| Breast lesion removal (open) (19120) |
$907.20 |
$1,512 |
0.2× |
| Shoulder arthroscopy with decompression (29826) |
$1,380 |
$2,300 |
— |
| Knee arthroscopy with meniscectomy (29881) |
$1,746 |
$2,910 |
0.6× |
Tonsillectomy and adenoidectomy (under age 12) (42820)
likely a partial charge, not the full procedure |
$600 |
$1,000 |
0.1× |
| Upper GI endoscopy (EGD), diagnostic (43235) |
$1,152 |
$1,920 |
1.3× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$1,315.80 |
$2,193 |
1.5× |
| Diagnostic colonoscopy (45378) |
$1,135.20 |
$1,892 |
1.3× |
| Colonoscopy with biopsy (45380) |
$1,335 |
$2,225 |
1.2× |
| Colonoscopy with lesion removal (45385) |
$1,437.30 |
$2,395.50 |
1.3× |
| Colonoscopy with endoscopic ultrasound (45391) |
$715.20 |
$1,192 |
0.6× |
Laparoscopic gallbladder removal (47562)
likely a partial charge, not the full procedure |
$1,725 |
$2,875 |
0.3× |
| Inguinal hernia repair (age 5+) (49505) |
$1,106.40 |
$1,844 |
0.3× |
Laparoscopic radical prostatectomy (55866)
unusually low: confirm this is the full procedure |
$4,249.80 |
$7,083 |
0.4× |
| CT head/brain without contrast (70450) |
$993.90 |
$1,656.50 |
9.9× |
| MRI brain without contrast (70551) |
$2,258.40 |
$3,764 |
9.9× |
| MRI brain with contrast (70552) |
$2,622.90 |
$4,371.50 |
7.9× |
| MRI brain without and with contrast (70553) |
$3,166.20 |
$5,277 |
9.5× |
| X-ray lower spine, 4+ views (72110) |
$307.50 |
$512.50 |
3.1× |
| MRI lumbar spine without contrast (72148) |
$2,140.20 |
$3,567 |
9.4× |
| CT pelvis with contrast (72193) |
$1,292.10 |
$2,153.50 |
7.7× |
| MRI lower-extremity joint without contrast (73721) |
$2,709.90 |
$4,516.50 |
11.9× |
| CT abdomen and pelvis with contrast (74177) |
$2,266.80 |
$3,778 |
6.8× |
| Ultrasound, abdomen complete (76700) |
$457.20 |
$762 |
4.6× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$562.80 |
$938 |
5.6× |
| Ultrasound, transvaginal (76830) |
$390.60 |
$651 |
3.9× |
| Mammography, one breast (diagnostic) (77065) |
$224.70 |
$374.50 |
2.6× |
| Mammography, both breasts (diagnostic) (77066) |
$271.20 |
$452 |
2.5× |
| Mammography, screening (bilateral) (77067) |
$214.80 |
$358 |
2.4× |
| Basic metabolic panel (80048) |
$70.50 |
$117.50 |
8.3× |
| Comprehensive metabolic panel (80053) |
$72.95 |
$121.58 |
6.9× |
| Lipid panel (80061) |
$61.74 |
$102.90 |
4.6× |
| Renal function panel (80069) |
$83.70 |
$139.50 |
9.6× |
| Hepatic function panel (80076) |
$77.40 |
$129 |
9.5× |
| Urinalysis, non-automated, with microscopy (81000) |
$21.60 |
$36 |
5.4× |
| Urinalysis, non-automated, without microscopy (81002) |
$26.40 |
$44 |
7.6× |
| PSA, total (84153) |
$67.41 |
$112.35 |
3.7× |
| Thyroid stimulating hormone (TSH) (84443) |
$82.15 |
$136.92 |
4.9× |
| CBC with automated differential (85025) |
$72.95 |
$121.58 |
9.4× |
| CBC, automated (85027) |
$45.30 |
$75.50 |
7.0× |
| Prothrombin time (PT) (85610) |
$38.10 |
$63.50 |
8.9× |
| Partial thromboplastin time (PTT) (85730) |
$48 |
$80 |
8.0× |
| Psychotherapy, 30 minutes (90832) |
$113.40 |
$189 |
0.7× |
| Psychotherapy, 45 minutes (90834) |
$142.50 |
$237.50 |
0.8× |
| Psychotherapy, 60 minutes (90837) |
$169.20 |
$282 |
1.0× |
| Family psychotherapy, without patient (50 min) (90846) |
$103.50 |
$172.50 |
0.6× |
| Family psychotherapy, with patient (50 min) (90847) |
$121.50 |
$202.50 |
0.7× |
| Group psychotherapy (90853) |
$64.50 |
$107.50 |
0.7× |
| Electrocardiogram (ECG), complete (93000) |
$61.80 |
$103 |
1.1× |
| Left heart catheterization (93452) |
$3,758.70 |
$6,264.50 |
1.2× |
| Sleep study (attended polysomnography) (95810) |
$1,312.80 |
$2,188 |
1.6× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$68.10 |
$113.50 |
2.3× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$147.30 |
$245.50 |
1.2× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$199.50 |
$332.50 |
1.6× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$227.70 |
$379.50 |
1.8× |
| Office consultation (low complexity, ~30 min) (99243) |
$165 |
$275 |
1.3× |
| Office consultation (moderate complexity, ~40 min) (99244) |
$247.80 |
$413 |
1.9× |
| Preventive visit, new patient (age 18–39) (99385) |
$163.80 |
$273 |
— |
| Preventive visit, new patient (age 40–64) (99386) |
$189.60 |
$316 |
— |