Service Level | Physician Fee Due Today | Hospital Facility Fee |
Level 1 | $75 | $325 |
Level 2 | $75 | $650 |
Level 3 | $150 | $1050 |
Level 4 | $250 | $1475 |
Level 5 | $250 | $2400 |
Level 6 Observation Care | $350 | $3500 |
Level 7 IP Care Per Day | $400 | $3500 per day |
Study | Price |
2-D Echo with Color Flow and Doppler | 800 |
PICC Placement - Single, double or triple lumen BD PICC | 800 |
Midline Placement- BD Powerglide or Bard Power Midline | 575 |
PICC Removal | 250 |
PICC Troubleshoot | 200 |
Study | Price |
X-ray single extremity/joint | $75 |
Chest X-ray, 1 View | $75 |
Chest X-ray PA & LAT, 2 Views | $95 |
CT Any Body Part Without Contrast | $250 |
CT Any Body Part with Contrast | $325 |
CT Angiogram Any Body Part | $400 |
CT With & Without Contrast | $400 |
Ultrasound Any Body Part | $250 |
Ultrasound Pregnancy with Labs | $350 |
MRI Any Body Part Without Contrast | $400 |
MRI Any Body Part with Contrast | $550 |
MRI With & Without Contrast | $600 |
MRI Angiogram | $550 |
Lab Tests | Price |
Any single “in-house” lab | 50 |
Any single RML send out test | 200 |
COVID PCR | 200 |
Respiratory Panel | 350 |
GI Panel | 450 |
Cardiac Panel (ck, ckmb, troponin, bnp, d-dimer) | 300 |
STD Panel (UA, gonorrhea, chlamydia, trichomonas, yeast, BV | 650 |
