| Breast lesion removal (open) (19120) |
$7,957.20 |
$13,262 |
2.2× |
| Shoulder arthroscopy with decompression (29826) |
$14,851.20 |
$24,752 |
— |
| Knee arthroscopy with meniscectomy (29881) |
$8,337 |
$13,895 |
2.8× |
| Tonsillectomy and adenoidectomy (under age 12) (42820) |
$6,732 |
$11,220 |
1.3× |
| Upper GI endoscopy (EGD), diagnostic (43235) |
$3,621.60 |
$6,036 |
4.4× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$3,720.60 |
$6,201 |
4.5× |
| Diagnostic colonoscopy (45378) |
$3,781.20 |
$6,302 |
4.5× |
| Colonoscopy with biopsy (45380) |
$4,284.60 |
$7,141 |
4.0× |
| Colonoscopy with lesion removal (45385) |
$4,484.40 |
$7,474 |
4.1× |
| Laparoscopic gallbladder removal (47562) |
$13,257.60 |
$22,096 |
2.4× |
| Inguinal hernia repair (age 5+) (49505) |
$10,173 |
$16,955 |
3.1× |
| Epidural injection, lumbar/sacral (with imaging) (62322) |
$550.80 |
$918 |
0.7× |
| CT head/brain without contrast (70450) |
$1,339.80 |
$2,233 |
14.2× |
| MRI brain without contrast (70551) |
$2,124 |
$3,540 |
9.8× |
| MRI brain with contrast (70552) |
$2,740.80 |
$4,568 |
8.7× |
| MRI brain without and with contrast (70553) |
$2,986.20 |
$4,977 |
9.5× |
| X-ray lower spine, 4+ views (72110) |
$262.80 |
$438 |
2.8× |
| MRI lumbar spine without contrast (72148) |
$2,124 |
$3,540 |
9.8× |
| CT pelvis with contrast (72193) |
$1,123.20 |
$1,872 |
7.1× |
| MRI lower-extremity joint without contrast (73721) |
$1,432.80 |
$2,388 |
6.6× |
| CT abdomen and pelvis with contrast (74177) |
$2,510.10 |
$4,183.50 |
7.9× |
| Ultrasound, abdomen complete (76700) |
$707.40 |
$1,179 |
7.5× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$1,214.40 |
$2,024 |
12.8× |
| Ultrasound, transvaginal (76830) |
$467.40 |
$779 |
4.9× |
| Mammography, one breast (diagnostic) (77065) |
$214.20 |
$357 |
2.5× |
| Mammography, both breasts (diagnostic) (77066) |
$249.30 |
$415.50 |
2.3× |
| Mammography, screening (bilateral) (77067) |
$233.40 |
$389 |
2.6× |
| Basic metabolic panel (80048) |
$25.20 |
$42 |
3.0× |
| Comprehensive metabolic panel (80053) |
$31.20 |
$52 |
3.0× |
| Obstetric panel (80055) |
$146.40 |
$244 |
3.1× |
| Lipid panel (80061) |
$32.40 |
$54 |
2.4× |
| Renal function panel (80069) |
$100.20 |
$167 |
11.5× |
| Hepatic function panel (80076) |
$82.80 |
$138 |
10.1× |
| Urinalysis, non-automated, with microscopy (81000) |
$19.80 |
$33 |
4.9× |
| Urinalysis, non-automated, without microscopy (81002) |
$15 |
$25 |
4.3× |
| PSA, total (84153) |
$39 |
$65 |
2.1× |
| Thyroid stimulating hormone (TSH) (84443) |
$49.80 |
$83 |
3.0× |
| CBC with automated differential (85025) |
$22.80 |
$38 |
2.9× |
| CBC, automated (85027) |
$33.90 |
$56.50 |
5.2× |
| Prothrombin time (PT) (85610) |
$11.40 |
$19 |
2.7× |
| Partial thromboplastin time (PTT) (85730) |
$48.60 |
$81 |
8.1× |
| Psychotherapy, 30 minutes (90832) |
$54 |
$90 |
0.3× |
| Psychotherapy, 45 minutes (90834) |
$60 |
$100 |
0.4× |
| Family psychotherapy, without patient (50 min) (90846) |
$66 |
$110 |
0.4× |
| Family psychotherapy, with patient (50 min) (90847) |
$84 |
$140 |
0.5× |
| Group psychotherapy (90853) |
$90 |
$150 |
1.0× |
| Left heart catheterization (93452) |
$3,369 |
$5,615 |
1.1× |
| Sleep study (attended polysomnography) (95810) |
$1,215 |
$2,025 |
1.6× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$48 |
$80 |
1.7× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$88.80 |
$148 |
0.7× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$106.20 |
$177 |
0.9× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$147 |
$245 |
1.2× |
| Preventive visit, new patient (age 18–39) (99385) |
$94.20 |
$157 |
— |
| Preventive visit, new patient (age 40–64) (99386) |
$115.20 |
$192 |
— |