| Breast lesion removal (open) (19120) |
$888 |
$1,184 |
0.2× |
| Shoulder arthroscopy with decompression (29826) |
$2,322.38 |
$3,096.50 |
— |
| Knee arthroscopy with meniscectomy (29881) |
$2,741.62 |
$3,655.50 |
0.9× |
| Tonsillectomy and adenoidectomy (under age 12) (42820) |
$5,801.25 |
$7,735 |
1.1× |
| Upper GI endoscopy (EGD), diagnostic (43235) |
$781.12 |
$1,041.50 |
0.9× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$887.25 |
$1,183 |
1.1× |
| Diagnostic colonoscopy (45378) |
$603 |
$804 |
0.7× |
| Colonoscopy with biopsy (45380) |
$1,094.25 |
$1,459 |
1.0× |
| Colonoscopy with lesion removal (45385) |
$644.25 |
$859 |
0.6× |
Laparoscopic gallbladder removal (47562)
likely a partial charge, not the full procedure |
$1,425 |
$1,900 |
0.3× |
| Inguinal hernia repair (age 5+) (49505) |
$2,705.25 |
$3,607 |
0.8× |
| Obstetric care, vaginal delivery (global) (59400) |
$2,452.50 |
$3,270 |
— |
| Obstetric care, cesarean delivery (global) (59510) |
$2,703 |
$3,604 |
— |
| Epidural injection, lumbar/sacral (with imaging) (62322) |
$662.72 |
$883.62 |
0.8× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$442.50 |
$590 |
0.5× |
| CT head/brain without contrast (70450) |
$1,232.25 |
$1,643 |
12.8× |
| MRI brain without contrast (70551) |
$1,551.75 |
$2,069 |
7.1× |
| MRI brain with contrast (70552) |
$799.50 |
$1,066 |
2.5× |
| MRI brain without and with contrast (70553) |
$2,724.75 |
$3,633 |
8.5× |
| X-ray lower spine, 4+ views (72110) |
$571.50 |
$762 |
5.9× |
| MRI lumbar spine without contrast (72148) |
$1,551.75 |
$2,069 |
7.1× |
| CT pelvis with contrast (72193) |
$1,641 |
$2,188 |
10.2× |
| MRI lower-extremity joint without contrast (73721) |
$1,219.12 |
$1,625.50 |
5.6× |
| CT abdomen and pelvis with contrast (74177) |
$1,128.75 |
$1,505 |
3.5× |
| Ultrasound, abdomen complete (76700) |
$717 |
$956 |
7.5× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$560.25 |
$747 |
5.8× |
| Ultrasound, transvaginal (76830) |
$600.75 |
$801 |
6.2× |
| Mammography, one breast (diagnostic) (77065) |
$188.25 |
$251 |
2.2× |
| Mammography, both breasts (diagnostic) (77066) |
$243 |
$324 |
2.2× |
| Mammography, screening (bilateral) (77067) |
$167.25 |
$223 |
1.8× |
| Basic metabolic panel (80048) |
$66.38 |
$88.50 |
7.8× |
| Comprehensive metabolic panel (80053) |
$72.15 |
$96.20 |
6.8× |
| Lipid panel (80061) |
$63.38 |
$84.50 |
4.7× |
| Renal function panel (80069) |
$67.88 |
$90.50 |
7.8× |
| Hepatic function panel (80076) |
$42.94 |
$57.25 |
5.3× |
| Urinalysis, non-automated, with microscopy (81000) |
$21.47 |
$28.62 |
5.3× |
| Urinalysis, non-automated, without microscopy (81002) |
$11.06 |
$14.75 |
3.2× |
| PSA, total (84153) |
$92.06 |
$122.75 |
5.0× |
| Thyroid stimulating hormone (TSH) (84443) |
$59.62 |
$79.50 |
3.5× |
| CBC with automated differential (85025) |
$47.15 |
$62.86 |
6.1× |
| CBC, automated (85027) |
$40.09 |
$53.45 |
6.2× |
| Prothrombin time (PT) (85610) |
$30.10 |
$40.12 |
7.0× |
| Partial thromboplastin time (PTT) (85730) |
$30.38 |
$40.50 |
5.1× |
| Psychotherapy, 30 minutes (90832) |
$174 |
$232 |
1.1× |
| Psychotherapy, 45 minutes (90834) |
$196.88 |
$262.50 |
1.2× |
| Psychotherapy, 60 minutes (90837) |
$238.12 |
$317.50 |
1.5× |
| Family psychotherapy, without patient (50 min) (90846) |
$311.25 |
$415 |
1.9× |
| Family psychotherapy, with patient (50 min) (90847) |
$311.25 |
$415 |
1.9× |
| Group psychotherapy (90853) |
$221.25 |
$295 |
2.4× |
| Electrocardiogram (ECG), complete (93000) |
$32.81 |
$43.75 |
0.6× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$59.25 |
$79 |
2.0× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$164.25 |
$219 |
1.3× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$281.25 |
$375 |
2.3× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$367.50 |
$490 |
3.0× |
| Office consultation (moderate complexity, ~40 min) (99244) |
$247.50 |
$330 |
2.0× |
| Preventive visit, new patient (age 18–39) (99385) |
$186 |
$248 |
— |
| Preventive visit, new patient (age 40–64) (99386) |
$184.50 |
$246 |
— |