Medical Procedure Pricing - Patient Resources | Revere Health
Procedure Pricing

Revere Health believes all patients should have access to information that helps them make educated healthcare decisions, including information about the cost of care. That’s why we’ve created pricing charts that highlight the most common procedures in each specialty and what they cost at any Revere Health location.

The pricing information below* represents the “sticker price” of a particular procedure or service for someone without insurance. Uninsured patients are eligible to receive a 30% discount on the sticker price for prompt payment. Patients with health insurance will typically be charged an amount less than the sticker price (the exact cost varies based on individual insurance plans).

The average patient experience also results in some additional testing or services that could appear on your bill. We’re happy to discuss the specifics of your bill with you if you have any questions.

*These prices reflect our most current data and will be updated periodically.

Adult Medicine
CPT Code
Description
Price
99396
Prev visit est age 40-64
$137
99232
Subsequent hospital care
$127
G0250
Md inr test revie inter mgmt
$119
99231
Subsequent hospital care
$110
99239
Hospital discharge day
$110
90662
Iiv no prsv increased ag im
$100
G0008
Admin influenza virus vac
$98
J1030
Methylprednisolone 40 mg inj
$93
99223
Initial hospital care
$61
20610
Drain/inj joint/bursa w/o us
$55
Cardiology
CPT Code
Description
Price
99214
Office/outpatient visit est
$182
93000
Electrocardiogram complete
$45
A9505
Tl201 thallium
$190
99213
Office/outpatient visit est
$123
J2785
Regadenoson injection
$78
93306
Tte w/doppler complete
$527
85610
Prothrombin time
$8
9330626
Tte w/doppler complete
$164
99204
Office/outpatient visit new
$280
93296
Rem interrog evl pm/ids
$74
ENT
CPT Code
Description
Price
95027
Icut allergy titrate-airborn
$10
95117
Immunotherapy injections
$32
95165
Antigen therapy services
$30
99203
Office/outpatient visit new
$183
99213
Office/outpatient visit est
$123
99203
Office/outpatient visit new
$183
99214
Office/outpatient visit est
$182
99213
Office/outpatient visit est
$123
99203
Office/outpatient visit new
$183
99204
Office/outpatient visit new
$280
Family Medicine
CPT Code
Description
Price
J1050
Medroxyprogesterone acetate
$1
99214
Office/outpatient visit est
$182
99213
Office/outpatient visit est
$123
36415
Routine venipuncture
$10
83036
Glycosylated hemoglobin test
$20
80061
Lipid panel
$28
99203
Office/outpatient visit new
$183
J1885
Ketorolac tromethamine inj
$16
81003
Urinalysis auto w/o scope
$6
90471
Immunization admin
$38
Gastroenterology
CPT Code
Description
Price
99152
Mod sed same phys/qhp 5/>yrs
$131
99214
Office/outpatient visit est
$182
36415
Routine venipuncture
$10
G0500
Mod sedat endo service >5yrs
$147
45378
Diagnostic colonoscopy
$882
43239
Egd biopsy single/multiple
$943
99213
Office/outpatient visit est
$123
45380
Colonoscopy and biopsy
$1122
85025
Complete cbc w/auto diff wbc
$15
99204
Office/outpatient visit new
$280
Internal Medicine
CPT Code
Description
Price
99214
$182
J1071
$0
99214
$182
J0897
$22
36415
$10
99214
$182
80053
$22
36415
$10
Nephrology
CPT Code
Description
Price
36415
Routine venipuncture
$10
80069
Renal function panel
$18
99214
Office/outpatient visit est
$182
J0885
Epoetin alfa, non-esrd
$17
82570
Assay of urine creatinine
$10
81001
Urinalysis auto w/scope
$15
90960
Esrd srv 4 visits p mo 20+
$528
83970
Assay of parathormone
$86
85025
Complete cbc w/auto diff wbc
$15
99213
Office/outpatient visit est
$123
OBG/YN
CPT Code
Description
Price
J1050
Medroxyprogesterone acetate
$1
36415
Routine venipuncture
$10
99213
Office/outpatient visit est
$123
99214
Office/outpatient visit est
$182
84443
