| Breast lesion removal (open) (19120) |
$8,536 |
$8,536 |
2.2× |
| Shoulder arthroscopy with decompression (29826) |
$4,470.50 |
$4,470.50 |
— |
| Knee arthroscopy with meniscectomy (29881) |
$3,606 |
$3,606 |
1.1× |
| Tonsillectomy and adenoidectomy (under age 12) (42820) |
$7,666 |
$7,666 |
1.3× |
| Upper GI endoscopy (EGD), diagnostic (43235) |
$1,897.50 |
$1,897.50 |
2.1× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$1,702.50 |
$1,702.50 |
1.9× |
| Diagnostic colonoscopy (45378) |
$2,093 |
$2,093 |
2.2× |
| Colonoscopy with biopsy (45380) |
$2,274.50 |
$2,274.50 |
1.9× |
| Colonoscopy with lesion removal (45385) |
$2,274.50 |
$2,274.50 |
1.9× |
| Colonoscopy with endoscopic ultrasound (45391) |
$2,310 |
$2,310 |
1.9× |
| Laparoscopic gallbladder removal (47562) |
$7,483.50 |
$7,483.50 |
1.2× |
| Inguinal hernia repair (age 5+) (49505) |
$7,805 |
$7,805 |
2.2× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$3,963.50 |
$3,963.50 |
4.5× |
| Cataract removal with lens insertion (66984) |
$6,010.50 |
$6,010.50 |
2.6× |
| CT head/brain without contrast (70450) |
$1,430 |
$1,430 |
13.6× |
| MRI brain without contrast (70551) |
$1,430 |
$1,430 |
6.0× |
| MRI brain with contrast (70552) |
$1,409 |
$1,409 |
4.0× |
| MRI brain without and with contrast (70553) |
$2,090 |
$2,090 |
6.0× |
| X-ray lower spine, 4+ views (72110) |
$520 |
$520 |
5.0× |
| MRI lumbar spine without contrast (72148) |
$1,980 |
$1,980 |
8.3× |
| CT pelvis with contrast (72193) |
$1,430 |
$1,430 |
8.1× |
| MRI lower-extremity joint without contrast (73721) |
$1,430 |
$1,430 |
6.0× |
| CT abdomen and pelvis with contrast (74177) |
$1,870 |
$1,870 |
5.3× |
| Ultrasound, abdomen complete (76700) |
$851 |
$851 |
8.1× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$442.50 |
$442.50 |
4.2× |
| Ultrasound, transvaginal (76830) |
$641 |
$641 |
6.1× |
| Mammography, one breast (diagnostic) (77065) |
$260 |
$260 |
3.0× |
| Mammography, both breasts (diagnostic) (77066) |
$370 |
$370 |
3.3× |
| Mammography, screening (bilateral) (77067) |
$220 |
$220 |
2.4× |
| Basic metabolic panel (80048) |
$84 |
$84 |
9.9× |
| Comprehensive metabolic panel (80053) |
$46 |
$46 |
4.4× |
| Lipid panel (80061) |
$97 |
$97 |
7.2× |
| Renal function panel (80069) |
$42.50 |
$42.50 |
4.9× |
| Hepatic function panel (80076) |
$45.50 |
$45.50 |
5.6× |
| Urinalysis, non-automated, without microscopy (81002) |
$20 |
$20 |
5.7× |
| PSA, total (84153) |
$30 |
$30 |
1.6× |
| Thyroid stimulating hormone (TSH) (84443) |
$87 |
$87 |
5.2× |
| CBC with automated differential (85025) |
$62.50 |
$62.50 |
8.0× |
| CBC, automated (85027) |
$50 |
$50 |
7.7× |
| Prothrombin time (PT) (85610) |
$22.50 |
$22.50 |
5.2× |
| Partial thromboplastin time (PTT) (85730) |
$92 |
$92 |
15.3× |
| Electrocardiogram (ECG), complete (93000) |
$52 |
$52 |
0.9× |
| Left heart catheterization (93452) |
$10,637.50 |
$10,637.50 |
3.3× |
| Sleep study (attended polysomnography) (95810) |
$3,805 |
$3,805 |
4.4× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$129.50 |
$129.50 |
4.5× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$252 |
$252 |
1.9× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$298 |
$298 |
2.2× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$281 |
$281 |
2.1× |