| 3D mammogram (tomosynthesis) |
— |
— |
$65 |
$51 | |
| Abdominal ultrasound |
— |
— |
$138 |
$100 | |
| Abdominal ultrasound (complete) |
— |
— |
$152 |
$114 | |
| Abdominal ultrasound (limited) |
— |
— |
$128 |
$86 | |
| Adenoid removal (adenoidectomy) |
— |
— |
$4,600 |
$204 | |
| Allergy patch testing |
— |
— |
$943 |
$5 | |
| Allergy shots |
— |
— |
$54 |
$11 | |
| Allergy testing |
— |
— |
$943 |
$4 | |
| Anal fistula repair |
— |
— |
$3,048 |
$541 | |
| Ankle fracture repair |
— |
— |
$8,393 |
$608 | |
| Ankle replacement |
— |
— |
$29,941 |
$885 | |
| Aortic aneurysm repair (AAA) |
— |
— |
$1,311 |
$1,345 | |
| Aortic valve replacement |
— |
— |
$2,860 |
$1,603 | |
| Barium swallow study |
— |
— |
$201 |
$107 | |
| Bone density scan (DEXA) |
— |
— |
$128 |
$39 | |
| Bone scan (nuclear) |
— |
— |
$491 |
$259 | |
| Breast MRI |
— |
— |
$423 |
$216 | |
| Breast MRI without contrast |
— |
— |
$423 |
$216 | |
| Breast reconstruction |
— |
— |
$7,138 |
$1,227 | |
| Breast reduction |
— |
— |
$7,327 |
$980 | |
| Breast ultrasound |
— |
— |
$115 |
$92 | |
| Breast ultrasound (complete) |
— |
— |
$120 |
$100 | |
| Breast ultrasound (limited) |
— |
— |
$99 |
$84 | |
| Bunion surgery (bunionectomy) |
— |
— |
$7,969 |
$883 | |
| Capsule endoscopy |
— |
— |
$1,039 |
$802 | |
| Cardiac event monitor |
— |
— |
$165 |
$170 | |
| Cardiac MRI |
— |
— |
$705 |
$322 | |
| Cardiac MRI without contrast |
— |
— |
$550 |
$280 | |
| Cardiac stress test |
— |
— |
$73 |
$39 | |
| Carotid artery surgery |
— |
— |
$1,496 |
$1,026 | |
| Carotid artery ultrasound |
— |
— |
$257 |
$156 | |
| Cervical LEEP procedure |
— |
— |
$3,386 |
$325 | |
| Cesarean section (C-section) |
— |
— |
$14,997 |
$7,552 | |
| Chalazion (eyelid cyst) removal |
— |
— |
$1,043 |
$131 | |
| Chest tube insertion |
— |
— |
$1,696 |
$143 | |
| Chest X-ray |
— |
— |
$100 |
$37 | |
| Chest X-ray (1 view) |
— |
— |
$96 |
$25 | |
| Chest X-ray (2 views) |
— |
— |
$96 |
$33 | |
| Chiropractic adjustment |
— |
— |
$27 |
$38 | |
| Colon resection (colectomy) |
— |
— |
$1,978 |
$1,238 | |
| Colostomy |
— |
— |
$1,190 |
$1,122 | |
| Comprehensive eye exam |
— |
— |
$146 |
$138 | |
| Contact lens fitting |
— |
— |
$48 |
— | |
| Continuous glucose monitor setup |
— |
— |
$41 |
$35 | |
| Coronary artery bypass (CABG) |
— |
— |
$54,030 |
$36,593 | |
| Coronary CT angiography |
— |
— |
$627 |
$326 | |
| Craniotomy (brain surgery) |
— |
— |
$2,610 |
$2,161 | |
| CT angiography of the chest |
— |
— |
$449 |
$281 | |
| CT angiography of the head |
— |
— |
$437 |
$274 | |
| CT colonography (virtual colonoscopy) |
— |
— |
$728 |
$835 | |
| CT scan of the abdomen |
— |
— |
$268 |
$230 | |
| CT scan of the abdomen and pelvis |
— |
— |
$489 |
$300 | |
| CT scan of the abdomen and pelvis with and without contrast |
— |
— |
$657 |
$338 | |
| CT scan of the abdomen and pelvis with contrast |
— |
— |
$595 |
$300 | |
| CT scan of the abdomen and pelvis without contrast |
— |
— |
$376 |
$183 | |
| CT scan of the abdomen with and without contrast |
— |
— |
$339 |
$259 | |
| CT scan of the abdomen with contrast |