Assay thyroid stim hormone
$35
84439
Assay of free thyroxine
$18
81003
Urinalysis auto w/o scope
$6
85018
Hemoglobin
$6
82951
Glucose tolerance test (gtt)
$24
99203
Office/outpatient visit new
$183
Orthopedics
CPT Code
Description
Price
99213
Office/outpatient visit est
$123
J0702
Betamethasone acet&sod phosp
$11
J3301
Triamcinolone acet inj nos
$3
20610
Drain/inj joint/bursa w/o us
$162
99203
Office/outpatient visit new
$183
99214
Office/outpatient visit est
$182
J7325
Synvisc or synvisc-one
$25
99212
Office/outpatient visit est
$74
J7323
Euflexxa inj per dose
$376
73562
X-ray exam of knee 3
$102
Physical Therapy
CPT Code
Description
Price
97110
Therapeutic exercises
$49
97140
Manual therapy 1/> regions
$46
97010
Hot or cold packs therapy
$10
97530
Therapeutic activities
$63
97016
Vasopneumatic device therapy
$29
97014
Electric stimulation therapy
$24
97161
Pt eval low complex 20 min
$135
Radiology
CPT Code
Description
Price
Q9967
Locm 300-399mg/ml iodine,1ml
$1
A9585
Gadobutrol injection
$1
77063
Breast tomosynthesis bi
$153
77067
Breast tomosynthesis bi
$374
7706726
Breast tomosynthesis bi
$110
7706326
Breast tomosynthesis bi
$86
7045026
Ct head/brain w/o dye
$123
7417726
Ct abd & pelv w/contrast
$264
73721
Mri jnt of lwr extre w/o dye
$930
72148
Mri lumbar spine w/o dye
$875
Spine & Rehab
CPT Code
Description
Price
97110
Therapeutic exercises
$49
99213
Office/outpatient visit est
$123
97140
Manual therapy 1/> regions
$46
G0283
Elec stim other than wound
$22
97035
Ultrasound therapy
$22
97014
Electric stimulation therapy
$24
99214
Office/outpatient visit est
$182
97012
Mechanical traction therapy
$25
J0702
Betamethasone acet&sod phosp
$11
J0586
Abobotulinumtoxina
$12
Urgent Care
CPT Code
Description
Price
J1071
Inj testosterone cypionate
$0
99214
Office/outpatient visit est
$182
99213
Office/outpatient visit est
$123
J1885
Ketorolac tromethamine inj
$16
99203
Office/outpatient visit new
$183
96372
Ther/proph/diag inj sc/im
$42
81003
Urinalysis auto w/o scope
$6
99202
Office/outpatient visit new
$127
87880
Strep a assay w/optic
$28
J1100
Dexamethasone sodium phos
$7
Wellness Center
CPT Code
Description
Price
97803
Med nutrition indiv subseq
$51
97802
Medical nutrition indiv in
$59
G0439
Ppps, subseq visit
$206
G0438
Ppps, initial visit
$310
99386
Prev visit new age 40-64
$267
99213
Office/outpatient visit est
$123
99396
Prev visit est age 40-64
$202
G0402
Initial preventive exam
$311
99212
Office/outpatient visit est
$74
36415
Routine venipuncture
$10
Allergy & Immunology
CPT Code
Description
Price
95004
Percut allergy skin tests
$10
95165
Antigen therapy services
$30
95117
Immunotherapy injections
$32
95115
Immunotherapy one injection
$25
99213
Office/outpatient visit est
$123
95044
Allergy patch tests
$13
99204
Office/outpatient visit new
$280
99214
Office/outpatient visit est
$182
95024
Icut allergy test drug/bug
$17
99203
Office/outpatient visit new
$183
Dermatology
CPT Code
Description
Price
99213
Office/outpatient visit est
$123
17003
Destruct premalg les 2-14
$19
88305
Tissue exam by pathologist
$160
17003
Destruct premalg les 2-14
$19
99213
Office/outpatient visit est
$123
99202
Office/outpatient visit new
$127
8830526
Tissue exam by pathologist
$82
17000
Destruct premalg lesion
$132
95044
Allergy patch tests
$13
99202
Office/outpatient visit new
$127
Endocrinology
CPT Code
Description
Price
36415
Routine venipuncture
$10
84443
Assay thyroid stim hormone
$35
99214
Office/outpatient visit est
$182
36415
Routine venipuncture
$10
82306
Vitamin d 25 hydroxy
$62
99214
Office/outpatient visit est
$182
84439
Assay of free thyroxine
$18
84443
Assay thyroid stim hormone
$35
82306
Vitamin d 25 hydroxy
$62
84439
Assay of free thyroxine
$18
Family Practice
CPT Code
Description
Price
99214
Office/outpatient visit est
$182
J1071
