| Abdominal ultrasound |
$474 |
$790 |
— |
$100 | |
| Abdominal ultrasound (complete) |
$657 |
$1,096 |
— |
$114 | |
| Abdominal ultrasound (limited) |
$474 |
$790 |
— |
$86 | |
| Adenoid removal (adenoidectomy) |
— |
— |
$5,878 |
$204 | |
| Albumin blood test |
$26 |
$44 |
$8,871 |
$5 | |
| Aldosterone test |
$172 |
$287 |
$2,884 |
$41 | |
| Alkaline phosphatase test |
$106 |
$177 |
— |
$5 | |
| Allergy patch testing |
— |
— |
$2,884 |
$5 | |
| Alpha-fetoprotein (AFP) test |
$100 |
$166 |
— |
$17 | |
| ALT liver enzyme test |
$121 |
$202 |
— |
$5 | |
| Ammonia blood test |
$96 |
$161 |
— |
$15 | |
| Amniocentesis |
— |
— |
$8,871 |
$120 | |
| Amylase test |
$111 |
$185 |
— |
$6 | |
| Anal fistula repair |
— |
— |
$8,871 |
$541 | |
| Ankle fracture repair |
— |
— |
$2,884 |
$608 | |
| Annual physical (established patient) |
— |
— |
$5,878 |
— | |
| Annual physical (new patient) |
— |
— |
$8,871 |
— | |
| Anoscopy |
— |
— |
$2,884 |
$129 | |
| Antinuclear antibody (ANA) test |
$120 |
$200 |
$8,871 |
$12 | |
| Aortic aneurysm repair (AAA) |
— |
— |
$2,884 |
$1,345 | |
| Appendix removal (appendectomy) |
— |
— |
$6,159 |
$592 | |
| Arterial blood gas (ABG) |
$167 |
$278 |
— |
$26 | |
| AST liver enzyme test |
$100 |
$166 |
— |
$5 | |
| Barium swallow study |
$431 |
$718 |
— |
$107 | |
| Bartholin cyst removal |
$385 |
$641 |
$2,884 |
$182 | |
| Basic metabolic panel |
$71 |
$118 |
$2,884 |
$8 | |
| Benign skin lesion removal |
— |
— |
$2,884 |
$171 | |
| Bilirubin blood test |
$29 |
$49 |
$2,884 |
$5 | |
| Bladder function test (urodynamics) |
— |
— |
$8,871 |
$345 | |
| Bladder scope (cystoscopy) |
— |
— |
$8,871 |
$216 | |
| Bladder tumor removal (TURBT) |
— |
— |
$8,871 |
$236 | |
| Blood clotting test (PT/INR) |
$44 |
$74 |
— |
$4 | |
| Blood crossmatch |
$183 |
$306 |
— |
— | |
| Blood glucose test |
$48 |
$81 |
$8,871 |
$5 | |
| Blood transfusion |
$940 |
$1,566 |
$8,871 |
$47 | |
| Blood type and screen |
$78 |
$130 |
$8,871 |
$10 | |
| Blood type test |
$62 |
$104 |
— |
$3 | |
| Blood type test (ABO group) |
$57 |
$95 |
— |
$3 | |
| Blood type test (Rh/D antigen) |
$62 |
$104 |
— |
$3 | |
| BNP (heart failure) test |
$148 |
$247 |
— |
$39 | |
| Bone marrow biopsy |
— |
— |
$2,884 |
$172 | |
| Botox for migraine |
— |
— |
$2,884 |
$157 | |
| Breast biopsy |
— |
— |
$5,878 |
$478 | |
| Breast reconstruction |
— |
— |
$2,884 |
$1,227 | |
| Breast ultrasound |
$353 |
$589 |
$8,871 |
$92 | |
| Breast ultrasound (complete) |
$353 |
$589 |
$8,871 |
$100 | |
| Breathing tube insertion (intubation) |
$352 |
$587 |
— |
$133 | |
| Bronchoscopy |
— |
— |
$8,871 |
$303 | |
| Bunion surgery (bunionectomy) |
— |
— |
$8,871 |
$883 | |
| C-reactive protein (CRP) |
$78 |
$130 |
— |
$5 | |
| CA 19-9 tumor marker test |
$152 |
$253 |
$2,884 |
$21 | |
| CA-125 ovarian marker test |
$131 |
$218 |
— |
$21 | |
| Calcium blood test |
