| Shoulder arthroscopy with decompression (29826) |
$204.75 |
$525 |
— |
| Knee arthroscopy with meniscectomy (29881) |
$3,779.45 |
$9,690.90 |
1.3× |
| Tonsillectomy and adenoidectomy (under age 12) (42820) |
$6,882.54 |
$17,647.53 |
1.3× |
| Upper GI endoscopy (EGD), diagnostic (43235) |
$600.91 |
$1,540.80 |
0.7× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$1,705.49 |
$4,373.06 |
2.1× |
| Diagnostic colonoscopy (45378) |
$1,604.04 |
$4,112.92 |
1.9× |
| Colonoscopy with biopsy (45380) |
$1,943.83 |
$4,984.18 |
1.8× |
| Colonoscopy with lesion removal (45385) |
$1,975.43 |
$5,065.21 |
1.8× |
| Epidural injection, lumbar/sacral (with imaging) (62322) |
$3.76 |
$9.64 |
0.0× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$772.77 |
$1,981.45 |
1.0× |
| CT head/brain without contrast (70450) |
$1,087.80 |
$2,789.22 |
11.4× |
| MRI brain without contrast (70551) |
$1,373.38 |
$3,521.50 |
6.3× |
| MRI brain with contrast (70552) |
$1,517.02 |
$3,889.80 |
4.8× |
| MRI brain without and with contrast (70553) |
$1,971.65 |
$5,055.52 |
6.2× |
| X-ray lower spine, 4+ views (72110) |
$213.61 |
$547.72 |
2.2× |
| MRI lumbar spine without contrast (72148) |
$1,381.86 |
$3,543.23 |
6.4× |
| CT pelvis with contrast (72193) |
$873.80 |
$2,240.50 |
5.5× |
| MRI lower-extremity joint without contrast (73721) |
$1,166.35 |
$2,990.63 |
5.4× |
| CT abdomen and pelvis with contrast (74177) |
$1,490.64 |
$3,822.15 |
4.7× |
| Ultrasound, abdomen complete (76700) |
$461.28 |
$1,182.76 |
4.8× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$124.37 |
$318.90 |
1.3× |
| Ultrasound, transvaginal (76830) |
$299.91 |
$769 |
3.2× |
| Mammography, one breast (diagnostic) (77065) |
$173.28 |
$444.31 |
2.0× |
| Mammography, both breasts (diagnostic) (77066) |
$232.44 |
$596 |
2.1× |
| Mammography, screening (bilateral) (77067) |
$145.86 |
$374 |
1.6× |
| Basic metabolic panel (80048) |
$221.01 |
$566.69 |
26.1× |
| Comprehensive metabolic panel (80053) |
$393.86 |
$1,009.89 |
37.3× |
| Obstetric panel (80055) |
$158.89 |
$407.40 |
3.3× |
| Lipid panel (80061) |
$171.13 |
$438.80 |
12.8× |
| Hepatic function panel (80076) |
$193.28 |
$495.60 |
23.7× |
| Urinalysis, non-automated, without microscopy (81002) |
$14.60 |
$37.43 |
4.2× |
| PSA, total (84153) |
$72.20 |
$185.12 |
3.9× |
| Thyroid stimulating hormone (TSH) (84443) |
$180.98 |
$464.05 |
10.8× |
| CBC with automated differential (85025) |
$62.78 |
$160.97 |
8.1× |
| CBC, automated (85027) |
$51.60 |
$132.30 |
8.0× |
| Prothrombin time (PT) (85610) |
$35.69 |
$91.51 |
8.3× |
| Partial thromboplastin time (PTT) (85730) |
$22.36 |
$57.33 |
3.7× |
| Psychotherapy, 30 minutes (90832) |
$206.82 |
$530.30 |
1.3× |
| Psychotherapy, 45 minutes (90834) |
$302.27 |
$775.06 |
1.9× |
| Psychotherapy, 60 minutes (90837) |
$349.71 |
$896.70 |
2.2× |
| Family psychotherapy, without patient (50 min) (90846) |
$86.42 |
$221.60 |
0.5× |
| Family psychotherapy, with patient (50 min) (90847) |
$362.04 |
$928.31 |
2.2× |
| Group psychotherapy (90853) |
$105.41 |
$270.27 |
1.1× |
| Left heart catheterization (93452) |
$2,699.88 |
$6,922.78 |
0.9× |
| Sleep study (attended polysomnography) (95810) |
$1,629.56 |
$4,178.37 |
2.1× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$57.27 |
$146.85 |
2.0× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$87.85 |
$225.25 |
0.7× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$119.19 |
$305.61 |
1.0× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$142.80 |
$366.15 |
1.2× |