| Shoulder arthroscopy with decompression (29826) |
$2,634.76 |
$10,539.02 |
— |
| Knee arthroscopy with meniscectomy (29881) |
$3,687.51 |
$14,750.04 |
1.2× |
| Upper GI endoscopy (EGD), diagnostic (43235) |
$500.76 |
$2,003.04 |
0.6× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$1,193.18 |
$4,772.72 |
1.4× |
| Diagnostic colonoscopy (45378) |
$1,169.57 |
$4,678.27 |
1.4× |
| Colonoscopy with biopsy (45380) |
$747.78 |
$2,991.10 |
0.7× |
| Colonoscopy with lesion removal (45385) |
$759.46 |
$3,037.84 |
0.7× |
| Laparoscopic gallbladder removal (47562) |
$5,915.11 |
$23,660.44 |
1.1× |
| Inguinal hernia repair (age 5+) (49505) |
$5,321.02 |
$21,284.09 |
1.6× |
| Epidural injection, lumbar/sacral (with imaging) (62322) |
$608.40 |
$2,433.60 |
0.8× |
| CT head/brain without contrast (70450) |
$384.28 |
$1,537.12 |
4.0× |
| MRI brain without contrast (70551) |
$583.70 |
$2,334.80 |
2.7× |
| MRI brain with contrast (70552) |
$583.70 |
$2,334.80 |
1.8× |
| MRI brain without and with contrast (70553) |
$583.70 |
$2,334.80 |
1.8× |
| X-ray lower spine, 4+ views (72110) |
$120.38 |
$481.52 |
1.3× |
| MRI lumbar spine without contrast (72148) |
$583.70 |
$2,334.80 |
2.7× |
| CT pelvis with contrast (72193) |
$384.28 |
$1,537.12 |
2.4× |
| MRI lower-extremity joint without contrast (73721) |
$583.70 |
$2,334.80 |
2.7× |
| CT abdomen and pelvis with contrast (74177) |
$384.28 |
$1,537.12 |
1.2× |
| Ultrasound, abdomen complete (76700) |
$376.74 |
$1,506.96 |
4.0× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$96.98 |
$387.92 |
1.0× |
| Ultrasound, transvaginal (76830) |
$165.10 |
$660.40 |
1.7× |
| Mammography, one breast (diagnostic) (77065) |
$160.94 |
$643.76 |
1.9× |
| Mammography, both breasts (diagnostic) (77066) |
$281.06 |
$1,124.24 |
2.5× |
| Mammography, screening (bilateral) (77067) |
$126.36 |
$505.44 |
1.4× |
| Basic metabolic panel (80048) |
$79.82 |
$319.28 |
9.4× |
| Comprehensive metabolic panel (80053) |
$310.44 |
$1,241.76 |
29.4× |
| Lipid panel (80061) |
$16.64 |
$66.56 |
1.2× |
| Renal function panel (80069) |
$20.80 |
$83.20 |
2.4× |
| Hepatic function panel (80076) |
$19.50 |
$78 |
2.4× |
| Urinalysis, non-automated, without microscopy (81002) |
$9.62 |
$38.48 |
2.8× |
| PSA, total (84153) |
$31.72 |
$126.88 |
1.7× |
| Thyroid stimulating hormone (TSH) (84443) |
$40.04 |
$160.16 |
2.4× |
| CBC with automated differential (85025) |
$20.80 |
$83.20 |
2.7× |
| CBC, automated (85027) |
$20.80 |
$83.20 |
3.2× |
| Prothrombin time (PT) (85610) |
$4.16 |
$16.64 |
1.0× |
| Partial thromboplastin time (PTT) (85730) |
$7.02 |
$28.08 |
1.2× |
| Sleep study (attended polysomnography) (95810) |
$940.42 |
$3,761.68 |
1.2× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$64.99 |
$259.96 |
2.2× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$99.84 |
$399.36 |
0.8× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$148.72 |
$594.88 |
1.2× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$151.06 |
$604.24 |
1.2× |