| 3D mammogram (tomosynthesis) |
$35 |
$220 |
$22 |
$51 | |
| Abdominal fluid drain (paracentesis) |
$533 |
$3,330 |
$1,527 |
$284 | |
| Abdominal ultrasound |
$260 |
$1,625 |
$245 |
$100 | |
| Abdominal ultrasound (complete) |
$319 |
$1,992 |
$245 |
$114 | |
| Abdominal ultrasound (limited) |
$201 |
$1,257 |
$233 |
$86 | |
| Abscess drainage (complex or multiple) |
$124 |
$776 |
$1,142 |
$220 | |
| Abscess drainage (simple) |
$93 |
$579 |
$1,142 |
$129 | |
| Abscess incision and drainage |
$108 |
$678 |
$1,142 |
$174 | |
| Acupuncture |
$16 |
$97 |
$17 |
$38 | |
| Acupuncture (each additional) |
$16 |
$97 |
$0 |
$28 | |
| Albumin blood test |
$13 |
$81 |
$5 |
$5 | |
| Aldosterone test |
$89 |
$559 |
$41 |
$41 | |
| Alkaline phosphatase test |
$20 |
$122 |
$5 |
$5 | |
| Allergy patch testing |
$480 |
$2,998 |
$154 |
$5 | |
| Allergy shots |
$27 |
$167 |
$1,181 |
$11 | |
| Alpha-fetoprotein (AFP) test |
$80 |
$503 |
$17 |
$17 | |
| ALT liver enzyme test |
$19 |
$121 |
$5 |
$5 | |
| Ammonia blood test |
$33 |
$204 |
$15 |
$15 | |
| Amniocentesis |
$206 |
$1,287 |
$1,142 |
$120 | |
| Amylase test |
$29 |
$183 |
$6 |
$6 | |
| Anal fistula repair |
$919 |
$5,314 |
$1,952 |
$541 | |
| Annual physical (established patient) |
$74 |
$465 |
$119 |
— | |
| Anoscopy |
$134 |
$840 |
$1,142 |
$129 | |
| Aortic aneurysm repair (AAA) |
$629 |
$3,929 |
$2,847 |
$1,345 | |
| Aortic valve replacement |
$25,933 |
$162,081 |
— |
$1,603 | |
| Arterial blood gas (ABG) |
$55 |
$344 |
$26 |
$26 | |
| AST liver enzyme test |
$23 |
$146 |
$5 |
$5 | |
| Barium swallow study |
$209 |
$1,306 |
$172 |
$107 | |
| Bartholin cyst removal |
$81 |
$504 |
$1,142 |
$182 | |
| Basic metabolic panel |
$57 |
$358 |
$8 |
$8 | |
| Benign skin lesion removal |
$224 |
$1,402 |
$1,142 |
$171 | |
| Bilirubin blood test |
$20 |
$127 |
$5 |
$5 | |
| Bladder function test (urodynamics) |
$241 |
$1,508 |
$1,142 |
$345 | |
| Bladder scope (cystoscopy) |
$551 |
$3,442 |
$1,142 |
$216 | |
| Bladder tumor removal (TURBT) |
$1,636 |
$10,223 |
$1,636 |
$236 | |
| Blood clotting test (PT/INR) |
$17 |
$104 |
$4 |
$4 | |
| Blood crossmatch |
$60 |
$375 |
$51 |
— | |
| Blood glucose test |
$16 |
$99 |
$4 |
$5 | |
| Blood transfusion |
$261 |
$1,630 |
$170 |
$47 | |
| Blood type and screen |
$58 |
$361 |
$7 |
$10 | |
| BNP (heart failure) test |
$54 |
$335 |
$39 |
$39 | |
| Bone density scan (DEXA) |
$207 |
$1,295 |
$146 |
$39 | |
| Bone marrow biopsy |
$546 |
$3,413 |
$1,142 |
$172 | |
| Bone scan (nuclear) |
$607 |
$3,795 |
$887 |
$259 | |
| Botox for migraine |
$141 |
$880 |
$1,142 |
$157 | |
| Breast biopsy |
$463 |
$2,892 |
$1,527 |
$478 | |
| Breast MRI |
$772 |
$7,533 |
$1,476 |
$216 | |
| Breast MRI without contrast |
$309 |
$1,934 |
$1,476 |
$216 | |
| Breast reconstruction |
$1,648 |
$10,298 |
— |
$1,227 | |
| Breast ultrasound |
$167 |
$1,041 |
$245 |
$92 | |
| Breast ultrasound (complete) |
$168 |
$1,050 |
$245 |
$100 | |
| Breast ultrasound (limited) |
$165 |
$1,032 |
$207 |
$84 | |
| Breathing tube insertion (intubation) |
$170 |
$1,064 |
$1,142 |
$133 | |
| Bronchoscopy |
$418 |
$2,612 |
$1,527 |
$303 | |
| Burn dressing and debridement (medium) |
$128 |
$798 |
$1,527 |
$166 | |
| Burn dressing and debridement (small) |
$41 |
$258 |
$1,142 |
$93 | |
| Burn treatment |
$84 |
$528 |
$1,142 |
$129 | |
| C-reactive protein (CRP) |
$25 |
$158 |
$5 |
$5 | |
| CA 19-9 tumor marker test |
$61 |
$379 |
$21 |
$21 | |
| CA-125 ovarian marker test |
$72 |
$451 |
$21 |
$21 | |
| Calcium blood test |
