|
Abdominal CT scan (with and without contrast)
|
$194.55 |
$197.04 |
$209.65 |
|
|
Abdominal CT scan (with contrast)
|
$194.55 |
$197.04 |
$209.65 |
|
|
Abdominal CT scan (without contrast)
|
$116.22 |
$117.70 |
$125.23 |
|
|
Abdominal MRI (with and without contrast)
|
$390.30 |
$395.29 |
$420.58 |
|
|
Abdominal MRI (with contrast)
|
$390.30 |
$395.29 |
$420.58 |
|
|
Abdominal MRI (without contrast)
|
$264.17 |
$267.55 |
$284.66 |
|
|
Abdominal Ultrasound (complete)
|
$116.22 |
$117.70 |
$125.23 |
|
|
Abdominal Ultrasound (limited)
|
$116.22 |
$117.70 |
$125.23 |
|
|
Allergy Skin Testing
|
$1,111.89 |
$1,126.11 |
$1,198.14 |
|
|
Ankle X-ray
|
$96.23 |
$97.46 |
$253.20 |
|
|
Appendix Removal (Laparoscopic)
|
$6,376.26 |
$6,457.82 |
$6,870.89 |
|
|
Blood Clotting (PT/INR) Test
|
$4.29 |
$4.29 |
$38.80 |
|
|
Blood Clotting (PTT) Test
|
$6.01 |
$6.01 |
$6.01 |
|
|
Blood Count (CBC) Test
|
$7.77 |
$7.77 |
$59.60 |
|
|
Blood Count (CBC) Test (without differential)
|
$6.47 |
$6.47 |
$42.40 |
|
|
Blood Culture Test
|
$10.32 |
$10.32 |
$91.60 |
|
|
Bone Density Scan (DEXA)
|
$116.22 |
$117.70 |
$125.23 |
|
|
Brain MRA (blood vessel MRI, with and without contrast)
|
$390.30 |
$395.29 |
$420.58 |
|
|
Brain MRA (blood vessel MRI, with contrast)
|
$390.30 |
$395.29 |
$420.58 |
|
|
Brain MRA (blood vessel MRI, without contrast)
|
$264.17 |
$267.55 |
$284.66 |
|
|
Brain MRI (with and without contrast)
|
$390.30 |
$395.29 |
$420.58 |
|
|
Brain MRI (with contrast)
|
$390.30 |
$395.29 |
$420.58 |
|
|
Brain MRI (without contrast)
|
$264.17 |
$267.55 |
$284.66 |
|
|
Breast Biopsy (ultrasound-guided, percutaneous)
|
$1,770.73 |
$1,793.38 |
$1,908.09 |
|
|
CT Angiogram of Abdomen and Pelvis
|
$390.30 |
$395.29 |
$420.58 |
|
|
CT Angiogram of the Chest (for blood clot)
|
$194.55 |
$197.04 |
$209.65 |
|
|
CT Angiogram of the Head
|
$194.55 |
$197.04 |
$209.65 |
|
|
CT Scan of Abdomen and Pelvis (with and without contrast)
|
$390.30 |
$395.29 |
$420.58 |
|
|
CT Scan of Abdomen and Pelvis (with contrast)
|
$390.30 |
$395.29 |
$420.58 |
|
|
CT Scan of Abdomen and Pelvis (without contrast)
|
$264.17 |
$267.55 |
$284.66 |
|
|
Carotid Artery Ultrasound (Duplex)
|
$264.17 |
$267.55 |
$284.66 |
|
|
Carpal Tunnel Release Surgery
|
$2,134.14 |
$2,161.44 |
$2,299.70 |
|
|
Cataract Surgery
|
$2,492.56 |
$2,524.45 |
$2,685.92 |
|
|
Chest CT scan (with and without contrast)
|
$194.55 |
$197.04 |
$209.65 |
|
|
Chest CT scan (with contrast)
|
$194.55 |
$197.04 |
$209.65 |
|
|
Chest CT scan (without contrast)
|
$116.22 |
$117.70 |
$125.23 |
|
|
Chest X-ray
|
$96.23 |
$97.46 |
$198.80 |
|
|
Chest X-ray (single view)
|
$96.23 |
$97.46 |
$171.60 |
|
|
Cholesterol (Lipid) Test
|
$13.39 |
$13.39 |
$102.00 |
|
|
Circumcision (newborn)
|
$2,238.78 |
$2,267.41 |
$2,412.45 |
|
|
Colonoscopy (diagnostic)
|
$996.39 |
$1,009.14 |
$1,073.68 |
|
|
Colonoscopy (with biopsy)
|
$1,288.59 |
$1,305.08 |
$1,388.56 |
|
|
Colonoscopy (with polyp removal)
|
$1,288.59 |
$1,305.08 |
$1,388.56 |
|
|
Cystoscopy (Bladder Scope)
|
$729.46 |
$738.80 |
$786.05 |
|
|
Diabetes (HbA1c) Test
|
$9.71 |
$9.71 |
$22.00 |
|
|
Diagnostic Mammogram (both breasts)
|
$207.95 |
$207.95 |
$207.95 |
|
|
