UMC Pricing Information
Diagnostic Tests & Outpatient Procedures

When comparing charges with other hospitals or provider practices, it is important to understand their charges may or may not include both the hospital and the doctor or other provider services. Average charges are estimates; your out-of-pocket expense will depend on your individual insurance coverage (such as co-insurance or deductibles).

The services you receive from your provider are based on your individual need and medical condition. Actual charges will vary based on services delivered and medical condition. Additional tests or services not listed in the estimate may be ordered by your doctor or provider, in order to treat, diagnose or care for individual needs.

CT Scans MRI/MRA Ultrasound X-Ray

Lab Cardiology Outpatient Procedures

CT Scan

Description Price CPT Code CT ABD & PELVIS ANGIOGRAPHY $11077 74174 CT ABD & PELVIS W CONTRAST $4885 74177 CT ABD & PELVIS W WO CONTRAST $5446 74178 CT ABD & PELVIS WO CONTR $3158 74176 CT OF THE ABDOMEN WITHOUT CONTRAST FOLLOWED BY CT OF THE ABDOMEN WITH CONTRAST $5116 74170 CT AORTA ANGIOGRAPHY $10829 75635 CT OF THE CERVICAL SPINE WITHOUT CONTRAST $3564 72125 CT CHEST ANGIOGRAPHY $8844 71275 CT OF THE CHEST WITH CONTRAST $4268 71260 CT CHEST WO CONTR $3564 71250 CT HEAD ANGIOGRAPHY $6679 70496 CT OF THE HEAD WITHOUT CONTRAST $3036 70450 CT L E WO CONTR $3088 73700 CT L SPINE W CONTRAST $4268 72132 CT L SPINE WO CONTR $3564 72131 CT OF THE FACE AND JAW WITHOUT CONTRAST $3036 70486 CT NECK ANGIOGRAPHY $6679 70498 CT NECK W CONTRAST $4007 70491 CT T SPINE W CONTRAST $4268 72129 CT T SPINE WO CONTR $3564 72128

MRI/MRA

Description Price CPT Code MRI ABDOMEN W WO CONTRAST $7022 74183 MRI ABDOMEN WO CONTR $2755 74181 MRI OF THE BRAIN WITHOUT CONTRAST FOLLOWED BY AN MRI OF THE BRAIN WITH CONTRAST $7299 70553 MRI BRAIN W WO CONTRAST + MRA HEAD WO CONTR $10921 70553 MRI OF THE BRAIN WITHOUT CONTRAST $3287 70551 MRI BREAST W W/O CONTRAST BILATERAL $3843 C8908 MRI OF THE CERVICAL SPINE WITHOUT CONTRAST FOLLOWED BY AN MRI OF THE CERVICAL SPINE WITH CONTRAST $6437 72156 MRI OF THE CERVICAL SPINE WITHOUT CONTRAST $3217 72141 MRI OF THE LUMBAR SPINE WITHOUT CONTRAST FOLLOWED BY AN MRI OF THE LUMBAR SPINE WITH CONTRAST $6122 72158 MRI OF THE LUMBAR SPINE WITHOUT CONTRAST $3059 72148 MRI LOWER EXTREM JOINT W WO CONTRAST $6993 73723 MRI OF THE TOE, ANKLE, OR KNEE WITHOUT CONTRAST $2755 73721 MRI LOWER EXTREM W WO CONTRAST $4181 73720 MRI LOWER EXTREM WO CONTR $3153 73718 MRI ORB FACE NECK W WO CONTRAST $7860 70543 MRI PELVIS W WO CONTRAST $7022 72197 MRI T SPINE W WO CONTRAST $6122 72157 MRI OF THE THORACIC SPINE WITHOUT CONTRAST $3059 72146 MRI OF THE SHOULDER, ELBOW, WRIST, OR FINGERS WITHOUT CONTRAST $2755 73221 MRSA BY PCR $391 87641

Ultrasound

Description Price CPT Code ULTRASOUND OF THE RETROPERITONEUM -- ALL AREAS OF THE RETROPERITONEUM $1205 76700 ULTRASOUND OF THE RETROPERITONEUM -- PARTIAL AREA OF THE KIDNEYS AND ABDOMINAL AORTA $1205 76705 US BREAST UNILAT LIMITED $539 76642 US BX BREAST 1ST LESION $4167 19083 US DUPLEX ARTERIAL FLOW COMPLETE $1897 93975 ULTRASOUND USED TO GUIDE THE NEEDLE DURING A NEEDLE BIOPSY OF NEEDLE ASPIRATION $1473 76942 US GUIDE VASCULAR ACCESS (RSP) $246 76937 US HEAD NECK SOFT TISSUE $1205 76536 US INFANT HIPS LIMITED $768 76886 US INTRAOPERATIVE $990 76998 US PARACENTESIS $2653 49083 ULTRASOUND OF THE PELVIS $1162 76856 ULTRASOUND OF THE ABDOMEN -- ALL AREAS OF THE ABDOMEN $1205 76770 US TESTICULAR/SCROTAL $1205 76870 US THORACENTESIS W IMAGING $2178 32555 US TRANSVAGINAL $1162 76830 ULTRASOUND OF THE VAGINAL TRACT $1162 76830 ULTRASOUND OF A PREGNANT UTERUS $741 76817 USTEKINUMAB*1 MG INJ (J3357) $1349 J3357 USTEKINUMAB*1 MG INJ (J3358) $87 J3358

