|
Abdominal CT scan (with and without contrast)
|
$2,904.85 |
$2,904.85 |
$2,904.85 |
$2,049.00
|
|
Abdominal CT scan (with contrast)
|
$2,507.70 |
$2,507.70 |
$2,507.70 |
$1,683.63
|
|
Abdominal CT scan (without contrast)
|
$2,261.35 |
$2,261.35 |
$2,261.35 |
$1,358.76
|
|
Abdominal MRI (with and without contrast)
|
$3,599.05 |
$3,599.05 |
$3,599.05 |
$3,061.80
|
|
Abdominal MRI (with contrast)
|
$3,599.05 |
$3,599.05 |
$3,599.05 |
$2,096.25
|
|
Abdominal MRI (without contrast)
|
$3,270.80 |
$3,270.80 |
$3,270.80 |
$1,902.00
|
|
Abdominal Ultrasound (complete)
|
$1,326.00 |
$1,326.00 |
$1,326.00 |
$755.00
|
|
Abdominal Ultrasound (limited)
|
$1,046.50 |
$1,046.50 |
$1,046.50 |
$629.42
|
|
Ankle X-ray
|
$537.55 |
$537.55 |
$537.55 |
$312.74
|
|
Blood Clotting (PT/INR) Test
|
$65.00 |
$65.00 |
$65.00 |
$45.00
|
|
Blood Clotting (PTT) Test
|
$150.80 |
$150.80 |
$150.80 |
$64.35
|
|
Blood Count (CBC) Test
|
$216.45 |
$216.45 |
$216.45 |
$66.75
|
|
Blood Count (CBC) Test (without differential)
|
$126.10 |
$126.10 |
$126.10 |
$57.50
|
|
Blood Culture Test
|
$383.50 |
$383.50 |
$383.50 |
$112.20
|
|
Bone Density Scan (DEXA)
|
$488.80 |
$488.80 |
$488.80 |
$398.56
|
|
Brain MRA (blood vessel MRI, with and without contrast)
|
$3,806.40 |
$3,806.40 |
$3,806.40 |
$2,650.00
|
|
Brain MRA (blood vessel MRI, with contrast)
|
$3,043.95 |
$3,043.95 |
$3,043.95 |
$1,998.00
|
|
Brain MRA (blood vessel MRI, without contrast)
|
$2,533.70 |
$2,533.70 |
$2,533.70 |
$1,802.40
|
|
Brain MRI (with and without contrast)
|
$4,411.55 |
$4,411.55 |
$4,411.55 |
$2,919.75
|
|
Brain MRI (with contrast)
|
$3,497.00 |
$3,497.00 |
$3,497.00 |
$2,224.96
|
|
Brain MRI (without contrast)
|
$3,110.25 |
$3,110.25 |
$3,110.25 |
$1,830.00
|
|
Breast Biopsy (ultrasound-guided, percutaneous)
|
$4,024.80 |
$4,024.80 |
$4,024.80 |
$3,069.25
|
|
CT Angiogram of Abdomen and Pelvis
|
$3,801.85 |
$3,801.85 |
$3,801.85 |
$2,839.85
|
|
CT Angiogram of the Chest (for blood clot)
|
$2,945.15 |
$2,945.15 |
$2,945.15 |
$2,094.23
|
|
CT Angiogram of the Head
|
$2,400.45 |
$2,400.45 |
$2,400.45 |
$2,094.23
|
|
CT Scan of Abdomen and Pelvis (with and without contrast)
|
$4,280.25 |
$4,280.25 |
$4,280.25 |
$3,669.25
|
|
CT Scan of Abdomen and Pelvis (with contrast)
|
$3,688.10 |
$3,688.10 |
$3,688.10 |
$3,217.18
|
|
CT Scan of Abdomen and Pelvis (without contrast)
|
$3,325.40 |
$3,325.40 |
$3,325.40 |
$2,418.75
|
|
Carotid Artery Ultrasound (Duplex)
|
$1,940.25 |
$1,940.25 |
