| Abdominal ultrasound |
$310 |
$310 |
$217 |
$100 | |
| Abdominal ultrasound (complete) |
$279 |
$279 |
$159 |
$114 | |
| Abdominal ultrasound (limited) |
$310 |
$310 |
$225 |
$86 | |
| Abscess drainage (complex or multiple) |
$200 |
$200 |
$158 |
$220 | |
| Abscess drainage (simple) |
$532 |
$532 |
$172 |
$129 | |
| Abscess incision and drainage |
$200 |
$200 |
$171 |
$174 | |
| Albumin blood test |
$53 |
$53 |
$29 |
$5 | |
| Alkaline phosphatase test |
$93 |
$93 |
$68 |
$5 | |
| Alpha-fetoprotein (AFP) test |
$140 |
$140 |
$102 |
$17 | |
| ALT liver enzyme test |
$41 |
$41 |
$29 |
$5 | |
| Ammonia blood test |
$94 |
$94 |
$69 |
$15 | |
| Amylase test |
$72 |
$72 |
$52 |
$6 | |
| Annual physical (established patient) |
$170 |
$170 |
$123 |
— | |
| Annual physical (new patient) |
$190 |
$190 |
$138 |
— | |
| Antinuclear antibody (ANA) test |
$65 |
$65 |
$48 |
$12 | |
| Arterial blood gas (ABG) |
$151 |
$151 |
$110 |
$26 | |
| AST liver enzyme test |
$51 |
$51 |
$37 |
$5 | |
| Basic metabolic panel |
$110 |
$110 |
$80 |
$8 | |
| Benign skin lesion removal |
$140 |
$140 |
$103 |
$171 | |
| Bilirubin blood test |
$79 |
$79 |
$57 |
$5 | |
| Blood clotting test (PT/INR) |
$57 |
$57 |
$42 |
$4 | |
| Blood crossmatch |
$54 |
$54 |
$30 |
— | |
| Blood glucose test |
$29 |
$29 |
$21 |
$5 | |
| Blood transfusion |
$886 |
$886 |
$643 |
$47 | |
| Blood type and screen |
$74 |
$74 |
$54 |
$10 | |
| Blood type test |
$148 |
$148 |
$76 |
$3 | |
| Blood type test (ABO group) |
$243 |
$243 |
$176 |
$3 | |
| Blood type test (Rh/D antigen) |
$53 |
$53 |
$39 |
$3 | |
| BNP (heart failure) test |
$154 |
$154 |
$91 |
$39 | |
| Breast ultrasound |
$525 |
$525 |
$381 |
$92 | |
| Breast ultrasound (complete) |
$525 |
$525 |
$381 |
$100 | |
| Breathing tube insertion (intubation) |
$786 |
$786 |
$570 |
$133 | |
| Burn dressing and debridement (small) |
$287 |
$287 |
$54 |
$93 | |
| Burn treatment |
$287 |
$287 |
$54 |
$129 | |
| C-reactive protein (CRP) |
$40 |
$40 |
$29 |
$5 | |
| CA 19-9 tumor marker test |
$259 |
$259 |
$202 |
$21 | |
| CA-125 ovarian marker test |
$268 |
$268 |
$195 |
$21 | |
| Calcium blood test |
$106 |
$106 |
$77 |
$5 | |
| Cardiac event monitor |
$450 |
$450 |
$327 |
$170 | |
| Cardioversion |
$419 |
$419 |
$304 |
$155 | |
| Carotid artery ultrasound |
$493 |
$493 |
$358 |
$156 | |
| CEA tumor marker test |
$136 |
$136 |
$99 |
$19 | |
| Central line placement |
$2,822 |
$2,822 |
$2,046 |
$238 | |
| Chest tube insertion |
$700 |
$700 |
$508 |
$143 | |
| Chest X-ray |
$180 |
$180 |
$144 |
$37 | |
| Chest X-ray (1 view) |
$156 |
$156 |
$113 |
$25 | |
| Chest X-ray (2 views) |
$180 |
$180 |
$126 |
$33 | |
| Chickenpox (varicella) vaccine |
$300 |
$300 |
$218 |
— | |
| CK-MB heart enzyme test |
$96 |
$96 |
$70 |
$12 | |
| Clotting time test (PTT) |
$58 |
$58 |
$43 |
$6 | |
| Complete blood count (CBC) |
$53 |
$53 |
$35 |
$7 | |
