| Breast lesion removal (open) (19120) |
$670 |
$837 |
0.2× |
| Upper GI endoscopy (EGD), diagnostic (43235) |
$498 |
$622 |
0.5× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$577 |
$721 |
0.6× |
| Diagnostic colonoscopy (45378) |
$705 |
$881 |
0.8× |
| Colonoscopy with biopsy (45380) |
$775 |
$969 |
0.6× |
| Colonoscopy with lesion removal (45385) |
$998 |
$1,247 |
0.8× |
Laparoscopic gallbladder removal (47562)
likely a partial charge, not the full procedure |
$1,700 |
$2,125 |
0.3× |
| Inguinal hernia repair (age 5+) (49505) |
$1,050 |
$1,313 |
0.3× |
| CT head/brain without contrast (70450) |
$774 |
$968 |
7.4× |
| MRI brain without contrast (70551) |
$1,116 |
$1,395 |
4.7× |
| MRI brain with contrast (70552) |
$1,243 |
$1,554 |
3.5× |
| MRI brain without and with contrast (70553) |
$1,608 |
$2,010 |
4.6× |
| X-ray lower spine, 4+ views (72110) |
$230 |
$288 |
2.2× |
| MRI lumbar spine without contrast (72148) |
$1,116 |
$1,395 |
4.7× |
| CT pelvis with contrast (72193) |
$842 |
$1,052 |
4.8× |
| MRI lower-extremity joint without contrast (73721) |
$1,116 |
$1,395 |
4.7× |
| CT abdomen and pelvis with contrast (74177) |
$1,019 |
$1,274 |
2.9× |
| Ultrasound, abdomen complete (76700) |
$320 |
$400 |
3.0× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$282 |
$352 |
2.7× |
| Ultrasound, transvaginal (76830) |
$282 |
$352 |
2.7× |
| Mammography, one breast (diagnostic) (77065) |
$93 |
$116 |
1.1× |
| Mammography, both breasts (diagnostic) (77066) |
$154 |
$193 |
1.4× |
| Mammography, screening (bilateral) (77067) |
$134 |
$167 |
1.5× |
| Basic metabolic panel (80048) |
$44.50 |
$55.50 |
5.3× |
| Comprehensive metabolic panel (80053) |
$91 |
$114 |
8.6× |
| Lipid panel (80061) |
$75 |
$94 |
5.6× |
| Renal function panel (80069) |
$70 |
$88 |
8.1× |
| Hepatic function panel (80076) |
$89.50 |
$112 |
11.0× |
| Urinalysis, non-automated, with microscopy (81000) |
$15.50 |
$19.50 |
3.9× |
| Urinalysis, non-automated, without microscopy (81002) |
$12 |
$15 |
3.4× |
| PSA, total (84153) |
$50 |
$62.50 |
2.7× |
| Thyroid stimulating hormone (TSH) (84443) |
$75 |
$94 |
4.5× |
| CBC with automated differential (85025) |
$32 |
$40 |
4.1× |
| CBC, automated (85027) |
$43.50 |
$54.50 |
6.7× |
| Prothrombin time (PT) (85610) |
$19.50 |
$24 |
4.5× |
| Partial thromboplastin time (PTT) (85730) |
$28 |
$35 |
4.7× |
| Psychotherapy, 30 minutes (90832) |
$140 |
$175 |
0.8× |
| Psychotherapy, 45 minutes (90834) |
$243 |
$304 |
1.4× |
| Psychotherapy, 60 minutes (90837) |
$194 |
$242.50 |
1.1× |
| Family psychotherapy, with patient (50 min) (90847) |
$240 |
$300 |
1.3× |
| Group psychotherapy (90853) |
$200 |
$250 |
2.0× |
| Electrocardiogram (ECG), complete (93000) |
$56 |
$70 |
0.9× |
| Sleep study (attended polysomnography) (95810) |
$1,785 |
$2,231 |
2.1× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$65.50 |
$82 |
2.3× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$64 |
$80 |
0.5× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$72 |
$90 |
0.5× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$80 |
$100 |
0.6× |
| Office consultation (low complexity, ~30 min) (99243) |
$126 |
$157 |
0.9× |
| Office consultation (moderate complexity, ~40 min) (99244) |
$170 |
$212 |
1.3× |
| Preventive visit, new patient (age 18–39) (99385) |
$194 |
$243 |
— |
| Preventive visit, new patient (age 40–64) (99386) |
$228 |
$285 |
— |