| Breast lesion removal (open) (19120) |
$879 |
$879 |
0.2× |
| Upper GI endoscopy (EGD), diagnostic (43235) |
$1,304.33 |
$1,304.33 |
1.6× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$1,456.05 |
$1,456.05 |
1.7× |
| Diagnostic colonoscopy (45378) |
$1,667.70 |
$1,667.70 |
1.9× |
| Colonoscopy with biopsy (45380) |
$1,721.25 |
$1,721.25 |
1.6× |
| Colonoscopy with lesion removal (45385) |
$1,876.80 |
$1,876.80 |
1.7× |
| Epidural injection, lumbar/sacral (with imaging) (62322) |
$601 |
$601 |
0.7× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$1,735 |
$1,735 |
2.1× |
| CT head/brain without contrast (70450) |
$990 |
$990 |
10.3× |
| MRI brain without contrast (70551) |
$962 |
$962 |
4.4× |
| MRI brain with contrast (70552) |
$1,142 |
$1,142 |
3.6× |
| MRI brain without and with contrast (70553) |
$1,142.50 |
$1,142.50 |
3.6× |
| X-ray lower spine, 4+ views (72110) |
$313 |
$313 |
3.3× |
| MRI lumbar spine without contrast (72148) |
$962 |
$962 |
4.4× |
| CT pelvis with contrast (72193) |
$940 |
$940 |
5.8× |
| MRI lower-extremity joint without contrast (73721) |
$864 |
$864 |
3.9× |
| CT abdomen and pelvis with contrast (74177) |
$1,790 |
$1,790 |
5.6× |
| Ultrasound, abdomen complete (76700) |
$360 |
$360 |
3.7× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$180 |
$180 |
1.9× |
| Ultrasound, transvaginal (76830) |
$368 |
$368 |
3.8× |
| Mammography, one breast (diagnostic) (77065) |
$255 |
$255 |
3.0× |
| Mammography, both breasts (diagnostic) (77066) |
$425 |
$425 |
3.8× |
| Mammography, screening (bilateral) (77067) |
$155 |
$155 |
1.7× |
| Basic metabolic panel (80048) |
$73 |
$73 |
8.6× |
| Comprehensive metabolic panel (80053) |
$90.12 |
$90.12 |
8.5× |
| Lipid panel (80061) |
$53.50 |
$53.50 |
4.0× |
| Renal function panel (80069) |
$75 |
$75 |
8.6× |
| Hepatic function panel (80076) |
$72 |
$72 |
8.8× |
| Urinalysis, non-automated, without microscopy (81002) |
$10.68 |
$10.68 |
3.1× |
| PSA, total (84153) |
$126.75 |
$126.75 |
6.9× |
| Thyroid stimulating hormone (TSH) (84443) |
$54.50 |
$54.50 |
3.2× |
| CBC with automated differential (85025) |
$16.50 |
$16.50 |
2.1× |
| CBC, automated (85027) |
$45 |
$45 |
7.0× |
| Prothrombin time (PT) (85610) |
$30.50 |
$30.50 |
7.1× |
| Partial thromboplastin time (PTT) (85730) |
$52 |
$52 |
8.7× |
| Psychotherapy, 30 minutes (90832) |
$93 |
$93 |
0.6× |
| Psychotherapy, 45 minutes (90834) |
$132 |
$132 |
0.8× |
| Psychotherapy, 60 minutes (90837) |
$201 |
$201 |
1.2× |
| Electrocardiogram (ECG), complete (93000) |
$119 |
$119 |
2.2× |
| Sleep study (attended polysomnography) (95810) |
$573.86 |
$573.86 |
0.7× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$73.50 |
$73.50 |
2.5× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$212.50 |
$212.50 |
1.7× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$290 |
$290 |
2.4× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$349 |
$349 |
2.9× |
| Preventive visit, new patient (age 18–39) (99385) |
$262 |
$262 |
— |
| Preventive visit, new patient (age 40–64) (99386) |
$306 |
$306 |
— |