| Breast lesion removal (open) (19120) |
$2,354.40 |
$3,924 |
0.6× |
| Shoulder arthroscopy with decompression (29826) |
$3,102 |
$5,170 |
— |
| Knee arthroscopy with meniscectomy (29881) |
$3,979.80 |
$6,633 |
1.2× |
| Tonsillectomy and adenoidectomy (under age 12) (42820) |
$3,102 |
$5,170 |
0.5× |
| Upper GI endoscopy (EGD), diagnostic (43235) |
$3,102 |
$5,170 |
3.4× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$2,354.40 |
$3,924 |
2.6× |
| Diagnostic colonoscopy (45378) |
$1,156.80 |
$1,928 |
1.2× |
| Colonoscopy with biopsy (45380) |
$3,102 |
$5,170 |
2.6× |
| Colonoscopy with lesion removal (45385) |
$1,410 |
$2,350 |
1.2× |
| Laparoscopic gallbladder removal (47562) |
$3,979.80 |
$6,633 |
0.7× |
| Inguinal hernia repair (age 5+) (49505) |
$3,102 |
$5,170 |
0.9× |
| Laparoscopic radical prostatectomy (55866) |
$11,145 |
$18,575 |
1.0× |
| Epidural injection, lumbar/sacral (with imaging) (62322) |
$1,156.80 |
$1,928 |
1.3× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$1,156.80 |
$1,928 |
1.3× |
| After-cataract laser surgery (YAG capsulotomy) (66821) |
$1,156.80 |
$1,928 |
2.1× |
| Cataract removal with lens insertion (66984) |
$3,102 |
$5,170 |
1.3× |
| CT head/brain without contrast (70450) |
$1,467 |
$2,445 |
13.9× |
| MRI brain without contrast (70551) |
$1,703.40 |
$2,839 |
7.1× |
| MRI brain with contrast (70552) |
$1,776 |
$2,960 |
5.1× |
| MRI brain without and with contrast (70553) |
$2,343 |
$3,905 |
6.7× |
| X-ray lower spine, 4+ views (72110) |
$517.20 |
$862 |
4.9× |
| MRI lumbar spine without contrast (72148) |
$1,703.40 |
$2,839 |
7.1× |
| CT pelvis with contrast (72193) |
$1,934.40 |
$3,224 |
10.9× |
| MRI lower-extremity joint without contrast (73721) |
$1,703.40 |
$2,839 |
7.1× |
| CT abdomen and pelvis with contrast (74177) |
$900 |
$1,500 |
2.6× |
| Ultrasound, abdomen complete (76700) |
$325.80 |
$543 |
3.1× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$325.80 |
$543 |
3.1× |
| Ultrasound, transvaginal (76830) |
$325.80 |
$543 |
3.1× |
| Basic metabolic panel (80048) |
$220.80 |
$368 |
26.1× |
| Comprehensive metabolic panel (80053) |
$252 |
$420 |
23.9× |
| Lipid panel (80061) |
$291.60 |
$486 |
21.8× |
| Renal function panel (80069) |
$268.80 |
$448 |
31.0× |
| Hepatic function panel (80076) |
$228.60 |
$381 |
28.0× |
| Urinalysis, non-automated, without microscopy (81002) |
$55.20 |
$92 |
15.9× |
| PSA, total (84153) |
$236.40 |
$394 |
12.9× |
| Thyroid stimulating hormone (TSH) (84443) |
$198 |
$330 |
11.8× |
| CBC with automated differential (85025) |
$94.80 |
$158 |
12.2× |
| CBC, automated (85027) |
$85.20 |
$142 |
13.2× |
| Prothrombin time (PT) (85610) |
$63 |
$105 |
14.7× |
| Partial thromboplastin time (PTT) (85730) |
$85.20 |
$142 |
14.2× |
| Left heart catheterization (93452) |
$4,311.60 |
$7,186 |
1.3× |
| Sleep study (attended polysomnography) (95810) |
$3,121.20 |
$5,202 |
3.6× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$78.60 |
$131 |
2.7× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$59.10 |
$98.50 |
0.4× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$97.20 |
$162 |
0.7× |