| Breast lesion removal (open) (19120) |
$743.36 |
$1,161.50 |
0.2× |
| Shoulder arthroscopy with decompression (29826) |
$736 |
$1,150 |
— |
| Knee arthroscopy with meniscectomy (29881) |
$1,247.68 |
$1,949.50 |
0.4× |
Tonsillectomy and adenoidectomy (under age 12) (42820)
likely a partial charge, not the full procedure |
$585.60 |
$915 |
0.1× |
| Upper GI endoscopy (EGD), diagnostic (43235) |
$505.92 |
$790.50 |
0.5× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$543.68 |
$849.50 |
0.6× |
| Diagnostic colonoscopy (45378) |
$723.20 |
$1,130 |
0.8× |
| Colonoscopy with biopsy (45380) |
$769.28 |
$1,202 |
0.6× |
| Colonoscopy with lesion removal (45385) |
$947.20 |
$1,480 |
0.8× |
Laparoscopic gallbladder removal (47562)
likely a partial charge, not the full procedure |
$1,320.32 |
$2,063 |
0.2× |
| Inguinal hernia repair (age 5+) (49505) |
$835.20 |
$1,305 |
0.2× |
| Obstetric care, vaginal delivery (global) (59400) |
$2,400 |
$3,750 |
— |
| Obstetric care, cesarean delivery (global) (59510) |
$3,011.20 |
$4,705 |
— |
| Obstetric care, VBAC delivery (global) (59610) |
$2,848 |
$4,450 |
— |
| Epidural injection, lumbar/sacral (with imaging) (62322) |
$492.80 |
$770 |
0.5× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$1,270.08 |
$1,984.50 |
1.4× |
| CT head/brain without contrast (70450) |
$1,333.76 |
$2,084 |
12.4× |
| MRI brain without contrast (70551) |
$2,170.24 |
$3,391 |
8.8× |
| MRI brain with contrast (70552) |
$3,404.16 |
$5,319 |
9.5× |
| MRI brain without and with contrast (70553) |
$3,404.16 |
$5,319 |
9.5× |
| X-ray lower spine, 4+ views (72110) |
$508.16 |
$794 |
4.7× |
| MRI lumbar spine without contrast (72148) |
$2,170.24 |
$3,391 |
8.8× |
| CT pelvis with contrast (72193) |
$1,626.24 |
$2,541 |
9.0× |
| MRI lower-extremity joint without contrast (73721) |
$2,170.24 |
$3,391 |
8.8× |
| CT abdomen and pelvis with contrast (74177) |
$1,915.68 |
$2,993.25 |
5.3× |
| Ultrasound, abdomen complete (76700) |
$1,050.88 |
$1,642 |
9.7× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$1,050.88 |
$1,642 |
9.7× |
| Ultrasound, transvaginal (76830) |
$558.72 |
$873 |
5.2× |
| Mammography, one breast (diagnostic) (77065) |
$154.75 |
$241.80 |
1.8× |
| Mammography, both breasts (diagnostic) (77066) |
$405.76 |
$634 |
3.7× |
| Mammography, screening (bilateral) (77067) |
$97.60 |
$152.50 |
1.1× |
| Basic metabolic panel (80048) |
$62.72 |
$98 |
7.4× |
| Comprehensive metabolic panel (80053) |
$78.08 |
$122 |
7.4× |
| Lipid panel (80061) |
$98.56 |
$154 |
7.4× |
| Renal function panel (80069) |
$64 |
$100 |
7.4× |
| Hepatic function panel (80076) |
$60.16 |
$94 |
7.4× |
| Urinalysis, non-automated, with microscopy (81000) |
$30.08 |
$47 |
7.5× |
| Urinalysis, non-automated, without microscopy (81002) |
$26.24 |
$41 |
7.5× |
| PSA, total (84153) |
$135.68 |
$212 |
7.4× |
| Thyroid stimulating hormone (TSH) (84443) |
$101.44 |
$158.50 |
6.0× |
| CBC with automated differential (85025) |
$47.04 |
$73.50 |
6.1× |
| CBC, automated (85027) |
$48 |
$75 |
7.4× |
| Prothrombin time (PT) (85610) |
$32 |
$50 |
7.5× |
| Partial thromboplastin time (PTT) (85730) |
$44.80 |
$70 |
7.5× |
| Electrocardiogram (ECG), complete (93000) |
$215.68 |
$337 |
3.5× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$138.72 |
$216.75 |
1.0× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$152.16 |
$237.75 |
1.1× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$184.32 |
$288 |
1.3× |
| Office consultation (low complexity, ~30 min) (99243) |
$126.48 |
$197.63 |
0.9× |
| Office consultation (moderate complexity, ~40 min) (99244) |
$181.20 |
$283.13 |
1.3× |
| Preventive visit, new patient (age 18–39) (99385) |
$168 |
$262.50 |
— |
| Preventive visit, new patient (age 40–64) (99386) |
$183.84 |
$287.25 |
— |