|
Abdominal CT scan (with and without contrast)
|
$1,819.80 |
$1,819.80 |
$1,819.80 |
$2,049.00
|
|
Abdominal CT scan (with contrast)
|
$1,565.40 |
$1,565.40 |
$1,565.40 |
$1,683.63
|
|
Abdominal CT scan (without contrast)
|
$1,187.40 |
$1,187.40 |
$1,187.40 |
$1,358.76
|
|
Abdominal MRI (with and without contrast)
|
$2,946.00 |
$2,946.00 |
$2,946.00 |
$3,061.80
|
|
Abdominal MRI (with contrast)
|
$2,535.00 |
$2,535.00 |
$2,535.00 |
$2,077.14
|
|
Abdominal MRI (without contrast)
|
$1,855.80 |
$1,855.80 |
$1,855.80 |
$1,902.00
|
|
Abdominal Ultrasound (complete)
|
$912.00 |
$912.00 |
$912.00 |
$755.00
|
|
Abdominal Ultrasound (limited)
|
$703.20 |
$703.20 |
$703.20 |
$629.42
|
|
Ankle X-ray
|
$258.00 |
$258.00 |
$258.00 |
$312.74
|
|
Blood Clotting (PT/INR) Test
|
$15.60 |
$15.60 |
$15.60 |
$45.00
|
|
Blood Clotting (PTT) Test
|
$25.80 |
$25.80 |
$25.80 |
$65.00
|
|
Blood Count (CBC) Test
|
$31.80 |
$31.80 |
$31.80 |
$67.20
|
|
Blood Count (CBC) Test (without differential)
|
$28.20 |
$28.20 |
$28.20 |
$56.55
|
|
Blood Culture Test
|
$64.80 |
$64.80 |
$64.80 |
$112.20
|
|
Bone Density Scan (DEXA)
|
$240.00 |
$240.00 |
$240.00 |
$398.56
|
|
Brain MRA (blood vessel MRI, with and without contrast)
|
$1,596.60 |
$1,596.60 |
$1,596.60 |
$2,604.00
|
|
Brain MRA (blood vessel MRI, without contrast)
|
$1,037.40 |
$1,037.40 |
$1,037.40 |
$1,790.00
|
|
Brain MRI (with and without contrast)
|
$2,584.20 |
$2,584.20 |
$2,584.20 |
$2,884.20
|
|
Brain MRI (with contrast)
|
$2,119.20 |
$2,119.20 |
$2,119.20 |
$2,224.96
|
|
Brain MRI (without contrast)
|
$1,911.60 |
$1,911.60 |
$1,911.60 |
$1,825.59
|
|
Breast Biopsy (ultrasound-guided, percutaneous)
|
$3,146.40 |
$3,146.40 |
$3,146.40 |
$3,092.06
|
|
CT Angiogram of Abdomen and Pelvis
|
$2,169.00 |
$2,169.00 |
$2,169.00 |
$2,839.85
|
|
CT Angiogram of the Chest (for blood clot)
|
$1,942.80 |
$1,942.80 |
$1,942.80 |
$2,094.23
|
|
CT Angiogram of the Head
|
$653.40 |
$653.40 |
$653.40 |
$2,094.23
|
|
CT Scan of Abdomen and Pelvis (with and without contrast)
|
$3,337.20 |
$3,337.20 |
$3,337.20 |
$3,669.25
|
|
CT Scan of Abdomen and Pelvis (with contrast)
|
$2,754.60 |
$2,754.60 |
$2,754.60 |
$3,217.18
|
|
CT Scan of Abdomen and Pelvis (without contrast)
|
$2,161.80 |
$2,161.80 |
$2,161.80 |
$2,418.75
|
|
Carotid Artery Ultrasound (Duplex)
|
$598.20 |
$598.20 |
$598.20 |
$1,059.82
|
|
Chest CT scan (with and without contrast)
|
$1,207.20 |
$1,207.20 |
$1,207.20 |
$2,105.40
