| Breast lesion removal (open) (19120) |
$2,315.75 |
$2,315.75 |
0.6× |
| Knee arthroscopy with meniscectomy (29881) |
$4,924 |
$4,924 |
1.7× |
| Tonsillectomy and adenoidectomy (under age 12) (42820) |
$6,174 |
$6,174 |
1.1× |
| Upper GI endoscopy (EGD), diagnostic (43235) |
$1,641 |
$1,641 |
2.0× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$2,276.50 |
$2,276.50 |
2.8× |
| Diagnostic colonoscopy (45378) |
$1,283.75 |
$1,283.75 |
1.5× |
| Colonoscopy with biopsy (45380) |
$2,089 |
$2,089 |
1.9× |
| Colonoscopy with lesion removal (45385) |
$3,463.75 |
$3,463.75 |
3.2× |
| Laparoscopic gallbladder removal (47562) |
$11,067.75 |
$11,067.75 |
2.0× |
| Inguinal hernia repair (age 5+) (49505) |
$6,380.50 |
$6,380.50 |
2.0× |
| CT head/brain without contrast (70450) |
$2,275.50 |
$2,275.50 |
23.9× |
| X-ray lower spine, 4+ views (72110) |
$977.50 |
$977.50 |
10.3× |
| CT pelvis with contrast (72193) |
$3,397.12 |
$3,397.12 |
21.3× |
| CT abdomen and pelvis with contrast (74177) |
$3,149.88 |
$3,149.88 |
9.9× |
| Ultrasound, abdomen complete (76700) |
$87.50 |
$87.50 |
0.9× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$534 |
$534 |
5.6× |
| Ultrasound, transvaginal (76830) |
$498.25 |
$498.25 |
5.2× |
| Basic metabolic panel (80048) |
$332.50 |
$332.50 |
39.3× |
| Comprehensive metabolic panel (80053) |
$479 |
$479 |
45.4× |
| Lipid panel (80061) |
$296.50 |
$296.50 |
22.1× |
| Renal function panel (80069) |
$252.75 |
$252.75 |
29.1× |
| Hepatic function panel (80076) |
$929.25 |
$929.25 |
113.7× |
| Urinalysis, non-automated, with microscopy (81000) |
$34 |
$34 |
8.5× |
| Urinalysis, non-automated, without microscopy (81002) |
$14.75 |
$14.75 |
4.2× |
| PSA, total (84153) |
$359.25 |
$359.25 |
19.5× |
| Thyroid stimulating hormone (TSH) (84443) |
$330.75 |
$330.75 |
19.7× |
| CBC with automated differential (85025) |
$154 |
$154 |
19.8× |
| CBC, automated (85027) |
$110.25 |
$110.25 |
17.0× |
| Prothrombin time (PT) (85610) |
$135 |
$135 |
31.5× |
| Partial thromboplastin time (PTT) (85730) |
$119.75 |
$119.75 |
19.9× |
| Psychotherapy, 30 minutes (90832) |
$224 |
$224 |
1.4× |
| Psychotherapy, 45 minutes (90834) |
$378.75 |
$378.75 |
2.3× |
| Psychotherapy, 60 minutes (90837) |
$367.50 |
$367.50 |
2.3× |
| Electrocardiogram (ECG), complete (93000) |
$59 |
$59 |
1.1× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$221 |
$221 |
7.6× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$250.70 |
$259.75 |
2.1× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$306 |
$380 |
2.5× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$388 |
$510 |
3.2× |
| Preventive visit, new patient (age 18–39) (99385) |
$100 |
$253.50 |
— |
| Preventive visit, new patient (age 40–64) (99386) |
$100 |
$302.50 |
— |