| Breast lesion removal (open) (19120) |
$354 |
$443 |
0.1× |
| Upper GI endoscopy (EGD), diagnostic (43235) |
$744 |
$930 |
0.9× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$573 |
$716 |
0.7× |
| Diagnostic colonoscopy (45378) |
$573 |
$716 |
0.6× |
| Colonoscopy with biopsy (45380) |
$744 |
$930 |
0.6× |
| Colonoscopy with lesion removal (45385) |
$744 |
$930 |
0.6× |
| Cataract removal with lens insertion (66984) |
$320 |
$400 |
0.1× |
| CT head/brain without contrast (70450) |
$1,008 |
$1,260 |
10.0× |
| MRI brain without contrast (70551) |
$1,691 |
$2,114 |
7.4× |
| MRI brain with contrast (70552) |
$2,113 |
$2,641 |
6.3× |
| MRI brain without and with contrast (70553) |
$1,848.50 |
$2,310.50 |
5.5× |
| X-ray lower spine, 4+ views (72110) |
$382 |
$477 |
3.8× |
| MRI lumbar spine without contrast (72148) |
$1,550 |
$1,938 |
6.8× |
| CT pelvis with contrast (72193) |
$1,159 |
$1,449 |
6.9× |
| CT abdomen and pelvis with contrast (74177) |
$2,267 |
$2,834 |
6.8× |
| Ultrasound, abdomen complete (76700) |
$448 |
$560 |
4.5× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$258 |
$322.50 |
2.6× |
| Ultrasound, transvaginal (76830) |
$534 |
$668 |
5.3× |
| Basic metabolic panel (80048) |
$55 |
$69 |
6.5× |
| Comprehensive metabolic panel (80053) |
$73.50 |
$92 |
7.0× |
| Lipid panel (80061) |
$45 |
$56.50 |
3.4× |
| Renal function panel (80069) |
$22 |
$27 |
2.5× |
| Hepatic function panel (80076) |
$43 |
$54 |
5.3× |
| Urinalysis, non-automated, without microscopy (81002) |
$12 |
$15 |
3.4× |
| PSA, total (84153) |
$49.50 |
$62 |
2.7× |
| Thyroid stimulating hormone (TSH) (84443) |
$50 |
$63 |
3.0× |
| CBC with automated differential (85025) |
$50 |
$63 |
6.4× |
| CBC, automated (85027) |
$42 |
$52 |
6.5× |
| Prothrombin time (PT) (85610) |
$28 |
$35 |
6.5× |
| Partial thromboplastin time (PTT) (85730) |
$24 |
$30 |
4.0× |
| Family psychotherapy, without patient (50 min) (90846) |
$110 |
$137 |
0.6× |
| Family psychotherapy, with patient (50 min) (90847) |
$132 |
$165 |
0.8× |
| Group psychotherapy (90853) |
$35 |
$44 |
0.4× |
| Electrocardiogram (ECG), complete (93000) |
$79.50 |
$99.50 |
1.4× |
| Sleep study (attended polysomnography) (95810) |
$1,920 |
$2,400 |
2.3× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$60 |
$75 |
2.1× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$206 |
$257 |
1.6× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$316 |
$395 |
2.5× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$400 |
$500 |
3.1× |
| Office consultation (low complexity, ~30 min) (99243) |
$170 |
$212 |
1.3× |
| Office consultation (moderate complexity, ~40 min) (99244) |
$238 |
$298 |
1.9× |
| Preventive visit, new patient (age 18–39) (99385) |
$165.50 |
$207 |
— |
| Preventive visit, new patient (age 40–64) (99386) |
$181 |
$226.50 |
— |