|
Abdominal CT scan (with and without contrast)
|
$2,667.20 |
$2,667.20 |
$2,667.20 |
$2,049.00
|
|
Abdominal CT scan (with contrast)
|
$3,044.00 |
$3,044.00 |
$3,044.00 |
$1,683.63
|
|
Abdominal CT scan (without contrast)
|
$2,257.60 |
$2,257.60 |
$2,257.60 |
$1,358.76
|
|
Abdominal MRI (with and without contrast)
|
$4,865.60 |
$4,865.60 |
$4,865.60 |
$3,061.80
|
|
Abdominal MRI (with contrast)
|
$3,056.80 |
$3,056.80 |
$3,056.80 |
$2,096.25
|
|
Abdominal MRI (without contrast)
|
$3,511.20 |
$3,511.20 |
$3,511.20 |
$1,902.00
|
|
Abdominal Ultrasound (complete)
|
$1,129.60 |
$1,129.60 |
$1,129.60 |
$755.00
|
|
Abdominal Ultrasound (limited)
|
$824.80 |
$824.80 |
$824.80 |
$629.42
|
|
Ankle X-ray
|
$467.20 |
$467.20 |
$467.20 |
$312.74
|
|
Bone Density Scan (DEXA)
|
$477.60 |
$477.60 |
$477.60 |
$398.56
|
|
Brain MRA (blood vessel MRI, with and without contrast)
|
$3,717.60 |
$3,717.60 |
$3,717.60 |
$2,650.00
|
|
Brain MRA (blood vessel MRI, with contrast)
|
$3,000.00 |
$3,000.00 |
$3,000.00 |
$1,998.00
|
|
Brain MRA (blood vessel MRI, without contrast)
|
$2,653.60 |
$2,653.60 |
$2,653.60 |
$1,802.40
|
|
Brain MRI (with and without contrast)
|
$4,780.80 |
$4,780.80 |
$4,780.80 |
$2,919.75
|
|
Brain MRI (with contrast)
|
$3,202.40 |
$3,202.40 |
$3,202.40 |
$2,224.96
|
|
Brain MRI (without contrast)
|
$3,141.60 |
$3,141.60 |
$3,141.60 |
$1,830.00
|
|
Breast Biopsy (ultrasound-guided, percutaneous)
|
$3,276.00 |
$3,276.00 |
$3,276.00 |
$3,069.25
|
|
CT Angiogram of Abdomen and Pelvis
|
$4,633.60 |
$4,633.60 |
$4,633.60 |
$2,839.85
|
|
CT Angiogram of the Chest (for blood clot)
|
$3,498.40 |
$3,498.40 |
$3,498.40 |
$2,094.23
|
|
CT Angiogram of the Head
|
$3,371.20 |
$3,371.20 |
$3,371.20 |
$2,094.23
|
|
CT Scan of Abdomen and Pelvis (with and without contrast)
|
$5,212.80 |
$5,212.80 |
$5,212.80 |
$3,669.25
|
|
CT Scan of Abdomen and Pelvis (with contrast)
|
$4,883.20 |
$4,883.20 |
$4,883.20 |
$3,217.18
|
|
CT Scan of Abdomen and Pelvis (without contrast)
|
$4,235.20 |
$4,235.20 |
$4,235.20 |
$2,418.75
|
|
Carotid Artery Ultrasound (Duplex)
|
$1,284.00 |
$1,284.00 |
$1,284.00 |
$1,059.82
|
|
Carpal Tunnel Release Surgery
|
$4,592.80 |
$4,592.80 |
$4,592.80 |
$3,503.75
|
|
Chest CT scan (with and without contrast)
|
$3,485.60 |
$3,485.60 |
$3,485.60 |
$2,105.40
|
|
Chest CT scan (with contrast)
|
$2,969.60 |
$2,969.60 |
$2,969.60 |
$1,697.25
|
|
Chest CT scan (without contrast)
|
$2,569.60 |
$2,569.60 |
$2,569.60 |
$1,350.03
|
|
Chest X-ray
|
$380.80 |
$380.80 |
$380.80 |
$303.24
|
|
Chest X-ray (single view)
|
$307.20 |
$307.20 |
$307.20 |
$225.00
|
|
Cystoscopy (Bladder Scope)
|
$1,525.60 |
$1,525.60 |
$1,525.60 |
$1,636.00
|
|
ER Visit (level 1, minor)
|
$296.00 |
$296.00 |
$296.00 |
$286.51
|
|
ER Visit (level 2)
|
$508.00 |
$508.00 |
$508.00 |
$469.39
|
|
ER Visit (level 3)
|
$864.80 |
$864.80 |
$864.80 |
$827.20
|
|
ER Visit (level 4)
|
$1,384.00 |
