| Breast lesion removal (open) (19120) |
$664.68 |
$1,740 |
0.2× |
| Shoulder arthroscopy with decompression (29826) |
$194.44 |
$509 |
— |
| Knee arthroscopy with meniscectomy (29881) |
$1,022.23 |
$2,676 |
0.3× |
| Upper GI endoscopy (EGD), diagnostic (43235) |
$393.46 |
$1,030 |
0.5× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$552.56 |
$1,446.50 |
0.7× |
| Diagnostic colonoscopy (45378) |
$532.89 |
$1,395 |
0.6× |
| Colonoscopy with biopsy (45380) |
$642.90 |
$1,682.98 |
0.6× |
| Colonoscopy with lesion removal (45385) |
$1,315.80 |
$3,444.50 |
1.2× |
Laparoscopic gallbladder removal (47562)
likely a partial charge, not the full procedure |
$1,343.49 |
$3,517 |
0.2× |
| Inguinal hernia repair (age 5+) (49505) |
$764 |
$2,000 |
0.2× |
Laparoscopic radical prostatectomy (55866)
likely a partial charge, not the full procedure |
$828.18 |
$2,168 |
0.1× |
| Epidural injection, lumbar/sacral (with imaging) (62322) |
$737.26 |
$1,930 |
0.9× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$721.98 |
$1,890 |
0.9× |
| CT head/brain without contrast (70450) |
$519.52 |
$1,360 |
5.5× |
| MRI brain without contrast (70551) |
$123 |
$322 |
0.6× |
| MRI brain with contrast (70552) |
$161.20 |
$422 |
0.5× |
| MRI brain without and with contrast (70553) |
$191 |
$500 |
0.6× |
| X-ray lower spine, 4+ views (72110) |
$87.86 |
$230 |
0.9× |
| MRI lumbar spine without contrast (72148) |
$123 |
$322 |
0.6× |
| CT pelvis with contrast (72193) |
$534.80 |
$1,400 |
3.4× |
| MRI lower-extremity joint without contrast (73721) |
$123 |
$322 |
0.6× |
| CT abdomen and pelvis with contrast (74177) |
$663.53 |
$1,737 |
2.1× |
| Ultrasound, abdomen complete (76700) |
$359.84 |
$942 |
3.8× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$364.05 |
$953 |
3.8× |
| Ultrasound, transvaginal (76830) |
$359.84 |
$942 |
3.8× |
| Mammography, one breast (diagnostic) (77065) |
$172.28 |
$451 |
2.0× |
| Mammography, both breasts (diagnostic) (77066) |
$232.26 |
$608 |
2.1× |
| Mammography, screening (bilateral) (77067) |
$137.90 |
$361 |
1.5× |
| Basic metabolic panel (80048) |
$45.84 |
$120 |
5.4× |
| Comprehensive metabolic panel (80053) |
$69.52 |
$182 |
6.6× |
| Lipid panel (80061) |
$29.80 |
$78 |
2.2× |
| Renal function panel (80069) |
$48.51 |
$127 |
5.6× |
| Hepatic function panel (80076) |
$42.02 |
$110 |
5.1× |
| Urinalysis, non-automated, without microscopy (81002) |
$14.70 |
$38.50 |
4.2× |
| PSA, total (84153) |
$42.02 |
$110 |
2.3× |
| Thyroid stimulating hormone (TSH) (84443) |
$35.14 |
$91.50 |
2.1× |
| CBC with automated differential (85025) |
$6.49 |
$17 |
0.8× |
| CBC, automated (85027) |
$4.78 |
$12.50 |
0.7× |
| Prothrombin time (PT) (85610) |
$27.12 |
$71 |
6.3× |
| Partial thromboplastin time (PTT) (85730) |
$4.20 |
$11 |
0.7× |
| Psychotherapy, 30 minutes (90832) |
$45.84 |
$120 |
0.3× |
| Psychotherapy, 45 minutes (90834) |
$45.46 |
$119 |
0.3× |
| Psychotherapy, 60 minutes (90837) |
$42.02 |
$110 |
0.3× |
| Electrocardiogram (ECG), complete (93000) |
$27.50 |
$72 |
0.5× |
| Sleep study (attended polysomnography) (95810) |
$311.71 |
$816 |
0.4× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$4.58 |
$12 |
0.2× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$51.76 |
$135.50 |
0.4× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$97.80 |
$256 |
0.8× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$150.32 |
$393.50 |
1.2× |
| Office consultation (low complexity, ~30 min) (99243) |
$30.18 |
$79 |
0.2× |
| Preventive visit, new patient (age 18–39) (99385) |
$48.51 |
$127 |
— |
| Preventive visit, new patient (age 40–64) (99386) |
$53.48 |
$140 |
— |