| Achilles tendon repair |
— |
— |
$12,012 |
$624 | |
| ACL knee reconstruction |
— |
— |
$21,960 |
$889 | |
| Adenoid removal (adenoidectomy) |
— |
— |
$11,090 |
$204 | |
| Albumin blood test |
$97 |
$97 |
$5 |
$5 | |
| Aldosterone test |
— |
— |
$41 |
$41 | |
| Alkaline phosphatase test |
$94 |
$94 |
$5 |
$5 | |
| Alpha-fetoprotein (AFP) test |
$176 |
$176 |
$17 |
$17 | |
| ALT liver enzyme test |
$112 |
$112 |
$5 |
$5 | |
| Ammonia blood test |
$387 |
$387 |
$15 |
$15 | |
| Amylase test |
$220 |
$220 |
$6 |
$6 | |
| Anal fistula repair |
— |
— |
$6,425 |
$541 | |
| Ankle fracture repair |
— |
— |
$12,901 |
$608 | |
| Anoscopy |
— |
— |
$172 |
$129 | |
| Antinuclear antibody (ANA) test |
$98 |
$98 |
$12 |
$12 | |
| Arterial blood gas (ABG) |
— |
— |
$26 |
$26 | |
| AST liver enzyme test |
$114 |
$114 |
$5 |
$5 | |
| Basic metabolic panel |
$383 |
$383 |
$8 |
$8 | |
| Bilirubin blood test |
$123 |
$123 |
$5 |
$5 | |
| Bladder scope (cystoscopy) |
— |
— |
$1,754 |
$216 | |
| Bladder tumor removal (TURBT) |
— |
— |
$7,137 |
$236 | |
| Blood clotting test (PT/INR) |
$158 |
$158 |
$4 |
$4 | |
| Blood crossmatch |
$544 |
$544 |
— |
— | |
| Blood glucose test |
$108 |
$108 |
$5 |
$5 | |
| Blood transfusion |
$2,549 |
$2,549 |
— |
$47 | |
| Blood type and screen |
$241 |
$241 |
— |
$10 | |
| Blood type test |
$183 |
$183 |
$172 |
$3 | |
| Blood type test (ABO group) |
$205 |
$205 |
$172 |
$3 | |
| Blood type test (Rh/D antigen) |
$161 |
$161 |
— |
$3 | |
| BNP (heart failure) test |
$566 |
$566 |
$39 |
$39 | |
| Bone marrow biopsy |
— |
— |
$9,132 |
$172 | |
| Breast biopsy |
$5,501 |
$5,501 |
$6,591 |
$478 | |
| Breast MRI |
— |
— |
$4,134 |
$216 | |
| Breast MRI without contrast |
— |
— |
$4,059 |
$216 | |
| Breast reconstruction |
— |
— |
$17,837 |
$1,227 | |
| Breast reduction |
— |
— |
$12,057 |
$980 | |
| Breast ultrasound |
— |
— |
$113 |
$92 | |
| Breast ultrasound (limited) |
— |
— |
$113 |
$84 | |
| Bunion surgery (bunionectomy) |
— |
— |
$9,392 |
$883 | |
| C-reactive protein (CRP) |
$177 |
$177 |
$5 |
$5 | |
| CA 19-9 tumor marker test |
$212 |
$212 |
$21 |
$21 | |
| CA-125 ovarian marker test |
$257 |
$257 |
$21 |
$21 | |
| Calcium blood test |
$108 |
$108 |
$5 |
$5 | |
| Cardiac MRI |
— |
— |
$2,858 |
$322 | |
| Cardioversion |
$3,919 |
$3,919 |
$855 |
$155 | |
| Carpal tunnel release |
— |
— |
$4,751 |
$483 | |
| Cataract surgery |
— |
— |
$6,020 |
$547 | |
| CEA tumor marker test |
$286 |
$286 |
$19 |
$19 | |
| Celiac disease test |
$64 |
$64 |
$12 |
$12 | |
| Central line placement |
— |
— |
$4,087 |
$238 | |
| Cervical cerclage |
— |
— |
$4,190 |
$137 | |
| Cervical LEEP procedure |
— |
— |
$5,327 |
$325 | |
| Cesarean section (C-section) |
— |
— |
$9,493 |
$7,552 | |
| Chemotherapy infusion |
$1,156 |
$1,156 |
— |
$81 | |
| Chemotherapy infusion (each additional) |
$645 |
$645 |
— |
$28 | |
