|
Abdominal CT scan (with and without contrast)
|
$3,036.80 |
$3,036.80 |
$3,036.80 |
$2,049.00
|
|
Abdominal CT scan (with contrast)
|
$2,656.00 |
$2,656.00 |
$2,656.00 |
$1,683.63
|
|
Abdominal CT scan (without contrast)
|
$2,140.00 |
$2,140.00 |
$2,140.00 |
$1,358.76
|
|
Abdominal MRI (with and without contrast)
|
$4,195.20 |
$4,195.20 |
$4,195.20 |
$3,061.80
|
|
Abdominal MRI (with contrast)
|
$3,488.80 |
$3,488.80 |
$3,488.80 |
$2,077.14
|
|
Abdominal MRI (without contrast)
|
$3,030.40 |
$3,030.40 |
$3,030.40 |
$1,902.00
|
|
Abdominal Ultrasound (complete)
|
$1,000.00 |
$1,000.00 |
$1,000.00 |
$755.00
|
|
Abdominal Ultrasound (limited)
|
$750.40 |
$750.40 |
$750.40 |
$629.42
|
|
Ankle X-ray
|
$368.00 |
$368.00 |
$368.00 |
$311.92
|
|
Blood Clotting (PT/INR) Test
|
$59.20 |
$59.20 |
$59.20 |
$45.00
|
|
Blood Clotting (PTT) Test
|
$85.60 |
$85.60 |
$85.60 |
$64.35
|
|
Blood Count (CBC) Test
|
$101.60 |
$101.60 |
$101.60 |
$66.75
|
|
Blood Count (CBC) Test (without differential)
|
$98.40 |
$98.40 |
$98.40 |
$56.55
|
|
Blood Culture Test
|
$84.00 |
$84.00 |
$84.00 |
$112.20
|
|
Bone Density Scan (DEXA)
|
$538.40 |
$538.40 |
$538.40 |
$398.56
|
|
Brain MRA (blood vessel MRI, with and without contrast)
|
$4,208.80 |
$4,208.80 |
$4,208.80 |
$2,604.00
|
|
Brain MRA (blood vessel MRI, with contrast)
|
$3,430.40 |
$3,430.40 |
$3,430.40 |
$1,998.00
|
|
Brain MRA (blood vessel MRI, without contrast)
|
$2,836.00 |
$2,836.00 |
$2,836.00 |
$1,790.00
|
|
Brain MRI (with and without contrast)
|
$4,156.00 |
$4,156.00 |
$4,156.00 |
$2,884.20
|
|
Brain MRI (with contrast)
|
$3,430.40 |
$3,430.40 |
$3,430.40 |
$2,224.96
|
|
Brain MRI (without contrast)
|
$3,007.20 |
$3,007.20 |
$3,007.20 |
$1,825.59
|
|
CT Angiogram of Abdomen and Pelvis
|
$4,180.00 |
$4,180.00 |
$4,180.00 |
$2,839.85
|
|
CT Angiogram of the Chest (for blood clot)
|
$2,992.00 |
$2,992.00 |
$2,992.00 |
$2,094.23
|
|
CT Angiogram of the Head
|
$2,936.80 |
$2,936.80 |
$2,936.80 |
$2,094.23
|
|
CT Scan of Abdomen and Pelvis (with and without contrast)
|
$5,310.40 |
$5,310.40 |
$5,310.40 |
$3,630.00
|
|
CT Scan of Abdomen and Pelvis (with contrast)
|
$4,458.40 |
$4,458.40 |
$4,458.40 |
$3,180.75
|
|
CT Scan of Abdomen and Pelvis (without contrast)
|
$3,744.00 |
$3,744.00 |
$3,744.00 |
$2,418.75
|
|
Carotid Artery Ultrasound (Duplex)
|
$1,102.40 |
$1,102.40 |
$1,102.40 |
$1,059.82
|
|
Chest CT scan (with and without contrast)
|
$3,224.00 |
$3,224.00 |
$3,224.00 |
$2,105.40
|
|
Chest CT scan (with contrast)
|
$2,691.20 |
$2,691.20 |
$2,691.20 |
$1,697.25
|
|
Chest CT scan (without contrast)
|
$2,095.20 |
$2,095.20 |
$2,095.20 |
$1,350.03
|
|
Chest X-ray
|
$350.40 |
$350.40 |
$350.40 |
$303.24
|
|
Chest X-ray (single view)
|
$276.00 |
$276.00 |
$276.00 |
$225.00
|
|
Cholesterol (Lipid) Test
|
$90.40 |
$90.40 |
$90.40 |
$100.00
|
|
Diabetes (HbA1c) Test
|
$79.20 |
$79.20 |
$79.20 |
$69.55
|
|
ER Visit (level 1, minor)
|
$300.00 |
$300.00 |
$300.00 |
$286.51
|
|
ER Visit (level 2)
