| Breast lesion removal (open) (19120) |
$879 |
$2,930 |
0.2× |
| Shoulder arthroscopy with decompression (29826) |
$188.70 |
$629 |
— |
| Knee arthroscopy with meniscectomy (29881) |
$443.10 |
$1,477 |
0.1× |
Tonsillectomy and adenoidectomy (under age 12) (42820)
likely a partial charge, not the full procedure |
$265.80 |
$886 |
0.0× |
| Upper GI endoscopy (EGD), diagnostic (43235) |
$189 |
$630 |
0.2× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$153.30 |
$511 |
0.2× |
| Diagnostic colonoscopy (45378) |
$213.60 |
$712 |
0.2× |
| Colonoscopy with biopsy (45380) |
$232.20 |
$774 |
0.2× |
| Colonoscopy with lesion removal (45385) |
$294.30 |
$981 |
0.2× |
| Colonoscopy with endoscopic ultrasound (45391) |
$297.90 |
$993 |
0.2× |
Laparoscopic gallbladder removal (47562)
likely a partial charge, not the full procedure |
$1,166.10 |
$3,887 |
0.2× |
| Inguinal hernia repair (age 5+) (49505) |
$986.70 |
$3,289 |
0.3× |
Laparoscopic radical prostatectomy (55866)
likely a partial charge, not the full procedure |
$3,042.90 |
$10,143 |
0.3× |
| Obstetric care, vaginal delivery (global) (59400) |
$2,555.10 |
$8,517 |
— |
| Obstetric care, cesarean delivery (global) (59510) |
$2,895.90 |
$9,653 |
— |
| Obstetric care, VBAC delivery (global) (59610) |
$2,670.90 |
$8,903 |
— |
| Epidural injection, lumbar/sacral (with imaging) (62322) |
$98.10 |
$327 |
0.1× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$119.70 |
$399 |
0.1× |
| After-cataract laser surgery (YAG capsulotomy) (66821) |
$216 |
$720 |
0.4× |
| Cataract removal with lens insertion (66984) |
$537 |
$1,790 |
0.2× |
| CT head/brain without contrast (70450) |
$484.50 |
$1,615 |
4.3× |
| MRI brain without contrast (70551) |
$925.50 |
$3,085 |
3.6× |
| MRI brain with contrast (70552) |
$1,133.40 |
$3,778 |
3.0× |
| MRI brain without and with contrast (70553) |
$1,413.90 |
$4,713 |
3.8× |
| X-ray lower spine, 4+ views (72110) |
$130.20 |
$434 |
1.2× |
| MRI lumbar spine without contrast (72148) |
$920.70 |
$3,069 |
3.6× |
| CT pelvis with contrast (72193) |
$405 |
$1,350 |
2.2× |
| MRI lower-extremity joint without contrast (73721) |
$931.80 |
$3,106 |
3.7× |
| CT abdomen and pelvis with contrast (74177) |
$765.90 |
$2,553 |
2.1× |
| Ultrasound, abdomen complete (76700) |
$134.25 |
$447.50 |
1.2× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$386.70 |
$1,289 |
3.5× |
| Ultrasound, transvaginal (76830) |
$379.50 |
$1,265 |
3.4× |
| Mammography, one breast (diagnostic) (77065) |
$159 |
$530 |
1.8× |
| Mammography, both breasts (diagnostic) (77066) |
$200.70 |
$669 |
1.8× |
| Mammography, screening (bilateral) (77067) |
$227.70 |
$759 |
2.5× |
| Basic metabolic panel (80048) |
$36.60 |
$122 |
4.3× |
| Comprehensive metabolic panel (80053) |
$30 |
$100 |
2.8× |
| Lipid panel (80061) |
$31.50 |
$105 |
2.4× |
| Renal function panel (80069) |
$36.60 |
$122 |
4.2× |
| Hepatic function panel (80076) |
$37.80 |
$126 |
4.6× |
| PSA, total (84153) |
$20.10 |
$67 |
1.1× |
| Thyroid stimulating hormone (TSH) (84443) |
$61.80 |
$206 |
3.7× |
| CBC with automated differential (85025) |
$30 |
$100 |
3.9× |
| CBC, automated (85027) |
$35.40 |
$118 |
5.5× |
| Prothrombin time (PT) (85610) |
$16.20 |
$54 |
3.8× |
| Partial thromboplastin time (PTT) (85730) |
$27.45 |
$91.50 |
4.6× |
| Psychotherapy, 30 minutes (90832) |
$84.15 |
$280.50 |
0.4× |
| Psychotherapy, 45 minutes (90834) |
$100.50 |
$335 |
0.5× |
| Psychotherapy, 60 minutes (90837) |
$164.10 |
$547 |
0.9× |
| Family psychotherapy, without patient (50 min) (90846) |
$135.90 |
$453 |
0.7× |
| Family psychotherapy, with patient (50 min) (90847) |
$153.60 |
$512 |
0.8× |
| Group psychotherapy (90853) |
$60.90 |
$203 |
0.6× |
| Left heart catheterization (93452) |
$917.55 |
$3,058.50 |
0.3× |
| Sleep study (attended polysomnography) (95810) |
$813.90 |
$2,713 |
0.9× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$49.65 |
$165.50 |
1.7× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$100.50 |
$335 |
0.7× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$143.40 |
$478 |
1.0× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$168.60 |
$562 |
1.2× |
| Preventive visit, new patient (age 18–39) (99385) |
$120.90 |
$403 |
— |
| Preventive visit, new patient (age 40–64) (99386) |
$146.70 |
$489 |
— |