| 3D mammogram (tomosynthesis) |
$188 |
$188 |
$104 |
$51 | |
| Abdominal fluid drain (paracentesis) |
$4,763 |
$4,763 |
$2,096 |
$284 | |
| Abdominal ultrasound |
$2,036 |
$2,036 |
$777 |
$100 | |
| Abdominal ultrasound (complete) |
$2,306 |
$2,306 |
$925 |
$114 | |
| Abdominal ultrasound (limited) |
$1,766 |
$1,766 |
$708 |
$86 | |
| Abscess drainage (complex or multiple) |
$1,566 |
$1,566 |
$689 |
$220 | |
| Abscess drainage (simple) |
$1,573 |
$1,573 |
$631 |
$129 | |
| Abscess incision and drainage |
$1,570 |
$1,570 |
$689 |
$174 | |
| Achilles tendon repair |
— |
— |
$12,084 |
$624 | |
| ACL knee reconstruction |
— |
— |
$12,084 |
$889 | |
| Adenoid removal (adenoidectomy) |
— |
— |
$5,920 |
$204 | |
| Albumin blood test |
$261 |
$261 |
$105 |
$5 | |
| Aldosterone test |
$1,042 |
$1,042 |
$418 |
$41 | |
| Alkaline phosphatase test |
$238 |
$238 |
$96 |
$5 | |
| Alpha-fetoprotein (AFP) test |
$522 |
$522 |
$209 |
$17 | |
| ALT liver enzyme test |
$242 |
$242 |
$97 |
$5 | |
| Ammonia blood test |
$542 |
$542 |
$217 |
$15 | |
| Amniocentesis |
$4,742 |
$4,742 |
$2,087 |
$120 | |
| Amylase test |
$366 |
$366 |
$147 |
$6 | |
| Anal fistula repair |
— |
— |
$5,017 |
$541 | |
| Ankle fracture repair |
— |
— |
$12,084 |
$608 | |
| Ankle replacement |
— |
— |
$2,137 |
$885 | |
| Anoscopy |
$1,198 |
$1,198 |
$527 |
$129 | |
| Antinuclear antibody (ANA) test |
$375 |
$375 |
$150 |
$12 | |
| Aortic aneurysm repair (AAA) |
— |
— |
$3,257 |
$1,345 | |
| Aortic valve replacement |
$9,609 |
$9,609 |
$4,498 |
$1,603 | |
| Appendix removal (appendectomy) |
— |
— |
$18,817 |
$592 | |
| Arterial blood gas (ABG) |
$930 |
$930 |
$373 |
$26 | |
| AST liver enzyme test |
$234 |
$234 |
$94 |
$5 | |
| Barium swallow study |
$1,456 |
$1,456 |
$600 |
$107 | |
| Bartholin cyst removal |
$1,091 |
$1,091 |
$490 |
$182 | |
| Basic metabolic panel |
$550 |
$550 |
$220 |
$8 | |
| Benign skin lesion removal |
$3,811 |
$3,811 |
$1,677 |
$171 | |
| Bilirubin blood test |
$233 |
$233 |
$94 |
$5 | |
| Bladder function test (urodynamics) |
$2,734 |
$2,734 |
$1,321 |
$345 | |
| Bladder scope (cystoscopy) |
$3,043 |
$3,043 |
$1,339 |
$216 | |
| Bladder tumor removal (TURBT) |
— |
— |
$6,097 |
$236 | |
| Blood clotting test (PT/INR) |
$292 |
$292 |
$117 |
$4 | |
| Blood crossmatch |
$570 |
$570 |
$351 |
— | |
| Blood glucose test |
$173 |
$173 |
$87 |
$5 | |
| Blood transfusion |
$2,141 |
$2,141 |
$942 |
$47 | |
| Blood type and screen |
$599 |
$599 |
$264 |
$10 | |
| Blood type test (ABO group) |
$599 |
$599 |
$330 |
$3 | |
| BNP (heart failure) test |
$801 |
$801 |
$321 |
$39 | |
| Bone density scan (DEXA) |
$1,338 |
$1,338 |
$537 |
$39 | |
| Bone marrow biopsy |
$11,887 |
$11,887 |
$5,572 |
$172 | |
| Bone scan (nuclear) |
$4,790 |
$4,790 |
$1,921 |
$259 | |
| Botox for migraine |
$1,335 |
$1,335 |
$562 |
$157 | |
| Brain shunt (VP shunt) |
$5,408 |
$5,408 |
$2,492 |
$1,023 | |
| Breast biopsy |
$10,245 |
$10,245 |
$4,354 |
$478 | |
| Breast MRI |
$1,521 |
$1,521 |
$830 |
$216 | |
| Breast MRI without contrast |
$1,521 |
$1,521 |
$788 |
$216 | |
| Breast reconstruction |
— |
— |
$7,875 |
$1,227 | |
| Breast reduction |
— |
— |
$10,579 |
$980 | |
| Breast ultrasound |
$743 |
$743 |
$262 |
$92 | |
| Breast ultrasound (complete) |
$892 |
$892 |
$358 |
$100 | |
| Breast ultrasound (limited) |
$594 |
$594 |
$238 |
$84 | |
| Breathing tube insertion (intubation) |
$1,860 |
$1,860 |
$818 |
$133 | |
| Bronchoscopy |
$5,920 |
$5,920 |
$3,371 |
$303 | |
| Bunion surgery (bunionectomy) |
— |
— |
$8,940 |
$883 | |
| Burn dressing and debridement (medium) |
$1,329 |
$1,329 |
$585 |
$166 | |
| Burn dressing and debridement (small) |
$1,329 |
$1,329 |
$585 |
$93 | |
| Burn treatment |
$1,329 |
$1,329 |
$585 |
$129 | |
| C-reactive protein (CRP) |
$244 |
$244 |
$98 |
$5 | |