|
|
Chest CT scan (with contrast)
|
$989.40 |
$989.40 |
$989.40 |
$1,697.25
|
|
Chest CT scan (without contrast)
|
$802.20 |
$802.20 |
$802.20 |
$1,350.03
|
|
Chest X-ray
|
$215.40 |
$215.40 |
$215.40 |
$303.24
|
|
Chest X-ray (single view)
|
$215.40 |
$215.40 |
$215.40 |
$225.00
|
|
Cholesterol (Lipid) Test
|
$75.60 |
$75.60 |
$75.60 |
$100.00
|
|
Colonoscopy (diagnostic)
|
$1,500.00 |
$1,500.00 |
$1,500.00 |
$1,500.00
|
|
Colonoscopy (with biopsy)
|
$2,476.20 |
$2,476.20 |
$2,476.20 |
$1,846.40
|
|
Colonoscopy (with polyp removal)
|
$2,476.20 |
$2,476.20 |
$2,476.20 |
$1,958.40
|
|
Diabetes (HbA1c) Test
|
$31.20 |
$31.20 |
$31.20 |
$69.55
|
|
Diagnostic Mammogram (both breasts)
|
$306.00 |
$306.00 |
$306.00 |
$424.00
|
|
Diagnostic Mammogram (one breast)
|
$175.80 |
$175.80 |
$175.80 |
$297.05
|
|
ER Visit (level 1, minor)
|
$57.60 |
$57.60 |
$57.60 |
$286.94
|
|
ER Visit (level 2)
|
$226.20 |
$226.20 |
$226.20 |
$469.39
|
|
ER Visit (level 3)
|
$385.80 |
$385.80 |
$385.80 |
$836.00
|
|
ER Visit (level 4)
|
$605.40 |
$605.40 |
$605.40 |
$1,330.12
|
|
ER Visit (level 5, high severity)
|
$888.60 |
$888.60 |
$888.60 |
$1,892.80
|
|
Echocardiogram (Heart Ultrasound)
|
$1,876.20 |
$1,876.20 |
$1,876.20 |
$2,024.64
|
|
Established Patient Office Visit (level 1)
|
$141.00 |
$141.00 |
$141.00 |
$115.05
|
|
Established Patient Office Visit (level 2)
|
$189.00 |
$189.00 |
$189.00 |
$127.53
|
|
Established Patient Office Visit (level 3)
|
$216.00 |
$216.00 |
$216.00 |
$183.60
|
|
Established Patient Office Visit (level 4)
|
$250.80 |
$250.80 |
$250.80 |
$228.60
|
|
Established Patient Office Visit (level 5)
|
$268.80 |
$268.80 |
$268.80 |
$306.40
|
|
Flexible Sigmoidoscopy
|
$598.20 |
$598.20 |
$598.20 |
$1,158.00
|
|
Foot X-ray
|
$327.00 |
$327.00 |
$327.00 |
$339.50
|
|
Hand X-ray
|
$315.00 |
$315.00 |
$315.00 |
$315.00
|
|
Head CT scan (with and without contrast)
|
$885.60 |
$885.60 |
$885.60 |
$1,914.25
|
|
Head CT scan (with contrast)
|
$828.60 |
$828.60 |
$828.60 |
$1,587.69
|
|
Head CT scan (without contrast)
|
$632.40 |
$632.40 |
$632.40 |
$1,268.90
|
|
Hip X-ray
|
$122.40 |
$122.40 |
$122.40 |
$290.00
|
|
Kidney (Retroperitoneal) Ultrasound (complete)
|
$352.20 |
$352.20 |
$352.20 |
$683.50
|
|
Knee MRI (with and without contrast)
|
$3,802.20 |
$3,802.20 |
$3,802.20 |
$3,008.26
|
|
Knee MRI (with contrast)
|
$3,019.80 |
$3,019.80 |
$3,019.80 |
$2,394.58
|
|
Knee MRI (without contrast)
|
$2,796.00 |
