|
Abdominal CT scan (with and without contrast)
|
$3,948.75 |
$3,948.75 |
$3,948.75 |
$2,049.00
|
|
Abdominal CT scan (with contrast)
|
$3,341.65 |
$3,341.65 |
$3,341.65 |
$1,683.63
|
|
Abdominal CT scan (without contrast)
|
$3,194.75 |
$3,194.75 |
$3,194.75 |
$1,358.76
|
|
Abdominal MRI (with and without contrast)
|
$4,013.75 |
$4,013.75 |
$4,013.75 |
$3,061.80
|
|
Abdominal MRI (with contrast)
|
$3,765.45 |
$3,765.45 |
$3,765.45 |
$2,096.25
|
|
Abdominal MRI (without contrast)
|
$3,647.80 |
$3,647.80 |
$3,647.80 |
$1,902.00
|
|
Abdominal Ultrasound (complete)
|
$1,479.40 |
$1,479.40 |
$1,479.40 |
$755.00
|
|
Abdominal Ultrasound (limited)
|
$1,167.40 |
$1,167.40 |
$1,167.40 |
$629.42
|
|
Ankle X-ray
|
$599.30 |
$599.30 |
$599.30 |
$312.74
|
|
Blood Clotting (PT/INR) Test
|
$130.65 |
$130.65 |
$130.65 |
$45.00
|
|
Blood Clotting (PTT) Test
|
$158.60 |
$158.60 |
$158.60 |
$64.35
|
|
Blood Count (CBC) Test
|
$252.85 |
$252.85 |
$252.85 |
$66.75
|
|
Blood Count (CBC) Test (without differential)
|
$160.55 |
$160.55 |
$160.55 |
$57.50
|
|
Blood Culture Test
|
$698.10 |
$698.10 |
$698.10 |
$112.20
|
|
Bone Density Scan (DEXA)
|
$546.00 |
$546.00 |
$546.00 |
$398.56
|
|
Brain MRA (blood vessel MRI, with and without contrast)
|
$4,244.50 |
$4,244.50 |
$4,244.50 |
$2,650.00
|
|
Brain MRA (blood vessel MRI, with contrast)
|
$3,395.60 |
$3,395.60 |
$3,395.60 |
$1,998.00
|
|
Brain MRA (blood vessel MRI, without contrast)
|
$2,825.55 |
$2,825.55 |
$2,825.55 |
$1,802.40
|
|
Brain MRI (with and without contrast)
|
$4,919.85 |
$4,919.85 |
$4,919.85 |
$2,919.75
|
|
Brain MRI (with contrast)
|
$3,900.65 |
$3,900.65 |
$3,900.65 |
$2,224.96
|
|
Brain MRI (without contrast)
|
$3,469.05 |
$3,469.05 |
$3,469.05 |
$1,830.00
|
|
Breast Biopsy (ultrasound-guided, percutaneous)
|
$7,027.80 |
$7,027.80 |
$7,027.80 |
$3,069.25
|
|
CT Angiogram of Abdomen and Pelvis
|
$5,921.50 |
$5,921.50 |
$5,921.50 |
$2,839.85
|
|
CT Angiogram of the Chest (for blood clot)
|
$4,726.15 |
$4,726.15 |
$4,726.15 |
$2,094.23
|
|
CT Angiogram of the Head
|
$2,639.65 |
$2,639.65 |
$2,639.65 |
$2,094.23
|
|
CT Scan of Abdomen and Pelvis (with and without contrast)
|
$6,971.90 |
$6,971.90 |
$6,971.90 |
$3,669.25
|
|
CT Scan of Abdomen and Pelvis (with contrast)
|
$5,964.40 |
$5,964.40 |
$5,964.40 |
$3,217.18
|
|
CT Scan of Abdomen and Pelvis (without contrast)
|
$5,537.35 |
$5,537.35 |
$5,537.35 |
$2,418.75
|
|
Carotid Artery Ultrasound (Duplex)
|
$2,163.85 |
$2,163.85 |
$2,163.85 |
$1,059.82
|
|
Chest CT scan (with and without contrast)
|
$3,785.60 |
$3,785.60 |
$3,785.60 |
$2,105.40
|
|
Chest CT scan (with contrast)
|
$3,599.05 |
$3,599.05 |
$3,599.05 |
$1,697.25
|
|
Chest CT scan (without contrast)
|
$2,913.95 |
$2,913.95 |
$2,913.95 |
$1,350.03
|
|
Chest X-ray
|
$497.25 |
$497.25 |
$497.25 |
$303.24
|
|
Chest X-ray (single view)
|
$418.60 |
$418.60 |
$418.60 |
$225.00
|
|
Cholesterol (Lipid) Test
|
$163.80 |
$163.80 |
$163.80 |
$100.00
|
|
