| 3D mammogram (tomosynthesis) |
$222 |
$370 |
— |
$51 | |
| Abdominal fluid drain (paracentesis) |
$5,924 |
$9,873 |
— |
$284 | |
| Abdominal ultrasound |
$436 |
$727 |
— |
$100 | |
| Abdominal ultrasound (complete) |
$582 |
$969 |
— |
$114 | |
| Abdominal ultrasound (limited) |
$422 |
$704 |
— |
$86 | |
| Abscess drainage (complex or multiple) |
$933 |
$1,554 |
— |
$220 | |
| Abscess drainage (simple) |
$922 |
$1,536 |
— |
$129 | |
| Abscess incision and drainage |
$927 |
$1,545 |
— |
$174 | |
| Achilles tendon repair |
$13,381 |
$22,301 |
— |
$624 | |
| ACL knee reconstruction |
$33,291 |
$55,484 |
— |
$889 | |
| Adenoid removal (adenoidectomy) |
$7,482 |
$12,471 |
— |
$204 | |
| Albumin blood test |
$221 |
$369 |
— |
$5 | |
| Aldosterone test |
$161 |
$269 |
— |
$41 | |
| Alkaline phosphatase test |
$78 |
$130 |
— |
$5 | |
| Allergy shots |
$59 |
$99 |
— |
$11 | |
| Alpha-fetoprotein (AFP) test |
$599 |
$999 |
— |
$17 | |
| ALT liver enzyme test |
$100 |
$167 |
— |
$5 | |
| Ammonia blood test |
$111 |
$186 |
— |
$15 | |
| Amylase test |
$124 |
$206 |
— |
$6 | |
| Anal fistula repair |
$9,152 |
$15,254 |
— |
$541 | |
| Ankle fracture repair |
$13,834 |
$23,057 |
— |
$608 | |
| Antinuclear antibody (ANA) test |
$161 |
$269 |
— |
$12 | |
| Arterial blood gas (ABG) |
$347 |
$579 |
— |
$26 | |
| AST liver enzyme test |
$100 |
$167 |
— |
$5 | |
| Barium swallow study |
$420 |
$700 |
— |
$107 | |
| Bartholin cyst removal |
$1,668 |
$2,780 |
— |
$182 | |
| Basic metabolic panel |
$130 |
$216 |
— |
$8 | |
| Benign skin lesion removal |
$3,075 |
$5,125 |
— |
$171 | |
| Bilirubin blood test |
$116 |
$194 |
— |
$5 | |
| Bladder function test (urodynamics) |
$767 |
$1,278 |
— |
$345 | |
| Blood clotting test (PT/INR) |
$73 |
$122 |
— |
$4 | |
| Blood glucose test |
$69 |
$115 |
— |
$5 | |
| Blood transfusion |
$760 |
$1,266 |
— |
$47 | |
| Blood type and screen |
$100 |
$167 |
— |
$10 | |
| Blood type test |
$88 |
$147 |
— |
$3 | |
| Blood type test (ABO group) |
$116 |
$194 |
— |
$3 | |
| Blood type test (Rh/D antigen) |
$60 |
$100 |
— |
$3 | |
| BNP (heart failure) test |
$235 |
$391 |
— |
$39 | |
| Bone density scan (DEXA) |
$387 |
$646 |
— |
$39 | |
| Bone marrow biopsy |
$6,352 |
$10,586 |
— |
$172 | |
| Bone scan (nuclear) |
$1,244 |
$2,073 |
— |
$259 | |
| Breast biopsy |
$4,313 |
$7,188 |
— |
$478 | |
| Breast MRI |
$2,402 |
$4,003 |
— |
$216 | |
| Breast MRI without contrast |
$2,402 |
$4,003 |
— |
$216 | |
| Breast ultrasound |
$336 |
$561 |
— |
$92 | |
| Breast ultrasound (complete) |
$317 |
$528 |
— |
$100 | |
| Breast ultrasound (limited) |
$367 |
$611 |
— |
$84 | |
| Burn dressing and debridement (medium) |
$250 |
$416 |
— |
$166 | |
| Burn dressing and debridement (small) |
$250 |
$416 |
— |
$93 | |
| Burn treatment |
$250 |
