scan of the pelvis with and without contrast |
— |
— |
$2,122 |
$251 | |
| CT scan of the pelvis with contrast |
— |
— |
$1,635 |
$226 | |
| CT scan of the pelvis without contrast |
— |
— |
$1,355 |
$133 | |
| CT scan of the sinuses |
$4,272 |
$4,272 |
$1,293 |
$152 | |
| CT scan of the sinuses without contrast |
$4,272 |
$4,272 |
$1,293 |
$128 | |
| D-dimer test |
$349 |
$349 |
— |
$10 | |
| DHEA-sulfate test |
$144 |
$144 |
— |
$22 | |
| Dialysis fistula creation |
— |
— |
$18,788 |
$601 | |
| Dilation and curettage (D&C) |
— |
— |
$5,694 |
$298 | |
| Droopy eyelid repair (ptosis) |
— |
— |
$13,291 |
$745 | |
| Drug screen (urine) |
$735 |
$735 |
— |
$17 | |
| Ear tubes (myringotomy) |
— |
— |
$4,318 |
$174 | |
| Eardrum repair (tympanoplasty) |
— |
— |
$11,902 |
$799 | |
| Echocardiogram |
$4,223 |
$4,223 |
— |
$138 | |
| EEG (awake and asleep) |
$2,191 |
$2,191 |
— |
$482 | |
| EKG / ECG (tracing only) |
$614 |
$614 |
— |
$7 | |
| Electrocardiogram (EKG) |
$614 |
$614 |
— |
$8 | |
| Electroencephalogram (EEG) |
$2,191 |
$2,191 |
— |
$448 | |
| Electrolyte panel |
$208 |
$208 |
— |
$7 | |
| Epidural steroid injection |
— |
— |
$2,425 |
$275 | |
| Estradiol (estrogen) test |
$256 |
$256 |
— |
$28 | |
| Eyelid surgery (blepharoplasty) |
— |
— |
$5,073 |
$552 | |
| Facet joint injection (spine) |
— |
— |
$1,972 |
$99 | |
| Family therapy session |
$668 |
$668 |
— |
$110 | |
| Fecal occult blood (stool) test |
$105 |
$105 |
— |
$10 | |
| Fecal occult blood (stool) test (guaiac, gFOBT) |
$96 |
$96 |
— |
$4 | |
| Fecal occult blood (stool) test (immunochemical, FIT) |
$114 |
$114 |
— |
$16 | |
| Ferritin (iron) test |
$256 |
$256 |
— |
$14 | |
| Flexible sigmoidoscopy |
— |
— |
$1,914 |
$323 | |
| Folate (folic acid) test |
$231 |
$231 |
— |
$15 | |
| Free T4 thyroid test |
$231 |
$231 |
— |
$9 | |
| FSH hormone test |
$234 |
$234 |
— |
$19 | |
| Gallbladder removal (laparoscopic) |
— |
— |
$12,642 |
$658 | |
| Ganglion cyst removal |
— |
— |
$5,464 |
$321 | |
| GGT liver test |
$143 |
$143 |
— |
$7 | |
| Group therapy session |
$289 |
$289 |
— |
$30 | |
| Hammertoe repair |
— |
— |
$5,968 |
$548 | |
| HDL cholesterol test |
$126 |
$126 |
— |
$8 | |
| Hematocrit test |
$98 |
$98 |
— |
$2 | |
| Hemoglobin A1c (diabetes test) |
$203 |
$203 |
— |
$10 | |
| Hepatitis A vaccine |
— |
— |
$166 |
— | |
| Hepatitis B test |
$147 |
$147 |
— |
$10 | |
| Hepatitis B vaccine |
— |
— |
$162 |
— | |
| Hepatitis C test |
$182 |
$182 |
— |
$14 | |
| Hip arthroscopy |
— |
— |
$42,642 |
$931 | |
| HIV test |
$236 |
$236 |
— |
$19 | |
| HIV test (antibody) |
$172 |
$172 |
— |
$14 | |
| HIV test (antigen/antibody combo) |
$299 |
$299 |
— |
$24 | |
| Hydrocele repair |
— |
— |
$14,612 |
$315 | |
| Hysterectomy |
— |
— |
$38,066 |
$933 | |
| Hysteroscopy |
— |
— |
$6,249 |
$1,270 | |
| Inguinal hernia repair |
— |
— |
$9,214 |
$538 | |
| Iron blood test |
$140 |
$140 |
— |
$6 | |
| IUD removal |