| CA 19-9 tumor marker test |
$668 |
$668 |
$268 |
$21 | |
| CA-125 ovarian marker test |
$698 |
$698 |
$280 |
$21 | |
| Calcium blood test |
$275 |
$275 |
$110 |
$5 | |
| Capsule endoscopy |
$5,397 |
$5,397 |
$2,164 |
$802 | |
| Cardiac ablation |
$116,150 |
$116,150 |
$49,871 |
$759 | |
| Cardiac catheterization |
$24,328 |
$24,328 |
$10,705 |
$1,049 | |
| Cardiac MRI |
$6,613 |
$6,613 |
$2,757 |
$322 | |
| Cardiac MRI without contrast |
$6,959 |
$6,959 |
$2,791 |
$280 | |
| Cardiac rehabilitation |
$646 |
$646 |
$284 |
$26 | |
| Cardiac stress test |
$3,004 |
$3,004 |
$1,322 |
$39 | |
| Cardioversion |
$4,071 |
$4,071 |
$1,791 |
$155 | |
| Carotid artery surgery |
— |
— |
$2,529 |
$1,026 | |
| Carotid artery ultrasound |
$2,473 |
$2,473 |
$1,076 |
$156 | |
| Carpal tunnel release |
— |
— |
$3,886 |
$483 | |
| Cataract surgery |
— |
— |
$4,569 |
$547 | |
| CEA tumor marker test |
$606 |
$606 |
$243 |
$19 | |
| Celiac disease test |
$51 |
$51 |
$28 |
$12 | |
| Central line placement |
$8,209 |
$8,209 |
$3,612 |
$238 | |
| Cervical cerclage |
— |
— |
$5,046 |
$137 | |
| Cervical LEEP procedure |
— |
— |
$4,746 |
$325 | |
| Cesarean section (C-section) |
— |
— |
$8,823 |
$7,552 | |
| Chalazion (eyelid cyst) removal |
— |
— |
$4,200 |
$131 | |
| Chemotherapy infusion |
$937 |
$937 |
$356 |
$81 | |
| Chemotherapy infusion (each additional) |
$509 |
$509 |
$224 |
$28 | |
| Chemotherapy infusion (first hour) |
$1,366 |
$1,366 |
$601 |
$133 | |
| Chest fluid drain (thoracentesis) |
$4,763 |
$4,763 |
$2,096 |
$311 | |
| Chest tube insertion |
$3,267 |
$3,267 |
$2,058 |
$143 | |
| Chest X-ray |
$908 |
$908 |
$384 |
$37 | |
| Chest X-ray (1 view) |
$854 |
$854 |
$343 |
$25 | |
| Chest X-ray (2 views) |
$876 |
$876 |
$351 |
$33 | |
| CK-MB heart enzyme test |
$391 |
$391 |
$157 |
$12 | |
| Clotting time test (PTT) |
$357 |
$357 |
$143 |
$6 | |
| Colon resection (colectomy) |
— |
— |
$3,028 |
$1,238 | |
| Colonoscopy |
$6,596 |
$6,596 |
$2,902 |
$480 | |
| Colostomy |
— |
— |
$2,688 |
$1,122 | |
| Colposcopy |
— |
— |
$4,200 |
$161 | |
| Complete blood count (CBC) |
$255 |
$255 |
$106 |
$7 | |
| Complete blood count (CBC) (complete) |
$265 |
$265 |
$106 |
$8 | |
| Complex wound repair |
$2,793 |
$2,793 |
$1,229 |
$390 | |
| Comprehensive metabolic panel |
$748 |
$748 |
$300 |
$11 | |
| Contraceptive implant (Nexplanon) |
— |
— |
$475 |
$115 | |
| Copper blood test |
$371 |
$371 |
$149 |
$12 | |
| Corneal transplant |
— |
— |
$8,023 |
$1,066 | |
| Coronary angioplasty / stent (PCI) |
— |
— |
$55,487 |
$426 | |
| Coronary artery bypass (CABG) |
— |
— |
$52,487 |
$36,593 | |
| Coronary CT angiography |
$2,206 |
$2,206 |
$329 |
$326 | |
| Cortisol test |
$534 |
$534 |
$214 |
$16 | |
| COVID-19 PCR test |
$313 |
$313 |
$170 |
$51 | |
| CPAP titration study |
$3,760 |
$3,760 |
$1,654 |
$69 | |
| Craniotomy (brain surgery) |
— |
— |
$4,943 |
$2,161 | |
| Creatine kinase (CK) test |
$345 |
$345 |
$138 |
$7 | |
| CT angiography of the chest |
$7,576 |
$7,576 |
$3,038 |
$281 | |
| CT angiography of the head |
$7,007 |
$7,007 |
$2,810 |
$274 | |
| CT colonography (virtual colonoscopy) |
$3,162 |
$3,162 |
$1,798 |
$835 | |
| CT scan of the abdomen |
$7,086 |
$7,086 |
$2,652 |
$230 | |
| CT scan of the abdomen and pelvis |
$11,095 |
$11,095 |
$4,449 |
$300 | |
| CT scan of the abdomen and pelvis with and without contrast |
$12,741 |
$12,741 |
$5,109 |
$338 | |
| CT scan of the abdomen and pelvis with contrast |
$11,095 |
$11,095 |
$4,449 |
$300 | |
| CT scan of the abdomen and pelvis without contrast |
$9,179 |
$9,179 |
$3,681 |
$183 | |
| CT scan of the abdomen with and without contrast |
$8,640 |
$8,640 |
$3,465 |
$259 | |
| CT scan of the abdomen with contrast |
$7,086 |
$7,086 |
$2,842 |
$230 | |
| CT scan of the abdomen without contrast |
$5,757 |
