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Sutter East Bay Medical Foundation Charges for Frequently Used Doctor Services

The services below expand to show charges for frequently used services provided by Sutter East Bay Medical Foundation. If you can’t find the service you are looking for, please call (866) 961-8535.

OpenDoctor's Office Visit

Doctor's Office Visit

Common Charges for Doctor's Office Visit
ServiceEstimated Charge
Doctor's Office Visit for a New Patient
Low-Level Visit $136
Low-to-Moderate Level Visit $231
Moderate Level Visit $331
Moderate-to-High Level Visit $501
High Level Visit $623
Doctor's Office Visit for an Established Patient
Low-Level Visit $65
Low-to-Moderate Level Visit $137
Moderate Level Visit $226
Moderate-to-High Level Visit $330
High Level Visit $441
Doctor's Office Visit - Specialist Consultation
Low-Level Visit $149
Low-to-Moderate Level Visit $277
Moderate Level Visit $377
Moderate-to-High Level Visit $556
High Level Visit $675

 

CloseDoctor's Office Visit

OpenEye Exams

Eye Exams

Common Charges for Eye Exams
ServiceEstimated Charge
Eye Exams
New Patient Intermediate Eye Exam $269
New Patient Comprehensive Eye Exam $476
Established Patient Intermediate Eye Exam $284
Established Patient Comprehensive Eye Exam $399
Eye Refraction for Vision Correction $59

 

CloseEye Exams

OpenPhysical/Occupational Therapy

Physical/Occupational Therapy

Common Charges for Physical/Occupational Therapy
ServiceEstimated Charge
Physical/Occupational Therapy
Occupational Therapy Evaluation (Low Level Visit) $275
Occupational Therapy Evaluation (Moderate Level Visit) $275
Occupational Therapy Evaluation (High Level Visit) $275
Occupational Therapy Re-evaluation $182
Electric Stimulation Therapy, Treatment Only $55
Physical Therapy Evaluation (Low Level Visit) $284
Physical Therapy Evaluation (Moderate Level Visit) $284
Physical Therapy Evaluation (High Level Visit) $291
Physical Therapy Re-evaluation $194
Physical Therapy Exercises, Treatment Only $108
Physical Therapy Ultrasound, Treatment Only $49
Physical Therapy ‐ Manual therapy $101

 

ClosePhysical/Occupational Therapy

OpenAllergy Injections

Allergy Injections

Common Charges for Allergy Injections
ServiceEstimated Charge
Allergy Injections
Allergy shot ‐ single injection $41
Allergy shot ‐ two or more injections $48

 

CloseAllergy Injections

OpenDiagnostic Imaging

Diagnostic Imaging

Common Charges for Diagnostic Imaging
ServiceEstimated Charge
Diagnostic Imaging
Abdomen CT Scan $758
Abdomen CT Scan with and without dye $1,397
Abdomen CT Scan, including dye $1,242
Abdomen X-ray $125
Abdomen/Pelvis CT scan $996
Abdomen/Pelvis CT scan with and without dye $1,793
Abdomen/Pelvis CT scan, including dye $1,528
Abdominal ultrasound $624
Abdominal ultrasound, limited $481
Ankle X-ray (3+ views) $151
Auditory Threshold Evaluation $150
Bone density scan (dexa scan) $221
Brain MRI with and without dye $2,459
Brain MRI without dye $1,892
Breast MRI $2,727
Breast MRI with CAD $2,792
Breathing Test (spirometry) $164
Bronchography $157
Cardiac Stress Test, complete $337
Cervical Spine MRI without dye $1,663
Cervical Spine X-ray, minimum 4-5 views $213
Chest CT Scan $934
Chest CT scan, including dye $1,170
Chest X-ray (One views) $89
Chest X-ray (two views) $139
Diagnostic mammography, including CAD unilateral $625
Diagnostic mammography, including CAD bilateral $793
Doppler Color Flow, add-on $87
Duplex scan of Extracranial Arteries $1,091
Echocardiogram, doppler $191
Elbow X-ray, complete $151
Electrocardiogram (ECG) $77
Femur X-ray (1 view) $112
Femur X-ray (2+ views) $131
Finger X-ray $154
Foot X-ray, complete $141
Hand X-ray, complete $147
Head CT Scan $732
Hip X-ray (1 view) $122
Hip X-ray (2-3 views) $169
Hip X-ray (4+ views) $203
Knee MRI without dye $1,204
Knee X-ray 3 views $169
Knee X-ray one or two views $138
Knee X-ray, bilateral $162
Knee X-ray, complete, 4+ views $197
Lumbar Spine MRI without dye $1,645
Lumbar spine x-ray (two or three views) $158
Pelvic ultrasound exam, complete $554
Pelvis CT Scan $746
Pelvis CT Scan, including dye $1,194
Pelvis MRI $1,868
Pelvis X-ray, AP view only $128
Radiologic Stress Test $2,230
Screening mammography, bilateral including CAD $643
Shoulder X-ray, complete $136
Sinus CT Scan $1,014
Stress Test w/ Doppler, complete $820
Stress Test w/ Echocardiogram, real-time image $1,008
Toe X-ray, minimum 2 views $138
Tone Screening Test
$56
Transvaginal ultrasound $323
Tympanometry $57
Ultrasound breast, complete $469
Ultrasound breast, limited $382
Upper Extremity Joint MRI without dye $1,204
Wrist X-ray, 2 views $144
Wrist X-ray, complete $171

 

