| Breast lesion removal (open) (19120) |
— |
$6,174.83 |
— |
| Knee arthroscopy with meniscectomy (29881) |
— |
$5,537.80 |
— |
| Upper GI endoscopy (EGD), diagnostic (43235) |
— |
$1,582.27 |
— |
| Upper GI endoscopy (EGD) with biopsy (43239) |
— |
$1,582.27 |
— |
| Diagnostic colonoscopy (45378) |
— |
$1,551.80 |
— |
| Colonoscopy with biopsy (45380) |
— |
$2,027.75 |
— |
| Colonoscopy with lesion removal (45385) |
— |
$2,027.75 |
— |
| Laparoscopic gallbladder removal (47562) |
— |
$9,894.44 |
— |
| Inguinal hernia repair (age 5+) (49505) |
— |
$6,221.47 |
— |
| Epidural injection, lumbar/sacral (with imaging) (62322) |
— |
$1,356.64 |
— |
| Transforaminal epidural injection, lumbar/sacral (64483) |
— |
$1,945.44 |
— |
| Cataract removal with lens insertion (66984) |
— |
$4,880.84 |
— |
| CT head/brain without contrast (70450) |
— |
$1,074.15 |
— |
| MRI brain without contrast (70551) |
— |
$2,584.31 |
— |
| MRI brain with contrast (70552) |
— |
$2,777.91 |
— |
| MRI brain without and with contrast (70553) |
— |
$3,376.66 |
— |
| X-ray lower spine, 4+ views (72110) |
— |
$426.32 |
— |
| MRI lumbar spine without contrast (72148) |
— |
$3,889.01 |
— |
| CT pelvis with contrast (72193) |
— |
$2,693.11 |
— |
| MRI lower-extremity joint without contrast (73721) |
— |
$2,509.04 |
— |
| CT abdomen and pelvis with contrast (74177) |
— |
$5,407.90 |
— |
| Ultrasound, abdomen complete (76700) |
— |
$1,586.64 |
— |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
— |
$583.41 |
— |
| Ultrasound, transvaginal (76830) |
— |
$753.54 |
— |
| Mammography, one breast (diagnostic) (77065) |
— |
$270.97 |
— |
| Mammography, both breasts (diagnostic) (77066) |
— |
$347.20 |
— |
| Mammography, screening (bilateral) (77067) |
— |
$477 |
— |
| Basic metabolic panel (80048) |
— |
$216.40 |
— |
| Comprehensive metabolic panel (80053) |
— |
$296.21 |
— |
| Obstetric panel (80055) |
— |
$119.42 |
— |
| Lipid panel (80061) |
— |
$153.70 |
— |
| Hepatic function panel (80076) |
— |
$243.68 |
— |
| Urinalysis, non-automated, with microscopy (81000) |
— |
$66.07 |
— |
| Urinalysis, non-automated, without microscopy (81002) |
— |
$83.98 |
— |
| PSA, total (84153) |
— |
$67.75 |
— |
| Thyroid stimulating hormone (TSH) (84443) |
— |
$46.99 |
— |
| CBC with automated differential (85025) |
— |
$113.48 |
— |
| CBC, automated (85027) |
— |
$24.04 |
— |
| Prothrombin time (PT) (85610) |
— |
$107.81 |
— |
| Psychotherapy, 45 minutes (90834) |
— |
$337.05 |
— |
| Psychotherapy, 60 minutes (90837) |
— |
$337.05 |
— |
| Group psychotherapy (90853) |
— |
$187.51 |
— |
| Sleep study (attended polysomnography) (95810) |
— |
$5,396.25 |
— |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
— |
$194.76 |
— |
| Office visit, new patient (low complexity, ~30 min) (99203) |
— |
$329.53 |
— |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
— |
$203.73 |
— |
| Office visit, new patient (high complexity, ~60 min) (99205) |
— |
$275.62 |
— |