| Knee arthroscopy with meniscectomy (29881) |
— |
$754 |
— |
| Upper GI endoscopy (EGD), diagnostic (43235) |
— |
$427 |
— |
| Upper GI endoscopy (EGD) with biopsy (43239) |
— |
$547 |
— |
| Diagnostic colonoscopy (45378) |
— |
$485 |
— |
| Colonoscopy with biopsy (45380) |
— |
$625 |
— |
| Colonoscopy with lesion removal (45385) |
— |
$649 |
— |
| Colonoscopy with endoscopic ultrasound (45391) |
— |
$354 |
— |
| Laparoscopic gallbladder removal (47562) |
— |
$920 |
— |
| Inguinal hernia repair (age 5+) (49505) |
— |
$730 |
— |
| Laparoscopic radical prostatectomy (55866) |
— |
$1,969 |
— |
| Transforaminal epidural injection, lumbar/sacral (64483) |
— |
$350 |
— |
| After-cataract laser surgery (YAG capsulotomy) (66821) |
— |
$459 |
— |
| Cataract removal with lens insertion (66984) |
— |
$740 |
— |
| CT head/brain without contrast (70450) |
— |
$158 |
— |
| MRI brain without contrast (70551) |
— |
$300 |
— |
| MRI brain with contrast (70552) |
— |
$418 |
— |
| MRI brain without and with contrast (70553) |
— |
$493 |
— |
| X-ray lower spine, 4+ views (72110) |
— |
$71 |
— |
| MRI lumbar spine without contrast (72148) |
— |
$294 |
— |
| CT pelvis with contrast (72193) |
— |
$321 |
— |
| MRI lower-extremity joint without contrast (73721) |
— |
$311 |
— |
| CT abdomen and pelvis with contrast (74177) |
— |
$461 |
— |
| Ultrasound, abdomen complete (76700) |
— |
$170 |
— |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
— |
$195 |
— |
| Ultrasound, transvaginal (76830) |
— |
$173 |
— |
| Mammography, one breast (diagnostic) (77065) |
— |
$179 |
— |
| Mammography, both breasts (diagnostic) (77066) |
— |
$226 |
— |
| Mammography, screening (bilateral) (77067) |
— |
$183 |
— |
| Basic metabolic panel (80048) |
— |
$11 |
— |
| Comprehensive metabolic panel (80053) |
— |
$14 |
— |
| Obstetric panel (80055) |
— |
$60 |
— |
| Lipid panel (80061) |
— |
$17 |
— |
| Renal function panel (80069) |
— |
$11 |
— |
| Hepatic function panel (80076) |
— |
$11 |
— |
| Urinalysis, non-automated, with microscopy (81000) |
— |
$6 |
— |
| Urinalysis, non-automated, without microscopy (81002) |
— |
$5 |
— |
| PSA, total (84153) |
— |
$23 |
— |
| Thyroid stimulating hormone (TSH) (84443) |
— |
$21 |
— |
| CBC with automated differential (85025) |
— |
$10 |
— |
| CBC, automated (85027) |
— |
$9 |
— |
| Prothrombin time (PT) (85610) |
— |
$6 |
— |
| Partial thromboplastin time (PTT) (85730) |
— |
$8 |
— |
| Electrocardiogram (ECG), complete (93000) |
— |
$20 |
— |
| Left heart catheterization (93452) |
— |
$1,312 |
— |
| Sleep study (attended polysomnography) (95810) |
— |
$845 |
— |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
— |
$41 |
— |
| Office visit, new patient (low complexity, ~30 min) (99203) |
— |
$155 |
— |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
— |
$230 |
— |
| Office visit, new patient (high complexity, ~60 min) (99205) |
— |
$305 |
— |