$5,757 |
$2,308 |
$136 | |
| CT scan of the arm |
$6,600 |
$6,600 |
$2,647 |
$199 | |
| CT scan of the arm with contrast |
$6,600 |
$6,600 |
$2,647 |
$199 | |
| CT scan of the arm without contrast |
$5,223 |
$5,223 |
$2,095 |
$161 | |
| CT scan of the chest |
$7,434 |
$7,434 |
$2,658 |
$167 | |
| CT scan of the chest with and without contrast |
$7,999 |
$7,999 |
$3,207 |
$196 | |
| CT scan of the chest with contrast |
$7,434 |
$7,434 |
$2,981 |
$167 | |
| CT scan of the chest without contrast |
$5,493 |
$5,493 |
$2,203 |
$133 | |
| CT scan of the head |
$5,793 |
$5,793 |
$2,517 |
$148 | |
| CT scan of the head with and without contrast |
$7,679 |
$7,679 |
$3,079 |
$173 | |
| CT scan of the head with contrast |
$5,793 |
$5,793 |
$2,323 |
$148 | |
| CT scan of the head without contrast |
$5,720 |
$5,720 |
$2,294 |
$107 | |
| CT scan of the leg |
$6,368 |
$6,368 |
$2,553 |
$166 | |
| CT scan of the leg with contrast |
$7,317 |
$7,317 |
$2,934 |
$166 | |
| CT scan of the leg without contrast |
$5,630 |
$5,630 |
$2,258 |
$130 | |
| CT scan of the lower back (lumbar spine) |
$6,878 |
$6,878 |
$2,946 |
$169 | |
| CT scan of the lower back (lumbar spine) with and without contrast |
$7,480 |
$7,480 |
$3,000 |
$197 | |
| CT scan of the lower back (lumbar spine) with contrast |
$6,878 |
$6,878 |
$2,758 |
$169 | |
| CT scan of the lower back (lumbar spine) without contrast |
$6,695 |
$6,695 |
$2,685 |
$130 | |
| CT scan of the neck |
$7,204 |
$7,204 |
$2,873 |
$183 | |
| CT scan of the neck (cervical spine) |
$7,072 |
$7,072 |
$3,026 |
$168 | |
| CT scan of the neck (cervical spine) with and without contrast |
$6,878 |
$6,878 |
$2,758 |
$196 | |
| CT scan of the neck (cervical spine) with contrast |
$8,263 |
$8,263 |
$3,313 |
$168 | |
| CT scan of the neck (cervical spine) without contrast |
$7,072 |
$7,072 |
$2,836 |
$131 | |
| CT scan of the neck with and without contrast |
$7,367 |
$7,367 |
$2,954 |
$220 | |
| CT scan of the neck with contrast |
$7,204 |
$7,204 |
$2,889 |
$183 | |
| CT scan of the neck without contrast |
$6,214 |
$6,214 |
$2,492 |
$150 | |
| CT scan of the pelvis |
$6,881 |
$6,881 |
$2,667 |
$226 | |
| CT scan of the pelvis with and without contrast |
$6,881 |
$6,881 |
$2,759 |
$251 | |
| CT scan of the pelvis with contrast |
$6,930 |
$6,930 |
$2,779 |
$226 | |
| CT scan of the pelvis without contrast |
$6,024 |
$6,024 |
$2,415 |
$133 | |
| CT scan of the sinuses |
$7,214 |
$7,214 |
$2,565 |
$152 | |
| CT scan of the sinuses with and without contrast |
$7,444 |
$7,444 |
$2,985 |
$184 | |
| CT scan of the sinuses with contrast |
$7,214 |
$7,214 |
$2,893 |
$152 | |
| CT scan of the sinuses without contrast |
$5,829 |
$5,829 |
$2,337 |
$128 | |
| D-dimer test |
$422 |
$422 |
$169 |
$10 | |
| Defibrillator (ICD) implant |
$150,528 |
$150,528 |
$67,659 |
$798 | |
| Developmental screening (child) |
$84 |
$84 |
$37 |
— | |
| DHEA-sulfate test |
$665 |
$665 |
$267 |
$22 | |
| Diagnostic mammogram |
$865 |
$865 |
$400 |
$140 | |
| Dialysis fistula creation |
— |
— |
$5,598 |
$601 | |
| Dilation and curettage (D&C) |
— |
— |
$5,046 |
$298 | |
| Droopy eyelid repair (ptosis) |
$7,498 |
$7,498 |
$4,124 |
$745 | |
| Drug screen (urine) |
$123 |
$123 |
$232 |
$17 | |
| Ear tubes (myringotomy) |
— |
— |
$3,211 |
$174 | |
| Eardrum repair (tympanoplasty) |
— |
— |
$9,798 |
$799 | |
| Echocardiogram |
$3,419 |
$3,419 |
$1,005 |
$138 | |
| Echocardiogram with and without contrast |
$2,229 |
$2,229 |
$894 |
$101 | |
| Echocardiogram without contrast |
$3,419 |
$3,419 |
$1,371 |
$138 | |
| EEG (awake and asleep) |
$2,687 |
$2,687 |
$1,182 |
$482 | |
| EKG / ECG (tracing only) |
$635 |
$635 |
$279 |
$7 | |
| Elbow replacement |
— |
— |
$34,125 |
$1,301 | |
| Electrocardiogram (EKG) |
$635 |
$635 |
$279 |
$8 | |
| Electroencephalogram (EEG) |