$416 |
— |
$129 | |
| C-reactive protein (CRP) |
$71 |
$118 |
— |
$5 | |
| CA 19-9 tumor marker test |
$66 |
$109 |
— |
$21 | |
| CA-125 ovarian marker test |
$66 |
$109 |
— |
$21 | |
| Calcium blood test |
$89 |
$149 |
— |
$5 | |
| Cardiac rehabilitation |
$246 |
$410 |
— |
$26 | |
| Cardiac stress test |
$619 |
$1,032 |
— |
$39 | |
| Cardioversion |
$1,088 |
$1,814 |
— |
$155 | |
| Carotid artery ultrasound |
$455 |
$758 |
— |
$156 | |
| Carpal tunnel release |
$4,519 |
$7,532 |
— |
$483 | |
| CEA tumor marker test |
$179 |
$298 |
— |
$19 | |
| Celiac disease test |
$20 |
$34 |
— |
$12 | |
| Cervical LEEP procedure |
$9,522 |
$15,869 |
— |
$325 | |
| Cesarean section (C-section) |
$18,543 |
$30,905 |
$9,623 |
$7,552 | |
| Chemotherapy infusion |
$375 |
$625 |
— |
$81 | |
| Chemotherapy infusion (each additional) |
$124 |
$206 |
— |
$28 | |
| Chemotherapy infusion (first hour) |
$626 |
$1,044 |
— |
$133 | |
| Chest fluid drain (thoracentesis) |
$215 |
$358 |
— |
$311 | |
| Chest tube insertion |
$2,829 |
$4,715 |
— |
$143 | |
| Chest X-ray |
$224 |
$373 |
— |
$37 | |
| Chest X-ray (1 view) |
$169 |
$282 |
— |
$25 | |
| Chest X-ray (2 views) |
$224 |
$373 |
— |
$33 | |
| CK-MB heart enzyme test |
$202 |
$336 |
— |
$12 | |
| Clotting time test (PTT) |
$370 |
$617 |
— |
$6 | |
| Colonoscopy |
$5,591 |
$9,318 |
— |
$480 | |
| Complete blood count (CBC) |
$57 |
$95 |
— |
$7 | |
| Complete blood count (CBC) (complete) |
$70 |
$116 |
— |
$8 | |
| Comprehensive metabolic panel |
$212 |
$353 |
— |
$11 | |
| Copper blood test |
$42 |
$70 |
— |
$12 | |
| Coronary CT angiography |
$2,169 |
$3,615 |
— |
$326 | |
| Cortisol test |
$65 |
$108 |
— |
$16 | |
| COVID-19 PCR test |
$106 |
$176 |
— |
$51 | |
| CPAP titration study |
$510 |
$850 |
— |
$69 | |
| Creatine kinase (CK) test |
$95 |
$159 |
— |
$7 | |
| CT angiography of the chest |
$1,860 |
$3,100 |
— |
$281 | |
| CT angiography of the head |
$1,783 |
$2,972 |
— |
$274 | |
| CT colonography (virtual colonoscopy) |
$1,830 |
$3,051 |
— |
$835 | |
| CT scan of the abdomen |
$2,114 |
$3,523 |
— |
$230 | |
| CT scan of the abdomen and pelvis |
$4,887 |
$8,145 |
— |
$300 | |
| CT scan of the abdomen and pelvis with and without contrast |
$6,162 |
$10,271 |
— |
$338 | |
| CT scan of the abdomen and pelvis with contrast |
$3,878 |
$6,463 |
— |
$300 | |
| CT scan of the abdomen and pelvis without contrast |
$3,537 |
$5,895 |
— |
$183 | |
| CT scan of the abdomen with and without contrast |
$3,931 |
$6,552 |
— |
$259 | |
| CT scan of the abdomen with contrast |
$1,998 |
$3,330 |
— |
$230 | |
| CT scan of the abdomen without contrast |
$1,591 |
$2,652 |
— |
$136 | |
| CT scan of the arm |
$1,940 |
$3,233 |
— |
$199 | |
| CT scan of the arm with contrast |
$1,728 |
$2,880 |
— |
$199 | |