$16 |
$97 |
$5 |
$5 | |
| Capsule endoscopy |
— |
$3,145 |
$1,197 |
$802 | |
| Cardiac ablation |
$12,768 |
$79,801 |
$3,403 |
$759 | |
| Cardiac catheterization |
$5,760 |
$36,000 |
$3,403 |
$1,049 | |
| Cardiac event monitor |
$181 |
$1,131 |
$286 |
$170 | |
| Cardiac MRI |
$736 |
$4,602 |
$1,476 |
$322 | |
| Cardiac MRI without contrast |
$714 |
$4,462 |
$1,476 |
$280 | |
| Cardiac rehabilitation |
$35 |
$217 |
$164 |
$26 | |
| Cardiac stress test |
$358 |
$2,237 |
$917 |
$39 | |
| Cardioversion |
$428 |
$2,678 |
$1,941 |
$155 | |
| Carotid artery surgery |
$3,810 |
$23,813 |
— |
$1,026 | |
| Carotid artery ultrasound |
$261 |
$1,632 |
$1,068 |
$156 | |
| Cataract surgery |
$1,193 |
$7,456 |
$2,448 |
$547 | |
| CEA tumor marker test |
$57 |
$356 |
$19 |
$19 | |
| Celiac disease test |
$6 |
$35 |
$12 |
$12 | |
| Central line placement |
$609 |
$3,805 |
$1,142 |
$238 | |
| Cervical cerclage |
$1,047 |
$6,542 |
$1,142 |
$137 | |
| Cervical LEEP procedure |
$745 |
$4,655 |
$1,527 |
$325 | |
| Chalazion (eyelid cyst) removal |
$211 |
$1,321 |
$1,142 |
$131 | |
| Chemotherapy infusion |
$164 |
$1,025 |
$1,074 |
$81 | |
| Chemotherapy infusion (each additional) |
$108 |
$672 |
$1,074 |
$28 | |
| Chemotherapy infusion (first hour) |
$220 |
$1,378 |
$1,074 |
$133 | |
| Chest fluid drain (thoracentesis) |
$200 |
$1,247 |
$1,142 |
$311 | |
| Chest tube insertion |
$548 |
$3,422 |
$1,527 |
$143 | |
| Chest X-ray |
$101 |
$633 |
$146 |
$37 | |
| Chest X-ray (1 view) |
$92 |
$574 |
$146 |
$25 | |
| Chest X-ray (2 views) |
$103 |
$645 |
$146 |
$33 | |
| Chickenpox (varicella) vaccine |
$142 |
$885 |
$182 |
— | |
| Circumcision |
$1,678 |
$10,488 |
$1,142 |
$167 | |
| CK-MB heart enzyme test |
$39 |
$243 |
$12 |
$12 | |
| Clotting time test (PTT) |
$24 |
$147 |
$6 |
$6 | |
| Colonoscopy |
$780 |
$4,873 |
$1,527 |
$480 | |
| Colposcopy |
$170 |
$1,065 |
$1,142 |
$161 | |
| Complete blood count (CBC) |
$34 |
$215 |
$8 |
$7 | |
| Complete blood count (CBC) (complete) |
$41 |
$257 |
$8 |
$8 | |
| Complex wound repair |
$187 |
$1,166 |
$1,744 |
$390 | |
| Comprehensive eye exam |
$64 |
$465 |
$226 |
$138 | |
| Comprehensive metabolic panel |
$87 |
$544 |
$11 |
$11 | |
| Contact lens fitting |
$91 |
$569 |
$0 |
— | |
| Contraceptive implant (Nexplanon) |
$589 |
$3,682 |
$1,142 |
$115 | |
| Copper blood test |
$14 |
$90 |
$12 |
$12 | |
| Coronary CT angiography |
$905 |
$5,657 |
$774 |
$326 | |
| Cortisol test |
$63 |
$392 |
$16 |
$16 | |
| COVID-19 PCR test |
$28 |
$172 |
$51 |
$51 | |
| COVID-19 vaccine |
— |
$0 |
$0 |
— | |
| CPAP titration study |
$236 |
$1,472 |
$1,000 |
$69 | |
| Creatine kinase (CK) test |
$60 |
$373 |
$7 |
$7 | |
| CT angiography of the chest |
$811 |
$5,069 |
$774 |
$281 | |
| CT angiography of the head |
$849 |
$5,307 |
$774 |
$274 | |
| CT colonography (virtual colonoscopy) |
$626 |
$3,912 |
$1,011 |
$835 | |
| CT scan of the abdomen |
$797 |
$4,984 |
$774 |
$230 | |
| CT scan of the abdomen and pelvis |
$720 |
$4,497 |
$774 |
$300 | |
| CT scan of the abdomen and pelvis with and without contrast |
$739 |
$4,616 |
$774 |
$338 | |
| CT scan of the abdomen and pelvis with contrast |
$720 |
$4,497 |
$774 |
$300 | |
| CT scan of the abdomen and pelvis without contrast |
$711 |
$4,441 |
$774 |
$183 | |
| CT scan of the abdomen with and without contrast |
$930 |
$5,811 |
$774 |
$259 | |
| CT scan of the abdomen with contrast |
$797 |
$4,984 |
$774 |
$230 | |
| CT scan of the abdomen without contrast |
$792 |
$4,950 |
$774 |
$136 | |