CloseDiagnostic Imaging

OpenPregnancy & Prenatal Tests

Pregnancy & Prenatal Tests

Common Charges for Pregnancy & Prenatal Tests
ServiceEstimated Charge
Pregnancy & Prenatal Tests
Fetal non-stress test $196
Pregnancy ultrasound, first trimester $554
Pregnancy ultrasound, after first trimester $653
Obstetric ultrasound, limited $398
Obstetric ultrasound, after first trimester $521
Obstetric ultrasound, transvaginal $448
Urine Pregnancy Test $13

 

ClosePregnancy & Prenatal Tests

OpenLab Testing

Lab Testing

Common Charges for Lab Tests
ServiceEstimated Charge
Lab Testing
ABO Blood Typing Test $16
Acute Hepatitis Panel $275
Alkaline Phosphatase, serum $30
Allergen-specific IgE Antibody Test $31
Alpha-Fetoprotein-Serum $96
Amylase Test, serum $38
Antinuclear Antibodies, direct $70
Assay of Calcium $30
Assay of Ferritin $79
Assay of Iron $38
Assay of Magnesium $39
Assay of Phosphorus $28
Assay of Testosterone, total $149
Assay of Thyroxine, total $40
Assay of Triidothyronine, total $82
Assay of Urea Nitrogen $24
Bacterial Culture, other source $49
Bacterial Culture, urine $46
Basic Metabolic Panel $48
Bilirubin Test, total $30
Blood Folic Acid Serum $85
Blood Serology, qualitative $25
Blood Sugar Test, monitoring $13
Carcinoembryonic Antigen $109
Chlamydia $168
Chorionic Gonadotropin Test $87
Complete Blood Count $44
Comprehensive Metabolic Panel $60
Cortisol, total $94
C-Reactive Protein $30
Creatine Kinase $38
Creatinine $30
Dehydrepiandrosterone Sulfate $128
Fecal Blood Occult $18
Feces Culture, bacteria $54
Gamma Glutamyltransferase $42
Gammaglobulin IgE $95
Glucose Test $24
Gonorrhea Test $168
Hemoglobin Test $13
Hemoglobin A1c Test $55
Hepatic Function Panel $47
Hepatitis B Surface Antibody Test $62
Hepatitis B Surface Antigen Test $59
Hepatitis C Antibody Test $82
Hepatitis C Test $247
High Sensitivity C-Reactive Protein Test $75
HIV-1/HIV-2 Single Assay Test $77
Influenza Test $53
Insulin Test, total $66
Lactate Dehydrogenase Test $35
LDL Cholesterol Test $54
Lipase Test $40
Lipid Panel Test $76
Pap Smear $117
Parathyroid Hormone, intact $238
Potassium Test $27
Prolactin Test $112
Prostate-Specific Antigen (PSA) Test $106
Prothrombin Time $24
Renal Function Panel $50
RH (D) Blood Typing Test $16
Rheumatoid Arthritis Factor Test $33
Screening Culture $38
Sedimentation Rate Test $21
Sodium, serum $28
Strep Group A $53
Thyroglobulin Antibody Test $91
Thyroid Peroxidase Antibody Test $84
Thyroid Stimulating Hormone Test $94
Thyroxine $52
Total Cholesterol Test $26
Total Protein, urine $21
Transferase Alanine Amino (ALT) Test $31
Transferase Aspartate Amino (AST) Test $30
Triglycerides Test $34
Triidothyronine, free $97
Uric Acid Test $27
Urinalysis $17
Urine Test $17
Urine Test, dipstick only $14
Urine Test, microanalysis only $17
Varicella-Zoster Antibody Test $75
Vitamin B-12 Test $85

 

CloseLab Testing

OpenOffice Procedures

Office Procedures

Common Charges for Office Procedures
ServiceEstimated Charge
Office Procedures
Apply Short-Arm Cast $362
Arthrocentesis $241
Bronchodilation $277
Control Nosebleed, simple $400
Impacted Cerumen Removal $169
Incision and Drainage $490
Inhalation Treatment $87
Injection, tendon $236
Injection/Aspiration, intermediate joint/bursa $258
Injection/Aspiration, small joint/bursa $189
Tangential Skin Biopsy $353
Punch Skin Biopsy $426
Incisional Skin Biopsy $515
Skin Lesion Destruction $234

CloseOffice Procedures

OpenVaccines

Vaccines

Common Charges for Vaccines
ServiceEstimated Charge
Vaccines
Diphtheria, Tetanus, and Pertussis (DTaP) $49
Diphtheria, Tetanus, and Pertussis (DTaP-Hib-IPV) $108
Flu $20
Flu - High Dose $55
Flu - Nasal Mist $25
H Papilloma Vaccine, 2 or 3 dose $413
Hepatitis A $59
Hepatitis A - Adult $135
Hepatitis B - Adult $98
Hepatitis B - Pediatric $80
Measles, Mumps, and Rubella (MMR) $112
Measles, Mumps, Rubella (MMRV) $312
Meningococcal $218
Pneumococcal, 13 valent $272
Pneumococcal, 23 valent $135
Polio $53
Rotavirus $141
Tetanus, Diphtheria, and Pertussis (TdaP) $77
Varicella Virus $200
Zoster $328

 

CloseVaccines

Disclaimer

The amounts you see are the most you would pay before any discounts that may be available to you. The charges also do not include any additional procedures that may be done as part of the visit. Charges for lab tests and vaccines do not include specimen collection fees or fees associated with administering vaccines.

Cost Estimator Tool

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