| Complete blood count (CBC) (complete) |
$36 |
$36 |
$27 |
$8 | |
| Comprehensive metabolic panel |
$155 |
$155 |
$113 |
$11 | |
| Contraceptive implant (Nexplanon) |
$75 |
$75 |
$55 |
$115 | |
| Cortisol test |
$72 |
$72 |
$52 |
$16 | |
| COVID-19 PCR test |
$200 |
$200 |
$145 |
$51 | |
| Creatine kinase (CK) test |
$40 |
$40 |
$29 |
$7 | |
| CT angiography of the chest |
$1,310 |
$1,310 |
$950 |
$281 | |
| CT angiography of the head |
$3,636 |
$3,636 |
$2,636 |
$274 | |
| CT scan of the abdomen |
$1,265 |
$1,265 |
$1,033 |
$230 | |
| CT scan of the abdomen and pelvis |
$1,882 |
$1,882 |
$1,349 |
$300 | |
| CT scan of the abdomen and pelvis with and without contrast |
$1,927 |
$1,927 |
$1,397 |
$338 | |
| CT scan of the abdomen and pelvis with contrast |
$1,882 |
$1,882 |
$1,365 |
$300 | |
| CT scan of the abdomen and pelvis without contrast |
$1,565 |
$1,565 |
$1,135 |
$183 | |
| CT scan of the abdomen with and without contrast |
$1,475 |
$1,475 |
$1,070 |
$259 | |
| CT scan of the abdomen without contrast |
$1,054 |
$1,054 |
$765 |
$136 | |
| CT scan of the arm |
$1,060 |
$1,060 |
$769 |
$199 | |
| CT scan of the arm without contrast |
$1,060 |
$1,060 |
$769 |
$161 | |
| CT scan of the chest |
$1,563 |
$1,563 |
$1,094 |
$167 | |
| CT scan of the chest with and without contrast |
$1,800 |
$1,800 |
$1,305 |
$196 | |
| CT scan of the chest with contrast |
$1,563 |
$1,563 |
$1,133 |
$167 | |
| CT scan of the chest without contrast |
$1,000 |
$1,000 |
$725 |
$133 | |
| CT scan of the head |
$1,226 |
$1,226 |
$889 |
$148 | |
| CT scan of the head without contrast |
$1,226 |
$1,226 |
$889 |
$107 | |
| CT scan of the leg |
$2,448 |
$2,448 |
$1,775 |
$166 | |
| CT scan of the leg without contrast |
$2,448 |
$2,448 |
$1,775 |
$130 | |
| CT scan of the lower back (lumbar spine) |
$935 |
$935 |
$678 |
$169 | |
| CT scan of the lower back (lumbar spine) without contrast |
$935 |
$935 |
$678 |
$130 | |
| CT scan of the neck |
$522 |
$522 |
$379 |
$183 | |
| CT scan of the neck (cervical spine) |
$1,199 |
$1,199 |
$869 |
$168 | |
| CT scan of the neck (cervical spine) without contrast |
$1,199 |
$1,199 |
$869 |
$131 | |
| CT scan of the neck with contrast |
$522 |
$522 |
$379 |
$183 | |
| CT scan of the pelvis |
$2,828 |
$2,828 |
$1,955 |
$226 | |
| CT scan of the pelvis with and without contrast |
$2,828 |
$2,828 |
$2,051 |
$251 | |
| CT scan of the pelvis with contrast |
$2,858 |
$2,858 |
$2,073 |
$226 | |
| CT scan of the pelvis without contrast |
$1,098 |
$1,098 |
$797 |
$133 | |
| CT scan of the sinuses |
$873 |
$873 |
$633 |
$152 | |
| CT scan of the sinuses without contrast |
$873 |
$873 |
$633 |
$128 | |
| D-dimer test |
$86 |
$86 |
$63 |
$10 | |
| Drug screen (urine) |
$75 |
$75 |
$56 |
$17 | |
| Echocardiogram |
$944 |
$944 |
$906 |
$138 | |
| Echocardiogram with and without contrast |
$924 |
$924 |
$670 |
$101 | |
| Echocardiogram without contrast |
$2,183 |
