| Breast lesion removal (open) (19120) |
— |
$352 |
— |
| Shoulder arthroscopy with decompression (29826) |
$169 |
$338 |
— |
| Knee arthroscopy with meniscectomy (29881) |
$4,382.50 |
$8,765 |
1.4× |
| Tonsillectomy and adenoidectomy (under age 12) (42820) |
$7,257.50 |
$14,515 |
1.3× |
| Upper GI endoscopy (EGD), diagnostic (43235) |
$1,197.50 |
$2,395 |
1.4× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$873.20 |
$1,594 |
1.0× |
| Diagnostic colonoscopy (45378) |
$1,266.50 |
$2,533 |
1.4× |
| Colonoscopy with biopsy (45380) |
$1,107.95 |
$2,039.50 |
1.0× |
| Colonoscopy with lesion removal (45385) |
$2,039.50 |
$3,385 |
1.8× |
| Laparoscopic gallbladder removal (47562) |
$7,533 |
$15,066 |
1.3× |
| Inguinal hernia repair (age 5+) (49505) |
$4,642.50 |
$9,285 |
1.4× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$1,192.50 |
$2,385 |
1.4× |
| CT head/brain without contrast (70450) |
$736.50 |
$1,473 |
7.3× |
| MRI brain without contrast (70551) |
$1,137 |
$2,274 |
5.0× |
| MRI brain with contrast (70552) |
$1,291.50 |
$2,583 |
3.9× |
| MRI brain without and with contrast (70553) |
$1,769 |
$3,538 |
5.3× |
| X-ray lower spine, 4+ views (72110) |
$214.50 |
$429 |
2.1× |
| MRI lumbar spine without contrast (72148) |
$1,412.10 |
$2,370 |
6.2× |
| CT pelvis with contrast (72193) |
$937 |
$1,874 |
5.6× |
| MRI lower-extremity joint without contrast (73721) |
$1,199 |
$2,398 |
5.2× |
| CT abdomen and pelvis with contrast (74177) |
$1,439.50 |
$2,879 |
4.3× |
| Ultrasound, abdomen complete (76700) |
$373.50 |
$747 |
3.7× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$526.40 |
$752 |
5.2× |
| Ultrasound, transvaginal (76830) |
$321 |
$642 |
3.2× |
| Mammography, one breast (diagnostic) (77065) |
$196.50 |
$393 |
2.3× |
| Mammography, both breasts (diagnostic) (77066) |
$233.35 |
$338 |
2.1× |
| Mammography, screening (bilateral) (77067) |
$198.50 |
$397 |
2.2× |
| Basic metabolic panel (80048) |
$62.50 |
$125 |
7.4× |
| Comprehensive metabolic panel (80053) |
$62.50 |
$125 |
5.9× |
| Obstetric panel (80055) |
$212 |
$424 |
4.4× |
| Lipid panel (80061) |
$50 |
$100 |
3.7× |
| Renal function panel (80069) |
$122.50 |
$245 |
14.1× |
| Hepatic function panel (80076) |
$141 |
$282 |
17.3× |
| Urinalysis, non-automated, with microscopy (81000) |
$25 |
$50 |
6.2× |
| Urinalysis, non-automated, without microscopy (81002) |
$12.50 |
$25 |
3.6× |
| PSA, total (84153) |
$68 |
$136 |
3.7× |
| Thyroid stimulating hormone (TSH) (84443) |
$50 |
$100 |
3.0× |
| CBC with automated differential (85025) |
$44 |
$88 |
5.7× |
| CBC, automated (85027) |
$33.25 |
$66.50 |
5.1× |
| Prothrombin time (PT) (85610) |
$23.50 |
$47 |
5.5× |
| Partial thromboplastin time (PTT) (85730) |
$95.50 |
$191 |
15.9× |
| Psychotherapy, 30 minutes (90832) |
$197 |
$394 |
1.2× |
| Psychotherapy, 45 minutes (90834) |
$197 |
$394 |
1.2× |
| Psychotherapy, 60 minutes (90837) |
$197 |
$394 |
1.2× |
| Family psychotherapy, without patient (50 min) (90846) |
$145.10 |
$290.19 |
0.9× |
| Family psychotherapy, with patient (50 min) (90847) |
$150.66 |
$301.32 |
0.9× |
| Group psychotherapy (90853) |
$74.92 |
$135.60 |
0.8× |
| Electrocardiogram (ECG), complete (93000) |
$29 |
$58 |
0.5× |
| Sleep study (attended polysomnography) (95810) |
$1,550 |
$3,100 |
1.9× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$32 |
$64 |
1.1× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$107 |
$214 |
0.8× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$136.70 |
$235 |
1.1× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$180.50 |
$325 |
1.4× |
| Office consultation (low complexity, ~30 min) (99243) |
$119 |
$238 |
0.9× |
| Office consultation (moderate complexity, ~40 min) (99244) |
$90.50 |
$181 |
0.7× |
| Preventive visit, new patient (age 18–39) (99385) |
$91.55 |
$151.50 |
— |
| Preventive visit, new patient (age 40–64) (99386) |
$93.10 |
$145 |
— |