$2,288 |
$2,288 |
$1,071 |
$448 | |
| Electrolyte panel |
$425 |
$425 |
$171 |
$7 | |
| Emergency department visit |
$1,707 |
$1,707 |
$2,159 |
$69 | |
| Emergency department visit (level 1) |
$732 |
$732 |
$394 |
$11 | |
| Emergency department visit (level 2) |
$1,373 |
$1,373 |
$740 |
$40 | |
| Emergency department visit (level 3) |
$1,157 |
$1,157 |
$1,204 |
$69 | |
| Endometrial biopsy |
— |
— |
$105 |
$98 | |
| Epidural steroid injection |
$3,899 |
$3,899 |
$1,822 |
$275 | |
| ERCP (bile duct endoscopy) |
$10,833 |
$10,833 |
$5,698 |
$311 | |
| Esophageal dilation |
$4,114 |
$4,114 |
$2,427 |
$522 | |
| Esophageal variceal banding |
$6,037 |
$6,037 |
$3,327 |
$126 | |
| Estradiol (estrogen) test |
$791 |
$791 |
$317 |
$28 | |
| Eyelid surgery (blepharoplasty) |
— |
— |
$3,667 |
$552 | |
| Facet joint injection (spine) |
$2,336 |
$2,336 |
$1,472 |
$99 | |
| Fallopian tube X-ray (HSG) |
$1,306 |
$1,306 |
$1 |
$164 | |
| Fecal occult blood (stool) test |
$281 |
$281 |
$93 |
$10 | |
| Fecal occult blood (stool) test (guaiac, gFOBT) |
$150 |
$150 |
$60 |
$4 | |
| Fecal occult blood (stool) test (immunochemical, FIT) |
$412 |
$412 |
$165 |
$16 | |
| Feeding tube (PEG) placement |
$7,714 |
$7,714 |
$3,550 |
$178 | |
| Femoral hernia repair |
— |
— |
$7,027 |
$584 | |
| Ferritin (iron) test |
$412 |
$412 |
$165 |
$14 | |
| Fibrinogen test |
$59 |
$59 |
$32 |
$10 | |
| Fibroid removal (myomectomy) |
— |
— |
$2,237 |
$914 | |
| Flexible sigmoidoscopy |
$5,223 |
$5,223 |
$2,303 |
$323 | |
| Flu test |
$590 |
$590 |
$237 |
$17 | |
| Flu vaccine |
$220 |
$220 |
$97 |
— | |
| Folate (folic acid) test |
$423 |
$423 |
$169 |
$15 | |
| Foreign body removal (skin) |
$971 |
$971 |
$427 |
$157 | |
| Free T4 thyroid test |
$406 |
$406 |
$163 |
$9 | |
| FSH hormone test |
$519 |
$519 |
$208 |
$19 | |
| Gallbladder removal (laparoscopic) |
— |
— |
$10,344 |
$658 | |
| Gallbladder scan (HIDA) |
$4,752 |
$4,752 |
$1,962 |
$334 | |
| Ganglion cyst removal |
— |
— |
$3,063 |
$321 | |
| GGT liver test |
$264 |
$264 |
$106 |
$7 | |
| Glaucoma surgery |
— |
— |
$4,569 |
$984 | |
| Glucose tolerance test |
$335 |
$335 |
$114 |
$8 | |
| H. pylori test |
$380 |
$380 |
$209 |
$67 | |
| Hammertoe repair |
— |
— |
$5,530 |
$548 | |
| HDL cholesterol test |
$233 |
$233 |
$94 |
$8 | |
| Hematocrit test |
$125 |
$125 |
$50 |
$2 | |
| Hemodialysis |
$3,984 |
$3,984 |
$1,753 |
$75 | |
| Hemoglobin A1c (diabetes test) |
$358 |
$358 |
$144 |
$10 | |
| Hemorrhoid removal |
$4,082 |
$4,082 |
$1,796 |
$338 | |
| Hepatitis A vaccine |
$1,014 |
$1,014 |
$446 |
— | |
| Hepatitis B test |
$351 |
$351 |
$141 |
$10 | |
| Hepatitis B vaccine |
$748 |
$748 |
$329 |
— | |
| Hepatitis C test |
$425 |
$425 |
$170 |
$14 | |
| Hip arthroscopy |
— |
— |
$12,084 |
$931 | |
| Hip fracture repair |
— |
— |
$2,738 |
$1,120 | |
| Hip replacement |
— |
— |
$25,468 |
$1,162 | |
| HIV test |
$342 |
$342 |
$117 |
$19 | |
| HIV test (antibody) |
— |
— |
$46 |
$14 | |
| HIV test (antigen/antibody combo) |
$342 |
$342 |
$137 |
$24 | |
| Holter heart monitor |
$1,686 |
$1,686 |
$716 |
$26 | |
| Home sleep apnea test |
$1,659 |
$1,659 |
$730 |
$123 | |
| Hydrocele repair |
— |
— |
$6,281 |
$315 | |
| Hysterectomy |
— |
— |
$15,985 |
$933 | |
| Hysteroscopy |
— |
— |
$5,046 |
$1,270 | |
| Ileostomy |
— |
— |
$2,332 |
$968 | |
| Incisional hernia repair |
— |
— |
$7,027 |
— | |
| Inguinal hernia repair |
— |
— |
$7,027 |
$538 | |
| Iron blood test |
$218 |
$218 |
$88 |
$6 | |
| IUD insertion |
— |
— |
$112 |
— | |
| IUD removal |
$2,057 |
$2,057 |
$905 |
$112 | |
| IV infusion therapy |
$628 |
$628 |
$219 |
$44 | |
| IV infusion therapy (each additional) |
$262 |
$262 |
$115 |
$21 | |
| IV infusion therapy (initial) |
$994 |
$994 |
$437 |
$67 | |
| IVC filter placement |
$41,883 |
$41,883 |