$29 |
$48 |
— |
$5 | |
| Cardiac ablation |
— |
— |
$2,884 |
$759 | |
| Cardiac stress test |
— |
— |
$2,884 |
$39 | |
| Carotid artery surgery |
— |
— |
$2,884 |
$1,026 | |
| Carotid artery ultrasound |
$435 |
$725 |
$2,884 |
$156 | |
| CEA tumor marker test |
$122 |
$204 |
— |
$19 | |
| Celiac disease test |
— |
— |
$8,871 |
$12 | |
| Cervical LEEP procedure |
— |
— |
$2,884 |
$325 | |
| Cesarean section (C-section) |
— |
— |
$7,188 |
$7,552 | |
| Chemotherapy infusion |
— |
— |
$2,884 |
$81 | |
| Chemotherapy infusion (first hour) |
— |
— |
$2,884 |
$133 | |
| Chest fluid drain (thoracentesis) |
$1,852 |
$3,087 |
— |
$311 | |
| Chest X-ray |
$177 |
$295 |
$5,878 |
$37 | |
| Chest X-ray (1 view) |
$173 |
$289 |
— |
$25 | |
| Chest X-ray (2 views) |
$180 |
$300 |
— |
$33 | |
| Chickenpox (varicella) vaccine |
— |
— |
$2,884 |
— | |
| Chiropractic adjustment |
— |
— |
$2,884 |
$38 | |
| CK-MB heart enzyme test |
$198 |
$330 |
— |
$12 | |
| Clotting time test (PTT) |
$83 |
$138 |
$8,871 |
$6 | |
| Colon resection (colectomy) |
— |
— |
$2,884 |
$1,238 | |
| Colonoscopy |
— |
— |
$2,884 |
$480 | |
| Colposcopy |
— |
— |
$2,884 |
$161 | |
| Complete blood count (CBC) |
$90 |
$149 |
— |
$7 | |
| Complete blood count (CBC) (complete) |
$84 |
$139 |
— |
$8 | |
| Comprehensive eye exam |
— |
— |
$5,878 |
$138 | |
| Comprehensive metabolic panel |
$105 |
$174 |
$8,871 |
$11 | |
| Contraceptive implant (Nexplanon) |
— |
— |
$2,884 |
$115 | |
| Copper blood test |
$68 |
$113 |
$2,884 |
$12 | |
| Corneal transplant |
— |
— |
$2,884 |
$1,066 | |
| Coronary angioplasty / stent (PCI) |
— |
— |
$6,521 |
$426 | |
| Coronary artery bypass (CABG) |
— |
— |
$11,268 |
$36,593 | |
| Cortisol test |
$110 |
$184 |
— |
$16 | |
| COVID-19 PCR test |
$203 |
$338 |
— |
$51 | |
| CPAP titration study |
$583 |
$971 |
$2,884 |
$69 | |
| Creatine kinase (CK) test |
$65 |
$108 |
— |
$7 | |
| CT angiography of the chest |
$1,956 |
$3,259 |
— |
$281 | |
| CT angiography of the head |
$2,090 |
$3,484 |
— |
$274 | |
| CT colonography (virtual colonoscopy) |
— |
— |
$8,871 |
$835 | |
| CT scan of the abdomen |
$1,849 |
$3,081 |
$8,871 |
$230 | |
| CT scan of the abdomen and pelvis |
$3,586 |
$5,977 |
— |
$300 | |
| CT scan of the abdomen and pelvis with and without contrast |
$3,770 |
$6,283 |
— |
$338 | |
| CT scan of the abdomen and pelvis with contrast |
$3,586 |
$5,977 |
— |
$300 | |
| CT scan of the abdomen and pelvis without contrast |
$2,875 |
$4,791 |
— |
$183 | |
| CT scan of the abdomen with and without contrast |
$1,882 |
$3,136 |
— |
$259 | |
| CT scan of the abdomen with contrast |
$1,849 |
$3,081 |
— |
$230 | |
| CT scan of the abdomen without contrast |
$1,628 |
$2,714 |
$8,871 |
$136 | |
| CT scan of the arm |
$1,936 |
$3,227 |
$2,884 |
$199 | |
| CT scan of the arm with contrast |
$1,936 |
$3,227 |
$2,884 |
$199 | |
