| Breast lesion removal (open) (19120) |
$11,297.25 |
— |
3.0× |
| Knee arthroscopy with meniscectomy (29881) |
$9,440.73 |
— |
3.0× |
| Tonsillectomy and adenoidectomy (under age 12) (42820) |
$17,080.53 |
— |
3.0× |
| Upper GI endoscopy (EGD), diagnostic (43235) |
$2,616.93 |
— |
3.0× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$2,616.93 |
— |
3.0× |
| Diagnostic colonoscopy (45378) |
$2,683.23 |
— |
3.0× |
| Colonoscopy with biopsy (45380) |
$3,452.67 |
— |
3.0× |
| Colonoscopy with lesion removal (45385) |
$3,452.67 |
— |
3.0× |
| Colonoscopy with endoscopic ultrasound (45391) |
$3,452.67 |
— |
3.0× |
| Laparoscopic gallbladder removal (47562) |
$17,443.23 |
— |
3.0× |
| Inguinal hernia repair (age 5+) (49505) |
$10,330.56 |
— |
3.0× |
| Laparoscopic radical prostatectomy (55866) |
$30,670.35 |
— |
3.0× |
| Epidural injection, lumbar/sacral (with imaging) (62322) |
$2,551.98 |
— |
3.0× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$2,551.98 |
$5,577 |
3.0× |
| After-cataract laser surgery (YAG capsulotomy) (66821) |
$1,586.91 |
— |
3.0× |
| Cataract removal with lens insertion (66984) |
$6,658.80 |
— |
3.0× |
| CT head/brain without contrast (70450) |
$301.65 |
$2,630 |
3.0× |
| MRI brain without contrast (70551) |
$688.44 |
$2,362 |
3.0× |
| MRI brain with contrast (70552) |
$1,006.62 |
$2,953 |
3.0× |
| MRI brain without and with contrast (70553) |
$1,006.62 |
$3,691 |
3.0× |
| X-ray lower spine, 4+ views (72110) |
$301.65 |
$1,313 |
3.0× |
| MRI lumbar spine without contrast (72148) |
$688.44 |
$2,439 |
3.0× |
| CT pelvis with contrast (72193) |
$506.10 |
$2,806 |
3.0× |
| MRI lower-extremity joint without contrast (73721) |
$688.44 |
$2,122 |
3.0× |
| CT abdomen and pelvis with contrast (74177) |
$1,006.62 |
$8,697 |
3.0× |
| Ultrasound, abdomen complete (76700) |
$301.65 |
$2,429 |
3.0× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$301.65 |
$1,157 |
3.0× |
| Ultrasound, transvaginal (76830) |
$301.65 |
$1,843 |
3.0× |
| Mammography, one breast (diagnostic) (77065) |
— |
$578 |
— |
| Mammography, both breasts (diagnostic) (77066) |
— |
$722 |
— |
| Mammography, screening (bilateral) (77067) |
— |
$674 |
— |
| Basic metabolic panel (80048) |
$25.38 |
$139 |
3.0× |
| Comprehensive metabolic panel (80053) |
$31.68 |
$757 |
3.0× |
| Obstetric panel (80055) |
$143.43 |
— |
3.0× |
| Lipid panel (80061) |
$40.17 |
$166 |
3.0× |
| Renal function panel (80069) |
$26.04 |
$79 |
3.0× |
| Hepatic function panel (80076) |
$24.51 |
$131 |
3.0× |
| Urinalysis, non-automated, with microscopy (81000) |
$12.06 |
— |
3.0× |
| Urinalysis, non-automated, without microscopy (81002) |
$10.44 |
$28 |
3.0× |
| PSA, total (84153) |
$55.17 |
$156 |
3.0× |
| Thyroid stimulating hormone (TSH) (84443) |
$50.40 |
$289 |
3.0× |
| CBC with automated differential (85025) |
$23.31 |
$116 |
3.0× |
| CBC, automated (85027) |
$19.41 |
$302 |
3.0× |
| Prothrombin time (PT) (85610) |
$12.87 |
$86 |
3.0× |
| Partial thromboplastin time (PTT) (85730) |
$18.03 |
$99 |
3.0× |
| Psychotherapy, 30 minutes (90832) |
$512.13 |
— |
3.0× |
| Psychotherapy, 45 minutes (90834) |
$512.13 |
— |
3.0× |
| Psychotherapy, 60 minutes (90837) |
$512.13 |
— |
3.0× |
| Family psychotherapy, without patient (50 min) (90846) |
$512.13 |
— |
3.0× |
| Family psychotherapy, with patient (50 min) (90847) |
$512.13 |
— |
3.0× |
| Group psychotherapy (90853) |
$293.13 |
— |
3.0× |
| Left heart catheterization (93452) |
$9,353.97 |
— |
3.0× |
| Sleep study (attended polysomnography) (95810) |
$2,477.73 |
— |
3.0× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
— |
$247 |
— |