| Breast lesion removal (open) (19120) |
$1,378.50 |
$1,838 |
0.3× |
| Shoulder arthroscopy with decompression (29826) |
$2,784.38 |
$3,712.50 |
— |
| Knee arthroscopy with meniscectomy (29881) |
$2,784 |
$3,712 |
0.8× |
Tonsillectomy and adenoidectomy (under age 12) (42820)
likely a partial charge — not the full procedure |
$579.75 |
$773 |
0.1× |
| Upper GI endoscopy (EGD), diagnostic (43235) |
$1,007.25 |
$1,343 |
1.1× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$1,786.12 |
$2,381.50 |
1.9× |
| Diagnostic colonoscopy (45378) |
$1,641 |
$2,188 |
1.7× |
| Colonoscopy with biopsy (45380) |
$1,641 |
$2,188 |
1.3× |
| Colonoscopy with lesion removal (45385) |
$1,641 |
$2,188 |
1.3× |
| Laparoscopic gallbladder removal (47562) |
$8,397 |
$11,196 |
1.4× |
| Inguinal hernia repair (age 5+) (49505) |
$2,777.25 |
$3,703 |
0.8× |
| Obstetric care, vaginal delivery (global) (59400) |
$4,338.75 |
$5,785 |
— |
| Obstetric care, cesarean delivery (global) (59510) |
$4,847.25 |
$6,463 |
— |
| Obstetric care, VBAC delivery (global) (59610) |
$3,467.25 |
$4,623 |
— |
| Epidural injection, lumbar/sacral (with imaging) (62322) |
$159.75 |
$213 |
0.2× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$1,320.75 |
$1,761 |
1.5× |
| CT head/brain without contrast (70450) |
$813.38 |
$1,084.50 |
7.6× |
| MRI brain without contrast (70551) |
$1,196.62 |
$1,595.50 |
4.9× |
| MRI brain with contrast (70552) |
$1,811.25 |
$2,415 |
5.1× |
| MRI brain without and with contrast (70553) |
$1,777.50 |
$2,370 |
5.0× |
| X-ray lower spine, 4+ views (72110) |
$249.38 |
$332.50 |
2.3× |
| MRI lumbar spine without contrast (72148) |
$1,341.38 |
$1,788.50 |
5.5× |
| CT pelvis with contrast (72193) |
$991.12 |
$1,321.50 |
5.5× |
| MRI lower-extremity joint without contrast (73721) |
$1,109.25 |
$1,479 |
4.6× |
| CT abdomen and pelvis with contrast (74177) |
$654.75 |
$873 |
1.8× |
| Ultrasound, abdomen complete (76700) |
$603.38 |
$804.50 |
5.6× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$205.12 |
$273.50 |
1.9× |
| Ultrasound, transvaginal (76830) |
$390.75 |
$521 |
3.7× |
| Mammography, one breast (diagnostic) (77065) |
$183.75 |
$245 |
2.1× |
| Mammography, both breasts (diagnostic) (77066) |
$238.12 |
$317.50 |
2.2× |
| Mammography, screening (bilateral) (77067) |
$204 |
$272 |
2.2× |
| Basic metabolic panel (80048) |
$66.75 |
$89 |
7.9× |
| Comprehensive metabolic panel (80053) |
$157.50 |
$210 |
14.9× |
| Lipid panel (80061) |
$44.94 |
$59.92 |
3.4× |
| Renal function panel (80069) |
$120 |
$160 |
13.8× |
| Hepatic function panel (80076) |
$69 |
$92 |
8.4× |
| PSA, total (84153) |
$42 |
$56 |
2.3× |
| Thyroid stimulating hormone (TSH) (84443) |
$67.50 |
$90 |
4.0× |
| CBC with automated differential (85025) |
$45.75 |
$61 |
5.9× |
| CBC, automated (85027) |
$48.75 |
$65 |
7.5× |
| Prothrombin time (PT) (85610) |
$48.75 |
$65 |
11.4× |
| Partial thromboplastin time (PTT) (85730) |
$85.50 |
$114 |
14.2× |
| Psychotherapy, 30 minutes (90832) |
$106.88 |
$142.50 |
0.6× |
| Psychotherapy, 45 minutes (90834) |
$141 |
$188 |
0.8× |
| Psychotherapy, 60 minutes (90837) |
$207 |
$276 |
1.1× |
| Electrocardiogram (ECG), complete (93000) |
$177.75 |
$237 |
2.9× |
| Sleep study (attended polysomnography) (95810) |
$2,151.38 |
$2,868.50 |
2.5× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$93 |
$124 |
3.2× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$164.25 |
$219 |
1.2× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$245.25 |
$327 |
1.8× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$324 |
$432 |
2.4× |
| Office consultation (low complexity, ~30 min) (99243) |
$166.12 |
$221.50 |
1.2× |
| Office consultation (moderate complexity, ~40 min) (99244) |
$247.50 |
$330 |
1.8× |
| Preventive visit, new patient (age 18–39) (99385) |
$181.88 |
$242.50 |
— |
| Preventive visit, new patient (age 40–64) (99386) |
$210 |
$280 |
— |