$1,384.00 |
$1,384.00 |
$1,330.00
|
|
ER Visit (level 5, high severity)
|
$2,037.60 |
$2,037.60 |
$2,037.60 |
$1,892.80
|
|
Echocardiogram (Heart Ultrasound)
|
$2,845.60 |
$2,845.60 |
$2,845.60 |
$2,021.12
|
|
Established Patient Office Visit (level 1)
|
$364.00 |
$364.00 |
$364.00 |
$115.05
|
|
Established Patient Office Visit (level 2)
|
$335.20 |
$335.20 |
$335.20 |
$127.53
|
|
Established Patient Office Visit (level 3)
|
$704.00 |
$704.00 |
$704.00 |
$183.60
|
|
Established Patient Office Visit (level 4)
|
$997.60 |
$997.60 |
$997.60 |
$228.60
|
|
Established Patient Office Visit (level 5)
|
$1,095.20 |
$1,095.20 |
$1,095.20 |
$306.40
|
|
Flexible Sigmoidoscopy
|
$3,328.00 |
$3,328.00 |
$3,328.00 |
$1,278.72
|
|
Foot X-ray
|
$488.00 |
$488.00 |
$488.00 |
$339.50
|
|
Hand X-ray
|
$432.80 |
$432.80 |
$432.80 |
$315.00
|
|
Head CT scan (with and without contrast)
|
$2,932.80 |
$2,932.80 |
$2,932.80 |
$1,914.25
|
|
Head CT scan (with contrast)
|
$2,648.80 |
$2,648.80 |
$2,648.80 |
$1,587.69
|
|
Head CT scan (without contrast)
|
$2,334.40 |
$2,334.40 |
$2,334.40 |
$1,268.90
|
|
Hip X-ray
|
$358.40 |
$358.40 |
$358.40 |
$290.35
|
|
Kidney (Retroperitoneal) Ultrasound (complete)
|
$1,036.00 |
$1,036.00 |
$1,036.00 |
$683.50
|
|
Knee MRI (with and without contrast)
|
$4,594.40 |
$4,594.40 |
$4,594.40 |
$3,008.26
|
|
Knee MRI (with contrast)
|
$3,850.40 |
$3,850.40 |
$3,850.40 |
$2,394.58
|
|
Knee MRI (without contrast)
|
$3,284.80 |
$3,284.80 |
$3,284.80 |
$2,209.22
|
|
Knee X-ray
|
$604.00 |
$604.00 |
$604.00 |
$387.20
|
|
Leg Vein Ultrasound (DVT study, both legs)
|
$1,436.80 |
$1,436.80 |
$1,436.80 |
$1,090.23
|
|
Lower Back (Lumbar Spine) CT scan (with and without contrast)
|
$3,156.00 |
$3,156.00 |
$3,156.00 |
$1,909.80
|
|
Lower Back (Lumbar Spine) CT scan (with contrast)
|
$2,603.20 |
$2,603.20 |
$2,603.20 |
$1,850.88
|
|
Lower Back (Lumbar Spine) CT scan (without contrast)
|
$2,652.00 |
$2,652.00 |
$2,652.00 |
$1,517.10
|
|
Lower Back (Lumbar Spine) MRI (with and without contrast)
|
$4,865.60 |
$4,865.60 |
$4,865.60 |
$2,750.00
|
|
Lower Back (Lumbar Spine) MRI (with contrast)
|
$3,289.60 |
$3,289.60 |
$3,289.60 |
$2,415.68
|
|
Lower Back (Lumbar Spine) MRI (without contrast)
|
$3,555.20 |
$3,555.20 |
$3,555.20 |
$2,013.08
|
|
Lower Back (Lumbar Spine) X-ray
|
$585.60 |
$585.60 |
$585.60 |
$341.64
|
|
Lung Function Test (Spirometry)
|
$469.60 |
$469.60 |
$469.60 |
$296.91
|
|
Neck (Cervical Spine) CT scan (with and without contrast)
|
$3,256.00 |
$3,256.00 |
$3,256.00 |
$1,992.00
|
|
Neck (Cervical Spine) CT scan (with contrast)
|
$2,797.60 |
$2,797.60 |
$2,797.60 |
$1,708.20
|
|
Neck (Cervical Spine) CT scan (without contrast)
|
$2,715.20 |
$2,715.20 |
$2,715.20 |
$1,513.95
|
|
Neck (Cervical Spine) MRI (with and without contrast)
|
$5,033.60 |
$5,033.60 |
$5,033.60 |
$2,750.00
|
|
Neck (Cervical Spine) MRI (with contrast)
|
$3,257.60 |
$3,257.60 |