| CT scan of the arm without contrast |
$1,516 |
$2,527 |
— |
$161 | |
| CT scan of the chest |
$2,462 |
$4,104 |
— |
$167 | |
| CT scan of the chest with and without contrast |
$2,573 |
$4,289 |
— |
$196 | |
| CT scan of the chest with contrast |
$5,854 |
$9,757 |
— |
$167 | |
| CT scan of the chest without contrast |
$1,728 |
$2,880 |
— |
$133 | |
| CT scan of the head |
$1,591 |
$2,652 |
— |
$148 | |
| CT scan of the head with and without contrast |
$2,067 |
$3,445 |
— |
$173 | |
| CT scan of the head with contrast |
$1,663 |
$2,772 |
— |
$148 | |
| CT scan of the head without contrast |
$1,443 |
$2,404 |
— |
$107 | |
| CT scan of the leg |
$1,803 |
$3,004 |
— |
$166 | |
| CT scan of the leg with contrast |
$1,803 |
$3,004 |
— |
$166 | |
| CT scan of the leg without contrast |
$1,516 |
$2,527 |
— |
$130 | |
| CT scan of the lower back (lumbar spine) |
$2,091 |
$3,484 |
— |
$169 | |
| CT scan of the lower back (lumbar spine) with and without contrast |
$2,242 |
$3,737 |
— |
$197 | |
| CT scan of the lower back (lumbar spine) with contrast |
$2,091 |
$3,484 |
— |
$169 | |
| CT scan of the lower back (lumbar spine) without contrast |
$1,728 |
$2,880 |
— |
$130 | |
| CT scan of the neck |
$1,613 |
$2,689 |
— |
$183 | |
| CT scan of the neck (cervical spine) |
$1,389 |
$2,315 |
— |
$168 | |
| CT scan of the neck (cervical spine) with contrast |
$1,078 |
$1,797 |
— |
$168 | |
| CT scan of the neck (cervical spine) without contrast |
$1,728 |
$2,880 |
— |
$131 | |
| CT scan of the neck with and without contrast |
$2,004 |
$3,340 |
— |
$220 | |
| CT scan of the neck with contrast |
$1,613 |
$2,689 |
— |
$183 | |
| CT scan of the neck without contrast |
$1,383 |
$2,305 |
— |
$150 | |
| CT scan of the pelvis |
$2,144 |
$3,573 |
— |
$226 | |
| CT scan of the pelvis with and without contrast |
$2,470 |
$4,116 |
— |
$251 | |
| CT scan of the pelvis with contrast |
$2,144 |
$3,573 |
— |
$226 | |
| CT scan of the pelvis without contrast |
$1,728 |
$2,880 |
— |
$133 | |
| CT scan of the sinuses |
$1,207 |
$2,012 |
— |
$152 | |
| CT scan of the sinuses with and without contrast |
$798 |
$1,330 |
— |
$184 | |
| CT scan of the sinuses without contrast |
$1,316 |
$2,193 |
— |
$128 | |
| D-dimer test |
$78 |
$130 |
— |
$10 | |
| Developmental screening (child) |
$349 |
$581 |
— |
— | |
| DHEA-sulfate test |
$83 |
$139 |
— |
$22 | |
| Diagnostic mammogram |
$515 |
$859 |
— |
$140 | |
| Dilation and curettage (D&C) |
$8,725 |
$14,541 |
— |
$298 | |
| Drug screen (urine) |
$259 |
$431 |
— |
$17 | |
| Ear tubes (myringotomy) |
$6,585 |
$10,974 |
— |
$174 | |
| Echocardiogram |
$1,248 |
$2,079 |
— |
$138 | |
| Echocardiogram with and without contrast |
$1,410 |
$2,351 |
— |
$101 | |
| Echocardiogram without contrast |
$1,248 |
$2,079 |
— |
$138 | |
| EEG (awake and asleep) |