Diagnostic Mammogram (one breast)
|
$164.52 |
$164.52 |
$164.52 |
|
|
ER Visit (level 1, minor)
|
$96.23 |
$97.46 |
$103.69 |
|
|
ER Visit (level 2)
|
$173.07 |
$175.28 |
$186.49 |
|
|
ER Visit (level 3)
|
$302.61 |
$306.48 |
$326.08 |
|
|
ER Visit (level 4)
|
$465.37 |
$471.32 |
$501.47 |
|
|
ER Visit (level 5, high severity)
|
$670.04 |
$678.62 |
$722.02 |
|
|
Echocardiogram (Heart Ultrasound)
|
$599.23 |
$606.89 |
$645.71 |
|
|
Established Patient Office Visit (level 4)
|
$198.00 |
$198.00 |
$198.00 |
|
|
Flexible Sigmoidoscopy
|
$996.39 |
$1,009.14 |
$1,073.68 |
|
|
Foot X-ray
|
$96.23 |
$97.46 |
$259.60 |
|
|
Gallbladder Removal (Laparoscopic)
|
$6,376.26 |
$6,457.82 |
$6,870.89 |
|
|
Hand X-ray
|
$96.23 |
$97.46 |
$220.00 |
|
|
Head CT scan (with and without contrast)
|
$194.55 |
$197.04 |
$209.65 |
|
|
Head CT scan (with contrast)
|
$194.55 |
$197.04 |
$209.65 |
|
|
Head CT scan (without contrast)
|
$116.22 |
$117.70 |
$125.23 |
|
|
Hernia Repair (Inguinal)
|
$3,856.84 |
$3,906.18 |
$4,156.03 |
|
|
Hip X-ray
|
$96.23 |
$97.46 |
$189.20 |
|
|
Kidney (Retroperitoneal) Ultrasound (complete)
|
$116.22 |
$117.70 |
$125.23 |
|
|
Knee Arthroscopy (Cartilage Repair)
|
$3,545.97 |
$3,591.33 |
$3,821.05 |
|
|
Knee Arthroscopy (Meniscus Repair)
|
$3,545.97 |
$3,591.33 |
$3,821.05 |
|
|
Knee MRI (with and without contrast)
|
$390.30 |
$395.29 |
$420.58 |
|
|
Knee MRI (with contrast)
|
$863.44 |
$874.49 |
$930.42 |
|
|
Knee MRI (without contrast)
|
$264.17 |
$267.55 |
$284.66 |
|
|
Knee X-ray
|
$116.22 |
$117.70 |
$323.60 |
|
|
Leg Vein Ultrasound (DVT study, both legs)
|
$264.17 |
$267.55 |
$284.66 |
|
|
Liver Function Test
|
$8.17 |
$8.17 |
$66.80 |
|
|
Lower Back (Lumbar Spine) CT scan (with and without contrast)
|
$194.55 |
$197.04 |
$209.65 |
|
|
Lower Back (Lumbar Spine) CT scan (with contrast)
|
$390.30 |
$395.29 |
$420.58 |
|
|
Lower Back (Lumbar Spine) CT scan (without contrast)
|
$116.22 |
$117.70 |
$125.23 |
|
|
Lower Back (Lumbar Spine) MRI (with and without contrast)
|
$390.30 |
$395.29 |
$420.58 |
|
|
Lower Back (Lumbar Spine) MRI (with contrast)
|
$390.30 |
$395.29 |
$420.58 |
|
|
Lower Back (Lumbar Spine) MRI (without contrast)
|
$264.17 |
$267.55 |
$284.66 |
|
|
Lower Back (Lumbar Spine) X-ray
|
$116.22 |
$117.70 |
$125.23 |
|
|
Lumbar Spinal Fusion (single level)
|
$20,098.12 |
$20,355.21 |
$21,657.23 |
|
|
Lung Function Test (Spirometry)
|
$170.99 |
$173.18 |
$184.26 |
|
|
Metabolic Blood Panel (Basic)
|
$8.46 |
$8.46 |
$74.80 |
|
|
Metabolic Blood Panel (Comprehensive)
|
$10.56 |
$10.56 |
$136.40 |
|
|
Neck (Cervical Spine) CT scan (with and without contrast)
|
$194.55 |
$197.04 |
$209.65 |
|
|
Neck (Cervical Spine) CT scan (with contrast)
|
$390.30 |
$395.29 |
$420.58 |
|
|
Neck (Cervical Spine) CT scan (without contrast)
|
$116.22 |
$117.70 |
$125.23 |
|
|
Neck (Cervical Spine) MRI (with and without contrast)
|
$390.30 |
$395.29 |
$420.58 |
|
|
Neck (Cervical Spine) MRI (with contrast)
|
$390.30 |
$395.29 |
$420.58 |
|
|
Neck (Cervical Spine) MRI (without contrast)
|
$264.17 |
$267.55 |
$284.66 |
|
|
Neck MRA (blood vessel MRI, with and without contrast)
|
$390.30 |
$395.29 |
$420.58 |
|
|
