| Breast lesion removal (open) (19120) |
$1,767.60 |
$2,946 |
0.5× |
| Upper GI endoscopy (EGD), diagnostic (43235) |
$4,715.43 |
$7,859.05 |
5.2× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$1,789.80 |
$2,983 |
2.0× |
| Diagnostic colonoscopy (45378) |
$2,876.91 |
$4,794.85 |
3.1× |
| Colonoscopy with biopsy (45380) |
$6,284.01 |
$10,473.35 |
5.2× |
| Colonoscopy with lesion removal (45385) |
$4,180.66 |
$6,967.78 |
3.5× |
| Epidural injection, lumbar/sacral (with imaging) (62322) |
$13,462.22 |
$22,437.03 |
15.2× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$1,747.77 |
$2,912.95 |
2.0× |
| After-cataract laser surgery (YAG capsulotomy) (66821) |
$2,736.90 |
$4,561.50 |
5.0× |
| Cataract removal with lens insertion (66984) |
$5,387.52 |
$8,979.20 |
2.3× |
| CT head/brain without contrast (70450) |
$1,132.80 |
$1,888 |
10.8× |
| MRI brain without contrast (70551) |
$1,650 |
$2,750 |
6.9× |
| MRI brain with contrast (70552) |
$1,830 |
$3,050 |
5.2× |
| MRI brain without and with contrast (70553) |
$2,130 |
$3,550 |
6.1× |
| X-ray lower spine, 4+ views (72110) |
$336.60 |
$561 |
3.2× |
| MRI lumbar spine without contrast (72148) |
$1,728 |
$2,880 |
7.2× |
| CT pelvis with contrast (72193) |
$1,380 |
$2,300 |
7.9× |
| MRI lower-extremity joint without contrast (73721) |
$1,542 |
$2,570 |
6.5× |
| CT abdomen and pelvis with contrast (74177) |
$2,058 |
$3,430 |
5.9× |
| Ultrasound, abdomen complete (76700) |
$645 |
$1,075 |
6.2× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$480 |
$800 |
4.6× |
| Ultrasound, transvaginal (76830) |
$444 |
$740 |
4.2× |
| Mammography, one breast (diagnostic) (77065) |
$164.40 |
$274 |
1.9× |
| Mammography, both breasts (diagnostic) (77066) |
$246.60 |
$411 |
2.2× |
| Mammography, screening (bilateral) (77067) |
$196.80 |
$328 |
2.2× |
| Basic metabolic panel (80048) |
$107.40 |
$179 |
12.7× |
| Comprehensive metabolic panel (80053) |
$153.60 |
$256 |
14.5× |
| Obstetric panel (80055) |
$337.20 |
$562 |
7.1× |
| Lipid panel (80061) |
$90 |
$150 |
6.7× |
| Renal function panel (80069) |
$108.60 |
$181 |
12.5× |
| Hepatic function panel (80076) |
$108 |
$180 |
13.2× |
| Urinalysis, non-automated, without microscopy (81002) |
$15.60 |
$26 |
4.5× |
| PSA, total (84153) |
$117 |
$195 |
6.4× |
| Thyroid stimulating hormone (TSH) (84443) |
$112.80 |
$188 |
6.7× |
| CBC with automated differential (85025) |
$54 |
$90 |
6.9× |
| CBC, automated (85027) |
$46.80 |
$78 |
7.2× |
| Prothrombin time (PT) (85610) |
$33.60 |
$56 |
7.8× |
| Partial thromboplastin time (PTT) (85730) |
$68.40 |
$114 |
11.4× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$85.20 |
$142 |
2.9× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$66 |
$110 |
0.5× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$66 |
$110 |
0.5× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$106.20 |
$177 |
0.8× |
| Preventive visit, new patient (age 18–39) (99385) |
$46.80 |
$78 |
— |
| Preventive visit, new patient (age 40–64) (99386) |
$52.80 |
$88 |
— |