| CT scan of the arm without contrast |
$1,671 |
$2,786 |
— |
$161 | |
| CT scan of the chest |
$1,672 |
$2,787 |
$8,871 |
$167 | |
| CT scan of the chest with and without contrast |
$2,052 |
$3,420 |
$8,871 |
$196 | |
| CT scan of the chest with contrast |
$1,813 |
$3,021 |
— |
$167 | |
| CT scan of the chest without contrast |
$1,532 |
$2,553 |
— |
$133 | |
| CT scan of the head |
$1,507 |
$2,511 |
$2,884 |
$148 | |
| CT scan of the head with and without contrast |
$1,884 |
$3,139 |
— |
$173 | |
| CT scan of the head with contrast |
$1,507 |
$2,511 |
— |
$148 | |
| CT scan of the head without contrast |
$1,409 |
$2,348 |
$2,884 |
$107 | |
| CT scan of the leg |
$1,899 |
$3,166 |
$8,871 |
$166 | |
| CT scan of the leg with contrast |
$1,899 |
$3,166 |
$8,871 |
$166 | |
| CT scan of the leg without contrast |
$1,583 |
$2,639 |
$8,871 |
$130 | |
| CT scan of the lower back (lumbar spine) |
$1,687 |
$2,812 |
— |
$169 | |
| CT scan of the lower back (lumbar spine) with and without contrast |
$2,043 |
$3,404 |
— |
$197 | |
| CT scan of the lower back (lumbar spine) with contrast |
$1,762 |
$2,937 |
— |
$169 | |
| CT scan of the lower back (lumbar spine) without contrast |
$1,612 |
$2,686 |
— |
$130 | |
| CT scan of the neck |
$1,358 |
$2,263 |
$5,878 |
$183 | |
| CT scan of the neck (cervical spine) |
$1,636 |
$2,727 |
$2,884 |
$168 | |
| CT scan of the neck (cervical spine) with and without contrast |
$1,899 |
$3,165 |
— |
$196 | |
| CT scan of the neck (cervical spine) with contrast |
$1,824 |
$3,040 |
$2,884 |
$168 | |
| CT scan of the neck (cervical spine) without contrast |
$1,448 |
$2,414 |
— |
$131 | |
| CT scan of the neck with and without contrast |
$1,358 |
$2,263 |
$5,878 |
$220 | |
| CT scan of the neck with contrast |
$1,669 |
$2,781 |
— |
$183 | |
| CT scan of the neck without contrast |
$1,245 |
$2,075 |
— |
$150 | |
| CT scan of the pelvis |
$1,741 |
$2,902 |
$8,871 |
$226 | |
| CT scan of the pelvis with and without contrast |
$1,892 |
$3,154 |
— |
$251 | |
| CT scan of the pelvis with contrast |
$1,741 |
$2,902 |
$8,871 |
$226 | |
| CT scan of the pelvis without contrast |
$1,429 |
$2,382 |
— |
$133 | |
| CT scan of the sinuses |
$1,339 |
$2,232 |
— |
$152 | |
| CT scan of the sinuses with and without contrast |
$1,811 |
$3,018 |
— |
$184 | |
| CT scan of the sinuses with contrast |
$1,497 |
$2,494 |
— |
$152 | |
| CT scan of the sinuses without contrast |
$1,182 |
$1,970 |
— |
$128 | |
| D-dimer test |
$114 |
$190 |
— |
$10 | |
| Developmental screening (child) |
— |
— |
$8,871 |
— | |
| DHEA-sulfate test |
$122 |
$203 |
$8,871 |
$22 | |
| Droopy eyelid repair (ptosis) |
— |
— |
$8,871 |
$745 | |
| Drug screen (urine) |
$148 |
$247 |
$8,871 |
$17 | |
| Echocardiogram |
$481 |
$801 |
$8,871 |
$138 | |
| Echocardiogram with and without contrast |
$286 |
$477 |
$8,871 |
$101 | |
| EEG (awake and asleep) |
$744 |
$1,240 |
