| Shoulder arthroscopy with decompression (29826) |
$2,513.50 |
$2,513.50 |
— |
| Knee arthroscopy with meniscectomy (29881) |
$3,885 |
$3,885 |
1.1× |
| Tonsillectomy and adenoidectomy (under age 12) (42820) |
$4,065 |
$4,065 |
0.7× |
| Upper GI endoscopy (EGD), diagnostic (43235) |
$2,127 |
$2,127 |
2.3× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$2,350 |
$2,350 |
2.5× |
| Diagnostic colonoscopy (45378) |
$2,303 |
$2,303 |
2.4× |
| Colonoscopy with biopsy (45380) |
$2,503 |
$2,503 |
2.0× |
| Colonoscopy with lesion removal (45385) |
$2,421 |
$2,421 |
1.9× |
| Laparoscopic gallbladder removal (47562) |
$5,336 |
$5,336 |
0.9× |
| Inguinal hernia repair (age 5+) (49505) |
$5,149 |
$5,149 |
1.4× |
| Obstetric care, vaginal delivery (global) (59400) |
$4,371 |
$4,371 |
— |
| Obstetric care, cesarean delivery (global) (59510) |
$8,278.50 |
$8,278.50 |
— |
| Epidural injection, lumbar/sacral (with imaging) (62322) |
$281 |
$281 |
0.3× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$868 |
$868 |
0.9× |
| After-cataract laser surgery (YAG capsulotomy) (66821) |
$884 |
$884 |
1.5× |
| CT head/brain without contrast (70450) |
$2,107 |
$2,107 |
19.4× |
| MRI brain without contrast (70551) |
$3,515 |
$3,515 |
14.2× |
| MRI brain with contrast (70552) |
$3,615 |
$3,615 |
10.0× |
| MRI brain without and with contrast (70553) |
$4,115 |
$4,115 |
11.4× |
| X-ray lower spine, 4+ views (72110) |
$372 |
$372 |
3.4× |
| MRI lumbar spine without contrast (72148) |
$3,310 |
$3,310 |
13.4× |
| CT pelvis with contrast (72193) |
$2,609 |
$2,609 |
14.3× |
| MRI lower-extremity joint without contrast (73721) |
$2,610 |
$2,610 |
10.5× |
| CT abdomen and pelvis with contrast (74177) |
$4,616 |
$4,616 |
12.7× |
| Ultrasound, abdomen complete (76700) |
$875 |
$875 |
8.1× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$750 |
$750 |
6.9× |
| Ultrasound, transvaginal (76830) |
$552 |
$552 |
5.1× |
| Mammography, one breast (diagnostic) (77065) |
$390 |
$390 |
4.5× |
| Mammography, both breasts (diagnostic) (77066) |
$450 |
$450 |
4.1× |
| Mammography, screening (bilateral) (77067) |
$390 |
$390 |
4.3× |
| Basic metabolic panel (80048) |
$146 |
$146 |
17.3× |
| Comprehensive metabolic panel (80053) |
$171 |
$171 |
16.2× |
| Obstetric panel (80055) |
$253 |
$253 |
5.3× |
| Lipid panel (80061) |
$136 |
$136 |
10.2× |
| Renal function panel (80069) |
$156 |
$156 |
18.0× |
| Hepatic function panel (80076) |
$146 |
$146 |
17.9× |
| Urinalysis, non-automated, with microscopy (81000) |
$42 |
$42 |
10.4× |
| Urinalysis, non-automated, without microscopy (81002) |
$31 |
$31 |
8.9× |
| PSA, total (84153) |
$136 |
$136 |
7.4× |
| Thyroid stimulating hormone (TSH) (84443) |
$126 |
$126 |
7.5× |
| CBC with automated differential (85025) |
$95 |
$95 |
12.2× |
| CBC, automated (85027) |
$77 |
$77 |
11.9× |
| Prothrombin time (PT) (85610) |
$37.50 |
$37.50 |
8.7× |
| Partial thromboplastin time (PTT) (85730) |
$85 |
$85 |
14.1× |
| Psychotherapy, 30 minutes (90832) |
$345 |
$345 |
1.9× |
| Psychotherapy, 45 minutes (90834) |
$452.50 |
$452.50 |
2.5× |
| Psychotherapy, 60 minutes (90837) |
$567.50 |
$567.50 |
3.1× |
| Family psychotherapy, without patient (50 min) (90846) |
$477.50 |
$477.50 |
2.6× |
| Family psychotherapy, with patient (50 min) (90847) |
$507.50 |
$507.50 |
2.8× |
| Group psychotherapy (90853) |
$845 |
$845 |
8.0× |
| Electrocardiogram (ECG), complete (93000) |
$229 |
$229 |
3.7× |
| Sleep study (attended polysomnography) (95810) |
$4,100 |
$4,100 |
4.6× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$100 |
$100 |
3.4× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$223 |
$223 |
1.6× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$341 |
$341 |
2.5× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$429 |
$429 |
3.1× |
| Preventive visit, new patient (age 18–39) (99385) |
$248 |
$248 |
— |
| Preventive visit, new patient (age 40–64) (99386) |
$287 |
$287 |
— |