| Breast lesion removal (open) (19120) |
$1,445.40 |
$4,380 |
0.4× |
| Shoulder arthroscopy with decompression (29826) |
$2,316.88 |
$7,020.83 |
— |
| Knee arthroscopy with meniscectomy (29881) |
$3,052.50 |
$9,250 |
0.9× |
Tonsillectomy and adenoidectomy (under age 12) (42820)
unusually low: confirm this is the full procedure |
$2,514.60 |
$7,620 |
0.4× |
| Upper GI endoscopy (EGD), diagnostic (43235) |
$1,501.50 |
$4,550 |
1.7× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$1,126.12 |
$3,412.50 |
1.2× |
| Diagnostic colonoscopy (45378) |
$750.75 |
$2,275 |
0.8× |
| Colonoscopy with biopsy (45380) |
$771.38 |
$2,337.50 |
0.6× |
| Colonoscopy with lesion removal (45385) |
$1,749 |
$5,300 |
1.5× |
| Laparoscopic gallbladder removal (47562) |
$3,634.12 |
$11,012.50 |
0.6× |
| Inguinal hernia repair (age 5+) (49505) |
$1,024.65 |
$3,105 |
0.3× |
| Laparoscopic radical prostatectomy (55866) |
$6,124.80 |
$18,560 |
0.6× |
| Epidural injection, lumbar/sacral (with imaging) (62322) |
$676.50 |
$2,050 |
0.8× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$861.30 |
$2,610 |
1.0× |
| Cataract removal with lens insertion (66984) |
$1,481.70 |
$4,490 |
0.6× |
| CT head/brain without contrast (70450) |
$820.05 |
$2,485 |
7.8× |
| MRI brain without contrast (70551) |
$1,260.60 |
$3,820 |
5.3× |
| MRI brain without and with contrast (70553) |
$1,417.35 |
$4,295 |
4.1× |
| X-ray lower spine, 4+ views (72110) |
$316.80 |
$960 |
3.0× |
| MRI lumbar spine without contrast (72148) |
$1,131.90 |
$3,430 |
4.7× |
| CT pelvis with contrast (72193) |
$966.90 |
$2,930 |
5.5× |
| MRI lower-extremity joint without contrast (73721) |
$1,108.80 |
$3,360 |
4.6× |
| CT abdomen and pelvis with contrast (74177) |
$1,717.65 |
$5,205 |
4.9× |
| Ultrasound, abdomen complete (76700) |
$480.15 |
$1,455 |
4.6× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$399.30 |
$1,210 |
3.8× |
| Ultrasound, transvaginal (76830) |
$300.30 |
$910 |
2.9× |
| Mammography, one breast (diagnostic) (77065) |
$128.70 |
$390 |
1.5× |
| Mammography, both breasts (diagnostic) (77066) |
$161.70 |
$490 |
1.5× |
| Mammography, screening (bilateral) (77067) |
$115.50 |
$350 |
1.3× |
| Basic metabolic panel (80048) |
$42.90 |
$130 |
5.1× |
| Comprehensive metabolic panel (80053) |
$59.40 |
$180 |
5.6× |
| Lipid panel (80061) |
$46.20 |
$140 |
3.5× |
| Renal function panel (80069) |
$56.10 |
$170 |
6.5× |
| Hepatic function panel (80076) |
$49.50 |
$150 |
6.1× |
| Urinalysis, non-automated, with microscopy (81000) |
$4.95 |
$15 |
1.2× |
| Urinalysis, non-automated, without microscopy (81002) |
$4.95 |
$15 |
1.4× |
| PSA, total (84153) |
$56.10 |
$170 |
3.1× |
| Thyroid stimulating hormone (TSH) (84443) |
$46.20 |
$140 |
2.8× |
| CBC with automated differential (85025) |
$32.18 |
$97.50 |
4.1× |
| CBC, automated (85027) |
$33 |
$100 |
5.1× |
| Prothrombin time (PT) (85610) |
$16.66 |
$50.50 |
3.9× |
| Partial thromboplastin time (PTT) (85730) |
$42.90 |
$130 |
7.1× |
| Psychotherapy, 30 minutes (90832) |
$16.83 |
$51 |
0.1× |
| Psychotherapy, 45 minutes (90834) |
$32.01 |
$97 |
0.2× |
| Psychotherapy, 60 minutes (90837) |
$29.70 |
$90 |
0.2× |
| Sleep study (attended polysomnography) (95810) |
$1,889.25 |
$5,725 |
2.2× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$89.10 |
$270 |
3.1× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$118.80 |
$360 |
0.9× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$90.58 |
$274.50 |
0.7× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$92.24 |
$279.50 |
0.7× |