$18,428 |
$1,885 | |
| Joint aspiration (small/intermediate) |
$2,056 |
$2,056 |
$904 |
$57 | |
| Joint aspiration or injection (mid-size joint) |
$2,056 |
$2,056 |
$904 |
$57 | |
| Joint aspiration or injection (small joint) |
$2,056 |
$2,056 |
$904 |
$56 | |
| Kidney biopsy |
$10,245 |
$10,245 |
$4,354 |
$492 | |
| Kidney removal (nephrectomy) |
— |
— |
$2,926 |
$1,164 | |
| Kidney scan (nuclear) |
$3,089 |
$3,089 |
$1,239 |
$172 | |
| Kidney stone shock-wave (lithotripsy) |
$36,814 |
$36,814 |
$15,480 |
$760 | |
| Kidney ultrasound |
$1,532 |
$1,532 |
$577 |
$84 | |
| Kidney ultrasound (limited) |
$1,312 |
$1,312 |
$526 |
$61 | |
| Knee arthroscopy |
— |
— |
$6,187 |
$524 | |
| Knee joint injection |
$2,056 |
$2,056 |
$904 |
$69 | |
| Knee replacement |
— |
— |
$32,617 |
$18,054 | |
| Lactate test |
$143 |
$143 |
$58 |
$12 | |
| Laminectomy (spine) |
— |
— |
$12,801 |
$1,157 | |
| LDH test |
$305 |
$305 |
$122 |
$6 | |
| LDL cholesterol test |
$282 |
$282 |
$113 |
$11 | |
| Leg artery angiogram |
$12,856 |
$12,856 |
$6,152 |
$149 | |
| Leg artery angioplasty |
$61,502 |
$61,502 |
$23,582 |
— | |
| Leg vein ultrasound (Doppler) |
$2,837 |
$2,837 |
$1,125 |
$150 | |
| Leg vein ultrasound (Doppler) (limited) |
$2,270 |
$2,270 |
$910 |
$116 | |
| LH hormone test |
$541 |
$541 |
$217 |
$19 | |
| Lipase test |
$377 |
$377 |
$151 |
$7 | |
| Lipid (cholesterol) panel |
$493 |
$493 |
$198 |
$13 | |
| Liver biopsy |
$6,074 |
$6,074 |
$3,102 |
$288 | |
| Liver function panel |
$578 |
$578 |
$232 |
$8 | |
| Lower back (lumbar) spinal fusion |
— |
— |
$89,018 |
$1,511 | |
| Lumbar discectomy |
— |
— |
$12,801 |
$898 | |
| Lumpectomy (breast) |
— |
— |
$7,543 |
$750 | |
| Lung function test (PFT) |
$1,197 |
$1,197 |
$538 |
$37 | |
| Lung scan (V/Q) |
$6,057 |
$6,057 |
$2,429 |
$291 | |
| Magnesium blood test |
$351 |
$351 |
$141 |
$7 | |
| Mastectomy |
— |
— |
$10,579 |
$1,021 | |
| Mastoidectomy |
— |
— |
$9,798 |
$840 | |
| Meniscus repair (knee) |
— |
— |
$5,530 |
$714 | |
| MMR vaccine |
$1,131 |
$1,131 |
$498 |
— | |
| Mohs skin cancer surgery |
— |
— |
$4,200 |
$535 | |
| MRA of the brain |
$7,477 |
$7,477 |
$2,998 |
$226 | |
| MRA of the brain with contrast |
$7,537 |
$7,537 |
$3,022 |
$226 | |
| MRA of the brain without contrast |
$7,093 |
$7,093 |
$2,844 |
$328 | |
| MRA of the neck |
$7,753 |
$7,753 |
$3,169 |
$245 | |
| MRA of the neck with contrast |
$7,753 |
$7,753 |
$3,109 |
$245 | |
| MRA of the neck without contrast |
$10,780 |
$10,780 |
$4,323 |
$343 | |
| MRI of the abdomen |
$8,197 |
$8,197 |
$3,494 |
$300 | |
| MRI of the abdomen with contrast |
$8,197 |
$8,197 |
$3,287 |
$300 | |
| MRI of the abdomen without contrast |
$7,848 |
$7,848 |
$3,147 |
$194 | |
| MRI of the ankle |
$7,815 |
$7,815 |
$3,262 |
$261 | |
| MRI of the ankle with contrast |
$7,414 |
$7,414 |
$2,973 |
$261 | |
| MRI of the ankle without contrast |
$7,815 |
$7,815 |
$3,134 |
$222 | |
| MRI of the brain |
$8,524 |
$8,524 |
$3,603 |
$269 | |
| MRI of the brain with contrast |
$8,524 |
$8,524 |
$3,418 |
$269 | |
| MRI of the brain without contrast |
$8,043 |
$8,043 |
$3,225 |
$195 | |
| MRI of the chest |
$8,645 |
$8,645 |
$2,701 |
$371 | |
| MRI of the chest with contrast |
$4,156 |
$4,156 |
$1,940 |
$371 | |
| MRI of the chest without contrast |
$11,349 |
$11,349 |
$4,551 |
$466 | |
| MRI of the knee |
$8,290 |
$8,290 |
$3,647 |
$315 | |
| MRI of the knee with contrast |
$7,837 |
$7,837 |
$3,142 |
$315 | |
| MRI of the knee without contrast |
$8,290 |
$8,290 |
$3,324 |
$204 | |
| MRI of the lower back (lumbar spine) |
$10,971 |
$10,971 |
$4,400 |
$270 | |
| MRI of the lower back (lumbar spine) with contrast |
$10,971 |
$10,971 |
$4,400 |
$270 | |
| MRI of the lower back (lumbar spine) without contrast |
$8,593 |
$8,593 |
$3,446 |
$192 | |
