| Abdominal ultrasound |
$297 |
$303 |
— |
$100 | |
| Abdominal ultrasound (complete) |
$333 |
$340 |
— |
$114 | |
| Abdominal ultrasound (limited) |
$261 |
$266 |
— |
$86 | |
| Abscess drainage (complex or multiple) |
$1,353 |
$1,381 |
— |
$220 | |
| Abscess drainage (simple) |
$338 |
$345 |
— |
$129 | |
| Abscess incision and drainage |
$846 |
$863 |
— |
$174 | |
| Albumin blood test |
$5 |
$5 |
— |
$5 | |
| Aldosterone test |
$59 |
$60 |
— |
$41 | |
| Alkaline phosphatase test |
$5 |
$5 |
— |
$5 | |
| Alpha-fetoprotein (AFP) test |
$35 |
$36 |
— |
$17 | |
| ALT liver enzyme test |
$5 |
$5 |
— |
$5 | |
| Ammonia blood test |
$47 |
$48 |
— |
$15 | |
| Amniocentesis |
$511 |
$522 |
— |
$120 | |
| Amylase test |
$14 |
$14 |
— |
$6 | |
| Antinuclear antibody (ANA) test |
$35 |
$36 |
— |
$12 | |
| Arterial blood gas (ABG) |
$73 |
$75 |
— |
$26 | |
| AST liver enzyme test |
$5 |
$5 |
— |
$5 | |
| Barium swallow study |
$333 |
$340 |
— |
$107 | |
| Bartholin cyst removal |
$682 |
$696 |
— |
$182 | |
| Basic metabolic panel |
$26 |
$27 |
— |
$8 | |
| Bilirubin blood test |
$14 |
$14 |
— |
$5 | |
| Blood clotting test (PT/INR) |
$19 |
$19 |
— |
$4 | |
| Blood crossmatch |
$19 |
$19 |
— |
— | |
| Blood glucose test |
$9 |
$10 |
— |
$5 | |
| Blood transfusion |
$1,166 |
$1,190 |
— |
$47 | |
| Blood type and screen |
$28 |
$29 |
— |
$10 | |
| Blood type test |
$9 |
$10 |
— |
$3 | |
| Blood type test (ABO group) |
$9 |
$10 |
— |
$3 | |
| Blood type test (Rh/D antigen) |
$9 |
$10 |
— |
$3 | |
| BNP (heart failure) test |
$71 |
$72 |
— |
$39 | |
| Bone scan (nuclear) |
$624 |
$637 |
— |
$259 | |
| Breast MRI |
$270 |
$275 |
— |
$216 | |
| Breast MRI without contrast |
$264 |
$270 |
— |
$216 | |
| Breast ultrasound |
$253 |
$258 |
— |
$92 | |
| Breast ultrasound (complete) |
$289 |
$295 |
— |
$100 | |
| Breast ultrasound (limited) |
$217 |
$222 |
— |
$84 | |
| Breathing tube insertion (intubation) |
$109 |
$112 |
— |
$133 | |
| Burn dressing and debridement (small) |
$338 |
$345 |
— |
$93 | |
| Burn treatment |
$338 |
$345 |
— |
$129 | |
| C-reactive protein (CRP) |
$35 |
$36 |
— |
$5 | |
| CA 19-9 tumor marker test |
$78 |
$80 |
— |
$21 | |
| CA-125 ovarian marker test |
$78 |
$80 |
— |
$21 | |
| Calcium blood test |
$5 |
$5 |
— |
$5 | |
| Cardiac rehabilitation |
$248 |
$253 |
— |
$26 | |
| Cardiac stress test |
$212 |
$216 |
— |
$39 | |
| Cardioversion |
$318 |
$324 |
— |
$155 | |
| Carotid artery ultrasound |
$543 |
$554 |
— |
$156 | |
| CEA tumor marker test |
$59 |
$60 |
— |
$19 | |
| Celiac disease test |
$9 |
$10 |
— |
$12 | |
| Central line placement |
$341 |
$348 |
— |
$238 | |
| Cervical cerclage |
$1,704 |
$1,739 |
— |
