| Breast lesion removal (open) (19120) |
$830.10 |
$1,383.50 |
0.2× |
| Upper GI endoscopy (EGD), diagnostic (43235) |
$834.90 |
$1,391.50 |
0.9× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$900 |
$1,500 |
1.0× |
| Diagnostic colonoscopy (45378) |
$1,278.60 |
$2,131 |
1.4× |
| Colonoscopy with biopsy (45380) |
$900 |
$1,500 |
0.8× |
| Colonoscopy with lesion removal (45385) |
$900 |
$1,500 |
0.8× |
| Colonoscopy with endoscopic ultrasound (45391) |
$1,024.80 |
$1,708 |
0.9× |
Laparoscopic gallbladder removal (47562)
likely a partial charge, not the full procedure |
$1,453.80 |
$2,423 |
0.2× |
| Inguinal hernia repair (age 5+) (49505) |
$1,170.90 |
$1,951.50 |
0.3× |
| Epidural injection, lumbar/sacral (with imaging) (62322) |
$1,335.60 |
$2,226 |
1.5× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$5,388.60 |
$8,981 |
6.1× |
| CT head/brain without contrast (70450) |
$830.40 |
$1,384 |
7.9× |
| MRI brain without contrast (70551) |
$589.20 |
$982 |
2.5× |
| MRI brain with contrast (70552) |
$814.80 |
$1,358 |
2.3× |
| MRI brain without and with contrast (70553) |
$1,216.50 |
$2,027.50 |
3.5× |
| X-ray lower spine, 4+ views (72110) |
$390 |
$650 |
3.7× |
| MRI lumbar spine without contrast (72148) |
$657 |
$1,095 |
2.7× |
| CT pelvis with contrast (72193) |
$1,140 |
$1,900 |
6.5× |
| MRI lower-extremity joint without contrast (73721) |
$872.40 |
$1,454 |
3.7× |
| CT abdomen and pelvis with contrast (74177) |
$1,240.80 |
$2,068 |
3.6× |
| Ultrasound, abdomen complete (76700) |
$853.80 |
$1,423 |
8.2× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$604.20 |
$1,007 |
5.8× |
| Ultrasound, transvaginal (76830) |
$645.60 |
$1,076 |
6.2× |
| Mammography, one breast (diagnostic) (77065) |
$150.60 |
$251 |
1.7× |
| Mammography, both breasts (diagnostic) (77066) |
$236.70 |
$394.50 |
2.1× |
| Mammography, screening (bilateral) (77067) |
$147.90 |
$246.50 |
1.6× |
| Basic metabolic panel (80048) |
$83.40 |
$139 |
9.9× |
| Comprehensive metabolic panel (80053) |
$109.80 |
$183 |
10.4× |
| Obstetric panel (80055) |
$142.80 |
$238 |
3.0× |
| Lipid panel (80061) |
$44.40 |
$74 |
3.3× |
| Renal function panel (80069) |
$31.80 |
$53 |
3.7× |
| Hepatic function panel (80076) |
$32.40 |
$54 |
4.0× |
| Urinalysis, non-automated, without microscopy (81002) |
$16.80 |
$28 |
4.8× |
| PSA, total (84153) |
$65.51 |
$109.18 |
3.6× |
| Thyroid stimulating hormone (TSH) (84443) |
$38.94 |
$64.89 |
2.3× |
| CBC with automated differential (85025) |
$36 |
$60 |
4.6× |
| CBC, automated (85027) |
$26.40 |
$44 |
4.1× |
| Prothrombin time (PT) (85610) |
$15.99 |
$26.65 |
3.7× |
| Partial thromboplastin time (PTT) (85730) |
$30.07 |
$50.11 |
5.0× |
| Left heart catheterization (93452) |
$6,088.80 |
$10,148 |
1.9× |
| Sleep study (attended polysomnography) (95810) |
$1,837.20 |
$3,062 |
2.1× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$54 |
$90 |
1.9× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$141 |
$235 |
1.1× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$169.80 |
$283 |
1.3× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$255 |
$425 |
1.9× |
| Office consultation (low complexity, ~30 min) (99243) |
$138.60 |
$231 |
1.0× |
| Office consultation (moderate complexity, ~40 min) (99244) |
$219.60 |
$366 |
1.6× |
| Preventive visit, new patient (age 18–39) (99385) |
$136.80 |
$228 |
— |
| Preventive visit, new patient (age 40–64) (99386) |
$158.40 |
$264 |
— |