| 3D mammogram (tomosynthesis) |
— |
$180 |
— |
$51 | |
| Abdominal fluid drain (paracentesis) |
— |
$1,687 |
— |
$284 | |
| Abdominal ultrasound |
$235 |
$1,084 |
— |
$100 | |
| Abdominal ultrasound (complete) |
$245 |
$1,862 |
— |
$114 | |
| Abdominal ultrasound (limited) |
$225 |
$305 |
— |
$86 | |
| Abscess drainage (complex or multiple) |
— |
$1,271 |
— |
$220 | |
| Abscess drainage (simple) |
$250 |
$665 |
— |
$129 | |
| Abscess incision and drainage |
$250 |
$968 |
— |
$174 | |
| Achilles tendon repair |
— |
$1,427 |
— |
$624 | |
| ACL knee reconstruction |
— |
$3,722 |
— |
$889 | |
| Adenoid removal (adenoidectomy) |
— |
$897 |
— |
$204 | |
| Albumin blood test |
— |
$48 |
— |
$5 | |
| Aldosterone test |
— |
$94 |
— |
$41 | |
| Alkaline phosphatase test |
— |
$32 |
— |
$5 | |
| Allergy shots |
— |
$31 |
— |
$11 | |
| Alpha-fetoprotein (AFP) test |
$45 |
$59 |
— |
$17 | |
| ALT liver enzyme test |
$10 |
$77 |
— |
$5 | |
| Ammonia blood test |
$25 |
$49 |
— |
$15 | |
| Amniocentesis |
— |
$21 |
— |
$120 | |
| Amylase test |
$10 |
$26 |
— |
$6 | |
| Anal fistula repair |
— |
$1,035 |
— |
$541 | |
| Ankle fracture repair |
— |
$1,241 |
— |
$608 | |
| Ankle replacement |
— |
$2,481 |
— |
$885 | |
| Annual physical (established patient) |
— |
$67 |
— |
— | |
| Annual physical (new patient) |
— |
$82 |
— |
— | |
| Anoscopy |
— |
$180 |
— |
$129 | |
| Antinuclear antibody (ANA) test |
$20 |
$51 |
— |
$12 | |
| Arterial blood gas (ABG) |
— |
$363 |
— |
$26 | |
| AST liver enzyme test |
$10 |
$74 |
— |
$5 | |
| Barium swallow study |
$210 |
$425 |
— |
$107 | |
| Bartholin cyst removal |
— |
$445 |
— |
$182 | |
| Basic metabolic panel |
$15 |
$30 |
— |
$8 | |
| Benign skin lesion removal |
— |
$329 |
— |
$171 | |
| Bilirubin blood test |
$15 |
$74 |
— |
$5 | |
| Bladder function test (urodynamics) |
$485 |
$1,146 |
— |
$345 | |
| Bladder scope (cystoscopy) |
— |
$493 |
— |
$216 | |
| Bladder tumor removal (TURBT) |
— |
$753 |
— |
$236 | |
| Blood clotting test (PT/INR) |
$10 |
$22 |
— |
$4 | |
| Blood crossmatch |
— |
$114 |
— |
— | |
| Blood glucose test |
$10 |
$14 |
— |
$5 | |
| Blood transfusion |
— |
$949 |
— |
$47 | |
| Blood type and screen |
$15 |
$142 |
— |
$10 | |
| Blood type test |
$15 |
$59 |
— |
$3 | |
| Blood type test (ABO group) |
$15 |
$57 |
— |
$3 | |
| Blood type test (Rh/D antigen) |
$15 |
$62 |
— |
$3 | |
| Bone marrow biopsy |
— |
$194 |
— |
$172 | |
| Bone scan (nuclear) |
— |
$804 |
— |
$259 | |
| Breast biopsy |
$550 |
$1,427 |
— |
$478 | |
| Breast MRI |
— |
$1,986 |
— |
$216 | |
| Breast MRI without contrast |
— |
$2,234 |
— |
$216 | |
| Breast ultrasound |
$160 |
$342 |
— |
$92 | |
| Breast ultrasound (limited) |
$100 |
$616 |
— |
$84 | |
| Breathing tube insertion (intubation) |