$137 | |
| Chemotherapy infusion |
$546 |
$557 |
— |
$81 | |
| Chemotherapy infusion (each additional) |
$198 |
$203 |
— |
$28 | |
| Chemotherapy infusion (first hour) |
$893 |
$911 |
— |
$133 | |
| Chest X-ray |
$87 |
$89 |
— |
$37 | |
| Chest X-ray (1 view) |
$43 |
$44 |
— |
$25 | |
| Chest X-ray (2 views) |
$72 |
$74 |
— |
$33 | |
| Chickenpox (varicella) vaccine |
$564 |
$575 |
— |
— | |
| Circumcision |
$511 |
$522 |
— |
$167 | |
| CK-MB heart enzyme test |
$35 |
$36 |
— |
$12 | |
| Clotting time test (PTT) |
$19 |
$19 |
— |
$6 | |
| Complete blood count (CBC) |
$21 |
$22 |
— |
$7 | |
| Complete blood count (CBC) (complete) |
$24 |
$24 |
— |
$8 | |
| Comprehensive metabolic panel |
$35 |
$36 |
— |
$11 | |
| Copper blood test |
$59 |
$60 |
— |
$12 | |
| Cortisol test |
$35 |
$36 |
— |
$16 | |
| COVID-19 PCR test |
$57 |
$58 |
— |
$51 | |
| CPAP titration study |
$525 |
$535 |
— |
$69 | |
| Creatine kinase (CK) test |
$14 |
$14 |
— |
$7 | |
| CT colonography (virtual colonoscopy) |
$526 |
$536 |
— |
$835 | |
| CT scan of the neck with and without contrast |
$169 |
$173 |
— |
$220 | |
| D-dimer test |
$35 |
$36 |
— |
$10 | |
| DHEA-sulfate test |
$35 |
$36 |
— |
$22 | |
| Drug screen (urine) |
$19 |
$19 |
— |
$17 | |
| Echocardiogram |
$318 |
$324 |
— |
$138 | |
| Echocardiogram with and without contrast |
$141 |
$144 |
— |
$101 | |
| Echocardiogram without contrast |
$318 |
$324 |
— |
$138 | |
| EEG (awake and asleep) |
$320 |
$326 |
— |
$482 | |
| EKG / ECG (tracing only) |
$85 |
$87 |
— |
$7 | |
| Electrocardiogram (EKG) |
$85 |
$87 |
— |
$8 | |
| Electroencephalogram (EEG) |
$294 |
$300 |
— |
$448 | |
| Electrolyte panel |
$19 |
$19 |
— |
$7 | |
| Electromyography (EMG) |
$73 |
$74 |
— |
$141 | |
| Emergency department visit |
$213 |
$217 |
— |
$69 | |
| Emergency department visit (level 1) |
$106 |
$109 |
— |
$11 | |
| Emergency department visit (level 2) |
$106 |
$109 |
— |
$40 | |
| Emergency department visit (level 3) |
$213 |
$217 |
— |
$69 | |
| Emergency department visit (level 4) |
$426 |
$435 |
— |
$118 | |
| Emergency department visit (level 5) |
$745 |
$761 |
— |
$171 | |
| Estradiol (estrogen) test |
$35 |
$36 |
— |
$28 | |
| Fallopian tube X-ray (HSG) |
$79 |
$80 |
— |
$164 | |
| Family therapy session |
$198 |
$203 |
— |
$110 | |
| Fecal occult blood (stool) test |
$12 |
$12 |
— |
$10 | |
| Fecal occult blood (stool) test (guaiac, gFOBT) |
$12 |
$12 |
— |
$4 | |
| Ferritin (iron) test |
$35 |
$36 |
— |
$14 | |
| Fibrinogen test |
$21 |
$22 |
— |
$10 | |
| Folate (folic acid) test |
$35 |
$36 |
— |
$15 | |
| Foreign body removal (skin) |
$338 |
$345 |
— |
$157 | |
| Free T4 thyroid test |
$35 |
