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Outpatient Services

Outpatient Radiology Test

Laboratory Test (Single) CPT Code Price
Antibody COVID-19 TESTING N/A $200
PCR COVID-19 TESTING N/A $200
Antigen COVID-19 TESTING N/A $200
Complete Blood Count (CBC) 85027 $60
Basic Metabolic Panel (BMP) 80048 $55
Comprehensive Metabolic Panel (CMP) 80053 $60
Hepatic Panel (LFT) 80076 $55
Urinalysis - Routine (UA) 81001 $35
Urinalysis Culture (UAC) 87088 $55
Serum Pregnancy Qualitative 84703 $35
D-Dimer 85379 $60
Uric Acid Level 84550 $25
Urine Pregnancy Test- Qualatative (UAHCG) 81025 $35
Lactate Level (CG4) 82803/83605 $55
Lipase 83690 $55
Lithium Level 80178 $50
Phenytoin Total 80185 $50
Valporic Acid Level 80164 $50
Prothrombin Time with INR (PT-INR) 85730 $35
Prothrombin Time with INR (PT-INR) (Warfarin Therapy
Only)
85730 $50
Point of Care Laboratory Test (Single) CPT Code Price
Urine Drug Screen (10 Panel) 80300 $55
Discounted Panels
Name of Panel Included Price
Nutrition Lab Panel CMP, CBC, Iron, Thiamine, Vitamin B12, Folate, Vitamin D, Vitamin C, Zinc. $175
Pre-Operative Lab Panel CBC, CMP, RH Factor, PT INR, aPTT. $140
STD Panel 1 (NAAT) GC, Chlamidia, Trich. $650
STD Panel 2 (NAAT) GC, Chlamidia, Trich, Herpes $750
Thyroid Panel TSH, FT3, FT4, T3 Uptake. $115
Study Price
X-ray Any Single Extremity or Joint, 2 views/3 views $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 labs and IV included
CT Any Body Part With and Without Contrast $400 labs and IV included
CT Angiogram Any Body Part $425 labs and IV included
Ultrasound Any Body Part $250
Ultrasound Pregnancy with Labs $350

Emergency Care Self-Pay Pricing

 

Tier Description Price
Tier 1 Minor care $300
Tier 2 Low Severity $660
Tier 3 Medium Severity $1260
Tier 4 Moderate Severity $1500
Tier 5 High Severity / Threat $1800
Tier 6 Observation Care $3300
Critical care and extended observation services are not included in the pricing above