— |
— |
$857 |
$112 | |
| Kidney biopsy |
— |
— |
$7,765 |
$492 | |
| Kidney stone shock-wave (lithotripsy) |
— |
— |
$11,223 |
$760 | |
| Kidney ultrasound |
$1,411 |
$1,411 |
— |
$84 | |
| Kidney ultrasound (limited) |
$1,253 |
$1,253 |
— |
$61 | |
| Knee arthroscopy |
— |
— |
$7,642 |
$524 | |
| Knee joint injection |
— |
— |
$857 |
$69 | |
| Knee replacement |
— |
— |
$88,902 |
$18,054 | |
| Lactate test |
$313 |
$313 |
— |
$12 | |
| Laminectomy (spine) |
— |
— |
$29,539 |
$1,157 | |
| LDH test |
$157 |
$157 |
— |
$6 | |
| LDL cholesterol test |
$129 |
$129 |
— |
$11 | |
| Leg vein ultrasound (Doppler) |
$2,316 |
$2,316 |
— |
$150 | |
| Leg vein ultrasound (Doppler) (limited) |
$1,927 |
$1,927 |
— |
$116 | |
| LH hormone test |
$314 |
$314 |
— |
$19 | |
| Lipase test |
$275 |
$275 |
— |
$7 | |
| Lipid (cholesterol) panel |
$343 |
$343 |
— |
$13 | |
| Liver function panel |
$309 |
$309 |
— |
$8 | |
| Lumbar discectomy |
— |
— |
$27,638 |
$898 | |
| Lumpectomy (breast) |
— |
— |
$11,648 |
$750 | |
| Lung scan (V/Q) |
$4,296 |
$4,296 |
— |
$291 | |
| Magnesium blood test |
$219 |
$219 |
— |
$7 | |
| Meniscus repair (knee) |
— |
— |
$7,642 |
$714 | |
| MRA of the brain |
— |
— |
$3,099 |
$226 | |
| MRI of the abdomen |
— |
— |
$4,570 |
$300 | |
| MRI of the abdomen without contrast |
— |
— |
$3,782 |
$194 | |
| MRI of the ankle |
— |
— |
$2,891 |
$261 | |
| MRI of the ankle without contrast |
— |
— |
$2,891 |
$222 | |
| MRI of the brain |
$6,908 |
$6,908 |
$3,180 |
$269 | |
| MRI of the brain without contrast |
$5,481 |
$5,481 |
$2,930 |
$195 | |
| MRI of the knee |
— |
— |
$2,847 |
$315 | |
| MRI of the knee without contrast |
— |
— |
$2,847 |
$204 | |
| MRI of the lower back (lumbar spine) |
$5,217 |
$5,217 |
$3,089 |
$270 | |
| MRI of the lower back (lumbar spine) without contrast |
$5,217 |
$5,217 |
$2,849 |
$192 | |
| MRI of the mid-back (thoracic spine) |
— |
— |
$3,093 |
$271 | |
| MRI of the mid-back (thoracic spine) with and without contrast |
— |
— |
$4,735 |
$319 | |
| MRI of the mid-back (thoracic spine) without contrast |
— |
— |
$2,852 |
$190 | |
| MRI of the neck (cervical spine) |
— |
— |
$2,931 |
$274 | |
| MRI of the neck (cervical spine) with and without contrast |
— |
— |
$4,918 |
$318 | |
| MRI of the neck (cervical spine) without contrast |
— |
— |
$2,703 |
$191 | |
| MRI of the pelvis |
$5,220 |
$5,220 |
$3,164 |
$268 | |
| MRI of the pelvis with contrast |
$5,220 |
$5,220 |
— |
$268 | |
| MRI of the pelvis without contrast |
— |
— |
$2,912 |
$227 | |
| MRI of the shoulder |
— |
— |
$2,808 |
$313 | |
| MRI of the shoulder without contrast |
— |
— |
$2,808 |
$205 | |
| MRI of the wrist |
— |
— |
$2,932 |
$330 | |
| MRI of the wrist without contrast |
— |
— |
$2,932 |
$303 | |
| Nebulizer breathing treatment |
$685 |
$685 |
— |
$9 | |
| Occupational therapy evaluation |
$566 |
$566 |
— |
$101 | |
| Occupational therapy evaluation (low complexity) |