$36 |
— |
$9 | |
| FSH hormone test |
$35 |
$36 |
— |
$19 | |
| Gallbladder scan (HIDA) |
$1,044 |
$1,065 |
— |
$334 | |
| Glucose tolerance test |
$22 |
$23 |
— |
$8 | |
| Group therapy session |
$99 |
$101 |
— |
$30 | |
| HDL cholesterol test |
$35 |
$36 |
— |
$8 | |
| Hematocrit test |
$9 |
$10 |
— |
$2 | |
| Hemodialysis |
$1,224 |
$1,248 |
— |
$75 | |
| Hemoglobin A1c (diabetes test) |
$47 |
$48 |
— |
$10 | |
| Hepatitis B test |
$59 |
$60 |
— |
$10 | |
| Hepatitis B vaccine |
$209 |
$213 |
— |
— | |
| Hepatitis C test |
$59 |
$60 |
— |
$14 | |
| HIV test |
$59 |
$60 |
— |
$19 | |
| HIV test (antigen/antibody combo) |
$59 |
$60 |
— |
$24 | |
| Holter heart monitor |
$71 |
$72 |
— |
$26 | |
| Iron blood test |
$14 |
$14 |
— |
$6 | |
| IV infusion therapy |
$546 |
$557 |
— |
$44 | |
| IV infusion therapy (each additional) |
$198 |
$203 |
— |
$21 | |
| IV infusion therapy (initial) |
$893 |
$911 |
— |
$67 | |
| Kidney scan (nuclear) |
$348 |
$355 |
— |
$172 | |
| Kidney ultrasound |
$217 |
$222 |
— |
$84 | |
| Kidney ultrasound (limited) |
$116 |
$118 |
— |
$61 | |
| Lactate test |
$47 |
$48 |
— |
$12 | |
| Laryngoscopy |
$293 |
$299 |
— |
$189 | |
| LDH test |
$9 |
$10 |
— |
$6 | |
| LDL cholesterol test |
$35 |
$36 |
— |
$11 | |
| Leg vein ultrasound (Doppler) |
$536 |
$546 |
— |
$150 | |
| Leg vein ultrasound (Doppler) (limited) |
$405 |
$414 |
— |
$116 | |
| LH hormone test |
$59 |
$60 |
— |
$19 | |
| Lipase test |
$19 |
$19 |
— |
$7 | |
| Lipid (cholesterol) panel |
$45 |
$46 |
— |
$13 | |
| Liver function panel |
$26 |
$27 |
— |
$8 | |
| Lung function test (PFT) |
$441 |
$450 |
— |
$37 | |
| Lung scan (V/Q) |
$839 |
$856 |
— |
$291 | |
| Magnesium blood test |
$14 |
$14 |
— |
$7 | |
| MMR vaccine |
$370 |
$377 |
— |
— | |
| MRA of the brain |
$499 |
$509 |
— |
$226 | |
| MRA of the brain with contrast |
$496 |
$506 |
— |
$226 | |
| MRA of the neck |
$534 |
$545 |
— |
$245 | |
| MRA of the neck with contrast |
$534 |
$545 |
— |
$245 | |
| MRA of the neck without contrast |
$776 |
$792 |
— |
$343 | |
| MRI of the abdomen |
$555 |
$567 |
— |
$300 | |
| MRI of the abdomen with contrast |
$555 |
$567 |
— |
$300 | |
| MRI of the abdomen without contrast |
$393 |
$402 |
— |
$194 | |
| MRI of the ankle |
$490 |
$501 |
— |
$261 | |
| MRI of the ankle with contrast |
$490 |
$501 |
— |
$261 | |
| MRI of the ankle without contrast |
$447 |
$457 |
— |
$222 | |
| MRI of the brain |
$350 |
$358 |
— |
$269 | |
| MRI of the brain with contrast |
$350 |
$358 |
— |
$269 | |
| MRI of the brain without contrast |
$237 |
$242 |
— |
$195 | |
| MRI of the chest |
$566 |
$578 |
— |
$371 | |
| MRI of the chest with contrast |
$566 |