$2,183 |
$1,583 |
$138 | |
| EKG / ECG (tracing only) |
$174 |
$174 |
$127 |
$7 | |
| Electrocardiogram (EKG) |
$125 |
$125 |
$74 |
$8 | |
| Electrolyte panel |
$86 |
$86 |
$63 |
$7 | |
| Emergency department visit |
$400 |
$400 |
$275 |
$69 | |
| Emergency department visit (level 1) |
$167 |
$167 |
$121 |
$11 | |
| Emergency department visit (level 2) |
$247 |
$247 |
$179 |
$40 | |
| Emergency department visit (level 3) |
$400 |
$400 |
$290 |
$69 | |
| Emergency department visit (level 4) |
$643 |
$643 |
$466 |
$118 | |
| Emergency department visit (level 5) |
$959 |
$959 |
$695 |
$171 | |
| Estradiol (estrogen) test |
$124 |
$124 |
$90 |
$28 | |
| Family therapy session |
$381 |
$381 |
$277 |
$110 | |
| Fecal occult blood (stool) test |
$38 |
$38 |
$28 |
$10 | |
| Fecal occult blood (stool) test (guaiac, gFOBT) |
$38 |
$38 |
$28 |
$4 | |
| Ferritin (iron) test |
$103 |
$103 |
$75 |
$14 | |
| Fibrinogen test |
$165 |
$165 |
$120 |
$10 | |
| Flu test |
$86 |
$86 |
$63 |
$17 | |
| Folate (folic acid) test |
$97 |
$97 |
$71 |
$15 | |
| Foreign body removal (skin) |
$614 |
$614 |
$147 |
$157 | |
| Free T4 thyroid test |
$59 |
$59 |
$34 |
$9 | |
| FSH hormone test |
$82 |
$82 |
$60 |
$19 | |
| GGT liver test |
$95 |
$95 |
$69 |
$7 | |
| Glucose tolerance test |
$125 |
$125 |
$117 |
$8 | |
| Group therapy session |
$192 |
$192 |
$139 |
$30 | |
| Hematocrit test |
$24 |
$24 |
$18 |
$2 | |
| Hemoglobin A1c (diabetes test) |
$72 |
$72 |
$52 |
$10 | |
| Hepatitis B test |
$198 |
$198 |
$144 |
$10 | |
| Hepatitis C test |
$221 |
$221 |
$161 |
$14 | |
| HIV test |
$191 |
$191 |
$139 |
$19 | |
| HIV test (antibody) |
$191 |
$191 |
$139 |
$14 | |
| Holter heart monitor |
$262 |
$262 |
$183 |
$26 | |
| Iron blood test |
$62 |
$62 |
$45 |
$6 | |
| IV infusion therapy |
$384 |
$384 |
$264 |
$44 | |
| IV infusion therapy (each additional) |
$125 |
$125 |
$109 |
$21 | |
| IV infusion therapy (initial) |
$384 |
$384 |
$288 |
$67 | |
| Joint aspiration (small/intermediate) |
$83 |
$83 |
$63 |
$57 | |
| Joint aspiration or injection (mid-size joint) |
$90 |
$90 |
$66 |
$57 | |
| Joint aspiration or injection (small joint) |
$75 |
$75 |
$55 |
$56 | |
| Kidney ultrasound |
$351 |
$351 |
$235 |
$84 | |
| Kidney ultrasound (limited) |
$240 |
$240 |
$174 |
$61 | |
| Knee joint injection |
$387 |
$387 |
$147 |
$69 | |
| Lactate test |
$214 |
$214 |
$156 |
$12 | |
| LDH test |
$38 |
$38 |
$22 |
$6 | |
| LDL cholesterol test |
$87 |
$87 |
$47 |
$11 | |
| Leg vein ultrasound (Doppler) |
$514 |
$514 |
$373 |
$150 | |
| Leg vein ultrasound (Doppler) (limited) |
$518 |
$518 |
$376 |
$116 | |
| LH hormone test |
$196 |
$196 |
$142 |
$19 | |
| Lipase test |
$61 |
$61 |
$45 |
$7 | |
| Lipid (cholesterol) panel |
$103 |
$103 |
$82 |
$13 | |
| Liver function panel |
$60 |
$60 |
$42 |
$8 | |
| Magnesium blood test |
$57 |
$57 |
$42 |
$7 | |
| MMR vaccine |
$95 |
$95 |
$69 |
— | |
