| Breast lesion removal (open) (19120) |
$918.75 |
$3,292.50 |
0.2× |
| Shoulder arthroscopy with decompression (29826) |
$408.75 |
$545 |
— |
| Knee arthroscopy with meniscectomy (29881) |
$1,530 |
$5,250 |
0.5× |
Tonsillectomy and adenoidectomy (under age 12) (42820)
likely a partial charge, not the full procedure |
$558.75 |
$5,510 |
0.1× |
| Upper GI endoscopy (EGD), diagnostic (43235) |
$348.75 |
$1,160 |
0.4× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$348.75 |
$1,212.50 |
0.4× |
| Diagnostic colonoscopy (45378) |
$588.75 |
$1,422.50 |
0.6× |
| Colonoscopy with biopsy (45380) |
$588.75 |
$1,475 |
0.5× |
| Colonoscopy with lesion removal (45385) |
$588.75 |
$1,475 |
0.5× |
Laparoscopic gallbladder removal (47562)
likely a partial charge, not the full procedure |
$1,507.50 |
$8,472.50 |
0.2× |
| Inguinal hernia repair (age 5+) (49505) |
$1,158.75 |
$5,692.50 |
0.3× |
| Epidural injection, lumbar/sacral (with imaging) (62322) |
$183.75 |
$1,102.50 |
0.2× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$217.50 |
$867.50 |
0.2× |
| CT head/brain without contrast (70450) |
$93.75 |
$1,145 |
0.9× |
| MRI brain without contrast (70551) |
$165 |
$1,605 |
0.7× |
| MRI brain with contrast (70552) |
$195 |
$1,985 |
0.6× |
| MRI brain without and with contrast (70553) |
$247.50 |
$2,330 |
0.7× |
| X-ray lower spine, 4+ views (72110) |
$33.75 |
$332.50 |
0.3× |
| MRI lumbar spine without contrast (72148) |
$165 |
$1,605 |
0.7× |
| CT pelvis with contrast (72193) |
$127.50 |
$1,477.50 |
0.7× |
| MRI lower-extremity joint without contrast (73721) |
$153.75 |
$1,442.50 |
0.6× |
| CT abdomen and pelvis with contrast (74177) |
$202.50 |
$2,710 |
0.6× |
| Ultrasound, abdomen complete (76700) |
$90 |
$680 |
0.9× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$108.75 |
$322.50 |
1.0× |
| Ultrasound, transvaginal (76830) |
$78.75 |
$825 |
0.8× |
| Mammography, one breast (diagnostic) (77065) |
$90 |
$245 |
1.0× |
| Mammography, both breasts (diagnostic) (77066) |
$108.75 |
$305 |
1.0× |
| Mammography, screening (bilateral) (77067) |
$86.25 |
$115 |
0.9× |
| Basic metabolic panel (80048) |
— |
$165 |
— |
| Comprehensive metabolic panel (80053) |
— |
$365 |
— |
| Lipid panel (80061) |
— |
$205 |
— |
| Renal function panel (80069) |
— |
$440 |
— |
| Hepatic function panel (80076) |
— |
$260 |
— |
| PSA, total (84153) |
— |
$172 |
— |
| Thyroid stimulating hormone (TSH) (84443) |
— |
$195 |
— |
| CBC with automated differential (85025) |
— |
$103 |
— |
| CBC, automated (85027) |
— |
$62 |
— |
| Prothrombin time (PT) (85610) |
— |
$73.50 |
— |
| Partial thromboplastin time (PTT) (85730) |
— |
$114 |
— |
| Psychotherapy, 30 minutes (90832) |
— |
$620 |
— |
| Psychotherapy, 45 minutes (90834) |
— |
$670 |
— |
| Psychotherapy, 60 minutes (90837) |
— |
$725 |
— |
| Family psychotherapy, without patient (50 min) (90846) |
— |
$825 |
— |
| Family psychotherapy, with patient (50 min) (90847) |
— |
$850 |
— |
| Group psychotherapy (90853) |
— |
$725 |
— |
| Sleep study (attended polysomnography) (95810) |
$273.75 |
$2,062.50 |
0.3× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
— |
$140 |
— |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$176.25 |
$260 |
1.3× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$273.75 |
$260 |
2.1× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$330 |
$260 |
2.5× |
| Office consultation (low complexity, ~30 min) (99243) |
$221.25 |
$295 |
1.7× |
| Office consultation (moderate complexity, ~40 min) (99244) |
$330 |
$440 |
2.5× |