| CT scan of the arm |
$519 |
$3,241 |
$774 |
$199 | |
| CT scan of the arm with contrast |
$519 |
$3,241 |
$774 |
$199 | |
| CT scan of the arm without contrast |
$416 |
$2,602 |
$774 |
$161 | |
| CT scan of the chest |
$973 |
$5,728 |
$774 |
$167 | |
| CT scan of the chest with and without contrast |
$1,029 |
$6,432 |
$774 |
$196 | |
| CT scan of the chest with contrast |
$916 |
$5,728 |
$774 |
$167 | |
| CT scan of the chest without contrast |
— |
$4,171 |
$774 |
$133 | |
| CT scan of the head |
$706 |
$4,412 |
$774 |
$148 | |
| CT scan of the head with and without contrast |
$777 |
$4,856 |
$774 |
$173 | |
| CT scan of the head with contrast |
$706 |
$4,412 |
$774 |
$148 | |
| CT scan of the head without contrast |
$590 |
$3,687 |
$774 |
$107 | |
| CT scan of the leg |
$717 |
$4,483 |
$774 |
$166 | |
| CT scan of the leg with contrast |
$717 |
$4,483 |
$774 |
$166 | |
| CT scan of the leg without contrast |
$571 |
$3,566 |
$774 |
$130 | |
| CT scan of the lower back (lumbar spine) |
$908 |
$5,675 |
$774 |
$169 | |
| CT scan of the lower back (lumbar spine) with and without contrast |
$913 |
$5,709 |
$774 |
$197 | |
| CT scan of the lower back (lumbar spine) with contrast |
$908 |
$5,675 |
$774 |
$169 | |
| CT scan of the lower back (lumbar spine) without contrast |
$671 |
$4,196 |
$774 |
$130 | |
| CT scan of the neck |
$615 |
$3,841 |
$774 |
$183 | |
| CT scan of the neck (cervical spine) |
$778 |
$4,861 |
$774 |
$168 | |
| CT scan of the neck (cervical spine) with and without contrast |
$904 |
$5,648 |
$774 |
$196 | |
| CT scan of the neck (cervical spine) with contrast |
$778 |
$4,861 |
$774 |
$168 | |
| CT scan of the neck (cervical spine) without contrast |
$625 |
$3,904 |
$774 |
$131 | |
| CT scan of the neck with and without contrast |
$858 |
$5,362 |
$774 |
$220 | |
| CT scan of the neck with contrast |
$593 |
$3,709 |
$774 |
$183 | |
| CT scan of the neck without contrast |
$615 |
$3,841 |
$774 |
$150 | |
| CT scan of the pelvis |
$754 |
$4,713 |
$774 |
$226 | |
| CT scan of the pelvis with and without contrast |
$880 |
$5,503 |
$774 |
$251 | |
| CT scan of the pelvis with contrast |
$754 |
$4,713 |
$774 |
$226 | |
| CT scan of the pelvis without contrast |
$531 |
$3,316 |
$774 |
$133 | |
| CT scan of the sinuses |
$500 |
$3,125 |
$774 |
$152 | |
| CT scan of the sinuses with and without contrast |
$828 |
$5,173 |
$774 |
$184 | |
| CT scan of the sinuses with contrast |
$443 |
$2,769 |
$774 |
$152 | |
| CT scan of the sinuses without contrast |
$500 |
$3,125 |
$774 |
$128 | |
| D-dimer test |
$27 |
$166 |
$10 |
$10 | |
| Defibrillator (ICD) implant |
$10,543 |
$65,891 |
$3,403 |
$798 | |
| Developmental screening (child) |
$133 |
$830 |
$177 |
— | |
| DHEA-sulfate test |
$58 |
$364 |
$22 |
$22 | |
| Diagnostic mammogram |
$115 |
$717 |
$104 |
$140 | |
| Dilation and curettage (D&C) |
$1,239 |
$7,745 |
$1,527 |
$298 | |
| Drug screen (urine) |
$20 |
$123 |
$62 |
$17 | |
| Ear pressure test (tympanometry) |
$58 |
$361 |
$497 |
$16 | |
| Ear tubes (myringotomy) |
$638 |
$3,989 |
$1,744 |
$174 | |
| Echocardiogram |
$470 |
$1,504 |
$651 |
$138 | |
| Echocardiogram with and without contrast |
— |
$1,481 |
$651 |
$101 | |
| Echocardiogram without contrast |
$241 |
$1,504 |
$651 |
$138 | |
| EEG (awake and asleep) |
$174 |
$1,086 |
$494 |
$482 | |
| EKG / ECG (tracing only) |
$98 |
$610 |
$286 |
$7 | |
| Electrocardiogram (EKG) |
$103 |
$643 |
$286 |
$8 | |
| Electroencephalogram (EEG) |
$240 |
$1,499 |
$494 |
$448 | |
| Electrolyte panel |
