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 $9890 74174 CT ABD & PELVIS W CONTRAST $4361 74177 CT ABD & PELVIS W WO CONTRAST $4862 74178 CT ABD & PELVIS WO CONTR $2819 74176 CT OF THE ABDOMEN WITHOUT CONTRAST FOLLOWED BY CT OF THE ABDOMEN WITH CONTRAST $4567 74170 CT OF THE CERVICAL SPINE WITHOUT CONTRAST $3182 72125 CT CHEST ANGIOGRAPHY $7896 71275 CT OF THE CHEST WITH CONTRAST $3810 71260 CT CHEST WO CONTR $3182 71250 CT GUIDE CYST ASPIRATION $2298 77012 CT HEAD ANGIOGRAPHY $5963 70496 CT OF THE HEAD WITHOUT CONTRAST $2710 70450 CT L E WO CONTR $2757 73700 CT L SPINE W CONTRAST $3810 72132 CT L SPINE WO CONTR $3182 72131 CT OF THE FACE AND JAW WITHOUT CONTRAST $2710 70486 CT NECK ANGIOGRAPHY $5963 70498 CT NECK W CONTRAST $3577 70491 CT T SPINE W CONTRAST $3810 72129 CT T SPINE WO CONTR $3182 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 BRAIN WO CONTR + MRA HEAD WO CONTR $6909 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 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 $1119 76700 ULTRASOUND OF THE RETROPERITONEUM -- PARTIAL AREA OF THE KIDNEYS AND ABDOMINAL AORTA $1119 76705 US BREAST UNILAT LIMITED $500 76642 US BX BREAST 1ST LESION $3720 19083 US DUPLEX ARTERIAL FLOW COMPLETE $1762 93975 US ENCEPHALOGRAM B $717 76506 ULTRASOUND USED TO GUIDE THE NEEDLE DURING A NEEDLE BIOPSY OF NEEDLE ASPIRATION $1368 76942 US GUIDE VASCULAR ACCESS (RSP) $228 76937 US HEAD NECK SOFT TISSUE $1119 76536 US INTRAOPERATIVE $919 76998 US PARACENTESIS $2368 49083 ULTRASOUND OF THE PELVIS $1079 76856 ULTRASOUND OF THE ABDOMEN -- ALL AREAS OF THE ABDOMEN $1119 76770 US TESTICULAR/SCROTAL $1119 76870 US THORACENTESIS W IMAGING $2178 32555 US TRANSVAGINAL $1079 76830 ULTRASOUND OF THE VAGINAL TRACT $1079 76830 ULTRASOUND OF A PREGNANT UTERUS $688 76817 USTEKINUMAB*1 MG INJ (J3357) $1349 J3357 USTEKINUMAB*1 MG INJ (J3358) $81 J3358

X-Ray

Description Price CPT Code X-RAY OF THE ANKLE MINIMUM OF 3 VIEWS $532 73610 XR BREAST TOMOSYNTHESIS SCREENING $160 77063 XR DEXA AXIAL SKELETON $892 77080 XR ELBOW COMPLETE 3+ $532 73080 XR EXAM CHEST 1 VIEW (RAD) $357 71045 XR EXAM CHEST 2 VIEWS (RAD) $357 71046 XR FEMUR 2+ VIEW $492 73552 X-RAY OF THE FOOT MINIMUM OF 3 VIEWS $532 73630 XR FOREARM AP LAT $532 73090 X-RAY OF THE HAND MINIMUM OF 3 VIEWS $532 73130 XR HIP UNILAT 2-3 VIEW $298 73502 X-RAY OF THE KNEE 3 VIEWS $532 73562 XR KNEE AP LAT $532 73560 XR LUMBAR SPINE 2 OR 3 VIEWS (RAD) $532 72100 MAMMOGRAM SCREENING -- BOTH BREASTS $809 77067 X-RAY OF THE PELVIS ONE OR TWO VIEWS $532 72170 X-RAY OF THE SHOULDER MINIMUM 2 VIEWS $532 73030 XR TIB FIB AP LAT $532 73590 XR WRIST COMPLETE 3+ $532 73110 XR X-RAY EXAM ABDOMEN 1 VIEW $324 74018

Lab

Description Price CPT Code ANTIBODY SCREEN RBC $160 86850 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 CULTURE BLOOD $141 87040 GLYCATED HEMOGLOBIN $158 83036 LACTATE (RT) $169 83605 MAGNESIUM $113 83735 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) $1002 93355 EKG $268 93005 CARDIOVASCULAR STRESS TEST USING A TREADMILL $1694 93017 MYOCARDIAL STRAIN IMAGING (CARDIO) $790 93356 PULMONARY STRESS COMPLEX $1025 94621 TEE W CONTRAST (CARDIO) $3077 C8925 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 $6924 Excision of Stomach, Endo, Diagn-0DB68ZX $6773 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 $14106 Replacement of Right Lens with Synth Sub, Perc Approach-08RJ3JZ $14188 X-RAY OF THE BLADDER WITH CONTRAST $2293 REMOVAL OF TONSILS AND ADENOIDS $6786