|
$488.80 |
$488.80 |
$488.80 |
$469.39
|
|
ER Visit (level 3)
|
$716.80 |
$716.80 |
$716.80 |
$827.20
|
|
ER Visit (level 4)
|
$1,078.40 |
$1,078.40 |
$1,078.40 |
$1,330.00
|
|
ER Visit (level 5, high severity)
|
$1,441.60 |
$1,441.60 |
$1,441.60 |
$1,892.80
|
|
Echocardiogram (Heart Ultrasound)
|
$2,103.20 |
$2,103.20 |
$2,103.20 |
$2,021.12
|
|
Established Patient Office Visit (level 1)
|
$159.20 |
$159.20 |
$159.20 |
$115.05
|
|
Established Patient Office Visit (level 2)
|
$124.80 |
$124.80 |
$124.80 |
$127.53
|
|
Foot X-ray
|
$362.40 |
$362.40 |
$362.40 |
$339.50
|
|
Hand X-ray
|
$334.40 |
$334.40 |
$334.40 |
$313.04
|
|
Head CT scan (with and without contrast)
|
$2,620.80 |
$2,620.80 |
$2,620.80 |
$1,881.36
|
|
Head CT scan (with contrast)
|
$2,447.20 |
$2,447.20 |
$2,447.20 |
$1,587.69
|
|
Head CT scan (without contrast)
|
$1,977.60 |
$1,977.60 |
$1,977.60 |
$1,268.90
|
|
Hip X-ray
|
$448.00 |
$448.00 |
$448.00 |
$290.00
|
|
Kidney (Retroperitoneal) Ultrasound (complete)
|
$830.40 |
$830.40 |
$830.40 |
$683.50
|
|
Knee MRI (with and without contrast)
|
$4,273.60 |
$4,273.60 |
$4,273.60 |
$3,008.26
|
|
Knee MRI (with contrast)
|
$3,372.80 |
$3,372.80 |
$3,372.80 |
$2,394.58
|
|
Knee MRI (without contrast)
|
$2,919.20 |
$2,919.20 |
$2,919.20 |
$2,205.00
|
|
Knee X-ray
|
$477.60 |
$477.60 |
$477.60 |
$387.20
|
|
Leg Vein Ultrasound (DVT study, both legs)
|
$1,168.80 |
$1,168.80 |
$1,168.80 |
$1,090.23
|
|
Liver Function Test
|
$108.00 |
$108.00 |
$108.00 |
$92.85
|
|
Lower Back (Lumbar Spine) CT scan (with and without contrast)
|
$2,968.00 |
$2,968.00 |
$2,968.00 |
$1,909.80
|
|
Lower Back (Lumbar Spine) CT scan (with contrast)
|
$2,680.00 |
$2,680.00 |
$2,680.00 |
$1,829.25
|
|
Lower Back (Lumbar Spine) CT scan (without contrast)
|
$2,376.00 |
$2,376.00 |
$2,376.00 |
$1,517.10
|
|
Lower Back (Lumbar Spine) MRI (with and without contrast)
|
$4,319.20 |
$4,319.20 |
$4,319.20 |
$2,713.80
|
|
Lower Back (Lumbar Spine) MRI (with contrast)
|
$3,616.00 |
$3,616.00 |
$3,616.00 |
$2,415.68
|
|
Lower Back (Lumbar Spine) MRI (without contrast)
|
$3,180.80 |
$3,180.80 |
$3,180.80 |
$2,013.08
|
|
Lower Back (Lumbar Spine) X-ray
|
$444.00 |
$444.00 |
$444.00 |
$341.64
|
|
Lung Function Test (Spirometry)
|
$379.20 |
$379.20 |
$379.20 |
$296.91
|
|
Metabolic Blood Panel (Basic)
|
$120.80 |
$120.80 |
$120.80 |
$97.20
|
|
Metabolic Blood Panel (Comprehensive)
|
$142.40 |
$142.40 |
$142.40 |
$130.97
|
|
Neck (Cervical Spine) CT scan (with and without contrast)
|
$3,067.20 |
$3,067.20 |
$3,067.20 |
$1,992.00
|
|
Neck (Cervical Spine) CT scan (with contrast)
|
$2,708.80 |
$2,708.80 |
$2,708.80 |
$1,708.20
|
|
Neck (Cervical Spine) CT scan (without contrast)
|
$2,253.60 |
$2,253.60 |
$2,253.60 |
$1,513.95
|
|
Neck (Cervical Spine) MRI (with and without contrast)
|
$4,566.40 |
$4,566.40 |
$4,566.40 |
$2,750.00
|
|
Neck (Cervical Spine) MRI (with contrast)
|
$3,585.60 |
$3,585.60 |
$3,585.60 |
$2,231.16
|
|
Neck (Cervical Spine) MRI (without contrast)
