| Breast lesion removal (open) (19120) |
$250.40 |
$626 |
0.1× |
| Shoulder arthroscopy with decompression (29826) |
$633.60 |
$1,584 |
— |
| Knee arthroscopy with meniscectomy (29881) |
$475.20 |
$1,188 |
0.1× |
Tonsillectomy and adenoidectomy (under age 12) (42820)
likely a partial charge, not the full procedure |
$300 |
$750 |
0.0× |
| Upper GI endoscopy (EGD), diagnostic (43235) |
$185.20 |
$463 |
0.2× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$219.60 |
$549 |
0.2× |
| Diagnostic colonoscopy (45378) |
$277.20 |
$693 |
0.3× |
| Colonoscopy with biopsy (45380) |
$332.80 |
$832 |
0.3× |
| Colonoscopy with lesion removal (45385) |
$394.40 |
$986 |
0.3× |
Laparoscopic gallbladder removal (47562)
likely a partial charge, not the full procedure |
$835.60 |
$2,089 |
0.1× |
| Inguinal hernia repair (age 5+) (49505) |
$630 |
$1,575 |
0.2× |
| Obstetric care, vaginal delivery (global) (59400) |
$1,334.80 |
$3,337 |
— |
| Obstetric care, cesarean delivery (global) (59510) |
$1,511.20 |
$3,778 |
— |
| Obstetric care, VBAC delivery (global) (59610) |
$1,405.20 |
$3,513 |
— |
| Epidural injection, lumbar/sacral (with imaging) (62322) |
$135.60 |
$339 |
0.1× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$196 |
$490 |
0.2× |
| After-cataract laser surgery (YAG capsulotomy) (66821) |
$199.60 |
$499 |
0.3× |
| Cataract removal with lens insertion (66984) |
$500.80 |
$1,252 |
0.2× |
| CT head/brain without contrast (70450) |
$328.80 |
$822 |
3.0× |
| MRI brain without contrast (70551) |
$650 |
$1,625 |
2.6× |
| MRI brain with contrast (70552) |
$762.80 |
$1,907 |
2.1× |
| MRI brain without and with contrast (70553) |
$932 |
$2,330 |
2.5× |
| X-ray lower spine, 4+ views (72110) |
$296.40 |
$741 |
2.7× |
| MRI lumbar spine without contrast (72148) |
$538 |
$1,345 |
2.1× |
| CT pelvis with contrast (72193) |
$366.80 |
$917 |
2.0× |
MRI lower-extremity joint without contrast (73721)
range across 2 matching MRF lines |
$565.20–$847.80 |
$1,413–$2,119.50 |
varies |
| CT abdomen and pelvis with contrast (74177) |
$966 |
$2,415 |
2.6× |
| Ultrasound, abdomen complete (76700) |
$580 |
$1,450 |
5.2× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$114.40 |
$286 |
1.0× |
| Ultrasound, transvaginal (76830) |
$176.40 |
$441 |
1.6× |
| Mammography, one breast (diagnostic) (77065) |
$171.20 |
$428 |
2.0× |
| Mammography, both breasts (diagnostic) (77066) |
$322.80 |
$807 |
2.9× |
| Mammography, screening (bilateral) (77067) |
$258.80 |
$647 |
2.8× |
| Basic metabolic panel (80048) |
$44 |
$110 |
5.2× |
| Comprehensive metabolic panel (80053) |
$36.80 |
$92 |
3.5× |
| Obstetric panel (80055) |
$156.40 |
$391 |
3.3× |
| Lipid panel (80061) |
$48.40 |
$121 |
3.6× |
| Renal function panel (80069) |
$33.60 |
$84 |
3.9× |
| Hepatic function panel (80076) |
$24.80 |
$62 |
3.0× |
| Urinalysis, non-automated, without microscopy (81002) |
$16.40 |
$41 |
4.7× |
| PSA, total (84153) |
$82.40 |
$206 |
4.5× |
| Thyroid stimulating hormone (TSH) (84443) |
$50.80 |
$127 |
3.0× |
| CBC with automated differential (85025) |
$42.40 |
$106 |
5.5× |
| CBC, automated (85027) |
$30.40 |
$76 |
4.7× |
| Prothrombin time (PT) (85610) |
$18.40 |
$46 |
4.3× |
| Partial thromboplastin time (PTT) (85730) |
$27.20 |
$68 |
4.5× |
| Left heart catheterization (93452) |
$3,765.20 |
$9,413 |
1.1× |
Sleep study (attended polysomnography) (95810)
range across 2 matching MRF lines |
$126–$2,977.20 |
$315–$7,443 |
varies |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$49.60 |
$124 |
1.7× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$54.80 |
$137 |
0.4× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$83.20 |
$208 |
0.6× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$104.40 |
$261 |
0.7× |