|
Abdominal CT scan (with and without contrast)
|
$2,784.45 |
$2,784.45 |
$2,784.45 |
$2,049.00
|
|
Abdominal CT scan (with contrast)
|
$2,515.80 |
$2,515.80 |
$2,515.80 |
$1,683.63
|
|
Abdominal CT scan (without contrast)
|
$2,019.15 |
$2,019.15 |
$2,019.15 |
$1,358.76
|
|
Abdominal MRI (with and without contrast)
|
$3,273.10 |
$3,273.10 |
$3,273.10 |
$3,061.80
|
|
Abdominal MRI (with contrast)
|
$3,061.10 |
$3,061.10 |
$3,061.10 |
$2,096.25
|
|
Abdominal MRI (without contrast)
|
$2,696.70 |
$2,696.70 |
$2,696.70 |
$1,902.00
|
|
Abdominal Ultrasound (complete)
|
$1,159.45 |
$1,159.45 |
$1,159.45 |
$755.00
|
|
Abdominal Ultrasound (limited)
|
$751.80 |
$751.80 |
$751.80 |
$629.42
|
|
Ankle X-ray
|
$403.55 |
$403.55 |
$403.55 |
$312.74
|
|
Blood Clotting (PT/INR) Test
|
$74.30 |
$74.30 |
$74.30 |
$45.00
|
|
Blood Clotting (PTT) Test
|
$170.05 |
$170.05 |
$170.05 |
$64.35
|
|
Blood Count (CBC) Test
|
$76.95 |
$76.95 |
$76.95 |
$66.75
|
|
Blood Count (CBC) Test (without differential)
|
$51.25 |
$51.25 |
$51.25 |
$57.50
|
|
Blood Culture Test
|
$274.05 |
$274.05 |
$274.05 |
$112.20
|
|
Bone Density Scan (DEXA)
|
$377.95 |
$377.95 |
$377.95 |
$398.56
|
|
Brain MRA (blood vessel MRI, with and without contrast)
|
$3,190.70 |
$3,190.70 |
$3,190.70 |
$2,650.00
|
|
Brain MRA (blood vessel MRI, with contrast)
|
$2,650.80 |
$2,650.80 |
$2,650.80 |
$1,998.00
|
|
Brain MRA (blood vessel MRI, without contrast)
|
$2,109.55 |
$2,109.55 |
$2,109.55 |
$1,802.40
|
|
Brain MRI (with and without contrast)
|
$3,088.05 |
$3,088.05 |
$3,088.05 |
$2,919.75
|
|
Brain MRI (with contrast)
|
$2,725.05 |
$2,725.05 |
$2,725.05 |
$2,224.96
|
|
Brain MRI (without contrast)
|
$2,360.60 |
$2,360.60 |
$2,360.60 |
$1,830.00
|
|
Breast Biopsy (ultrasound-guided, percutaneous)
|
$3,048.95 |
$3,048.95 |
$3,048.95 |
$3,069.25
|
|
CT Angiogram of Abdomen and Pelvis
|
$3,725.10 |
$3,725.10 |
$3,725.10 |
$2,839.85
|
|
CT Angiogram of the Chest (for blood clot)
|
$3,630.70 |
$3,630.70 |
$3,630.70 |
$2,094.23
|
|
CT Angiogram of the Head
|
$3,038.15 |
$3,038.15 |
$3,038.15 |
$2,094.23
|
|
CT Scan of Abdomen and Pelvis (with and without contrast)
|
$6,057.45 |
$6,057.45 |
$6,057.45 |
$3,669.25
|
|
CT Scan of Abdomen and Pelvis (with contrast)
|
$4,781.90 |
$4,781.90 |
$4,781.90 |
$3,217.18
|
|
CT Scan of Abdomen and Pelvis (without contrast)
|
$3,659.00 |
$3,659.00 |
$3,659.00 |
$2,418.75
|
|
Carotid Artery Ultrasound (Duplex)
|
$1,333.55 |
$1,333.55 |
$1,333.55 |
$1,059.82
