| Actual costs may vary based on individual circumstances. |
| Evaluation & Management Services (CPT Codes 99201-99499) |
Average Charge |
2018 CPT Code |
| Emergency Room Visit, Level 2 (low to moderate severity) |
$1,063.00 |
99282 |
| Emergency Room Visit, Level 3 (moderate severity) |
$1,615.00 |
99283 |
| Emergency Room Visit, Level 4 (high severity without significant threat) |
$2,232.00 |
99284 |
| Outpatient Visit, established patient, 15 minutes |
$621.00 |
99213 |
| Laboratory & Pathology Services (CPT Codes 80047-89398) |
Average Charge |
2018 CPT Code |
| Basic Metabolic Panel |
$63.00 |
80048 |
| Complete Blood Count, automated |
$75.00 |
85027 |
| Complete Blood Count, with differential WBC, automated |
$82.00 |
85025 |
| Comprehensive Metabolic Panel |
$78.00 |
80053 |
| Creatine Kinase (CK), (CPK), Total |
$236.00 |
82550 |
| Lipid Panel |
$135.00 |
80061 |
| Partial Thromboplastin Time |
$177.00 |
85730 |
| Prothrombin Time |
$75.00 |
85610 |
| Thyroid Stimulating Hormone |
$188.00 |
84443 |
| Troponin, Quantitative |
$142.00 |
84484 |
| Radiology Services (CPT Codes 70010-79999) |
Average Charge |
2018 CPT Code |
| CT Scan, Abdomen, with contrast |
$1,800.00 |
74160 |
| CT Scan, Head or Brain, without contrast |
$2,032.00 |
70450 |
| CT Scan, Pelvis, with contrast |
$3,115.00 |
72193 |
| MRI, Brain, without contrast, followed by contrast |
$1,313.00 |
70553 |
| Ultrasound, Abdomen, Complete |
$1,223.00 |
76700 |
| Ultrasound, OB, 14 weeks or more, transabdominal |
$936.00 |
76805 |
| X-Ray, Lower Back, minimum four views |
$553.00 |
72110 |
| X-Ray, Chest, two views |
$443.00 |
71046 |
| Medicine Services (CPT Codes 90281-99607) |
Average Charge |
2018 CPT Code |
| Inhalation Treatment, pressurized or nonpressurized |
$265.00 |
94640 |
| Physical Therapy, Evaluation |
$339.00 |
97161-97163 |
| Physical Therapy, Gait Training |
$163.00 |
97116 |
| Physical Therapy, Therapeutic Exercise |
$163.00 |
97110 |
| Surgery Services (CPT Codes 10021-69990) |
Average Charge |
2018 CPT Code |
| Injection, Anesthetic or Steroid, transforaminal epidural, lumbar |
$3,942.00 |
64483 |
