|
Abdominal CT scan (with and without contrast)
|
$3,160.00 |
$3,160.00 |
$3,160.00 |
$2,049.00
|
|
Abdominal CT scan (with contrast)
|
$2,553.60 |
$2,553.60 |
$2,553.60 |
$1,683.63
|
|
Abdominal CT scan (without contrast)
|
$2,429.60 |
$2,429.60 |
$2,429.60 |
$1,358.76
|
|
Abdominal MRI (with and without contrast)
|
$3,937.60 |
$3,937.60 |
$3,937.60 |
$3,061.80
|
|
Abdominal MRI (without contrast)
|
$2,902.40 |
$2,902.40 |
$2,902.40 |
$1,902.00
|
|
Abdominal Ultrasound (complete)
|
$952.80 |
$952.80 |
$952.80 |
$755.00
|
|
Abdominal Ultrasound (limited)
|
$741.60 |
$741.60 |
$741.60 |
$629.42
|
|
Ankle X-ray
|
$380.00 |
$380.00 |
$380.00 |
$312.74
|
|
Bone Density Scan (DEXA)
|
$491.20 |
$491.20 |
$491.20 |
$398.56
|
|
Brain MRA (blood vessel MRI, with and without contrast)
|
$3,681.60 |
$3,681.60 |
$3,681.60 |
$2,650.00
|
|
Brain MRA (blood vessel MRI, with contrast)
|
$2,950.40 |
$2,950.40 |
$2,950.40 |
$1,998.00
|
|
Brain MRA (blood vessel MRI, without contrast)
|
$2,590.40 |
$2,590.40 |
$2,590.40 |
$1,802.40
|
|
Brain MRI (with and without contrast)
|
$3,904.80 |
$3,904.80 |
$3,904.80 |
$2,919.75
|
|
Brain MRI (with contrast)
|
$3,315.20 |
$3,315.20 |
$3,315.20 |
$2,224.96
|
|
Brain MRI (without contrast)
|
$2,930.40 |
$2,930.40 |
$2,930.40 |
$1,830.00
|
|
Breast Biopsy (ultrasound-guided, percutaneous)
|
$3,278.40 |
$3,278.40 |
$3,278.40 |
$3,069.25
|
|
CT Angiogram of Abdomen and Pelvis
|
$4,349.60 |
$4,349.60 |
$4,349.60 |
$2,839.85
|
|
CT Angiogram of the Chest (for blood clot)
|
$2,884.00 |
$2,884.00 |
$2,884.00 |
$2,094.23
|
|
CT Angiogram of the Head
|
$3,008.00 |
$3,008.00 |
$3,008.00 |
$2,094.23
|
|
CT Scan of Abdomen and Pelvis (with and without contrast)
|
$4,808.00 |
$4,808.00 |
$4,808.00 |
$3,669.25
|
|
CT Scan of Abdomen and Pelvis (with contrast)
|
$4,120.00 |
$4,120.00 |
$4,120.00 |
$3,217.18
|
|
CT Scan of Abdomen and Pelvis (without contrast)
|
$4,120.00 |
$4,120.00 |
$4,120.00 |
$2,418.75
|
|
Carotid Artery Ultrasound (Duplex)
|
$1,155.20 |
$1,155.20 |
$1,155.20 |
$1,059.82
|
|
Chest CT scan (with and without contrast)
|
$2,920.80 |
$2,920.80 |
$2,920.80 |
$2,105.40
|
|
Chest CT scan (with contrast)
|
$2,472.00 |
$2,472.00 |
$2,472.00 |
$1,697.25
|
|
Chest CT scan (without contrast)
|
$2,060.00 |
$2,060.00 |
$2,060.00 |
$1,350.03
|
|
Chest X-ray
|
$332.80 |
$332.80 |
$332.80 |
$303.24
|
|
Chest X-ray (single view)
|
$288.80 |
$288.80 |
$288.80 |
$225.00
|
|
Circumcision (newborn)
|
$2,354.40 |
$2,354.40 |
$2,354.40 |
$1,549.50
|
|
ER Visit (level 1, minor)
|
$309.60 |
$309.60 |
$309.60 |
$286.51
|
|
ER Visit (level 2)
|
$510.40 |
$510.40 |
$510.40 |
$469.39
|
|
ER Visit (level 3)
|
$712.00 |
$712.00 |
$712.00 |
$827.20
|
|
ER Visit (level 4)
|
$984.80 |
$984.80 |
$984.80 |
$1,330.00