| Chemotherapy infusion (first hour) |
$1,666 |
$1,666 |
— |
$133 | |
| Chest tube insertion |
— |
— |
$2,037 |
$143 | |
| Chest X-ray |
$738 |
$738 |
$113 |
$37 | |
| Chest X-ray (1 view) |
$738 |
$738 |
$113 |
$25 | |
| Chest X-ray (2 views) |
$804 |
$804 |
$113 |
$33 | |
| Chickenpox (varicella) vaccine |
— |
— |
$552 |
— | |
| Circumcision |
— |
— |
$6,146 |
$167 | |
| CK-MB heart enzyme test |
$377 |
$377 |
$12 |
$12 | |
| Clotting time test (PTT) |
$221 |
$221 |
$6 |
$6 | |
| Colonoscopy |
— |
— |
$2,855 |
$480 | |
| Complete blood count (CBC) |
$198 |
$198 |
$7 |
$7 | |
| Complete blood count (CBC) (complete) |
$217 |
$217 |
$8 |
$8 | |
| Comprehensive metabolic panel |
$471 |
$471 |
$11 |
$11 | |
| Contraceptive implant (Nexplanon) |
— |
— |
$172 |
$115 | |
| Copper blood test |
— |
— |
$12 |
$12 | |
| Coronary artery bypass (CABG) |
— |
— |
$163,438 |
$36,593 | |
| Coronary CT angiography |
— |
— |
$2,556 |
$326 | |
| Cortisol test |
$283 |
$283 |
$16 |
$16 | |
| COVID-19 PCR test |
$360 |
$360 |
$51 |
$51 | |
| Creatine kinase (CK) test |
$243 |
$243 |
$7 |
$7 | |
| CT angiography of the chest |
— |
— |
$4,248 |
$281 | |
| CT angiography of the head |
— |
— |
$4,068 |
$274 | |
| CT scan of the abdomen |
— |
— |
$1,314 |
$230 | |
| CT scan of the abdomen and pelvis |
— |
— |
$4,817 |
$300 | |
| CT scan of the abdomen and pelvis with and without contrast |
— |
— |
$5,446 |
$338 | |
| CT scan of the abdomen and pelvis with contrast |
— |
— |
$5,114 |
$300 | |
| CT scan of the abdomen and pelvis without contrast |
— |
— |
$4,195 |
$183 | |
| CT scan of the abdomen with and without contrast |
— |
— |
$1,477 |
$259 | |
| CT scan of the abdomen with contrast |
— |
— |
$1,181 |
$230 | |
| CT scan of the abdomen without contrast |
— |
— |
$974 |
$136 | |
| CT scan of the arm |
— |
— |
$847 |
$199 | |
| CT scan of the arm without contrast |
— |
— |
$847 |
$161 | |
| CT scan of the chest |
— |
— |
$1,167 |
$167 | |
| CT scan of the chest with and without contrast |
— |
— |
$2,629 |
$196 | |
| CT scan of the chest with contrast |
— |
— |
$1,226 |
$167 | |
| CT scan of the chest without contrast |
— |
— |
$1,030 |
$133 | |
| CT scan of the head |
— |
— |
$1,089 |
$148 | |
| CT scan of the head with and without contrast |
— |
— |
$1,226 |
$173 | |
| CT scan of the head without contrast |
— |
— |
$824 |
$107 | |
| CT scan of the leg |
— |
— |
$847 |
$166 | |
| CT scan of the leg with contrast |
— |
— |
$3,154 |
$166 | |
| CT scan of the leg without contrast |
— |
— |
$847 |
$130 | |
| CT scan of the lower back (lumbar spine) |
— |
— |
$1,030 |
$169 | |
| CT scan of the lower back (lumbar spine) without contrast |
— |
— |
$1,030 |
$130 | |
| CT scan of the neck |
— |
— |
$974 |
$183 | |
| CT scan of the neck (cervical spine) |
— |
— |
$1,030 |
$168 | |
| CT scan of the neck (cervical spine) without contrast |
— |
— |
$1,030 |
$131 | |
