| Breast lesion removal (open) (19120) |
$875 |
$875 |
0.2× |
| Shoulder arthroscopy with decompression (29826) |
$549.50 |
$549.50 |
— |
| Knee arthroscopy with meniscectomy (29881) |
$1,720 |
$1,720 |
0.6× |
| Upper GI endoscopy (EGD), diagnostic (43235) |
$488 |
$488 |
0.6× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$631 |
$631 |
0.8× |
| Diagnostic colonoscopy (45378) |
$760.50 |
$760.50 |
0.9× |
| Colonoscopy with biopsy (45380) |
$897.50 |
$897.50 |
0.8× |
| Colonoscopy with lesion removal (45385) |
$1,112 |
$1,112 |
1.0× |
Laparoscopic gallbladder removal (47562)
likely a partial charge, not the full procedure |
$1,376 |
$1,376 |
0.2× |
| Inguinal hernia repair (age 5+) (49505) |
$926.50 |
$926.50 |
0.3× |
| Obstetric care, vaginal delivery (global) (59400) |
$4,299.50 |
$4,299.50 |
— |
| Obstetric care, cesarean delivery (global) (59510) |
$4,414.50 |
$4,414.50 |
— |
| Epidural injection, lumbar/sacral (with imaging) (62322) |
$326.50 |
$326.50 |
0.4× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$520 |
$520 |
0.6× |
| CT head/brain without contrast (70450) |
$1,156 |
$1,156 |
12.0× |
| MRI brain without contrast (70551) |
$2,663 |
$2,663 |
12.1× |
| MRI brain with contrast (70552) |
$2,849 |
$2,849 |
8.9× |
| MRI brain without and with contrast (70553) |
$4,515 |
$4,515 |
14.1× |
| X-ray lower spine, 4+ views (72110) |
$760 |
$760 |
7.9× |
| MRI lumbar spine without contrast (72148) |
$2,895 |
$2,895 |
13.2× |
| CT pelvis with contrast (72193) |
$2,288 |
$2,288 |
14.2× |
| MRI lower-extremity joint without contrast (73721) |
$2,895 |
$2,895 |
13.2× |
| CT abdomen and pelvis with contrast (74177) |
$3,613 |
$3,613 |
11.3× |
| Ultrasound, abdomen complete (76700) |
$737 |
$737 |
7.7× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$1,073 |
$1,073 |
11.2× |
| Ultrasound, transvaginal (76830) |
$977 |
$977 |
10.2× |
| Mammography, one breast (diagnostic) (77065) |
$303 |
$303 |
3.5× |
| Mammography, both breasts (diagnostic) (77066) |
$386 |
$386 |
3.5× |
| Mammography, screening (bilateral) (77067) |
$344.50 |
$344.50 |
3.8× |
| Basic metabolic panel (80048) |
$84 |
$84 |
9.9× |
| Comprehensive metabolic panel (80053) |
$105 |
$105 |
9.9× |
| Obstetric panel (80055) |
$292.50 |
$292.50 |
6.1× |
| Lipid panel (80061) |
$134 |
$134 |
10.0× |
| Renal function panel (80069) |
$86 |
$86 |
9.9× |
| Hepatic function panel (80076) |
$82 |
$82 |
10.0× |
| Urinalysis, non-automated, with microscopy (81000) |
$53 |
$53 |
13.2× |
| Urinalysis, non-automated, without microscopy (81002) |
$145.50 |
$145.50 |
41.8× |
| PSA, total (84153) |
$218.50 |
$218.50 |
11.9× |
| Thyroid stimulating hormone (TSH) (84443) |
$170 |
$170 |
10.1× |
| CBC with automated differential (85025) |
$47 |
$47 |
6.0× |
| CBC, automated (85027) |
$64 |
$64 |
9.9× |
| Prothrombin time (PT) (85610) |
$40 |
$40 |
9.3× |
| Partial thromboplastin time (PTT) (85730) |
$60.50 |
$60.50 |
10.1× |
| Psychotherapy, 30 minutes (90832) |
$420 |
$420 |
2.6× |
| Psychotherapy, 45 minutes (90834) |
$420 |
$420 |
2.6× |
| Psychotherapy, 60 minutes (90837) |
$420 |
$420 |
2.6× |
| Family psychotherapy, without patient (50 min) (90846) |
$420 |
$420 |
2.6× |
| Family psychotherapy, with patient (50 min) (90847) |
$420 |
$420 |
2.6× |
| Group psychotherapy (90853) |
$218 |
$218 |
2.3× |
| Electrocardiogram (ECG), complete (93000) |
$81 |
$81 |
1.5× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$132.50 |
$132.50 |
4.6× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$298 |
$298 |
2.4× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$316 |
$316 |
2.6× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$390 |
$390 |
3.2× |
| Office consultation (low complexity, ~30 min) (99243) |
$288 |
$288 |
2.4× |
| Office consultation (moderate complexity, ~40 min) (99244) |
$459 |
$459 |
3.7× |
| Preventive visit, new patient (age 18–39) (99385) |
$328 |
$328 |
— |
| Preventive visit, new patient (age 40–64) (99386) |
$339 |
$339 |
— |