Neck MRA (blood vessel MRI, with contrast)
|
$390.30 |
$395.29 |
$420.58 |
|
|
Neck MRA (blood vessel MRI, without contrast)
|
$264.17 |
$267.55 |
$284.66 |
|
|
New Patient Office Visit (level 3)
|
$209.20 |
$209.20 |
$209.20 |
|
|
Nuclear Stress Test (Heart)
|
$1,426.73 |
$1,444.98 |
$1,537.41 |
|
|
PSA (Prostate) Test
|
$18.39 |
$18.39 |
$131.20 |
|
|
Pelvic CT scan (with and without contrast)
|
$194.55 |
$197.04 |
$209.65 |
|
|
Pelvic CT scan (with contrast)
|
$194.55 |
$197.04 |
$209.65 |
|
|
Pelvic CT scan (without contrast)
|
$116.22 |
$117.70 |
$125.23 |
|
|
Pelvic MRI (with and without contrast)
|
$390.30 |
$395.29 |
$420.58 |
|
|
Pelvic MRI (with contrast)
|
$390.30 |
$395.29 |
$420.58 |
|
|
Pelvic MRI (without contrast)
|
$264.17 |
$267.55 |
$284.66 |
|
|
Pelvic Ultrasound (complete)
|
$116.22 |
$117.70 |
$125.23 |
|
|
Pelvic Ultrasound (limited)
|
$116.22 |
$117.70 |
$125.23 |
|
|
Pregnancy Ultrasound (complete, after first trimester)
|
$116.22 |
$117.70 |
$125.23 |
|
|
Pregnancy Ultrasound (first trimester)
|
$116.22 |
$117.70 |
$125.23 |
|
|
Rapid Strep Test
|
$16.53 |
$16.53 |
$33.20 |
|
|
Screening Colonoscopy (average risk)
|
$996.39 |
$1,009.14 |
$1,073.68 |
|
|
Screening Colonoscopy (high risk)
|
$996.39 |
$1,009.14 |
$1,073.68 |
|
|
Screening Mammogram
|
$169.06 |
$169.06 |
$169.06 |
|
|
Shoulder Arthroscopy (Rotator Cuff Repair)
|
$7,807.24 |
$7,907.11 |
$8,412.89 |
|
|
Shoulder MRI (with and without contrast)
|
$390.30 |
$395.29 |
$420.58 |
|
|
Shoulder MRI (with contrast)
|
$863.44 |
$874.49 |
$930.42 |
|
|
Shoulder MRI (without contrast)
|
$264.17 |
$267.55 |
$284.66 |
|
|
Shoulder X-ray
|
$96.23 |
$97.46 |
$275.20 |
|
|
Sinus CT scan (with and without contrast)
|
$194.55 |
$197.04 |
$209.65 |
|
|
Sinus CT scan (with contrast)
|
$194.55 |
$197.04 |
$209.65 |
|
|
Sinus CT scan (without contrast)
|
$116.22 |
$117.70 |
$125.23 |
|
|
Skin Biopsy
|
$217.16 |
$219.93 |
$234.00 |
|
|
Sleep Study (Polysomnography)
|
$1,111.89 |
$1,126.11 |
$1,198.14 |
|
|
Thyroid (TSH) Test
|
$16.80 |
$16.80 |
$106.40 |
|
|
Thyroid Ultrasound
|
$116.22 |
$117.70 |
$125.23 |
|
|
Tonsillectomy (age 12+)
|
$3,544.29 |
$3,589.62 |
$3,819.23 |
|
|
Tonsillectomy (child under 12)
|
$6,465.11 |
$6,547.81 |
$6,966.64 |
|
|
Total Hip Replacement
|
$14,061.89 |
$14,241.77 |
$15,152.74 |
|
|
Total Knee Replacement
|
$14,061.89 |
$14,241.77 |
$15,152.74 |
|
|
Tubal Ligation (Laparoscopic)
|
$6,376.26 |
$6,457.82 |
$6,870.89 |
|
|
Upper Back (Thoracic Spine) MRI (with and without contrast)
|
$390.30 |
$395.29 |
$420.58 |
|
|
Upper Back (Thoracic Spine) MRI (with contrast)
|
$390.30 |
$395.29 |
$420.58 |
|
|
Upper Back (Thoracic Spine) MRI (without contrast)
|
$264.17 |
$267.55 |
$284.66 |
|
|
Upper Endoscopy (EGD, diagnostic)
|
$1,024.64 |
$1,037.75 |
$1,104.13 |
|
|
Upper Endoscopy (EGD, with biopsy)
|
$1,024.64 |
$1,037.75 |
$1,104.13 |
|
|
Urinalysis (with microscopy)
|
$3.17 |
$3.17 |
$42.80 |
|
|
Urinalysis (without microscopy)
|
$2.25 |
$2.25 |
$32.00 |
|
|
Urine Culture Test
|
$8.07 |
$8.07 |
$57.20 |
|
|
Vasectomy
|
$2,238.78 |
$2,267.41 |
$2,412.45 |
|
|
Vitamin D Test
|
$29.60 |
$29.60 |
$180.00 |
|
|
Wrist X-ray
|
$96.23 |
$97.46 |
$240.00 |
|