| Breast lesion removal (open) (19120) |
$3,883 |
$11,513.30 |
1.0× |
| Shoulder arthroscopy with decompression (29826) |
— |
$10,468.02 |
— |
| Knee arthroscopy with meniscectomy (29881) |
$3,245 |
$13,124.40 |
1.0× |
| Upper GI endoscopy (EGD), diagnostic (43235) |
$899 |
$7,486.04 |
1.0× |
Upper GI endoscopy (EGD) with biopsy (43239)
range across 2 matching MRF lines |
$899 |
$4,126.05–$7,529.17 |
1.0× |
Diagnostic colonoscopy (45378)
range across 2 matching MRF lines |
$922 |
$4,354.05–$7,470.56 |
1.0× |
Colonoscopy with biopsy (45380)
range across 2 matching MRF lines |
$1,187 |
$5,414.05–$7,416.58 |
1.0× |
| Colonoscopy with lesion removal (45385) |
$1,187 |
$7,526.16 |
1.0× |
| Laparoscopic gallbladder removal (47562) |
$5,996 |
$19,763.80 |
1.0× |
| Inguinal hernia repair (age 5+) (49505) |
$3,551 |
$15,897.30 |
1.0× |
| Epidural injection, lumbar/sacral (with imaging) (62322) |
$877 |
$1,000 |
1.0× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$877 |
$4,112.30 |
1.0× |
| Cataract removal with lens insertion (66984) |
$2,289 |
$7,477.95 |
1.0× |
| CT head/brain without contrast (70450) |
$103 |
$2,219 |
1.0× |
| MRI brain without contrast (70551) |
$236 |
$3,587 |
1.0× |
| MRI brain with contrast (70552) |
$346 |
$4,185.75 |
1.0× |
| MRI brain without and with contrast (70553) |
$346 |
$5,116.57 |
1.0× |
| X-ray lower spine, 4+ views (72110) |
$103 |
$701 |
1.0× |
| MRI lumbar spine without contrast (72148) |
$236 |
$3,572.30 |
1.0× |
| CT pelvis with contrast (72193) |
$173 |
$2,978.46 |
1.0× |
| MRI lower-extremity joint without contrast (73721) |
$236 |
$1,681 |
1.0× |
| CT abdomen and pelvis with contrast (74177) |
$346 |
$5,307.25 |
1.0× |
| Ultrasound, abdomen complete (76700) |
$103 |
$1,135 |
1.0× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$103 |
$924 |
1.0× |
| Ultrasound, transvaginal (76830) |
$103 |
$792 |
1.0× |
| Mammography, one breast (diagnostic) (77065) |
$83 |
$291 |
1.0× |
| Mammography, both breasts (diagnostic) (77066) |
$107 |
$322 |
1.0× |
| Mammography, screening (bilateral) (77067) |
$88 |
$1,272.40 |
1.0× |
| Basic metabolic panel (80048) |
$8 |
$262 |
0.9× |
| Comprehensive metabolic panel (80053) |
$10 |
$370 |
0.9× |
| Lipid panel (80061) |
$13 |
$99 |
1.0× |
| Renal function panel (80069) |
$8 |
$264.42 |
0.9× |
| Hepatic function panel (80076) |
$8 |
$261.13 |
1.0× |
| Urinalysis, non-automated, without microscopy (81002) |
$3 |
$15 |
0.9× |
PSA, total (84153)
range across 2 matching MRF lines |
$18 |
$27.59–$200.61 |
1.0× |
| Thyroid stimulating hormone (TSH) (84443) |
$16 |
$211.92 |
1.0× |
| CBC with automated differential (85025) |
$7 |
$150 |
0.9× |
| CBC, automated (85027) |
$6 |
$114 |
0.9× |
| Prothrombin time (PT) (85610) |
$4 |
$33.19 |
0.9× |
| Partial thromboplastin time (PTT) (85730) |
$6 |
$33.35 |
1.0× |
| Psychotherapy, 30 minutes (90832) |
$176 |
$447.45 |
1.0× |
| Psychotherapy, 45 minutes (90834) |
$176 |
$577.60 |
1.0× |
| Left heart catheterization (93452) |
$3,215 |
$6,727 |
1.0× |
| Sleep study (attended polysomnography) (95810) |
$851 |
$4,326 |
1.0× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$28 |
$150.97 |
1.0× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
— |
$325 |
— |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
— |
$407 |
— |
| Office visit, new patient (high complexity, ~60 min) (99205) |
— |
$488 |
— |