| Breast lesion removal (open) (19120) |
— |
$3,769 |
— |
| Upper GI endoscopy (EGD), diagnostic (43235) |
— |
$2,148 |
— |
| Upper GI endoscopy (EGD) with biopsy (43239) |
— |
$2,016 |
— |
| Diagnostic colonoscopy (45378) |
— |
$1,756 |
— |
| Colonoscopy with biopsy (45380) |
— |
$2,184 |
— |
| Colonoscopy with lesion removal (45385) |
— |
$2,204 |
— |
| Epidural injection, lumbar/sacral (with imaging) (62322) |
— |
$1,143 |
— |
| Transforaminal epidural injection, lumbar/sacral (64483) |
— |
$4,130 |
— |
| After-cataract laser surgery (YAG capsulotomy) (66821) |
— |
$2,211 |
— |
| CT head/brain without contrast (70450) |
— |
$2,321 |
— |
| MRI brain without contrast (70551) |
— |
$3,144 |
— |
| MRI brain with contrast (70552) |
— |
$4,369 |
— |
| MRI brain without and with contrast (70553) |
— |
$4,982 |
— |
| X-ray lower spine, 4+ views (72110) |
— |
$348 |
— |
| MRI lumbar spine without contrast (72148) |
— |
$3,200 |
— |
| CT pelvis with contrast (72193) |
— |
$2,627 |
— |
| MRI lower-extremity joint without contrast (73721) |
— |
$4,220 |
— |
| CT abdomen and pelvis with contrast (74177) |
— |
$4,402 |
— |
| Ultrasound, abdomen complete (76700) |
— |
$1,136 |
— |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
— |
$827 |
— |
| Ultrasound, transvaginal (76830) |
— |
$787 |
— |
| Mammography, one breast (diagnostic) (77065) |
— |
$527 |
— |
| Mammography, both breasts (diagnostic) (77066) |
— |
$682 |
— |
Mammography, screening (bilateral) (77067)
range across 2 matching MRF lines |
— |
$374–$497 |
— |
| Basic metabolic panel (80048) |
— |
$102 |
— |
| Comprehensive metabolic panel (80053) |
— |
$123 |
— |
| Obstetric panel (80055) |
— |
$461 |
— |
| Lipid panel (80061) |
— |
$99 |
— |
| Renal function panel (80069) |
— |
$114 |
— |
| Hepatic function panel (80076) |
— |
$116 |
— |
| Urinalysis, non-automated, without microscopy (81002) |
— |
$25 |
— |
PSA, total (84153)
range across 2 matching MRF lines |
— |
$18–$130 |
— |
| Thyroid stimulating hormone (TSH) (84443) |
— |
$113 |
— |
| CBC with automated differential (85025) |
— |
$63 |
— |
| CBC, automated (85027) |
— |
$46 |
— |
| Prothrombin time (PT) (85610) |
— |
$39 |
— |
| Partial thromboplastin time (PTT) (85730) |
— |
$87 |
— |
Psychotherapy, 30 minutes (90832)
range across 6 matching MRF lines |
— |
$131–$199 |
— |
Psychotherapy, 45 minutes (90834)
range across 6 matching MRF lines |
— |
$184–$287 |
— |
Psychotherapy, 60 minutes (90837)
range across 4 matching MRF lines |
— |
$225–$405 |
— |
Family psychotherapy, without patient (50 min) (90846)
range across 4 matching MRF lines |
— |
$143–$250 |
— |
Family psychotherapy, with patient (50 min) (90847)
range across 5 matching MRF lines |
— |
$85–$195 |
— |
Group psychotherapy (90853)
range across 5 matching MRF lines |
— |
$68–$284 |
— |
| Left heart catheterization (93452) |
— |
$6,388 |
— |
| Sleep study (attended polysomnography) (95810) |
— |
$5,253 |
— |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
— |
$166 |
— |
| Office visit, new patient (low complexity, ~30 min) (99203) |
— |
$117 |
— |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
— |
$135 |
— |
| Office visit, new patient (high complexity, ~60 min) (99205) |
— |
$165 |
— |
| Office consultation (low complexity, ~30 min) (99243) |
— |
$117 |
— |
| Office consultation (moderate complexity, ~40 min) (99244) |
— |
$123 |
— |
| Preventive visit, new patient (age 18–39) (99385) |
— |
$133 |
— |
| Preventive visit, new patient (age 40–64) (99386) |
— |
$171 |
— |