— |
$445 |
— |
$133 | |
| Bronchoscopy |
— |
$832 |
— |
$303 | |
| Burn dressing and debridement (medium) |
— |
$665 |
— |
$166 | |
| Burn dressing and debridement (small) |
— |
$665 |
— |
$93 | |
| Burn treatment |
— |
$665 |
— |
$129 | |
| CA 19-9 tumor marker test |
— |
$69 |
— |
$21 | |
| CA-125 ovarian marker test |
— |
$72 |
— |
$21 | |
| Calcium blood test |
— |
$72 |
— |
$5 | |
| Cardiac rehabilitation |
$100 |
$148 |
— |
$26 | |
| Cardiac stress test |
— |
$917 |
— |
$39 | |
| Cardioversion |
— |
$211 |
— |
$155 | |
| Carotid artery ultrasound |
— |
$1,056 |
— |
$156 | |
| Carpal tunnel release |
— |
$1,055 |
— |
$483 | |
| CEA tumor marker test |
— |
$148 |
— |
$19 | |
| Central line placement |
— |
$120 |
— |
$238 | |
| Cervical cerclage |
— |
$761 |
— |
$137 | |
| Cervical LEEP procedure |
$800 |
$1,392 |
— |
$325 | |
| Chemotherapy infusion |
— |
$558 |
— |
$81 | |
| Chemotherapy infusion (each additional) |
— |
$185 |
— |
$28 | |
| Chemotherapy infusion (first hour) |
— |
$930 |
— |
$133 | |
| Chest fluid drain (thoracentesis) |
— |
$770 |
— |
$311 | |
| Chest tube insertion |
— |
$1,324 |
— |
$143 | |
| Chest X-ray |
$115 |
$341 |
— |
$37 | |
| Chest X-ray (1 view) |
— |
$34 |
— |
$25 | |
| Chest X-ray (2 views) |
$115 |
$457 |
— |
$33 | |
| Chickenpox (varicella) vaccine |
— |
$683 |
— |
— | |
| Circumcision |
— |
$395 |
— |
$167 | |
| CK-MB heart enzyme test |
— |
$175 |
— |
$12 | |
| Clotting time test (PTT) |
$10 |
$30 |
— |
$6 | |
| Colon resection (colectomy) |
— |
$2,902 |
— |
$1,238 | |
| Colostomy |
— |
$2,481 |
— |
$1,122 | |
| Colposcopy |
$450 |
$639 |
— |
$161 | |
| Complete blood count (CBC) |
$15 |
$158 |
— |
$7 | |
| Complete blood count (CBC) (complete) |
$15 |
$173 |
— |
$8 | |
| Complex wound repair |
— |
$1,421 |
— |
$390 | |
| Comprehensive metabolic panel |
$20 |
$35 |
— |
$11 | |
| Copper blood test |
— |
$129 |
— |
$12 | |
| Coronary CT angiography |
$613 |
$708 |
— |
$326 | |
| Cortisol test |
$35 |
$105 |
— |
$16 | |
| CPAP titration study |
— |
$1,135 |
— |
$69 | |
| Creatine kinase (CK) test |
— |
$106 |
— |
$7 | |
| CT angiography of the chest |
— |
$869 |
— |
$281 | |
| CT angiography of the head |
$668 |
$1,738 |
— |
$274 | |
| CT scan of the abdomen |
$663 |
$2,608 |
— |
$230 | |
| CT scan of the abdomen and pelvis |
$645 |
$4,725 |
— |
$300 | |
| CT scan of the abdomen and pelvis with and without contrast |
$690 |
$5,148 |
— |
$338 | |
| CT scan of the abdomen and pelvis with contrast |
$603 |
$4,725 |
— |
$300 | |
| CT scan of the abdomen and pelvis without contrast |
$645 |
$4,143 |
— |
$183 | |
| CT scan of the abdomen with and without contrast |
$633 |
$2,608 |
— |
$259 | |
| CT scan of the abdomen with contrast |
$663 |
$2,439 |
— |
$230 | |
