| Breast lesion removal (open) (19120) |
$732.20 |
$1,046 |
0.2× |
| Shoulder arthroscopy with decompression (29826) |
$233.80 |
$334 |
— |
| Knee arthroscopy with meniscectomy (29881) |
$767.20 |
$1,096 |
0.2× |
| Upper GI endoscopy (EGD), diagnostic (43235) |
$409.50 |
$585 |
0.4× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$536.20 |
$766 |
0.6× |
| Diagnostic colonoscopy (45378) |
$480.90 |
$687 |
0.5× |
| Colonoscopy with biopsy (45380) |
$615.30 |
$879 |
0.5× |
| Colonoscopy with lesion removal (45385) |
$641.20 |
$916 |
0.5× |
Laparoscopic gallbladder removal (47562)
likely a partial charge — not the full procedure |
$912.80 |
$1,304 |
0.1× |
| Inguinal hernia repair (age 5+) (49505) |
$726.60 |
$1,038 |
0.2× |
| Obstetric care, vaginal delivery (global) (59400) |
$3,341.80 |
$4,774 |
— |
| Obstetric care, cesarean delivery (global) (59510) |
$3,704.40 |
$5,292 |
— |
| Epidural injection, lumbar/sacral (with imaging) (62322) |
$976.85 |
$1,395.50 |
1.0× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$1,192.80 |
$1,704 |
1.3× |
| CT head/brain without contrast (70450) |
$703.15 |
$1,004.50 |
6.4× |
| MRI brain without contrast (70551) |
$1,131.20 |
$1,616 |
4.5× |
| MRI brain with contrast (70552) |
$1,065.05 |
$1,521.50 |
2.9× |
| MRI brain without and with contrast (70553) |
$1,814.75 |
$2,592.50 |
4.9× |
| X-ray lower spine, 4+ views (72110) |
$166.95 |
$238.50 |
1.5× |
| MRI lumbar spine without contrast (72148) |
$1,127.70 |
$1,611 |
4.5× |
| CT pelvis with contrast (72193) |
$796.95 |
$1,138.50 |
4.3× |
| MRI lower-extremity joint without contrast (73721) |
$1,036.70 |
$1,481 |
4.1× |
| CT abdomen and pelvis with contrast (74177) |
$1,450.75 |
$2,072.50 |
3.9× |
| Ultrasound, abdomen complete (76700) |
$327.25 |
$467.50 |
3.0× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$378 |
$540 |
3.4× |
| Ultrasound, transvaginal (76830) |
$385.35 |
$550.50 |
3.5× |
| Mammography, one breast (diagnostic) (77065) |
$119.35 |
$170.50 |
1.4× |
| Mammography, both breasts (diagnostic) (77066) |
$287.70 |
$411 |
2.6× |
| Mammography, screening (bilateral) (77067) |
$195.30 |
$279 |
2.1× |
| Basic metabolic panel (80048) |
$44.80 |
$64 |
5.3× |
| Comprehensive metabolic panel (80053) |
$57.40 |
$82 |
5.4× |
| Lipid panel (80061) |
$45.50 |
$65 |
3.4× |
| Renal function panel (80069) |
$59.50 |
$85 |
6.9× |
| Hepatic function panel (80076) |
$54.60 |
$78 |
6.7× |
| PSA, total (84153) |
$57.40 |
$82 |
3.1× |
| Thyroid stimulating hormone (TSH) (84443) |
$55.30 |
$79 |
3.3× |
| CBC with automated differential (85025) |
$25.20 |
$36 |
3.2× |
| CBC, automated (85027) |
$22.40 |
$32 |
3.5× |
| Prothrombin time (PT) (85610) |
$27.30 |
$39 |
6.4× |
| Partial thromboplastin time (PTT) (85730) |
$40.60 |
$58 |
6.8× |
| Psychotherapy, 30 minutes (90832) |
$314.30 |
$449 |
1.7× |
| Psychotherapy, 45 minutes (90834) |
$241.15 |
$344.50 |
1.3× |
| Psychotherapy, 60 minutes (90837) |
$279.30 |
$399 |
1.5× |
| Group psychotherapy (90853) |
$308 |
$440 |
2.9× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$80.50 |
$115 |
2.8× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$156.80 |
$224 |
1.1× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$234.50 |
$335 |
1.7× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$308.70 |
$441 |
2.2× |
| Office consultation (low complexity, ~30 min) (99243) |
$210 |
$300 |
1.5× |
| Office consultation (moderate complexity, ~40 min) (99244) |
$301 |
$430 |
2.1× |
| Preventive visit, new patient (age 18–39) (99385) |
$221.90 |
$317 |
— |
| Preventive visit, new patient (age 40–64) (99386) |
$255.50 |
$365 |
— |