| Breast lesion removal (open) (19120) |
$647.03 |
$872 |
0.2× |
| Shoulder arthroscopy with decompression (29826) |
$272.32 |
$367 |
— |
| Knee arthroscopy with meniscectomy (29881) |
$843.66 |
$1,137 |
0.2× |
| Upper GI endoscopy (EGD), diagnostic (43235) |
$1,076.64 |
$1,451 |
1.1× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$1,088.88 |
$1,467.50 |
1.1× |
| Diagnostic colonoscopy (45378) |
$1,096.31 |
$1,477.50 |
1.1× |
| Colonoscopy with biopsy (45380) |
$1,409.44 |
$1,899.50 |
1.1× |
| Colonoscopy with lesion removal (45385) |
$1,450.62 |
$1,955 |
1.1× |
| Colonoscopy with endoscopic ultrasound (45391) |
$2,512.42 |
$3,386 |
2.0× |
Laparoscopic gallbladder removal (47562)
likely a partial charge, not the full procedure |
$940.86 |
$1,268 |
0.1× |
| Inguinal hernia repair (age 5+) (49505) |
$811.01 |
$1,093 |
0.2× |
Laparoscopic radical prostatectomy (55866)
likely a partial charge, not the full procedure |
$1,834.97 |
$2,473 |
0.2× |
| Epidural injection, lumbar/sacral (with imaging) (62322) |
$211.47 |
$285 |
0.2× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$1,480.29 |
$1,995 |
1.6× |
| CT head/brain without contrast (70450) |
$1,262.89 |
$1,702 |
11.3× |
| MRI brain without contrast (70551) |
$992.80 |
$1,338 |
3.9× |
| MRI brain with contrast (70552) |
$1,090.74 |
$1,470 |
2.9× |
| MRI brain without and with contrast (70553) |
$1,370.48 |
$1,847 |
3.7× |
| X-ray lower spine, 4+ views (72110) |
$231.51 |
$312 |
2.1× |
| MRI lumbar spine without contrast (72148) |
$946.80 |
$1,276 |
3.7× |
| CT pelvis with contrast (72193) |
$595.83 |
$803 |
3.2× |
| MRI lower-extremity joint without contrast (73721) |
$1,889.14 |
$2,546 |
7.4× |
| CT abdomen and pelvis with contrast (74177) |
$1,173.11 |
$1,581 |
3.2× |
| Ultrasound, abdomen complete (76700) |
$287.16 |
$387 |
2.6× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$391.78 |
$528 |
3.5× |
| Ultrasound, transvaginal (76830) |
$404.39 |
$545 |
3.6× |
| Mammography, one breast (diagnostic) (77065) |
$251.54 |
$339 |
2.9× |
| Mammography, both breasts (diagnostic) (77066) |
$333.16 |
$449 |
3.0× |
| Mammography, screening (bilateral) (77067) |
$201.09 |
$271 |
2.2× |
| Basic metabolic panel (80048) |
$81.62 |
$110 |
9.6× |
| Comprehensive metabolic panel (80053) |
$21.52 |
$29 |
2.0× |
| Lipid panel (80061) |
$28.94 |
$39 |
2.2× |
| Renal function panel (80069) |
$77.92 |
$105 |
9.0× |
| Hepatic function panel (80076) |
$63.08 |
$85 |
7.7× |
| Urinalysis, non-automated, with microscopy (81000) |
$58.62 |
$79 |
14.6× |
| Urinalysis, non-automated, without microscopy (81002) |
$5.20 |
$7 |
1.5× |
| PSA, total (84153) |
$47.33 |
$63.78 |
2.6× |
| Thyroid stimulating hormone (TSH) (84443) |
$131.70 |
$177.50 |
7.8× |
| CBC with automated differential (85025) |
$89.42 |
$120.50 |
11.5× |
| CBC, automated (85027) |
$72.72 |
$98 |
11.2× |
| Prothrombin time (PT) (85610) |
$12.74 |
$17.16 |
3.0× |
| Partial thromboplastin time (PTT) (85730) |
$54.63 |
$73.62 |
9.1× |
| Electrocardiogram (ECG), complete (93000) |
$31.17 |
$42 |
0.5× |
| Left heart catheterization (93452) |
$356.16 |
$480 |
0.1× |
| Sleep study (attended polysomnography) (95810) |
$182.54 |
$246 |
0.2× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$109.08 |
$147 |
3.8× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$166.21 |
$224 |
1.2× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$526.82 |
$710 |
3.7× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$487.13 |
$656.50 |
3.4× |
| Office consultation (low complexity, ~30 min) (99243) |
$170.66 |
$230 |
1.2× |
| Office consultation (moderate complexity, ~40 min) (99244) |
$255.99 |
$345 |
1.8× |
| Preventive visit, new patient (age 18–39) (99385) |
$187.73 |
$253 |
— |
| Preventive visit, new patient (age 40–64) (99386) |
$218.15 |
$294 |
— |