| CT scan of the abdomen without contrast |
$695 |
$5,148 |
— |
$136 | |
| CT scan of the arm |
$698 |
$2,421 |
— |
$199 | |
| CT scan of the arm with contrast |
$698 |
$2,482 |
— |
$199 | |
| CT scan of the arm without contrast |
— |
$2,359 |
— |
$161 | |
| CT scan of the chest |
$695 |
$2,344 |
— |
$167 | |
| CT scan of the chest with and without contrast |
— |
$3,173 |
— |
$196 | |
| CT scan of the chest with contrast |
— |
$2,344 |
— |
$167 | |
| CT scan of the chest without contrast |
$695 |
$2,151 |
— |
$133 | |
| CT scan of the head |
$738 |
$2,234 |
— |
$148 | |
| CT scan of the head with and without contrast |
$738 |
$2,582 |
— |
$173 | |
| CT scan of the head with contrast |
$763 |
$2,234 |
— |
$148 | |
| CT scan of the head without contrast |
$710 |
$2,048 |
— |
$107 | |
| CT scan of the leg |
$708 |
$1,963 |
— |
$166 | |
| CT scan of the leg with contrast |
$743 |
$1,963 |
— |
$166 | |
| CT scan of the leg without contrast |
$695 |
$1,798 |
— |
$130 | |
| CT scan of the lower back (lumbar spine) |
$708 |
$2,607 |
— |
$169 | |
| CT scan of the lower back (lumbar spine) with and without contrast |
$708 |
$2,731 |
— |
$197 | |
| CT scan of the lower back (lumbar spine) with contrast |
$865 |
$2,607 |
— |
$169 | |
| CT scan of the lower back (lumbar spine) without contrast |
$695 |
$2,392 |
— |
$130 | |
| CT scan of the neck |
$693 |
$2,159 |
— |
$183 | |
| CT scan of the neck (cervical spine) |
$708 |
$2,420 |
— |
$168 | |
| CT scan of the neck (cervical spine) with and without contrast |
$708 |
$2,545 |
— |
$196 | |
| CT scan of the neck (cervical spine) with contrast |
$865 |
$2,420 |
— |
$168 | |
| CT scan of the neck (cervical spine) without contrast |
$695 |
$2,357 |
— |
$131 | |
| CT scan of the neck with and without contrast |
$693 |
$2,243 |
— |
$220 | |
| CT scan of the neck with contrast |
$733 |
$2,159 |
— |
$183 | |
| CT scan of the neck without contrast |
$685 |
$2,117 |
— |
$150 | |
| CT scan of the pelvis |
$643 |
$2,286 |
— |
$226 | |
| CT scan of the pelvis with and without contrast |
$633 |
$2,541 |
— |
$251 | |
| CT scan of the pelvis with contrast |
$643 |
$2,286 |
— |
$226 | |
| CT scan of the pelvis without contrast |
$695 |
$2,008 |
— |
$133 | |
| CT scan of the sinuses |
$723 |
$2,234 |
— |
$152 | |
| CT scan of the sinuses with and without contrast |
$723 |
$2,582 |
— |
$184 | |
| CT scan of the sinuses with contrast |
$758 |
$2,234 |
— |
$152 | |
| CT scan of the sinuses without contrast |
$685 |
$1,862 |
— |
$128 | |
| D-dimer test |
$20 |
$52 |
— |
$10 | |
| DHEA-sulfate test |
— |
$151 |
— |
$22 | |
| Diagnostic mammogram |
$150 |
$155 |
— |
$140 | |
| Dialysis fistula creation |
— |
$2,910 |
— |
$601 | |
| Dilation and curettage (D&C) |
— |
$1,265 |
— |
$298 | |
| Drug screen (urine) |