|
|
Chest CT scan (with and without contrast)
|
$3,101.65 |
$3,101.65 |
$3,101.65 |
$2,105.40
|
|
Chest CT scan (with contrast)
|
$2,352.50 |
$2,352.50 |
$2,352.50 |
$1,697.25
|
|
Chest CT scan (without contrast)
|
$1,899.05 |
$1,899.05 |
$1,899.05 |
$1,350.03
|
|
Chest X-ray
|
$471.05 |
$471.05 |
$471.05 |
$303.24
|
|
Chest X-ray (single view)
|
$332.00 |
$332.00 |
$332.00 |
$225.00
|
|
Cholesterol (Lipid) Test
|
$137.90 |
$137.90 |
$137.90 |
$100.00
|
|
Circumcision (newborn)
|
$294.75 |
$294.75 |
$294.75 |
$1,549.50
|
|
Cystoscopy (Bladder Scope)
|
$1,610.20 |
$1,610.20 |
$1,610.20 |
$1,636.00
|
|
Diabetes (HbA1c) Test
|
$77.70 |
$77.70 |
$77.70 |
$70.00
|
|
Diagnostic Mammogram (both breasts)
|
$503.35 |
$503.35 |
$503.35 |
$424.00
|
|
Diagnostic Mammogram (one breast)
|
$418.40 |
$418.40 |
$418.40 |
$297.05
|
|
ER Visit (level 1, minor)
|
$199.80 |
$199.80 |
$199.80 |
$286.51
|
|
ER Visit (level 2)
|
$248.35 |
$248.35 |
$248.35 |
$469.39
|
|
ER Visit (level 3)
|
$472.40 |
$472.40 |
$472.40 |
$827.20
|
|
ER Visit (level 4)
|
$917.80 |
$917.80 |
$917.80 |
$1,330.00
|
|
ER Visit (level 5, high severity)
|
$1,391.50 |
$1,391.50 |
$1,391.50 |
$1,892.80
|
|
Echocardiogram (Heart Ultrasound)
|
$2,336.35 |
$2,336.35 |
$2,336.35 |
$2,021.12
|
|
Established Patient Office Visit (level 1)
|
$45.85 |
$45.85 |
$45.85 |
$115.05
|
|
Established Patient Office Visit (level 2)
|
$160.60 |
$160.60 |
$160.60 |
$127.53
|
|
Established Patient Office Visit (level 3)
|
$194.40 |
$194.40 |
$194.40 |
$183.60
|
|
Established Patient Office Visit (level 4)
|
$303.75 |
$303.75 |
$303.75 |
$228.60
|
|
Established Patient Office Visit (level 5)
|
$381.95 |
$381.95 |
$381.95 |
$306.40
|
|
Foot X-ray
|
$403.55 |
$403.55 |
$403.55 |
$339.50
|
|
Hand X-ray
|
$400.85 |
$400.85 |
$400.85 |
$315.00
|
|
Head CT scan (with and without contrast)
|
$2,409.20 |
$2,409.20 |
$2,409.20 |
$1,914.25
|
|
Head CT scan (with contrast)
|
$2,073.15 |
$2,073.15 |
$2,073.15 |
$1,587.69
|
|
Head CT scan (without contrast)
|
$1,715.45 |
$1,715.45 |
$1,715.45 |
$1,268.90
|
|
Hip X-ray
|
$495.40 |
$495.40 |
$495.40 |
$290.35
|
|
Kidney (Retroperitoneal) Ultrasound (complete)
|
$781.50 |
$781.50 |
$781.50 |
$683.50
|
|
Knee MRI (with and without contrast)
|
$3,657.70 |
$3,657.70 |
$3,657.70 |
$3,008.26
|
|
Knee MRI (with contrast)
|
$2,915.35 |
$2,915.35 |
$2,915.35 |
$2,394.58
|
|
Knee MRI (without contrast)
|
$2,352.50 |
$2,352.50 |
$2,352.50 |
$2,209.22
|
|
Knee X-ray
|
