| Breast lesion removal (open) (19120) |
$4,491.25 |
$8,982.50 |
1.2× |
| Shoulder arthroscopy with decompression (29826) |
$3,005.06 |
$6,010.12 |
— |
| Knee arthroscopy with meniscectomy (29881) |
$2,650.56 |
$5,301.12 |
0.8× |
| Tonsillectomy and adenoidectomy (under age 12) (42820) |
$6,935 |
$13,870 |
1.2× |
| Upper GI endoscopy (EGD), diagnostic (43235) |
$352.50 |
$705 |
0.4× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$428.02 |
$856.04 |
0.5× |
| Diagnostic colonoscopy (45378) |
$210.83 |
$421.66 |
0.2× |
| Colonoscopy with biopsy (45380) |
$702.50 |
$1,405 |
0.6× |
| Colonoscopy with lesion removal (45385) |
$553.75 |
$1,107.50 |
0.5× |
| Colonoscopy with endoscopic ultrasound (45391) |
$527 |
$1,054 |
0.5× |
| Laparoscopic gallbladder removal (47562) |
$19,107.75 |
$38,215.50 |
3.3× |
| Inguinal hernia repair (age 5+) (49505) |
$8,468 |
$16,936 |
2.4× |
| Epidural injection, lumbar/sacral (with imaging) (62322) |
$1,093 |
$2,186 |
1.3× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$1,226.92 |
$2,453.84 |
1.4× |
| After-cataract laser surgery (YAG capsulotomy) (66821) |
$751.50 |
$1,503 |
1.4× |
| CT head/brain without contrast (70450) |
$817 |
$1,634 |
8.1× |
| MRI brain without contrast (70551) |
$1,214.75 |
$2,429.50 |
5.3× |
| MRI brain with contrast (70552) |
$1,417 |
$2,834 |
4.2× |
| MRI brain without and with contrast (70553) |
$1,899 |
$3,798 |
5.6× |
| X-ray lower spine, 4+ views (72110) |
$320.75 |
$641.50 |
3.2× |
| MRI lumbar spine without contrast (72148) |
$1,161 |
$2,322 |
5.0× |
| CT pelvis with contrast (72193) |
$1,093.25 |
$2,186.50 |
6.4× |
| MRI lower-extremity joint without contrast (73721) |
$1,210 |
$2,420 |
5.2× |
| CT abdomen and pelvis with contrast (74177) |
$2,077.25 |
$4,154.50 |
6.2× |
| Ultrasound, abdomen complete (76700) |
$420.75 |
$841.50 |
4.2× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$427.50 |
$855 |
4.2× |
| Ultrasound, transvaginal (76830) |
$420.75 |
$841.50 |
4.2× |
| Mammography, one breast (diagnostic) (77065) |
$214.50 |
$429 |
2.5× |
| Mammography, both breasts (diagnostic) (77066) |
$334.25 |
$668.50 |
3.0× |
| Mammography, screening (bilateral) (77067) |
$242.75 |
$485.50 |
2.7× |
| Basic metabolic panel (80048) |
$39 |
$78 |
4.6× |
| Comprehensive metabolic panel (80053) |
$49 |
$98 |
4.6× |
| Obstetric panel (80055) |
$267.75 |
$535.50 |
5.6× |
| Lipid panel (80061) |
$62.50 |
$125 |
4.7× |
| Renal function panel (80069) |
$40 |
$80 |
4.6× |
| Hepatic function panel (80076) |
$38 |
$76 |
4.7× |
| Urinalysis, non-automated, with microscopy (81000) |
$17.25 |
$34.50 |
4.3× |
| Urinalysis, non-automated, without microscopy (81002) |
$14 |
$28 |
4.0× |
| PSA, total (84153) |
$70.75 |
$141.50 |
3.8× |
| Thyroid stimulating hormone (TSH) (84443) |
$55.50 |
$111 |
3.3× |
| CBC with automated differential (85025) |
$50.50 |
$101 |
6.5× |
| CBC, automated (85027) |
$65 |
$130 |
10.0× |
| Prothrombin time (PT) (85610) |
$43 |
$86 |
10.0× |
| Partial thromboplastin time (PTT) (85730) |
$50.75 |
$101.50 |
8.4× |
| Family psychotherapy, without patient (50 min) (90846) |
$198.25 |
$396.50 |
1.2× |
| Family psychotherapy, with patient (50 min) (90847) |
$194 |
$388 |
1.1× |
| Left heart catheterization (93452) |
$6,445.50 |
$12,891 |
2.1× |
| Sleep study (attended polysomnography) (95810) |
$2,648 |
$5,296 |
3.2× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$157 |
$314 |
5.4× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$71 |
$142 |
0.6× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$86 |
$172 |
0.7× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$86 |
$172 |
0.7× |
| Preventive visit, new patient (age 18–39) (99385) |
$70 |
$140 |
— |
| Preventive visit, new patient (age 40–64) (99386) |
$82 |
$164 |
— |