|
|
ER Visit (level 5, high severity)
|
$1,569.60 |
$1,569.60 |
$1,569.60 |
$1,892.80
|
|
Echocardiogram (Heart Ultrasound)
|
$2,229.60 |
$2,229.60 |
$2,229.60 |
$2,021.12
|
|
Established Patient Office Visit (level 1)
|
$92.80 |
$92.80 |
$92.80 |
$115.05
|
|
Established Patient Office Visit (level 2)
|
$125.60 |
$125.60 |
$125.60 |
$127.53
|
|
Established Patient Office Visit (level 3)
|
$168.00 |
$168.00 |
$168.00 |
$183.60
|
|
Established Patient Office Visit (level 4)
|
$234.40 |
$234.40 |
$234.40 |
$228.60
|
|
Established Patient Office Visit (level 5)
|
$306.40 |
$306.40 |
$306.40 |
$306.40
|
|
Foot X-ray
|
$380.00 |
$380.00 |
$380.00 |
$339.50
|
|
Hand X-ray
|
$252.00 |
$252.00 |
$252.00 |
$315.00
|
|
Head CT scan (with and without contrast)
|
$2,427.20 |
$2,427.20 |
$2,427.20 |
$1,914.25
|
|
Head CT scan (with contrast)
|
$2,151.20 |
$2,151.20 |
$2,151.20 |
$1,587.69
|
|
Head CT scan (without contrast)
|
$1,977.60 |
$1,977.60 |
$1,977.60 |
$1,268.90
|
|
Hip X-ray
|
$339.20 |
$339.20 |
$339.20 |
$290.35
|
|
Kidney (Retroperitoneal) Ultrasound (complete)
|
$854.40 |
$854.40 |
$854.40 |
$683.50
|
|
Knee MRI (with and without contrast)
|
$3,904.80 |
$3,904.80 |
$3,904.80 |
$3,008.26
|
|
Knee MRI (with contrast)
|
$3,223.20 |
$3,223.20 |
$3,223.20 |
$2,394.58
|
|
Knee MRI (without contrast)
|
$3,253.60 |
$3,253.60 |
$3,253.60 |
$2,209.22
|
|
Knee X-ray
|
$435.20 |
$435.20 |
$435.20 |
$387.20
|
|
Leg Vein Ultrasound (DVT study, both legs)
|
$1,285.60 |
$1,285.60 |
$1,285.60 |
$1,090.23
|
|
Lower Back (Lumbar Spine) CT scan (with and without contrast)
|
$2,604.00 |
$2,604.00 |
$2,604.00 |
$1,909.80
|
|
Lower Back (Lumbar Spine) CT scan (with contrast)
|
$2,371.20 |
$2,371.20 |
$2,371.20 |
$1,850.88
|
|
Lower Back (Lumbar Spine) CT scan (without contrast)
|
$2,472.00 |
$2,472.00 |
$2,472.00 |
$1,517.10
|
|
Lower Back (Lumbar Spine) MRI (with and without contrast)
|
$4,230.40 |
$4,230.40 |
$4,230.40 |
$2,750.00
|
|
Lower Back (Lumbar Spine) MRI (with contrast)
|
$3,348.00 |
$3,348.00 |
$3,348.00 |
$2,415.68
|
|
Lower Back (Lumbar Spine) MRI (without contrast)
|
$3,253.60 |
$3,253.60 |
$3,253.60 |
$2,013.08
|
|
Lower Back (Lumbar Spine) X-ray
|
$439.20 |
$439.20 |
$439.20 |
$341.64
|
|
Lung Function Test (Spirometry)
|
$273.60 |
$273.60 |
$273.60 |
$296.91
|
|
Neck (Cervical Spine) CT scan (with and without contrast)
|
$2,704.80 |
$2,704.80 |
$2,704.80 |
$1,992.00
|
|
Neck (Cervical Spine) CT scan (with contrast)
|
$2,402.40 |
$2,402.40 |
$2,402.40 |
$1,708.20
|
|
Neck (Cervical Spine) CT scan (without contrast)
|
$2,199.20 |
$2,199.20 |
$2,199.20 |
$1,513.95
|
|
Neck (Cervical Spine) MRI (with and without contrast)
|
$4,230.40 |
$4,230.40 |
$4,230.40 |
$2,750.00
|
|
Neck (Cervical Spine) MRI (with contrast)