$2,884 |
$482 | |
| EKG / ECG (tracing only) |
$144 |
$240 |
— |
$7 | |
| Elbow replacement |
— |
— |
$5,878 |
$1,301 | |
| Electrocardiogram (EKG) |
$144 |
$240 |
— |
$8 | |
| Electroencephalogram (EEG) |
$744 |
$1,240 |
$5,878 |
$448 | |
| Electrolyte panel |
$118 |
$197 |
— |
$7 | |
| Emergency department visit |
$657 |
$1,095 |
$5,878 |
$69 | |
| Emergency department visit (level 1) |
$361 |
$601 |
— |
$11 | |
| Emergency department visit (level 2) |
$509 |
$848 |
— |
$40 | |
| Emergency department visit (level 3) |
$657 |
$1,095 |
— |
$69 | |
| Emergency department visit (level 4) |
$805 |
$1,342 |
— |
$118 | |
| Emergency department visit (level 5) |
$1,200 |
$2,000 |
$5,878 |
$171 | |
| Endometrial biopsy |
— |
— |
$8,871 |
$98 | |
| Epidural steroid injection |
— |
— |
$2,884 |
$275 | |
| Estradiol (estrogen) test |
$120 |
$199 |
— |
$28 | |
| Eyelid surgery (blepharoplasty) |
— |
— |
$2,884 |
$552 | |
| Facet joint injection (spine) |
— |
— |
$2,884 |
$99 | |
| Fallopian tube X-ray (HSG) |
$349 |
$582 |
— |
$164 | |
| Family therapy session |
— |
— |
$8,871 |
$110 | |
| Fecal occult blood (stool) test |
$77 |
$128 |
$2,884 |
$10 | |
| Fecal occult blood (stool) test (guaiac, gFOBT) |
$77 |
$128 |
— |
$4 | |
| Fecal occult blood (stool) test (immunochemical, FIT) |
— |
— |
$2,884 |
$16 | |
| Ferritin (iron) test |
$94 |
$156 |
— |
$14 | |
| Fibrinogen test |
$117 |
$195 |
— |
$10 | |
| Fibroid removal (myomectomy) |
— |
— |
$2,884 |
$914 | |
| Flu test |
$82 |
$137 |
$2,884 |
$17 | |
| Folate (folic acid) test |
$101 |
$168 |
$5,878 |
$15 | |
| Free T4 thyroid test |
$84 |
$140 |
$2,884 |
$9 | |
| FSH hormone test |
$99 |
$165 |
$8,871 |
$19 | |
| Gallbladder removal (laparoscopic) |
— |
— |
$2,884 |
$658 | |
| GGT liver test |
$37 |
$61 |
$8,871 |
$7 | |
| Glaucoma surgery |
— |
— |
$8,871 |
$984 | |
| HDL cholesterol test |
— |
— |
$2,884 |
$8 | |
| Hearing test (audiometry) |
— |
— |
$8,871 |
$36 | |
| Hematocrit test |
$42 |
$71 |
— |
$2 | |
| Hemodialysis |
— |
— |
$8,871 |
$75 | |
| Hemoglobin A1c (diabetes test) |
$60 |
$100 |
— |
$10 | |
| Hemorrhoid removal |
— |
— |
$2,884 |
$338 | |
| Hepatitis B test |
$80 |
$133 |
— |
$10 | |
| Hepatitis B vaccine |
— |
— |
$2,884 |
— | |
| Hepatitis C test |
$161 |
$269 |
— |
$14 | |
| Hip arthroscopy |
— |
— |
$8,871 |
$931 | |
| Hip fracture repair |
— |
— |
$2,884 |
$1,120 | |
| Hip replacement |
— |
— |
$2,884 |
$1,162 | |
| HIV test |
$97 |
$162 |
— |
$19 | |
| HIV test (antibody) |
$85 |
$142 |
— |
$14 | |
| HIV test (antigen/antibody combo) |
$212 |
$353 |
— |
$24 | |
| Holter heart monitor |
— |
— |
$8,871 |
$26 | |
| Home sleep apnea test |
$1,056 |
$1,760 |
— |
$123 | |
| Hydrocele repair |
— |
— |
$8,871 |
$315 | |
| Hysterectomy |
— |
— |
$8,871 |
$933 | |
| Ileostomy |
— |
— |
$2,884 |
$968 | |
| Iron blood test |
$54 |
$90 |
— |
$6 | |