$95 |
$248 |
— |
$17 | |
| Ear pressure test (tympanometry) |
— |
$37 |
— |
$16 | |
| Eardrum repair (tympanoplasty) |
— |
$3,351 |
— |
$799 | |
| Echocardiogram |
$410 |
$656 |
— |
$138 | |
| Echocardiogram with and without contrast |
$410 |
$656 |
— |
$101 | |
| Echocardiogram without contrast |
— |
$66 |
— |
$138 | |
| Elbow replacement |
— |
$2,607 |
— |
$1,301 | |
| Electrolyte panel |
— |
$127 |
— |
$7 | |
| Electromyography (EMG) |
— |
$211 |
— |
$141 | |
| Emergency department visit |
— |
$946 |
— |
$69 | |
| Emergency department visit (level 1) |
— |
$317 |
— |
$11 | |
| Emergency department visit (level 2) |
— |
$569 |
— |
$40 | |
| Emergency department visit (level 3) |
— |
$946 |
— |
$69 | |
| Emergency department visit (level 4) |
— |
$1,451 |
— |
$118 | |
| Emergency department visit (level 5) |
— |
$2,107 |
— |
$171 | |
| Esophageal dilation |
— |
$222 |
— |
$522 | |
| Estradiol (estrogen) test |
$40 |
$63 |
— |
$28 | |
| Facet joint injection (spine) |
— |
$199 |
— |
$99 | |
| Fallopian tube X-ray (HSG) |
— |
$354 |
— |
$164 | |
| Fecal occult blood (stool) test |
$10 |
$57 |
— |
$10 | |
| Fecal occult blood (stool) test (guaiac, gFOBT) |
$10 |
$48 |
— |
$4 | |
| Fecal occult blood (stool) test (immunochemical, FIT) |
— |
$65 |
— |
$16 | |
| Feeding tube (PEG) placement |
— |
$658 |
— |
$178 | |
| Femoral hernia repair |
— |
$1,329 |
— |
$584 | |
| Ferritin (iron) test |
$25 |
$70 |
— |
$14 | |
| Fibrinogen test |
— |
$186 |
— |
$10 | |
| Fibroid removal (myomectomy) |
— |
$3,414 |
— |
$914 | |
| Flexible sigmoidoscopy |
— |
$218 |
— |
$323 | |
| Flu test |
$25 |
$63 |
— |
$17 | |
| Flu vaccine |
— |
$6 |
— |
— | |
| Folate (folic acid) test |
$25 |
$32 |
— |
$15 | |
| Foreign body removal (skin) |
— |
$1,271 |
— |
$157 | |
| Free T4 thyroid test |
$15 |
$161 |
— |
$9 | |
| FSH hormone test |
$26 |
$95 |
— |
$19 | |
| Gallbladder scan (HIDA) |
$460 |
$1,621 |
— |
$334 | |
| Ganglion cyst removal |
— |
$311 |
— |
$321 | |
| GGT liver test |
$15 |
$80 |
— |
$7 | |
| Glucose tolerance test |
$25 |
$72 |
— |
$8 | |
| H. pylori test |
— |
$116 |
— |
$67 | |
| Hammertoe repair |
— |
$651 |
— |
$548 | |
| HDL cholesterol test |
— |
$60 |
— |
$8 | |
| Hematocrit test |
$10 |
$8 |
— |
$2 | |
| Hemodialysis |
— |
$1,746 |
— |
$75 | |
| Hemoglobin A1c (diabetes test) |
$20 |
$30 |
— |
$10 | |
| Hemorrhoid removal |
— |
$363 |
— |
$338 | |
| Hepatitis A vaccine |
— |
$113 |
— |
— | |
| Hepatitis B test |
$20 |
$52 |
— |
$10 | |
| Hepatitis B vaccine |
— |
$222 |
— |
— | |
| Hepatitis C test |
$30 |
$94 |
— |
$14 | |
| Hip arthroscopy |
— |
$2,513 |
— |
$931 | |
| Hip fracture repair |
— |
$2,590 |
— |
$1,120 | |
| Hip replacement |
— |
$3,722 |
— |
$1,162 | |
| HIV test |
$50 |
$58 |
— |
$19 | |
