| Breast lesion removal (open) (19120) |
$417 |
$834 |
0.1× |
| Shoulder arthroscopy with decompression (29826) |
$167.50 |
$335 |
— |
| Upper GI endoscopy (EGD), diagnostic (43235) |
$120.50 |
$241 |
0.1× |
| Diagnostic colonoscopy (45378) |
$180 |
$360 |
0.2× |
| Colonoscopy with biopsy (45380) |
$1,823.50 |
$3,647 |
1.4× |
Laparoscopic gallbladder removal (47562)
likely a partial charge — not the full procedure |
$652 |
$1,304 |
0.1× |
| Inguinal hernia repair (age 5+) (49505) |
$519 |
$1,038 |
0.1× |
Laparoscopic radical prostatectomy (55866)
likely a partial charge — not the full procedure |
$1,172 |
$2,344 |
0.1× |
| Obstetric care, vaginal delivery (global) (59400) |
$2,387.50 |
$4,775 |
— |
| Obstetric care, cesarean delivery (global) (59510) |
$9,476.50 |
$18,953 |
— |
| Obstetric care, VBAC delivery (global) (59610) |
$2,494 |
$4,988 |
— |
| Epidural injection, lumbar/sacral (with imaging) (62322) |
$1,148 |
$2,296 |
1.2× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$648.50 |
$1,297 |
0.7× |
| CT head/brain without contrast (70450) |
$1,944.50 |
$3,889 |
17.6× |
| MRI brain without contrast (70551) |
$2,542.50 |
$5,085 |
10.1× |
| MRI brain with contrast (70552) |
$2,542.50 |
$5,085 |
6.9× |
| MRI brain without and with contrast (70553) |
$2,542.50 |
$5,085 |
6.9× |
| X-ray lower spine, 4+ views (72110) |
$1,425 |
$2,850 |
12.9× |
| MRI lumbar spine without contrast (72148) |
$2,542.50 |
$5,085 |
10.1× |
| CT pelvis with contrast (72193) |
$2,102 |
$4,204 |
11.4× |
| MRI lower-extremity joint without contrast (73721) |
$2,542.50 |
$5,085 |
10.1× |
| CT abdomen and pelvis with contrast (74177) |
$2,102 |
$4,204 |
5.7× |
| Ultrasound, abdomen complete (76700) |
$1,001.75 |
$2,003.50 |
9.1× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$313 |
$626 |
2.8× |
| Ultrasound, transvaginal (76830) |
$761.75 |
$1,523.50 |
6.9× |
| Mammography, one breast (diagnostic) (77065) |
$237.50 |
$475 |
2.8× |
| Mammography, both breasts (diagnostic) (77066) |
$303.50 |
$607 |
2.7× |
| Mammography, screening (bilateral) (77067) |
$251 |
$502 |
2.8× |
| Basic metabolic panel (80048) |
$71.75 |
$143.50 |
8.5× |
| Comprehensive metabolic panel (80053) |
$110.75 |
$221.50 |
10.5× |
| Obstetric panel (80055) |
$462 |
$924 |
9.7× |
| Lipid panel (80061) |
$80.25 |
$160.50 |
6.0× |
| Renal function panel (80069) |
$114.50 |
$229 |
13.2× |
| Hepatic function panel (80076) |
$82.50 |
$165 |
10.1× |
| Urinalysis, non-automated, without microscopy (81002) |
$70.50 |
$141 |
20.3× |
| PSA, total (84153) |
$25.50 |
$51 |
1.4× |
| Thyroid stimulating hormone (TSH) (84443) |
$73.25 |
$146.50 |
4.4× |
| CBC with automated differential (85025) |
$86.50 |
$173 |
11.1× |
| CBC, automated (85027) |
$75.50 |
$151 |
11.7× |
| Prothrombin time (PT) (85610) |
$68 |
$136 |
15.9× |
| Partial thromboplastin time (PTT) (85730) |
$43 |
$86 |
7.2× |
| Psychotherapy, 30 minutes (90832) |
$217 |
$434 |
1.2× |
| Psychotherapy, 45 minutes (90834) |
$284.50 |
$569 |
1.5× |
| Psychotherapy, 60 minutes (90837) |
$633.50 |
$1,267 |
3.4× |
| Family psychotherapy, without patient (50 min) (90846) |
$633.50 |
$1,267 |
3.4× |
| Family psychotherapy, with patient (50 min) (90847) |
$401.50 |
$803 |
2.1× |
| Group psychotherapy (90853) |
$726.50 |
$1,453 |
6.8× |
| Left heart catheterization (93452) |
$7,761.25 |
$15,522.50 |
2.3× |
| Sleep study (attended polysomnography) (95810) |
$3,885 |
$7,770 |
4.3× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$138.50 |
$277 |
4.8× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$108.75 |
$217.50 |
0.8× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$667.75 |
$1,335.50 |
4.8× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$997.50 |
$1,995 |
7.1× |
| Office consultation (low complexity, ~30 min) (99243) |
$80.75 |
$161.50 |
0.6× |
| Office consultation (moderate complexity, ~40 min) (99244) |
$115.50 |
$231 |
0.8× |