| Breast lesion removal (open) (19120) |
$10,920 |
$10,920 |
2.9× |
| Shoulder arthroscopy with decompression (29826) |
$1,719 |
$1,719 |
— |
| Knee arthroscopy with meniscectomy (29881) |
$1,659 |
$1,659 |
0.5× |
Tonsillectomy and adenoidectomy (under age 12) (42820)
likely a partial charge, not the full procedure |
$792 |
$792 |
0.1× |
| Upper GI endoscopy (EGD), diagnostic (43235) |
$1,010.50 |
$1,010.50 |
1.2× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$435 |
$435 |
0.5× |
| Diagnostic colonoscopy (45378) |
$570 |
$570 |
0.6× |
| Colonoscopy with biopsy (45380) |
$681 |
$681 |
0.6× |
| Colonoscopy with lesion removal (45385) |
$823 |
$823 |
0.7× |
| Colonoscopy with endoscopic ultrasound (45391) |
$788 |
$788 |
0.7× |
Laparoscopic gallbladder removal (47562)
unusually low: confirm this is the full procedure |
$2,007 |
$2,007 |
0.3× |
| Inguinal hernia repair (age 5+) (49505) |
$1,476 |
$1,476 |
0.4× |
Laparoscopic radical prostatectomy (55866)
unusually low: confirm this is the full procedure |
$4,660 |
$4,660 |
0.5× |
| Obstetric care, vaginal delivery (global) (59400) |
$5,900 |
$5,900 |
— |
| Obstetric care, cesarean delivery (global) (59510) |
$13,079 |
$13,079 |
— |
| Epidural injection, lumbar/sacral (with imaging) (62322) |
$222 |
$222 |
0.3× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$307 |
$307 |
0.4× |
| After-cataract laser surgery (YAG capsulotomy) (66821) |
$1,981.50 |
$1,981.50 |
3.8× |
| Cataract removal with lens insertion (66984) |
$1,919 |
$1,919 |
0.9× |
| CT head/brain without contrast (70450) |
$1,647 |
$1,647 |
16.4× |
| MRI brain without contrast (70551) |
$3,730.50 |
$3,730.50 |
16.3× |
| MRI brain with contrast (70552) |
$3,413 |
$3,413 |
10.2× |
| MRI brain without and with contrast (70553) |
$4,512 |
$4,512 |
13.5× |
| X-ray lower spine, 4+ views (72110) |
$771 |
$771 |
7.7× |
| MRI lumbar spine without contrast (72148) |
$2,949 |
$2,949 |
12.9× |
| CT pelvis with contrast (72193) |
$2,384 |
$2,384 |
14.2× |
| MRI lower-extremity joint without contrast (73721) |
$2,949 |
$2,949 |
12.9× |
| CT abdomen and pelvis with contrast (74177) |
$4,771 |
$4,771 |
14.3× |
| Ultrasound, abdomen complete (76700) |
$567.50 |
$567.50 |
5.7× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$597 |
$597 |
6.0× |
| Ultrasound, transvaginal (76830) |
$755 |
$755 |
7.5× |
| Mammography, one breast (diagnostic) (77065) |
$764 |
$764 |
8.9× |
| Mammography, both breasts (diagnostic) (77066) |
$983 |
$983 |
8.9× |
| Mammography, screening (bilateral) (77067) |
$610 |
$610 |
6.7× |
| Basic metabolic panel (80048) |
$199 |
$199 |
23.5× |
| Comprehensive metabolic panel (80053) |
$251 |
$251 |
23.8× |
| Lipid panel (80061) |
$313 |
$313 |
23.4× |
| Renal function panel (80069) |
$206 |
$206 |
23.7× |
| Hepatic function panel (80076) |
$191 |
$191 |
23.4× |
| Urinalysis, non-automated, with microscopy (81000) |
$23 |
$23 |
5.7× |
| Urinalysis, non-automated, without microscopy (81002) |
$22 |
$22 |
6.3× |
| PSA, total (84153) |
$403.75 |
$403.75 |
22.0× |
| Thyroid stimulating hormone (TSH) (84443) |
$189 |
$189 |
11.3× |
| CBC with automated differential (85025) |
$185 |
$185 |
23.8× |
| CBC, automated (85027) |
$154 |
$154 |
23.8× |
| Prothrombin time (PT) (85610) |
$90 |
$90 |
21.0× |
| Partial thromboplastin time (PTT) (85730) |
$141 |
$141 |
23.5× |
| Family psychotherapy, without patient (50 min) (90846) |
$461 |
$461 |
2.7× |
| Electrocardiogram (ECG), complete (93000) |
$55 |
$55 |
1.0× |
| Sleep study (attended polysomnography) (95810) |
$3,000 |
$3,000 |
3.6× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$141 |
$141 |
4.9× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$240 |
$240 |
1.9× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$240 |
$240 |
1.9× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$240 |
$240 |
1.9× |
| Preventive visit, new patient (age 18–39) (99385) |
$342 |
$342 |
— |
| Preventive visit, new patient (age 40–64) (99386) |
$397 |
$397 |
— |