$775 |
$1,291 |
— |
$482 | |
| EKG / ECG (tracing only) |
$193 |
$322 |
— |
$7 | |
| Electrocardiogram (EKG) |
$101 |
$169 |
— |
$8 | |
| Electroencephalogram (EEG) |
$741 |
$1,235 |
— |
$448 | |
| Electrolyte panel |
$163 |
$271 |
— |
$7 | |
| Emergency department visit |
$672 |
$1,120 |
— |
$69 | |
| Emergency department visit (level 1) |
$250 |
$417 |
— |
$11 | |
| Emergency department visit (level 2) |
$388 |
$647 |
— |
$40 | |
| Emergency department visit (level 3) |
$672 |
$1,120 |
— |
$69 | |
| Emergency department visit (level 4) |
$1,186 |
$1,977 |
— |
$118 | |
| Emergency department visit (level 5) |
$1,854 |
$3,090 |
— |
$171 | |
| Epidural steroid injection |
$1,998 |
$3,330 |
— |
$275 | |
| Estradiol (estrogen) test |
$75 |
$124 |
— |
$28 | |
| Fallopian tube X-ray (HSG) |
$868 |
$1,447 |
— |
$164 | |
| Fecal occult blood (stool) test |
$51 |
$85 |
— |
$10 | |
| Fecal occult blood (stool) test (guaiac, gFOBT) |
$44 |
$73 |
— |
$4 | |
| Fecal occult blood (stool) test (immunochemical, FIT) |
$58 |
$97 |
— |
$16 | |
| Feeding tube (PEG) placement |
$3,724 |
$6,206 |
— |
$178 | |
| Ferritin (iron) test |
$179 |
$298 |
— |
$14 | |
| Fibrinogen test |
$124 |
$206 |
— |
$10 | |
| Flexible sigmoidoscopy |
$3,796 |
$6,326 |
— |
$323 | |
| Flu test |
$223 |
$371 |
— |
$17 | |
| Folate (folic acid) test |
$99 |
$165 |
— |
$15 | |
| Foreign body removal (skin) |
$1,225 |
$2,041 |
— |
$157 | |
| Free T4 thyroid test |
$60 |
$100 |
— |
$9 | |
| FSH hormone test |
$95 |
$159 |
— |
$19 | |
| Gallbladder removal (laparoscopic) |
$24,069 |
$40,114 |
— |
$658 | |
| Gallbladder scan (HIDA) |
$2,016 |
$3,360 |
— |
$334 | |
| GGT liver test |
$78 |
$130 |
— |
$7 | |
| Glucose tolerance test |
$115 |
$192 |
— |
$8 | |
| H. pylori test |
$102 |
$171 |
— |
$67 | |
| HDL cholesterol test |
$104 |
$173 |
— |
$8 | |
| Hematocrit test |
$56 |
$93 |
— |
$2 | |
| Hemoglobin A1c (diabetes test) |
$89 |
$149 |
— |
$10 | |
| Hepatitis B test |
$73 |
$122 |
— |
$10 | |
| Hepatitis C test |
$391 |
$652 |
— |
$14 | |
| Hip replacement |
$48,790 |
$81,317 |
— |
$1,162 | |
| HIV test |
$100 |
$166 |
— |
$19 | |
| HIV test (antibody) |
$163 |
$272 |
— |
$14 | |
| HIV test (antigen/antibody combo) |
$36 |
$59 |
— |
$24 | |
| Holter heart monitor |
$1,528 |
$2,546 |
— |
$26 | |
| Home sleep apnea test |
$168 |
$280 |
— |
$123 | |
| Hysterectomy |
$27,003 |
$45,004 |
— |
$933 | |
| Hysteroscopy |
$11,287 |
$18,811 |
— |
$1,270 | |
| Inguinal hernia repair |
$11,950 |
$19,917 |
— |
$538 | |
| Iron blood test |
$60 |
$100 |
— |
$6 | |
| IV infusion therapy |
$190 |
$316 |
— |
$44 | |
| IV infusion therapy (each additional) |
$94 |
$157 |
— |
$21 | |
| IV infusion therapy (initial) |
$285 |
$475 |
— |
$67 | |
| Joint aspiration (small/intermediate) |
$3,482 |
