| Breast lesion removal (open) (19120) |
$3,914 |
$28,771.50 |
1.0× |
| Shoulder arthroscopy with decompression (29826) |
— |
$8,981.96 |
— |
| Knee arthroscopy with meniscectomy (29881) |
$3,270 |
$35,281.50 |
1.0× |
| Upper GI endoscopy (EGD), diagnostic (43235) |
$906 |
$3,523.34 |
1.0× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$906 |
$3,523.34 |
1.0× |
| Diagnostic colonoscopy (45378) |
$929 |
$3,552.36 |
1.0× |
| Colonoscopy with biopsy (45380) |
$1,196 |
$4,586.69 |
1.0× |
| Colonoscopy with lesion removal (45385) |
$1,196 |
$4,586.69 |
1.0× |
| Colonoscopy with endoscopic ultrasound (45391) |
$1,196 |
$4,586.69 |
1.0× |
| Laparoscopic gallbladder removal (47562) |
$6,043 |
$28,082.94 |
1.0× |
| Inguinal hernia repair (age 5+) (49505) |
$3,579 |
$20,244.12 |
1.0× |
| Epidural injection, lumbar/sacral (with imaging) (62322) |
$884 |
$2,060.95 |
1.0× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$884 |
$1,398.76 |
1.0× |
| After-cataract laser surgery (YAG capsulotomy) (66821) |
$549 |
$2,128.58 |
1.0× |
| CT head/brain without contrast (70450) |
$104 |
$3,878 |
1.0× |
| MRI brain without contrast (70551) |
$238 |
$6,636.72 |
1.0× |
| MRI brain with contrast (70552) |
$348 |
$8,947.48 |
1.0× |
| MRI brain without and with contrast (70553) |
$348 |
$16,198.60 |
1.0× |
| X-ray lower spine, 4+ views (72110) |
$104 |
$2,238.24 |
1.0× |
| MRI lumbar spine without contrast (72148) |
$238 |
$11,369.80 |
1.0× |
| CT pelvis with contrast (72193) |
$175 |
$5,775.48 |
1.0× |
| MRI lower-extremity joint without contrast (73721) |
$238 |
$14,562.80 |
1.0× |
| CT abdomen and pelvis with contrast (74177) |
$348 |
$12,735.80 |
1.0× |
| Ultrasound, abdomen complete (76700) |
$104 |
$1,910.85 |
1.0× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$104 |
$1,960.61 |
1.0× |
| Ultrasound, transvaginal (76830) |
$104 |
$1,651 |
1.0× |
| Mammography, one breast (diagnostic) (77065) |
$85 |
$743.80 |
1.0× |
| Mammography, both breasts (diagnostic) (77066) |
$110 |
$913.02 |
1.0× |
| Mammography, screening (bilateral) (77067) |
$90 |
$767.25 |
1.0× |
| Basic metabolic panel (80048) |
$8 |
$878.04 |
0.9× |
| Comprehensive metabolic panel (80053) |
$10 |
$917.10 |
0.9× |
| Lipid panel (80061) |
$13 |
$590.33 |
1.0× |
| Renal function panel (80069) |
$8 |
$451 |
0.9× |
| Hepatic function panel (80076) |
$8 |
$712.49 |
1.0× |
| Urinalysis, non-automated, with microscopy (81000) |
$4 |
$88 |
1.0× |
| Urinalysis, non-automated, without microscopy (81002) |
$3 |
$95 |
0.9× |
| PSA, total (84153) |
$18 |
$575 |
1.0× |
| Thyroid stimulating hormone (TSH) (84443) |
$16 |
$874.24 |
1.0× |
| CBC with automated differential (85025) |
$7 |
$250.34 |
0.9× |
| CBC, automated (85027) |
$6 |
$173 |
0.9× |
| Prothrombin time (PT) (85610) |
$4 |
$246 |
0.9× |
| Partial thromboplastin time (PTT) (85730) |
$6 |
$226 |
1.0× |
| Psychotherapy, 30 minutes (90832) |
$177 |
$528.70 |
1.0× |
| Psychotherapy, 45 minutes (90834) |
$177 |
$375.12 |
1.0× |
| Psychotherapy, 60 minutes (90837) |
$177 |
$335.48 |
1.0× |
| Family psychotherapy, without patient (50 min) (90846) |
$177 |
$473 |
1.0× |
| Family psychotherapy, with patient (50 min) (90847) |
$177 |
$634 |
1.0× |
| Group psychotherapy (90853) |
$101 |
$909 |
1.0× |
| Left heart catheterization (93452) |
$3,240 |
$18,928 |
1.0× |
| Sleep study (attended polysomnography) (95810) |
$858 |
$10,678 |
1.0× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$29 |
$337 |
1.0× |