| Breast lesion removal (open) (19120) |
$123.20 |
$704 |
0.0× |
Tonsillectomy and adenoidectomy (under age 12) (42820) likely a partial charge, not the full procedure |
$65.45 |
$374 |
0.0× |
| Upper GI endoscopy (EGD), diagnostic (43235) |
$393.75 |
$2,250 |
0.4× |
| Colonoscopy with biopsy (45380) |
$97.30 |
$556 |
0.1× |
| Epidural injection, lumbar/sacral (with imaging) (62322) |
$314.13 |
$1,795 |
0.4× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$530.78 |
$3,033 |
0.6× |
| CT head/brain without contrast (70450) |
$510.65 |
$2,918 |
4.9× |
| MRI brain without contrast (70551) |
$784.18 |
$4,481 |
3.3× |
| MRI brain with contrast (70552) |
$891.63 |
$5,095 |
2.5× |
| MRI brain without and with contrast (70553) |
$1,074.15 |
$6,138 |
3.1× |
| MRI lumbar spine without contrast (72148) |
$827.75 |
$4,730 |
3.5× |
| CT pelvis with contrast (72193) |
$537.43 |
$3,071 |
3.1× |
| CT abdomen and pelvis with contrast (74177) |
$1,474.38 |
$8,425 |
4.2× |
| Ultrasound, abdomen complete (76700) |
$310.45 |
$1,774 |
3.0× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$329 |
$1,880 |
3.1× |
| Ultrasound, transvaginal (76830) |
$196.35 |
$1,122 |
1.9× |
| Mammography, both breasts (diagnostic) (77066) |
$100.98 |
$577 |
0.9× |
| Mammography, screening (bilateral) (77067) |
$78.93 |
$451 |
0.9× |
| Basic metabolic panel (80048) |
$98.88 |
$565 |
11.7× |
| Comprehensive metabolic panel (80053) |
$135.80 |
$776 |
12.9× |
| Obstetric panel (80055) |
$159.43 |
$911 |
3.3× |
| Lipid panel (80061) |
$56.35 |
$322 |
4.2× |
| Renal function panel (80069) |
$170.28 |
$973 |
19.6× |
| Hepatic function panel (80076) |
$111.13 |
$635 |
13.6× |
| Urinalysis, non-automated, with microscopy (81000) |
$2.63 |
$15 |
0.7× |
| Urinalysis, non-automated, without microscopy (81002) |
$6.56 |
$37.50 |
1.9× |
| PSA, total (84153) |
$51.10 |
$292 |
2.8× |
| Thyroid stimulating hormone (TSH) (84443) |
$34.04 |
$194.50 |
2.0× |
| CBC with automated differential (85025) |
$37.63 |
$215 |
4.8× |
| CBC, automated (85027) |
$42.35 |
$242 |
6.5× |
| Prothrombin time (PT) (85610) |
$47.25 |
$270 |
11.0× |
| Partial thromboplastin time (PTT) (85730) |
$53.38 |
$305 |
8.9× |
| Psychotherapy, 30 minutes (90832) |
$44.28 |
$253 |
0.2× |
| Psychotherapy, 45 minutes (90834) |
$61.25 |
$350 |
0.3× |
| Psychotherapy, 60 minutes (90837) |
$70 |
$400 |
0.4× |
| Family psychotherapy, without patient (50 min) (90846) |
$61.25 |
$350 |
0.3× |
| Family psychotherapy, with patient (50 min) (90847) |
$68.25 |
$390 |
0.4× |
| Group psychotherapy (90853) |
$67.20 |
$384 |
0.7× |
| Left heart catheterization (93452) |
$2,178.05 |
$12,446 |
0.7× |
| Sleep study (attended polysomnography) (95810) |
$1,780.45 |
$10,174 |
2.1× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$150.50 |
$860 |
1.1× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$184.80 |
$1,056 |
1.4× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$129.85 |
$742 |
1.0× |
| Office consultation (low complexity, ~30 min) (99243) |
$64.58 |
$369 |
0.5× |
| Office consultation (moderate complexity, ~40 min) (99244) |
$100.80 |
$576 |
0.8× |
| Preventive visit, new patient (age 40–64) (99386) |
$26.25 |
$150 |
— |