X-Ray

Description Price CPT Code X-RAY OF THE ANKLE MINIMUM OF 3 VIEWS $589 73610 XR BREAST TOMOSYNTHESIS SCREENING $180 77063 XR DEXA AXIAL SKELETON $988 77080 XR ELBOW COMPLETE 3+ $589 73080 XR EXAM CHEST 1 VIEW (RAD) $400 71045 XR EXAM CHEST 2 VIEWS (RAD) $400 71046 XR FEMUR 2+ VIEW $545 73552 X-RAY OF THE FOOT MINIMUM OF 3 VIEWS $589 73630 XR FOREARM AP LAT $589 73090 X-RAY OF THE HAND MINIMUM OF 3 VIEWS $589 73130 XR HIP UNILAT 2-3 VIEW $330 73502 X-RAY OF THE KNEE 3 VIEWS $589 73562 XR KNEE 4+VIEWS $589 73564 XR LUMBAR SPINE 2 OR 3 VIEWS (RAD) $589 72100 MAMMOGRAM SCREENING -- BOTH BREASTS $907 77067 X-RAY OF THE PELVIS ONE OR TWO VIEWS $589 72170 X-RAY OF THE SHOULDER MINIMUM 2 VIEWS $589 73030 XR TIB FIB AP LAT $589 73590 XR WRIST COMPLETE 3+ $589 73110 XR X-RAY EXAM ABDOMEN 1 VIEW $363 74018

Lab

Description Price CPT Code CBCD -- COMPLETE BLOOD COUNT WITH DIFFERENTIAL $138 85025 BMP $180 80048 BLOOD GAS (RT) $297 82803 BLOOD TYPING SEROLOGIC ABO $374 86900 BLOOD TYPING SEROLOGIC RH(D) $114 86901 CBC -- COMPLETE BLOOD COUNT ONLY $118 85027 CMP -- COMPREHENSIVE METABOLIC PANEL $214 80053 GLYCATED HEMOGLOBIN $158 83036 LACTATE (RT) $169 83605 LACTIC ACID $169 83605 MAGNESIUM $113 83735 NATRIURETIC PEPTIDE TYPE B $503 83880 PHOSPHORUS SERUM $83 84100 PT $80 85610 SOFIA SARS AG FIA (POCL) $416 87426 PTT $111 85730 THYROID STIMULATING HORMONE (CHEM) $258 84443 TROPONIN QUANT (CHEM) $159 84484 UA $78 81001 CHARGE FOR BLOOD COLLECTION $0 36415

Cardiology

Description Price CPT Code 2D TTE W OR W/O FOL W/CON FU $1771 C8924 3D RENDER WO POSTPROCESS (CARDIO) $386 76376 ADMIN ECG CONTRAST AGENT $227 93352 DOPPLER USED WITH THE ECHOCARDIOGRAPHY OF THE HEART FOR COLOR FLOW MAPPING $726 93325 DOPPLER USED WITH THE ECHOCARDIOGRAPHY OF THE HEART FOR SPECTRAL DISPLAY $726 93320 DOPPLER LTD CARDIAC FU $812 93321 ECG ECHO 2 DIM CHD $1632 93303 ECG ECHO FU LIMITED $812 93308 ULTRASOUND USED DURING THE CARDIOVASCULAR STRESS TEST $3557 C8928 ECHO TRANSESOPHAGEAL (TEE) $1079 93355 EKG $268 93005 CARDIOVASCULAR STRESS TEST USING A TREADMILL $1694 93017 MYOCARDIAL STRAIN IMAGING (CARDIO) $790 93356 PULMONARY STRESS COMPLEX $1025 94621 TEE WO CONTR (CARDIO) $3172 93312 TTE W CONTRAST (CARDIO) $3593 C8929 TTE W/DOPPLER COMPLETE NO CONTRAST $3593 93306

Outpatient Procedures

Description Average Charges [ENDOSCOPIC] POLYPECTOMY OF RECTUM $6986 C (PERCUTAN) (NEEDLE) BIOPSY OF THYROID GLAND $1846 LIVER BIOPSY DONE USING A NEEDLE $4737 CARPAL TUNNEL RELEASE $6904 CATARACT REMOVAL WITH INSERTION OF A NEW LENS $10491 COLONSCOPY $5466 ENDOSCOPIC POLYP REMOVAL FROM THE LARGE INTESTINE $7488 EGD WITH A BIOPSY $5747 LITHOTRIPSY $18421 EXCIS KNEE SEMILUN CARTL $12877 Excision of Duodenum, Endo, Diagn-0DB98ZX $7002 Excision of Stomach, Endo, Diagn-0DB68ZX $6822 LAPROSCOPIC REMOVAL OF GALL BLADDER $11767 LEFT HEART CATH $20775 REMOVAL OF FLUID FROM THE EYEBALL $12223 INSERTING TUBE INTO THE INNER EAR $5759 Replacement of Left Lens with Synth Sub, Perc Approach-08RK3JZ $14142 Replacement of Right Lens with Synth Sub, Perc Approach-08RJ3JZ $14240 X-RAY OF THE BLADDER WITH CONTRAST $2293 REMOVAL OF TONSILS AND ADENOIDS $6786