$5,803 |
— |
$57 | |
| Joint aspiration or injection (mid-size joint) |
$3,888 |
$6,479 |
— |
$57 | |
| Joint aspiration or injection (small joint) |
$3,076 |
$5,126 |
— |
$56 | |
| Kidney scan (nuclear) |
$2,154 |
$3,590 |
— |
$172 | |
| Kidney ultrasound |
$607 |
$1,011 |
— |
$84 | |
| Kidney ultrasound (limited) |
$607 |
$1,011 |
— |
$61 | |
| Knee arthroscopy |
$11,892 |
$19,820 |
— |
$524 | |
| Knee joint injection |
$2,037 |
$3,394 |
— |
$69 | |
| Knee replacement |
$55,047 |
$91,745 |
$18,369 |
$18,054 | |
| Lactate test |
$50 |
$84 |
— |
$12 | |
| LDH test |
$108 |
$179 |
— |
$6 | |
| LDL cholesterol test |
$105 |
$174 |
— |
$11 | |
| Leg vein ultrasound (Doppler) |
$504 |
$840 |
— |
$150 | |
| Leg vein ultrasound (Doppler) (limited) |
$672 |
$1,119 |
— |
$116 | |
| LH hormone test |
$61 |
$102 |
— |
$19 | |
| Lipase test |
$51 |
$86 |
— |
$7 | |
| Lipid (cholesterol) panel |
$247 |
$412 |
— |
$13 | |
| Liver function panel |
$157 |
$261 |
— |
$8 | |
| Lower back (lumbar) spinal fusion |
$112,992 |
$188,320 |
— |
$1,511 | |
| Lumpectomy (breast) |
$8,976 |
$14,960 |
— |
$750 | |
| Lung function test (PFT) |
$637 |
$1,062 |
— |
$37 | |
| Lung scan (V/Q) |
$1,691 |
$2,818 |
— |
$291 | |
| Magnesium blood test |
$75 |
$124 |
— |
$7 | |
| Mastectomy |
$18,185 |
$30,309 |
— |
$1,021 | |
| Meniscus repair (knee) |
$16,614 |
$27,691 |
— |
$714 | |
| MRA of the brain |
$3,408 |
$5,680 |
— |
$226 | |
| MRA of the brain with contrast |
$3,267 |
$5,445 |
— |
$226 | |
| MRA of the brain without contrast |
$3,408 |
$5,680 |
— |
$328 | |
| MRA of the neck |
$3,267 |
$5,445 |
— |
$245 | |
| MRA of the neck with contrast |
$3,267 |
$5,445 |
— |
$245 | |
| MRA of the neck without contrast |
$3,267 |
$5,445 |
— |
$343 | |
| MRI of the abdomen |
$3,126 |
$5,211 |
— |
$300 | |
| MRI of the abdomen with contrast |
$3,267 |
$5,445 |
— |
$300 | |
| MRI of the abdomen without contrast |
$3,267 |
$5,445 |
— |
$194 | |
| MRI of the ankle |
$3,267 |
$5,445 |
— |
$261 | |
| MRI of the ankle with contrast |
$3,408 |
$5,680 |
— |
$261 | |
| MRI of the ankle without contrast |
$3,267 |
$5,445 |
— |
$222 | |
| MRI of the brain |
$4,097 |
$6,829 |
— |
$269 | |
| MRI of the brain with contrast |
$4,097 |
$6,829 |
— |
$269 | |
| MRI of the brain without contrast |
$3,408 |
$5,680 |
— |
$195 | |
| MRI of the chest |
$3,188 |
$5,313 |
— |
$371 | |
| MRI of the chest with contrast |
$3,267 |
$5,445 |
— |
$371 | |
| MRI of the chest without contrast |
$3,267 |
$5,445 |
— |
$466 | |
| MRI of the knee |
$3,408 |
$5,680 |
— |
$315 | |
| MRI of the knee with contrast |
$3,408 |
$5,680 |
— |
$315 | |
| MRI of the knee without contrast |
$3,267 |
$5,445 |
— |
$204 | |
| MRI of the lower back (lumbar spine) |
$3,805 |
$6,342 |
— |
$270 | |
| MRI of the lower back (lumbar spine) with contrast |
