Effective 12/18. Prices are subject to change without notice.
Outpatient Surgical Procedures
| PROCEDURE | AVERAGE CHARGES |
|---|---|
| Arthroscopy Shoulder with Rotator Cuff Repair | $25,350.00 |
| Arthroscopy Knee | $9,560.00 |
| Arhtorscopy Knee with meniscectomy | $9,300.00 |
| Carpal Tunnel Release | $8,140.00 |
| Insertion Spinal Neurostimulator via Laminectomy | $122,970.00 |
| Insertion Spinal Neurostimulator Pain Management - Trial | $25,610.00 |
| Insertion Spinal Neurostimulator via Percutaneous - 1 Lead | $102,200.00 |
| Insertion Spinal Neurostimulator via Percutaneous - 2 Lead | $118,690.00 |
| Insertion Pain Pump | $65,230.00 |
| Kyphoplasty | $30,350.00 |
| Laminotomy | $15,390.00 |
| Laminectomy | $16,130.00 |
| Microdiscectomy | $15,390.00 |
| Manipulation of Knee Joint | $4,100.00 |
| Partial Knee Replacement | $50,220.00 |
| Total Knee Arthroplasty (Replacement) | $53,980.00 |
| Anterior Cervical Discectomy and Fusion (ACDF) - 1 Level | $37,440.00 |
| Cystourethroscopy with Insertion of Stent | $12,330.00 |
| Cystourethroscopy with Biopsy | $17,490.00 |
| Cystourerthroscopy with Removal of Tumor Small | $10,400.00 |
| Cystourerthroscopy with Removal of Bladder Tumor | $12,400.00 |
| Anterior Colporrhapy (Repair of Cystocele) | $12,950.00 |
| Insertion of Penile Prosthesis | $79,340.00 |
| Vasectomy | $7,120.00 |
| Sling Operation | $14,520.00 |
| Lithotripsy | $14,400.00 |
| Cystouretroscopy with Stone Removal | $13,770.00 |
| Transurethral Resection of Prostate | $15,130.00 |
Outpatient Pain Management Procedures
| PROCEDURE | AVERAGE CHARGES |
|---|---|
| Epidural Steroid Injection | $1,159.45 |
| Epidural Blood Patch | $1,008.66 |
| Trigger Point Injection 1-2 muscles | $496.94 |
| Trigger Point Injection 3+ muscles | $496.94 |
| Discogram, 1 level injection | $7,253.08 |
| Discogram, 2 level injection | $12,778.11 |
| Discogram, 3 level injection | $18,379.24 |
| Major joint injection - Hip, Knee, & Shoulder | $810.00 |
| Pain Pump Trial | $2,100.00 |
| Spinal Neurostimulator Trial | $27,228.55 |
| Botox Injection | $5,316.88 |
| **Each Additional | $350.40 |
| Radiofrequency Ablation of Facet Joint (RFA) - 1 level with sedation | $2,885.17 |
| **Each Additional | $880.00 |
| Medial Branch Facet Inj | $1,599.99 |
| ** Each Additional | $492.25 |
| SI Joint Injection | $2,413.60 |
| Transforaminal Injection | $1,175.46 |
Outpatient Diagnostic and Laboratory Services
| PROCEDURE | PRICE (LOW) | PRICE (HIGH) |
|---|---|---|
| CT Abdomen | $1,444.25 | $1,920.85 |
| CT Abdomen/Pelvis | $1,512.03 | $2,607.07 |
| CT Brain | $1,444.25 | $1,902.85 |
| CT Cervical Spine | $1,444.25 | $1,920.85 |
| CT Chest | $1,444.25 | $1,920.85 |
| CT Lower Extremity | $1,444.25 | $1,920.85 |
| CT Upper Extremity | $1,444.25 | $1,920.85 |
| CT Lumbar Spine | $1,444.25 | $1,920.85 |
| CT Neck Soft Tissue | $1,444.25 | $1,920.85 |
| CT Pelvis | $1,444.25 | $1,920.85 |
| CT Thoracic Spine | $1,444.25 | $1,920.85 |
| MRA Brain | $2,719.31 | $3,616.68 |
| MRI Brain | $2,719.31 | $3,918.49 |
| MRI Cervical Spine | $2,719.31 | $3,616.68 |
| MRI Chest | $2,719.31 | $3,616.68 |
| MRI Hip | $1,133.05 | $1,506.96 |
| MRI Knee | $1,133.05 | $1,506.96 |
| MRI Lumbar Spine | $2,719.31 | $3,616.68 |
| MRI Pelvis | $2,719.31 | $3,616.68 |
| MRI Shoulder | $1,133.05 | $1,506.96 |
| MRI Thoracic Spine | $2,719.31 | $3,616.68 |
| MRI Wrist | $1,133.05 | $1,632.71 |
| Myelogram - Includes post myelogram CT | $3,509.84 | $3,660.25 |
| XR Abdomen | $332.05 | $560.74 |
| XR Ankle | $332.05 | $332.05 |
| XR Cervical Spine | $332.05 | $560.74 |
| XR Chest 2 Views | $332.05 | $332.05 |
| XR Hip | $332.05 | $562.66 |
| XR Hips Bilateral | $562.66 | $1,072.74 |
| XR Knee | $261.60 | $332.05 |
| XR Lumbar Spine 1 View | $332.05 | $560.74 |
| XR Pelvis | $332.05 | $332.05 |
| XR Ribs | $261.60 | $560.74 |
| XR Shoulder | $332.05 | $332.05 |
| XR Skull | $332.05 | $560.74 |
| XR Thoracic Spine | $332.05 | $332.05 |
| ECG | $123.50 | $123.50 |
| Complete Blood Count (CBC) | $47.26 | $47.26 |
| Metabolic Panel | $86.02 | $141.70 |
| Drug Screen | $116.31 | $664.11 |