$3,257.60 |
$2,231.16
|
|
Neck (Cervical Spine) MRI (without contrast)
|
$3,659.20 |
$3,659.20 |
$3,659.20 |
$1,947.58
|
|
Neck MRA (blood vessel MRI, with and without contrast)
|
$3,557.60 |
$3,557.60 |
$3,557.60 |
$2,750.00
|
|
Neck MRA (blood vessel MRI, with contrast)
|
$3,000.80 |
$3,000.80 |
$3,000.80 |
$2,030.23
|
|
Neck MRA (blood vessel MRI, without contrast)
|
$2,566.40 |
$2,566.40 |
$2,566.40 |
$1,790.58
|
|
New Patient Office Visit (level 2)
|
$324.80 |
$324.80 |
$324.80 |
$178.00
|
|
New Patient Office Visit (level 3)
|
$540.80 |
$540.80 |
$540.80 |
$229.20
|
|
New Patient Office Visit (level 4)
|
$740.80 |
$740.80 |
$740.80 |
$307.00
|
|
New Patient Office Visit (level 5)
|
$962.40 |
$962.40 |
$962.40 |
$401.50
|
|
Nuclear Stress Test (Heart)
|
$5,011.20 |
$5,011.20 |
$5,011.20 |
$3,799.90
|
|
Pelvic CT scan (with and without contrast)
|
$2,727.20 |
$2,727.20 |
$2,727.20 |
$1,992.00
|
|
Pelvic CT scan (with contrast)
|
$2,283.20 |
$2,283.20 |
$2,283.20 |
$1,706.25
|
|
Pelvic CT scan (without contrast)
|
$2,350.40 |
$2,350.40 |
$2,350.40 |
$1,366.50
|
|
Pelvic MRI (with and without contrast)
|
$4,811.20 |
$4,811.20 |
$4,811.20 |
$2,713.80
|
|
Pelvic MRI (without contrast)
|
$3,602.40 |
$3,602.40 |
$3,602.40 |
$1,810.38
|
|
Pelvic Ultrasound (complete)
|
$996.00 |
$996.00 |
$996.00 |
$647.87
|
|
Pelvic Ultrasound (limited)
|
$508.80 |
$508.80 |
$508.80 |
$476.50
|
|
Pregnancy Ultrasound (complete, after first trimester)
|
$960.00 |
$960.00 |
$960.00 |
$607.12
|
|
Pregnancy Ultrasound (first trimester)
|
$984.80 |
$984.80 |
$984.80 |
$592.15
|
|
Shoulder MRI (with and without contrast)
|
$4,187.20 |
$4,187.20 |
$4,187.20 |
$2,650.10
|
|
Shoulder MRI (with contrast)
|
$3,850.40 |
$3,850.40 |
$3,850.40 |
$2,822.25
|
|
Shoulder MRI (without contrast)
|
$3,271.20 |
$3,271.20 |
$3,271.20 |
$1,938.28
|
|
Shoulder X-ray
|
$461.60 |
$461.60 |
$461.60 |
$307.20
|
|
Sinus CT scan (with and without contrast)
|
$2,981.60 |
$2,981.60 |
$2,981.60 |
$1,871.00
|
|
Sinus CT scan (with contrast)
|
$2,778.40 |
$2,778.40 |
$2,778.40 |
$1,566.40
|
|
Sinus CT scan (without contrast)
|
$2,199.20 |
$2,199.20 |
$2,199.20 |
$1,275.30
|
|
Skin Biopsy
|
$423.20 |
$423.20 |
$423.20 |
$381.60
|
|
Sleep Study (Polysomnography)
|
$5,137.60 |
$5,137.60 |
$5,137.60 |
$4,141.16
|
|
Thyroid Ultrasound
|
$892.00 |
$892.00 |
$892.00 |
$603.90
|
|
Upper Back (Thoracic Spine) MRI (with and without contrast)
|
$5,039.20 |
$5,039.20 |
$5,039.20 |
$2,713.80
|
|
Upper Back (Thoracic Spine) MRI (with contrast)
|
$3,152.80 |
$3,152.80 |
$3,152.80 |
$2,039.85
|
|
Upper Back (Thoracic Spine) MRI (without contrast)
|
$3,687.20 |
$3,687.20 |
$3,687.20 |
$2,013.08
|
|
Upper Endoscopy (EGD, diagnostic)
|
$2,539.20 |
$2,539.20 |
$2,539.20 |
$1,751.66
|
|
Upper Endoscopy (EGD, with biopsy)
|
$2,540.00 |
$2,540.00 |
$2,540.00 |
$1,675.80
|
|
Wrist X-ray
|
$440.80 |
$440.80 |
$440.80 |
$311.20
|