$1,940.25 |
$1,059.82
|
|
Chest CT scan (with and without contrast)
|
$3,441.75 |
$3,441.75 |
$3,441.75 |
$2,105.40
|
|
Chest CT scan (with contrast)
|
$3,272.75 |
$3,272.75 |
$3,272.75 |
$1,697.25
|
|
Chest CT scan (without contrast)
|
$2,051.40 |
$2,051.40 |
$2,051.40 |
$1,350.03
|
|
Chest X-ray
|
$445.90 |
$445.90 |
$445.90 |
$303.24
|
|
Chest X-ray (single view)
|
$375.05 |
$375.05 |
$375.05 |
$225.00
|
|
Cholesterol (Lipid) Test
|
$187.20 |
$187.20 |
$187.20 |
$100.00
|
|
Circumcision (newborn)
|
$1,616.55 |
$1,616.55 |
$1,616.55 |
$1,549.50
|
|
Cystoscopy (Bladder Scope)
|
$1,809.60 |
$1,809.60 |
$1,809.60 |
$1,636.00
|
|
Diabetes (HbA1c) Test
|
$169.65 |
$169.65 |
$169.65 |
$70.00
|
|
Diagnostic Mammogram (both breasts)
|
$502.45 |
$502.45 |
$502.45 |
$424.00
|
|
Diagnostic Mammogram (one breast)
|
$386.75 |
$386.75 |
$386.75 |
$297.05
|
|
ER Visit (level 1, minor)
|
$437.45 |
$437.45 |
$437.45 |
$286.51
|
|
ER Visit (level 2)
|
$598.65 |
$598.65 |
$598.65 |
$469.39
|
|
ER Visit (level 3)
|
$1,008.80 |
$1,008.80 |
$1,008.80 |
$827.20
|
|
ER Visit (level 4)
|
$1,359.15 |
$1,359.15 |
$1,359.15 |
$1,330.00
|
|
ER Visit (level 5, high severity)
|
$1,619.15 |
$1,619.15 |
$1,619.15 |
$1,892.80
|
|
Echocardiogram (Heart Ultrasound)
|
$2,720.25 |
$2,720.25 |
$2,720.25 |
$2,021.12
|
|
Established Patient Office Visit (level 1)
|
$945.75 |
$945.75 |
$945.75 |
$115.05
|
|
Established Patient Office Visit (level 2)
|
$945.75 |
$945.75 |
$945.75 |
$127.53
|
|
Established Patient Office Visit (level 3)
|
$481.00 |
$481.00 |
$481.00 |
$183.60
|
|
Established Patient Office Visit (level 4)
|
$668.20 |
$668.20 |
$668.20 |
$228.60
|
|
Established Patient Office Visit (level 5)
|
$679.25 |
$679.25 |
$679.25 |
$306.40
|
|
Foot X-ray
|
$538.20 |
$538.20 |
$538.20 |
$339.50
|
|
Hand X-ray
|
$520.00 |
$520.00 |
$520.00 |
$315.00
|
|
Head CT scan (with and without contrast)
|
$3,943.55 |
$3,943.55 |
$3,943.55 |
$1,914.25
|
|
Head CT scan (with contrast)
|
$3,117.40 |
$3,117.40 |
$3,117.40 |
$1,587.69
|
|
Head CT scan (without contrast)
|
$2,777.45 |
$2,777.45 |
$2,777.45 |
$1,268.90
|
|
Hernia Repair (Inguinal)
|
$5,870.15 |
$5,870.15 |
$5,870.15 |
$6,210.72
|
|
Hip X-ray
|
$598.65 |
$598.65 |
$598.65 |
$290.35
|
|
Kidney (Retroperitoneal) Ultrasound (complete)
|
$1,168.05 |
$1,168.05 |
$1,168.05 |
$683.50
|
|
Knee MRI (with and without contrast)
|
$5,110.30 |
$5,110.30 |
$5,110.30 |
$3,008.26
|
|
Knee MRI (with contrast)
|
$3,970.85 |
$3,970.85 |