Diabetes (HbA1c) Test
|
$309.40 |
$309.40 |
$309.40 |
$70.00
|
|
ER Visit (level 1, minor)
|
$510.25 |
$510.25 |
$510.25 |
$286.51
|
|
ER Visit (level 2)
|
$698.75 |
$698.75 |
$698.75 |
$469.39
|
|
ER Visit (level 3)
|
$1,179.10 |
$1,179.10 |
$1,179.10 |
$827.20
|
|
ER Visit (level 4)
|
$1,588.60 |
$1,588.60 |
$1,588.60 |
$1,330.00
|
|
ER Visit (level 5, high severity)
|
$1,892.80 |
$1,892.80 |
$1,892.80 |
$1,892.80
|
|
Echocardiogram (Heart Ultrasound)
|
$4,108.65 |
$4,108.65 |
$4,108.65 |
$2,021.12
|
|
Established Patient Office Visit (level 1)
|
$360.75 |
$360.75 |
$360.75 |
$115.05
|
|
Foot X-ray
|
$600.60 |
$600.60 |
$600.60 |
$339.50
|
|
Hand X-ray
|
$580.45 |
$580.45 |
$580.45 |
$315.00
|
|
Head CT scan (with and without contrast)
|
$4,335.50 |
$4,335.50 |
$4,335.50 |
$1,914.25
|
|
Head CT scan (with contrast)
|
$3,426.80 |
$3,426.80 |
$3,426.80 |
$1,587.69
|
|
Head CT scan (without contrast)
|
$3,054.35 |
$3,054.35 |
$3,054.35 |
$1,268.90
|
|
Hip X-ray
|
$666.90 |
$666.90 |
$666.90 |
$290.35
|
|
Kidney (Retroperitoneal) Ultrasound (complete)
|
$1,302.60 |
$1,302.60 |
$1,302.60 |
$683.50
|
|
Knee MRI (with and without contrast)
|
$5,699.20 |
$5,699.20 |
$5,699.20 |
$3,008.26
|
|
Knee MRI (with contrast)
|
$4,427.80 |
$4,427.80 |
$4,427.80 |
$2,394.58
|
|
Knee MRI (without contrast)
|
$3,591.90 |
$3,591.90 |
$3,591.90 |
$2,209.22
|
|
Knee X-ray
|
$662.35 |
$662.35 |
$662.35 |
$387.20
|
|
Leg Vein Ultrasound (DVT study, both legs)
|
$1,136.20 |
$1,136.20 |
$1,136.20 |
$1,090.23
|
|
Liver Function Test
|
$383.50 |
$383.50 |
$383.50 |
$93.60
|
|
Lower Back (Lumbar Spine) CT scan (with and without contrast)
|
$4,265.30 |
$4,265.30 |
$4,265.30 |
$1,909.80
|
|
Lower Back (Lumbar Spine) CT scan (with contrast)
|
$3,625.70 |
$3,625.70 |
$3,625.70 |
$1,850.88
|
|
Lower Back (Lumbar Spine) CT scan (without contrast)
|
$3,282.50 |
$3,282.50 |
$3,282.50 |
$1,517.10
|
|
Lower Back (Lumbar Spine) MRI (with and without contrast)
|
$4,846.40 |
$4,846.40 |
$4,846.40 |
$2,750.00
|
|
Lower Back (Lumbar Spine) MRI (with contrast)
|
$4,028.70 |
$4,028.70 |
$4,028.70 |
$2,415.68
|
|
Lower Back (Lumbar Spine) MRI (without contrast)
|
$3,775.20 |
$3,775.20 |
$3,775.20 |
$2,013.08
|
|
Lower Back (Lumbar Spine) X-ray
|
$691.60 |
$691.60 |
$691.60 |
$341.64
|
|
Lung Function Test (Spirometry)
|
$170.95 |
$170.95 |
$170.95 |
$296.91
|
|
Metabolic Blood Panel (Basic)
|
$438.75 |
$438.75 |
$438.75 |
$97.60
|
|
Metabolic Blood Panel (Comprehensive)
|
$765.70 |
$765.70 |
$765.70 |
$130.97
|
|
Neck (Cervical Spine) CT scan (with and without contrast)
|
$4,158.70 |
$4,158.70 |
$4,158.70 |
$1,992.00
|
|
Neck (Cervical Spine) CT scan (with contrast)
|
$3,245.45 |
$3,245.45 |
$3,245.45 |
$1,708.20
|
|
Neck (Cervical Spine) CT scan (without contrast)
|
$3,395.60 |
$3,395.60 |
$3,395.60 |
$1,513.95
|
|
Neck (Cervical Spine) MRI (with and without contrast)
|
$4,778.80 |
$4,778.80 |
$4,778.80 |
$2,750.00
|
|
Neck (Cervical Spine) MRI (with contrast)
