| Breast lesion removal (open) (19120) |
$2,662.40 |
$3,328 |
0.7× |
| Shoulder arthroscopy with decompression (29826) |
$1,700.40 |
$2,125.50 |
— |
| Knee arthroscopy with meniscectomy (29881) |
$3,128.27 |
$3,910.34 |
1.0× |
| Upper GI endoscopy (EGD), diagnostic (43235) |
$630 |
$787.50 |
0.7× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$1,146 |
$1,432.50 |
1.3× |
| Diagnostic colonoscopy (45378) |
$1,008 |
$1,260 |
1.1× |
| Colonoscopy with biopsy (45380) |
$1,433.60 |
$1,792 |
1.2× |
| Colonoscopy with lesion removal (45385) |
$1,814.40 |
$2,268 |
1.6× |
| Laparoscopic gallbladder removal (47562) |
$6,913.60 |
$8,642 |
1.2× |
| Inguinal hernia repair (age 5+) (49505) |
$8,569.60 |
$10,712 |
2.5× |
| Epidural injection, lumbar/sacral (with imaging) (62322) |
$4,863.20 |
$6,079 |
5.7× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$1,402.40 |
$1,753 |
1.7× |
| CT head/brain without contrast (70450) |
$1,274.40 |
$1,593 |
12.7× |
| MRI brain without contrast (70551) |
$946.40 |
$1,183 |
4.1× |
| MRI brain with contrast (70552) |
$1,948 |
$2,435 |
5.8× |
| MRI brain without and with contrast (70553) |
$1,550.80 |
$1,938.50 |
4.6× |
| X-ray lower spine, 4+ views (72110) |
$169.20 |
$211.50 |
1.7× |
| MRI lumbar spine without contrast (72148) |
$946.40 |
$1,183 |
4.1× |
| CT pelvis with contrast (72193) |
$748 |
$935 |
4.4× |
| MRI lower-extremity joint without contrast (73721) |
$946.40 |
$1,183 |
4.1× |
| CT abdomen and pelvis with contrast (74177) |
$2,032 |
$2,540 |
6.1× |
| Ultrasound, abdomen complete (76700) |
$253.60 |
$317 |
2.5× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$398.40 |
$498 |
4.0× |
| Ultrasound, transvaginal (76830) |
$253.60 |
$317 |
2.5× |
| Mammography, one breast (diagnostic) (77065) |
$183.20 |
$229 |
2.1× |
| Mammography, both breasts (diagnostic) (77066) |
$234 |
$292.50 |
2.1× |
| Mammography, screening (bilateral) (77067) |
$199.20 |
$249 |
2.2× |
| Basic metabolic panel (80048) |
$62.40 |
$78 |
7.4× |
| Comprehensive metabolic panel (80053) |
$63.20 |
$79 |
6.0× |
| Lipid panel (80061) |
$20.80 |
$26 |
1.6× |
| Renal function panel (80069) |
$23.20 |
$29 |
2.7× |
| Hepatic function panel (80076) |
$24 |
$30 |
2.9× |
| Urinalysis, non-automated, with microscopy (81000) |
$8.80 |
$11 |
2.2× |
| Urinalysis, non-automated, without microscopy (81002) |
$4 |
$5 |
1.1× |
| PSA, total (84153) |
$34.40 |
$43 |
1.9× |
| Thyroid stimulating hormone (TSH) (84443) |
$23.20 |
$29 |
1.4× |
| CBC with automated differential (85025) |
$21.60 |
$27 |
2.8× |
| CBC, automated (85027) |
$15.60 |
$19.50 |
2.4× |
| Prothrombin time (PT) (85610) |
$18.40 |
$23 |
4.3× |
| Partial thromboplastin time (PTT) (85730) |
$22.40 |
$28 |
3.7× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$128 |
$160 |
4.4× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$89.20 |
$111.50 |
0.7× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$94.40 |
$118 |
0.7× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$89.20 |
$111.50 |
0.7× |
| Preventive visit, new patient (age 18–39) (99385) |
$180.40 |
$225.50 |
— |
| Preventive visit, new patient (age 40–64) (99386) |
$211.60 |
$264.50 |
— |