| Breast lesion removal (open) (19120) |
$3,280 |
$4,970 |
0.8× |
| Shoulder arthroscopy with decompression (29826) |
$22,155 |
$33,568 |
— |
| Knee arthroscopy with meniscectomy (29881) |
$10,394 |
$15,749 |
3.1× |
| Upper GI endoscopy (EGD), diagnostic (43235) |
$1,592 |
$2,412 |
1.7× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$3,755 |
$5,689.50 |
4.0× |
| Diagnostic colonoscopy (45378) |
$2,759.50 |
$4,181 |
2.9× |
| Colonoscopy with biopsy (45380) |
$3,791.50 |
$5,744.50 |
3.1× |
| Colonoscopy with lesion removal (45385) |
$4,275.50 |
$6,478 |
3.4× |
| Laparoscopic gallbladder removal (47562) |
$6,758 |
$10,240 |
1.1× |
| Inguinal hernia repair (age 5+) (49505) |
$9,814 |
$14,870 |
2.6× |
| Epidural injection, lumbar/sacral (with imaging) (62322) |
$1,330 |
$2,015 |
1.4× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$1,117.50 |
$1,692.50 |
1.2× |
| After-cataract laser surgery (YAG capsulotomy) (66821) |
$2,845.50 |
$4,311.50 |
5.0× |
| Cataract removal with lens insertion (66984) |
$4,836 |
$7,328 |
2.0× |
| CT head/brain without contrast (70450) |
$1,021 |
$1,547 |
9.4× |
| MRI brain without contrast (70551) |
$1,903 |
$2,883 |
7.7× |
| MRI brain with contrast (70552) |
$2,186 |
$3,312 |
6.0× |
| MRI brain without and with contrast (70553) |
$2,332 |
$3,534 |
6.4× |
| X-ray lower spine, 4+ views (72110) |
$365 |
$553 |
3.4× |
| MRI lumbar spine without contrast (72148) |
$1,549 |
$2,347 |
6.3× |
| CT pelvis with contrast (72193) |
$1,199 |
$1,817 |
6.6× |
| MRI lower-extremity joint without contrast (73721) |
$1,360 |
$2,060 |
5.5× |
| CT abdomen and pelvis with contrast (74177) |
$2,468 |
$3,740 |
6.8× |
| Ultrasound, abdomen complete (76700) |
$599 |
$908 |
5.5× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$559 |
$847 |
5.1× |
| Ultrasound, transvaginal (76830) |
$420 |
$636 |
3.9× |
| Mammography, one breast (diagnostic) (77065) |
$209 |
$317 |
2.4× |
| Mammography, both breasts (diagnostic) (77066) |
$300 |
$455 |
2.7× |
| Mammography, screening (bilateral) (77067) |
$259 |
$393 |
2.8× |
| Basic metabolic panel (80048) |
$67 |
$102 |
7.9× |
| Comprehensive metabolic panel (80053) |
$116 |
$176 |
11.0× |
| Lipid panel (80061) |
$106 |
$160 |
7.9× |
| Renal function panel (80069) |
$106 |
$160 |
12.2× |
| Hepatic function panel (80076) |
$86 |
$130 |
10.5× |
| Urinalysis, non-automated, without microscopy (81002) |
$33 |
$50 |
9.5× |
| Thyroid stimulating hormone (TSH) (84443) |
$96 |
$145.50 |
5.7× |
| CBC with automated differential (85025) |
$90 |
$137 |
11.6× |
| CBC, automated (85027) |
$57 |
$87 |
8.8× |
| Prothrombin time (PT) (85610) |
$50 |
$75 |
11.7× |
| Partial thromboplastin time (PTT) (85730) |
$63 |
$96 |
10.5× |
| Sleep study (attended polysomnography) (95810) |
$2,788 |
$4,224 |
3.1× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$75 |
$114 |
2.6× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$157.50 |
$238.50 |
1.1× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$178 |
$270 |
1.3× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$199 |
$301.50 |
1.4× |