| IV infusion therapy |
$418 |
$697 |
— |
$44 | |
| IV infusion therapy (each additional) |
$106 |
$176 |
— |
$21 | |
| IV infusion therapy (initial) |
$418 |
$697 |
— |
$67 | |
| IVC filter placement |
— |
— |
$8,871 |
$1,885 | |
| Joint aspiration (small/intermediate) |
— |
— |
$8,871 |
$57 | |
| Joint aspiration or injection (small joint) |
— |
— |
$8,871 |
$56 | |
| Kidney removal (nephrectomy) |
— |
— |
$5,878 |
$1,164 | |
| Kidney ultrasound |
$471 |
$785 |
— |
$84 | |
| Knee replacement |
— |
— |
$16,375 |
$18,054 | |
| Lactate test |
$84 |
$141 |
— |
$12 | |
| Laminectomy (spine) |
— |
— |
$2,884 |
$1,157 | |
| Laryngoscopy |
— |
— |
$2,884 |
$189 | |
| LDH test |
$46 |
$76 |
$2,884 |
$6 | |
| LDL cholesterol test |
$46 |
$77 |
$5,878 |
$11 | |
| Leg vein ultrasound (Doppler) |
$551 |
$918 |
$8,871 |
$150 | |
| Leg vein ultrasound (Doppler) (limited) |
$523 |
$872 |
$8,871 |
$116 | |
| LH hormone test |
$95 |
$159 |
$5,878 |
$19 | |
| Lipase test |
$125 |
$209 |
— |
$7 | |
| Lipid (cholesterol) panel |
$118 |
$197 |
— |
$13 | |
| Liver function panel |
$162 |
$271 |
— |
$8 | |
| Lower back (lumbar) spinal fusion |
— |
— |
$33,433 |
$1,511 | |
| Lumpectomy (breast) |
— |
— |
$2,884 |
$750 | |
| Lung function test (PFT) |
$279 |
$465 |
— |
$37 | |
| Magnesium blood test |
$62 |
$103 |
— |
$7 | |
| Mastectomy |
— |
— |
$8,871 |
$1,021 | |
| Mohs skin cancer surgery |
— |
— |
$8,871 |
$535 | |
| MRA of the brain |
$1,357 |
$2,261 |
— |
$226 | |
| MRA of the brain with contrast |
$1,357 |
$2,261 |
— |
$226 | |
| MRA of the brain without contrast |
$2,661 |
$4,436 |
— |
$328 | |
| MRA of the neck |
$1,772 |
$2,954 |
— |
$245 | |
| MRA of the neck with contrast |
$1,772 |
$2,954 |
— |
$245 | |
| MRA of the neck without contrast |
$2,319 |
$3,865 |
— |
$343 | |
| MRI of the abdomen |
$1,853 |
$3,088 |
$2,884 |
$300 | |
| MRI of the abdomen with contrast |
— |
— |
$8,871 |
$300 | |
| MRI of the abdomen without contrast |
$1,853 |
$3,088 |
$2,884 |
$194 | |
| MRI of the ankle |
$2,133 |
$3,555 |
$2,884 |
$261 | |
| MRI of the ankle without contrast |
$1,827 |
$3,044 |
— |
$222 | |
| MRI of the brain |
$2,305 |
$3,842 |
$8,871 |
$269 | |
| MRI of the brain with contrast |
— |
— |
$8,871 |
$269 | |
| MRI of the brain without contrast |
$1,909 |
$3,182 |
— |
$195 | |
| MRI of the chest |
$1,336 |
$2,226 |
$5,878 |
$371 | |
| MRI of the chest with contrast |
— |
— |
$2,884 |
$371 | |
| MRI of the knee |
$2,161 |
$3,601 |
$2,884 |
$315 | |
| MRI of the knee with contrast |
$2,304 |
$3,839 |
— |
$315 | |
| MRI of the knee without contrast |
$2,161 |
$3,601 |
— |
$204 | |
| MRI of the lower back (lumbar spine) |
$2,741 |
$4,569 |
$8,871 |
$270 | |
| MRI of the lower back (lumbar spine) with contrast |
$2,963 |
$4,938 |
— |
$270 | |
| MRI of the lower back (lumbar spine) without contrast |
$2,114 |
$3,523 |
$8,871 |
$192 | |