| CT scan of the neck with contrast |
— |
— |
$974 |
$183 | |
| CT scan of the pelvis |
— |
— |
$1,334 |
$226 | |
| CT scan of the pelvis with and without contrast |
— |
— |
$1,477 |
$251 | |
| CT scan of the pelvis with contrast |
— |
— |
$1,181 |
$226 | |
| CT scan of the pelvis without contrast |
— |
— |
$1,030 |
$133 | |
| CT scan of the sinuses |
— |
— |
$824 |
$152 | |
| CT scan of the sinuses without contrast |
— |
— |
$824 |
$128 | |
| D-dimer test |
$349 |
$349 |
$10 |
$10 | |
| Defibrillator (ICD) implant |
— |
— |
$40,627 |
$798 | |
| DHEA-sulfate test |
$144 |
$144 |
$22 |
$22 | |
| Dialysis fistula creation |
— |
— |
$17,296 |
$601 | |
| Dilation and curettage (D&C) |
— |
— |
$5,610 |
$298 | |
| Droopy eyelid repair (ptosis) |
— |
— |
$12,457 |
$745 | |
| Drug screen (urine) |
$735 |
$735 |
$17 |
$17 | |
| Ear tubes (myringotomy) |
— |
— |
$4,318 |
$174 | |
| Eardrum repair (tympanoplasty) |
— |
— |
$11,902 |
$799 | |
| EKG / ECG (tracing only) |
$614 |
$614 |
$76 |
$7 | |
| Elbow replacement |
— |
— |
$22,694 |
$1,301 | |
| Electrocardiogram (EKG) |
$614 |
$614 |
$76 |
$8 | |
| Electrolyte panel |
$208 |
$208 |
$7 |
$7 | |
| Electromyography (EMG) |
— |
— |
$172 |
$141 | |
| Epidural steroid injection |
— |
— |
$2,872 |
$275 | |
| Estradiol (estrogen) test |
$256 |
$256 |
$28 |
$28 | |
| Eyelid surgery (blepharoplasty) |
— |
— |
$4,859 |
$552 | |
| Facet joint injection (spine) |
— |
— |
$2,007 |
$99 | |
| Fecal occult blood (stool) test |
$105 |
$105 |
$10 |
$10 | |
| Fecal occult blood (stool) test (guaiac, gFOBT) |
$96 |
$96 |
$4 |
$4 | |
| Fecal occult blood (stool) test (immunochemical, FIT) |
$114 |
$114 |
$16 |
$16 | |
| Femoral hernia repair |
— |
— |
$4,634 |
$584 | |
| Ferritin (iron) test |
$256 |
$256 |
$14 |
$14 | |
| Fibrinogen test |
$302 |
$302 |
$10 |
$10 | |
| Flexible sigmoidoscopy |
— |
— |
$1,786 |
$323 | |
| Flu test |
— |
— |
$17 |
$17 | |
| Flu vaccine |
— |
— |
$65 |
— | |
| Folate (folic acid) test |
$231 |
$231 |
$15 |
$15 | |
| Free T4 thyroid test |
$231 |
$231 |
$9 |
$9 | |
| FSH hormone test |
$234 |
$234 |
$19 |
$19 | |
| Gallbladder removal (laparoscopic) |
— |
— |
$12,642 |
$658 | |
| Ganglion cyst removal |
— |
— |
$5,464 |
$321 | |
| GGT liver test |
$143 |
$143 |
$7 |
$7 | |
| Glucose tolerance test |
$117 |
$117 |
$8 |
$8 | |
| H. pylori test |
— |
— |
$67 |
$67 | |
| Hammertoe repair |
— |
— |
$5,936 |
$548 | |
| HDL cholesterol test |
$126 |
$126 |
$8 |
$8 | |
| Hematocrit test |
$98 |
$98 |
$2 |
$2 | |
| Hemoglobin A1c (diabetes test) |
$203 |
$203 |
$10 |
$10 | |
| Hemorrhoid removal |
— |
— |
$2,398 |
$338 | |
| Hepatitis A vaccine |
— |
— |
$166 |
— | |
| Hepatitis B test |
$147 |
$147 |
$10 |
$10 | |
| Hepatitis B vaccine |
— |
— |
$162 |
— | |
| Hepatitis C test |
$182 |
$182 |
$14 |
$14 | |
| Hip arthroscopy |
— |
— |
$37,653 |
$931 | |
| Hip fracture repair |