| MRA of the brain |
$3,306 |
$3,306 |
$2,381 |
$226 | |
| MRA of the brain with contrast |
$3,044 |
$3,044 |
$2,207 |
$226 | |
| MRA of the brain without contrast |
$3,402 |
$3,402 |
$2,467 |
$328 | |
| MRA of the neck |
$3,829 |
$3,829 |
$2,808 |
$245 | |
| MRA of the neck with contrast |
$3,829 |
$3,829 |
$2,776 |
$245 | |
| MRA of the neck without contrast |
$4,011 |
$4,011 |
$2,908 |
$343 | |
| MRI of the abdomen |
$3,580 |
$3,580 |
$2,506 |
$300 | |
| MRI of the abdomen with contrast |
$2,325 |
$2,325 |
$1,686 |
$300 | |
| MRI of the abdomen without contrast |
$3,580 |
$3,580 |
$2,596 |
$194 | |
| MRI of the ankle |
$3,430 |
$3,430 |
$2,401 |
$261 | |
| MRI of the ankle with contrast |
$662 |
$662 |
$480 |
$261 | |
| MRI of the ankle without contrast |
$3,430 |
$3,430 |
$2,487 |
$222 | |
| MRI of the brain |
$2,151 |
$2,151 |
$1,636 |
$269 | |
| MRI of the brain with contrast |
$3,845 |
$3,845 |
$2,788 |
$269 | |
| MRI of the brain without contrast |
$1,669 |
$1,669 |
$1,210 |
$195 | |
| MRI of the chest |
$1,780 |
$1,780 |
$1,609 |
$371 | |
| MRI of the chest with contrast |
$1,642 |
$1,642 |
$1,191 |
$371 | |
| MRI of the chest without contrast |
$4,168 |
$4,168 |
$3,022 |
$466 | |
| MRI of the knee |
$3,915 |
$3,915 |
$2,741 |
$315 | |
| MRI of the knee with contrast |
$3,915 |
$3,915 |
$2,839 |
$315 | |
| MRI of the knee without contrast |
$1,409 |
$1,409 |
$1,022 |
$204 | |
| MRI of the lower back (lumbar spine) |
$2,965 |
$2,965 |
$2,076 |
$270 | |
| MRI of the lower back (lumbar spine) with contrast |
$2,965 |
$2,965 |
$2,150 |
$270 | |
| MRI of the lower back (lumbar spine) without contrast |
$1,678 |
$1,678 |
$1,217 |
$192 | |
| MRI of the mid-back (thoracic spine) |
$3,193 |
$3,193 |
$2,235 |
$271 | |
| MRI of the mid-back (thoracic spine) with and without contrast |
$5,023 |
$5,023 |
$3,642 |
$319 | |
| MRI of the mid-back (thoracic spine) with contrast |
$3,193 |
$3,193 |
$2,315 |
$271 | |
| MRI of the mid-back (thoracic spine) without contrast |
$1,381 |
$1,381 |
$1,002 |
$190 | |
| MRI of the neck (cervical spine) |
$3,362 |
$3,362 |
$2,353 |
$274 | |
| MRI of the neck (cervical spine) with and without contrast |
$5,301 |
$5,301 |
$3,844 |
$318 | |
| MRI of the neck (cervical spine) with contrast |
$3,362 |
$3,362 |
$2,438 |
$274 | |
| MRI of the neck (cervical spine) without contrast |
$1,670 |
$1,670 |
$1,211 |
$191 | |
| MRI of the pelvis |
$3,245 |
$3,245 |
$2,272 |
$268 | |
| MRI of the pelvis with contrast |
$2,093 |
$2,093 |
$1,518 |
$268 | |
| MRI of the pelvis without contrast |
$3,245 |
$3,245 |
$2,353 |
$227 | |
| MRI of the shoulder |
$3,912 |
$3,912 |
$2,738 |
$313 | |
| MRI of the shoulder with contrast |
$3,912 |
$3,912 |
$2,836 |
$313 | |
| MRI of the shoulder without contrast |
$907 |
$907 |
$658 |
$205 | |
| MRI of the wrist |
$3,607 |
$3,607 |
$2,525 |
$330 | |
| MRI of the wrist with contrast |
$1,066 |
$1,066 |
