| Breast lesion removal (open) (19120) |
$781.20 |
$976.50 |
0.2× |
| Upper GI endoscopy (EGD), diagnostic (43235) |
$493.20 |
$616.50 |
0.6× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$671.20 |
$839 |
0.8× |
| Diagnostic colonoscopy (45378) |
$748.80 |
$936 |
0.9× |
| Colonoscopy with biopsy (45380) |
$956 |
$1,195 |
0.9× |
| Colonoscopy with lesion removal (45385) |
$1,174.40 |
$1,468 |
1.1× |
Laparoscopic gallbladder removal (47562)
likely a partial charge, not the full procedure |
$1,261.60 |
$1,577 |
0.2× |
| Inguinal hernia repair (age 5+) (49505) |
$897.60 |
$1,122 |
0.3× |
| Obstetric care, vaginal delivery (global) (59400) |
$2,897.60 |
$3,622 |
— |
| Obstetric care, cesarean delivery (global) (59510) |
$3,445.20 |
$4,306.50 |
— |
| Obstetric care, VBAC delivery (global) (59610) |
$4,448.80 |
$5,561 |
— |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$1,142.40 |
$1,428 |
1.4× |
| CT head/brain without contrast (70450) |
$1,464 |
$1,830 |
15.2× |
| MRI brain without contrast (70551) |
$2,422.40 |
$3,028 |
11.0× |
| MRI brain with contrast (70552) |
$2,222.40 |
$2,778 |
6.9× |
| MRI brain without and with contrast (70553) |
$2,915.20 |
$3,644 |
9.1× |
| X-ray lower spine, 4+ views (72110) |
$579.20 |
$724 |
6.0× |
| MRI lumbar spine without contrast (72148) |
$2,364.80 |
$2,956 |
10.8× |
| CT pelvis with contrast (72193) |
$1,771.20 |
$2,214 |
11.0× |
| MRI lower-extremity joint without contrast (73721) |
$2,097.60 |
$2,622 |
9.6× |
| CT abdomen and pelvis with contrast (74177) |
$2,644.10 |
$3,305.12 |
8.2× |
| Ultrasound, abdomen complete (76700) |
$695.20 |
$869 |
7.2× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$236 |
$295 |
2.5× |
| Ultrasound, transvaginal (76830) |
$547.20 |
$684 |
5.7× |
| Mammography, one breast (diagnostic) (77065) |
$206.40 |
$258 |
2.4× |
| Mammography, both breasts (diagnostic) (77066) |
$245.60 |
$307 |
2.2× |
| Mammography, screening (bilateral) (77067) |
$192.40 |
$240.50 |
2.1× |
| Basic metabolic panel (80048) |
$125.60 |
$157 |
14.8× |
| Comprehensive metabolic panel (80053) |
$150.40 |
$188 |
14.2× |
| Lipid panel (80061) |
$128.80 |
$161 |
9.6× |
| Renal function panel (80069) |
$129.60 |
$162 |
14.9× |
| Hepatic function panel (80076) |
$108 |
$135 |
13.2× |
| PSA, total (84153) |
$182.40 |
$228 |
9.9× |
| Thyroid stimulating hormone (TSH) (84443) |
$150.40 |
$188 |
9.0× |
| CBC with automated differential (85025) |
$111.20 |
$139 |
14.3× |
| CBC, automated (85027) |
$73.60 |
$92 |
11.4× |
| Prothrombin time (PT) (85610) |
$38.80 |
$48.50 |
9.0× |
| Partial thromboplastin time (PTT) (85730) |
$98.40 |
$123 |
16.4× |
| Psychotherapy, 30 minutes (90832) |
$515.20 |
$644 |
3.2× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$80.80 |
$101 |
2.8× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$75 |
$158 |
0.6× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$75 |
$208 |
0.6× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$75 |
$230 |
0.6× |
| Office consultation (low complexity, ~30 min) (99243) |
$75 |
$246 |
0.6× |
| Office consultation (moderate complexity, ~40 min) (99244) |
$75 |
$385 |
0.6× |
| Preventive visit, new patient (age 18–39) (99385) |
$75 |
$225 |
— |
| Preventive visit, new patient (age 40–64) (99386) |
$75 |
$189 |
— |