| MRI of the mid-back (thoracic spine) |
$2,149 |
$3,582 |
$5,878 |
$271 | |
| MRI of the mid-back (thoracic spine) with and without contrast |
$2,817 |
$4,696 |
$8,871 |
$319 | |
| MRI of the mid-back (thoracic spine) with contrast |
$1,956 |
$3,260 |
— |
$271 | |
| MRI of the mid-back (thoracic spine) without contrast |
$2,149 |
$3,582 |
$2,884 |
$190 | |
| MRI of the neck (cervical spine) |
$2,419 |
$4,031 |
— |
$274 | |
| MRI of the neck (cervical spine) with and without contrast |
$2,663 |
$4,438 |
— |
$318 | |
| MRI of the neck (cervical spine) without contrast |
$2,175 |
$3,625 |
— |
$191 | |
| MRI of the pelvis |
$1,886 |
$3,143 |
$8,871 |
$268 | |
| MRI of the pelvis without contrast |
$1,587 |
$2,645 |
$8,871 |
$227 | |
| MRI of the shoulder |
$2,118 |
$3,529 |
— |
$313 | |
| MRI of the shoulder with contrast |
$1,648 |
$2,746 |
— |
$313 | |
| MRI of the shoulder without contrast |
$2,118 |
$3,529 |
— |
$205 | |
| MRI of the wrist |
$2,805 |
$4,675 |
— |
$330 | |
| MRI of the wrist without contrast |
$1,885 |
$3,142 |
— |
$303 | |
| Nebulizer breathing treatment |
$120 |
$200 |
— |
$9 | |
| Nerve conduction study |
— |
— |
$8,871 |
$118 | |
| Nuchal translucency ultrasound |
— |
— |
$8,871 |
$116 | |
| Occupational therapy evaluation |
$233 |
$388 |
$8,871 |
$101 | |
| Occupational therapy evaluation (high complexity) |
$237 |
$395 |
— |
$101 | |
| Occupational therapy evaluation (low complexity) |
$214 |
$356 |
— |
$101 | |
| Occupational therapy evaluation (moderate complexity) |
$233 |
$388 |
$8,871 |
$101 | |
| Office visit (established patient) |
$336 |
$560 |
— |
$115 | |
| Office visit (new patient) |
$365 |
$608 |
— |
$177 | |
| Office visit, established patient (level 3) |
$307 |
$512 |
— |
$95 | |
| Office visit, established patient (level 4) |
$365 |
$608 |
— |
$136 | |
| Office visit, new patient (level 3) |
$307 |
$512 |
— |
$118 | |
| Office visit, new patient (level 4) |
$365 |
$608 |
— |
$177 | |
| Office visit, new patient (level 5) |
$422 |
$704 |
— |
$237 | |
| Orthopedic hardware removal |
— |
— |
$8,871 |
$632 | |
| Ovary removal (oophorectomy) |
— |
— |
$5,878 |
$822 | |
| Pacemaker insertion |
— |
— |
$10,675 |
$15,506 | |
| Pap smear (cervical screening) |
$40 |
$67 |
$8,871 |
$20 | |
| Parathyroid hormone (PTH) test |
$169 |
$281 |
$8,871 |
$41 | |
| Pelvic ultrasound |
$440 |
$733 |
$8,871 |
$78 | |
| Pelvic ultrasound (complete) |
$560 |
$934 |
$2,884 |
$105 | |
| Pelvic ultrasound (limited) |
$440 |
$733 |
$8,871 |
$51 | |
| Phosphorus blood test |
$97 |
$161 |
— |
$5 | |
| Physical therapy evaluation |
$198 |
$329 |
$5,878 |
$98 | |
| Physical therapy evaluation (high complexity) |
$237 |
$395 |
— |
$98 | |
| Physical therapy evaluation (moderate complexity) |
$198 |
$329 |
$8,871 |
$98 | |
| Platelet count |
$106 |
$176 |
— |
$4 | |
| Pneumonia vaccine |
$149 |
$248 |
$8,871 |
— | |
