| 3D mammogram (tomosynthesis) |
— |
$375 |
$188 |
$51 | |
| Abdominal ultrasound |
— |
$566 |
$196 |
$100 | |
| Abdominal ultrasound (complete) |
— |
$636 |
$196 |
$114 | |
| Abdominal ultrasound (limited) |
— |
$495 |
$208 |
$86 | |
| Abscess drainage (complex or multiple) |
— |
$354 |
$24 |
$220 | |
| Abscess drainage (simple) |
— |
$69 |
$69 |
$129 | |
| Abscess incision and drainage |
— |
$212 |
$69 |
$174 | |
| Albumin blood test |
— |
$29 |
$9 |
$5 | |
| Alkaline phosphatase test |
— |
$30 |
$30 |
$5 | |
| ALT liver enzyme test |
— |
$62 |
$19 |
$5 | |
| Amylase test |
— |
$35 |
$6 |
$6 | |
| Annual physical (established patient) |
— |
$250 |
$137 |
— | |
| Arterial blood gas (ABG) |
— |
$636 |
$197 |
$26 | |
| AST liver enzyme test |
— |
$62 |
$19 |
$5 | |
| Basic metabolic panel |
— |
$75 |
$8 |
$8 | |
| Benign skin lesion removal |
— |
$908 |
$291 |
$171 | |
| Bilirubin blood test |
— |
$29 |
$5 |
$5 | |
| Blood clotting test (PT/INR) |
— |
$29 |
$4 |
$4 | |
| Blood crossmatch |
— |
$151 |
$109 |
— | |
| Blood glucose test |
— |
$35 |
$28 |
$5 | |
| Blood transfusion |
— |
$1,002 |
$361 |
$47 | |
| Blood type and screen |
— |
$147 |
$46 |
$10 | |
| Blood type test |
— |
$83 |
$15 |
$3 | |
| Blood type test (ABO group) |
— |
$121 |
$38 |
$3 | |
| Blood type test (Rh/D antigen) |
— |
$44 |
$14 |
$3 | |
| BNP (heart failure) test |
— |
$142 |
$39 |
$39 | |
| Breast ultrasound |
— |
$407 |
$200 |
$92 | |
| Breast ultrasound (complete) |
— |
$438 |
$261 |
$100 | |
| Breast ultrasound (limited) |
— |
$375 |
$135 |
$84 | |
| Breathing tube insertion (intubation) |
— |
$270 |
$115 |
$133 | |
| Burn dressing and debridement (small) |
— |
$104 |
$58 |
$93 | |
| Burn treatment |
— |
$104 |
$58 |
$129 | |
| C-reactive protein (CRP) |
— |
$124 |
$5 |
$5 | |
| Calcium blood test |
— |
$32 |
$21 |
$5 | |
| Carotid artery ultrasound |
— |
$743 |
$279 |
$156 | |
| Chest X-ray |
— |
$268 |
$122 |
$37 | |
| Chest X-ray (1 view) |
— |
$281 |
$87 |
$25 | |
| Chest X-ray (2 views) |
— |
$255 |
$123 |
$33 | |
| CK-MB heart enzyme test |
— |
$76 |
$24 |
$12 | |
| Clotting time test (PTT) |
— |
$50 |
$6 |
$6 | |
| Colonoscopy |
— |
$2,178 |
$697 |
$480 | |
| Complete blood count (CBC) |
— |
$66 |
$8 |
$7 | |
| Complete blood count (CBC) (complete) |
— |
$66 |
$8 |
$8 | |
| Comprehensive metabolic panel |
— |
$99 |
$11 |
$11 | |
| Copper blood test |
— |
$552 |
$552 |
$12 | |
| CPAP titration study |
— |
$63 |
$63 |
$69 | |
| Creatine kinase (CK) test |
— |
$35 |
$11 |
$7 | |
| CT angiography of the chest |
— |
$1,362 |
$657 |
$281 | |
| CT scan of the abdomen |
— |
$1,053 |
$455 |
$230 | |
| CT scan of the abdomen and pelvis |
— |
$1,271 |
$563 |
$300 | |
| CT scan of the abdomen and pelvis with and without contrast |
— |
$1,815 |
$978 |
$338 | |
| CT scan of the abdomen and pelvis with contrast |
— |
$1,271 |
$626 |
$300 | |
| CT scan of the abdomen and pelvis without contrast |
— |
$1,271 |
$394 |
$183 | |
| CT scan of the abdomen with and without contrast |
— |
$1,263 |
$752 |
$259 | |
| CT scan of the abdomen with contrast |