— |
— |
$9,392 |
$1,120 | |
| Hip replacement |
— |
— |
$38,111 |
$1,162 | |
| HIV test |
$236 |
$236 |
$19 |
$19 | |
| HIV test (antibody) |
$172 |
$172 |
$14 |
$14 | |
| HIV test (antigen/antibody combo) |
$299 |
$299 |
$24 |
$24 | |
| Holter heart monitor |
— |
— |
$124 |
$26 | |
| Home sleep apnea test |
— |
— |
$76 |
$123 | |
| HPV vaccine |
— |
— |
$927 |
— | |
| Hydrocele repair |
— |
— |
$13,692 |
$315 | |
| Hysterectomy |
— |
— |
$34,631 |
$933 | |
| Hysteroscopy |
— |
— |
$6,178 |
$1,270 | |
| Inguinal hernia repair |
— |
— |
$8,497 |
$538 | |
| Iron blood test |
$140 |
$140 |
$6 |
$6 | |
| IUD removal |
— |
— |
$820 |
$112 | |
| IV infusion therapy |
$849 |
$849 |
— |
$44 | |
| IV infusion therapy (each additional) |
$555 |
$555 |
— |
$21 | |
| IV infusion therapy (initial) |
$1,143 |
$1,143 |
— |
$67 | |
| Kidney biopsy |
— |
— |
$7,277 |
$492 | |
| Kidney stone shock-wave (lithotripsy) |
— |
— |
$10,689 |
$760 | |
| Knee arthroscopy |
— |
— |
$7,387 |
$524 | |
| Knee joint injection |
$2,883 |
$2,883 |
$851 |
$69 | |
| Knee replacement |
— |
— |
$82,883 |
$18,054 | |
| Lactate test |
$313 |
$313 |
$12 |
$12 | |
| Laminectomy (spine) |
— |
— |
$27,227 |
$1,157 | |
| LDH test |
$157 |
$157 |
$6 |
$6 | |
| LDL cholesterol test |
$129 |
$129 |
$11 |
$11 | |
| Leg artery angiogram |
$10,002 |
$10,002 |
$4,087 |
$149 | |
| LH hormone test |
$314 |
$314 |
$19 |
$19 | |
| Lipase test |
$275 |
$275 |
$7 |
$7 | |
| Lipid (cholesterol) panel |
$343 |
$343 |
$13 |
$13 | |
| Liver biopsy |
— |
— |
$2,138 |
$288 | |
| Liver function panel |
$309 |
$309 |
$8 |
$8 | |
| Lower back (lumbar) spinal fusion |
— |
— |
$158,386 |
$1,511 | |
| Lumbar discectomy |
— |
— |
$25,901 |
$898 | |
| Lumpectomy (breast) |
— |
— |
$10,738 |
$750 | |
| Magnesium blood test |
$219 |
$219 |
$7 |
$7 | |
| Mastectomy |
— |
— |
$8,595 |
$1,021 | |
| Meniscus repair (knee) |
— |
— |
$7,365 |
$714 | |
| MMR vaccine |
— |
— |
$319 |
— | |
| MRA of the brain |
$6,062 |
$6,062 |
$1,936 |
$226 | |
| MRA of the brain with contrast |
$6,062 |
$6,062 |
— |
$226 | |
| MRA of the brain without contrast |
$7,383 |
$7,383 |
— |
$328 | |
| MRA of the neck |
$5,630 |
$5,630 |
$3,530 |
$245 | |
| MRA of the neck with contrast |
$5,630 |
$5,630 |
— |
$245 | |
| MRA of the neck without contrast |
$8,310 |
$8,310 |
$3,530 |
$343 | |
| MRI of the abdomen |
$5,217 |
$5,217 |
$3,841 |
$300 | |
| MRI of the abdomen with contrast |
$5,071 |
$5,071 |
— |
$300 | |
| MRI of the abdomen without contrast |
$5,217 |
$5,217 |
$3,461 |
$194 | |
| MRI of the ankle |
$9,456 |
$9,456 |
$1,899 |
$261 | |
| MRI of the ankle with contrast |
$9,536 |
$9,536 |
— |
$261 | |
| MRI of the ankle without contrast |
$6,351 |
$6,351 |
$1,899 |
$222 | |
| MRI of the brain |
$7,192 |
$7,192 |
$2,939 |
$269 | |
| MRI of the brain with contrast |
$7,192 |
$7,192 |
— |
$269 | |