$3,928 |
$6,547 |
— |
$270 | |
| MRI of the lower back (lumbar spine) without contrast |
$3,626 |
$6,044 |
— |
$192 | |
| MRI of the mid-back (thoracic spine) |
$3,805 |
$6,342 |
— |
$271 | |
| MRI of the mid-back (thoracic spine) with and without contrast |
$4,000 |
$6,666 |
— |
$319 | |
| MRI of the mid-back (thoracic spine) with contrast |
$3,928 |
$6,547 |
— |
$271 | |
| MRI of the mid-back (thoracic spine) without contrast |
$3,626 |
$6,044 |
— |
$190 | |
| MRI of the neck (cervical spine) |
$3,793 |
$6,322 |
— |
$274 | |
| MRI of the neck (cervical spine) with and without contrast |
$4,000 |
$6,666 |
— |
$318 | |
| MRI of the neck (cervical spine) with contrast |
$3,928 |
$6,547 |
— |
$274 | |
| MRI of the neck (cervical spine) without contrast |
$3,267 |
$5,445 |
— |
$191 | |
| MRI of the pelvis |
$3,267 |
$5,445 |
— |
$268 | |
| MRI of the pelvis with contrast |
$3,267 |
$5,445 |
— |
$268 | |
| MRI of the pelvis without contrast |
$3,267 |
$5,445 |
— |
$227 | |
| MRI of the shoulder |
$3,408 |
$5,680 |
— |
$313 | |
| MRI of the shoulder with contrast |
$3,267 |
$5,445 |
— |
$313 | |
| MRI of the shoulder without contrast |
$3,267 |
$5,445 |
— |
$205 | |
| MRI of the wrist |
$3,408 |
$5,680 |
— |
$330 | |
| MRI of the wrist with contrast |
$3,408 |
$5,680 |
— |
$330 | |
| MRI of the wrist without contrast |
$3,267 |
$5,445 |
— |
$303 | |
| Nebulizer breathing treatment |
$259 |
$432 |
— |
$9 | |
| Nuclear cardiac stress test |
$5,610 |
$9,350 |
— |
$428 | |
| Occupational therapy evaluation |
$258 |
$430 |
— |
$101 | |
| Occupational therapy evaluation (high complexity) |
$258 |
$430 |
— |
$101 | |
| Occupational therapy evaluation (low complexity) |
$258 |
$430 |
— |
$101 | |
| Occupational therapy evaluation (moderate complexity) |
$258 |
$430 |
— |
$101 | |
| Office visit (established patient) |
$206 |
$343 |
— |
$115 | |
| Office visit (new patient) |
$168 |
$279 |
— |
$177 | |
| Office visit, established patient (level 3) |
$206 |
$343 |
— |
$95 | |
| Office visit, established patient (level 4) |
$206 |
$343 |
— |
$136 | |
| Office visit, new patient (level 3) |
$117 |
$196 |
— |
$118 | |
| Office visit, new patient (level 4) |
$168 |
$279 |
— |
$177 | |
| Office visit, new patient (level 5) |
$207 |
$345 |
— |
$237 | |
| Orthopedic hardware removal |
$10,655 |
$17,759 |
— |
$632 | |
| Ovarian cyst removal |
$7,463 |
$12,438 |
— |
$698 | |
| Pap smear (cervical screening) |
$162 |
$269 |
— |
$20 | |
| Parathyroid hormone (PTH) test |
$195 |
$324 |
— |
$41 | |
| Pelvic ultrasound |
$431 |
$719 |
— |
$78 | |
| Pelvic ultrasound (complete) |
$472 |
$787 |
— |
$105 | |
| Pelvic ultrasound (limited) |
$407 |
$678 |
— |
$51 | |
| PET scan |
$2,496 |
$4,160 |
— |
— | |
| Phosphorus blood test |
$75 |
$124 |