$46 |
$285 |
$7 |
$7 | |
| Electromyography (EMG) |
$87 |
$542 |
$509 |
$141 | |
| Emergency department visit |
$223 |
$1,393 |
$863 |
$69 | |
| Emergency department visit (level 1) |
$48 |
$297 |
$309 |
$11 | |
| Emergency department visit (level 2) |
$135 |
$842 |
$863 |
$40 | |
| Emergency department visit (level 3) |
$223 |
$1,393 |
$863 |
$69 | |
| Emergency department visit (level 4) |
$345 |
$2,154 |
$863 |
$118 | |
| Emergency department visit (level 5) |
$519 |
$3,242 |
$985 |
$171 | |
| Endometrial biopsy |
$69 |
$431 |
$1,142 |
$98 | |
| Epidural steroid injection |
$339 |
$2,121 |
$1,142 |
$275 | |
| ERCP (bile duct endoscopy) |
$827 |
$5,170 |
$1,527 |
$311 | |
| Esophageal dilation |
$697 |
$4,358 |
$1,142 |
$522 | |
| Esophageal variceal banding |
$810 |
$5,061 |
$1,142 |
$126 | |
| Estradiol (estrogen) test |
$79 |
$495 |
$28 |
$28 | |
| Eyelid surgery (blepharoplasty) |
$608 |
$3,799 |
$2,096 |
$552 | |
| Facet joint injection (spine) |
$348 |
$2,174 |
$1,142 |
$99 | |
| Fallopian tube X-ray (HSG) |
$191 |
$1,193 |
$286 |
$164 | |
| Family therapy session |
$72 |
$447 |
$257 |
$110 | |
| Fecal occult blood (stool) test |
$11 |
$69 |
$13 |
$10 | |
| Fecal occult blood (stool) test (guaiac, gFOBT) |
$13 |
$79 |
$4 |
$4 | |
| Fecal occult blood (stool) test (immunochemical, FIT) |
$9 |
$59 |
$16 |
$16 | |
| Feeding tube (PEG) placement |
$398 |
$2,489 |
$1,527 |
$178 | |
| Ferritin (iron) test |
$31 |
$194 |
$14 |
$14 | |
| Fibrinogen test |
$33 |
$209 |
$10 |
$10 | |
| Flexible sigmoidoscopy |
$238 |
$1,490 |
$1,142 |
$323 | |
| Flu test |
$23 |
$146 |
$17 |
$17 | |
| Flu vaccine |
$9 |
$58 |
$24 |
— | |
| Folate (folic acid) test |
$36 |
$222 |
$15 |
$15 | |
| Foreign body removal (skin) |
$64 |
$401 |
$1,142 |
$157 | |
| Free T4 thyroid test |
$34 |
$212 |
$9 |
$9 | |
| FSH hormone test |
$61 |
$380 |
$19 |
$19 | |
| Gallbladder removal (laparoscopic) |
$1,697 |
$11,158 |
$2,448 |
$658 | |
| Gallbladder scan (HIDA) |
$433 |
$2,706 |
$1,374 |
$334 | |
| GGT liver test |
$30 |
$185 |
$7 |
$7 | |
| Glucose tolerance test |
$25 |
$158 |
$13 |
$8 | |
| Group therapy session |
$27 |
$171 |
$153 |
$30 | |
| H. pylori test |
$107 |
$666 |
$67 |
$67 | |
| HDL cholesterol test |
$41 |
$257 |
$8 |
$8 | |
| Hearing test (audiometry) |
$104 |
$651 |
$497 |
$36 | |
| Hematocrit test |
$10 |
$64 |
$2 |
$2 | |
| Hemodialysis |
$298 |
$1,865 |
$461 |
$75 | |
| Hemoglobin A1c (diabetes test) |
$33 |
$205 |
$10 |
$10 | |
| Hemorrhoid removal |
$719 |
$4,497 |
$1,142 |
$338 | |
| Hepatitis A vaccine |
$33 |
$207 |
$65 |
— | |
| Hepatitis B test |
$56 |
$352 |
$10 |
$10 | |
| Hepatitis B vaccine |
$29 |
$182 |
$70 |
— | |
| Hepatitis C test |
$56 |
$352 |
$28 |
$14 | |
| HIV test |
$43 |
$270 |
$18 |
$19 | |
| HIV test (antibody) |
$50 |
$311 |
$14 |
$14 | |
| HIV test (antigen/antibody combo) |
$36 |
$228 |
$20 |
$24 | |
| Holter heart monitor |
$349 |
$2,184 |
$1,578 |
$26 | |
| Home sleep apnea test |
— |
$520 |
$411 |
$123 | |
| HPV vaccine |
$101 |
$633 |
$227 |
— | |
| Hydrocele repair |
— |
$11,495 |
$1,744 |
$315 | |
| Hysterectomy |
$4,729 |
$29,556 |
$2,847 |
$933 | |
| Hysteroscopy |
$1,274 |
$7,964 |
$1,744 |
$1,270 | |
| Iron blood test |
$21 |
$130 |
$6 |
$6 | |
| IUD insertion |
$130 |
$814 |
$1,142 |
— | |
| IUD removal |
$90 |
$563 |
$1,142 |
$112 | |
| IV infusion therapy |
$94 |
$587 |
$99 |
$44 | |
| IV infusion therapy (each additional) |
$60 |
$373 |
$74 |
$21 | |
| IV infusion therapy (initial) |
$128 |
$801 |