| Pregnancy blood test (hCG) |
$100 |
$166 |
$2,884 |
$8 | |
| Pregnancy ultrasound |
$327 |
$545 |
— |
$126 | |
| Pregnancy ultrasound (first trimester) |
$479 |
$799 |
— |
$117 | |
| Pregnancy ultrasound (second or third trimester) |
$318 |
$530 |
— |
$136 | |
| Procalcitonin test |
$283 |
$472 |
$5,878 |
$27 | |
| Prolactin test |
$116 |
$194 |
— |
$19 | |
| Prostate removal (prostatectomy) |
— |
— |
$2,884 |
$1,063 | |
| Prostate test (PSA) |
$126 |
$210 |
— |
$18 | |
| Psychiatric evaluation |
— |
— |
$8,871 |
$188 | |
| Radiofrequency nerve ablation |
— |
— |
$8,871 |
$462 | |
| Retinal (fundus) photography |
— |
— |
$8,871 |
$37 | |
| Retinal detachment repair |
— |
— |
$2,884 |
$966 | |
| Sacroiliac joint injection |
— |
— |
$8,871 |
$176 | |
| Scoliosis spine X-ray |
$222 |
$370 |
$2,884 |
$58 | |
| Scoliosis spine X-ray (1 view) |
$145 |
$241 |
— |
$44 | |
| Scoliosis spine X-ray (3 views) |
$300 |
$499 |
$2,884 |
$72 | |
| Scrotal ultrasound |
$424 |
$707 |
— |
$99 | |
| Sedimentation rate (ESR) test |
$39 |
$66 |
$5,878 |
$3 | |
| Septoplasty (deviated septum) |
— |
— |
$2,884 |
$613 | |
| Sex hormone binding globulin test |
$105 |
$174 |
$2,884 |
$22 | |
| Shingles vaccine |
— |
— |
$8,871 |
— | |
| Shoulder arthroscopy |
— |
— |
$2,884 |
$962 | |
| Simple laceration repair (small, up to 2.5 cm) |
— |
— |
$8,871 |
$114 | |
| Simple wound stitches |
— |
— |
$8,871 |
$127 | |
| Sinus surgery (endoscopic) |
— |
— |
$2,884 |
$224 | |
| Skin biopsy |
— |
— |
$8,871 |
$121 | |
| Skin biopsy (punch) |
— |
— |
$8,871 |
$121 | |
| Skin cancer lesion removal |
— |
— |
$2,884 |
$240 | |
| Sleep study (polysomnography) |
$2,313 |
$3,855 |
— |
$691 | |
| Soft tissue ultrasound |
$293 |
$489 |
— |
$64 | |
| Spinal cord stimulator |
— |
— |
$2,884 |
$2,388 | |
| Spinal tap (lumbar puncture) |
— |
— |
$8,871 |
$165 | |
| Spine fracture repair (kyphoplasty) |
— |
— |
$8,871 |
$5,803 | |
| Spirometry (lung function test) |
$279 |
$465 |
— |
$30 | |
| Spleen removal (splenectomy) |
— |
— |
$2,884 |
$1,036 | |
| Stress echocardiogram |
— |
— |
$5,878 |
$209 | |
| Stress echocardiogram (complete) |
— |
— |
$5,878 |
$233 | |
| Swallow study |
$198 |
$331 |
— |
$85 | |
| T3 thyroid test |
$148 |
$246 |
— |
$14 | |
| Tdap (tetanus) vaccine |
— |
— |
$2,884 |
— | |
| Testicle removal (orchiectomy) |
— |
— |
$8,871 |
$306 | |
| Testosterone test |
$125 |
$208 |
— |
$26 | |
| Thyroid removal (thyroidectomy) |
— |
— |
$2,884 |
$1,004 | |
| Thyroid test (TSH) |
$103 |
$172 |
— |
$17 | |
| Thyroid ultrasound |
$448 |
$746 |
— |
$109 | |
| Total IgE allergy test |
$94 |
$157 |
— |
$16 | |
| Total protein test |
$26 |
$44 |
$2,884 |
$4 | |
| Tracheostomy |
— |
— |
$5,878 |
$273 | |
| Transesophageal echocardiogram (TEE) |
— |
— |
$2,884 |
$239 | |
| Transvaginal ultrasound |
$455 |
$758 |
$8,871 |
$118 | |
| Triglycerides test |
$43 |