$773 |
$330 | |
| MRI of the wrist without contrast |
$3,607 |
$3,607 |
$2,615 |
$303 | |
| Nebulizer breathing treatment |
$121 |
$121 |
$88 |
$9 | |
| Occupational therapy evaluation |
$350 |
$350 |
$263 |
$101 | |
| Occupational therapy evaluation (high complexity) |
$375 |
$375 |
$272 |
$101 | |
| Occupational therapy evaluation (low complexity) |
$291 |
$291 |
$211 |
$101 | |
| Occupational therapy evaluation (moderate complexity) |
$350 |
$350 |
$254 |
$101 | |
| Office visit (established patient) |
$113 |
$113 |
$88 |
$115 | |
| Office visit (new patient) |
$108 |
$108 |
$78 |
$177 | |
| Office visit, established patient (level 3) |
$90 |
$90 |
$66 |
$95 | |
| Office visit, established patient (level 4) |
$135 |
$135 |
$98 |
$136 | |
| Office visit, new patient (level 3) |
$80 |
$80 |
$58 |
$118 | |
| Office visit, new patient (level 4) |
$135 |
$135 |
$98 |
$177 | |
| Parathyroid hormone (PTH) test |
$190 |
$190 |
$138 |
$41 | |
| Pelvic ultrasound |
$270 |
$270 |
$203 |
$78 | |
| Pelvic ultrasound (complete) |
$333 |
$333 |
$242 |
$105 | |
| Pelvic ultrasound (limited) |
$207 |
$207 |
$150 |
$51 | |
| Phosphorus blood test |
$42 |
$42 |
$31 |
$5 | |
| Physical therapy evaluation |
$120 |
$120 |
$84 |
$98 | |
| Physical therapy evaluation (high complexity) |
$140 |
$140 |
$102 |
$98 | |
| Physical therapy evaluation (moderate complexity) |
$120 |
$120 |
$87 |
$98 | |
| Pneumonia vaccine |
$245 |
$245 |
$178 |
— | |
| Pregnancy blood test (hCG) |
$55 |
$55 |
$40 |
$8 | |
| Pregnancy ultrasound |
$986 |
$986 |
$715 |
$126 | |
| Pregnancy ultrasound (second or third trimester) |
$986 |
$986 |
$715 |
$136 | |
| Procalcitonin test |
$277 |
$277 |
$201 |
$27 | |
| Prolactin test |
$231 |
$231 |
$168 |
$19 | |
| Prostate test (PSA) |
$96 |
$96 |
$63 |
$18 | |
| Psychotherapy session |
$80 |
$80 |
$58 |
$140 | |
| Sacroiliac joint injection |
$85 |
$85 |
$62 |
$176 | |
| Scrotal ultrasound |
$942 |
$942 |
$683 |
$99 | |
| Sedimentation rate (ESR) test |
$42 |
$42 |
$31 |
$3 | |
| Sex hormone binding globulin test |
$141 |
$141 |
$103 |
$22 | |
| Simple laceration repair (small, up to 2.5 cm) |
$184 |
$184 |
$147 |
$114 | |
| Simple wound stitches |
$188 |
$188 |
$147 |
$127 | |
| Skin biopsy |
$200 |
$200 |
$172 |
$121 | |
| Skin biopsy (punch) |
$180 |
$180 |
$131 |
$121 | |
| Skin cancer lesion removal |
$375 |
$375 |
$263 |
$240 | |
| Skin lesion freezing (cryotherapy) |
$137 |
$137 |
$83 |
$36 | |
| Skin tag removal |
$65 |
$65 |
$48 |
$92 | |
| Soft tissue ultrasound |
$630 |
$630 |
$457 |
$64 | |
| Speech therapy |
$115 |
$115 |
$84 |
$76 | |
| Spinal tap (lumbar puncture) |
$1,023 |
$1,023 |
$742 |
$165 | |
| Swallow study |
$275 |
$275 |
$200 |
$85 | |
| T3 thyroid test |
$191 |
$191 |
$139 |
$14 | |
| Tdap (tetanus) vaccine |
$143 |
$143 |
$99 |
— | |
| Testosterone test |
$154 |
$154 |
$112 |
$26 | |
| Thyroid test (TSH) |
$121 |