| HIV test (antibody) |
— |
$70 |
— |
$14 | |
| HIV test (antigen/antibody combo) |
$50 |
$46 |
— |
$24 | |
| HPV vaccine |
— |
$5 |
— |
— | |
| Hydrocele repair |
— |
$931 |
— |
$315 | |
| Hysterectomy |
— |
$1,966 |
— |
$933 | |
| Ileostomy |
— |
$2,481 |
— |
$968 | |
| Inguinal hernia repair |
— |
$1,337 |
— |
$538 | |
| Iron blood test |
$25 |
$34 |
— |
$6 | |
| IUD insertion |
$300 |
$295 |
— |
— | |
| IUD removal |
$285 |
$714 |
— |
$112 | |
| IV infusion therapy |
— |
$273 |
— |
$44 | |
| IV infusion therapy (each additional) |
— |
$155 |
— |
$21 | |
| IV infusion therapy (initial) |
— |
$391 |
— |
$67 | |
| IVC filter placement |
— |
$850 |
— |
$1,885 | |
| Joint aspiration or injection (small joint) |
$150 |
$148 |
— |
$56 | |
| Kidney scan (nuclear) |
— |
$2,905 |
— |
$172 | |
| Kidney stone shock-wave (lithotripsy) |
— |
$1,577 |
— |
$760 | |
| Kidney ultrasound |
$278 |
$919 |
— |
$84 | |
| Kidney ultrasound (limited) |
$300 |
$919 |
— |
$61 | |
| Knee arthroscopy |
— |
$1,346 |
— |
$524 | |
| Knee joint injection |
$400 |
$360 |
— |
$69 | |
| Lactate test |
— |
$68 |
— |
$12 | |
| Laryngoscopy |
— |
$1,360 |
— |
$189 | |
| LDH test |
— |
$31 |
— |
$6 | |
| LDL cholesterol test |
$20 |
$43 |
— |
$11 | |
| Leg artery angioplasty |
— |
$1,680 |
— |
— | |
| Leg vein ultrasound (Doppler) |
$420 |
$758 |
— |
$150 | |
| Leg vein ultrasound (Doppler) (limited) |
$420 |
$1,126 |
— |
$116 | |
| LH hormone test |
$30 |
$95 |
— |
$19 | |
| Lipase test |
$15 |
$115 |
— |
$7 | |
| Lipid (cholesterol) panel |
$25 |
$25 |
— |
$13 | |
| Liver biopsy |
— |
$621 |
— |
$288 | |
| Liver function panel |
$15 |
$30 |
— |
$8 | |
| Lumbar discectomy |
— |
$3,102 |
— |
$898 | |
| Lumpectomy (breast) |
— |
$1,564 |
— |
$750 | |
| Lung function test (PFT) |
$63 |
$254 |
— |
$37 | |
| Lung scan (V/Q) |
— |
$2,298 |
— |
$291 | |
| Magnesium blood test |
$28 |
$24 |
— |
$7 | |
| Mastectomy |
— |
$2,432 |
— |
$1,021 | |
| Meniscus repair (knee) |
— |
$2,481 |
— |
$714 | |
| MMR vaccine |
— |
$332 |
— |
— | |
| MRA of the brain |
— |
$2,165 |
— |
$226 | |
| MRA of the neck |
— |
$2,218 |
— |
$245 | |
| MRA of the neck with contrast |
— |
$2,332 |
— |
$245 | |
| MRA of the neck without contrast |
— |
$1,082 |
— |
$343 | |
| MRI of the abdomen |
$703 |
$2,793 |
— |
$300 | |
| MRI of the abdomen without contrast |
$705 |
$2,359 |
— |
$194 | |
| MRI of the ankle |
$680 |
$2,600 |
— |
$261 | |
| MRI of the ankle without contrast |
$660 |
$2,501 |
— |
$222 | |
| MRI of the brain |
$730 |
$2,482 |
— |
$269 | |
| MRI of the brain with contrast |
$765 |
$2,482 |
— |
$269 | |
| MRI of the brain without contrast |
$705 |
$2,420 |
— |
$195 | |
| MRI of the chest |
$530 |
$2,482 |
— |
$371 | |
| MRI of the chest with contrast |
$800 |
