| Breast lesion removal (open) (19120) |
$419.20 |
$1,310 |
0.1× |
| Shoulder arthroscopy with decompression (29826) |
$132.80 |
$415 |
— |
| Knee arthroscopy with meniscectomy (29881) |
$471.04 |
$1,472 |
0.1× |
| Upper GI endoscopy (EGD), diagnostic (43235) |
$96.96 |
$303 |
0.1× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$109.44 |
$342 |
0.1× |
| Diagnostic colonoscopy (45378) |
$144.96 |
$453 |
0.1× |
| Colonoscopy with biopsy (45380) |
$157.44 |
$492 |
0.1× |
| Colonoscopy with lesion removal (45385) |
$199.04 |
$622 |
0.1× |
Laparoscopic gallbladder removal (47562)
likely a partial charge, not the full procedure |
$478.72 |
$1,496 |
0.1× |
| Inguinal hernia repair (age 5+) (49505) |
$414.08 |
$1,294 |
0.1× |
Laparoscopic radical prostatectomy (55866)
likely a partial charge, not the full procedure |
$939.52 |
$2,936 |
0.1× |
| Obstetric care, vaginal delivery (global) (59400) |
$1,895.68 |
$5,924 |
— |
| Obstetric care, cesarean delivery (global) (59510) |
$1,540.48 |
$4,814 |
— |
| Obstetric care, VBAC delivery (global) (59610) |
$1,968.96 |
$6,153 |
— |
| CT head/brain without contrast (70450) |
$501.76 |
$1,568 |
4.1× |
| MRI brain without contrast (70551) |
$692.48 |
$2,164 |
2.5× |
| MRI brain with contrast (70552) |
$774.24 |
$2,419.50 |
1.9× |
| MRI brain without and with contrast (70553) |
$1,040.64 |
$3,252 |
2.5× |
| X-ray lower spine, 4+ views (72110) |
$160.48 |
$501.50 |
1.3× |
| MRI lumbar spine without contrast (72148) |
$678.40 |
$2,120 |
2.4× |
| CT pelvis with contrast (72193) |
$710.40 |
$2,220 |
3.4× |
| MRI lower-extremity joint without contrast (73721) |
$734.08 |
$2,294 |
2.6× |
| CT abdomen and pelvis with contrast (74177) |
$1,238.08 |
$3,869 |
3.0× |
| Ultrasound, abdomen complete (76700) |
$276.80 |
$865 |
2.2× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$52.80 |
$165 |
0.4× |
| Ultrasound, transvaginal (76830) |
$52.48 |
$164 |
0.4× |
| Mammography, one breast (diagnostic) (77065) |
$173.44 |
$542 |
2.0× |
| Mammography, both breasts (diagnostic) (77066) |
$228.16 |
$713 |
2.1× |
| Mammography, screening (bilateral) (77067) |
$141.92 |
$443.50 |
1.6× |
| Basic metabolic panel (80048) |
$89.88 |
$280.86 |
10.6× |
| Comprehensive metabolic panel (80053) |
$96.60 |
$301.87 |
9.1× |
| Obstetric panel (80055) |
$111.20 |
$347.50 |
2.3× |
| Lipid panel (80061) |
$108.70 |
$339.70 |
8.1× |
| Renal function panel (80069) |
$60.43 |
$188.83 |
7.0× |
| Hepatic function panel (80076) |
$82.88 |
$259 |
10.1× |
| Urinalysis, non-automated, with microscopy (81000) |
$5.12 |
$16 |
1.3× |
| Urinalysis, non-automated, without microscopy (81002) |
$3.20 |
$10 |
0.9× |
| PSA, total (84153) |
$32.80 |
$102.50 |
1.8× |
| Thyroid stimulating hormone (TSH) (84443) |
$81.17 |
$253.66 |
4.8× |
| CBC with automated differential (85025) |
$38.86 |
$121.45 |
5.0× |
| CBC, automated (85027) |
$40.94 |
$127.95 |
6.3× |
| Prothrombin time (PT) (85610) |
$22.08 |
$69 |
5.1× |
| Partial thromboplastin time (PTT) (85730) |
$22.40 |
$70 |
3.7× |
| Psychotherapy, 30 minutes (90832) |
$54.08 |
$169 |
0.3× |
| Electrocardiogram (ECG), complete (93000) |
$14.08 |
$44 |
0.2× |
| Left heart catheterization (93452) |
$4,443.52 |
$13,886 |
1.2× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$49.28 |
$154 |
1.7× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$51.84 |
$162 |
0.3× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$84.48 |
$264 |
0.5× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$114.88 |
$359 |
0.7× |
| Office consultation (low complexity, ~30 min) (99243) |
$17.92 |
$56 |
0.1× |
| Office consultation (moderate complexity, ~40 min) (99244) |
$27.52 |
$86 |
0.2× |
| Preventive visit, new patient (age 18–39) (99385) |
$28.64 |
$89.50 |
— |
| Preventive visit, new patient (age 40–64) (99386) |
$29.92 |
$93.50 |
— |