|
Abdominal CT scan (with and without contrast)
|
$2,489.60 |
$2,489.60 |
$2,489.60 |
$2,049.00
|
|
Abdominal CT scan (with contrast)
|
$2,431.20 |
$2,431.20 |
$2,431.20 |
$1,683.63
|
|
Abdominal CT scan (without contrast)
|
$1,976.00 |
$1,976.00 |
$1,976.00 |
$1,358.76
|
|
Abdominal MRI (with and without contrast)
|
$3,806.40 |
$3,806.40 |
$3,806.40 |
$3,061.80
|
|
Abdominal MRI (with contrast)
|
$3,154.40 |
$3,154.40 |
$3,154.40 |
$2,077.14
|
|
Abdominal MRI (without contrast)
|
$2,978.40 |
$2,978.40 |
$2,978.40 |
$1,902.00
|
|
Abdominal Ultrasound (complete)
|
$877.60 |
$877.60 |
$877.60 |
$755.00
|
|
Abdominal Ultrasound (limited)
|
$748.80 |
$748.80 |
$748.80 |
$629.42
|
|
Ankle X-ray
|
$284.00 |
$284.00 |
$284.00 |
$312.74
|
|
Blood Clotting (PT/INR) Test
|
$35.20 |
$35.20 |
$35.20 |
$45.00
|
|
Blood Clotting (PTT) Test
|
$50.40 |
$50.40 |
$50.40 |
$65.00
|
|
Blood Count (CBC) Test
|
$56.80 |
$56.80 |
$56.80 |
$66.60
|
|
Blood Count (CBC) Test (without differential)
|
$46.40 |
$46.40 |
$46.40 |
$56.55
|
|
Blood Culture Test
|
$98.40 |
$98.40 |
$98.40 |
$112.20
|
|
Bone Density Scan (DEXA)
|
$503.20 |
$503.20 |
$503.20 |
$398.56
|
|
Brain MRA (blood vessel MRI, with and without contrast)
|
$3,764.80 |
$3,764.80 |
$3,764.80 |
$2,604.00
|
|
Brain MRA (blood vessel MRI, without contrast)
|
$2,612.00 |
$2,612.00 |
$2,612.00 |
$1,790.00
|
|
Brain MRI (with and without contrast)
|
$4,264.00 |
$4,264.00 |
$4,264.00 |
$2,884.20
|
|
Brain MRI (with contrast)
|
$3,165.60 |
$3,165.60 |
$3,165.60 |
$2,224.96
|
|
Brain MRI (without contrast)
|
$2,913.60 |
$2,913.60 |
$2,913.60 |
$1,825.59
|
|
CT Angiogram of Abdomen and Pelvis
|
$3,961.60 |
$3,961.60 |
$3,961.60 |
$2,839.85
|
|
CT Angiogram of the Chest (for blood clot)
|
$2,702.40 |
$2,702.40 |
$2,702.40 |
$2,094.23
|
|
CT Angiogram of the Head
|
$2,834.40 |
$2,834.40 |
$2,834.40 |
$2,094.23
|
|
CT Scan of Abdomen and Pelvis (with and without contrast)
|
$4,421.60 |
$4,421.60 |
$4,421.60 |
$3,669.25
|
|
CT Scan of Abdomen and Pelvis (with contrast)
|
$4,324.00 |
$4,324.00 |
$4,324.00 |
$3,217.18
|
|
CT Scan of Abdomen and Pelvis (without contrast)
|
$3,812.80 |
$3,812.80 |
$3,812.80 |
$2,418.75
|
|
Carotid Artery Ultrasound (Duplex)
|
$1,158.40 |
$1,158.40 |
$1,158.40 |
$1,059.82
|
|
Chest CT scan (with and without contrast)
|
$2,819.20 |
$2,819.20 |
$2,819.20 |
$2,105.40
|
|
Chest CT scan (with contrast)
|
$2,300.80 |
$2,300.80 |
$2,300.80 |
$1,697.25
|
|
Chest CT scan (without contrast)
|
$1,888.00 |
$1,888.00 |
$1,888.00 |
$1,350.03
|
|
Chest X-ray
|
$256.80 |
$256.80 |
$256.80 |
$303.24
|
|
Chest X-ray (single view)
|
$172.00 |
$172.00 |
$172.00 |
$225.00
|
|
Cholesterol (Lipid) Test
|
$80.00 |
$80.00 |
$80.00 |
$100.00
|
|
Diabetes (HbA1c) Test
|
$54.40 |
$54.40 |
$54.40 |
$69.55
|
|
Diagnostic Mammogram (both breasts)
|
$573.60 |
$573.60 |
$573.60 |
$424.00
|
|
Diagnostic Mammogram (one breast)
|
$470.40 |
$470.40 |
$470.40 |
$297.05
|
|