$226 |
$67 | |
| IVC filter placement |
$3,264 |
$20,402 |
$1,744 |
$1,885 | |
| Joint aspiration (small/intermediate) |
$126 |
$785 |
$1,142 |
$57 | |
| Joint aspiration or injection (mid-size joint) |
$80 |
$499 |
$1,142 |
$57 | |
| Joint aspiration or injection (small joint) |
$171 |
$1,071 |
$1,142 |
$56 | |
| Kidney biopsy |
$405 |
$2,534 |
$1,142 |
$492 | |
| Kidney scan (nuclear) |
$517 |
$3,231 |
$922 |
$172 | |
| Kidney stone shock-wave (lithotripsy) |
$3,526 |
$22,037 |
$4,580 |
$760 | |
| Kidney ultrasound |
$213 |
$1,331 |
$245 |
$84 | |
| Kidney ultrasound (limited) |
$242 |
$1,510 |
$219 |
$61 | |
| Knee joint injection |
$124 |
$772 |
$1,142 |
$69 | |
| Lactate test |
$36 |
$225 |
$12 |
$12 | |
| Laryngoscopy |
$560 |
$3,503 |
$1,527 |
$189 | |
| LDH test |
$20 |
$122 |
$6 |
$6 | |
| LDL cholesterol test |
$24 |
$149 |
$11 |
$11 | |
| Leg artery angiogram |
$1,476 |
$9,228 |
$146 |
$149 | |
| Leg artery angioplasty |
$3,279 |
$20,495 |
$2,160 |
— | |
| Leg vein ultrasound (Doppler) |
$251 |
$1,568 |
$1,068 |
$150 | |
| Leg vein ultrasound (Doppler) (limited) |
$247 |
$1,541 |
$1,068 |
$116 | |
| LH hormone test |
$60 |
$375 |
$19 |
$19 | |
| Lipase test |
$29 |
$183 |
$7 |
$7 | |
| Lipid (cholesterol) panel |
$46 |
$285 |
$13 |
$13 | |
| Liver biopsy |
$523 |
$3,268 |
$1,142 |
$288 | |
| Liver function panel |
$65 |
$405 |
$8 |
$8 | |
| Lumbar discectomy |
$2,306 |
$14,412 |
$2,448 |
$898 | |
| Lung function test (PFT) |
$114 |
$711 |
$455 |
$37 | |
| Lung scan (V/Q) |
$633 |
$3,958 |
$977 |
$291 | |
| Magnesium blood test |
$21 |
$134 |
$7 |
$7 | |
| Meniscus repair (knee) |
$1,910 |
$11,937 |
$1,744 |
$714 | |
| MMR vaccine |
$35 |
$219 |
$76 |
— | |
| Mohs skin cancer surgery |
$277 |
$1,734 |
$1,142 |
$535 | |
| MRA of the brain |
$945 |
$5,906 |
$1,476 |
$226 | |
| MRA of the brain with contrast |
$945 |
$5,906 |
$1,476 |
$226 | |
| MRA of the brain without contrast |
$1,183 |
$7,391 |
$1,476 |
$328 | |
| MRA of the neck |
$929 |
$5,696 |
$1,476 |
$245 | |
| MRA of the neck with contrast |
$947 |
$5,919 |
$1,476 |
$245 | |
| MRA of the neck without contrast |
$911 |
$5,696 |
$1,476 |
$343 | |
| MRI of the abdomen |
$780 |
$4,872 |
$1,476 |
$300 | |
| MRI of the abdomen with contrast |
$543 |
$3,391 |
$1,476 |
$300 | |
| MRI of the abdomen without contrast |
$780 |
$4,872 |
$1,476 |
$194 | |
| MRI of the ankle |
$913 |
$5,709 |
$1,476 |
$261 | |
| MRI of the ankle with contrast |
$913 |
$5,709 |
$1,476 |
$261 | |
| MRI of the ankle without contrast |
$889 |
$5,558 |
$1,476 |
$222 | |
| MRI of the brain |
$947 |
$5,920 |
$1,476 |
$269 | |
| MRI of the brain with contrast |
$1,041 |
$6,508 |
$1,476 |
$269 | |
| MRI of the brain without contrast |
$785 |
$4,907 |
$1,476 |
$195 | |
| MRI of the chest |
$882 |
$5,514 |
$1,476 |
$371 | |
| MRI of the chest with contrast |
$538 |
$3,361 |
$1,476 |
$371 | |
| MRI of the chest without contrast |
$1,005 |
$6,279 |
$1,476 |
$466 | |
| MRI of the knee |
$937 |
$6,407 |
$1,476 |
$315 | |
| MRI of the knee with contrast |
$848 |
$5,300 |
$1,476 |
$315 | |
| MRI of the knee without contrast |
$1,025 |
$6,407 |
$1,476 |
$204 | |
| MRI of the lower back (lumbar spine) |
$870 |
$5,437 |
$1,476 |
$270 | |
| MRI of the lower back (lumbar spine) with contrast |
$870 |
$5,437 |
$1,476 |
$270 | |
| MRI of the lower back (lumbar spine) without contrast |
$866 |
$5,410 |
$1,476 |
$192 | |
| MRI of the mid-back (thoracic spine) |
$910 |
$5,685 |
$1,476 |
$271 | |
