| Breast lesion removal (open) (19120) |
$753.90 |
$1,077 |
0.2× |
| Shoulder arthroscopy with decompression (29826) |
$279.30 |
$399 |
— |
| Knee arthroscopy with meniscectomy (29881) |
$832.30 |
$1,189 |
0.3× |
Tonsillectomy and adenoidectomy (under age 12) (42820)
likely a partial charge, not the full procedure |
$445.90 |
$637 |
0.1× |
| Upper GI endoscopy (EGD), diagnostic (43235) |
$529.90 |
$757 |
0.6× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$498.40 |
$712 |
0.6× |
| Diagnostic colonoscopy (45378) |
$710.50 |
$1,015 |
0.8× |
| Colonoscopy with biopsy (45380) |
$846.30 |
$1,209 |
0.8× |
| Colonoscopy with lesion removal (45385) |
$633.50 |
$905 |
0.6× |
Laparoscopic gallbladder removal (47562)
likely a partial charge, not the full procedure |
$1,043 |
$1,490 |
0.2× |
| Inguinal hernia repair (age 5+) (49505) |
$820.40 |
$1,172 |
0.3× |
| Obstetric care, vaginal delivery (global) (59400) |
$3,294.90 |
$4,707 |
— |
| Obstetric care, cesarean delivery (global) (59510) |
$3,665.20 |
$5,236 |
— |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$283.50 |
$405 |
0.4× |
| CT head/brain without contrast (70450) |
$661.50 |
$945 |
7.0× |
| MRI brain without contrast (70551) |
$1,131.90 |
$1,617 |
5.2× |
| MRI brain with contrast (70552) |
$1,429.40 |
$2,042 |
4.5× |
| MRI brain without and with contrast (70553) |
$1,804.60 |
$2,578 |
5.7× |
| X-ray lower spine, 4+ views (72110) |
$149.80 |
$214 |
1.6× |
| MRI lumbar spine without contrast (72148) |
$1,131.90 |
$1,617 |
5.2× |
| CT pelvis with contrast (72193) |
$1,245.30 |
$1,779 |
7.8× |
| MRI lower-extremity joint without contrast (73721) |
$763.70 |
$1,091 |
3.5× |
| CT abdomen and pelvis with contrast (74177) |
$1,878.80 |
$2,684 |
5.9× |
| Ultrasound, abdomen complete (76700) |
$541.10 |
$773 |
5.7× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$373.10 |
$533 |
3.9× |
| Ultrasound, transvaginal (76830) |
$160.30 |
$229 |
1.7× |
| Mammography, one breast (diagnostic) (77065) |
$151.90 |
$217 |
1.8× |
| Mammography, both breasts (diagnostic) (77066) |
$162.40 |
$232 |
1.5× |
| Mammography, screening (bilateral) (77067) |
$191.10 |
$273 |
2.1× |
| Basic metabolic panel (80048) |
$74.20 |
$106 |
8.8× |
| Comprehensive metabolic panel (80053) |
$42.70 |
$61 |
4.0× |
| Obstetric panel (80055) |
$81.90 |
$117 |
1.7× |
| Lipid panel (80061) |
$58.10 |
$83 |
4.3× |
| Renal function panel (80069) |
$77.70 |
$111 |
9.0× |
| Hepatic function panel (80076) |
$78.05 |
$111.50 |
9.6× |
| Urinalysis, non-automated, with microscopy (81000) |
$10.50 |
$15 |
2.6× |
| Urinalysis, non-automated, without microscopy (81002) |
$9.10 |
$13 |
2.6× |
| PSA, total (84153) |
$74.20 |
$106 |
4.0× |
| Thyroid stimulating hormone (TSH) (84443) |
$70.70 |
$101 |
4.2× |
| CBC with automated differential (85025) |
$25.20 |
$36 |
3.2× |
| CBC, automated (85027) |
$34.65 |
$49.50 |
5.4× |
| Prothrombin time (PT) (85610) |
$26.25 |
$37.50 |
6.1× |
| Partial thromboplastin time (PTT) (85730) |
$33.25 |
$47.50 |
5.5× |
| Psychotherapy, 30 minutes (90832) |
$128.80 |
$184 |
0.8× |
| Psychotherapy, 45 minutes (90834) |
$147 |
$210 |
0.9× |
| Psychotherapy, 60 minutes (90837) |
$165.90 |
$237 |
1.0× |
| Group psychotherapy (90853) |
$128.80 |
$184 |
1.4× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$48.30 |
$69 |
1.7× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$161 |
$230 |
1.3× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$246.40 |
$352 |
2.0× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$310.80 |
$444 |
2.6× |
| Office consultation (low complexity, ~30 min) (99243) |
$186.90 |
$267 |
1.6× |
| Office consultation (moderate complexity, ~40 min) (99244) |
$281.40 |
$402 |
2.3× |
| Preventive visit, new patient (age 18–39) (99385) |
$196 |
$280 |
— |
| Preventive visit, new patient (age 40–64) (99386) |
$228.20 |
$326 |
— |