$508 |
$508 |
— |
$101 | |
| Occupational therapy evaluation (moderate complexity) |
$624 |
$624 |
— |
$101 | |
| Orthopedic hardware removal |
— |
— |
$5,870 |
$632 | |
| Ovarian cyst removal |
— |
— |
$29,466 |
$698 | |
| Pacemaker insertion |
— |
— |
$99,323 |
$15,506 | |
| Parathyroid removal |
— |
— |
$29,384 |
$891 | |
| Pelvic ultrasound |
$1,270 |
$1,270 |
— |
$78 | |
| Pelvic ultrasound (complete) |
$1,596 |
$1,596 |
— |
$105 | |
| Pelvic ultrasound (limited) |
$944 |
$944 |
— |
$51 | |
| PET scan |
$10,163 |
$10,163 |
— |
— | |
| Phosphorus blood test |
$142 |
$142 |
— |
$5 | |
| Physical therapy evaluation |
$527 |
$527 |
— |
$98 | |
| Physical therapy evaluation (moderate complexity) |
$558 |
$558 |
— |
$98 | |
| Pilonidal cyst removal |
— |
— |
$14,466 |
$541 | |
| Platelet count |
$140 |
$140 |
— |
$4 | |
| Pneumonia vaccine |
— |
— |
$307 |
— | |
| Pregnancy blood test (hCG) |
$278 |
$278 |
— |
$8 | |
| Pregnancy ultrasound |
$1,625 |
$1,625 |
— |
$126 | |
| Pregnancy ultrasound (first trimester) |
$1,625 |
$1,625 |
— |
$117 | |
| Prolactin test |
$262 |
$262 |
— |
$19 | |
| Prostate biopsy |
— |
— |
$12,227 |
— | |
| Prostate removal (prostatectomy) |
— |
— |
$62,147 |
$1,063 | |
| Prostate surgery (TURP) |
— |
— |
$22,198 |
$526 | |
| Prostate test (PSA) |
$242 |
$242 |
— |
$18 | |
| Psychiatric evaluation |
$516 |
$516 |
— |
$188 | |
| Psychotherapy session |
$597 |
$597 |
— |
$140 | |
| Rheumatoid factor test |
$136 |
$136 |
— |
$6 | |
| Rotator cuff repair |
— |
— |
$13,565 |
$792 | |
| Screening colonoscopy |
— |
— |
$2,496 |
$378 | |
| Scrotal ultrasound |
$1,448 |
$1,448 |
— |
$99 | |
| Sedimentation rate (ESR) test |
$125 |
$125 |
— |
$3 | |
| Septoplasty (deviated septum) |
— |
— |
$6,561 |
$613 | |
| Sex hormone binding globulin test |
$172 |
$172 |
— |
$22 | |
| Shoulder arthroscopy |
— |
— |
$15,091 |
$962 | |
| Sinus surgery (endoscopic) |
— |
— |
$10,376 |
$224 | |
| Skin lesion freezing (cryotherapy) |
— |
— |
$857 |
$36 | |
| Soft tissue ultrasound |
$798 |
$798 |
— |
$64 | |
| Strabismus (eye muscle) surgery |
— |
— |
$6,159 |
$475 | |
| Stress echocardiogram |
$4,073 |
$4,073 |
— |
$209 | |
| Stress echocardiogram (complete) |
$4,168 |
$4,168 |
— |
$233 | |
| Swallow study |
$778 |
$778 |
— |
$85 | |
| T3 thyroid test |
$191 |
$191 |
— |
$14 | |
| Tdap (tetanus) vaccine |
$381 |
$381 |
$90 |
— | |
| Testosterone test |
$141 |
$141 |
— |
$26 | |
| Thyroid removal (thyroidectomy) |
— |
— |
$33,263 |
$1,004 | |
| Thyroid test (TSH) |
$313 |
$313 |
— |
$17 | |
| Thyroid ultrasound |
$1,368 |
$1,368 |
— |
$109 | |
| Tonsillectomy |
— |
— |
$7,015 |
$252 | |
| Total IgE allergy test |
$185 |
$185 |
— |
$16 | |
| Total protein test |
$53 |
$53 |
— |
$4 | |
| Trigger finger release |
— |
— |
$4,429 |
$630 | |
| Trigger point injection |
— |
— |
$857 |
$56 | |
| Triglycerides test |
$162 |
$162 |
— |
$6 | |
| Troponin (heart) test |
$463 |
