Sutter West Bay Medical Group Charges for Frequently Used Doctor Services
The services below have drop-down menus that show charges for frequently used services provided by Sutter West Bay Medical Group. If you can't find the service you are looking for, please call (866) 699-3627.
Doctor's Office Visit
Common Charges for Doctor's Office Visit Service Estimated Charge Doctor's Office Visit for a New Patient Low-to-Moderate Level Visit $254 Moderate Level Visit $364 Moderate-to-High Level Visit $551 High Level Visit $684 Doctor's Office Visit for an Established Patient Low Level Visit $72 Low-to-Moderate Level Visit $150 Moderate Level Visit $248 Moderate-to-High Level Visit $363 High Level Visit $484 Doctor's Office Visit - Specialist Consultation Low Level Visit $164 Low-to-Moderate Level Visit $304 Moderate Level Visit $415 Moderate-to-High Level Visit $610 High Level Visit $741
Common Charges for Eye Exams Service Estimated 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
Common Charges for Physical/Occupational Therapy Service Estimated Charge Physical/Occupational Therapy Occupational Therapy Evaluation (Low Level Visit) $344 Occupational Therapy Evaluation (Moderate Level Visit) $344 Occupational Therapy Evaluation (High Level Visit) $336 Occupational Therapy Re-evaluation $229 Electric Stimulation Therapy, Treatment Only $60 Physical Therapy Evaluation (Low Level Visit) $356 Physical Therapy Evaluation (Moderate Level Visit) $356 Physical Therapy Evaluation (High Level Visit) $348 Physical Therapy Re-evaluation $238 Physical Therapy Exercises, Treatment Only $123 Physical Therapy Ultrasound, Treatment Only $49 Physical Therapy ‐ Manual therapy $115
Common Charges for Allergy Injections Service Estimated Charge Allergy Injections Allergy shot ‐ single injection $46 Allergy shot ‐ two or more injections $52
Common Charges for Diagnostic Imaging Service Estimated Charge Diagnostic Imaging Abdomen CT Scan $758 Abdomen CT Scan with and without dye $1,397 Abdomen CT Scan, including dye $1,212 Abdomen X-ray $125 Abdomen/Pelvis CT scan $1,069 Abdomen/Pelvis CT scan with and without dye $1,749 Abdomen/Pelvis CT scan, including dye $1,491 Abdominal ultrasound $669 Abdominal ultrasound, limited $469 Ankle X-ray (3+ views) $167 Auditory Threshold Evaluation $149 Bone density scan (dexa scan) $237 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 $1,003 Chest CT scan, including dye $1,254 Chest X-ray (One views) $89 Chest X-ray (two views) $139 Diagnostic mammography, including CAD unilateral $609 Diagnostic mammography, including CAD bilateral $773 Doppler Color Flow, add-on $92 Duplex scan of Extracranial Arteries $1,089 Echocardiogram, doppler $190 Elbow X-ray, complete $150 Electrocardiogram (ECG) $77 Femur X-ray (1 view) $132 Femur X-ray (2+ views) $158 Finger X-ray $154 Foot X-ray, complete $156 Hand X-ray, complete $146 Head CT Scan $804 Hip X-ray (1 view) $120 Hip X-ray (2-3 views) $167 Hip X-ray (4+ views) $242 Knee MRI without dye $1,324 Knee X-ray 3 views $185 Knee X-ray one or two views $151 Knee X-ray, bilateral $162 Knee X-ray, complete, 4+ views $197 Lumbar Spine MRI without dye $1,809 Lumbar spine x-ray (two or three views) $174 Pelvic ultrasound exam, complete $540 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 $2,227 Screening mammography, bilateral including CAD $627 Shoulder X-ray, complete $149 Sinus CT Scan $1,088 Stress Test w/ Doppler, complete $819 Stress Test w/ Echocardiogram, real-time image $931 Toe X-ray, minimum 2 views $138 Tone Screening Test
$56 Transvaginal ultrasound $322 Tympanometry $56 Ultrasound breast, complete $469 Ultrasound breast, limited $382 Upper Extremity Joint MRI without dye $1,204 Wrist X-ray, 2 views $143 Wrist X-ray, complete $176
Pregnancy & Prenatal Tests
Common Charges for Pregnancy & Prenatal Tests Service Estimated Charge Pregnancy & Prenatal Tests Fetal non-stress test $216 Pregnancy ultrasound, first trimester $608 Pregnancy ultrasound, after first trimester $717 Obstetric ultrasound, limited $437 Obstetric ultrasound, after first trimester $572 Obstetric ultrasound, transvaginal $492 Urine Pregnancy Test $13
Common Charges for Lab Tests Service Estimated Charge Lab Testing ABO Blood Typing Test $16 Acute Hepatitis Panel $274 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 $148 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 $108 Chlamydia $198 Chorionic Gonadotropin Test $87 Complete Blood Count $44 Comprehensive Metabolic Panel $60 Cortisol, total $94 COVID 19 Antibody $65 COVID 19 Detection by High Throughput Technology $100 COVID 19 Detection by Nucleic Acid (DNA or RNA) $69 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 $198 Hemoglobin Test $12 Hemoglobin A1c Test $55 Hepatic Function Panel $47 Hepatitis B Surface Antigen $61 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 $114 Parathyroid Hormone, intact $237 Potassium Test $27 Prolactin Test $112 Prostate-Specific Antigen (PSA) Test $105 Prothrombin Time $24 Rheumatoid Arthritis Factor Test $33 Renal Function Panel $50 RH (D) Blood Typing Test $16 Screening Culture $38 Sedimentation Rate Test $20 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 $20 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
Common Charges for Office Procedures Service Estimated Charge Office Procedures Apply Short-Arm Cast $362 Arthrocentesis $241 Bronchodilation $276 Control Nosebleed, simple $399 Impacted Cerumen Removal $169 Incision and Drainage $489 Inhalation Treatment $87 Injection, tendon $235 Injection/Aspiration, intermediate joint/bursa $258 Injection/Aspiration, small joint/bursa $188 Tangential Skin Biopsy $353 Punch Skin Biopsy $426 Incisional Skin Biopsy $515 Skin Lesion Destruction $233
Common Charges for Vaccines Service Estimated Charge Vaccines Diphtheria, Tetanus, and Pertussis (DTaP) $49 Diphtheria, Tetanus, and Pertussis (DTaP-Hib-IPV) $108 Flu $22 Flu - High Dose $64 Flu - Nasal Mist $26 H Papilloma Vaccine, 2 or 3 dose $451 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 $142 Tetanus, Diphtheria, and Pertussis (TdaP) $77 Varicella Virus $200 Zoster $328
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.