| MRI of the brain without contrast |
$5,481 |
$5,481 |
$1,936 |
$195 | |
| MRI of the chest |
$5,928 |
$5,928 |
— |
$371 | |
| MRI of the chest with contrast |
$5,928 |
$5,928 |
— |
$371 | |
| MRI of the chest without contrast |
$7,584 |
$7,584 |
— |
$466 | |
| MRI of the knee |
$7,678 |
$7,678 |
$1,899 |
$315 | |
| MRI of the knee with contrast |
$7,678 |
$7,678 |
— |
$315 | |
| MRI of the knee without contrast |
$7,464 |
$7,464 |
$1,899 |
$204 | |
| MRI of the lower back (lumbar spine) |
$8,076 |
$8,076 |
$2,857 |
$270 | |
| MRI of the lower back (lumbar spine) with contrast |
$8,076 |
$8,076 |
— |
$270 | |
| MRI of the lower back (lumbar spine) without contrast |
$5,217 |
$5,217 |
$2,154 |
$192 | |
| MRI of the mid-back (thoracic spine) |
$6,508 |
$6,508 |
$2,860 |
$271 | |
| MRI of the mid-back (thoracic spine) with and without contrast |
$8,406 |
$8,406 |
$4,317 |
$319 | |
| MRI of the mid-back (thoracic spine) with contrast |
$6,508 |
$6,508 |
— |
$271 | |
| MRI of the mid-back (thoracic spine) without contrast |
$5,458 |
$5,458 |
$2,154 |
$190 | |
| MRI of the neck (cervical spine) |
$6,480 |
$6,480 |
$2,710 |
$274 | |
| MRI of the neck (cervical spine) with and without contrast |
$8,560 |
$8,560 |
$4,317 |
$318 | |
| MRI of the neck (cervical spine) with contrast |
$6,480 |
$6,480 |
— |
$274 | |
| MRI of the neck (cervical spine) without contrast |
$5,265 |
$5,265 |
$1,936 |
$191 | |
| MRI of the pelvis |
$5,735 |
$5,735 |
$2,920 |
$268 | |
| MRI of the pelvis with contrast |
$5,220 |
$5,220 |
— |
$268 | |
| MRI of the pelvis without contrast |
$5,735 |
$5,735 |
$1,936 |
$227 | |
| MRI of the shoulder |
$7,576 |
$7,576 |
$1,899 |
$313 | |
| MRI of the shoulder with contrast |
$7,576 |
$7,576 |
— |
$313 | |
| MRI of the shoulder without contrast |
$7,291 |
$7,291 |
$1,899 |
$205 | |
| MRI of the wrist |
$6,294 |
$6,294 |
$1,899 |
$330 | |
| MRI of the wrist with contrast |
$5,538 |
$5,538 |
— |
$330 | |
| MRI of the wrist without contrast |
$6,294 |
$6,294 |
$1,899 |
$303 | |
| Nebulizer breathing treatment |
$665 |
$665 |
— |
$9 | |
| Neck (cervical) spinal fusion |
— |
— |
$16,617 |
$1,410 | |
| Orthopedic hardware removal |
— |
— |
$5,814 |
$632 | |
| Ovarian cyst removal |
— |
— |
$28,302 |
$698 | |
| Pacemaker insertion |
— |
— |
$86,946 |
$15,506 | |
| Pap smear (cervical screening) |
$57 |
$57 |
$20 |
$20 | |
| Parathyroid hormone (PTH) test |
$400 |
$400 |
$41 |
$41 | |
| Parathyroid removal |
— |
— |
$27,537 |
$891 | |
| Pelvic ultrasound |
$944 |
$944 |
— |
$78 | |
| Pelvic ultrasound (limited) |
$944 |
$944 |
— |
$51 | |
| PET scan |
— |
— |
$5,240 |
— | |
| Phosphorus blood test |
$142 |
$142 |
$5 |
$5 | |
| Physical therapy evaluation |
$558 |
$558 |
— |
$98 | |
| Physical therapy evaluation (high complexity) |
$629 |
$629 |
— |
$98 | |
| Physical therapy evaluation (moderate complexity) |
$558 |
$558 |
— |