$3,970.85 |
$2,394.58
|
|
Knee MRI (without contrast)
|
$3,220.10 |
$3,220.10 |
$3,220.10 |
$2,209.22
|
|
Knee X-ray
|
$593.45 |
$593.45 |
$593.45 |
$387.20
|
|
Leg Vein Ultrasound (DVT study, both legs)
|
$1,018.55 |
$1,018.55 |
$1,018.55 |
$1,090.23
|
|
Liver Function Test
|
$276.90 |
$276.90 |
$276.90 |
$93.60
|
|
Lower Back (Lumbar Spine) CT scan (with and without contrast)
|
$3,879.85 |
$3,879.85 |
$3,879.85 |
$1,909.80
|
|
Lower Back (Lumbar Spine) CT scan (with contrast)
|
$3,296.80 |
$3,296.80 |
$3,296.80 |
$1,850.88
|
|
Lower Back (Lumbar Spine) CT scan (without contrast)
|
$2,984.80 |
$2,984.80 |
$2,984.80 |
$1,517.10
|
|
Lower Back (Lumbar Spine) MRI (with and without contrast)
|
$4,345.90 |
$4,345.90 |
$4,345.90 |
$2,750.00
|
|
Lower Back (Lumbar Spine) MRI (with contrast)
|
$3,612.70 |
$3,612.70 |
$3,612.70 |
$2,415.68
|
|
Lower Back (Lumbar Spine) MRI (without contrast)
|
$3,385.20 |
$3,385.20 |
$3,385.20 |
$2,013.08
|
|
Lower Back (Lumbar Spine) X-ray
|
$620.10 |
$620.10 |
$620.10 |
$341.64
|
|
Lung Function Test (Spirometry)
|
$169.00 |
$169.00 |
$169.00 |
$296.91
|
|
Metabolic Blood Panel (Basic)
|
$310.70 |
$310.70 |
$310.70 |
$97.60
|
|
Metabolic Blood Panel (Comprehensive)
|
$364.00 |
$364.00 |
$364.00 |
$130.97
|
|
Neck (Cervical Spine) CT scan (with and without contrast)
|
$3,783.00 |
$3,783.00 |
$3,783.00 |
$1,992.00
|
|
Neck (Cervical Spine) CT scan (with contrast)
|
$2,951.00 |
$2,951.00 |
$2,951.00 |
$1,708.20
|
|
Neck (Cervical Spine) CT scan (without contrast)
|
$2,192.45 |
$2,192.45 |
$2,192.45 |
$1,513.95
|
|
Neck (Cervical Spine) MRI (with and without contrast)
|
$4,284.80 |
$4,284.80 |
$4,284.80 |
$2,750.00
|
|
Neck (Cervical Spine) MRI (with contrast)
|
$3,542.50 |
$3,542.50 |
$3,542.50 |
$2,231.16
|
|
Neck (Cervical Spine) MRI (without contrast)
|
$3,417.70 |
$3,417.70 |
$3,417.70 |
$1,947.58
|
|
Neck MRA (blood vessel MRI, with and without contrast)
|
$2,479.75 |
$2,479.75 |
$2,479.75 |
$2,750.00
|
|
Neck MRA (blood vessel MRI, with contrast)
|
$1,983.80 |
$1,983.80 |
$1,983.80 |
$2,030.23
|
|
Neck MRA (blood vessel MRI, without contrast)
|
$1,655.55 |
$1,655.55 |
$1,655.55 |
$1,790.58
|
|
New Patient Office Visit (level 2)
|
$465.40 |
$465.40 |
$465.40 |
$178.00
|
|
New Patient Office Visit (level 3)
|
$481.65 |
$481.65 |
$481.65 |
$229.20
|
|
New Patient Office Visit (level 4)
|
$668.85 |
$668.85 |
$668.85 |
$307.00
|
|
New Patient Office Visit (level 5)
|
$674.70 |
$674.70 |