— |
$1,053 |
$1,053 |
$230 | |
| CT scan of the abdomen without contrast |
— |
$944 |
$340 |
$136 | |
| CT scan of the arm |
— |
$1,035 |
$704 |
$199 | |
| CT scan of the arm with contrast |
— |
$1,126 |
$704 |
$199 | |
| CT scan of the arm without contrast |
— |
$944 |
$618 |
$161 | |
| CT scan of the chest |
— |
$763 |
$349 |
$167 | |
| CT scan of the chest with contrast |
— |
$1,035 |
$405 |
$167 | |
| CT scan of the chest without contrast |
— |
$491 |
$292 |
$133 | |
| CT scan of the head |
— |
$1,082 |
$434 |
$148 | |
| CT scan of the head with and without contrast |
— |
$1,263 |
$609 |
$173 | |
| CT scan of the head without contrast |
— |
$900 |
$405 |
$107 | |
| CT scan of the leg |
— |
$922 |
$477 |
$166 | |
| CT scan of the leg with contrast |
— |
$990 |
$477 |
$166 | |
| CT scan of the leg without contrast |
— |
$854 |
$460 |
$130 | |
| CT scan of the lower back (lumbar spine) |
— |
$1,017 |
$562 |
$169 | |
| CT scan of the lower back (lumbar spine) with contrast |
— |
$1,089 |
$1,089 |
$169 | |
| CT scan of the lower back (lumbar spine) without contrast |
— |
$944 |
$507 |
$130 | |
| CT scan of the neck |
— |
$1,035 |
$568 |
$183 | |
| CT scan of the neck (cervical spine) |
— |
$944 |
$300 |
$168 | |
| CT scan of the neck (cervical spine) without contrast |
— |
$944 |
$300 |
$131 | |
| CT scan of the neck with contrast |
— |
$1,035 |
$510 |
$183 | |
| CT scan of the neck without contrast |
— |
$1,035 |
$617 |
$150 | |
| CT scan of the pelvis |
— |
$1,172 |
$590 |
$226 | |
| CT scan of the pelvis with and without contrast |
— |
$1,263 |
$1,263 |
$251 | |
| CT scan of the pelvis with contrast |
— |
$1,172 |
$375 |
$226 | |
| CT scan of the pelvis without contrast |
— |
$990 |
$534 |
$133 | |
| CT scan of the sinuses |
— |
$899 |
$412 |
$152 | |
| CT scan of the sinuses with contrast |
— |
$944 |
$455 |
$152 | |
| CT scan of the sinuses without contrast |
— |
$854 |
$412 |
$128 | |
| D-dimer test |
— |
$363 |
$10 |
$10 | |
| Diagnostic mammogram |
— |
$210 |
$101 |
$140 | |
| Drug screen (urine) |
— |
$128 |
$62 |
$17 | |
| Echocardiogram |
— |
$375 |
$181 |
$138 | |
| EKG / ECG (tracing only) |
— |
$264 |
$72 |
$7 | |
| Electrocardiogram (EKG) |
— |
$264 |
$72 |
$8 | |
| Electrolyte panel |
— |
$43 |
$28 |
$7 | |
| Emergency department visit |
— |
$182 |
$101 |
$69 | |
| Emergency department visit (level 1) |
— |
$182 |
$66 |
$11 | |
| Emergency department visit (level 2) |
— |
$124 |
$58 |
$40 | |
| Emergency department visit (level 3) |
— |
$165 |
$99 |
$69 | |
| Emergency department visit (level 4) |
— |
$454 |
$169 |
$118 | |
| Emergency department visit (level 5) |
— |
$275 |
$169 |
$171 | |
| Esophageal dilation |
— |
$2,178 |
$2,178 |
$522 | |
| Fecal occult blood (stool) test |
— |
$30 |
$13 |
$10 | |
| Fecal occult blood (stool) test (guaiac, gFOBT) |
— |
$40 |
$14 |
$4 | |
| Fecal occult blood (stool) test (immunochemical, FIT) |
— |
$20 |
$6 |
$16 | |
| Ferritin (iron) test |
— |
$144 |
$14 |
$14 | |
| Flu test |
— |
$85 |
$21 |
$17 | |
| Folate (folic acid) test |