$578 |
— |
$371 | |
| MRI of the chest without contrast |
$706 |
$721 |
— |
$466 | |
| MRI of the knee |
$453 |
$462 |
— |
$315 | |
| MRI of the knee with contrast |
$453 |
$462 |
— |
$315 | |
| MRI of the knee without contrast |
$253 |
$259 |
— |
$204 | |
| MRI of the lower back (lumbar spine) |
$350 |
$358 |
— |
$270 | |
| MRI of the lower back (lumbar spine) with contrast |
$350 |
$358 |
— |
$270 | |
| MRI of the lower back (lumbar spine) without contrast |
$226 |
$231 |
— |
$192 | |
| MRI of the mid-back (thoracic spine) |
$356 |
$363 |
— |
$271 | |
| MRI of the mid-back (thoracic spine) with and without contrast |
$404 |
$413 |
— |
$319 | |
| MRI of the mid-back (thoracic spine) with contrast |
$356 |
$363 |
— |
$271 | |
| MRI of the mid-back (thoracic spine) without contrast |
$226 |
$231 |
— |
$190 | |
| MRI of the neck (cervical spine) |
$356 |
$363 |
— |
$274 | |
| MRI of the neck (cervical spine) with and without contrast |
$399 |
$407 |
— |
$318 | |
| MRI of the neck (cervical spine) with contrast |
$356 |
$363 |
— |
$274 | |
| MRI of the neck (cervical spine) without contrast |
$226 |
$231 |
— |
$191 | |
| MRI of the pelvis |
$490 |
$501 |
— |
$268 | |
| MRI of the pelvis with contrast |
$490 |
$501 |
— |
$268 | |
| MRI of the pelvis without contrast |
$458 |
$468 |
— |
$227 | |
| MRI of the shoulder |
$447 |
$457 |
— |
$313 | |
| MRI of the shoulder with contrast |
$447 |
$457 |
— |
$313 | |
| MRI of the shoulder without contrast |
$253 |
$259 |
— |
$205 | |
| MRI of the wrist |
$485 |
$495 |
— |
$330 | |
| MRI of the wrist with contrast |
$485 |
$495 |
— |
$330 | |
| MRI of the wrist without contrast |
$453 |
$462 |
— |
$303 | |
| Nebulizer breathing treatment |
$705 |
$719 |
— |
$9 | |
| Nerve conduction study |
$51 |
$52 |
— |
$118 | |
| Nuchal translucency ultrasound |
$511 |
$522 |
— |
$116 | |
| Nuclear cardiac stress test |
$1,177 |
$1,201 |
— |
$428 | |
| Occupational therapy evaluation |
$360 |
$368 |
— |
$101 | |
| Occupational therapy evaluation (high complexity) |
$360 |
$368 |
— |
$101 | |
| Occupational therapy evaluation (low complexity) |
$360 |
$368 |
— |
$101 | |
| Occupational therapy evaluation (moderate complexity) |
$360 |
$368 |
— |
$101 | |
| Office visit (established patient) |
$223 |
$228 |
— |
$115 | |
| Office visit (new patient) |
$248 |
$253 |
— |
$177 | |
| Office visit, established patient (level 3) |
$198 |
$203 |
— |
$95 | |
| Office visit, established patient (level 4) |
$248 |
$253 |
— |
$136 | |
| Office visit, new patient (level 3) |
$198 |
$203 |
— |
$118 | |
| Office visit, new patient (level 4) |
$248 |
$253 |
— |
$177 | |
| Office visit, new patient (level 5) |
