| Breast lesion removal (open) (19120) |
— |
$8,429 |
— |
| Shoulder arthroscopy with decompression (29826) |
— |
$7,851 |
— |
| Knee arthroscopy with meniscectomy (29881) |
— |
$9,491 |
— |
| Tonsillectomy and adenoidectomy (under age 12) (42820) |
— |
$6,234 |
— |
| Upper GI endoscopy (EGD), diagnostic (43235) |
— |
$3,734 |
— |
| Upper GI endoscopy (EGD) with biopsy (43239) |
— |
$5,002 |
— |
| Diagnostic colonoscopy (45378) |
— |
$5,002 |
— |
| Colonoscopy with biopsy (45380) |
— |
$5,002 |
— |
| Colonoscopy with lesion removal (45385) |
— |
$5,002 |
— |
| Laparoscopic gallbladder removal (47562) |
— |
$15,418 |
— |
| Inguinal hernia repair (age 5+) (49505) |
— |
$10,074 |
— |
| Laparoscopic radical prostatectomy (55866) |
— |
$32,483 |
— |
Obstetric care, vaginal delivery (global) (59400)
range across 2 matching MRF lines |
— |
$2,999–$4,065 |
— |
Obstetric care, cesarean delivery (global) (59510)
range across 4 matching MRF lines |
— |
$3,758–$4,786 |
— |
| Obstetric care, VBAC delivery (global) (59610) |
— |
$4,280 |
— |
| Epidural injection, lumbar/sacral (with imaging) (62322) |
— |
$1,881 |
— |
Transforaminal epidural injection, lumbar/sacral (64483)
range across 2 matching MRF lines |
— |
$794–$3,172 |
— |
After-cataract laser surgery (YAG capsulotomy) (66821)
range across 2 matching MRF lines |
— |
$4,546–$5,002 |
— |
| Cataract removal with lens insertion (66984) |
— |
$10,913 |
— |
| CT head/brain without contrast (70450) |
— |
$1,156 |
— |
| MRI brain without contrast (70551) |
— |
$1,797 |
— |
| MRI brain with contrast (70552) |
— |
$1,671 |
— |
| MRI brain without and with contrast (70553) |
— |
$3,117 |
— |
| X-ray lower spine, 4+ views (72110) |
— |
$339 |
— |
| MRI lumbar spine without contrast (72148) |
— |
$1,797 |
— |
| CT pelvis with contrast (72193) |
— |
$2,057 |
— |
| MRI lower-extremity joint without contrast (73721) |
— |
$1,797 |
— |
| CT abdomen and pelvis with contrast (74177) |
— |
$1,646 |
— |
| Ultrasound, abdomen complete (76700) |
— |
$578 |
— |
Ultrasound, pregnant uterus (≥14 weeks) (76805)
range across 3 matching MRF lines |
— |
$513–$529 |
— |
Ultrasound, transvaginal (76830)
range across 2 matching MRF lines |
— |
$206–$578 |
— |
| Mammography, one breast (diagnostic) (77065) |
— |
$440 |
— |
| Mammography, both breasts (diagnostic) (77066) |
— |
$600 |
— |
| Mammography, screening (bilateral) (77067) |
— |
$480 |
— |
| Basic metabolic panel (80048) |
— |
$106 |
— |
| Comprehensive metabolic panel (80053) |
— |
$121 |
— |
| Lipid panel (80061) |
— |
$159 |
— |
| Renal function panel (80069) |
— |
$109 |
— |
| Hepatic function panel (80076) |
— |
$104 |
— |
| Urinalysis, non-automated, with microscopy (81000) |
— |
$8 |
— |
Urinalysis, non-automated, without microscopy (81002)
range across 5 matching MRF lines |
— |
$5–$31.60 |
— |
| PSA, total (84153) |
— |
$68.30 |
— |
Thyroid stimulating hormone (TSH) (84443)
range across 2 matching MRF lines |
— |
$62–$207 |
— |
CBC with automated differential (85025)
range across 2 matching MRF lines |
— |
$72.42–$79.60 |
— |
| CBC, automated (85027) |
— |
$70.40 |
— |
Prothrombin time (PT) (85610)
range across 3 matching MRF lines |
— |
$15.20–$50 |
— |
Partial thromboplastin time (PTT) (85730)
range across 3 matching MRF lines |
— |
$22.70–$76.50 |
— |
Electrocardiogram (ECG), complete (93000)
range across 4 matching MRF lines |
— |
$46–$85 |
— |
| Left heart catheterization (93452) |
— |
$15,217 |
— |
| Sleep study (attended polysomnography) (95810) |
— |
$4,740 |
— |
Physical therapy, therapeutic exercise (per 15 min) (97110)
range across 2 matching MRF lines |
— |
$117–$128 |
— |
Office visit, new patient (low complexity, ~30 min) (99203)
range across 7 matching MRF lines |
— |
$146–$936 |
— |
Office visit, new patient (moderate complexity, ~45 min) (99204)
range across 6 matching MRF lines |
— |
$228–$1,402 |
— |
Office visit, new patient (high complexity, ~60 min) (99205)
range across 6 matching MRF lines |
— |
$285–$1,756 |
— |
Office consultation (low complexity, ~30 min) (99243)
range across 2 matching MRF lines |
— |
$222–$229 |
— |
Office consultation (moderate complexity, ~40 min) (99244)
range across 2 matching MRF lines |
— |
$307–$332 |
— |
Preventive visit, new patient (age 18–39) (99385)
range across 4 matching MRF lines |
— |
$221–$268 |
— |
Preventive visit, new patient (age 40–64) (99386)
range across 4 matching MRF lines |
— |
$242–$313 |
— |