| MRI of the mid-back (thoracic spine) with and without contrast |
$1,179 |
$7,367 |
$1,476 |
$319 | |
| MRI of the mid-back (thoracic spine) with contrast |
$910 |
$5,685 |
$1,476 |
$271 | |
| MRI of the mid-back (thoracic spine) without contrast |
$768 |
$4,797 |
$1,476 |
$190 | |
| MRI of the neck (cervical spine) |
$1,034 |
$6,462 |
$1,476 |
$274 | |
| MRI of the neck (cervical spine) with and without contrast |
$1,197 |
$7,479 |
$1,476 |
$318 | |
| MRI of the neck (cervical spine) with contrast |
$1,034 |
$6,462 |
$1,476 |
$274 | |
| MRI of the neck (cervical spine) without contrast |
$924 |
$5,772 |
$1,476 |
$191 | |
| MRI of the pelvis |
$952 |
$5,472 |
$1,476 |
$268 | |
| MRI of the pelvis with contrast |
— |
$3,421 |
$1,476 |
$268 | |
| MRI of the pelvis without contrast |
$876 |
$5,472 |
$1,476 |
$227 | |
| MRI of the shoulder |
$1,080 |
$6,753 |
$1,476 |
$313 | |
| MRI of the shoulder with contrast |
— |
$6,753 |
$1,476 |
$313 | |
| MRI of the shoulder without contrast |
$1,080 |
$6,753 |
$1,476 |
$205 | |
| MRI of the wrist |
$853 |
$5,330 |
$1,476 |
$330 | |
| MRI of the wrist with contrast |
$853 |
$5,330 |
$1,476 |
$330 | |
| MRI of the wrist without contrast |
$852 |
$5,328 |
$1,476 |
$303 | |
| Nebulizer breathing treatment |
$87 |
$545 |
$1,000 |
$9 | |
| Nerve conduction study |
$199 |
$1,242 |
$509 |
$118 | |
| Nuchal translucency ultrasound |
$203 |
$1,268 |
$229 |
$116 | |
| Nuclear cardiac stress test |
$1,194 |
$7,460 |
$2,484 |
$428 | |
| Occupational therapy evaluation |
$49 |
$309 |
$84 |
$101 | |
| Occupational therapy evaluation (high complexity) |
$49 |
$309 |
$84 |
$101 | |
| Occupational therapy evaluation (low complexity) |
$49 |
$309 |
$84 |
$101 | |
| Occupational therapy evaluation (moderate complexity) |
$49 |
$308 |
$84 |
$101 | |
| Office visit (established patient) |
$29 |
$181 |
$57 |
$115 | |
| Office visit (new patient) |
$29 |
$181 |
$57 |
$177 | |
| Office visit, established patient (level 3) |
$29 |
$181 |
$38 |
$95 | |
| Office visit, established patient (level 4) |
$29 |
$181 |
$57 |
$136 | |
| Office visit, new patient (level 3) |
$29 |
$181 |
$38 |
$118 | |
| Office visit, new patient (level 4) |
$29 |
$181 |
$57 |
$177 | |
| Orthopedic hardware removal |
$609 |
$3,804 |
$1,744 |
$632 | |
| Pap smear (cervical screening) |
$40 |
$252 |
$25 |
$20 | |
| Parathyroid hormone (PTH) test |
$54 |
$336 |
$41 |
$41 | |
| Pelvic ultrasound |
$231 |
$1,445 |
$245 |
$78 | |
| Pelvic ultrasound (complete) |
$243 |
$1,517 |
$245 |
$105 | |
| Pelvic ultrasound (limited) |
$220 |
$1,373 |
$219 |
$51 | |
| PET scan |
$2,253 |
$14,084 |
$2,611 |
— | |
| Phosphorus blood test |
$18 |
$112 |
$5 |
$5 | |
| Physical therapy evaluation |
$62 |
$389 |
$87 |
$98 | |
| Physical therapy evaluation (high complexity) |
$62 |
$389 |
$87 |
$98 | |
| Physical therapy evaluation (moderate complexity) |
$62 |
$388 |
$87 |
$98 | |
| Pilonidal cyst removal |
$910 |
$5,685 |
$1,744 |
$541 | |
| Platelet count |
$36 |
$223 |
$4 |
$4 | |
| Pneumonia vaccine |
$52 |
$325 |
$133 |
— | |
| Pregnancy blood test (hCG) |
$43 |
$269 |
$8 |
$8 | |
| Pregnancy ultrasound |
$250 |
$1,564 |
$245 |
$126 | |
| Pregnancy ultrasound (first trimester) |
$246 |
$1,536 |
$245 |
$117 | |
| Pregnancy ultrasound (second or third trimester) |
$255 |
$1,591 |
$245 |
$136 | |
| Procalcitonin test |
$53 |
$331 |
$27 |
$27 | |
| Prolactin test |
$81 |
$505 |
$19 |
$19 | |
| Prostate biopsy |
$770 |
$4,811 |
$1,527 |
— | |
| Prostate removal (prostatectomy) |
$5,451 |
$34,069 |
$2,448 |