$2,482 |
— |
$371 | |
| MRI of the chest without contrast |
$530 |
$2,731 |
— |
$466 | |
| MRI of the knee |
$690 |
$2,545 |
— |
$315 | |
| MRI of the knee with contrast |
$875 |
$2,545 |
— |
$315 | |
| MRI of the knee without contrast |
$690 |
$2,540 |
— |
$204 | |
| MRI of the lower back (lumbar spine) |
$730 |
$2,855 |
— |
$270 | |
| MRI of the lower back (lumbar spine) with contrast |
$765 |
$2,855 |
— |
$270 | |
| MRI of the lower back (lumbar spine) without contrast |
$710 |
$2,482 |
— |
$192 | |
| MRI of the mid-back (thoracic spine) |
$730 |
$2,668 |
— |
$271 | |
| MRI of the mid-back (thoracic spine) with and without contrast |
$730 |
$2,855 |
— |
$319 | |
| MRI of the mid-back (thoracic spine) with contrast |
$760 |
$2,668 |
— |
$271 | |
| MRI of the mid-back (thoracic spine) without contrast |
$710 |
$2,482 |
— |
$190 | |
| MRI of the neck (cervical spine) |
$730 |
$2,607 |
— |
$274 | |
| MRI of the neck (cervical spine) with and without contrast |
$730 |
$2,855 |
— |
$318 | |
| MRI of the neck (cervical spine) with contrast |
$760 |
$2,607 |
— |
$274 | |
| MRI of the neck (cervical spine) without contrast |
$710 |
$2,607 |
— |
$191 | |
| MRI of the pelvis |
$705 |
$2,234 |
— |
$268 | |
| MRI of the pelvis with contrast |
$765 |
$2,234 |
— |
$268 | |
| MRI of the pelvis without contrast |
$660 |
$1,862 |
— |
$227 | |
| MRI of the shoulder |
$690 |
$2,485 |
— |
$313 | |
| MRI of the shoulder with contrast |
$875 |
$2,485 |
— |
$313 | |
| MRI of the shoulder without contrast |
$690 |
$2,424 |
— |
$205 | |
| MRI of the wrist |
$580 |
$2,483 |
— |
$330 | |
| MRI of the wrist without contrast |
$555 |
$2,359 |
— |
$303 | |
| Nebulizer breathing treatment |
$35 |
$111 |
— |
$9 | |
| Nerve conduction study |
— |
$211 |
— |
$118 | |
| Newborn hospital care |
— |
$101 |
— |
$58 | |
| Nuclear cardiac stress test |
— |
$4,028 |
— |
$428 | |
| Office visit (established patient) |
— |
$152 |
— |
$115 | |
| Office visit (new patient) |
— |
$288 |
— |
$177 | |
| Office visit, established patient (level 3) |
— |
$129 |
— |
$95 | |
| Office visit, established patient (level 4) |
— |
$174 |
— |
$136 | |
| Office visit, new patient (level 3) |
— |
$204 |
— |
$118 | |
| Office visit, new patient (level 4) |
— |
$288 |
— |
$177 | |
| Office visit, new patient (level 5) |
— |
$707 |
— |
$237 | |
| Orthopedic hardware removal |
— |
$701 |
— |
$632 | |
| Ovarian cyst removal |
— |
$695 |
— |
$698 | |
| Ovary removal (oophorectomy) |
— |
$1,725 |
— |
$822 | |
| Pap smear (cervical screening) |
— |
$87 |
— |
$20 | |
| Parathyroid removal |
— |
$1,858 |
— |
$891 | |
| Pelvic ultrasound |
$100 |
$384 |
— |
$78 | |
| Pelvic ultrasound (complete) |
$100 |
$366 |
— |
$105 | |
| Pelvic ultrasound (limited) |
— |
$403 |
— |
$51 | |