| MRI of the mid-back (thoracic spine) |
$8,620 |
$8,620 |
$3,776 |
$271 | |
| MRI of the mid-back (thoracic spine) with and without contrast |
$12,344 |
$12,344 |
$4,950 |
$319 | |
| MRI of the mid-back (thoracic spine) with contrast |
$8,620 |
$8,620 |
$3,457 |
$271 | |
| MRI of the mid-back (thoracic spine) without contrast |
$8,581 |
$8,581 |
$3,441 |
$190 | |
| MRI of the neck (cervical spine) |
$8,391 |
$8,391 |
$3,671 |
$274 | |
| MRI of the neck (cervical spine) with and without contrast |
$11,690 |
$11,690 |
$4,688 |
$318 | |
| MRI of the neck (cervical spine) with contrast |
$8,343 |
$8,343 |
$3,346 |
$274 | |
| MRI of the neck (cervical spine) without contrast |
$8,391 |
$8,391 |
$3,365 |
$191 | |
| MRI of the pelvis |
$8,450 |
$8,450 |
$3,576 |
$268 | |
| MRI of the pelvis with contrast |
$8,450 |
$8,450 |
$3,389 |
$268 | |
| MRI of the pelvis without contrast |
$7,404 |
$7,404 |
$2,969 |
$227 | |
| MRI of the shoulder |
$9,912 |
$9,912 |
$3,975 |
$313 | |
| MRI of the shoulder with contrast |
$9,912 |
$9,912 |
$3,975 |
$313 | |
| MRI of the shoulder without contrast |
$7,890 |
$7,890 |
$3,164 |
$205 | |
| MRI of the wrist |
$8,920 |
$8,920 |
$2,701 |
$330 | |
| MRI of the wrist with contrast |
$4,156 |
$4,156 |
$1,667 |
$330 | |
| MRI of the wrist without contrast |
$8,920 |
$8,920 |
$3,577 |
$303 | |
| Nebulizer breathing treatment |
$1,066 |
$1,066 |
$469 |
$9 | |
| Neck (cervical) spinal fusion |
— |
— |
$25,468 |
$1,410 | |
| Nerve conduction study |
$1,445 |
$1,445 |
$831 |
$118 | |
| Newborn hospital care |
$1,023 |
$1,023 |
$450 |
$58 | |
| Nuchal translucency ultrasound |
$540 |
$540 |
$249 |
$116 | |
| Nuclear cardiac stress test |
$11,414 |
$11,414 |
$4,577 |
$428 | |
| Occupational therapy evaluation |
$842 |
$842 |
$371 |
$101 | |
| Occupational therapy evaluation (high complexity) |
$842 |
$842 |
$371 |
$101 | |
| Occupational therapy evaluation (low complexity) |
$842 |
$842 |
$371 |
$101 | |
| Occupational therapy evaluation (moderate complexity) |
$842 |
$842 |
$371 |
$101 | |
| Orthopedic hardware removal |
— |
— |
$4,684 |
$632 | |
| Ovarian cyst removal |
— |
— |
$9,141 |
$698 | |
| Ovary removal (oophorectomy) |
— |
— |
$1,827 |
$822 | |
| Pacemaker insertion |
— |
— |
$40,730 |
$15,506 | |
| Pap smear (cervical screening) |
$114 |
$114 |
$67 |
$20 | |
| Parathyroid hormone (PTH) test |
$1,081 |
$1,081 |
$433 |
$41 | |
| Parathyroid removal |
— |
— |
$10,380 |
$891 | |
| Pelvic ultrasound |
$1,615 |
$1,615 |
$660 |
$78 | |
| Pelvic ultrasound (complete) |
$2,031 |
$2,031 |
$814 |
$105 | |
| Pelvic ultrasound (limited) |
$1,200 |
$1,200 |
$481 |
$51 | |
| PET scan |
$18,289 |
$18,289 |
$7,559 |
— | |
| Phosphorus blood test |
$236 |
$236 |
$95 |
$5 | |
| Physical therapy evaluation |
$748 |
$748 |
$329 |
$98 | |
| Physical therapy evaluation (high complexity) |
$748 |
$748 |
$329 |
$98 | |
| Physical therapy evaluation (moderate complexity) |
$748 |
$748 |
$329 |
$98 | |
| Pilonidal cyst removal |
— |
— |
$4,684 |
$541 | |
| Platelet count |
$224 |
$224 |
$90 |
$4 | |
| Pneumonia vaccine |
$1,277 |
$1,277 |
$571 |
— | |
| Pregnancy blood test (hCG) |
$37 |
$37 |
$20 |
$8 | |
| Pregnancy ultrasound |
$1,760 |
$1,760 |
$813 |
$126 | |
| Pregnancy ultrasound (first trimester) |
$1,435 |
$1,435 |
$575 |
$117 | |
| Pregnancy ultrasound (second or third trimester) |
$2,085 |
$2,085 |
$836 |
$136 | |
| Procalcitonin test |
$631 |
$631 |
$253 |
$27 | |
| Prolactin test |
$556 |
$556 |
$223 |
$19 | |
| Prostate biopsy |
$14,232 |
$14,232 |
$5,984 |
— | |
| Prostate removal (prostatectomy) |
— |
— |
$9,447 |
$1,063 | |
| Prostate surgery (TURP) |
— |
— |
$8,548 |
$526 | |
| Prostate test (PSA) |
$515 |
$515 |
$206 |
$18 | |
| Pterygium removal (eye) |
— |
— |
$4,171 |
$540 | |
| Pulmonary rehabilitation |
$509 |
$509 |
