| Breast lesion removal (open) (19120) |
$621 |
$2,070 |
0.1× |
| Shoulder arthroscopy with decompression (29826) |
$1,205.10 |
$4,017 |
— |
| Knee arthroscopy with meniscectomy (29881) |
$1,589.10 |
$5,297 |
0.4× |
Tonsillectomy and adenoidectomy (under age 12) (42820)
likely a partial charge, not the full procedure |
$484.73 |
$1,615.75 |
0.1× |
| Upper GI endoscopy (EGD), diagnostic (43235) |
$271.20 |
$904 |
0.2× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$314.10 |
$1,047 |
0.3× |
| Diagnostic colonoscopy (45378) |
$381.30 |
$1,271 |
0.3× |
| Colonoscopy with biopsy (45380) |
$1,161 |
$3,870 |
0.8× |
| Colonoscopy with lesion removal (45385) |
$540.30 |
$1,801 |
0.4× |
Laparoscopic gallbladder removal (47562)
likely a partial charge, not the full procedure |
$1,210.80 |
$4,036 |
0.2× |
| Inguinal hernia repair (age 5+) (49505) |
$983.67 |
$3,278.91 |
0.2× |
| Obstetric care, vaginal delivery (global) (59400) |
$1,847.10 |
$6,157 |
— |
| Obstetric care, cesarean delivery (global) (59510) |
$1,663.20 |
$5,544 |
— |
| Obstetric care, VBAC delivery (global) (59610) |
$1,468.80 |
$4,896 |
— |
| Epidural injection, lumbar/sacral (with imaging) (62322) |
$645.90 |
$2,153 |
0.6× |
| CT head/brain without contrast (70450) |
$420.32 |
$1,401.05 |
3.2× |
| MRI brain without contrast (70551) |
$1,327.20 |
$4,424 |
4.5× |
| MRI brain with contrast (70552) |
$1,327.20 |
$4,424 |
3.0× |
| MRI brain without and with contrast (70553) |
$1,747.50 |
$5,825 |
4.0× |
| X-ray lower spine, 4+ views (72110) |
$136.04 |
$453.45 |
1.0× |
| MRI lumbar spine without contrast (72148) |
$824.70 |
$2,749 |
2.8× |
| CT pelvis with contrast (72193) |
$457.01 |
$1,523.35 |
2.1× |
| MRI lower-extremity joint without contrast (73721) |
$805.80 |
$2,686 |
2.7× |
| CT abdomen and pelvis with contrast (74177) |
— |
$3,138.45 |
— |
| Ultrasound, abdomen complete (76700) |
$159.54 |
$531.80 |
1.2× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$87.30 |
$291 |
0.7× |
| Ultrasound, transvaginal (76830) |
$130.20 |
$434 |
1.0× |
| Mammography, both breasts (diagnostic) (77066) |
$70.50 |
$235 |
0.6× |
| Mammography, screening (bilateral) (77067) |
$58.50 |
$195 |
0.6× |
| Basic metabolic panel (80048) |
$60 |
$200 |
7.1× |
| Comprehensive metabolic panel (80053) |
$69.90 |
$233 |
6.6× |
| Obstetric panel (80055) |
$40.17 |
$133.90 |
0.8× |
| Lipid panel (80061) |
$80.10 |
$267 |
6.0× |
| Renal function panel (80069) |
$75 |
$250 |
8.6× |
| Hepatic function panel (80076) |
$62.40 |
$208 |
7.6× |
| Urinalysis, non-automated, with microscopy (81000) |
$8.79 |
$29.30 |
2.2× |
| Urinalysis, non-automated, without microscopy (81002) |
$5.63 |
$18.75 |
1.6× |
| PSA, total (84153) |
$25.82 |
$86.05 |
1.4× |
| Thyroid stimulating hormone (TSH) (84443) |
$49.22 |
$164.05 |
2.9× |
| CBC with automated differential (85025) |
$30.30 |
$101 |
3.9× |
| CBC, automated (85027) |
$28.56 |
$95.20 |
4.4× |
| Prothrombin time (PT) (85610) |
$10.79 |
$35.95 |
2.5× |
| Partial thromboplastin time (PTT) (85730) |
$13.56 |
$45.20 |
2.3× |
| Psychotherapy, 30 minutes (90832) |
$32.78 |
$109.28 |
0.1× |
| Psychotherapy, 45 minutes (90834) |
$45 |
$150 |
0.2× |
| Psychotherapy, 60 minutes (90837) |
$52.50 |
$175 |
0.2× |
| Family psychotherapy, without patient (50 min) (90846) |
$48 |
$160 |
0.2× |
| Family psychotherapy, with patient (50 min) (90847) |
$51.90 |
$173 |
0.2× |
| Group psychotherapy (90853) |
$96 |
$320 |
0.8× |
| Electrocardiogram (ECG), complete (93000) |
$52.50 |
$175 |
0.7× |
| Sleep study (attended polysomnography) (95810) |
$198.60 |
$662 |
0.2× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$18 |
$60 |
0.6× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$68.70 |
$229 |
0.4× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$98.70 |
$329 |
0.6× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$128.70 |
$429 |
0.8× |
| Office consultation (low complexity, ~30 min) (99243) |
$100.50 |
$335 |
0.6× |
| Office consultation (moderate complexity, ~40 min) (99244) |
$130.50 |
$435 |
0.8× |
| Preventive visit, new patient (age 18–39) (99385) |
$80.48 |
$268.28 |
— |
| Preventive visit, new patient (age 40–64) (99386) |
$90 |
$300 |
— |