| Breast lesion removal (open) (19120) |
$456.19 |
$608.25 |
0.1× |
| Knee arthroscopy with meniscectomy (29881) |
$1,119.58 |
$1,599.40 |
0.4× |
| Upper GI endoscopy (EGD), diagnostic (43235) |
$225.27 |
$321.82 |
0.3× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$253.32 |
$361.89 |
0.3× |
| Diagnostic colonoscopy (45378) |
$339.28 |
$484.69 |
0.4× |
| Colonoscopy with biopsy (45380) |
$378.34 |
$540.49 |
0.3× |
| Colonoscopy with lesion removal (45385) |
$1,748.19 |
$2,330.92 |
1.5× |
Laparoscopic gallbladder removal (47562)
likely a partial charge, not the full procedure |
$788.29 |
$1,126.13 |
0.1× |
| Inguinal hernia repair (age 5+) (49505) |
$586.90 |
$838.43 |
0.2× |
| Cataract removal with lens insertion (66984) |
$4,712 |
$6,510 |
2.1× |
| CT head/brain without contrast (70450) |
$498.30 |
$711.86 |
4.9× |
| MRI brain without contrast (70551) |
$1,202.02 |
$1,717.17 |
5.2× |
| MRI brain with contrast (70552) |
$1,322.64 |
$1,889.48 |
3.9× |
| MRI brain without and with contrast (70553) |
$2,574.55 |
$3,677.93 |
7.6× |
| X-ray lower spine, 4+ views (72110) |
$180.78 |
$258.26 |
1.8× |
| MRI lumbar spine without contrast (72148) |
$1,232.90 |
$1,761.28 |
5.3× |
| CT pelvis with contrast (72193) |
$932.98 |
$1,332.84 |
5.5× |
| MRI lower-extremity joint without contrast (73721) |
$1,192.11 |
$1,703.01 |
5.1× |
| CT abdomen and pelvis with contrast (74177) |
$2,475.30 |
$3,536.14 |
7.3× |
| Ultrasound, abdomen complete (76700) |
$293.44 |
$419.21 |
2.9× |
| Ultrasound, transvaginal (76830) |
$236.06 |
$337.24 |
2.3× |
| Mammography, one breast (diagnostic) (77065) |
$265.80 |
$379.71 |
3.1× |
| Mammography, both breasts (diagnostic) (77066) |
$339.64 |
$485.20 |
3.1× |
| Mammography, screening (bilateral) (77067) |
$279.33 |
$399.04 |
3.1× |
| Basic metabolic panel (80048) |
$49.48 |
$70.68 |
5.8× |
| Comprehensive metabolic panel (80053) |
$61.05 |
$87.22 |
5.8× |
| Lipid panel (80061) |
$67.64 |
$93.45 |
5.1× |
| Renal function panel (80069) |
$66.37 |
$94.81 |
7.6× |
| Hepatic function panel (80076) |
$62.39 |
$89.13 |
7.6× |
| Urinalysis, non-automated, with microscopy (81000) |
$23.10 |
$33 |
5.7× |
| Urinalysis, non-automated, without microscopy (81002) |
$18.87 |
$26.95 |
5.4× |
| PSA, total (84153) |
$110.02 |
$157.17 |
6.0× |
| Thyroid stimulating hormone (TSH) (84443) |
$97.90 |
$139.85 |
5.8× |
| CBC with automated differential (85025) |
$45.27 |
$64.67 |
5.8× |
| CBC, automated (85027) |
$21.08 |
$29.75 |
3.3× |
| Prothrombin time (PT) (85610) |
$27.72 |
$39.60 |
6.5× |
| Partial thromboplastin time (PTT) (85730) |
$34.98 |
$49.97 |
5.8× |
| Psychotherapy, 30 minutes (90832) |
$123.72 |
$176.74 |
0.7× |
| Psychotherapy, 45 minutes (90834) |
$130.90 |
$187 |
0.8× |
| Psychotherapy, 60 minutes (90837) |
$196.35 |
$280.50 |
1.1× |
| Family psychotherapy, without patient (50 min) (90846) |
$138.60 |
$198 |
0.8× |
| Family psychotherapy, with patient (50 min) (90847) |
$138.60 |
$198 |
0.8× |
| Electrocardiogram (ECG), complete (93000) |
$84.70 |
$121 |
1.5× |
| Sleep study (attended polysomnography) (95810) |
$2,138.23 |
$3,054.62 |
2.6× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$95.55 |
$127.40 |
3.3× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$115.50 |
$165 |
0.9× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$167.09 |
$238.70 |
1.3× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$206.36 |
$294.80 |
1.6× |
| Preventive visit, new patient (age 18–39) (99385) |
$127.82 |
$182.60 |
— |
| Preventive visit, new patient (age 40–64) (99386) |
$147.84 |
$211.20 |
— |