$2,796.00 |
$2,796.00 |
$2,205.00
|
|
Knee X-ray
|
$289.20 |
$289.20 |
$289.20 |
$388.44
|
|
Leg Vein Ultrasound (DVT study, both legs)
|
$436.80 |
$436.80 |
$436.80 |
$1,090.23
|
|
Liver Function Test
|
$87.60 |
$87.60 |
$87.60 |
$93.60
|
|
Lower Back (Lumbar Spine) CT scan (with and without contrast)
|
$1,124.40 |
$1,124.40 |
$1,124.40 |
$1,909.80
|
|
Lower Back (Lumbar Spine) CT scan (with contrast)
|
$930.00 |
$930.00 |
$930.00 |
$1,829.25
|
|
Lower Back (Lumbar Spine) CT scan (without contrast)
|
$750.00 |
$750.00 |
$750.00 |
$1,517.10
|
|
Lower Back (Lumbar Spine) MRI (with and without contrast)
|
$2,946.00 |
$2,946.00 |
$2,946.00 |
$2,713.80
|
|
Lower Back (Lumbar Spine) MRI (with contrast)
|
$1,884.60 |
$1,884.60 |
$1,884.60 |
$2,415.68
|
|
Lower Back (Lumbar Spine) MRI (without contrast)
|
$1,519.80 |
$1,519.80 |
$1,519.80 |
$2,013.08
|
|
Lower Back (Lumbar Spine) X-ray
|
$215.40 |
$215.40 |
$215.40 |
$341.64
|
|
Lung Function Test (Spirometry)
|
$1,249.20 |
$1,249.20 |
$1,249.20 |
$296.91
|
|
Metabolic Blood Panel (Basic)
|
$80.40 |
$80.40 |
$80.40 |
$97.60
|
|
Metabolic Blood Panel (Comprehensive)
|
$124.20 |
$124.20 |
$124.20 |
$135.20
|
|
Neck (Cervical Spine) CT scan (with and without contrast)
|
$1,858.80 |
$1,858.80 |
$1,858.80 |
$1,992.00
|
|
Neck (Cervical Spine) CT scan (with contrast)
|
$1,543.20 |
$1,543.20 |
$1,543.20 |
$1,708.20
|
|
Neck (Cervical Spine) CT scan (without contrast)
|
$1,263.00 |
$1,263.00 |
$1,263.00 |
$1,513.95
|
|
Neck (Cervical Spine) MRI (with and without contrast)
|
$2,946.00 |
$2,946.00 |
$2,946.00 |
$2,750.00
|
|
Neck (Cervical Spine) MRI (with contrast)
|
$1,929.60 |
$1,929.60 |
$1,929.60 |
$2,231.16
|
|
Neck (Cervical Spine) MRI (without contrast)
|
$1,519.80 |
$1,519.80 |
$1,519.80 |
$1,914.00
|
|
Neck MRA (blood vessel MRI, with and without contrast)
|
$1,763.40 |
$1,763.40 |
$1,763.40 |
$2,750.00
|
|
Neck MRA (blood vessel MRI, without contrast)
|
$1,146.00 |
$1,146.00 |
$1,146.00 |
$1,790.58
|
|
New Patient Office Visit (level 2)
|
$260.40 |
$260.40 |
$260.40 |
$178.00
|
|
New Patient Office Visit (level 3)
|
$338.40 |
$338.40 |
$338.40 |
$229.20
|
|
New Patient Office Visit (level 4)
|
$433.80 |
$433.80 |
$433.80 |
$307.00
|
|
New Patient Office Visit (level 5)
|
$526.20 |
$526.20 |
$526.20 |
$401.50
|
|
Nuclear Stress Test (Heart)
|
$2,604.60 |
$2,604.60 |
$2,604.60 |
$3,842.40
|
|
PSA (Prostate) Test
|
$117.00 |
$117.00 |
$117.00 |
$103.85
|
