| Breast lesion removal (open) (19120) |
$426 |
$426 |
0.1× |
| Shoulder arthroscopy with decompression (29826) |
$8,788 |
$8,788 |
— |
| Knee arthroscopy with meniscectomy (29881) |
$1,126 |
$1,126 |
0.4× |
Tonsillectomy and adenoidectomy (under age 12) (42820)
likely a partial charge, not the full procedure |
$588.36 |
$588.36 |
0.1× |
| Upper GI endoscopy (EGD), diagnostic (43235) |
$3,372 |
$3,372 |
4.0× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$1,902 |
$1,902 |
2.3× |
| Diagnostic colonoscopy (45378) |
$4,028 |
$4,028 |
4.7× |
| Colonoscopy with biopsy (45380) |
$2,212.50 |
$2,212.50 |
2.0× |
| Colonoscopy with lesion removal (45385) |
$2,201.50 |
$2,201.50 |
2.0× |
| Colonoscopy with endoscopic ultrasound (45391) |
$473 |
$473 |
0.4× |
Laparoscopic gallbladder removal (47562)
likely a partial charge, not the full procedure |
$1,321.67 |
$1,321.67 |
0.2× |
| Inguinal hernia repair (age 5+) (49505) |
$742.34 |
$742.34 |
0.2× |
| Obstetric care, vaginal delivery (global) (59400) |
$1,879 |
$1,879 |
— |
| Obstetric care, cesarean delivery (global) (59510) |
$3,480.87 |
$3,480.87 |
— |
| Obstetric care, VBAC delivery (global) (59610) |
$4,398.85 |
$4,398.85 |
— |
| Epidural injection, lumbar/sacral (with imaging) (62322) |
$2,139 |
$2,139 |
2.6× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$5,116 |
$5,116 |
6.2× |
| CT head/brain without contrast (70450) |
$1,875 |
$1,875 |
19.3× |
| MRI brain without contrast (70551) |
$788.19 |
$788.19 |
3.6× |
| MRI brain with contrast (70552) |
$1,100.20 |
$1,100.20 |
3.4× |
| MRI brain without and with contrast (70553) |
$1,333.32 |
$1,333.32 |
4.1× |
| X-ray lower spine, 4+ views (72110) |
$94.37 |
$94.37 |
1.0× |
| MRI lumbar spine without contrast (72148) |
$996.23 |
$996.23 |
4.5× |
| CT pelvis with contrast (72193) |
$1,472 |
$1,472 |
9.0× |
| MRI lower-extremity joint without contrast (73721) |
$1,580 |
$1,580 |
7.1× |
| CT abdomen and pelvis with contrast (74177) |
$6,412 |
$6,412 |
19.8× |
| Ultrasound, abdomen complete (76700) |
$523.48 |
$523.48 |
5.4× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$243.54 |
$243.54 |
2.5× |
| Ultrasound, transvaginal (76830) |
$193.18 |
$193.18 |
2.0× |
| Mammography, one breast (diagnostic) (77065) |
$147 |
$147 |
1.7× |
| Mammography, both breasts (diagnostic) (77066) |
$183 |
$183 |
1.7× |
| Mammography, screening (bilateral) (77067) |
$174 |
$174 |
1.9× |
| Basic metabolic panel (80048) |
$70 |
$70 |
8.3× |
| Comprehensive metabolic panel (80053) |
$451 |
$451 |
42.7× |
| Lipid panel (80061) |
$31 |
$31 |
2.3× |
| Renal function panel (80069) |
$369 |
$369 |
42.5× |
| Hepatic function panel (80076) |
$90 |
$90 |
11.0× |
| Urinalysis, non-automated, with microscopy (81000) |
$8.92 |
$8.92 |
2.2× |
| Urinalysis, non-automated, without microscopy (81002) |
$9 |
$9 |
2.6× |
| PSA, total (84153) |
$128 |
$128 |
7.0× |
| Thyroid stimulating hormone (TSH) (84443) |
$15 |
$15 |
0.9× |
| CBC with automated differential (85025) |
$24 |
$24 |
3.1× |
| CBC, automated (85027) |
$91 |
$91 |
14.1× |
| Prothrombin time (PT) (85610) |
$21 |
$21 |
4.9× |
| Partial thromboplastin time (PTT) (85730) |
$100 |
$100 |
16.6× |
| Electrocardiogram (ECG), complete (93000) |
$142 |
$142 |
2.6× |
| Left heart catheterization (93452) |
$5,316.68 |
$5,316.68 |
1.8× |
| Sleep study (attended polysomnography) (95810) |
$3,311.60 |
$3,311.60 |
4.1× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$158 |
$158 |
5.4× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$410 |
$410 |
3.3× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$625 |
$625 |
5.0× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$794 |
$794 |
6.4× |
| Office consultation (low complexity, ~30 min) (99243) |
$147 |
$147 |
1.2× |
| Office consultation (moderate complexity, ~40 min) (99244) |
$209 |
$209 |
1.7× |
| Preventive visit, new patient (age 18–39) (99385) |
$137 |
$137 |
— |
| Preventive visit, new patient (age 40–64) (99386) |
$137 |
$137 |
— |