ER Visit (level 1, minor)
|
$268.80 |
$268.80 |
$268.80 |
$286.94
|
|
ER Visit (level 2)
|
$431.20 |
$431.20 |
$431.20 |
$469.39
|
|
ER Visit (level 3)
|
$684.80 |
$684.80 |
$684.80 |
$836.00
|
|
ER Visit (level 4)
|
$1,360.80 |
$1,360.80 |
$1,360.80 |
$1,330.12
|
|
ER Visit (level 5, high severity)
|
$1,895.20 |
$1,895.20 |
$1,895.20 |
$1,892.80
|
|
Echocardiogram (Heart Ultrasound)
|
$2,126.40 |
$2,126.40 |
$2,126.40 |
$2,024.64
|
|
Established Patient Office Visit (level 1)
|
$144.00 |
$144.00 |
$144.00 |
$115.05
|
|
Established Patient Office Visit (level 2)
|
$166.40 |
$166.40 |
$166.40 |
$127.53
|
|
Established Patient Office Visit (level 3)
|
$199.20 |
$199.20 |
$199.20 |
$183.60
|
|
Established Patient Office Visit (level 4)
|
$252.00 |
$252.00 |
$252.00 |
$228.60
|
|
Established Patient Office Visit (level 5)
|
$322.40 |
$322.40 |
$322.40 |
$306.40
|
|
Foot X-ray
|
$258.40 |
$258.40 |
$258.40 |
$339.50
|
|
Hand X-ray
|
$302.40 |
$302.40 |
$302.40 |
$315.00
|
|
Head CT scan (with and without contrast)
|
$2,418.40 |
$2,418.40 |
$2,418.40 |
$1,914.25
|
|
Head CT scan (with contrast)
|
$2,299.20 |
$2,299.20 |
$2,299.20 |
$1,587.69
|
|
Head CT scan (without contrast)
|
$1,756.80 |
$1,756.80 |
$1,756.80 |
$1,268.90
|
|
Hip X-ray
|
$329.60 |
$329.60 |
$329.60 |
$290.00
|
|
Kidney (Retroperitoneal) Ultrasound (complete)
|
$778.40 |
$778.40 |
$778.40 |
$683.50
|
|
Knee MRI (with and without contrast)
|
$3,893.60 |
$3,893.60 |
$3,893.60 |
$3,008.26
|
|
Knee MRI (without contrast)
|
$3,292.00 |
$3,292.00 |
$3,292.00 |
$2,205.00
|
|
Knee X-ray
|
$336.80 |
$336.80 |
$336.80 |
$388.44
|
|
Leg Vein Ultrasound (DVT study, both legs)
|
$1,186.40 |
$1,186.40 |
$1,186.40 |
$1,090.23
|
|
Liver Function Test
|
$82.40 |
$82.40 |
$82.40 |
$93.60
|
|
Lower Back (Lumbar Spine) CT scan (with and without contrast)
|
$3,000.00 |
$3,000.00 |
$3,000.00 |
$1,909.80
|
|
Lower Back (Lumbar Spine) CT scan (with contrast)
|
$2,474.40 |
$2,474.40 |
$2,474.40 |
$1,829.25
|
|
Lower Back (Lumbar Spine) CT scan (without contrast)
|
$2,018.40 |
$2,018.40 |
$2,018.40 |
$1,517.10
|
|
Lower Back (Lumbar Spine) MRI (with and without contrast)
|
$4,184.80 |
$4,184.80 |
$4,184.80 |
$2,713.80
|
|
Lower Back (Lumbar Spine) MRI (with contrast)
|
$3,169.60 |
$3,169.60 |
$3,169.60 |
$2,415.68
|
|
Lower Back (Lumbar Spine) MRI (without contrast)
|
$3,374.40 |
$3,374.40 |
$3,374.40 |
$2,013.08
|
|
Lower Back (Lumbar Spine) X-ray
|
$344.00 |
$344.00 |
$344.00 |
$341.64
|
|
Lung Function Test (Spirometry)
|
$307.20 |
$307.20 |
$307.20 |
$296.91
|
|
Metabolic Blood Panel (Basic)
|
$81.60 |
$81.60 |
$81.60 |
$97.60
|
|
Metabolic Blood Panel (Comprehensive)
|
$112.80 |
$112.80 |
$112.80 |
$135.20
|
|
Neck (Cervical Spine) CT scan (with contrast)
|
$2,508.80 |
$2,508.80 |
$2,508.80 |
$1,708.20
|
|
Neck (Cervical Spine) CT scan (without contrast)
|
$2,022.40 |
$2,022.40 |
$2,022.40 |
$1,513.95
|
|
Neck (Cervical Spine) MRI (with and without contrast)
|
$4,052.00 |