$514.30 |
$514.30 |
$514.30 |
$387.20
|
|
Leg Vein Ultrasound (DVT study, both legs)
|
$1,344.30 |
$1,344.30 |
$1,344.30 |
$1,090.23
|
|
Liver Function Test
|
$159.35 |
$159.35 |
$159.35 |
$93.60
|
|
Lower Back (Lumbar Spine) CT scan (with and without contrast)
|
$2,812.75 |
$2,812.75 |
$2,812.75 |
$1,909.80
|
|
Lower Back (Lumbar Spine) CT scan (with contrast)
|
$2,254.00 |
$2,254.00 |
$2,254.00 |
$1,850.88
|
|
Lower Back (Lumbar Spine) CT scan (without contrast)
|
$1,853.10 |
$1,853.10 |
$1,853.10 |
$1,517.10
|
|
Lower Back (Lumbar Spine) MRI (with and without contrast)
|
$3,382.30 |
$3,382.30 |
$3,382.30 |
$2,750.00
|
|
Lower Back (Lumbar Spine) MRI (with contrast)
|
$2,775.00 |
$2,775.00 |
$2,775.00 |
$2,415.68
|
|
Lower Back (Lumbar Spine) MRI (without contrast)
|
$2,440.30 |
$2,440.30 |
$2,440.30 |
$2,013.08
|
|
Lower Back (Lumbar Spine) X-ray
|
$514.30 |
$514.30 |
$514.30 |
$341.64
|
|
Lung Function Test (Spirometry)
|
$224.05 |
$224.05 |
$224.05 |
$296.91
|
|
Metabolic Blood Panel (Basic)
|
$136.35 |
$136.35 |
$136.35 |
$97.60
|
|
Metabolic Blood Panel (Comprehensive)
|
$159.35 |
$159.35 |
$159.35 |
$130.97
|
|
Neck (Cervical Spine) CT scan (with and without contrast)
|
$3,109.70 |
$3,109.70 |
$3,109.70 |
$1,992.00
|
|
Neck (Cervical Spine) CT scan (with contrast)
|
$2,113.65 |
$2,113.65 |
$2,113.65 |
$1,708.20
|
|
Neck (Cervical Spine) CT scan (without contrast)
|
$1,755.90 |
$1,755.90 |
$1,755.90 |
$1,513.95
|
|
Neck (Cervical Spine) MRI (with and without contrast)
|
$2,669.70 |
$2,669.70 |
$2,669.70 |
$2,750.00
|
|
Neck (Cervical Spine) MRI (with contrast)
|
$2,775.00 |
$2,775.00 |
$2,775.00 |
$2,231.16
|
|
Neck (Cervical Spine) MRI (without contrast)
|
$2,301.25 |
$2,301.25 |
$2,301.25 |
$1,947.58
|
|
Neck MRA (blood vessel MRI, with and without contrast)
|
$5,211.25 |
$5,211.25 |
$5,211.25 |
$2,750.00
|
|
Neck MRA (blood vessel MRI, with contrast)
|
$2,931.50 |
$2,931.50 |
$2,931.50 |
$2,030.23
|
|
Neck MRA (blood vessel MRI, without contrast)
|
$2,282.40 |
$2,282.40 |
$2,282.40 |
$1,790.58
|
|
New Patient Office Visit (level 2)
|
$307.70 |
$307.70 |
$307.70 |
$178.00
|
|
New Patient Office Visit (level 3)
|
$441.30 |
$441.30 |
$441.30 |
$229.20
|
|
New Patient Office Visit (level 4)
|
$680.20 |
$680.20 |
$680.20 |
$307.00
|
|
New Patient Office Visit (level 5)
|
$857.05 |
$857.05 |
$857.05 |
$401.50
|
|
Nuclear Stress Test (Heart)
|
$3,228.40 |
$3,228.40 |
$3,228.40 |
$3,799.90
|
|
PSA (Prostate) Test
|
$152.55 |