— |
$165 |
$15 |
$15 | |
| Foreign body removal (skin) |
— |
$69 |
$62 |
$157 | |
| Free T4 thyroid test |
— |
$47 |
$9 |
$9 | |
| FSH hormone test |
— |
$29 |
$14 |
$19 | |
| Hematocrit test |
— |
$32 |
$32 |
$2 | |
| Hemoglobin A1c (diabetes test) |
— |
$68 |
$23 |
$10 | |
| HIV test |
— |
$80 |
$24 |
$19 | |
| HIV test (antigen/antibody combo) |
— |
$80 |
$24 |
$24 | |
| Iron blood test |
— |
$32 |
$6 |
$6 | |
| IV infusion therapy |
— |
$158 |
$60 |
$44 | |
| IV infusion therapy (each additional) |
— |
$60 |
$59 |
$21 | |
| IV infusion therapy (initial) |
— |
$255 |
$123 |
$67 | |
| Joint aspiration (small/intermediate) |
— |
$375 |
$116 |
$57 | |
| Joint aspiration or injection (mid-size joint) |
— |
$375 |
$116 |
$57 | |
| Kidney ultrasound |
— |
$454 |
$245 |
$84 | |
| Knee joint injection |
— |
$313 |
$74 |
$69 | |
| LDH test |
— |
$32 |
$6 |
$6 | |
| Leg vein ultrasound (Doppler) |
— |
$784 |
$274 |
$150 | |
| Leg vein ultrasound (Doppler) (limited) |
— |
$743 |
$230 |
$116 | |
| Lipase test |
— |
$65 |
$20 |
$7 | |
| Lipid (cholesterol) panel |
— |
$88 |
$13 |
$13 | |
| Liver function panel |
— |
$47 |
$8 |
$8 | |
| Lung function test (PFT) |
— |
$176 |
$111 |
$37 | |
| Magnesium blood test |
— |
$29 |
$7 |
$7 | |
| Nebulizer breathing treatment |
— |
$123 |
$44 |
$9 | |
| Occupational therapy evaluation |
— |
$236 |
$57 |
$101 | |
| Occupational therapy evaluation (low complexity) |
— |
$236 |
$57 |
$101 | |
| Office visit (established patient) |
— |
$269 |
$75 |
$115 | |
| Office visit (new patient) |
— |
$288 |
$125 |
$177 | |
| Office visit, established patient (level 3) |
— |
$263 |
$74 |
$95 | |
| Office visit, established patient (level 4) |
— |
$275 |
$77 |
$136 | |
| Office visit, new patient (level 3) |
— |
$275 |
$95 |
$118 | |
| Office visit, new patient (level 4) |
— |
$288 |
$184 |
$177 | |
| Office visit, new patient (level 5) |
— |
$300 |
$61 |
$237 | |
| Pelvic ultrasound |
— |
$454 |
$249 |
$78 | |
| Pelvic ultrasound (complete) |
— |
$454 |
$249 |
$105 | |
| Phosphorus blood test |
— |
$25 |
$5 |
$5 | |
| Physical therapy evaluation |
— |
$236 |
$59 |
$98 | |
| Platelet count |
— |
$29 |
$29 |
$4 | |
| Pneumonia vaccine |
— |
$57 |
$57 |
— | |
| Pregnancy blood test (hCG) |
— |
$65 |
$17 |
$8 | |
| Pregnancy ultrasound |
— |
$660 |
$318 |
$126 | |
| Pregnancy ultrasound (first trimester) |
— |
$660 |
$318 |
$117 | |
| Procalcitonin test |
— |
$69 |
$27 |
$27 | |
| Prolactin test |
— |
$382 |
$382 |
$19 | |
| Prostate test (PSA) |
— |
$73 |
$24 |
$18 | |
| Retinal (fundus) photography |
— |
$0 |
$0 |
$37 | |
| Scoliosis spine X-ray |
— |
$738 |
$356 |
$58 | |
| Scoliosis spine X-ray (3 views) |
— |
$738 |
$356 |
$72 | |
| Screening colonoscopy |
— |
$1,815 |
$581 |
$378 | |
| Screening mammogram |
— |
$188 |
$93 |
$126 | |
| Scrotal ultrasound |
— |
$273 |
$132 |
$99 | |
| Sedimentation rate (ESR) test |
— |
$24 |
$4 |
$3 | |
| Simple laceration repair (small, up to 2.5 cm) |
— |
$454 |
$120 |
$114 | |
| Simple wound stitches |
— |
$454 |
$141 |
$127 | |
| Skin biopsy |
— |