$298 |
$304 |
— |
$237 | |
| Pap smear (cervical screening) |
$57 |
$58 |
— |
$20 | |
| Parathyroid hormone (PTH) test |
$35 |
$36 |
— |
$41 | |
| Pelvic ultrasound |
$408 |
$416 |
— |
$78 | |
| Pelvic ultrasound (complete) |
$408 |
$416 |
— |
$105 | |
| Pelvic ultrasound (limited) |
$306 |
$313 |
— |
$51 | |
| PET scan |
$4,758 |
$4,855 |
— |
— | |
| Phosphorus blood test |
$5 |
$5 |
— |
$5 | |
| Physical therapy evaluation |
$664 |
$678 |
— |
$98 | |
| Physical therapy evaluation (high complexity) |
$664 |
$678 |
— |
$98 | |
| Physical therapy evaluation (moderate complexity) |
$664 |
$678 |
— |
$98 | |
| Platelet count |
$9 |
$10 |
— |
$4 | |
| Pregnancy blood test (hCG) |
$24 |
$24 |
— |
$8 | |
| Pregnancy ultrasound |
$444 |
$453 |
— |
$126 | |
| Pregnancy ultrasound (first trimester) |
$408 |
$416 |
— |
$117 | |
| Pregnancy ultrasound (second or third trimester) |
$444 |
$453 |
— |
$136 | |
| Procalcitonin test |
$354 |
$362 |
— |
$27 | |
| Prolactin test |
$47 |
$48 |
— |
$19 | |
| Prostate test (PSA) |
$47 |
$48 |
— |
$18 | |
| Psychotherapy session |
$298 |
$304 |
— |
$140 | |
| Pulmonary rehabilitation |
$744 |
$759 |
— |
$87 | |
| RSV vaccine |
$943 |
$962 |
— |
— | |
| Scoliosis spine X-ray |
$145 |
$148 |
— |
$58 | |
| Scoliosis spine X-ray (1 view) |
$101 |
$103 |
— |
$44 | |
| Scoliosis spine X-ray (3 views) |
$188 |
$192 |
— |
$72 | |
| Scrotal ultrasound |
$145 |
$148 |
— |
$99 | |
| Sedimentation rate (ESR) test |
$12 |
$12 |
— |
$3 | |
| Semen analysis |
$19 |
$19 |
— |
$12 | |
| Sex hormone binding globulin test |
$59 |
$60 |
— |
$22 | |
| Simple laceration repair (small, up to 2.5 cm) |
$226 |
$230 |
— |
$114 | |
| Simple wound stitches |
$226 |
$230 |
— |
$127 | |
| Skin biopsy |
$338 |
$345 |
— |
$121 | |
| Skin biopsy (punch) |
$338 |
$345 |
— |
$121 | |
| Soft tissue ultrasound |
$43 |
$44 |
— |
$64 | |
| Speech therapy |
$149 |
$152 |
— |
$76 | |
| Spirometry (lung function test) |
$275 |
$281 |
— |
$30 | |
| Spirometry with bronchodilator |
$652 |
$665 |
— |
$43 | |
| Stress echocardiogram |
$424 |
$433 |
— |
$209 | |
| Swallow study |
$199 |
$203 |
— |
$85 | |
| T3 thyroid test |
$35 |
$36 |
— |
$14 | |
| Tdap (tetanus) vaccine |
$171 |
$174 |
— |
— | |
| Testosterone test |
$35 |
$36 |
— |
$26 | |
| Thyroid test (TSH) |
$35 |
$36 |
— |
$17 | |
| Thyroid ultrasound |
$362 |
$369 |
— |
$109 | |
| Thyroid uptake scan |
$430 |
$438 |
— |
$145 | |
| Tilt table test |
$424 |
$433 |
— |
$168 | |
| Total IgE allergy test |
$35 |
$36 |
— |
$16 | |
| Total protein test |
$5 |
$5 |
— |
$4 | |
| Transesophageal echocardiogram (TEE) |
$424 |
$433 |
— |
$239 | |
| Transesophageal echocardiogram (TEE) with and without contrast |