|
$3,950.70 |
$3,950.70 |
$3,950.70 |
$2,231.16
|
|
Neck (Cervical Spine) MRI (without contrast)
|
$3,811.60 |
$3,811.60 |
$3,811.60 |
$1,947.58
|
|
Neck MRA (blood vessel MRI, with and without contrast)
|
$2,765.10 |
$2,765.10 |
$2,765.10 |
$2,750.00
|
|
Neck MRA (blood vessel MRI, with contrast)
|
$2,213.25 |
$2,213.25 |
$2,213.25 |
$2,030.23
|
|
Neck MRA (blood vessel MRI, without contrast)
|
$1,846.65 |
$1,846.65 |
$1,846.65 |
$1,790.58
|
|
New Patient Office Visit (level 2)
|
$211.90 |
$211.90 |
$211.90 |
$178.00
|
|
Nuclear Stress Test (Heart)
|
$6,571.50 |
$6,571.50 |
$6,571.50 |
$3,799.90
|
|
PSA (Prostate) Test
|
$313.30 |
$313.30 |
$313.30 |
$103.85
|
|
Pelvic CT scan (with and without contrast)
|
$3,695.90 |
$3,695.90 |
$3,695.90 |
$1,992.00
|
|
Pelvic CT scan (with contrast)
|
$3,380.65 |
$3,380.65 |
$3,380.65 |
$1,706.25
|
|
Pelvic CT scan (without contrast)
|
$3,043.95 |
$3,043.95 |
$3,043.95 |
$1,366.50
|
|
Pelvic MRI (with and without contrast)
|
$3,604.25 |
$3,604.25 |
$3,604.25 |
$2,713.80
|
|
Pelvic MRI (with contrast)
|
$3,424.20 |
$3,424.20 |
$3,424.20 |
$1,966.42
|
|
Pelvic MRI (without contrast)
|
$3,249.35 |
$3,249.35 |
$3,249.35 |
$1,810.38
|
|
Pelvic Ultrasound (complete)
|
$1,264.25 |
$1,264.25 |
$1,264.25 |
$647.87
|
|
Pelvic Ultrasound (limited)
|
$1,123.85 |
$1,123.85 |
$1,123.85 |
$476.50
|
|
Pregnancy Ultrasound (complete, after first trimester)
|
$818.35 |
$818.35 |
$818.35 |
$607.12
|
|
Pregnancy Ultrasound (first trimester)
|
$748.15 |
$748.15 |
$748.15 |
$592.15
|
|
Shoulder MRI (with and without contrast)
|
$4,485.00 |
$4,485.00 |
$4,485.00 |
$2,650.10
|
|
Shoulder MRI (with contrast)
|
$3,842.80 |
$3,842.80 |
$3,842.80 |
$2,822.25
|
|
Shoulder MRI (without contrast)
|
$3,305.25 |
$3,305.25 |
$3,305.25 |
$1,938.28
|
|
Shoulder X-ray
|
$644.80 |
$644.80 |
$644.80 |
$307.20
|
|
Sinus CT scan (with and without contrast)
|
$3,688.10 |
$3,688.10 |
$3,688.10 |
$1,871.00
|
|
Sinus CT scan (with contrast)
|
$3,521.70 |
$3,521.70 |
$3,521.70 |
$1,566.40
|
|
Sinus CT scan (without contrast)
|
$2,984.15 |
$2,984.15 |
$2,984.15 |
$1,275.30
|
|
Skin Biopsy
|
$665.60 |
$665.60 |
$665.60 |
$381.60
|
|
Sleep Study (Polysomnography)
|
$4,228.25 |
$4,228.25 |
$4,228.25 |
$4,141.16
|
|
Thyroid (TSH) Test
|
$165.75 |
$165.75 |
$165.75 |
$110.00
|
|
Thyroid Ultrasound
|
$718.25 |
$718.25 |
$718.25 |
$603.90
|
|
Upper Back (Thoracic Spine) MRI (with and without contrast)
|
$4,832.10 |
$4,832.10 |
$4,832.10 |
$2,713.80
|
|
Upper Back (Thoracic Spine) MRI (with contrast)
|
$4,122.95 |
$4,122.95 |
$4,122.95 |
$2,039.85
|
|
Upper Back (Thoracic Spine) MRI (without contrast)
|
$3,775.20 |
$3,775.20 |
$3,775.20 |
$2,013.08
|
|
Urinalysis (with microscopy)
|
$163.15 |
$163.15 |
$163.15 |
$36.52
|
|
Urinalysis (without microscopy)
|
$88.40 |
$88.40 |
$88.40 |
$32.50
|
|
Vitamin D Test
|
$88.40 |
$88.40 |
$88.40 |
$145.80
|
|
Wrist X-ray
|
$640.25 |
$640.25 |
$640.25 |
$311.20
|