|
$3,250.40 |
$3,250.40 |
$3,250.40 |
$1,914.00
|
|
Neck MRA (blood vessel MRI, with and without contrast)
|
$4,024.80 |
$4,024.80 |
$4,024.80 |
$2,733.00
|
|
Neck MRA (blood vessel MRI, with contrast)
|
$3,220.00 |
$3,220.00 |
$3,220.00 |
$2,030.23
|
|
Neck MRA (blood vessel MRI, without contrast)
|
$2,756.00 |
$2,756.00 |
$2,756.00 |
$1,790.58
|
|
Nuclear Stress Test (Heart)
|
$4,810.40 |
$4,810.40 |
$4,810.40 |
$3,799.90
|
|
PSA (Prostate) Test
|
$89.60 |
$89.60 |
$89.60 |
$103.85
|
|
Pelvic CT scan (with and without contrast)
|
$2,809.60 |
$2,809.60 |
$2,809.60 |
$1,992.00
|
|
Pelvic CT scan (with contrast)
|
$2,428.80 |
$2,428.80 |
$2,428.80 |
$1,680.60
|
|
Pelvic CT scan (without contrast)
|
$1,926.40 |
$1,926.40 |
$1,926.40 |
$1,313.40
|
|
Pelvic MRI (with and without contrast)
|
$4,349.60 |
$4,349.60 |
$4,349.60 |
$2,713.80
|
|
Pelvic MRI (with contrast)
|
$3,974.40 |
$3,974.40 |
$3,974.40 |
$1,966.42
|
|
Pelvic MRI (without contrast)
|
$3,053.60 |
$3,053.60 |
$3,053.60 |
$1,810.38
|
|
Pelvic Ultrasound (complete)
|
$720.00 |
$720.00 |
$720.00 |
$647.87
|
|
Pelvic Ultrasound (limited)
|
$548.80 |
$548.80 |
$548.80 |
$476.50
|
|
Pregnancy Ultrasound (complete, after first trimester)
|
$932.00 |
$932.00 |
$932.00 |
$607.12
|
|
Pregnancy Ultrasound (first trimester)
|
$783.20 |
$783.20 |
$783.20 |
$580.03
|
|
Rapid Strep Test
|
$72.00 |
$72.00 |
$72.00 |
$72.00
|
|
Screening Mammogram
|
$434.40 |
$434.40 |
$434.40 |
$331.50
|
|
Shoulder MRI (with and without contrast)
|
$3,925.60 |
$3,925.60 |
$3,925.60 |
$2,650.10
|
|
Shoulder MRI (with contrast)
|
$3,516.00 |
$3,516.00 |
$3,516.00 |
$2,769.75
|
|
Shoulder MRI (without contrast)
|
$2,931.20 |
$2,931.20 |
$2,931.20 |
$1,938.28
|
|
Shoulder X-ray
|
$382.40 |
$382.40 |
$382.40 |
$306.88
|
|
Sinus CT scan (with and without contrast)
|
$3,063.20 |
$3,063.20 |
$3,063.20 |
$1,871.00
|
|
Sinus CT scan (with contrast)
|
$2,598.40 |
$2,598.40 |
$2,598.40 |
$1,566.40
|
|
Sinus CT scan (without contrast)
|
$2,034.40 |
$2,034.40 |
$2,034.40 |
$1,275.30
|
|
Sleep Study (Polysomnography)
|
$4,370.40 |
$4,370.40 |
$4,370.40 |
$4,141.16
|
|
Thyroid (TSH) Test
|
$98.40 |
$98.40 |
$98.40 |
$110.00
|
|
Thyroid Ultrasound
|
$783.20 |
$783.20 |
$783.20 |
$603.90
|
|
Upper Back (Thoracic Spine) MRI (with and without contrast)
|
$4,324.80 |
$4,324.80 |
$4,324.80 |
$2,713.80
|
|
Upper Back (Thoracic Spine) MRI (with contrast)
|
$3,603.20 |
$3,603.20 |
$3,603.20 |
$2,039.85
|
|
Upper Back (Thoracic Spine) MRI (without contrast)
|
$3,200.00 |
$3,200.00 |
$3,200.00 |
$2,013.08
|
|
Upper Endoscopy (EGD, diagnostic)
|
$2,482.40 |
$2,482.40 |
$2,482.40 |
$1,751.66
|
|
Urinalysis (with microscopy)
|
$52.00 |
$52.00 |
$52.00 |
$36.52
|
|
Urinalysis (without microscopy)
|
$41.60 |
$41.60 |
$41.60 |
$32.50
|
|
Urine Culture Test
|
$74.40 |
$74.40 |
$74.40 |
$65.15
|
|
Vitamin D Test
|
$132.00 |
$132.00 |
$132.00 |
$142.35
|
|
Wrist X-ray
|
$334.40 |
$334.40 |
$334.40 |
$311.17
|