$1,063 | |
| Prostate test (PSA) |
$48 |
$299 |
$18 |
$18 | |
| Psychiatric evaluation |
$109 |
$681 |
$509 |
$188 | |
| Psychotherapy session |
$109 |
$681 |
$257 |
$140 | |
| Pterygium removal (eye) |
$834 |
$5,210 |
$1,527 |
$540 | |
| Pulmonary rehabilitation |
$132 |
$822 |
$455 |
$87 | |
| Radiofrequency nerve ablation |
$921 |
$5,758 |
$1,142 |
$462 | |
| Retina scan (OCT) |
$55 |
$345 |
$107 |
$33 | |
| Retinal (fundus) photography |
— |
$327 |
$213 |
$37 | |
| Retinal detachment repair |
— |
$3,532 |
$3,403 |
$966 | |
| Rheumatoid factor test |
$26 |
$165 |
$6 |
$6 | |
| Routine eye exam |
$84 |
$464 |
$226 |
$88 | |
| Sacroiliac joint injection |
$469 |
$2,932 |
$1,142 |
$176 | |
| Scoliosis spine X-ray |
$98 |
$611 |
$146 |
$58 | |
| Scoliosis spine X-ray (1 view) |
$90 |
$562 |
$146 |
$44 | |
| Scoliosis spine X-ray (3 views) |
$105 |
$659 |
$146 |
$72 | |
| Screening colonoscopy |
$494 |
$3,085 |
$1,527 |
$378 | |
| Screening mammogram |
$99 |
$616 |
$103 |
$126 | |
| Scrotal ultrasound |
$213 |
$1,332 |
$245 |
$99 | |
| Sedimentation rate (ESR) test |
$21 |
$130 |
$4 |
$3 | |
| Semen analysis |
$42 |
$264 |
$15 |
$12 | |
| Sex hormone binding globulin test |
$49 |
$307 |
$22 |
$22 | |
| Shingles vaccine |
$75 |
$469 |
$172 |
— | |
| Simple laceration repair (small, up to 2.5 cm) |
$62 |
$389 |
$1,142 |
$114 | |
| Simple wound stitches |
$69 |
$429 |
$1,142 |
$127 | |
| Sinus surgery (endoscopic) |
$3,189 |
$19,930 |
$1,744 |
$224 | |
| Skin biopsy |
$346 |
$641 |
$1,142 |
$121 | |
| Skin biopsy (punch) |
$103 |
$641 |
$1,142 |
$121 | |
| Skin cancer lesion removal |
$200 |
$1,247 |
$1,142 |
$240 | |
| Skin graft |
$1,301 |
$8,131 |
$1,527 |
$898 | |
| Skin lesion freezing (cryotherapy) |
$42 |
$264 |
$1,142 |
$36 | |
| Skin tag removal |
$93 |
$583 |
$1,142 |
$92 | |
| Sleep study (polysomnography) |
$1,249 |
$7,808 |
$3,277 |
$691 | |
| Soft tissue ultrasound |
$260 |
$1,622 |
$219 |
$64 | |
| Speech therapy |
$56 |
$351 |
$55 |
$76 | |
| Spinal cord stimulator |
$2,332 |
$14,573 |
$1,527 |
$2,388 | |
| Spinal tap (lumbar puncture) |
$340 |
$2,124 |
$1,142 |
$165 | |
| Spine fracture repair (kyphoplasty) |
$2,246 |
$14,035 |
$2,448 |
$5,803 | |
| Spirometry (lung function test) |
$84 |
$528 |
$455 |
$30 | |
| Spirometry with bronchodilator |
$143 |
$893 |
$455 |
$43 | |
| Strep throat test |
$15 |
$96 |
$17 |
$17 | |
| Stress echocardiogram |
$620 |
$2,754 |
$651 |
$209 | |
| Stress echocardiogram (complete) |
— |
$1,636 |
$651 |
$233 | |
| Swallow study |
$83 |
$520 |
$67 |
$85 | |
| T3 thyroid test |
$49 |
$308 |
$14 |
$14 | |
| Tdap (tetanus) vaccine |
$56 |
$349 |
$36 |
— | |
| Testosterone test |
$55 |
$341 |
$26 |
$26 | |
| Thyroid ultrasound |
$212 |
$1,327 |
$245 |
$109 | |
| Thyroid uptake scan |
$352 |
$2,199 |
$754 |
$145 | |
| Tilt table test |
$482 |
$3,014 |
$917 |
$168 | |
| Tonsillectomy |
$3,143 |
$19,644 |
$1,744 |
$252 | |
| Total IgE allergy test |
$49 |
$308 |
$16 |
$16 | |
| Total protein test |
$20 |
$126 |
$4 |
$4 | |
| Tracheostomy |
$1,117 |
$6,980 |
$1,527 |
$273 | |
| Transesophageal echocardiogram (TEE) |
$417 |
$2,604 |
$651 |
$239 | |
| Transesophageal echocardiogram (TEE) with and without contrast |
$602 |
$3,761 |
$651 |
$239 | |
| Transvaginal ultrasound |
$186 |
$1,164 |
$245 |
$118 | |
| Trigger point injection |
$122 |
$763 |
$1,142 |
$56 | |
| Trigger point injection (1-2 muscles) |
$133 |
$832 |
$1,142 |
$52 | |
| Triglycerides test |
$24 |
$149 |
$6 |
$6 | |
| Troponin (heart) test |
