| Shoulder arthroscopy with decompression (29826) |
$1,134.90 |
$1,261 |
— |
| Knee arthroscopy with meniscectomy (29881) |
$3,159.22 |
$3,510.25 |
0.9× |
| Tonsillectomy and adenoidectomy (under age 12) (42820) |
$3,398.40 |
$3,776 |
0.6× |
| Upper GI endoscopy (EGD), diagnostic (43235) |
$2,079 |
$2,310 |
2.2× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$1,709.10 |
$1,899 |
1.8× |
| Diagnostic colonoscopy (45378) |
$1,968.75 |
$2,187.50 |
2.0× |
| Colonoscopy with biopsy (45380) |
$1,709.10 |
$1,899 |
1.4× |
| Colonoscopy with lesion removal (45385) |
$1,499.85 |
$1,666.50 |
1.2× |
| Laparoscopic gallbladder removal (47562) |
$5,220.90 |
$5,801 |
0.8× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$410.40 |
$456 |
0.4× |
| Cataract removal with lens insertion (66984) |
$3,420 |
$3,800 |
1.4× |
| CT head/brain without contrast (70450) |
$2,235.60 |
$2,484 |
20.6× |
| MRI brain without contrast (70551) |
$3,809.25 |
$4,232.50 |
15.4× |
| MRI brain with contrast (70552) |
$3,989.70 |
$4,433 |
11.0× |
| MRI brain without and with contrast (70553) |
$4,268.25 |
$4,742.50 |
11.8× |
| X-ray lower spine, 4+ views (72110) |
$560.25 |
$622.50 |
5.2× |
| MRI lumbar spine without contrast (72148) |
$3,764.25 |
$4,182.50 |
15.2× |
| CT pelvis with contrast (72193) |
$2,673 |
$2,970 |
14.7× |
| MRI lower-extremity joint without contrast (73721) |
$3,312.90 |
$3,681 |
13.4× |
| CT abdomen and pelvis with contrast (74177) |
$5,322.60 |
$5,914 |
14.7× |
| Ultrasound, abdomen complete (76700) |
$932.40 |
$1,036 |
8.6× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$903.15 |
$1,003.50 |
8.3× |
| Ultrasound, transvaginal (76830) |
$740.25 |
$822.50 |
6.8× |
| Mammography, one breast (diagnostic) (77065) |
$446.40 |
$496 |
5.2× |
| Mammography, both breasts (diagnostic) (77066) |
$568.35 |
$631.50 |
5.1× |
| Mammography, screening (bilateral) (77067) |
$493.20 |
$548 |
5.4× |
| Basic metabolic panel (80048) |
$166.50 |
$185 |
19.7× |
| Comprehensive metabolic panel (80053) |
$188.10 |
$209 |
17.8× |
| Obstetric panel (80055) |
$359.10 |
$399 |
7.5× |
| Lipid panel (80061) |
$216 |
$240 |
16.1× |
| Renal function panel (80069) |
$160.20 |
$178 |
18.5× |
| Hepatic function panel (80076) |
$214.65 |
$238.50 |
26.3× |
| Urinalysis, non-automated, without microscopy (81002) |
$45.45 |
$50.50 |
13.1× |
| PSA, total (84153) |
$144 |
$160 |
7.8× |
| Thyroid stimulating hormone (TSH) (84443) |
$134.10 |
$149 |
8.0× |
| CBC with automated differential (85025) |
$128.70 |
$143 |
16.6× |
| CBC, automated (85027) |
$98.55 |
$109.50 |
15.2× |
| Prothrombin time (PT) (85610) |
$85.95 |
$95.50 |
20.0× |
| Partial thromboplastin time (PTT) (85730) |
$106.20 |
$118 |
17.7× |
| Sleep study (attended polysomnography) (95810) |
$4,626.45 |
$5,140.50 |
5.2× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$191.25 |
$212.50 |
6.6× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$160.65 |
$178.50 |
1.2× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$312.30 |
$347 |
2.3× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$439.20 |
$488 |
3.2× |