— |
$5 | |
| Physical therapy evaluation |
$258 |
$430 |
— |
$98 | |
| Physical therapy evaluation (high complexity) |
$258 |
$430 |
— |
$98 | |
| Physical therapy evaluation (moderate complexity) |
$258 |
$430 |
— |
$98 | |
| Pilonidal cyst removal |
$7,958 |
$13,264 |
— |
$541 | |
| Pregnancy blood test (hCG) |
$89 |
$149 |
— |
$8 | |
| Pregnancy ultrasound |
$620 |
$1,033 |
— |
$126 | |
| Pregnancy ultrasound (first trimester) |
$558 |
$931 |
— |
$117 | |
| Pregnancy ultrasound (second or third trimester) |
$644 |
$1,073 |
— |
$136 | |
| Procalcitonin test |
$261 |
$434 |
— |
$27 | |
| Prolactin test |
$66 |
$109 |
— |
$19 | |
| Prostate test (PSA) |
$104 |
$173 |
— |
$18 | |
| Pulmonary rehabilitation |
$187 |
$312 |
— |
$87 | |
| Retinal (fundus) photography |
$199 |
$332 |
— |
$37 | |
| Rheumatoid factor test |
$78 |
$130 |
— |
$6 | |
| Rotator cuff repair |
$33,457 |
$55,761 |
— |
$792 | |
| Sacroiliac joint injection |
$1,558 |
$2,597 |
— |
$176 | |
| Scoliosis spine X-ray |
$195 |
$324 |
— |
$58 | |
| Scoliosis spine X-ray (1 view) |
$148 |
$247 |
— |
$44 | |
| Scoliosis spine X-ray (3 views) |
$245 |
$409 |
— |
$72 | |
| Screening mammogram |
$481 |
$801 |
— |
$126 | |
| Scrotal ultrasound |
$453 |
$754 |
— |
$99 | |
| Sedimentation rate (ESR) test |
$73 |
$122 |
— |
$3 | |
| Semen analysis |
$104 |
$173 |
— |
$12 | |
| Septoplasty (deviated septum) |
$5,428 |
$9,046 |
— |
$613 | |
| Sex hormone binding globulin test |
$156 |
$259 |
— |
$22 | |
| Shoulder arthroscopy |
$23,776 |
$39,627 |
— |
$962 | |
| Simple laceration repair (small, up to 2.5 cm) |
$1,004 |
$1,673 |
— |
$114 | |
| Simple wound stitches |
$1,106 |
$1,843 |
— |
$127 | |
| Skin graft |
$9,879 |
$16,464 |
— |
$898 | |
| Sleep study (polysomnography) |
$6,367 |
$10,611 |
— |
$691 | |
| Soft tissue ultrasound |
$823 |
$1,372 |
— |
$64 | |
| Speech therapy |
$330 |
$550 |
— |
$76 | |
| Spirometry (lung function test) |
$321 |
$536 |
— |
$30 | |
| Spirometry with bronchodilator |
$666 |
$1,110 |
— |
$43 | |
| Strep throat test |
$73 |
$122 |
— |
$17 | |
| Stress echocardiogram |
$1,676 |
$2,793 |
— |
$209 | |
| Swallow study |
$456 |
$760 |
— |
$85 | |
| T3 thyroid test |
$48 |
$80 |
— |
$14 | |
| Testosterone test |
$137 |
$228 |
— |
$26 | |
| Thyroid test (TSH) |
$152 |
$253 |
— |
$17 | |
| Thyroid ultrasound |
$400 |
$667 |
— |
$109 | |
| Thyroid uptake scan |
$1,372 |
$2,287 |
— |
$145 | |
| Tonsillectomy |
$8,110 |
$13,517 |
— |
$252 | |
| Total IgE allergy test |
$56 |
$93 |
— |
$16 | |
| Total protein test |
$100 |
$167 |
— |
$4 | |
| Transesophageal echocardiogram (TEE) |
$877 |
$1,462 |
— |
$239 | |
| Transesophageal echocardiogram (TEE) with and without contrast |
$877 |
$1,462 |
— |
$239 | |
| Transvaginal ultrasound |
$440 |
$733 |
— |
$118 | |