$674.70 |
$401.50
|
|
Nuclear Stress Test (Heart)
|
$5,848.05 |
$5,848.05 |
$5,848.05 |
$3,799.90
|
|
PSA (Prostate) Test
|
$186.55 |
$186.55 |
$186.55 |
$103.85
|
|
Pelvic CT scan (with and without contrast)
|
$3,361.80 |
$3,361.80 |
$3,361.80 |
$1,992.00
|
|
Pelvic CT scan (with contrast)
|
$3,074.50 |
$3,074.50 |
$3,074.50 |
$1,706.25
|
|
Pelvic CT scan (without contrast)
|
$2,769.00 |
$2,769.00 |
$2,769.00 |
$1,366.50
|
|
Pelvic MRI (with and without contrast)
|
$3,232.45 |
$3,232.45 |
$3,232.45 |
$2,713.80
|
|
Pelvic MRI (with contrast)
|
$3,070.60 |
$3,070.60 |
$3,070.60 |
$1,966.42
|
|
Pelvic MRI (without contrast)
|
$2,913.30 |
$2,913.30 |
$2,913.30 |
$1,810.38
|
|
Pelvic Ultrasound (complete)
|
$1,134.25 |
$1,134.25 |
$1,134.25 |
$647.87
|
|
Pelvic Ultrasound (limited)
|
$1,007.50 |
$1,007.50 |
$1,007.50 |
$476.50
|
|
Pregnancy Ultrasound (complete, after first trimester)
|
$733.85 |
$733.85 |
$733.85 |
$607.12
|
|
Pregnancy Ultrasound (first trimester)
|
$669.50 |
$669.50 |
$669.50 |
$592.15
|
|
Screening Mammogram
|
$426.40 |
$426.40 |
$426.40 |
$331.50
|
|
Shoulder MRI (with and without contrast)
|
$4,020.90 |
$4,020.90 |
$4,020.90 |
$2,650.10
|
|
Shoulder MRI (with contrast)
|
$3,445.00 |
$3,445.00 |
$3,445.00 |
$2,822.25
|
|
Shoulder MRI (without contrast)
|
$2,964.00 |
$2,964.00 |
$2,964.00 |
$1,938.28
|
|
Shoulder X-ray
|
$577.85 |
$577.85 |
$577.85 |
$307.20
|
|
Sinus CT scan (with and without contrast)
|
$3,354.00 |
$3,354.00 |
$3,354.00 |
$1,871.00
|
|
Sinus CT scan (with contrast)
|
$3,201.90 |
$3,201.90 |
$3,201.90 |
$1,566.40
|
|
Sinus CT scan (without contrast)
|
$2,714.40 |
$2,714.40 |
$2,714.40 |
$1,275.30
|
|
Skin Biopsy
|
$568.10 |
$568.10 |
$568.10 |
$381.60
|
|
Thyroid (TSH) Test
|
$131.95 |
$131.95 |
$131.95 |
$110.00
|
|
Thyroid Ultrasound
|
$643.50 |
$643.50 |
$643.50 |
$603.90
|
|
Upper Back (Thoracic Spine) MRI (with and without contrast)
|
$4,332.25 |
$4,332.25 |
$4,332.25 |
$2,713.80
|
|
Upper Back (Thoracic Spine) MRI (with contrast)
|
$3,697.20 |
$3,697.20 |
$3,697.20 |
$2,039.85
|
|
Upper Back (Thoracic Spine) MRI (without contrast)
|
$3,385.20 |
$3,385.20 |
$3,385.20 |
$2,013.08
|
|
Urinalysis (with microscopy)
|
$99.45 |
$99.45 |
$99.45 |
$36.52
|
|
Urinalysis (without microscopy)
|
$48.75 |
$48.75 |
$48.75 |
$32.50
|
|
Urine Culture Test
|
$71.50 |
$71.50 |
$71.50 |
$65.25
|
|
Vitamin D Test
|
$78.65 |
$78.65 |
$78.65 |
$145.80
|
|
Wrist X-ray
|
$574.60 |
$574.60 |
$574.60 |
$311.20
|