| Breast lesion removal (open) (19120) |
$3,360 |
$3,500 |
0.8× |
| Knee arthroscopy with meniscectomy (29881) |
$3,840 |
$4,000 |
1.1× |
| Upper GI endoscopy (EGD), diagnostic (43235) |
$1,632 |
$1,700 |
1.7× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$1,632 |
$1,700 |
1.7× |
| Diagnostic colonoscopy (45378) |
$1,632 |
$1,700 |
1.7× |
| Colonoscopy with biopsy (45380) |
$1,632 |
$1,700 |
1.3× |
| Colonoscopy with lesion removal (45385) |
$1,920 |
$2,000 |
1.5× |
| Laparoscopic gallbladder removal (47562) |
$4,800 |
$5,000 |
0.8× |
| Inguinal hernia repair (age 5+) (49505) |
$4,320 |
$4,500 |
1.2× |
| Epidural injection, lumbar/sacral (with imaging) (62322) |
$672 |
$700 |
0.7× |
| CT head/brain without contrast (70450) |
$2,016 |
$2,100 |
18.6× |
| MRI brain without contrast (70551) |
$3,168 |
$3,300 |
12.8× |
| MRI brain with contrast (70552) |
$3,744 |
$3,900 |
10.3× |
| MRI brain without and with contrast (70553) |
$3,864 |
$4,025 |
10.7× |
| X-ray lower spine, 4+ views (72110) |
$504 |
$525 |
4.6× |
| MRI lumbar spine without contrast (72148) |
$3,264 |
$3,400 |
13.2× |
| CT pelvis with contrast (72193) |
$2,496 |
$2,600 |
13.7× |
| MRI lower-extremity joint without contrast (73721) |
$2,640 |
$2,750 |
10.7× |
| CT abdomen and pelvis with contrast (74177) |
$4,080 |
$4,250 |
11.3× |
| Ultrasound, abdomen complete (76700) |
$816 |
$850 |
7.5× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$768 |
$800 |
7.1× |
| Ultrasound, transvaginal (76830) |
$672 |
$700 |
6.2× |
| Mammography, one breast (diagnostic) (77065) |
$360 |
$375 |
4.2× |
| Mammography, both breasts (diagnostic) (77066) |
$456 |
$475 |
4.1× |
| Mammography, screening (bilateral) (77067) |
$360 |
$375 |
3.9× |
| Basic metabolic panel (80048) |
$111.73 |
$116.39 |
13.2× |
| Comprehensive metabolic panel (80053) |
$128.54 |
$133.90 |
12.2× |
| Obstetric panel (80055) |
$173.04 |
$180.25 |
3.6× |
| Lipid panel (80061) |
$94.92 |
$98.88 |
7.1× |
| Renal function panel (80069) |
$98.88 |
$103 |
11.4× |
| Hepatic function panel (80076) |
$93.94 |
$97.85 |
11.5× |
| Urinalysis, non-automated, without microscopy (81002) |
$25.71 |
$26.78 |
7.4× |
| PSA, total (84153) |
$88.99 |
$92.70 |
4.8× |
| Thyroid stimulating hormone (TSH) (84443) |
$49.44 |
$51.50 |
2.9× |
| CBC with automated differential (85025) |
$78.12 |
$81.37 |
10.1× |
| CBC, automated (85027) |
$66.25 |
$69.01 |
10.2× |
| Prothrombin time (PT) (85610) |
$42.02 |
$43.78 |
9.8× |
| Partial thromboplastin time (PTT) (85730) |
$24.72 |
$25.75 |
4.1× |
| Sleep study (attended polysomnography) (95810) |
$4,128 |
$4,300 |
4.6× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$139.20 |
$145 |
4.8× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$182.40 |
$190 |
1.3× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$192 |
$200 |
1.4× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$360 |
$375 |
2.6× |