| Breast lesion removal (open) (19120) |
$2,499.60 |
$6,249 |
0.6× |
| Shoulder arthroscopy with decompression (29826) |
$525.80 |
$1,314.50 |
— |
| Knee arthroscopy with meniscectomy (29881) |
$2,374.80 |
$5,937 |
0.7× |
| Upper GI endoscopy (EGD), diagnostic (43235) |
$667.60 |
$1,669 |
0.7× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$574.80 |
$1,437 |
0.6× |
| Diagnostic colonoscopy (45378) |
$637.60 |
$1,594 |
0.7× |
| Colonoscopy with biopsy (45380) |
$840.80 |
$2,102 |
0.7× |
| Colonoscopy with lesion removal (45385) |
$869.60 |
$2,174 |
0.7× |
| Laparoscopic gallbladder removal (47562) |
$4,031.20 |
$10,078 |
0.6× |
| Inguinal hernia repair (age 5+) (49505) |
$2,613.60 |
$6,534 |
0.7× |
| Epidural injection, lumbar/sacral (with imaging) (62322) |
$439.60 |
$1,099 |
0.5× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$577.20 |
$1,443 |
0.6× |
| After-cataract laser surgery (YAG capsulotomy) (66821) |
$438.40 |
$1,096 |
0.8× |
| Cataract removal with lens insertion (66984) |
$1,579.60 |
$3,949 |
0.7× |
| CT head/brain without contrast (70450) |
$223.20 |
$558 |
2.0× |
| MRI brain without contrast (70551) |
$464 |
$1,160 |
1.9× |
| MRI brain with contrast (70552) |
$537.60 |
$1,344 |
1.5× |
| MRI brain without and with contrast (70553) |
$995.20 |
$2,488 |
2.7× |
| X-ray lower spine, 4+ views (72110) |
$128 |
$320 |
1.2× |
| MRI lumbar spine without contrast (72148) |
$497.20 |
$1,243 |
2.0× |
| CT pelvis with contrast (72193) |
$350 |
$875 |
1.9× |
| MRI lower-extremity joint without contrast (73721) |
$463.20 |
$1,158 |
1.9× |
| CT abdomen and pelvis with contrast (74177) |
$682 |
$1,705 |
1.9× |
| Ultrasound, abdomen complete (76700) |
$180 |
$450 |
1.6× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$180 |
$450 |
1.6× |
| Ultrasound, transvaginal (76830) |
$180 |
$450 |
1.6× |
| Mammography, one breast (diagnostic) (77065) |
$129.20 |
$323 |
1.5× |
| Mammography, both breasts (diagnostic) (77066) |
$172.40 |
$431 |
1.6× |
| Mammography, screening (bilateral) (77067) |
$172.40 |
$431 |
1.9× |
| Basic metabolic panel (80048) |
$28 |
$70 |
3.3× |
| Comprehensive metabolic panel (80053) |
$48 |
$120 |
4.5× |
| Obstetric panel (80055) |
$60.80 |
$152 |
1.3× |
| Lipid panel (80061) |
$42 |
$105 |
3.1× |
| Renal function panel (80069) |
$28 |
$70 |
3.2× |
| Hepatic function panel (80076) |
$28 |
$70 |
3.4× |
| Urinalysis, non-automated, without microscopy (81002) |
$5.60 |
$14 |
1.6× |
| PSA, total (84153) |
$42.80 |
$107 |
2.3× |
| Thyroid stimulating hormone (TSH) (84443) |
$40.40 |
$101 |
2.4× |
| CBC with automated differential (85025) |
$25.20 |
$63 |
3.2× |
| CBC, automated (85027) |
$17.20 |
$43 |
2.7× |
| Prothrombin time (PT) (85610) |
$8 |
$20 |
1.9× |
| Partial thromboplastin time (PTT) (85730) |
$14.69 |
$36.73 |
2.4× |
| Electrocardiogram (ECG), complete (93000) |
$36.80 |
$92 |
0.6× |
| Sleep study (attended polysomnography) (95810) |
$1,084 |
$2,710 |
1.2× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$35 |
$87.50 |
1.2× |