| Breast lesion removal (open) (19120) |
— |
$51,449.33 |
— |
Shoulder arthroscopy with decompression (29826)
range across 2 matching MRF lines |
— |
$39,574.33–$41,232.15 |
— |
| Knee arthroscopy with meniscectomy (29881) |
— |
$71,076.74 |
— |
| Tonsillectomy and adenoidectomy (under age 12) (42820) |
— |
$16,467.03 |
— |
| Upper GI endoscopy (EGD), diagnostic (43235) |
— |
$4,539.59 |
— |
| Upper GI endoscopy (EGD) with biopsy (43239) |
— |
$8,574 |
— |
| Diagnostic colonoscopy (45378) |
— |
$5,488.45 |
— |
| Colonoscopy with biopsy (45380) |
— |
$13,016.37 |
— |
| Colonoscopy with lesion removal (45385) |
— |
$12,072.03 |
— |
| Colonoscopy with endoscopic ultrasound (45391) |
— |
$59,245.59 |
— |
| Laparoscopic gallbladder removal (47562) |
— |
$39,254.74 |
— |
| Inguinal hernia repair (age 5+) (49505) |
— |
$21,996.56 |
— |
| Laparoscopic radical prostatectomy (55866) |
— |
$88,928.41 |
— |
| Obstetric care, vaginal delivery (global) (59400) |
— |
$23,996.28 |
— |
| Obstetric care, cesarean delivery (global) (59510) |
— |
$35,708.44 |
— |
| Obstetric care, VBAC delivery (global) (59610) |
— |
$24,082.84 |
— |
| Epidural injection, lumbar/sacral (with imaging) (62322) |
— |
$1,743.50 |
— |
| Transforaminal epidural injection, lumbar/sacral (64483) |
— |
$8,270.83 |
— |
| CT head/brain without contrast (70450) |
— |
$2,106.25 |
— |
| MRI brain without contrast (70551) |
— |
$3,860 |
— |
| MRI brain with contrast (70552) |
— |
$3,949.50 |
— |
| MRI brain without and with contrast (70553) |
— |
$7,110.75 |
— |
| X-ray lower spine, 4+ views (72110) |
— |
$551.50 |
— |
| MRI lumbar spine without contrast (72148) |
— |
$3,419.75 |
— |
| CT pelvis with contrast (72193) |
— |
$3,385 |
— |
| MRI lower-extremity joint without contrast (73721) |
— |
$2,373 |
— |
| CT abdomen and pelvis with contrast (74177) |
— |
$6,312.50 |
— |
| Ultrasound, abdomen complete (76700) |
— |
$1,397.50 |
— |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
— |
$1,094.25 |
— |
| Ultrasound, transvaginal (76830) |
— |
$1,051.75 |
— |
| Mammography, one breast (diagnostic) (77065) |
— |
$678.50 |
— |
| Mammography, both breasts (diagnostic) (77066) |
— |
$826.25 |
— |
| Mammography, screening (bilateral) (77067) |
— |
$798 |
— |
| Basic metabolic panel (80048) |
— |
$117.25 |
— |
| Comprehensive metabolic panel (80053) |
— |
$405.50 |
— |
| Lipid panel (80061) |
— |
$150.50 |
— |
| Renal function panel (80069) |
— |
$169.50 |
— |
| Hepatic function panel (80076) |
— |
$256.50 |
— |
| Urinalysis, non-automated, without microscopy (81002) |
— |
$11.55 |
— |
| PSA, total (84153) |
— |
$165.50 |
— |
| Thyroid stimulating hormone (TSH) (84443) |
— |
$150.50 |
— |
| CBC with automated differential (85025) |
— |
$142 |
— |
| CBC, automated (85027) |
— |
$118.75 |
— |
| Prothrombin time (PT) (85610) |
— |
$90.75 |
— |
| Partial thromboplastin time (PTT) (85730) |
— |
$202.75 |
— |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
— |
$172.75 |
— |
| Office visit, new patient (low complexity, ~30 min) (99203) |
— |
$905.25 |
— |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
— |
$1,011 |
— |
| Office visit, new patient (high complexity, ~60 min) (99205) |
— |
$1,084.50 |
— |