$98 | |
| Pilonidal cyst removal |
— |
— |
$13,782 |
$541 | |
| Platelet count |
$140 |
$140 |
$4 |
$4 | |
| Pneumonia vaccine |
— |
— |
$307 |
— | |
| Pregnancy blood test (hCG) |
$278 |
$278 |
$8 |
$8 | |
| Procalcitonin test |
$589 |
$589 |
$27 |
$27 | |
| Prolactin test |
$262 |
$262 |
$19 |
$19 | |
| Prostate biopsy |
— |
— |
$12,005 |
— | |
| Prostate removal (prostatectomy) |
— |
— |
$57,638 |
$1,063 | |
| Prostate surgery (TURP) |
— |
— |
$20,463 |
$526 | |
| Prostate test (PSA) |
$242 |
$242 |
$18 |
$18 | |
| Pulmonary rehabilitation |
— |
— |
$76 |
$87 | |
| Radiofrequency nerve ablation |
— |
— |
$2,527 |
$462 | |
| Retina scan (OCT) |
— |
— |
$76 |
$33 | |
| Retinal (fundus) photography |
— |
— |
$172 |
$37 | |
| Rheumatoid factor test |
$136 |
$136 |
$6 |
$6 | |
| Rotator cuff repair |
— |
— |
$12,906 |
$792 | |
| Scoliosis spine X-ray |
$657 |
$657 |
$113 |
$58 | |
| Scoliosis spine X-ray (1 view) |
$541 |
$541 |
$113 |
$44 | |
| Scoliosis spine X-ray (3 views) |
$772 |
$772 |
— |
$72 | |
| Screening colonoscopy |
— |
— |
$2,421 |
$378 | |
| Sedimentation rate (ESR) test |
$125 |
$125 |
$3 |
$3 | |
| Semen analysis |
— |
— |
$12 |
$12 | |
| Septoplasty (deviated septum) |
— |
— |
$6,561 |
$613 | |
| Sex hormone binding globulin test |
$172 |
$172 |
$22 |
$22 | |
| Shoulder arthroscopy |
— |
— |
$14,514 |
$962 | |
| Shoulder replacement |
— |
— |
$22,694 |
$1,300 | |
| Simple laceration repair (small, up to 2.5 cm) |
$1,125 |
$1,125 |
— |
$114 | |
| Simple wound stitches |
$1,125 |
$1,125 |
— |
$127 | |
| Sinus surgery (endoscopic) |
— |
— |
$9,135 |
$224 | |
| Skin lesion freezing (cryotherapy) |
— |
— |
$851 |
$36 | |
| Spine fracture repair (kyphoplasty) |
— |
— |
$9,392 |
$5,803 | |
| Strabismus (eye muscle) surgery |
— |
— |
$6,159 |
$475 | |
| Strep throat test |
— |
— |
$17 |
$17 | |
| T3 thyroid test |
$191 |
$191 |
$14 |
$14 | |
| Tdap (tetanus) vaccine |
$381 |
$381 |
$90 |
— | |
| Testosterone test |
$141 |
$141 |
$26 |
$26 | |
| Thyroid removal (thyroidectomy) |
— |
— |
$30,752 |
$1,004 | |
| Thyroid test (TSH) |
$313 |
$313 |
$17 |
$17 | |
| Tonsillectomy |
— |
— |
$6,769 |
$252 | |
| Total IgE allergy test |
$185 |
$185 |
$16 |
$16 | |
| Total protein test |
$53 |
$53 |
$4 |
$4 | |
| Trigger finger release |
— |
— |
$4,255 |
$630 | |
| Trigger point injection |
— |
— |
$851 |
$56 | |
| Triglycerides test |
$162 |
$162 |
$6 |
$6 | |
| Troponin (heart) test |
$463 |
$463 |
$12 |
$12 | |
| Tubal ligation |
— |
— |
$12,642 |
$333 | |
| Turbinate reduction |
— |
— |
$6,553 |
$294 | |
| Turning a breech baby (version) |
— |
— |
$4,190 |
$94 | |
| Ulnar nerve surgery (elbow) |
— |
— |
$4,751 |
$575 | |
| Umbilical hernia repair |
— |
— |
$11,640 |
— | |
| Upper GI endoscopy (EGD) |
— |
— |
$2,598 |
$371 | |
| Ureteral stent placement |
— |
— |
$7,057 |
$373 | |
| Ureteroscopy (stone removal) |
