| Breast lesion removal (open) (19120) |
$2,990 |
$4,600 |
0.8× |
| Knee arthroscopy with meniscectomy (29881) |
$4,550 |
$7,000 |
1.4× |
| Tonsillectomy and adenoidectomy (under age 12) (42820) |
$3,347.50 |
$5,150 |
0.6× |
| Upper GI endoscopy (EGD), diagnostic (43235) |
$1,056.25 |
$1,625 |
1.2× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$639.60 |
$984 |
0.7× |
| Diagnostic colonoscopy (45378) |
$733.85 |
$1,129 |
0.8× |
| Colonoscopy with biopsy (45380) |
$753.35 |
$1,159 |
0.6× |
| Colonoscopy with lesion removal (45385) |
$798.85 |
$1,229 |
0.7× |
| Laparoscopic gallbladder removal (47562) |
$7,029.75 |
$10,815 |
1.2× |
| Inguinal hernia repair (age 5+) (49505) |
$4,550 |
$7,000 |
1.3× |
| Epidural injection, lumbar/sacral (with imaging) (62322) |
$1,004.25 |
$1,545 |
1.1× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$1,339 |
$2,060 |
1.5× |
| After-cataract laser surgery (YAG capsulotomy) (66821) |
$535.60 |
$824 |
1.0× |
| Cataract removal with lens insertion (66984) |
$2,470 |
$3,800 |
1.1× |
| CT head/brain without contrast (70450) |
$910 |
$1,400 |
8.7× |
| MRI brain without contrast (70551) |
$1,040 |
$1,600 |
4.4× |
| MRI brain with contrast (70552) |
$1,105 |
$1,700 |
3.2× |
| MRI brain without and with contrast (70553) |
$1,365 |
$2,100 |
3.9× |
| X-ray lower spine, 4+ views (72110) |
$273 |
$420 |
2.6× |
| MRI lumbar spine without contrast (72148) |
$1,007.50 |
$1,550 |
4.2× |
| CT pelvis with contrast (72193) |
$1,056.25 |
$1,625 |
6.0× |
| MRI lower-extremity joint without contrast (73721) |
$1,131 |
$1,740 |
4.7× |
| CT abdomen and pelvis with contrast (74177) |
$1,852.50 |
$2,850 |
5.3× |
| Ultrasound, abdomen complete (76700) |
$568.75 |
$875 |
5.4× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$290.55 |
$447 |
2.8× |
| Ultrasound, transvaginal (76830) |
$390 |
$600 |
3.7× |
| Mammography, one breast (diagnostic) (77065) |
$136.50 |
$210 |
1.6× |
| Mammography, both breasts (diagnostic) (77066) |
$169 |
$260 |
1.5× |
| Mammography, screening (bilateral) (77067) |
$113.75 |
$175 |
1.2× |
| Basic metabolic panel (80048) |
$81.25 |
$125 |
9.6× |
| Comprehensive metabolic panel (80053) |
$107.25 |
$165 |
10.2× |
| Lipid panel (80061) |
$61.75 |
$95 |
4.6× |
| Renal function panel (80069) |
$71.50 |
$110 |
8.2× |
| Hepatic function panel (80076) |
$81.25 |
$125 |
9.9× |
| PSA, total (84153) |
$59.80 |
$92 |
3.3× |
| Thyroid stimulating hormone (TSH) (84443) |
$61.75 |
$95 |
3.7× |
| CBC with automated differential (85025) |
$55.25 |
$85 |
7.1× |
| CBC, automated (85027) |
$44.85 |
$69 |
6.9× |
| Prothrombin time (PT) (85610) |
$29.25 |
$45 |
6.8× |
| Partial thromboplastin time (PTT) (85730) |
$48.75 |
$75 |
8.1× |
| Psychotherapy, 30 minutes (90832) |
$151.12 |
$232.50 |
0.9× |
| Psychotherapy, 45 minutes (90834) |
$289.90 |
$446 |
1.6× |
| Psychotherapy, 60 minutes (90837) |
$181.02 |
$278.50 |
1.0× |
| Family psychotherapy, without patient (50 min) (90846) |
$297.05 |
$457 |
1.7× |
| Family psychotherapy, with patient (50 min) (90847) |
$297.05 |
$457 |
1.7× |
| Group psychotherapy (90853) |
$280.15 |
$431 |
2.8× |
| Sleep study (attended polysomnography) (95810) |
$2,177.50 |
$3,350 |
2.5× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$71.50 |
$110 |
2.5× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$88.40 |
$136 |
0.7× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$151.12 |
$232.50 |
1.1× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$223.28 |
$343.50 |
1.7× |