| Breast lesion removal (open) (19120) |
$4,577.83 |
$108.04 |
1.0× |
| Knee arthroscopy with meniscectomy (29881) |
$3,878.87 |
— |
1.0× |
| Tonsillectomy and adenoidectomy (under age 12) (42820) |
$7,072.05 |
— |
1.0× |
| Upper GI endoscopy (EGD), diagnostic (43235) |
$1,120.83 |
— |
1.0× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$1,120.83 |
$197.05 |
1.0× |
| Diagnostic colonoscopy (45378) |
$1,089.93 |
— |
1.0× |
| Colonoscopy with biopsy (45380) |
$1,409.57 |
— |
1.0× |
| Colonoscopy with lesion removal (45385) |
$1,409.57 |
— |
1.0× |
| Colonoscopy with endoscopic ultrasound (45391) |
$1,409.57 |
— |
1.0× |
| Laparoscopic gallbladder removal (47562) |
$6,974.86 |
— |
1.0× |
| Inguinal hernia repair (age 5+) (49505) |
$4,218.92 |
— |
1.0× |
| Laparoscopic radical prostatectomy (55866) |
$12,446.41 |
— |
1.0× |
| Epidural injection, lumbar/sacral (with imaging) (62322) |
$1,064.32 |
$472.77 |
1.0× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$1,064.32 |
— |
1.0× |
| After-cataract laser surgery (YAG capsulotomy) (66821) |
$655.84 |
— |
1.0× |
| Cataract removal with lens insertion (66984) |
$2,726.57 |
— |
1.0× |
| CT head/brain without contrast (70450) |
$127.13 |
$2,475.05 |
1.0× |
| MRI brain without contrast (70551) |
$288.97 |
$7,023.84 |
1.0× |
| MRI brain with contrast (70552) |
$426.94 |
$6,753.71 |
1.0× |
| MRI brain without and with contrast (70553) |
$426.94 |
$7,013.53 |
1.0× |
| X-ray lower spine, 4+ views (72110) |
$127.13 |
$1,769.48 |
1.0× |
| MRI lumbar spine without contrast (72148) |
$288.97 |
$7,023.84 |
1.0× |
| CT pelvis with contrast (72193) |
$212.82 |
$3,445.18 |
1.0× |
| MRI lower-extremity joint without contrast (73721) |
$288.97 |
$7,019.09 |
1.0× |
| CT abdomen and pelvis with contrast (74177) |
$426.94 |
$6,359.62 |
1.0× |
| Ultrasound, abdomen complete (76700) |
$127.13 |
$3,445.18 |
1.0× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$127.13 |
— |
1.0× |
| Ultrasound, transvaginal (76830) |
$127.13 |
$3,357 |
1.0× |
| Mammography, one breast (diagnostic) (77065) |
$164.52 |
$858.91 |
1.9× |
| Mammography, both breasts (diagnostic) (77066) |
$207.95 |
$1,017.43 |
1.9× |
| Mammography, screening (bilateral) (77067) |
$169.06 |
$961.01 |
1.9× |
| Basic metabolic panel (80048) |
$8.46 |
$218.49 |
1.0× |
| Comprehensive metabolic panel (80053) |
$10.56 |
$289.23 |
1.0× |
| Obstetric panel (80055) |
$47.81 |
— |
1.0× |
| Lipid panel (80061) |
$13.39 |
$161.30 |
1.0× |
| Renal function panel (80069) |
$8.68 |
$254.25 |
1.0× |
| Hepatic function panel (80076) |
$8.17 |
$182.75 |
1.0× |
| Urinalysis, non-automated, with microscopy (81000) |
$4.02 |
— |
1.0× |
| Urinalysis, non-automated, without microscopy (81002) |
$3.48 |
$16.68 |
1.0× |
| PSA, total (84153) |
$18.39 |
$215.34 |
1.0× |
| Thyroid stimulating hormone (TSH) (84443) |
$16.80 |
$199.44 |
1.0× |
| CBC with automated differential (85025) |
$7.77 |
$92.57 |
1.0× |
| CBC, automated (85027) |
$6.47 |
$77.87 |
1.0× |
| Prothrombin time (PT) (85610) |
$4.29 |
$75.49 |
1.0× |
| Partial thromboplastin time (PTT) (85730) |
$6.01 |
$89.80 |
1.0× |
| Psychotherapy, 30 minutes (90832) |
$192.08 |
$419.53 |
0.9× |
| Psychotherapy, 45 minutes (90834) |
$192.08 |
$669.82 |
0.9× |
| Psychotherapy, 60 minutes (90837) |
$192.08 |
$579.57 |
0.9× |
| Family psychotherapy, without patient (50 min) (90846) |
$192.08 |
$392.52 |
0.9× |
| Family psychotherapy, with patient (50 min) (90847) |
$192.08 |
$463.62 |
0.9× |
| Group psychotherapy (90853) |
$110.58 |
$375.83 |
0.9× |
| Left heart catheterization (93452) |
$3,845.15 |
— |
1.0× |
| Sleep study (attended polysomnography) (95810) |
$1,216.27 |
$7,872.66 |
1.2× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$37.06 |
$277.31 |
1.3× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
— |
$464.02 |
— |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
— |
$564.14 |
— |
| Office visit, new patient (high complexity, ~60 min) (99205) |
— |
$543.09 |
— |
| Office consultation (low complexity, ~30 min) (99243) |
— |
$367.09 |
— |
| Office consultation (moderate complexity, ~40 min) (99244) |
— |
$669.82 |
— |