— |
— |
$314 |
$230 | |
| CT scan of the abdomen without contrast |
— |
— |
$218 |
$136 | |
| CT scan of the arm |
— |
— |
$250 |
$199 | |
| CT scan of the arm with contrast |
— |
— |
$383 |
$199 | |
| CT scan of the arm without contrast |
— |
— |
$188 |
$161 | |
| CT scan of the chest |
— |
— |
$263 |
$167 | |
| CT scan of the chest with and without contrast |
— |
— |
$331 |
$196 | |
| CT scan of the chest with contrast |
— |
— |
$311 |
$167 | |
| CT scan of the chest without contrast |
— |
— |
$221 |
$133 | |
| CT scan of the head |
— |
— |
$254 |
$148 | |
| CT scan of the head with and without contrast |
— |
— |
$323 |
$173 | |
| CT scan of the head with contrast |
— |
— |
$301 |
$148 | |
| CT scan of the head without contrast |
— |
— |
$212 |
$107 | |
| CT scan of the leg |
— |
— |
$202 |
$166 | |
| CT scan of the leg with contrast |
— |
— |
$202 |
$166 | |
| CT scan of the leg without contrast |
— |
— |
$188 |
$130 | |
| CT scan of the lower back (lumbar spine) |
— |
— |
$380 |
$169 | |
| CT scan of the lower back (lumbar spine) with and without contrast |
— |
— |
$355 |
$197 | |
| CT scan of the lower back (lumbar spine) with contrast |
— |
— |
$504 |
$169 | |
| CT scan of the lower back (lumbar spine) without contrast |
— |
— |
$226 |
$130 | |
| CT scan of the neck |
— |
— |
$253 |
$183 | |
| CT scan of the neck (cervical spine) |
— |
— |
$380 |
$168 | |
| CT scan of the neck (cervical spine) with and without contrast |
— |
— |
$355 |
$196 | |
| CT scan of the neck (cervical spine) with contrast |
— |
— |
$503 |
$168 | |
| CT scan of the neck (cervical spine) without contrast |
— |
— |
$221 |
$131 | |
| CT scan of the neck with and without contrast |
— |
— |
$319 |
$220 | |
| CT scan of the neck with contrast |
— |
— |
$304 |
$183 | |
| CT scan of the neck without contrast |
— |
— |
$220 |
$150 | |
| CT scan of the pelvis |
— |
— |
$259 |
$226 | |
| CT scan of the pelvis with and without contrast |
— |
— |
$323 |
$251 | |
| CT scan of the pelvis with contrast |
— |
— |
$306 |
$226 | |
| CT scan of the pelvis without contrast |
— |
— |
$209 |
$133 | |
| CT scan of the sinuses |
— |
— |
$259 |
$152 | |
| CT scan of the sinuses with and without contrast |
— |
— |
$329 |
$184 | |
| CT scan of the sinuses with contrast |
— |
— |
$301 |
$152 | |
| CT scan of the sinuses without contrast |
— |
— |
$218 |
$128 | |
| Developmental screening (child) |
— |
— |
$10 |
— | |
| Diagnostic mammogram |
— |
— |
$176 |
$140 | |
| Dialysis fistula creation |
— |
— |
$4,063 |
$601 | |
| Drug screen (urine) |
— |
— |
$20 |
$17 | |
| Ear tubes (myringotomy) |
— |
— |
$1,249 |
$174 | |
| Eardrum repair (tympanoplasty) |
— |
— |
$6,501 |
$799 | |
| Echocardiogram |
— |
— |
$572 |
$138 | |
| Echocardiogram with and without contrast |
— |
— |
$263 |
$101 | |
| EEG (awake and asleep) |
— |
— |
$238 |
$482 | |
| Elbow replacement |
— |
— |
$19,623 |
$1,301 | |
| Electrocardiogram (EKG) |
— |
— |
$20 |
$8 | |
| Electroencephalogram (EEG) |
— |
— |
$237 |
$448 | |
| Electromyography (EMG) |
— |
— |
$147 |
$141 | |
| Eye refraction (glasses prescription) |