$152.55 |
$152.55 |
$103.85
|
|
Pelvic CT scan (with and without contrast)
|
$2,604.95 |
$2,604.95 |
$2,604.95 |
$1,992.00
|
|
Pelvic CT scan (with contrast)
|
$2,055.55 |
$2,055.55 |
$2,055.55 |
$1,706.25
|
|
Pelvic CT scan (without contrast)
|
$1,732.95 |
$1,732.95 |
$1,732.95 |
$1,366.50
|
|
Pelvic MRI (with and without contrast)
|
$3,390.40 |
$3,390.40 |
$3,390.40 |
$2,713.80
|
|
Pelvic MRI (with contrast)
|
$2,630.60 |
$2,630.60 |
$2,630.60 |
$1,966.42
|
|
Pelvic MRI (without contrast)
|
$2,460.50 |
$2,460.50 |
$2,460.50 |
$1,810.38
|
|
Pelvic Ultrasound (complete)
|
$800.35 |
$800.35 |
$800.35 |
$647.87
|
|
Pelvic Ultrasound (limited)
|
$435.95 |
$435.95 |
$435.95 |
$476.50
|
|
Pregnancy Ultrasound (complete, after first trimester)
|
$558.75 |
$558.75 |
$558.75 |
$607.12
|
|
Pregnancy Ultrasound (first trimester)
|
$426.00 |
$426.00 |
$426.00 |
$592.15
|
|
Rapid Strep Test
|
$96.15 |
$96.15 |
$96.15 |
$72.00
|
|
Screening Mammogram
|
$383.30 |
$383.30 |
$383.30 |
$331.50
|
|
Shoulder MRI (with and without contrast)
|
$3,559.15 |
$3,559.15 |
$3,559.15 |
$2,650.10
|
|
Shoulder MRI (with contrast)
|
$2,959.85 |
$2,959.85 |
$2,959.85 |
$2,822.25
|
|
Shoulder MRI (without contrast)
|
$2,361.95 |
$2,361.95 |
$2,361.95 |
$1,938.28
|
|
Shoulder X-ray
|
$425.20 |
$425.20 |
$425.20 |
$307.20
|
|
Sinus CT scan (with and without contrast)
|
$2,598.20 |
$2,598.20 |
$2,598.20 |
$1,871.00
|
|
Sinus CT scan (with contrast)
|
$1,893.70 |
$1,893.70 |
$1,893.70 |
$1,566.40
|
|
Sinus CT scan (without contrast)
|
$1,544.10 |
$1,544.10 |
$1,544.10 |
$1,275.30
|
|
Skin Biopsy
|
$214.60 |
$214.60 |
$214.60 |
$381.60
|
|
Sleep Study (Polysomnography)
|
$3,829.05 |
$3,829.05 |
$3,829.05 |
$4,141.16
|
|
Thyroid (TSH) Test
|
$191.65 |
$191.65 |
$191.65 |
$110.00
|
|
Thyroid Ultrasound
|
$727.50 |
$727.50 |
$727.50 |
$603.90
|
|
Upper Back (Thoracic Spine) MRI (with and without contrast)
|
$3,186.60 |
$3,186.60 |
$3,186.60 |
$2,713.80
|
|
Upper Back (Thoracic Spine) MRI (with contrast)
|
$2,775.00 |
$2,775.00 |
$2,775.00 |
$2,039.85
|
|
Upper Back (Thoracic Spine) MRI (without contrast)
|
$2,438.90 |
$2,438.90 |
$2,438.90 |
$2,013.08
|
|
Urinalysis (with microscopy)
|
$35.05 |
$35.05 |
$35.05 |
$36.52
|
|
Urinalysis (without microscopy)
|
$21.55 |
$21.55 |
$21.55 |
$32.50
|
|
Urine Culture Test
|
$206.55 |
$206.55 |
$206.55 |
$65.25
|
|
Vitamin D Test
|
$206.45 |
$206.45 |
$206.45 |
$145.80
|
|
Wrist X-ray
|
$406.20 |
$406.20 |
$406.20 |
$311.20
|