| Breast lesion removal (open) (19120) |
— |
$1,083 |
— |
| Shoulder arthroscopy with decompression (29826) |
— |
$358 |
— |
| Knee arthroscopy with meniscectomy (29881) |
— |
$1,150 |
— |
| Upper GI endoscopy (EGD), diagnostic (43235) |
— |
$2,065.50 |
— |
| Upper GI endoscopy (EGD) with biopsy (43239) |
— |
$1,973.50 |
— |
| Diagnostic colonoscopy (45378) |
— |
$723 |
— |
| Colonoscopy with biopsy (45380) |
— |
$2,027.50 |
— |
| Colonoscopy with lesion removal (45385) |
— |
$2,264.50 |
— |
| Laparoscopic gallbladder removal (47562) |
— |
$1,353 |
— |
| Inguinal hernia repair (age 5+) (49505) |
— |
$1,076 |
— |
| Obstetric care, vaginal delivery (global) (59400) |
— |
$4,925 |
— |
| Obstetric care, cesarean delivery (global) (59510) |
— |
$5,421 |
— |
| Obstetric care, VBAC delivery (global) (59610) |
— |
$5,106 |
— |
| Transforaminal epidural injection, lumbar/sacral (64483) |
— |
$227 |
— |
| After-cataract laser surgery (YAG capsulotomy) (66821) |
— |
$1,278 |
— |
| Cataract removal with lens insertion (66984) |
— |
$4,782 |
— |
| CT head/brain without contrast (70450) |
— |
$2,788 |
— |
| MRI brain without contrast (70551) |
— |
$4,739 |
— |
| MRI brain with contrast (70552) |
— |
$4,136 |
— |
| MRI brain without and with contrast (70553) |
— |
$5,400 |
— |
| X-ray lower spine, 4+ views (72110) |
— |
$740 |
— |
| MRI lumbar spine without contrast (72148) |
— |
$4,955 |
— |
| CT pelvis with contrast (72193) |
— |
$3,465 |
— |
| MRI lower-extremity joint without contrast (73721) |
— |
$3,609 |
— |
| CT abdomen and pelvis with contrast (74177) |
— |
$6,617 |
— |
| Ultrasound, abdomen complete (76700) |
— |
$1,288 |
— |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
— |
$1,158 |
— |
| Ultrasound, transvaginal (76830) |
— |
$966 |
— |
| Mammography, one breast (diagnostic) (77065) |
— |
$534 |
— |
| Mammography, both breasts (diagnostic) (77066) |
— |
$666 |
— |
| Mammography, screening (bilateral) (77067) |
— |
$529 |
— |
| Basic metabolic panel (80048) |
— |
$246 |
— |
| Comprehensive metabolic panel (80053) |
— |
$143.62 |
— |
| Obstetric panel (80055) |
— |
$185 |
— |
| Lipid panel (80061) |
— |
$93.62 |
— |
| Hepatic function panel (80076) |
— |
$208 |
— |
| Urinalysis, non-automated, without microscopy (81002) |
— |
$38 |
— |
| PSA, total (84153) |
— |
$180 |
— |
| Thyroid stimulating hormone (TSH) (84443) |
— |
$92.12 |
— |
| CBC with automated differential (85025) |
— |
$147 |
— |
| CBC, automated (85027) |
— |
$60.62 |
— |
| Prothrombin time (PT) (85610) |
— |
$27 |
— |
| Partial thromboplastin time (PTT) (85730) |
— |
$27 |
— |
| Psychotherapy, 30 minutes (90832) |
— |
$641 |
— |
| Psychotherapy, 45 minutes (90834) |
— |
$793 |
— |
| Psychotherapy, 60 minutes (90837) |
— |
$809 |
— |
| Family psychotherapy, without patient (50 min) (90846) |
— |
$845 |
— |
| Family psychotherapy, with patient (50 min) (90847) |
— |
$887 |
— |
| Group psychotherapy (90853) |
— |
$772 |
— |
| Electrocardiogram (ECG), complete (93000) |
— |
$72 |
— |
| Sleep study (attended polysomnography) (95810) |
— |
$5,749 |
— |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
— |
$156 |
— |
| Office visit, new patient (low complexity, ~30 min) (99203) |
— |
$208.50 |
— |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
— |
$324.50 |
— |
| Office visit, new patient (high complexity, ~60 min) (99205) |
— |
$433.50 |
— |
| Office consultation (low complexity, ~30 min) (99243) |
— |
$241 |
— |
| Office consultation (moderate complexity, ~40 min) (99244) |
— |
$345 |
— |
| Preventive visit, new patient (age 18–39) (99385) |
— |
$276 |
— |
| Preventive visit, new patient (age 40–64) (99386) |
— |
$319 |
— |