| PET scan |
— |
$497 |
— |
— | |
| Phosphorus blood test |
$10 |
$72 |
— |
$5 | |
| Pilonidal cyst removal |
— |
$608 |
— |
$541 | |
| Platelet count |
— |
$100 |
— |
$4 | |
| Pneumonia vaccine |
— |
$308 |
— |
— | |
| Pregnancy blood test (hCG) |
$15 |
$111 |
— |
$8 | |
| Pregnancy ultrasound |
$160 |
$146 |
— |
$126 | |
| Pregnancy ultrasound (first trimester) |
$160 |
$146 |
— |
$117 | |
| Pregnancy ultrasound (second or third trimester) |
$160 |
$146 |
— |
$136 | |
| Procalcitonin test |
$45 |
$443 |
— |
$27 | |
| Prolactin test |
$30 |
$100 |
— |
$19 | |
| Prostate biopsy |
— |
$368 |
— |
— | |
| Prostate surgery (TURP) |
— |
$2,048 |
— |
$526 | |
| Prostate test (PSA) |
$30 |
$30 |
— |
$18 | |
| Pulmonary rehabilitation |
— |
$148 |
— |
$87 | |
| Radiofrequency nerve ablation |
— |
$438 |
— |
$462 | |
| Rotator cuff repair |
— |
$1,675 |
— |
$792 | |
| Sacroiliac joint injection |
— |
$354 |
— |
$176 | |
| Scoliosis spine X-ray |
$110 |
$320 |
— |
$58 | |
| Scoliosis spine X-ray (3 views) |
$110 |
$320 |
— |
$72 | |
| Screening colonoscopy |
— |
$976 |
— |
$378 | |
| Screening mammogram |
$125 |
$139 |
— |
$126 | |
| Scrotal ultrasound |
— |
$731 |
— |
$99 | |
| Sedimentation rate (ESR) test |
$10 |
$23 |
— |
$3 | |
| Semen analysis |
$20 |
$146 |
— |
$12 | |
| Septoplasty (deviated septum) |
— |
$2,536 |
— |
$613 | |
| Sex hormone binding globulin test |
$35 |
$80 |
— |
$22 | |
| Shoulder arthroscopy |
— |
$2,296 |
— |
$962 | |
| Shoulder replacement |
— |
$931 |
— |
$1,300 | |
| Simple laceration repair (small, up to 2.5 cm) |
— |
$111 |
— |
$114 | |
| Sinus surgery (endoscopic) |
— |
$1,349 |
— |
$224 | |
| Skin biopsy |
$265 |
$691 |
— |
$121 | |
| Skin biopsy (punch) |
$265 |
$1,271 |
— |
$121 | |
| Skin cancer lesion removal |
— |
$421 |
— |
$240 | |
| Skin graft |
— |
$1,454 |
— |
$898 | |
| Skin lesion freezing (cryotherapy) |
— |
$61 |
— |
$36 | |
| Skin tag removal |
— |
$190 |
— |
$92 | |
| Sleep study (polysomnography) |
$1,625 |
$2,567 |
— |
$691 | |
| Small bowel resection |
— |
$2,607 |
— |
$1,136 | |
| Soft tissue ultrasound |
— |
$63 |
— |
$64 | |
| Speech therapy |
— |
$280 |
— |
$76 | |
| Spinal cord stimulator |
— |
$695 |
— |
$2,388 | |
| Spinal tap (lumbar puncture) |
— |
$254 |
— |
$165 | |
| Spine fracture repair (kyphoplasty) |
— |
$3,474 |
— |
$5,803 | |
| Spirometry (lung function test) |
$50 |
$60 |
— |
$30 | |
| Spirometry with bronchodilator |
$75 |
$448 |
— |
$43 | |
| Spleen removal (splenectomy) |
— |
$3,504 |
— |
$1,036 | |
| Strep throat test |
$25 |
$31 |
— |
$17 | |
| Stress echocardiogram |
— |
$2,678 |
— |
$209 | |
| Swallow study |
— |
$351 |
— |
$85 | |
| T3 thyroid test |
$20 |
$61 |
— |
$14 | |
| Tdap (tetanus) vaccine |
— |
$259 |
— |
— | |