$4,052.00 |
$4,052.00 |
$2,750.00
|
|
Neck (Cervical Spine) MRI (with contrast)
|
$3,216.80 |
$3,216.80 |
$3,216.80 |
$2,231.16
|
|
Neck (Cervical Spine) MRI (without contrast)
|
$3,374.40 |
$3,374.40 |
$3,374.40 |
$1,914.00
|
|
Neck MRA (blood vessel MRI, with and without contrast)
|
$3,569.60 |
$3,569.60 |
$3,569.60 |
$2,750.00
|
|
Neck MRA (blood vessel MRI, without contrast)
|
$2,512.80 |
$2,512.80 |
$2,512.80 |
$1,790.58
|
|
New Patient Office Visit (level 2)
|
$128.80 |
$128.80 |
$128.80 |
$178.00
|
|
Nuclear Stress Test (Heart)
|
$3,851.20 |
$3,851.20 |
$3,851.20 |
$3,799.90
|
|
PSA (Prostate) Test
|
$89.60 |
$89.60 |
$89.60 |
$103.85
|
|
Pelvic CT scan (with and without contrast)
|
$2,370.40 |
$2,370.40 |
$2,370.40 |
$1,992.00
|
|
Pelvic CT scan (with contrast)
|
$2,075.20 |
$2,075.20 |
$2,075.20 |
$1,706.25
|
|
Pelvic CT scan (without contrast)
|
$1,829.60 |
$1,829.60 |
$1,829.60 |
$1,313.40
|
|
Pelvic MRI (with and without contrast)
|
$3,835.20 |
$3,835.20 |
$3,835.20 |
$2,713.80
|
|
Pelvic MRI (with contrast)
|
$3,472.80 |
$3,472.80 |
$3,472.80 |
$1,966.42
|
|
Pelvic MRI (without contrast)
|
$2,995.20 |
$2,995.20 |
$2,995.20 |
$1,810.38
|
|
Pelvic Ultrasound (complete)
|
$628.80 |
$628.80 |
$628.80 |
$647.87
|
|
Pelvic Ultrasound (limited)
|
$494.40 |
$494.40 |
$494.40 |
$476.50
|
|
Pregnancy Ultrasound (complete, after first trimester)
|
$778.40 |
$778.40 |
$778.40 |
$607.12
|
|
Pregnancy Ultrasound (first trimester)
|
$629.60 |
$629.60 |
$629.60 |
$580.03
|
|
Rapid Strep Test
|
$46.40 |
$46.40 |
$46.40 |
$72.00
|
|
Screening Mammogram
|
$459.20 |
$459.20 |
$459.20 |
$331.50
|
|
Shoulder MRI (with and without contrast)
|
$3,837.60 |
$3,837.60 |
$3,837.60 |
$2,650.10
|
|
Shoulder MRI (without contrast)
|
$3,374.40 |
$3,374.40 |
$3,374.40 |
$1,938.28
|
|
Shoulder X-ray
|
$296.00 |
$296.00 |
$296.00 |
$307.20
|
|
Sinus CT scan (with and without contrast)
|
$2,475.20 |
$2,475.20 |
$2,475.20 |
$1,871.00
|
|
Sinus CT scan (with contrast)
|
$2,216.00 |
$2,216.00 |
$2,216.00 |
$1,566.40
|
|
Sinus CT scan (without contrast)
|
$1,705.60 |
$1,705.60 |
$1,705.60 |
$1,275.30
|
|
Sleep Study (Polysomnography)
|
$4,099.20 |
$4,099.20 |
$4,099.20 |
$4,141.16
|
|
Thyroid (TSH) Test
|
$84.00 |
$84.00 |
$84.00 |
$110.00
|
|
Thyroid Ultrasound
|
$708.80 |
$708.80 |
$708.80 |
$603.90
|
|
Upper Back (Thoracic Spine) MRI (with and without contrast)
|
$3,919.20 |
$3,919.20 |
$3,919.20 |
$2,713.80
|
|
Upper Back (Thoracic Spine) MRI (with contrast)
|
$3,048.80 |
$3,048.80 |
$3,048.80 |
$2,039.85
|
|
Upper Back (Thoracic Spine) MRI (without contrast)
|
$2,896.00 |
$2,896.00 |
$2,896.00 |
$2,013.08
|
|
Urinalysis (with microscopy)
|
$38.40 |
$38.40 |
$38.40 |
$36.52
|
|
Urinalysis (without microscopy)
|
$24.80 |
$24.80 |
$24.80 |
$32.50
|
|
Urine Culture Test
|
$58.40 |
$58.40 |
$58.40 |
$65.15
|
|
Vitamin D Test
|
$132.00 |
$132.00 |
$132.00 |
$142.35
|
|
Wrist X-ray
|
$339.20 |
$339.20 |
$339.20 |
$311.20
|