| Tonsillectomy and adenoidectomy (under age 12) (42820) |
$6,196.50 |
$12,393 |
1.1× |
| Upper GI endoscopy (EGD), diagnostic (43235) |
$1,500 |
$3,000 |
1.7× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$1,500 |
$3,000 |
1.7× |
| Diagnostic colonoscopy (45378) |
$982.50 |
$1,965 |
1.1× |
| Colonoscopy with biopsy (45380) |
$1,065 |
$2,130 |
0.9× |
| Laparoscopic gallbladder removal (47562) |
$6,299 |
$12,598 |
1.1× |
| Inguinal hernia repair (age 5+) (49505) |
$4,294.50 |
$8,589 |
1.2× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$561.75 |
$1,123.50 |
0.7× |
| CT head/brain without contrast (70450) |
$790 |
$1,580 |
7.9× |
| X-ray lower spine, 4+ views (72110) |
$169.50 |
$339 |
1.7× |
| CT pelvis with contrast (72193) |
$1,029.50 |
$2,059 |
6.1× |
| CT abdomen and pelvis with contrast (74177) |
$1,502 |
$3,004 |
4.5× |
| Ultrasound, abdomen complete (76700) |
$309.50 |
$619 |
3.1× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$202 |
$404 |
2.0× |
| Ultrasound, transvaginal (76830) |
$202 |
$404 |
2.0× |
| Mammography, one breast (diagnostic) (77065) |
$45 |
$90 |
0.5× |
| Mammography, both breasts (diagnostic) (77066) |
$50 |
$100 |
0.5× |
| Mammography, screening (bilateral) (77067) |
$45 |
$90 |
0.5× |
| Basic metabolic panel (80048) |
$62 |
$124 |
7.3× |
| Comprehensive metabolic panel (80053) |
$88 |
$176 |
8.3× |
| Lipid panel (80061) |
$76.50 |
$153 |
5.7× |
| Renal function panel (80069) |
$65 |
$130 |
7.5× |
| Hepatic function panel (80076) |
$78.50 |
$157 |
9.6× |
| Urinalysis, non-automated, without microscopy (81002) |
$9 |
$18 |
2.6× |
| PSA, total (84153) |
$41.50 |
$83 |
2.3× |
| Thyroid stimulating hormone (TSH) (84443) |
$56.50 |
$113 |
3.4× |
| CBC with automated differential (85025) |
$30 |
$60 |
3.9× |
| CBC, automated (85027) |
$30 |
$60 |
4.6× |
| Prothrombin time (PT) (85610) |
$18.50 |
$37 |
4.3× |
| Partial thromboplastin time (PTT) (85730) |
$22 |
$44 |
3.7× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$49.50 |
$99 |
1.7× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$163.50 |
$327 |
1.3× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$249 |
$498 |
1.9× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$312 |
$624 |
2.4× |
| Preventive visit, new patient (age 18–39) (99385) |
$100 |
$200 |
— |
| Preventive visit, new patient (age 40–64) (99386) |
$100 |
$200 |
— |