| Breast lesion removal (open) (19120) |
$478.50 |
$638 |
0.1× |
| Shoulder arthroscopy with decompression (29826) |
$134.25 |
$179 |
— |
| Knee arthroscopy with meniscectomy (29881) |
$406.50 |
$542 |
0.1× |
Tonsillectomy and adenoidectomy (under age 12) (42820)
likely a partial charge, not the full procedure |
$221.25 |
$295 |
0.0× |
| Upper GI endoscopy (EGD), diagnostic (43235) |
$232.50 |
$310 |
0.3× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$296.25 |
$395 |
0.4× |
| Diagnostic colonoscopy (45378) |
$288 |
$384 |
0.3× |
| Colonoscopy with biopsy (45380) |
$342.75 |
$457 |
0.3× |
| Colonoscopy with lesion removal (45385) |
$387.75 |
$517 |
0.4× |
| Colonoscopy with endoscopic ultrasound (45391) |
$223.50 |
$298 |
0.2× |
Laparoscopic gallbladder removal (47562)
likely a partial charge, not the full procedure |
$495.75 |
$661 |
0.1× |
| Inguinal hernia repair (age 5+) (49505) |
$391.50 |
$522 |
0.1× |
Laparoscopic radical prostatectomy (55866)
likely a partial charge, not the full procedure |
$1,329 |
$1,772 |
0.1× |
| Obstetric care, vaginal delivery (global) (59400) |
$1,573.50 |
$2,098 |
— |
| Obstetric care, cesarean delivery (global) (59510) |
$1,737 |
$2,316 |
— |
| Obstetric care, VBAC delivery (global) (59610) |
$1,647 |
$2,196 |
— |
| Epidural injection, lumbar/sacral (with imaging) (62322) |
$163.50 |
$218 |
0.2× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$162.75 |
$217 |
0.2× |
| After-cataract laser surgery (YAG capsulotomy) (66821) |
$245.25 |
$327 |
0.5× |
| Cataract removal with lens insertion (66984) |
$480 |
$640 |
0.2× |
| CT head/brain without contrast (70450) |
$295.52 |
$394.03 |
3.1× |
| MRI brain without contrast (70551) |
$1,048.50 |
$1,398 |
4.8× |
| MRI brain with contrast (70552) |
$232.50 |
$310 |
0.7× |
| MRI brain without and with contrast (70553) |
$1,550.25 |
$2,067 |
4.9× |
| X-ray lower spine, 4+ views (72110) |
$174.75 |
$233 |
1.8× |
| MRI lumbar spine without contrast (72148) |
$162 |
$216 |
0.7× |
| CT pelvis with contrast (72193) |
$535.66 |
$714.22 |
3.4× |
| MRI lower-extremity joint without contrast (73721) |
$171 |
$228 |
0.8× |
| CT abdomen and pelvis with contrast (74177) |
$981.48 |
$1,308.64 |
3.1× |
| Ultrasound, abdomen complete (76700) |
$171.95 |
$229.26 |
1.8× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$179.08 |
$238.76 |
1.9× |
| Ultrasound, transvaginal (76830) |
$171.58 |
$228.76 |
1.8× |
| Mammography, one breast (diagnostic) (77065) |
$93.75 |
$125 |
1.1× |
| Mammography, both breasts (diagnostic) (77066) |
$119.25 |
$159 |
1.1× |
| Mammography, screening (bilateral) (77067) |
$97.50 |
$130 |
1.1× |
| Comprehensive metabolic panel (80053) |
$33.30 |
$44.40 |
3.2× |
| Lipid panel (80061) |
$43.40 |
$57.86 |
3.2× |
| Renal function panel (80069) |
$48.24 |
$64.32 |
5.6× |
| Hepatic function panel (80076) |
$26.49 |
$35.32 |
3.2× |
| Urinalysis, non-automated, without microscopy (81002) |
$12 |
$16 |
3.4× |
| PSA, total (84153) |
$58.76 |
$78.35 |
3.2× |
| Thyroid stimulating hormone (TSH) (84443) |
$52.99 |
$70.65 |
3.2× |
| CBC with automated differential (85025) |
$24.50 |
$32.66 |
3.2× |
| Prothrombin time (PT) (85610) |
$15.75 |
$21 |
3.7× |
| Partial thromboplastin time (PTT) (85730) |
$19.20 |
$25.60 |
3.2× |
| Psychotherapy, 30 minutes (90832) |
$67.96 |
$90.62 |
0.4× |
| Psychotherapy, 45 minutes (90834) |
$90.02 |
$120.02 |
0.6× |
| Psychotherapy, 60 minutes (90837) |
$133.60 |
$178.13 |
0.8× |
| Family psychotherapy, without patient (50 min) (90846) |
$94.45 |
$125.93 |
0.6× |
| Family psychotherapy, with patient (50 min) (90847) |
$98.26 |
$131.02 |
0.6× |
| Group psychotherapy (90853) |
$20.25 |
$27 |
0.2× |
| Electrocardiogram (ECG), complete (93000) |
$28.68 |
$38.24 |
0.5× |
| Left heart catheterization (93452) |
$645 |
$860 |
0.2× |
| Sleep study (attended polysomnography) (95810) |
$450.75 |
$601 |
0.6× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$24.75 |
$33 |
0.9× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$111.48 |
$148.64 |
0.9× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$165.24 |
$220.32 |
1.4× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$213.96 |
$285.27 |
1.8× |
| Preventive visit, new patient (age 18–39) (99385) |
$113.71 |
$151.62 |
— |
| Preventive visit, new patient (age 40–64) (99386) |
$143.51 |
$191.34 |
— |