$463 |
— |
$12 | |
| Tubal ligation |
— |
— |
$12,642 |
$333 | |
| Turbinate reduction |
— |
— |
$6,553 |
$294 | |
| Ulnar nerve surgery (elbow) |
— |
— |
$4,903 |
$575 | |
| Umbilical hernia repair |
— |
— |
$11,640 |
— | |
| Upper GI endoscopy (EGD) |
— |
— |
$2,598 |
$371 | |
| Ureteral stent placement |
— |
— |
$7,111 |
$373 | |
| Ureteroscopy (stone removal) |
— |
— |
$21,923 |
$365 | |
| Uric acid (gout) test |
$134 |
$134 |
— |
$5 | |
| Urinalysis |
$119 |
$119 |
— |
$3 | |
| Urine microalbumin test |
$113 |
$113 |
— |
$5 | |
| Urine pregnancy test |
$190 |
$190 |
— |
$9 | |
| Varicocele repair |
— |
— |
$18,015 |
$327 | |
| Vasectomy |
— |
— |
$6,146 |
$347 | |
| Vitamin B12 test |
$228 |
$228 |
— |
$15 | |
| Vitamin D test |
$274 |
$274 |
— |
$30 | |
| Wrist fracture repair |
— |
— |
$17,943 |
$735 | |
| X-ray of the abdomen |
$666 |
$666 |
— |
$36 | |
| X-ray of the ankle |
$1,300 |
$1,300 |
— |
$37 | |
| X-ray of the collarbone |
$1,088 |
$1,088 |
— |
$33 | |
| X-ray of the elbow |
$1,265 |
$1,265 |
— |
$33 | |
| X-ray of the facial bones |
$791 |
$791 |
— |
$39 | |
| X-ray of the foot |
$1,377 |
$1,377 |
— |
$34 | |
| X-ray of the forearm |
$1,288 |
$1,288 |
— |
$29 | |
| X-ray of the hand |
$1,329 |
$1,329 |
— |
$38 | |
| X-ray of the hip |
$768 |
$768 |
— |
$49 | |
| X-ray of the hip (1 view) |
$685 |
$685 |
— |
$34 | |
| X-ray of the hip (3 views) |
$768 |
$768 |
— |
$49 | |
| X-ray of the hip (4 views) |
$1,048 |
$1,048 |
— |
$63 | |
| X-ray of the knee |
$1,431 |
$1,431 |
— |
$42 | |
| X-ray of the knee (2 views) |
$1,064 |
$1,064 |
— |
$34 | |
| X-ray of the knee (3 views) |
$1,431 |
$1,431 |
— |
$42 | |
| X-ray of the knee (4+ views) |
$1,537 |
$1,537 |
— |
$49 | |
| X-ray of the lower back (lumbar spine) |
$1,059 |
$1,059 |
— |
$47 | |
| X-ray of the lower back (lumbar spine) (2 views) |
$966 |
$966 |
— |
$40 | |
| X-ray of the lower back (lumbar spine) (4+ views) |
$1,151 |
$1,151 |
— |
$53 | |
| X-ray of the lower leg |
$1,144 |
$1,144 |
— |
$31 | |
| X-ray of the mid-back (thoracic spine) |
$956 |
$956 |
— |
$36 | |
| X-ray of the mid-back (thoracic spine) (2 views) |
$932 |
$932 |
— |
$33 | |
| X-ray of the mid-back (thoracic spine) (3 views) |
$980 |
$980 |
— |
$39 | |
| X-ray of the neck (cervical spine) |
$1,020 |
$1,020 |
— |
$47 | |
| X-ray of the neck (cervical spine) (3 views) |
$864 |
$864 |
— |
$40 | |
| X-ray of the pelvis |
$770 |
$770 |
— |
$36 | |
| X-ray of the pelvis (1 view) |
$770 |
$770 |
— |
$28 | |
| X-ray of the ribs |
$987 |
$987 |
— |
$42 | |
| X-ray of the ribs (2 views) |
$756 |
$756 |
— |
$36 | |
| X-ray of the ribs (3 views) |
$1,011 |
$1,011 |
— |
$42 | |
| X-ray of the shoulder |
$1,335 |
$1,335 |
— |
$36 | |
| X-ray of the skull |
$960 |
$960 |
— |
$40 | |
| X-ray of the upper arm |
$866 |
$866 |
— |
$32 | |
| X-ray of the wrist |
$1,294 |
$1,294 |
— |
$43 | |
| YAG laser capsulotomy (eye) |
— |
— |
$1,423 |
$335 | |