$71 |
$8,871 |
$6 | |
| Troponin (heart) test |
$169 |
$281 |
— |
$12 | |
| Turning a breech baby (version) |
$3,519 |
$5,865 |
— |
$94 | |
| Ulnar nerve surgery (elbow) |
— |
— |
$8,871 |
$575 | |
| Upper GI endoscopy (EGD) |
— |
— |
$2,884 |
$371 | |
| Upper GI series (barium) |
$417 |
$695 |
$8,871 |
$128 | |
| Uric acid (gout) test |
$155 |
$258 |
— |
$5 | |
| Urinalysis |
$36 |
$60 |
$5,878 |
$3 | |
| Urine microalbumin test |
$44 |
$74 |
$8,871 |
$5 | |
| Urine pregnancy test |
$100 |
$166 |
$2,884 |
$9 | |
| Vaccine administration |
$28 |
$47 |
— |
$19 | |
| Vaccine administration (each additional) |
$15 |
$25 |
— |
$16 | |
| Vaginal delivery |
— |
— |
$8,524 |
$5,487 | |
| Vasectomy |
— |
— |
$2,884 |
$347 | |
| Vitamin B12 test |
$103 |
$171 |
— |
$15 | |
| Vitamin D test |
$122 |
$204 |
— |
$30 | |
| Vocal cord injection |
— |
— |
$8,871 |
$211 | |
| Weight-loss (bariatric) surgery |
— |
— |
$14,597 |
$11,645 | |
| Wrist fracture repair |
— |
— |
$8,871 |
$735 | |
| X-ray of the abdomen |
$171 |
$285 |
$2,884 |
$36 | |
| X-ray of the ankle |
$264 |
$440 |
— |
$37 | |
| X-ray of the collarbone |
$212 |
$354 |
— |
$33 | |
| X-ray of the elbow |
$290 |
$484 |
— |
$33 | |
| X-ray of the facial bones |
$335 |
$559 |
— |
$39 | |
| X-ray of the foot |
$340 |
$567 |
— |
$34 | |
| X-ray of the forearm |
$279 |
$465 |
$2,884 |
$29 | |
| X-ray of the hand |
$296 |
$494 |
— |
$38 | |
| X-ray of the hip |
$223 |
$372 |
$2,884 |
$49 | |
| X-ray of the hip (1 view) |
$207 |
$346 |
— |
$34 | |
| X-ray of the hip (3 views) |
$223 |
$372 |
$2,884 |
$49 | |
| X-ray of the hip (4 views) |
— |
— |
$2,884 |
$63 | |
| X-ray of the knee |
$309 |
$514 |
$8,871 |
$42 | |
| X-ray of the knee (2 views) |
$219 |
$365 |
— |
$34 | |
| X-ray of the knee (3 views) |
$284 |
$474 |
— |
$42 | |
| X-ray of the knee (4+ views) |
$333 |
$555 |
$8,871 |
$49 | |
| X-ray of the lower back (lumbar spine) |
$354 |
$590 |
$2,884 |
$47 | |
| X-ray of the lower back (lumbar spine) (2 views) |
$284 |
$473 |
$2,884 |
$40 | |
| X-ray of the lower back (lumbar spine) (4+ views) |
$424 |
$707 |
— |
$53 | |
| X-ray of the lower leg |
$273 |
$455 |
$2,884 |
$31 | |
| X-ray of the mid-back (thoracic spine) |
$251 |
$418 |
— |
$36 | |
| X-ray of the mid-back (thoracic spine) (2 views) |
$251 |
$418 |
— |
$33 | |
| X-ray of the neck (cervical spine) |
$313 |
$522 |
— |
$47 | |
| X-ray of the neck (cervical spine) (3 views) |
$313 |
$522 |
— |
$40 | |
| X-ray of the ribs |
$351 |
$584 |
— |
$42 | |
| X-ray of the ribs (2 views) |
$247 |
$411 |
— |
$36 | |
| X-ray of the shoulder |
$274 |
$456 |
— |
$36 | |
| X-ray of the skull |
$264 |
$440 |
$8,871 |
$40 | |
| X-ray of the upper arm |
$272 |
$453 |
$8,871 |
$32 | |
| X-ray of the wrist |
$276 |
$460 |
— |
$43 | |
| YAG laser capsulotomy (eye) |
— |
— |
$8,871 |
$335 | |
| Zinc blood test |
$65 |
$108 |
— |
$11 | |