Acne |
Higher Cost |
Adenoid and Tonsil Removal |
Medium Cost |
Adenoid Removal |
Medium Cost |
Allergy/Runny Nose |
Medium Cost |
Appendectomy |
Higher Cost |
Asthma, without complications |
Higher Cost |
Bladder Scope (Cystoscopy) |
Higher Cost |
Bone Density Dexa Scan |
Higher Cost |
Bronchitis, acute |
Medium Cost |
Bunion Surgery |
Higher Cost |
Bursitis and Tendinitis |
Medium Cost |
Cardiac (Myocardial) Perfusion Scan |
Medium Cost |
Carpal Tunnel Surgery |
Lower Cost |
Cataract Removal, Implant Artificial Lens |
Higher Cost |
Cataract, without surgery |
Medium Cost |
Colonoscopy, without biopsy |
Medium Cost |
Contact Dermatitis |
Lower Cost |
Contraceptive Drug Management |
Higher Cost |
CT Scan - Neck (Cervical Spine), without contrast |
Medium Cost |
CT Scan - Abdomen and Pelvis, with contrast |
Higher Cost |
CT Scan - Abdomen and Pelvis, without contrast |
Higher Cost |
CT Scan - Abdomen, with contrast |
Higher Cost |
CT Scan - Chest, with contrast |
Higher Cost |
CT Scan - Chest, without contrast |
Higher Cost |
CT Scan - Face and Jaw (Maxillofacial Area), without contrast |
Medium Cost |
CT Scan - Head, without contrast |
Medium Cost |
CT Scan - Lower Extremity, without contrast |
Medium Cost |
CT Scan - Lumbar Spine, without contrast |
Higher Cost |
CT Scan - Neck, soft tissue, with contrast |
Higher Cost |
CT Scan - Upper Extremity, without contrast |
Medium Cost |
Diabetes, insulin dependent |
Higher Cost |
Diverticulitis and Inflammatory Bowel Disease |
Medium Cost |
Ear Infection, middle ear |
Medium Cost |
Ear Infection, with minor surgery |
Higher Cost |
Ear Tubes and Eardrum Drainage |
Higher Cost |
Echo Heart Exam, Doppler |
Higher Cost |
Epilepsy |
Higher Cost |
Esophagus Inflammation |
Higher Cost |
Eye Problems, Visual Disturbances |
Medium Cost |
Foot/Ankle Sprain/Strain |
Medium Cost |
Gallbladder Removal, laparoscopic |
Higher Cost |
Genitourinary Infections, nonsexually transmitted |
Higher Cost |
Glaucoma (Open-Angle), without surgery |
Medium Cost |
Gout |
Lower Cost |
Headache, migraine |
Lower Cost |
Hernia Repair, Inguinal (Groin) |
Medium Cost |
Hernia, inguinal (total cost) |
Medium Cost |
High Blood Pressure (Hypertension) |
Medium Cost |
High Cholesterol/High Triglyceride (Hyperlipidemia) |
Higher Cost |
Inflammatory Eye Disease (Uveitis) |
Medium Cost |
Joint Degeneration, back, without surgery |
Higher Cost |
Joint Degeneration, knee and lower leg |
Medium Cost |
Knee Surgery, arthroscopic, with meniscectomy |
Higher Cost |
Lung Infection, bacterial |
Higher Cost |
Mammogram, screening, digital |
Lower Cost |
Menstrual Conditions, without surgery |
Higher Cost |
MRI - Abdomen, with and without contrast |
Higher Cost |
MRI - Back (Lumbar Spine), with contrast |
Higher Cost |
MRI - Brain with and without contrast |
Higher Cost |
MRI - Brain, without contrast |
Higher Cost |
MRI - Chest, without contrast |
Higher Cost |
MRI - Lower Extremity, without contrast |
Higher Cost |
MRI - Neck (Cervical Spine), with contrast |
Higher Cost |
MRI - Neck (Cervical Spine), without contrast |
Higher Cost |
MRI - Neck (Soft Tissue), with contrast |
Higher Cost |
MRI - Pelvis, with and without contrast |
Higher Cost |
MRI - Pelvis, without contrast |
Higher Cost |
MRI - Spine, without contrast |
Higher Cost |
MRI - Upper Extremity, without contrast |
Higher Cost |
Nutritional Deficiency |
Higher Cost |
Orthopedic Deformity, foot and ankle |
Lower Cost |
Pinkeye (Conjunctivitis) |
Medium Cost |
Pneumonia, viral |
Medium Cost |
Psoriasis |
Higher Cost |
Routine Exam |
Lower Cost |
Sinusitis, acute |
Medium Cost |
Skin Infection, bacterial, minor |
Medium Cost |
Skin Infection, fungal |
Medium Cost |
Skin Infection, viral |
Lower Cost |
Skin Inflammation, minor |
Medium Cost |
Sore Throat and Tonsillitis/Adenoiditis, without surgery |
Higher Cost |
Thyroid Disease, hypothyroidism |
Medium Cost |
Tonsillitis, Adenoiditis, Pharyngitis (sore throat), without surgery |
Higher Cost |
Tumor Removal, Breast, non-cancerous |
Lower Cost |
Tumor Removal, Female Reproductive Tract, non-cancerous |
Lower Cost |
Tumor Removal, Prostate, non-cancerous |
Medium Cost |
Ultrasound - Abdomen |
Higher Cost |
Ultrasound - Breast |
Medium Cost |
Ultrasound - Head and Neck |
Higher Cost |
Ultrasound - Kidney |
Higher Cost |
Ultrasound - Pelvic |
Higher Cost |
Ultrasound - Scrotum |
Higher Cost |
Ultrasound - Transabdominal, first trimester |
Medium Cost |
Ultrasound - Transvaginal (across vaginal area) |
Higher Cost |
Upper GI Endoscopy |
Medium Cost |
Vaginal Infection |
Medium Cost |
Vasectomy |
Higher Cost |
Wrist Sprain/Strain |
Medium Cost |
X-ray - Abdomen |
Higher Cost |
X-ray - Ankle |
Higher Cost |
X-ray - Chest |
Higher Cost |
X-Ray - Collar Bone |
Higher Cost |
X-ray - Elbow |
Higher Cost |
X-ray - Finger(s) |
Higher Cost |
X-ray - Foot |
Higher Cost |
X-ray - Forearm |
Higher Cost |
X-ray - Hand |
Higher Cost |
X-ray - Hip |
Higher Cost |
X-ray - Knee |
Higher Cost |
X-ray - Neck (Cervical Spine) |
Higher Cost |
X-ray - Pelvis |
Higher Cost |
X-ray - Shoulder |
Higher Cost |
X-ray - Spine |
Higher Cost |
X-ray - Wrist |
Higher Cost |