|
$3,223.20 |
$3,223.20 |
$3,223.20 |
$2,231.16
|
|
Neck (Cervical Spine) MRI (without contrast)
|
$3,253.60 |
$3,253.60 |
$3,253.60 |
$1,947.58
|
|
Neck MRA (blood vessel MRI, with and without contrast)
|
$3,592.80 |
$3,592.80 |
$3,592.80 |
$2,750.00
|
|
Neck MRA (blood vessel MRI, with contrast)
|
$2,936.00 |
$2,936.00 |
$2,936.00 |
$2,030.23
|
|
Neck MRA (blood vessel MRI, without contrast)
|
$2,516.80 |
$2,516.80 |
$2,516.80 |
$1,790.58
|
|
New Patient Office Visit (level 2)
|
$145.60 |
$145.60 |
$145.60 |
$178.00
|
|
New Patient Office Visit (level 3)
|
$217.60 |
$217.60 |
$217.60 |
$229.20
|
|
New Patient Office Visit (level 4)
|
$315.20 |
$315.20 |
$315.20 |
$307.00
|
|
New Patient Office Visit (level 5)
|
$390.40 |
$390.40 |
$390.40 |
$401.50
|
|
Nuclear Stress Test (Heart)
|
$4,556.00 |
$4,556.00 |
$4,556.00 |
$3,799.90
|
|
Pelvic CT scan (with and without contrast)
|
$2,577.60 |
$2,577.60 |
$2,577.60 |
$1,992.00
|
|
Pelvic CT scan (with contrast)
|
$2,242.40 |
$2,242.40 |
$2,242.40 |
$1,706.25
|
|
Pelvic CT scan (without contrast)
|
$1,896.00 |
$1,896.00 |
$1,896.00 |
$1,366.50
|
|
Pelvic MRI (with and without contrast)
|
$4,295.20 |
$4,295.20 |
$4,295.20 |
$2,713.80
|
|
Pelvic MRI (without contrast)
|
$3,223.20 |
$3,223.20 |
$3,223.20 |
$1,810.38
|
|
Pelvic Ultrasound (complete)
|
$820.80 |
$820.80 |
$820.80 |
$647.87
|
|
Pelvic Ultrasound (limited)
|
$641.60 |
$641.60 |
$641.60 |
$476.50
|
|
Pregnancy Ultrasound (complete, after first trimester)
|
$913.60 |
$913.60 |
$913.60 |
$607.12
|
|
Pregnancy Ultrasound (first trimester)
|
$741.60 |
$741.60 |
$741.60 |
$592.15
|
|
Shoulder MRI (with and without contrast)
|
$3,900.80 |
$3,900.80 |
$3,900.80 |
$2,650.10
|
|
Shoulder MRI (with contrast)
|
$3,223.20 |
$3,223.20 |
$3,223.20 |
$2,822.25
|
|
Shoulder MRI (without contrast)
|
$3,253.60 |
$3,253.60 |
$3,253.60 |
$1,938.28
|
|
Shoulder X-ray
|
$380.00 |
$380.00 |
$380.00 |
$307.20
|
|
Sinus CT scan (with and without contrast)
|
$2,472.00 |
$2,472.00 |
$2,472.00 |
$1,871.00
|
|
Sinus CT scan (with contrast)
|
$2,266.40 |
$2,266.40 |
$2,266.40 |
$1,566.40
|
|
Sinus CT scan (without contrast)
|
$1,854.40 |
$1,854.40 |
$1,854.40 |
$1,275.30
|
|
Skin Biopsy
|
$337.60 |
$337.60 |
$337.60 |
$381.60
|
|
Sleep Study (Polysomnography)
|
$3,936.80 |
$3,936.80 |
$3,936.80 |
$4,141.16
|
|
Thyroid Ultrasound
|
$741.60 |
$741.60 |
$741.60 |
$603.90
|
|
Upper Back (Thoracic Spine) MRI (with and without contrast)
|
$4,230.40 |
$4,230.40 |
$4,230.40 |
$2,713.80
|
|
Upper Back (Thoracic Spine) MRI (with contrast)
|
$3,348.00 |
$3,348.00 |
$3,348.00 |
$2,039.85
|
|
Upper Back (Thoracic Spine) MRI (without contrast)
|
$3,253.60 |
$3,253.60 |
$3,253.60 |
$2,013.08
|
|
Wrist X-ray
|
$288.80 |
$288.80 |
$288.80 |
$311.20
|