| Knee arthroscopy with meniscectomy (29881) |
$3,984 |
$5,312 |
1.2× |
Tonsillectomy and adenoidectomy (under age 12) (42820)
unusually low: confirm this is the full procedure |
$2,554.50 |
$3,406 |
0.4× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$1,452 |
$1,936 |
1.5× |
| Diagnostic colonoscopy (45378) |
$1,368.50 |
$1,824.50 |
1.4× |
| Colonoscopy with biopsy (45380) |
$1,927 |
$2,569.50 |
1.6× |
| Colonoscopy with lesion removal (45385) |
$1,317 |
$1,756 |
1.1× |
Laparoscopic gallbladder removal (47562)
likely a partial charge, not the full procedure |
$1,201 |
$1,601 |
0.2× |
| Inguinal hernia repair (age 5+) (49505) |
$956 |
$1,274 |
0.3× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$1,275 |
$1,700 |
1.4× |
| Cataract removal with lens insertion (66984) |
$1,232.50 |
$1,643 |
0.5× |
| CT head/brain without contrast (70450) |
$1,720 |
$2,293 |
15.8× |
| MRI brain without contrast (70551) |
$2,938 |
$3,917 |
11.9× |
| MRI brain with contrast (70552) |
$3,086 |
$4,114 |
8.5× |
| MRI brain without and with contrast (70553) |
$3,236 |
$4,314 |
8.9× |
| X-ray lower spine, 4+ views (72110) |
$395 |
$526 |
3.6× |
| MRI lumbar spine without contrast (72148) |
$2,787 |
$3,716 |
11.2× |
| CT pelvis with contrast (72193) |
$2,037 |
$2,716 |
11.2× |
| MRI lower-extremity joint without contrast (73721) |
$2,091 |
$2,788 |
8.4× |
| CT abdomen and pelvis with contrast (74177) |
$3,517 |
$4,689 |
9.7× |
| Ultrasound, abdomen complete (76700) |
$695 |
$927 |
6.4× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$654 |
$872 |
6.0× |
| Ultrasound, transvaginal (76830) |
$573 |
$764 |
5.3× |
| Mammography, one breast (diagnostic) (77065) |
$286 |
$381.50 |
3.3× |
| Mammography, both breasts (diagnostic) (77066) |
$321 |
$428 |
2.9× |
| Mammography, screening (bilateral) (77067) |
$285 |
$380 |
3.1× |
| Basic metabolic panel (80048) |
$119 |
$159 |
14.1× |
| Comprehensive metabolic panel (80053) |
$131 |
$175 |
12.4× |
| Lipid panel (80061) |
$98 |
$130 |
7.3× |
| Renal function panel (80069) |
$120 |
$160 |
13.8× |
| Hepatic function panel (80076) |
$113 |
$150 |
13.8× |
| PSA, total (84153) |
$97 |
$129 |
5.3× |
| Thyroid stimulating hormone (TSH) (84443) |
$95 |
$127 |
5.7× |
| CBC with automated differential (85025) |
$82 |
$109 |
10.6× |
| CBC, automated (85027) |
$65 |
$87 |
10.0× |
| Prothrombin time (PT) (85610) |
$48 |
$64 |
11.2× |
| Partial thromboplastin time (PTT) (85730) |
$85 |
$113 |
14.1× |
| Electrocardiogram (ECG), complete (93000) |
$180 |
$240 |
2.9× |
| Sleep study (attended polysomnography) (95810) |
$3,225 |
$4,300 |
3.6× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$77 |
$103 |
2.6× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$166 |
$221 |
1.2× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$248 |
$330 |
1.8× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$327 |
$436 |
2.4× |
| Preventive visit, new patient (age 18–39) (99385) |
$173 |
$230 |
— |
| Preventive visit, new patient (age 40–64) (99386) |
$200 |
$266 |
— |