|
Pelvic CT scan (with and without contrast)
|
$1,519.20 |
$1,519.20 |
$1,519.20 |
$1,992.00
|
|
Pelvic CT scan (with contrast)
|
$1,188.60 |
$1,188.60 |
$1,188.60 |
$1,706.25
|
|
Pelvic CT scan (without contrast)
|
$975.00 |
$975.00 |
$975.00 |
$1,313.40
|
|
Pelvic MRI (with and without contrast)
|
$1,659.60 |
$1,659.60 |
$1,659.60 |
$2,713.80
|
|
Pelvic MRI (with contrast)
|
$1,311.00 |
$1,311.00 |
$1,311.00 |
$1,966.42
|
|
Pelvic MRI (without contrast)
|
$1,177.80 |
$1,177.80 |
$1,177.80 |
$1,810.38
|
|
Pelvic Ultrasound (complete)
|
$394.80 |
$394.80 |
$394.80 |
$647.87
|
|
Pelvic Ultrasound (limited)
|
$312.00 |
$312.00 |
$312.00 |
$476.50
|
|
Pregnancy Ultrasound (complete, after first trimester)
|
$242.40 |
$242.40 |
$242.40 |
$607.12
|
|
Pregnancy Ultrasound (first trimester)
|
$242.40 |
$242.40 |
$242.40 |
$580.03
|
|
Rapid Strep Test
|
$63.60 |
$63.60 |
$63.60 |
$72.00
|
|
Screening Mammogram
|
$205.20 |
$205.20 |
$205.20 |
$331.50
|
|
Shoulder MRI (with and without contrast)
|
$3,830.40 |
$3,830.40 |
$3,830.40 |
$2,650.10
|
|
Shoulder MRI (with contrast)
|
$3,155.40 |
$3,155.40 |
$3,155.40 |
$2,822.25
|
|
Shoulder MRI (without contrast)
|
$2,920.80 |
$2,920.80 |
$2,920.80 |
$1,938.28
|
|
Shoulder X-ray
|
$215.40 |
$215.40 |
$215.40 |
$307.20
|
|
Sinus CT scan (with and without contrast)
|
$898.20 |
$898.20 |
$898.20 |
$1,871.00
|
|
Sinus CT scan (with contrast)
|
$739.20 |
$739.20 |
$739.20 |
$1,566.40
|
|
Sinus CT scan (without contrast)
|
$616.20 |
$616.20 |
$616.20 |
$1,275.30
|
|
Thyroid (TSH) Test
|
$60.00 |
$60.00 |
$60.00 |
$110.00
|
|
Thyroid Ultrasound
|
$761.40 |
$761.40 |
$761.40 |
$603.90
|
|
Upper Back (Thoracic Spine) MRI (with and without contrast)
|
$2,946.00 |
$2,946.00 |
$2,946.00 |
$2,713.80
|
|
Upper Back (Thoracic Spine) MRI (with contrast)
|
$3,130.80 |
$3,130.80 |
$3,130.80 |
$2,039.85
|
|
Upper Back (Thoracic Spine) MRI (without contrast)
|
$2,796.00 |
$2,796.00 |
$2,796.00 |
$2,013.08
|
|
Upper Endoscopy (EGD, diagnostic)
|
$1,872.60 |
$1,872.60 |
$1,872.60 |
$1,751.66
|
|
Upper Endoscopy (EGD, with biopsy)
|
$1,318.20 |
$1,318.20 |
$1,318.20 |
$1,675.80
|
|
Urinalysis (with microscopy)
|
$27.60 |
$27.60 |
$27.60 |
$36.66
|
|
Urinalysis (without microscopy)
|
$24.60 |
$24.60 |
$24.60 |
$32.50
|
|
Urine Culture Test
|
$54.60 |
$54.60 |
$54.60 |
$65.15
|
|
Vitamin D Test
|
$100.20 |
$100.20 |
$100.20 |
$142.35
|
|
Wrist X-ray
|
$322.20 |
$322.20 |
$322.20 |
$311.20
|