| Breast lesion removal (open) (19120) |
$1,865.75 |
$3,731.50 |
0.5× |
| Shoulder arthroscopy with decompression (29826) |
$2,322.60 |
$4,645.20 |
— |
| Knee arthroscopy with meniscectomy (29881) |
$4,097 |
$8,194 |
1.3× |
| Tonsillectomy and adenoidectomy (under age 12) (42820) |
$3,626 |
$7,252 |
0.6× |
| Upper GI endoscopy (EGD), diagnostic (43235) |
$648 |
$1,296 |
0.7× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$391 |
$782 |
0.4× |
| Diagnostic colonoscopy (45378) |
$524 |
$1,048 |
0.6× |
| Colonoscopy with biopsy (45380) |
$492 |
$984 |
0.4× |
| Colonoscopy with lesion removal (45385) |
$659.62 |
$1,319.25 |
0.6× |
| Laparoscopic gallbladder removal (47562) |
$5,617 |
$11,234 |
1.0× |
| Inguinal hernia repair (age 5+) (49505) |
$8,157.25 |
$16,314.50 |
2.4× |
| Laparoscopic radical prostatectomy (55866) |
$34,807.50 |
$69,615 |
3.4× |
| Epidural injection, lumbar/sacral (with imaging) (62322) |
$1,087.50 |
$2,175 |
1.3× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$1,268.50 |
$2,537 |
1.5× |
| After-cataract laser surgery (YAG capsulotomy) (66821) |
$632 |
$1,264 |
1.2× |
| Cataract removal with lens insertion (66984) |
$5,465 |
$10,930 |
2.5× |
| CT head/brain without contrast (70450) |
$764.25 |
$1,528.50 |
7.6× |
| MRI brain without contrast (70551) |
$1,629.75 |
$3,259.50 |
7.1× |
| MRI brain with contrast (70552) |
$2,029.75 |
$4,059.50 |
6.1× |
| MRI brain without and with contrast (70553) |
$2,301 |
$4,602 |
6.9× |
| X-ray lower spine, 4+ views (72110) |
$325.25 |
$650.50 |
3.2× |
| MRI lumbar spine without contrast (72148) |
$1,585.25 |
$3,170.50 |
6.9× |
| CT pelvis with contrast (72193) |
$1,114.75 |
$2,229.50 |
6.6× |
| MRI lower-extremity joint without contrast (73721) |
$1,555 |
$3,110 |
6.8× |
| CT abdomen and pelvis with contrast (74177) |
$1,578.25 |
$3,156.50 |
4.7× |
| Ultrasound, abdomen complete (76700) |
$451 |
$902 |
4.5× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$433.25 |
$866.50 |
4.3× |
| Ultrasound, transvaginal (76830) |
$412 |
$824 |
4.1× |
| Mammography, one breast (diagnostic) (77065) |
$238 |
$476 |
2.8× |
| Mammography, both breasts (diagnostic) (77066) |
$317.50 |
$635 |
2.9× |
| Mammography, screening (bilateral) (77067) |
$229 |
$458 |
2.5× |
| Basic metabolic panel (80048) |
$39 |
$78 |
4.6× |
| Comprehensive metabolic panel (80053) |
$49 |
$98 |
4.6× |
| Obstetric panel (80055) |
$221.50 |
$443 |
4.6× |
| Lipid panel (80061) |
$62.50 |
$125 |
4.7× |
| Renal function panel (80069) |
$40 |
$80 |
4.6× |
| Hepatic function panel (80076) |
$38 |
$76 |
4.7× |
| Urinalysis, non-automated, with microscopy (81000) |
$25 |
$50 |
6.2× |
| Urinalysis, non-automated, without microscopy (81002) |
$13 |
$26 |
3.7× |
| PSA, total (84153) |
$68 |
$136 |
3.7× |
| Thyroid stimulating hormone (TSH) (84443) |
$86.50 |
$173 |
5.1× |
| CBC with automated differential (85025) |
$44.50 |
$89 |
5.7× |
| CBC, automated (85027) |
$42.75 |
$85.50 |
6.6× |
| Prothrombin time (PT) (85610) |
$27 |
$54 |
6.3× |
| Partial thromboplastin time (PTT) (85730) |
$51.50 |
$103 |
8.6× |
| Family psychotherapy, without patient (50 min) (90846) |
$596 |
$1,192 |
3.5× |
| Family psychotherapy, with patient (50 min) (90847) |
$596 |
$1,192 |
3.5× |
| Electrocardiogram (ECG), complete (93000) |
$190.50 |
$381 |
3.4× |
| Left heart catheterization (93452) |
$5,990.50 |
$11,981 |
1.9× |
| Sleep study (attended polysomnography) (95810) |
$2,195 |
$4,390 |
2.7× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$75.50 |
$151 |
2.6× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$63 |
$126 |
0.5× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$63 |
$126 |
0.5× |
| Preventive visit, new patient (age 18–39) (99385) |
$43 |
$86 |
— |
| Preventive visit, new patient (age 40–64) (99386) |
$49.50 |
$99 |
— |