$224 |
$87 | |
| Radiofrequency nerve ablation |
$9,966 |
$9,966 |
$4,385 |
$462 | |
| Retinal detachment repair |
— |
— |
$8,023 |
$966 | |
| Rheumatoid factor test |
$284 |
$284 |
$114 |
$6 | |
| Rotator cuff repair |
— |
— |
$12,084 |
$792 | |
| RSV vaccine |
$2,896 |
$2,896 |
$1,274 |
— | |
| Sacroiliac joint injection |
$295 |
$295 |
$163 |
$176 | |
| Scoliosis spine X-ray |
$803 |
$803 |
$322 |
$58 | |
| Scoliosis spine X-ray (1 view) |
$605 |
$605 |
$243 |
$44 | |
| Scoliosis spine X-ray (3 views) |
$1,002 |
$1,002 |
$402 |
$72 | |
| Screening colonoscopy |
$5,669 |
$5,669 |
$2,648 |
$378 | |
| Screening mammogram |
$761 |
$761 |
$335 |
$126 | |
| Scrotal ultrasound |
$1,764 |
$1,764 |
$708 |
$99 | |
| Sedimentation rate (ESR) test |
$93 |
$93 |
$13 |
$3 | |
| Semen analysis |
$241 |
$241 |
$56 |
$12 | |
| Septoplasty (deviated septum) |
— |
— |
$5,920 |
$613 | |
| Sex hormone binding globulin test |
$406 |
$406 |
$163 |
$22 | |
| Shoulder arthroscopy |
— |
— |
$12,084 |
$962 | |
| Shoulder replacement |
— |
— |
$3,234 |
$1,300 | |
| Simple laceration repair (small, up to 2.5 cm) |
$957 |
$957 |
$421 |
$114 | |
| Simple wound stitches |
$991 |
$991 |
$421 |
$127 | |
| Sinus surgery (endoscopic) |
— |
— |
$8,663 |
$224 | |
| Skin biopsy |
$1,413 |
$1,413 |
$777 |
$121 | |
| Skin biopsy (punch) |
$1,413 |
$1,413 |
$622 |
$121 | |
| Skin cancer lesion removal |
— |
— |
$4,200 |
$240 | |
| Skin graft |
$22,400 |
$22,400 |
$9,419 |
$898 | |
| Skin lesion freezing (cryotherapy) |
$587 |
$587 |
$53 |
$36 | |
| Skin tag removal |
$563 |
$563 |
$332 |
$92 | |
| Sleep study (polysomnography) |
$12,816 |
$12,816 |
$5,704 |
$691 | |
| Small bowel resection |
— |
— |
$2,736 |
$1,136 | |
| Soft tissue ultrasound |
$1,280 |
$1,280 |
$513 |
$64 | |
| Speech therapy |
$792 |
$792 |
$348 |
$76 | |
| Spinal cord stimulator |
— |
— |
$12,498 |
$2,388 | |
| Spinal tap (lumbar puncture) |
$3,628 |
$3,628 |
$1,596 |
$165 | |
| Spine fracture repair (kyphoplasty) |
$61,536 |
$61,536 |
$27,076 |
$5,803 | |
| Spirometry (lung function test) |
$1,044 |
$1,044 |
$459 |
$30 | |
| Spirometry with bronchodilator |
$1,351 |
$1,351 |
$594 |
$43 | |
| Spleen removal (splenectomy) |
— |
— |
$7,875 |
$1,036 | |
| Stomach removal (gastrectomy) |
— |
— |
$3,757 |
$1,595 | |
| Strabismus (eye muscle) surgery |
— |
— |
$5,274 |
$475 | |
| Strep throat test |
$93 |
$93 |
$51 |
$17 | |
| Stress echocardiogram |
$4,803 |
$4,803 |
$2,242 |
$209 | |
| Stress echocardiogram (complete) |
$5,749 |
$5,749 |
$2,530 |
$233 | |
| Swallow study |
$845 |
$845 |
$372 |
$85 | |
| T3 thyroid test |
$436 |
$436 |
$175 |
$14 | |
| Tdap (tetanus) vaccine |
$626 |
$626 |
$275 |
— | |
| Testicle removal (orchiectomy) |
— |
— |
$6,097 |
$306 | |
| Testosterone test |
$732 |
$732 |
$294 |
$26 | |
| Thyroid removal (thyroidectomy) |
— |
— |
$10,362 |
$1,004 | |
| Thyroid test (TSH) |
$543 |
$543 |
$218 |
$17 | |
| Thyroid ultrasound |
$1,580 |
$1,580 |
$634 |
$109 | |
| Thyroid uptake scan |
$2,293 |
$2,293 |
$911 |
$145 | |
| Tilt table test |
$5,960 |
$5,960 |
$2,623 |
$168 | |
| Tonsillectomy |
— |
— |
$7,875 |
$252 | |
| Total IgE allergy test |
$522 |
$522 |
$209 |
$16 | |
| Total protein test |
$207 |
$207 |
$83 |
$4 | |
| Tracheostomy |
— |
— |
$5,291 |
$273 | |
| Transesophageal echocardiogram (TEE) |
$6,428 |
$6,428 |
$2,578 |
$239 | |
| Transesophageal echocardiogram (TEE) with and without contrast |
$6,428 |
$6,428 |
$2,578 |
$239 | |
| Transvaginal ultrasound |
$1,660 |
$1,660 |
$666 |
$118 | |
| Trigger finger release |
— |
— |
$3,063 |
$630 | |
| Trigger point injection |
$1,715 |
$1,715 |
$743 |
$56 | |
| Trigger point injection (1-2 muscles) |
$1,741 |
$1,741 |
$766 |
$52 | |
| Triglycerides test |
$349 |
$349 |
$140 |
$6 | |
| Troponin (heart) test |
$445 |
$445 |
