| Breast lesion removal (open) (19120) |
— |
$1,412 |
— |
| Upper GI endoscopy (EGD), diagnostic (43235) |
— |
$851 |
— |
Upper GI endoscopy (EGD) with biopsy (43239)
range across 2 matching MRF lines |
— |
$970–$987 |
— |
Colonoscopy with biopsy (45380)
range across 2 matching MRF lines |
— |
$970–$1,261 |
— |
Colonoscopy with lesion removal (45385)
range across 2 matching MRF lines |
— |
$970–$1,624 |
— |
| Laparoscopic gallbladder removal (47562) |
— |
$3,413 |
— |
| Inguinal hernia repair (age 5+) (49505) |
— |
$1,986 |
— |
Transforaminal epidural injection, lumbar/sacral (64483)
range across 2 matching MRF lines |
— |
$1,202–$6,556 |
— |
| CT head/brain without contrast (70450) |
— |
$2,638 |
— |
| MRI brain without contrast (70551) |
— |
$4,029 |
— |
| MRI brain with contrast (70552) |
— |
$4,300 |
— |
| MRI brain without and with contrast (70553) |
— |
$4,835 |
— |
| X-ray lower spine, 4+ views (72110) |
— |
$561 |
— |
| MRI lumbar spine without contrast (72148) |
— |
$4,029 |
— |
| CT pelvis with contrast (72193) |
— |
$3,166 |
— |
MRI lower-extremity joint without contrast (73721)
range across 3 matching MRF lines |
— |
$3,663–$4,029 |
— |
| CT abdomen and pelvis with contrast (74177) |
— |
$4,748 |
— |
| Ultrasound, abdomen complete (76700) |
— |
$702 |
— |
| Ultrasound, transvaginal (76830) |
— |
$773 |
— |
| Mammography, one breast (diagnostic) (77065) |
— |
$437 |
— |
| Mammography, both breasts (diagnostic) (77066) |
— |
$552 |
— |
| Mammography, screening (bilateral) (77067) |
— |
$470 |
— |
| Basic metabolic panel (80048) |
— |
$293 |
— |
Comprehensive metabolic panel (80053)
range across 2 matching MRF lines |
— |
$23–$440 |
— |
Lipid panel (80061)
range across 3 matching MRF lines |
— |
$52–$263 |
— |
| Renal function panel (80069) |
— |
$293 |
— |
Hepatic function panel (80076)
range across 2 matching MRF lines |
— |
$18–$257 |
— |
Urinalysis, non-automated, without microscopy (81002)
range across 3 matching MRF lines |
— |
$24–$74 |
— |
PSA, total (84153)
range across 3 matching MRF lines |
— |
$80–$137 |
— |
Thyroid stimulating hormone (TSH) (84443)
range across 3 matching MRF lines |
— |
$38–$205 |
— |
CBC with automated differential (85025)
range across 4 matching MRF lines |
— |
$17–$148 |
— |
| CBC, automated (85027) |
— |
$134 |
— |
Prothrombin time (PT) (85610)
range across 3 matching MRF lines |
— |
$12–$89 |
— |
Partial thromboplastin time (PTT) (85730)
range across 2 matching MRF lines |
— |
$28–$104 |
— |
| Psychotherapy, 30 minutes (90832) |
— |
$102 |
— |
| Psychotherapy, 45 minutes (90834) |
— |
$192 |
— |
| Psychotherapy, 60 minutes (90837) |
— |
$386 |
— |
| Family psychotherapy, without patient (50 min) (90846) |
— |
$192 |
— |
| Family psychotherapy, with patient (50 min) (90847) |
— |
$192 |
— |
| Group psychotherapy (90853) |
— |
$265 |
— |
| Electrocardiogram (ECG), complete (93000) |
— |
$110 |
— |
Sleep study (attended polysomnography) (95810)
range across 3 matching MRF lines |
— |
$1,091–$3,726 |
— |
Physical therapy, therapeutic exercise (per 15 min) (97110)
range across 2 matching MRF lines |
— |
$75–$98 |
— |
Office visit, new patient (low complexity, ~30 min) (99203)
range across 2 matching MRF lines |
— |
$86–$253 |
— |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
— |
$396 |
— |
| Office visit, new patient (high complexity, ~60 min) (99205) |
— |
$425 |
— |
| Office consultation (low complexity, ~30 min) (99243) |
— |
$320 |
— |
| Office consultation (moderate complexity, ~40 min) (99244) |
— |
$420 |
— |
| Preventive visit, new patient (age 18–39) (99385) |
— |
$311 |
— |
| Preventive visit, new patient (age 40–64) (99386) |
— |
$338 |
— |