— |
— |
$25 |
— | |
| Eyelid surgery (blepharoplasty) |
— |
— |
$3,274 |
$552 | |
| Fallopian tube X-ray (HSG) |
— |
— |
$262 |
$164 | |
| Femoral hernia repair |
— |
— |
$3,932 |
$584 | |
| Fibroid removal (myomectomy) |
— |
— |
$1,204 |
$914 | |
| Flu vaccine |
— |
— |
$17 |
— | |
| Gallbladder removal (laparoscopic) |
— |
— |
$6,892 |
$658 | |
| Gallbladder scan (HIDA) |
— |
— |
$608 |
$334 | |
| Glaucoma surgery |
— |
— |
$2,547 |
$984 | |
| Hemodialysis |
— |
— |
$172 |
$75 | |
| Hemorrhoid removal |
— |
— |
$2,961 |
$338 | |
| Hip arthroscopy |
— |
— |
$8,273 |
$931 | |
| Hip replacement |
— |
— |
$14,100 |
$1,162 | |
| Holter heart monitor |
— |
— |
$69 |
$26 | |
| Home sleep apnea test |
— |
— |
$189 |
$123 | |
| Hysterectomy |
— |
— |
$8,437 |
$933 | |
| Ileostomy |
— |
— |
$1,179 |
$968 | |
| Incisional hernia repair |
— |
— |
$1,029 |
— | |
| IUD insertion |
— |
— |
$25 |
— | |
| Kidney removal (nephrectomy) |
— |
— |
$2,209 |
$1,164 | |
| Kidney scan (nuclear) |
— |
— |
$599 |
$172 | |
| Kidney stone shock-wave (lithotripsy) |
— |
— |
$3,871 |
$760 | |
| Kidney ultrasound |
— |
— |
$137 |
$84 | |
| Kidney ultrasound (limited) |
— |
— |
$137 |
$61 | |
| Knee replacement |
— |
— |
$50,755 |
$18,054 | |
| Laminectomy (spine) |
— |
— |
$8,197 |
$1,157 | |
| Leg artery angiogram |
— |
— |
$3,435 |
$149 | |
| Leg vein ultrasound (Doppler) |
— |
— |
$257 |
$150 | |
| Lumbar discectomy |
— |
— |
$8,121 |
$898 | |
| Lumpectomy (breast) |
— |
— |
$7,119 |
$750 | |
| Lung function test (PFT) |
— |
— |
$284 |
$37 | |
| Lung scan (V/Q) |
— |
— |
$667 |
$291 | |
| Mastectomy |
— |
— |
$8,725 |
$1,021 | |
| Meniscus repair (knee) |
— |
— |
$4,579 |
$714 | |
| Mohs skin cancer surgery |
— |
— |
$446 |
$535 | |
| MRA of the brain |
— |
— |
$741 |
$226 | |
| MRA of the brain with contrast |
— |
— |
$648 |
$226 | |
| MRA of the brain without contrast |
— |
— |
$866 |
$328 | |
| MRA of the neck |
— |
— |
$742 |
$245 | |
| MRA of the neck with contrast |
— |
— |
$648 |
$245 | |
| MRA of the neck without contrast |
— |
— |
$867 |
$343 | |
| MRI of the abdomen |
— |
— |
$716 |
$300 | |
| MRI of the abdomen with contrast |
— |
— |
$711 |
$300 | |
| MRI of the abdomen without contrast |
— |
— |
$538 |
$194 | |
| MRI of the ankle |
— |
— |
$492 |
$261 | |
| MRI of the ankle with contrast |
— |
— |
$555 |
$261 | |
| MRI of the ankle without contrast |
— |
— |
$463 |
$222 | |
| MRI of the brain |
— |
— |
$607 |
$269 | |
| MRI of the brain with contrast |
— |
— |
$663 |
$269 | |
| MRI of the brain without contrast |
— |
— |
$540 |
$195 | |
| MRI of the chest |
— |
— |
$861 |
$371 | |
| MRI of the chest with contrast |
— |
— |
$1,204 |
$371 | |
| MRI of the chest without contrast |
— |
— |
$882 |
$466 | |
| MRI of the knee |
— |
— |
$761 |
$315 | |
| MRI of the knee with contrast |
— |
— |
$861 |
$315 | |
| MRI of the knee without contrast |
— |
— |
$481 |
$204 | |
| MRI of the lower back (lumbar spine) |
— |
— |
$583 |
$270 | |
| MRI of the lower back (lumbar spine) with contrast |
— |
— |
$663 |
$270 | |