$121 |
$84 |
$17 | |
| Thyroid ultrasound |
$293 |
$293 |
$213 |
$109 | |
| Total IgE allergy test |
$167 |
$167 |
$121 |
$16 | |
| Total protein test |
$35 |
$35 |
$26 |
$4 | |
| Transvaginal ultrasound |
$674 |
$674 |
$466 |
$118 | |
| Trigger point injection |
$55 |
$55 |
$44 |
$56 | |
| Trigger point injection (1-2 muscles) |
$65 |
$65 |
$44 |
$52 | |
| Triglycerides test |
$136 |
$136 |
$99 |
$6 | |
| Troponin (heart) test |
$93 |
$93 |
$70 |
$12 | |
| Upper GI series (barium) |
$365 |
$365 |
$265 |
$128 | |
| Uric acid (gout) test |
$46 |
$46 |
$34 |
$5 | |
| Urinalysis |
$47 |
$47 |
$34 |
$3 | |
| Urine microalbumin test |
$55 |
$55 |
$36 |
$5 | |
| Urine pregnancy test |
$197 |
$197 |
$143 |
$9 | |
| Vaccine administration |
$80 |
$80 |
$60 |
$19 | |
| Vaccine administration (each additional) |
$80 |
$80 |
$60 |
$16 | |
| Vitamin B12 test |
$110 |
$110 |
$80 |
$15 | |
| Vitamin D test |
$97 |
$97 |
$48 |
$30 | |
| Wart removal |
$179 |
$179 |
$130 |
$121 | |
| Well-child visit |
$120 |
$120 |
$84 |
— | |
| X-ray of the abdomen |
$210 |
$210 |
$167 |
$36 | |
| X-ray of the ankle |
$184 |
$184 |
$134 |
$37 | |
| X-ray of the collarbone |
$151 |
$151 |
$110 |
$33 | |
| X-ray of the elbow |
$140 |
$140 |
$102 |
$33 | |
| X-ray of the facial bones |
$150 |
$150 |
$109 |
$39 | |
| X-ray of the foot |
$164 |
$164 |
$119 |
$34 | |
| X-ray of the forearm |
$453 |
$453 |
$329 |
$29 | |
| X-ray of the hand |
$163 |
$163 |
$118 |
$38 | |
| X-ray of the hip |
$249 |
$249 |
$196 |
$49 | |
| X-ray of the hip (1 view) |
$349 |
$349 |
$253 |
$34 | |
| X-ray of the hip (3 views) |
$249 |
$249 |
$181 |
$49 | |
| X-ray of the hip (4 views) |
$200 |
$200 |
$145 |
$63 | |
| X-ray of the knee |
$168 |
$168 |
$122 |
$42 | |
| X-ray of the knee (2 views) |
$168 |
$168 |
$122 |
$34 | |
| X-ray of the lower back (lumbar spine) |
$225 |
$225 |
$181 |
$47 | |
| X-ray of the lower back (lumbar spine) (2 views) |
$190 |
$190 |
$138 |
$40 | |
| X-ray of the lower back (lumbar spine) (4+ views) |
$259 |
$259 |
$188 |
$53 | |
| X-ray of the lower leg |
$145 |
$145 |
$106 |
$31 | |
| X-ray of the mid-back (thoracic spine) |
$151 |
$151 |
$110 |
$36 | |
| X-ray of the mid-back (thoracic spine) (2 views) |
$151 |
$151 |
$110 |
$33 | |
| X-ray of the neck (cervical spine) |
$238 |
$238 |
$190 |
$47 | |
| X-ray of the neck (cervical spine) (3 views) |
$204 |
$204 |
$148 |
$40 | |
| X-ray of the pelvis |
$165 |
$165 |
$120 |
$36 | |
| X-ray of the pelvis (1 view) |
$165 |
$165 |
$120 |
$28 | |
| X-ray of the ribs |
$159 |
$159 |
$113 |
$42 | |
| X-ray of the ribs (2 views) |
$159 |
$159 |
$115 |
$36 | |
| X-ray of the ribs (3 views) |
$153 |
$153 |
$111 |
$42 | |
| X-ray of the shoulder |
$187 |
$187 |
$136 |
$36 | |
| X-ray of the skull |
$443 |
$443 |
$135 |
$40 | |
| X-ray of the upper arm |
$152 |
$152 |
$110 |
$32 | |
| X-ray of the wrist |
$174 |
$174 |
$127 |
$43 | |