Inj testosterone cypionate
$0
J1071
Inj testosterone cypionate
$0
J1050
Medroxyprogesterone acetate
$1
99232
Subsequent hospital care
$126
J1071
Inj testosterone cypionate
$0
99213
Office/outpatient visit est
$123
99214
Office/outpatient visit est
$182
J1050
Medroxyprogesterone acetate
$1
99213
Office/outpatient visit est
$123
Hospitalist
CPT Code
Description
Price
99223
Initial hospital care
$350
99222
Initial hospital care
$237
99221
Initial hospital care
$176
92960
Cardioversion electric ext
$601
36556
Insert non-tunnel cv cath
$718
33210
Insert electrd/pm cath sngl
$487
99291
Critical care first hour
$612
36561
Insert tunneled cv cath
$3100
99226
Subsequent observation care
$181
Imaging
CPT Code
Description
Price
Q9967
Locm 300-399mg/ml iodine,1ml
$1
A9585
Gadobutrol injection
$1
A9579
Gad-base mr contrast nos,1ml
$11
72148TC
Mri lumbar spine w/o dye
$739
73721TC
Mri jnt of lwr extre w/o dye
$799
73221TC
Mri joint upr extrem w/o dye
$781
72141TC
Mri neck spine w/o dye
$720
74177TC
Ct abd & pelv w/contrast
$610
70553TC
Mri brain stem w/o & w/dye
$1543
71260TC
Ct thorax w/dye
$464
Neurology
CPT Code
Description
Price
J0585
Injection,onabotulinumtoxina
$10
99214
Office/outpatient visit est
$182
95886
Musc test done w/n test comp
$205
36415
Routine venipuncture
$10
J3301
Triamcinolone acet inj nos
$3
99205
Office/outpatient visit new
$353
99215
Office/outpatient visit est
$246
80053
Comprehen metabolic panel
$22
85025
Complete cbc w/auto diff wbc
$15
95923
Autonomic nrv syst funj test
$284
Oncology
CPT Code
Description
Price
J1442
Inj filgrastim excl biosimil
$2
J1439
Inj ferric carboxymaltos 1mg
$1
J0641
Levoleucovorin injection
$3
J9306
Injection, pertuzumab, 1 mg
$20
J9025
Azacitidine injection
$12
Ophthalmology
CPT Code
Description
Price
92015
Determine refractive state
$118
92014
Eye exam&tx estab pt 1/>vst
$196
92004
Eye exam new patient
$245
92134
Cptr ophth dx img post segmt
$89
92012
Eye exam establish patient
$134
66984
Cataract surg w/iol 1 stage
$1408
92136
Ophthalmic biometry
$150
92133
Cmptr ophth img optic nerve
$85
92083
Visual field examination(s)
$152
66821
After cataract laser surgery
$681
Plastic Surgery
CPT Code
Description
Price
J0585
Injection,onabotulinumtoxina
$10
15272
Skin sub graft t/a/l add-on
$52
99213
Office/outpatient visit est
$123
99204
Office/outpatient visit est
$280
99214
Office/outpatient visit est
$182
19357
Breast reconstruction
$4272
19380
Revise breast reconstruction
$1768
20926
Removal of tissue for graft
$936
11970
Replace tissue expander
$1184
15271
Skin sub graft trnk/arm/leg
$276
Surgery Center
CPT Code
Description
Price
J0585
Injection,onabotulinumtoxina
$10
43239
Egd biopsy single/multiple
$943
45385
Colonoscopy w/lesion removal
$1224
45380
Colonoscopy and biopsy
$1122
43249
Esoph egd dilation <30 mm
$2872
45378
Diagnostic colonoscopy
$882
30140
Resect inferior turbinate
$825
69436
Create eardrum opening
$357
30520
Repair of nasal septum
$1398
29848
Wrist endoscopy/surgery
$1134
Sports Medicine
CPT Code
Description
Price
J3301
Triamcinolone acet inj nos
$3
99213
Office/outpatient visit est
$123
99203
Office/outpatient visit new
$183
20610
Drain/inj joint/bursa w/o us
$162
99214
Office/outpatient visit est
$182
99212
Office/outpatient visit est
$74
J0585
Office/outpatient visit est
$10
J7325
Synvisc or synvisc-one
$25
73564
X-ray exam knee 4 or more
$114
73630
X-ray exam of foot
$86
Urology
CPT Code
Description
Price
J3145
Testosterone undecanoate 1mg
$2
J1644
Inj heparin sodium per 1000u
$1
J1071
Inj testosterone cypionate
$0
81003
Urinalysis auto w/o scope
$6
99214
Office/outpatient visit est
$182
99213
Office/outpatient visit est
$123
J0585
Injection,onabotulinumtoxina
$10
J9155
Degarelix injection
$6
J9155
Routine venipuncture
$10
51798
Us urine capacity measure
$37