$178 |
$12 | |
| Tubal ligation |
— |
— |
$9,764 |
$333 | |
| Turbinate reduction |
— |
— |
$5,291 |
$294 | |
| Turning a breech baby (version) |
$16,476 |
$16,476 |
$6,928 |
$94 | |
| Ulnar nerve surgery (elbow) |
— |
— |
$3,886 |
$575 | |
| Umbilical hernia repair |
— |
— |
$7,027 |
— | |
| Upper GI endoscopy (EGD) |
$5,999 |
$5,999 |
$2,675 |
$371 | |
| Upper GI series (barium) |
$2,004 |
$2,004 |
$820 |
$128 | |
| Ureteral stent placement |
$16,831 |
$16,831 |
$7,295 |
$373 | |
| Ureteroscopy (stone removal) |
$25,636 |
$25,636 |
$10,780 |
$365 | |
| Uric acid (gout) test |
$253 |
$253 |
$101 |
$5 | |
| Urinalysis |
$172 |
$172 |
$62 |
$3 | |
| Urine microalbumin test |
$262 |
$262 |
$89 |
$5 | |
| Urine pregnancy test |
$372 |
$372 |
$149 |
$9 | |
| Vaccine administration |
$195 |
$195 |
$85 |
$19 | |
| Vaccine administration (each additional) |
$92 |
$92 |
$40 |
$16 | |
| Vaginal delivery |
— |
— |
$6,419 |
$5,487 | |
| Varicocele repair |
— |
— |
$6,822 |
$327 | |
| Varicose vein ablation |
$14,187 |
$14,187 |
$6,419 |
$1,018 | |
| Vasectomy |
— |
— |
$3,996 |
$347 | |
| Vitamin B12 test |
$441 |
$441 |
$177 |
$15 | |
| Vitamin D test |
$746 |
$746 |
$299 |
$30 | |
| Vitrectomy (eye) |
— |
— |
$8,023 |
$814 | |
| Vocal cord injection |
— |
— |
$5,933 |
$211 | |
| Wart removal |
$563 |
$563 |
$332 |
$121 | |
| Weight-loss (bariatric) surgery |
— |
— |
$24,228 |
$11,645 | |
| Whipple procedure (pancreas) |
— |
— |
$6,987 |
$2,871 | |
| Wound debridement |
$2,756 |
$2,756 |
$1,198 |
$186 | |
| Wrist fracture repair |
— |
— |
$12,084 |
$735 | |
| X-ray of the abdomen |
$970 |
$970 |
$384 |
$36 | |
| X-ray of the ankle |
$924 |
$924 |
$371 |
$37 | |
| X-ray of the collarbone |
$922 |
$922 |
$370 |
$33 | |
| X-ray of the elbow |
$946 |
$946 |
$380 |
$33 | |
| X-ray of the facial bones |
$1,097 |
$1,097 |
$513 |
$39 | |
| X-ray of the foot |
$923 |
$923 |
$370 |
$34 | |
| X-ray of the forearm |
$944 |
$944 |
$379 |
$29 | |
| X-ray of the hand |
$912 |
$912 |
$366 |
$38 | |
| X-ray of the hip |
$605 |
$605 |
$295 |
$49 | |
| X-ray of the hip (1 view) |
$605 |
$605 |
$243 |
$34 | |
| X-ray of the hip (3 views) |
$605 |
$605 |
$243 |
$49 | |
| X-ray of the hip (4 views) |
$1,002 |
$1,002 |
$402 |
$63 | |
| X-ray of the knee |
$907 |
$907 |
$383 |
$42 | |
| X-ray of the knee (2 views) |
$870 |
$870 |
$349 |
$34 | |
| X-ray of the knee (3 views) |
$907 |
$907 |
$364 |
$42 | |
| X-ray of the knee (4+ views) |
$1,007 |
$1,007 |
$404 |
$49 | |
| X-ray of the lower back (lumbar spine) |
$1,203 |
$1,203 |
$494 |
$47 | |
| X-ray of the lower back (lumbar spine) (2 views) |
$1,017 |
$1,017 |
$408 |
$40 | |
| X-ray of the lower back (lumbar spine) (4+ views) |
$1,388 |
$1,388 |
$557 |
$53 | |
| X-ray of the lower leg |
$924 |
$924 |
$371 |
$31 | |
| X-ray of the mid-back (thoracic spine) |
$1,052 |
$1,052 |
$431 |
$36 | |
| X-ray of the mid-back (thoracic spine) (2 views) |
$1,022 |
$1,022 |
$410 |
$33 | |
| X-ray of the mid-back (thoracic spine) (3 views) |
$1,082 |
$1,082 |
$434 |
$39 | |
| X-ray of the neck (cervical spine) |
$1,150 |
$1,150 |
$461 |
$47 | |
| X-ray of the neck (cervical spine) (3 views) |
$931 |
$931 |
$373 |
$40 | |
| X-ray of the pelvis |
$908 |
$908 |
$377 |
$36 | |
| X-ray of the pelvis (1 view) |
$856 |
$856 |
$343 |
$28 | |
| X-ray of the ribs |
$759 |
$759 |
$321 |
$42 | |
| X-ray of the ribs (2 views) |
$730 |
$730 |
$293 |
$36 | |
| X-ray of the ribs (3 views) |
$759 |
$759 |
$312 |
$42 | |
| X-ray of the shoulder |
$940 |
$940 |
$377 |
$36 | |
| X-ray of the skull |
$1,154 |
$1,154 |
$470 |
$40 | |
| X-ray of the upper arm |
$865 |
$865 |
$347 |
$32 | |
| X-ray of the wrist |
$1,019 |
$1,019 |
$409 |
$43 | |
| YAG laser capsulotomy (eye) |
— |
— |
$1,146 |
$335 | |
| Zinc blood test |
$320 |
$320 |
$128 |
$11 | |