| MRI of the lower back (lumbar spine) without contrast |
— |
— |
$475 |
$192 | |
| MRI of the mid-back (thoracic spine) |
— |
— |
$581 |
$271 | |
| MRI of the mid-back (thoracic spine) with and without contrast |
— |
— |
$663 |
$319 | |
| MRI of the mid-back (thoracic spine) with contrast |
— |
— |
$663 |
$271 | |
| MRI of the mid-back (thoracic spine) without contrast |
— |
— |
$480 |
$190 | |
| MRI of the neck (cervical spine) |
— |
— |
$595 |
$274 | |
| MRI of the neck (cervical spine) with and without contrast |
— |
— |
$663 |
$318 | |
| MRI of the neck (cervical spine) with contrast |
— |
— |
$663 |
$274 | |
| MRI of the neck (cervical spine) without contrast |
— |
— |
$542 |
$191 | |
| MRI of the pelvis |
— |
— |
$743 |
$268 | |
| MRI of the pelvis with contrast |
— |
— |
$613 |
$268 | |
| MRI of the pelvis without contrast |
— |
— |
$526 |
$227 | |
| MRI of the shoulder |
— |
— |
$763 |
$313 | |
| MRI of the shoulder with contrast |
— |
— |
$861 |
$313 | |
| MRI of the shoulder without contrast |
— |
— |
$481 |
$205 | |
| MRI of the wrist |
— |
— |
$492 |
$330 | |
| MRI of the wrist with contrast |
— |
— |
$555 |
$330 | |
| MRI of the wrist without contrast |
— |
— |
$463 |
$303 | |
| Neck (cervical) spinal fusion |
— |
— |
$14,100 |
$1,410 | |
| Nerve conduction study |
— |
— |
$237 |
$118 | |
| Newborn hospital care |
— |
— |
$141 |
$58 | |
| Nuchal translucency ultrasound |
— |
— |
$149 |
$116 | |
| Nuclear cardiac stress test |
— |
— |
$1,429 |
$428 | |
| Ovarian cyst removal |
— |
— |
$5,520 |
$698 | |
| Ovary removal (oophorectomy) |
— |
— |
$1,186 |
$822 | |
| Pacemaker insertion |
— |
— |
$30,059 |
$15,506 | |
| Parathyroid removal |
— |
— |
$6,192 |
$891 | |
| Pelvic ultrasound |
— |
— |
$115 |
$78 | |
| Pelvic ultrasound (complete) |
— |
— |
$116 |
$105 | |
| Pelvic ultrasound (limited) |
— |
— |
$115 |
$51 | |
| PET scan |
— |
— |
$2,646 |
— | |
| Pilonidal cyst removal |
— |
— |
$3,190 |
$541 | |
| Pneumonia vaccine |
— |
— |
$141 |
— | |
| Pregnancy ultrasound |
— |
— |
$138 |
$126 | |
| Pregnancy ultrasound (first trimester) |
— |
— |
$140 |
$117 | |
| Pregnancy ultrasound (second or third trimester) |
— |
— |
$137 |
$136 | |
| Prostate biopsy |
— |
— |
$1,048 |
— | |
| Prostate removal (prostatectomy) |
— |
— |
$13,967 |
$1,063 | |
| Prostate surgery (TURP) |
— |
— |
$5,917 |
$526 | |
| Retina scan (OCT) |
— |
— |
$66 |
$33 | |
| Retinal (fundus) photography |
— |
— |
$147 |
$37 | |
| Retinal detachment repair |
— |
— |
$1,713 |
$966 | |
| Rheumatoid factor test |
— |
— |
$10 |
$6 | |
| Routine eye exam |
— |
— |
$146 |
$88 | |
| Scoliosis spine X-ray |
— |
— |
$115 |
$58 | |
| Scoliosis spine X-ray (1 view) |
— |
— |
$96 |
$44 | |
| Scoliosis spine X-ray (3 views) |
— |
— |
$128 |
$72 | |
| Screening mammogram |
— |
— |
$155 |
$126 | |
| Scrotal ultrasound |
— |
— |
$135 |
$99 | |
| Semen analysis |
— |
— |
$27 |
$12 | |
| Septoplasty (deviated septum) |
— |
— |
$4,600 |
$613 | |
| Sinus surgery (endoscopic) |
— |
— |
$7,898 |
$224 | |
| Sleep study (polysomnography) |
— |
— |
$970 |
$691 | |
| Small bowel resection |
— |