| Trigger finger release |
$4,700 |
$7,833 |
— |
$630 | |
| Trigger point injection |
$347 |
$578 |
— |
$56 | |
| Triglycerides test |
$82 |
$137 |
— |
$6 | |
| Troponin (heart) test |
$92 |
$153 |
— |
$12 | |
| Ulnar nerve surgery (elbow) |
$7,988 |
$13,313 |
— |
$575 | |
| Upper GI endoscopy (EGD) |
$4,091 |
$6,818 |
— |
$371 | |
| Upper GI series (barium) |
$542 |
$904 |
— |
$128 | |
| Uric acid (gout) test |
$75 |
$124 |
— |
$5 | |
| Urinalysis |
$87 |
$145 |
— |
$3 | |
| Urine microalbumin test |
$150 |
$249 |
— |
$5 | |
| Urine pregnancy test |
$18 |
$31 |
— |
$9 | |
| Vaccine administration |
$58 |
$97 |
— |
$19 | |
| Vaccine administration (each additional) |
$42 |
$69 |
— |
$16 | |
| Vaginal delivery |
$6,914 |
$11,523 |
$7,050 |
$5,487 | |
| Vitamin B12 test |
$99 |
$165 |
— |
$15 | |
| Vitamin D test |
$292 |
$487 |
— |
$30 | |
| Wrist fracture repair |
$20,213 |
$33,688 |
— |
$735 | |
| X-ray of the abdomen |
$215 |
$359 |
— |
$36 | |
| X-ray of the ankle |
$184 |
$307 |
— |
$37 | |
| X-ray of the collarbone |
$191 |
$318 |
— |
$33 | |
| X-ray of the elbow |
$155 |
$258 |
— |
$33 | |
| X-ray of the facial bones |
$284 |
$473 |
— |
$39 | |
| X-ray of the foot |
$192 |
$320 |
— |
$34 | |
| X-ray of the forearm |
$191 |
$318 |
— |
$29 | |
| X-ray of the hand |
$176 |
$294 |
— |
$38 | |
| X-ray of the hip |
$154 |
$257 |
— |
$49 | |
| X-ray of the hip (1 view) |
$154 |
$257 |
— |
$34 | |
| X-ray of the hip (3 views) |
$154 |
$257 |
— |
$49 | |
| X-ray of the hip (4 views) |
$245 |
$409 |
— |
$63 | |
| X-ray of the knee |
$328 |
$546 |
— |
$42 | |
| X-ray of the knee (2 views) |
$408 |
$680 |
— |
$34 | |
| X-ray of the knee (3 views) |
$211 |
$351 |
— |
$42 | |
| X-ray of the knee (4+ views) |
$281 |
$469 |
— |
$49 | |
| X-ray of the lower back (lumbar spine) |
$239 |
$398 |
— |
$47 | |
| X-ray of the lower back (lumbar spine) (2 views) |
$229 |
$381 |
— |
$40 | |
| X-ray of the lower back (lumbar spine) (4+ views) |
$327 |
$544 |
— |
$53 | |
| X-ray of the lower leg |
$191 |
$318 |
— |
$31 | |
| X-ray of the mid-back (thoracic spine) |
$232 |
$387 |
— |
$36 | |
| X-ray of the mid-back (thoracic spine) (2 views) |
$232 |
$387 |
— |
$33 | |
| X-ray of the neck (cervical spine) |
$503 |
$838 |
— |
$47 | |
| X-ray of the neck (cervical spine) (3 views) |
$548 |
$913 |
— |
$40 | |
| X-ray of the pelvis |
$205 |
$341 |
— |
$36 | |
| X-ray of the pelvis (1 view) |
$191 |
$318 |
— |
$28 | |
| X-ray of the ribs |
$218 |
$364 |
— |
$42 | |
| X-ray of the ribs (2 views) |
$135 |
$224 |
— |
$36 | |
| X-ray of the shoulder |
$211 |
$351 |
— |
$36 | |
| X-ray of the skull |
$271 |
$451 |
— |
$40 | |
| X-ray of the upper arm |
$211 |
$351 |
— |
$32 | |
| X-ray of the wrist |
$192 |
$320 |
— |
$43 | |
| Zinc blood test |
$38 |
$63 |
— |
$11 | |