| Shoulder arthroscopy with decompression (29826) |
$246.40 |
$308 |
— |
| Knee arthroscopy with meniscectomy (29881) |
$812 |
$1,015 |
0.3× |
| Upper GI endoscopy (EGD), diagnostic (43235) |
$2,145.60 |
$2,682 |
2.4× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$1,520 |
$1,900 |
1.7× |
| Diagnostic colonoscopy (45378) |
$2,236 |
$2,795 |
2.4× |
| Colonoscopy with biopsy (45380) |
$2,370.40 |
$2,963 |
2.0× |
| Colonoscopy with lesion removal (45385) |
$2,305.60 |
$2,882 |
2.0× |
| Inguinal hernia repair (age 5+) (49505) |
$3,854 |
$4,817.50 |
1.1× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$3,007.20 |
$3,759 |
3.4× |
| CT head/brain without contrast (70450) |
$376 |
$470 |
3.6× |
| MRI brain without contrast (70551) |
$722.40 |
$903 |
3.1× |
| MRI brain with contrast (70552) |
$853.60 |
$1,067 |
2.5× |
| MRI brain without and with contrast (70553) |
$1,053.60 |
$1,317 |
3.1× |
| X-ray lower spine, 4+ views (72110) |
$150.40 |
$188 |
1.5× |
| MRI lumbar spine without contrast (72148) |
$743.60 |
$929.50 |
3.2× |
| CT pelvis with contrast (72193) |
$510.40 |
$638 |
2.9× |
| MRI lower-extremity joint without contrast (73721) |
$716.40 |
$895.50 |
3.0× |
| CT abdomen and pelvis with contrast (74177) |
$902 |
$1,127.50 |
2.6× |
| Ultrasound, abdomen complete (76700) |
$232 |
$290 |
2.2× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$242 |
$302.50 |
2.3× |
| Ultrasound, transvaginal (76830) |
$226 |
$282.50 |
2.2× |
| Mammography, one breast (diagnostic) (77065) |
$137.60 |
$172 |
1.6× |
| Mammography, both breasts (diagnostic) (77066) |
$178.40 |
$223 |
1.6× |
| Mammography, screening (bilateral) (77067) |
$138.40 |
$173 |
1.5× |
| Basic metabolic panel (80048) |
$40.80 |
$51 |
4.8× |
| Comprehensive metabolic panel (80053) |
$50.40 |
$63 |
4.8× |
| Lipid panel (80061) |
$64 |
$80 |
4.8× |
| Renal function panel (80069) |
$41.60 |
$52 |
4.8× |
| Hepatic function panel (80076) |
$39.20 |
$49 |
4.8× |
| Urinalysis, non-automated, without microscopy (81002) |
$14.40 |
$18 |
4.1× |
| PSA, total (84153) |
$88 |
$110 |
4.8× |
| Thyroid stimulating hormone (TSH) (84443) |
$80.80 |
$101 |
4.8× |
| CBC with automated differential (85025) |
$37.60 |
$47 |
4.8× |
| CBC, automated (85027) |
$26.80 |
$33.50 |
4.1× |
| Prothrombin time (PT) (85610) |
$19.20 |
$24 |
4.5× |
| Partial thromboplastin time (PTT) (85730) |
$32.40 |
$40.50 |
5.4× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$64 |
$80 |
2.2× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$214.40 |
$268 |
1.6× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$266.40 |
$333 |
2.0× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$329.60 |
$412 |
2.5× |
| Office consultation (low complexity, ~30 min) (99243) |
$149.60 |
$187 |
1.1× |
| Office consultation (moderate complexity, ~40 min) (99244) |
$237.60 |
$297 |
1.8× |