— |
$1,127 |
$1,136 | |
| Soft tissue ultrasound |
— |
— |
$109 |
$64 | |
| Spirometry (lung function test) |
— |
— |
$237 |
$30 | |
| Spirometry with bronchodilator |
— |
— |
$410 |
$43 | |
| Spleen removal (splenectomy) |
— |
— |
$1,241 |
$1,036 | |
| Stomach removal (gastrectomy) |
— |
— |
$2,133 |
$1,595 | |
| Strabismus (eye muscle) surgery |
— |
— |
$2,512 |
$475 | |
| Stress echocardiogram |
— |
— |
$603 |
$209 | |
| Stress echocardiogram (complete) |
— |
— |
$603 |
$233 | |
| Thyroid removal (thyroidectomy) |
— |
— |
$6,501 |
$1,004 | |
| Thyroid ultrasound |
— |
— |
$137 |
$109 | |
| Thyroid uptake scan |
— |
— |
$422 |
$145 | |
| Tonsillectomy |
— |
— |
$6,378 |
$252 | |
| Transvaginal ultrasound |
— |
— |
$116 |
$118 | |
| Tubal ligation |
— |
— |
$6,639 |
$333 | |
| Turbinate reduction |
— |
— |
$3,641 |
$294 | |
| Umbilical hernia repair |
— |
— |
$1,020 |
— | |
| Upper GI series (barium) |
— |
— |
$215 |
$128 | |
| UV light therapy (skin) |
— |
— |
$73 |
$106 | |
| Vaginal delivery |
— |
— |
$10,323 |
$5,487 | |
| Varicocele repair |
— |
— |
$6,839 |
$327 | |
| Varicose vein ablation |
— |
— |
$3,484 |
$1,018 | |
| Visual field test |
— |
— |
$146 |
$64 | |
| Vitrectomy (eye) |
— |
— |
$4,323 |
$814 | |
| Vocal cord injection |
— |
— |
$4,095 |
$211 | |
| Weight-loss (bariatric) surgery |
— |
— |
$26,358 |
$11,645 | |
| Well-child visit |
— |
— |
$26 |
— | |
| Wrist fracture repair |
— |
— |
$8,121 |
$735 | |
| X-ray of the abdomen |
— |
— |
$115 |
$36 | |
| X-ray of the collarbone |
— |
— |
$94 |
$33 | |
| X-ray of the facial bones |
— |
— |
$113 |
$39 | |
| X-ray of the forearm |
— |
— |
$94 |
$29 | |
| X-ray of the hip |
— |
— |
$96 |
$49 | |
| X-ray of the hip (1 view) |
— |
— |
$94 |
$34 | |
| X-ray of the hip (3 views) |
— |
— |
$96 |
$49 | |
| X-ray of the hip (4 views) |
— |
— |
$115 |
$63 | |
| X-ray of the knee |
— |
— |
$96 |
$42 | |
| X-ray of the knee (2 views) |
— |
— |
$94 |
$34 | |
| X-ray of the knee (3 views) |
— |
— |
$94 |
$42 | |
| X-ray of the knee (4+ views) |
— |
— |
$113 |
$49 | |
| X-ray of the lower back (lumbar spine) |
— |
— |
$118 |
$47 | |
| X-ray of the lower back (lumbar spine) (2 views) |
— |
— |
$115 |
$40 | |
| X-ray of the lower back (lumbar spine) (4+ views) |
— |
— |
$121 |
$53 | |
| X-ray of the lower leg |
— |
— |
$93 |
$31 | |
| X-ray of the mid-back (thoracic spine) |
— |
— |
$115 |
$36 | |
| X-ray of the mid-back (thoracic spine) (2 views) |
— |
— |
$115 |
$33 | |
| X-ray of the mid-back (thoracic spine) (3 views) |
— |
— |
$115 |
$39 | |
| X-ray of the neck (cervical spine) |
— |
— |
$115 |
$47 | |
| X-ray of the neck (cervical spine) (3 views) |
— |
— |
$96 |
$40 | |
| X-ray of the pelvis |
— |
— |
$110 |
$36 | |
| X-ray of the pelvis (1 view) |
— |
— |
$110 |
$28 | |
| X-ray of the ribs |
— |
— |
$115 |
$42 | |
| X-ray of the ribs (2 views) |
— |
— |
$96 |
$36 | |
| X-ray of the ribs (3 views) |
— |
— |
$115 |
$42 | |
| X-ray of the skull |
— |
— |
$112 |
$40 | |
| X-ray of the upper arm |
— |
— |
$94 |
$32 | |
| YAG laser capsulotomy (eye) |
— |
— |
$970 |
$335 | |