$424 |
$433 |
— |
$239 | |
| Transvaginal ultrasound |
$362 |
$369 |
— |
$118 | |
| Triglycerides test |
$5 |
$5 |
— |
$6 | |
| Troponin (heart) test |
$59 |
$60 |
— |
$12 | |
| Turning a breech baby (version) |
$1,704 |
$1,739 |
— |
$94 | |
| Upper GI series (barium) |
$347 |
$354 |
— |
$128 | |
| Uric acid (gout) test |
$5 |
$5 |
— |
$5 | |
| Urinalysis |
$21 |
$22 |
— |
$3 | |
| Urine microalbumin test |
$30 |
$30 |
— |
$5 | |
| Urine pregnancy test |
$24 |
$24 |
— |
$9 | |
| Vaccine administration |
$170 |
$174 |
— |
$19 | |
| Vaccine administration (each additional) |
$170 |
$174 |
— |
$16 | |
| Vitamin B12 test |
$35 |
$36 |
— |
$15 | |
| Vitamin D test |
$35 |
$36 |
— |
$30 | |
| Wound debridement |
$902 |
$920 |
— |
$186 | |
| X-ray of the abdomen |
$87 |
$89 |
— |
$36 | |
| X-ray of the ankle |
$87 |
$89 |
— |
$37 | |
| X-ray of the collarbone |
$72 |
$74 |
— |
$33 | |
| X-ray of the elbow |
$87 |
$89 |
— |
$33 | |
| X-ray of the facial bones |
$94 |
$96 |
— |
$39 | |
| X-ray of the foot |
$87 |
$89 |
— |
$34 | |
| X-ray of the forearm |
$72 |
$74 |
— |
$29 | |
| X-ray of the hand |
$87 |
$89 |
— |
$38 | |
| X-ray of the hip |
$116 |
$118 |
— |
$49 | |
| X-ray of the hip (1 view) |
$87 |
$89 |
— |
$34 | |
| X-ray of the hip (3 views) |
$116 |
$118 |
— |
$49 | |
| X-ray of the hip (4 views) |
$145 |
$148 |
— |
$63 | |
| X-ray of the knee |
$101 |
$103 |
— |
$42 | |
| X-ray of the knee (2 views) |
$87 |
$89 |
— |
$34 | |
| X-ray of the knee (3 views) |
$101 |
$103 |
— |
$42 | |
| X-ray of the knee (4+ views) |
$116 |
$118 |
— |
$49 | |
| X-ray of the lower back (lumbar spine) |
$116 |
$118 |
— |
$47 | |
| X-ray of the lower back (lumbar spine) (2 views) |
$101 |
$103 |
— |
$40 | |
| X-ray of the lower back (lumbar spine) (4+ views) |
$130 |
$133 |
— |
$53 | |
| X-ray of the lower leg |
$87 |
$89 |
— |
$31 | |
| X-ray of the mid-back (thoracic spine) |
$87 |
$89 |
— |
$36 | |
| X-ray of the mid-back (thoracic spine) (2 views) |
$87 |
$89 |
— |
$33 | |
| X-ray of the neck (cervical spine) |
$101 |
$103 |
— |
$47 | |
| X-ray of the neck (cervical spine) (3 views) |
$87 |
$89 |
— |
$40 | |
| X-ray of the pelvis |
$101 |
$103 |
— |
$36 | |
| X-ray of the pelvis (1 view) |
$87 |
$89 |
— |
$28 | |
| X-ray of the ribs |
$87 |
$89 |
— |
$42 | |
| X-ray of the ribs (2 views) |
$87 |
$89 |
— |
$36 | |
| X-ray of the ribs (3 views) |
$87 |
$89 |
— |
$42 | |
| X-ray of the shoulder |
$72 |
$74 |
— |
$36 | |
| X-ray of the skull |
$109 |
$111 |
— |
$40 | |
| X-ray of the upper arm |
$87 |
$89 |
— |
$32 | |
| X-ray of the wrist |
$101 |
$103 |
— |
$43 | |
| Zinc blood test |
$59 |
$60 |
— |
$11 | |