| Breast lesion removal (open) (19120) |
$2,325 |
$2,325 |
0.6× |
| Shoulder arthroscopy with decompression (29826) |
$4,505 |
$4,505 |
— |
| Knee arthroscopy with meniscectomy (29881) |
$4,950 |
$4,950 |
1.5× |
| Tonsillectomy and adenoidectomy (under age 12) (42820) |
$3,165 |
$3,165 |
0.5× |
| Upper GI endoscopy (EGD), diagnostic (43235) |
$1,392 |
$1,392 |
1.5× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$1,915 |
$1,915 |
2.0× |
| Diagnostic colonoscopy (45378) |
$1,700 |
$1,700 |
1.8× |
| Colonoscopy with biopsy (45380) |
$1,965 |
$1,965 |
1.6× |
| Colonoscopy with lesion removal (45385) |
$2,025 |
$2,025 |
1.6× |
| Laparoscopic gallbladder removal (47562) |
$5,740 |
$5,740 |
0.9× |
| Inguinal hernia repair (age 5+) (49505) |
$4,520 |
$4,520 |
1.2× |
| Obstetric care, vaginal delivery (global) (59400) |
$3,440 |
$4,300 |
— |
| Obstetric care, cesarean delivery (global) (59510) |
$4,420 |
$4,420 |
— |
| Epidural injection, lumbar/sacral (with imaging) (62322) |
$1,080 |
$1,080 |
1.2× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$1,900 |
$1,900 |
2.1× |
| CT head/brain without contrast (70450) |
$2,125 |
$2,125 |
19.6× |
| MRI brain without contrast (70551) |
$3,666 |
$3,666 |
14.8× |
| MRI brain with contrast (70552) |
$3,044 |
$3,805 |
8.4× |
| MRI brain without and with contrast (70553) |
$4,150 |
$4,150 |
11.5× |
| X-ray lower spine, 4+ views (72110) |
$545 |
$545 |
5.0× |
| MRI lumbar spine without contrast (72148) |
$3,350 |
$3,350 |
13.5× |
| CT pelvis with contrast (72193) |
$2,450 |
$2,450 |
13.5× |
| MRI lower-extremity joint without contrast (73721) |
$2,730 |
$2,730 |
11.0× |
| CT abdomen and pelvis with contrast (74177) |
$4,665 |
$4,665 |
12.9× |
| Ultrasound, abdomen complete (76700) |
$910 |
$910 |
8.4× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$800 |
$800 |
7.4× |
| Ultrasound, transvaginal (76830) |
$762 |
$762 |
7.0× |
| Mammography, one breast (diagnostic) (77065) |
$375 |
$375 |
4.4× |
| Mammography, both breasts (diagnostic) (77066) |
$465 |
$465 |
4.2× |
| Mammography, screening (bilateral) (77067) |
$400 |
$400 |
4.4× |
| Basic metabolic panel (80048) |
$155 |
$155 |
18.3× |
| Comprehensive metabolic panel (80053) |
$190 |
$190 |
18.0× |
| Obstetric panel (80055) |
$214.40 |
$268 |
4.5× |
| Lipid panel (80061) |
$145 |
$145 |
10.8× |
| Renal function panel (80069) |
$170 |
$170 |
19.6× |
| Hepatic function panel (80076) |
$150 |
$150 |
18.4× |
| Urinalysis, non-automated, with microscopy (81000) |
$36 |
$45 |
9.0× |
| Urinalysis, non-automated, without microscopy (81002) |
$24 |
$30 |
6.9× |
| PSA, total (84153) |
$145 |
$145 |
7.9× |
| Thyroid stimulating hormone (TSH) (84443) |
$140 |
$140 |
8.3× |
| CBC with automated differential (85025) |
$115 |
$115 |
14.8× |
| CBC, automated (85027) |
$62.40 |
$78 |
9.6× |
| Prothrombin time (PT) (85610) |
$70 |
$70 |
16.3× |
| Partial thromboplastin time (PTT) (85730) |
$100 |
$100 |
16.6× |
| Electrocardiogram (ECG), complete (93000) |
$130 |
$130 |
2.1× |
| Sleep study (attended polysomnography) (95810) |
$3,865 |
$3,865 |
4.3× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$110 |
$110 |
3.8× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$220 |
$220 |
1.6× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$320 |
$320 |
2.3× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$420 |
$420 |
3.0× |
| Preventive visit, new patient (age 18–39) (99385) |
$204 |
$255 |
— |
| Preventive visit, new patient (age 40–64) (99386) |
$232 |
$290 |
— |