| Breast lesion removal (open) (19120) |
$426.89 |
$792 |
0.1× |
| Shoulder arthroscopy with decompression (29826) |
$280.82 |
$521 |
— |
| Knee arthroscopy with meniscectomy (29881) |
$854.31 |
$1,585 |
0.2× |
| Upper GI endoscopy (EGD), diagnostic (43235) |
$932.74 |
$1,730.50 |
1.0× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$1,086.08 |
$2,015 |
1.1× |
| Diagnostic colonoscopy (45378) |
$1,040.26 |
$1,930 |
1.0× |
| Colonoscopy with biopsy (45380) |
$1,141.34 |
$2,117.50 |
0.9× |
| Colonoscopy with lesion removal (45385) |
$1,113.03 |
$2,065 |
0.9× |
Laparoscopic gallbladder removal (47562)
likely a partial charge, not the full procedure |
$1,189.57 |
$2,207 |
0.2× |
| Inguinal hernia repair (age 5+) (49505) |
$666.20 |
$1,236 |
0.2× |
| Obstetric care, vaginal delivery (global) (59400) |
$2,621.70 |
$4,864 |
— |
| Obstetric care, cesarean delivery (global) (59510) |
$2,968.27 |
$5,507 |
— |
| Obstetric care, VBAC delivery (global) (59610) |
$2,759.14 |
$5,119 |
— |
| Epidural injection, lumbar/sacral (with imaging) (62322) |
$160.89 |
$298.50 |
0.2× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$1,109.26 |
$2,058 |
1.2× |
| CT head/brain without contrast (70450) |
$646.26 |
$1,199 |
5.8× |
| MRI brain without contrast (70551) |
$1,445.06 |
$2,681 |
5.7× |
| MRI brain with contrast (70552) |
$1,400.32 |
$2,598 |
3.8× |
| MRI brain without and with contrast (70553) |
$3,819.89 |
$7,087 |
10.3× |
| X-ray lower spine, 4+ views (72110) |
$384.31 |
$713 |
3.4× |
| MRI lumbar spine without contrast (72148) |
$1,521.06 |
$2,822 |
6.0× |
| CT pelvis with contrast (72193) |
$1,154 |
$2,141 |
6.2× |
| MRI lower-extremity joint without contrast (73721) |
$1,544.23 |
$2,865 |
6.1× |
| CT abdomen and pelvis with contrast (74177) |
$1,331.87 |
$2,471 |
3.6× |
| Ultrasound, abdomen complete (76700) |
$537.38 |
$997 |
4.8× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$530.91 |
$985 |
4.8× |
| Ultrasound, transvaginal (76830) |
$278.93 |
$517.50 |
2.5× |
| Mammography, one breast (diagnostic) (77065) |
$465.70 |
$864 |
5.4× |
| Mammography, both breasts (diagnostic) (77066) |
$596.67 |
$1,107 |
5.4× |
| Mammography, screening (bilateral) (77067) |
$494.26 |
$917 |
5.4× |
| Basic metabolic panel (80048) |
$91.09 |
$169 |
10.8× |
| Comprehensive metabolic panel (80053) |
$120.74 |
$224 |
11.4× |
| Lipid panel (80061) |
$85.16 |
$158 |
6.4× |
| Renal function panel (80069) |
$70.61 |
$131 |
8.1× |
| Hepatic function panel (80076) |
$95.40 |
$177 |
11.7× |
| Urinalysis, non-automated, with microscopy (81000) |
$10.24 |
$19 |
2.5× |
| Urinalysis, non-automated, without microscopy (81002) |
$4.85 |
$9 |
1.4× |
| PSA, total (84153) |
$68.99 |
$128 |
3.8× |
| Thyroid stimulating hormone (TSH) (84443) |
$78.96 |
$146.50 |
4.7× |
| CBC with automated differential (85025) |
$59.83 |
$111 |
7.7× |
| CBC, automated (85027) |
$55.52 |
$103 |
8.6× |
| Prothrombin time (PT) (85610) |
$22.37 |
$41.50 |
5.2× |
| Partial thromboplastin time (PTT) (85730) |
$37.46 |
$69.50 |
6.2× |
| Psychotherapy, 30 minutes (90832) |
$76 |
$141 |
0.4× |
| Psychotherapy, 45 minutes (90834) |
$101.06 |
$187.50 |
0.5× |
| Psychotherapy, 60 minutes (90837) |
$149.30 |
$277 |
0.8× |
| Family psychotherapy, without patient (50 min) (90846) |
$96.75 |
$179.50 |
0.5× |
| Family psychotherapy, with patient (50 min) (90847) |
$99.72 |
$185 |
0.5× |
| Group psychotherapy (90853) |
$26.95 |
$50 |
0.2× |
| Sleep study (attended polysomnography) (95810) |
$1,006.04 |
$1,866.50 |
1.1× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$45.28 |
$84 |
1.6× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$119.39 |
$221.50 |
0.8× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$189.46 |
$351.50 |
1.3× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$238.78 |
$443 |
1.7× |
| Office consultation (low complexity, ~30 min) (99243) |
$251.17 |
$466 |
1.8× |
| Office consultation (moderate complexity, ~40 min) (99244) |
$387.54 |
$719 |
2.7× |
| Preventive visit, new patient (age 18–39) (99385) |
$93.24 |
$173 |
— |
| Preventive visit, new patient (age 40–64) (99386) |
$109.42 |
$203 |
— |