— |
— |
$19,842 |
$365 | |
| Uric acid (gout) test |
$134 |
$134 |
$5 |
$5 | |
| Urinalysis |
$119 |
$119 |
$3 |
$3 | |
| Urine microalbumin test |
$113 |
$113 |
$5 |
$5 | |
| Urine pregnancy test |
$190 |
$190 |
$9 |
$9 | |
| UV light therapy (skin) |
— |
— |
$76 |
$106 | |
| Vaginal delivery |
— |
— |
$6,897 |
$5,487 | |
| Varicocele repair |
— |
— |
$16,883 |
$327 | |
| Varicose vein ablation |
— |
— |
$4,087 |
$1,018 | |
| Vasectomy |
— |
— |
$6,146 |
$347 | |
| Visual field test |
— |
— |
$172 |
$64 | |
| Vitamin B12 test |
$228 |
$228 |
$15 |
$15 | |
| Vitamin D test |
$274 |
$274 |
$30 |
$30 | |
| Weight-loss (bariatric) surgery |
— |
— |
$14,638 |
$11,645 | |
| Wrist fracture repair |
— |
— |
$17,943 |
$735 | |
| X-ray of the abdomen |
$732 |
$732 |
$113 |
$36 | |
| X-ray of the ankle |
$1,300 |
$1,300 |
$113 |
$37 | |
| X-ray of the collarbone |
$1,088 |
$1,088 |
$113 |
$33 | |
| X-ray of the elbow |
$1,265 |
$1,265 |
$113 |
$33 | |
| X-ray of the facial bones |
$791 |
$791 |
$113 |
$39 | |
| X-ray of the foot |
$1,377 |
$1,377 |
$113 |
$34 | |
| X-ray of the forearm |
$1,288 |
$1,288 |
$113 |
$29 | |
| X-ray of the hand |
$1,329 |
$1,329 |
$113 |
$38 | |
| X-ray of the hip |
$727 |
$727 |
$113 |
$49 | |
| X-ray of the hip (1 view) |
$685 |
$685 |
$113 |
$34 | |
| X-ray of the hip (3 views) |
$768 |
$768 |
$113 |
$49 | |
| X-ray of the knee |
$1,431 |
$1,431 |
$113 |
$42 | |
| X-ray of the knee (2 views) |
$1,064 |
$1,064 |
$113 |
$34 | |
| X-ray of the knee (3 views) |
$1,431 |
$1,431 |
$113 |
$42 | |
| X-ray of the knee (4+ views) |
$1,537 |
$1,537 |
— |
$49 | |
| X-ray of the lower back (lumbar spine) |
$1,059 |
$1,059 |
— |
$47 | |
| X-ray of the lower back (lumbar spine) (2 views) |
$966 |
$966 |
— |
$40 | |
| X-ray of the lower back (lumbar spine) (4+ views) |
$1,151 |
$1,151 |
— |
$53 | |
| X-ray of the lower leg |
$1,144 |
$1,144 |
$113 |
$31 | |
| X-ray of the mid-back (thoracic spine) |
$956 |
$956 |
— |
$36 | |
| X-ray of the mid-back (thoracic spine) (2 views) |
$932 |
$932 |
— |
$33 | |
| X-ray of the mid-back (thoracic spine) (3 views) |
$980 |
$980 |
— |
$39 | |
| X-ray of the neck (cervical spine) |
$1,020 |
$1,020 |
$113 |
$47 | |
| X-ray of the neck (cervical spine) (3 views) |
$864 |
$864 |
$113 |
$40 | |
| X-ray of the pelvis |
$770 |
$770 |
— |
$36 | |
| X-ray of the pelvis (1 view) |
$770 |
$770 |
— |
$28 | |
| X-ray of the ribs |
$999 |
$999 |
$113 |
$42 | |
| X-ray of the ribs (2 views) |
— |
— |
$113 |
$36 | |
| X-ray of the ribs (3 views) |
$1,011 |
$1,011 |
— |
$42 | |
| X-ray of the shoulder |
$1,335 |
$1,335 |
$113 |
$36 | |
| X-ray of the skull |
$960 |
$960 |
— |
$40 | |
| X-ray of the upper arm |
$866 |
$866 |
$113 |
$32 | |
| X-ray of the wrist |
$1,294 |
$1,294 |
$113 |
$43 | |
| YAG laser capsulotomy (eye) |
— |
— |
$1,423 |
$335 | |
| Zinc blood test |
— |
— |
$11 |
$11 | |