$44 |
$275 |
$12 |
$12 | |
| Turbinate reduction |
$997 |
$6,229 |
$1,527 |
$294 | |
| Turning a breech baby (version) |
$547 |
$3,416 |
$227 |
$94 | |
| Upper GI endoscopy (EGD) |
$525 |
$3,279 |
$1,142 |
$371 | |
| Upper GI series (barium) |
$201 |
$1,256 |
$181 |
$128 | |
| Ureteral stent placement |
$767 |
$4,794 |
$1,527 |
$373 | |
| Ureteroscopy (stone removal) |
$2,633 |
$16,454 |
$2,160 |
$365 | |
| Uric acid (gout) test |
$17 |
$104 |
$5 |
$5 | |
| Urinalysis |
$20 |
$128 |
$2 |
$3 | |
| Urine microalbumin test |
$20 |
$123 |
$5 |
$5 | |
| Urine pregnancy test |
$32 |
$197 |
$9 |
$9 | |
| UV light therapy (skin) |
$37 |
$230 |
$1,181 |
$106 | |
| Vaccine administration |
$9 |
$57 |
$15 |
$19 | |
| Vaccine administration (each additional) |
$16 |
$100 |
$9 |
$16 | |
| Varicocele repair |
— |
$8,995 |
$2,160 |
$327 | |
| Varicose vein ablation |
$1,229 |
$7,684 |
$1,744 |
$1,018 | |
| Vasectomy |
$884 |
$5,525 |
$1,527 |
$347 | |
| Visual field test |
$73 |
$457 |
$213 |
$64 | |
| Vitamin B12 test |
$40 |
$248 |
$15 |
$15 | |
| Vitamin D test |
$76 |
$475 |
$30 |
$30 | |
| Vitrectomy (eye) |
$2,035 |
$12,721 |
$3,403 |
$814 | |
| Vocal cord injection |
$1,342 |
$8,389 |
$1,527 |
$211 | |
| Wart removal |
$62 |
$389 |
$1,142 |
$121 | |
| Wound debridement |
$171 |
$1,070 |
$1,527 |
$186 | |
| X-ray of the abdomen |
$169 |
$1,059 |
$146 |
$36 | |
| X-ray of the ankle |
$77 |
$482 |
$146 |
$37 | |
| X-ray of the collarbone |
$89 |
$555 |
$146 |
$33 | |
| X-ray of the elbow |
$97 |
$606 |
$146 |
$33 | |
| X-ray of the facial bones |
$93 |
$580 |
$146 |
$39 | |
| X-ray of the foot |
$106 |
$665 |
$146 |
$34 | |
| X-ray of the forearm |
$104 |
$651 |
$146 |
$29 | |
| X-ray of the hand |
$83 |
$519 |
$146 |
$38 | |
| X-ray of the hip |
$117 |
$729 |
$146 |
$49 | |
| X-ray of the hip (1 view) |
$138 |
$861 |
$146 |
$34 | |
| X-ray of the hip (3 views) |
$104 |
$651 |
$146 |
$49 | |
| X-ray of the hip (4 views) |
$117 |
$729 |
$146 |
$63 | |
| X-ray of the knee |
$94 |
$587 |
$146 |
$42 | |
| X-ray of the knee (2 views) |
$81 |
$507 |
$146 |
$34 | |
| X-ray of the knee (3 views) |
$94 |
$587 |
$146 |
$42 | |
| X-ray of the knee (4+ views) |
$108 |
$673 |
$146 |
$49 | |
| X-ray of the lower back (lumbar spine) |
$135 |
$843 |
$146 |
$47 | |
| X-ray of the lower back (lumbar spine) (2 views) |
$104 |
$648 |
$146 |
$40 | |
| X-ray of the lower back (lumbar spine) (4+ views) |
$166 |
$1,037 |
$146 |
$53 | |
| X-ray of the lower leg |
$93 |
$582 |
$146 |
$31 | |
| X-ray of the mid-back (thoracic spine) |
$142 |
$890 |
$146 |
$36 | |
| X-ray of the mid-back (thoracic spine) (2 views) |
$115 |
$716 |
$146 |
$33 | |
| X-ray of the mid-back (thoracic spine) (3 views) |
$170 |
$1,063 |
$146 |
$39 | |
| X-ray of the neck (cervical spine) |
$156 |
$977 |
$146 |
$47 | |
| X-ray of the neck (cervical spine) (3 views) |
$101 |
$630 |
$146 |
$40 | |
| X-ray of the pelvis |
$125 |
$783 |
$146 |
$36 | |
| X-ray of the pelvis (1 view) |
$106 |
$664 |
$146 |
$28 | |
| X-ray of the ribs |
$175 |
$1,092 |
$146 |
$42 | |
| X-ray of the ribs (2 views) |
$133 |
$829 |
$146 |
$36 | |
| X-ray of the ribs (3 views) |
$175 |
$1,092 |
$146 |
$42 | |
| X-ray of the shoulder |
$121 |
$755 |
$146 |
$36 | |
| X-ray of the skull |
$122 |
$764 |
$146 |
$40 | |
| X-ray of the upper arm |
$90 |
$563 |
$146 |
$32 | |
| X-ray of the wrist |
$85 |
$531 |
$146 |
$43 | |
| YAG laser capsulotomy (eye) |
$460 |
$2,873 |
$1,527 |
$335 | |
| Zinc blood test |
$35 |
$220 |
$11 |
$11 | |