| Testicle removal (orchiectomy) |
— |
$931 |
— |
$306 | |
| Testosterone test |
$36 |
$148 |
— |
$26 | |
| Thyroid removal (thyroidectomy) |
— |
$2,393 |
— |
$1,004 | |
| Thyroid test (TSH) |
— |
$151 |
— |
$17 | |
| Thyroid ultrasound |
$240 |
$683 |
— |
$109 | |
| Thyroid uptake scan |
— |
$1,485 |
— |
$145 | |
| Total IgE allergy test |
— |
$21 |
— |
$16 | |
| Total protein test |
— |
$63 |
— |
$4 | |
| Tracheostomy |
— |
$780 |
— |
$273 | |
| Transesophageal echocardiogram (TEE) |
— |
$1,415 |
— |
$239 | |
| Transesophageal echocardiogram (TEE) with and without contrast |
— |
$1,415 |
— |
$239 | |
| Transvaginal ultrasound |
— |
$515 |
— |
$118 | |
| Trigger finger release |
— |
$961 |
— |
$630 | |
| Trigger point injection |
— |
$174 |
— |
$56 | |
| Trigger point injection (1-2 muscles) |
— |
$162 |
— |
$52 | |
| Triglycerides test |
— |
$63 |
— |
$6 | |
| Troponin (heart) test |
$45 |
$123 |
— |
$12 | |
| Tubal ligation |
— |
$1,464 |
— |
$333 | |
| Turbinate reduction |
— |
$1,756 |
— |
$294 | |
| Turning a breech baby (version) |
— |
$456 |
— |
$94 | |
| Ulnar nerve surgery (elbow) |
— |
$992 |
— |
$575 | |
| Upper GI series (barium) |
— |
$594 |
— |
$128 | |
| Ureteral stent placement |
— |
$437 |
— |
$373 | |
| Ureteroscopy (stone removal) |
— |
$1,164 |
— |
$365 | |
| Uric acid (gout) test |
$10 |
$63 |
— |
$5 | |
| Urinalysis |
— |
$23 |
— |
$3 | |
| Urine microalbumin test |
$10 |
$26 |
— |
$5 | |
| Vaccine administration |
— |
$111 |
— |
$19 | |
| Vaccine administration (each additional) |
— |
$16 |
— |
$16 | |
| Vasectomy |
$850 |
$1,118 |
— |
$347 | |
| Vitamin B12 test |
$25 |
$100 |
— |
$15 | |
| Vitamin D test |
$50 |
$102 |
— |
$30 | |
| Vocal cord injection |
— |
$807 |
— |
$211 | |
| Wart removal |
— |
$130 |
— |
$121 | |
| Well-child visit |
— |
$59 |
— |
— | |
| Wound debridement |
— |
$1,619 |
— |
$186 | |
| Wrist fracture repair |
— |
$1,288 |
— |
$735 | |
| X-ray of the collarbone |
— |
$48 |
— |
$33 | |
| X-ray of the elbow |
— |
$33 |
— |
$33 | |
| X-ray of the facial bones |
$100 |
$357 |
— |
$39 | |
| X-ray of the forearm |
— |
$48 |
— |
$29 | |
| X-ray of the hip (1 view) |
— |
$48 |
— |
$34 | |
| X-ray of the hip (3 views) |
$100 |
$82 |
— |
$49 | |
| X-ray of the hip (4 views) |
— |
$31 |
— |
$63 | |
| X-ray of the lower back (lumbar spine) (4+ views) |
— |
$58 |
— |
$53 | |
| X-ray of the lower leg |
— |
$42 |
— |
$31 | |
| X-ray of the mid-back (thoracic spine) (3 views) |
— |
$39 |
— |
$39 | |
| X-ray of the ribs (3 views) |
— |
$48 |
— |
$42 | |
| X-ray of the shoulder |
$115 |
$428 |
— |
$36 | |
| X-ray of the skull |
— |
$379 |
— |
$40 | |
| X-ray of the upper arm |
— |
$26 |
— |
$32 | |
| X-ray of the wrist |
$105 |
$90 |
— |
$43 | |
| Zinc blood test |
$20 |
$121 |
— |
$11 | |