$138 |
$40 |
$121 | |
| Skin biopsy (punch) |
— |
$138 |
$40 |
$121 | |
| Skin lesion freezing (cryotherapy) |
— |
$0 |
$0 |
$36 | |
| Skin tag removal |
— |
$250 |
$94 |
$92 | |
| Speech therapy |
— |
$410 |
$52 |
$76 | |
| Spirometry (lung function test) |
— |
$101 |
$81 |
$30 | |
| Spirometry with bronchodilator |
— |
$250 |
$121 |
$43 | |
| Strep throat test |
— |
$40 |
$16 |
$17 | |
| Swallow study |
— |
$319 |
$211 |
$85 | |
| T3 thyroid test |
— |
$80 |
$52 |
$14 | |
| Testosterone test |
— |
$258 |
$143 |
$26 | |
| Thyroid test (TSH) |
— |
$65 |
$20 |
$17 | |
| Thyroid ultrasound |
— |
$273 |
$100 |
$109 | |
| Transvaginal ultrasound |
— |
$330 |
$166 |
$118 | |
| Trigger point injection |
— |
$313 |
$313 |
$56 | |
| Trigger point injection (1-2 muscles) |
— |
$313 |
$313 |
$52 | |
| Troponin (heart) test |
— |
$86 |
$27 |
$12 | |
| Upper GI endoscopy (EGD) |
— |
$2,178 |
$675 |
$371 | |
| Uric acid (gout) test |
— |
$29 |
$5 |
$5 | |
| Urinalysis |
— |
$29 |
$3 |
$3 | |
| Urine microalbumin test |
— |
$207 |
$6 |
$5 | |
| Urine pregnancy test |
— |
$32 |
$7 |
$9 | |
| Vitamin B12 test |
— |
$176 |
$15 |
$15 | |
| Vitamin D test |
— |
$91 |
$30 |
$30 | |
| Wart removal |
— |
$94 |
$94 |
$121 | |
| Well-child visit |
— |
$250 |
$107 |
— | |
| Wound debridement |
— |
$1,725 |
$535 |
$186 | |
| X-ray of the abdomen |
— |
$299 |
$122 |
$36 | |
| X-ray of the ankle |
— |
$263 |
$144 |
$37 | |
| X-ray of the collarbone |
— |
$240 |
$143 |
$33 | |
| X-ray of the elbow |
— |
$266 |
$156 |
$33 | |
| X-ray of the facial bones |
— |
$337 |
$162 |
$39 | |
| X-ray of the foot |
— |
$261 |
$126 |
$34 | |
| X-ray of the forearm |
— |
$208 |
$124 |
$29 | |
| X-ray of the hand |
— |
$260 |
$143 |
$38 | |
| X-ray of the hip |
— |
$319 |
$111 |
$49 | |
| X-ray of the hip (3 views) |
— |
$319 |
$111 |
$49 | |
| X-ray of the knee |
— |
$260 |
$128 |
$42 | |
| X-ray of the knee (2 views) |
— |
$253 |
$91 |
$34 | |
| X-ray of the knee (3 views) |
— |
$266 |
$131 |
$42 | |
| X-ray of the lower back (lumbar spine) |
— |
$369 |
$187 |
$47 | |
| X-ray of the lower back (lumbar spine) (2 views) |
— |
$388 |
$155 |
$40 | |
| X-ray of the lower back (lumbar spine) (4+ views) |
— |
$349 |
$208 |
$53 | |
| X-ray of the lower leg |
— |
$261 |
$155 |
$31 | |
| X-ray of the mid-back (thoracic spine) |
— |
$349 |
$191 |
$36 | |
| X-ray of the mid-back (thoracic spine) (2 views) |
— |
$334 |
$199 |
$33 | |
| X-ray of the mid-back (thoracic spine) (3 views) |
— |
$363 |
$175 |
$39 | |
| X-ray of the neck (cervical spine) |
— |
$382 |
$182 |
$47 | |
| X-ray of the neck (cervical spine) (3 views) |
— |
$370 |
$186 |
$40 | |
| X-ray of the pelvis |
— |
$243 |
$117 |
$36 | |
| X-ray of the pelvis (1 view) |
— |
$243 |
$117 |
$28 | |
| X-ray of the ribs |
— |
$406 |
$175 |
$42 | |
| X-ray of the ribs (2 views) |
— |
$362 |
$175 |
$36 | |
| X-ray of the shoulder |
— |
$330 |
$104 |
$36 | |
| X-ray of the skull |
— |
$382 |
$195 |
$40 | |
| X-ray of the upper arm |
— |
$192 |
$98 |
$32 | |
| X-ray of the wrist |
— |
$271 |
$114 |
$43 | |