| Breast lesion removal (open) (19120) |
— |
$31,275.94 |
— |
Shoulder arthroscopy with decompression (29826)
range across 2 matching MRF lines |
— |
$108,986.11–$113,514.73 |
— |
| Knee arthroscopy with meniscectomy (29881) |
— |
$34,504.91 |
— |
| Upper GI endoscopy (EGD), diagnostic (43235) |
— |
$13,349.46 |
— |
| Upper GI endoscopy (EGD) with biopsy (43239) |
— |
$16,494.17 |
— |
| Diagnostic colonoscopy (45378) |
— |
$15,254.65 |
— |
| Colonoscopy with biopsy (45380) |
— |
$17,075.04 |
— |
| Colonoscopy with lesion removal (45385) |
— |
$17,183.69 |
— |
| Colonoscopy with endoscopic ultrasound (45391) |
— |
$57,993.11 |
— |
| Laparoscopic gallbladder removal (47562) |
— |
$43,441.06 |
— |
| Inguinal hernia repair (age 5+) (49505) |
— |
$39,205.15 |
— |
| Obstetric care, vaginal delivery (global) (59400) |
— |
$39,374.80 |
— |
| Obstetric care, cesarean delivery (global) (59510) |
— |
$74,204.78 |
— |
| Obstetric care, VBAC delivery (global) (59610) |
— |
$39,374.43 |
— |
| Epidural injection, lumbar/sacral (with imaging) (62322) |
— |
$7,779.32 |
— |
Cataract removal with lens insertion (66984)
range across 3 matching MRF lines |
— |
$17,003.02–$17,994.28 |
— |
| CT head/brain without contrast (70450) |
— |
$1,668.98 |
— |
| MRI brain without contrast (70551) |
— |
$5,964.49 |
— |
| MRI brain with contrast (70552) |
— |
$4,387.76 |
— |
| MRI brain without and with contrast (70553) |
— |
$8,324.84 |
— |
| X-ray lower spine, 4+ views (72110) |
— |
$2,181.48 |
— |
| MRI lumbar spine without contrast (72148) |
— |
$2,998.41 |
— |
| CT pelvis with contrast (72193) |
— |
$3,855.61 |
— |
| MRI lower-extremity joint without contrast (73721) |
— |
$7,911.23 |
— |
| CT abdomen and pelvis with contrast (74177) |
— |
$4,909.57 |
— |
| Ultrasound, abdomen complete (76700) |
— |
$3,449.19 |
— |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
— |
$1,021.50 |
— |
| Ultrasound, transvaginal (76830) |
— |
$712.78 |
— |
| Mammography, one breast (diagnostic) (77065) |
— |
$374.21 |
— |
| Mammography, both breasts (diagnostic) (77066) |
— |
$565.48 |
— |
| Mammography, screening (bilateral) (77067) |
— |
$366.74 |
— |
| Basic metabolic panel (80048) |
— |
$384.27 |
— |
| Comprehensive metabolic panel (80053) |
— |
$560.48 |
— |
| Obstetric panel (80055) |
— |
$476.87 |
— |
| Lipid panel (80061) |
— |
$373.62 |
— |
| Renal function panel (80069) |
— |
$149.79 |
— |
| Hepatic function panel (80076) |
— |
$377.53 |
— |
| Urinalysis, non-automated, without microscopy (81002) |
— |
$53.56 |
— |
| PSA, total (84153) |
— |
$207.23 |
— |
| Thyroid stimulating hormone (TSH) (84443) |
— |
$610.75 |
— |
| CBC with automated differential (85025) |
— |
$367.73 |
— |
| CBC, automated (85027) |
— |
$169.77 |
— |
| Prothrombin time (PT) (85610) |
— |
$228.21 |
— |
| Partial thromboplastin time (PTT) (85730) |
— |
$277.78 |
— |
| Left heart catheterization (93452) |
— |
$16,429.35 |
— |
| Sleep study (attended polysomnography) (95810) |
— |
$11,299.86 |
— |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
— |
$266.04 |
— |
| Office visit, new patient (low complexity, ~30 min) (99203) |
— |
$1,661.81 |
— |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
— |
$1,976.77 |
— |
| Office visit, new patient (high complexity, ~60 min) (99205) |
— |
$3,056.04 |
— |
| Office consultation (low complexity, ~30 min) (99243) |
— |
$540.04 |
— |