| Breast lesion removal (open) (19120) |
$2,184 |
$2,184 |
0.5× |
Tonsillectomy and adenoidectomy (under age 12) (42820)
likely a partial charge — not the full procedure |
$1,562 |
$1,562 |
0.3× |
| Upper GI endoscopy (EGD), diagnostic (43235) |
$1,481 |
$1,481 |
1.5× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$1,646 |
$1,646 |
1.7× |
| Diagnostic colonoscopy (45378) |
$1,760 |
$1,760 |
1.8× |
| Colonoscopy with biopsy (45380) |
$2,112 |
$2,112 |
1.7× |
| Colonoscopy with lesion removal (45385) |
$2,402 |
$2,402 |
1.9× |
| Laparoscopic gallbladder removal (47562) |
$4,462 |
$4,462 |
0.7× |
| Inguinal hernia repair (age 5+) (49505) |
$3,023 |
$3,023 |
0.8× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$2,898 |
$2,898 |
3.1× |
| Cataract removal with lens insertion (66984) |
$2,815 |
$2,815 |
1.2× |
| CT head/brain without contrast (70450) |
$2,252 |
$2,252 |
20.4× |
| MRI brain without contrast (70551) |
$3,886 |
$3,886 |
15.4× |
| MRI brain with contrast (70552) |
$3,963 |
$3,963 |
10.8× |
| MRI brain without and with contrast (70553) |
$4,277 |
$4,277 |
11.6× |
| X-ray lower spine, 4+ views (72110) |
$899 |
$899 |
8.2× |
| MRI lumbar spine without contrast (72148) |
$3,537 |
$3,537 |
14.1× |
| CT pelvis with contrast (72193) |
$2,602 |
$2,602 |
14.1× |
| MRI lower-extremity joint without contrast (73721) |
$3,759 |
$3,759 |
14.9× |
| CT abdomen and pelvis with contrast (74177) |
$5,358 |
$5,358 |
14.6× |
| Ultrasound, abdomen complete (76700) |
$1,050 |
$1,050 |
9.5× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$1,192 |
$1,192 |
10.8× |
| Ultrasound, transvaginal (76830) |
$1,028 |
$1,028 |
9.3× |
| Mammography, one breast (diagnostic) (77065) |
$434 |
$434 |
5.0× |
| Mammography, both breasts (diagnostic) (77066) |
$521 |
$521 |
4.7× |
| Mammography, screening (bilateral) (77067) |
$301 |
$301 |
3.3× |
| Basic metabolic panel (80048) |
$205 |
$205 |
24.2× |
| Comprehensive metabolic panel (80053) |
$253 |
$253 |
24.0× |
| Obstetric panel (80055) |
$508 |
$508 |
10.6× |
| Lipid panel (80061) |
$206.50 |
$206.50 |
15.4× |
| Renal function panel (80069) |
$393 |
$393 |
45.3× |
| Hepatic function panel (80076) |
$156 |
$156 |
19.1× |
| PSA, total (84153) |
$267 |
$267 |
14.5× |
| Thyroid stimulating hormone (TSH) (84443) |
$149.50 |
$149.50 |
8.9× |
| CBC with automated differential (85025) |
$119 |
$119 |
15.3× |
| CBC, automated (85027) |
$87 |
$87 |
13.4× |
| Prothrombin time (PT) (85610) |
$53.50 |
$53.50 |
12.5× |
| Partial thromboplastin time (PTT) (85730) |
$60 |
$60 |
10.0× |
| Sleep study (attended polysomnography) (95810) |
$3,193 |
$3,193 |
3.5× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$140 |
$140 |
4.8× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$603 |
$603 |
4.3× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$863 |
$863 |
6.1× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$1,103 |
$1,103 |
7.9× |
| Office consultation (low complexity, ~30 min) (99243) |
$655 |
$655 |
4.7× |
| Office consultation (moderate complexity, ~40 min) (99244) |
$985 |
$985 |
7.0× |