| Breast lesion removal (open) (19120) |
$941 |
$941 |
0.2× |
| Shoulder arthroscopy with decompression (29826) |
$232.50 |
$232.50 |
— |
| Knee arthroscopy with meniscectomy (29881) |
$749 |
$749 |
0.2× |
Tonsillectomy and adenoidectomy (under age 12) (42820)
likely a partial charge, not the full procedure |
$589 |
$589 |
0.1× |
| Upper GI endoscopy (EGD), diagnostic (43235) |
$610 |
$610 |
0.6× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$340.50 |
$340.50 |
0.3× |
| Diagnostic colonoscopy (45378) |
$757 |
$757 |
0.7× |
| Colonoscopy with biopsy (45380) |
$837 |
$837 |
0.6× |
| Colonoscopy with lesion removal (45385) |
$963 |
$963 |
0.7× |
Laparoscopic gallbladder removal (47562)
likely a partial charge, not the full procedure |
$1,967 |
$1,967 |
0.3× |
| Inguinal hernia repair (age 5+) (49505) |
$1,289.50 |
$1,289.50 |
0.3× |
Laparoscopic radical prostatectomy (55866)
likely a partial charge, not the full procedure |
$2,682 |
$2,682 |
0.2× |
| Obstetric care, vaginal delivery (global) (59400) |
$5,000 |
$5,000 |
— |
| Obstetric care, cesarean delivery (global) (59510) |
$5,700 |
$5,700 |
— |
| Obstetric care, VBAC delivery (global) (59610) |
$3,635 |
$3,635 |
— |
| Epidural injection, lumbar/sacral (with imaging) (62322) |
$187 |
$187 |
0.2× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$955.50 |
$955.50 |
1.0× |
| CT head/brain without contrast (70450) |
$1,500 |
$1,500 |
12.9× |
| MRI brain without contrast (70551) |
$2,073 |
$2,073 |
7.8× |
| MRI brain with contrast (70552) |
$2,850 |
$2,850 |
7.3× |
| MRI brain without and with contrast (70553) |
$4,247.50 |
$4,247.50 |
10.9× |
| X-ray lower spine, 4+ views (72110) |
$591 |
$591 |
5.1× |
| MRI lumbar spine without contrast (72148) |
$2,500 |
$2,500 |
9.4× |
| CT pelvis with contrast (72193) |
$1,687 |
$1,687 |
8.6× |
| MRI lower-extremity joint without contrast (73721) |
$2,315.50 |
$2,315.50 |
8.7× |
| CT abdomen and pelvis with contrast (74177) |
$4,000 |
$4,000 |
10.3× |
| Ultrasound, abdomen complete (76700) |
$580 |
$580 |
5.0× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$399 |
$399 |
3.4× |
| Ultrasound, transvaginal (76830) |
$387 |
$387 |
3.3× |
| Mammography, one breast (diagnostic) (77065) |
$350 |
$350 |
4.1× |
| Mammography, both breasts (diagnostic) (77066) |
$400 |
$400 |
3.6× |
| Mammography, screening (bilateral) (77067) |
$375 |
$375 |
4.1× |
| Basic metabolic panel (80048) |
$73.50 |
$73.50 |
8.7× |
| Comprehensive metabolic panel (80053) |
$116 |
$116 |
11.0× |
| Obstetric panel (80055) |
$448 |
$448 |
9.4× |
| Lipid panel (80061) |
$85 |
$85 |
6.3× |
| Renal function panel (80069) |
$92 |
$92 |
10.6× |
| Hepatic function panel (80076) |
$81 |
$81 |
9.9× |
| Urinalysis, non-automated, with microscopy (81000) |
$28 |
$28 |
7.0× |
| Urinalysis, non-automated, without microscopy (81002) |
$15 |
$15 |
4.3× |
| PSA, total (84153) |
$130 |
$130 |
7.1× |
| Thyroid stimulating hormone (TSH) (84443) |
$115 |
$115 |
6.8× |
| CBC with automated differential (85025) |
$68 |
$68 |
8.8× |
| CBC, automated (85027) |
$46 |
$46 |
7.1× |
| Prothrombin time (PT) (85610) |
$44 |
$44 |
10.3× |
| Partial thromboplastin time (PTT) (85730) |
$68 |
$68 |
11.3× |
| Psychotherapy, 30 minutes (90832) |
$138 |
$138 |
0.7× |
| Psychotherapy, 45 minutes (90834) |
$191 |
$191 |
1.0× |
| Psychotherapy, 60 minutes (90837) |
$277 |
$277 |
1.4× |
| Family psychotherapy, without patient (50 min) (90846) |
$208.50 |
$208.50 |
1.1× |
| Family psychotherapy, with patient (50 min) (90847) |
$223 |
$223 |
1.1× |
| Group psychotherapy (90853) |
$58 |
$58 |
0.5× |
| Electrocardiogram (ECG), complete (93000) |
$106 |
$106 |
1.6× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$86 |
$86 |
3.0× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$250 |
$250 |
1.7× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$310 |
$310 |
2.1× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$395 |
$395 |
2.7× |
| Office consultation (low complexity, ~30 min) (99243) |
$300 |
$300 |
2.0× |
| Office consultation (moderate complexity, ~40 min) (99244) |
$400 |
$400 |
2.7× |
| Preventive visit, new patient (age 18–39) (99385) |
$228 |
$228 |
— |
| Preventive visit, new patient (age 40–64) (99386) |
$263 |
$263 |
— |