| Breast lesion removal (open) (19120) |
$1,087.50 |
$1,087.50 |
0.3× |
| Shoulder arthroscopy with decompression (29826) |
$394 |
$394 |
— |
| Knee arthroscopy with meniscectomy (29881) |
$1,215 |
$1,215 |
0.4× |
Tonsillectomy and adenoidectomy (under age 12) (42820)
likely a partial charge, not the full procedure |
$698 |
$698 |
0.1× |
| Upper GI endoscopy (EGD), diagnostic (43235) |
$667.50 |
$667.50 |
0.8× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$770.25 |
$770.25 |
0.9× |
| Diagnostic colonoscopy (45378) |
$884.25 |
$884.25 |
1.0× |
| Colonoscopy with biopsy (45380) |
$1,053 |
$1,053 |
0.9× |
| Colonoscopy with lesion removal (45385) |
$1,185.75 |
$1,185.75 |
1.1× |
| Colonoscopy with endoscopic ultrasound (45391) |
$661 |
$661 |
0.6× |
Laparoscopic gallbladder removal (47562)
likely a partial charge, not the full procedure |
$1,663.50 |
$1,663.50 |
0.3× |
| Inguinal hernia repair (age 5+) (49505) |
$1,152.75 |
$1,152.75 |
0.3× |
Laparoscopic radical prostatectomy (55866)
unusually low: confirm this is the full procedure |
$3,161.33 |
$3,161.33 |
0.3× |
| Obstetric care, vaginal delivery (global) (59400) |
$4,223.39 |
$4,223.39 |
— |
| Obstetric care, cesarean delivery (global) (59510) |
$4,691.67 |
$4,691.67 |
— |
| Obstetric care, VBAC delivery (global) (59610) |
$5,056.23 |
$5,056.23 |
— |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$322.20 |
$322.20 |
0.4× |
| X-ray lower spine, 4+ views (72110) |
$103 |
$103 |
1.1× |
| Ultrasound, abdomen complete (76700) |
$313.50 |
$313.50 |
3.2× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$399 |
$399 |
4.1× |
| Ultrasound, transvaginal (76830) |
$344 |
$344 |
3.5× |
| Mammography, one breast (diagnostic) (77065) |
$191.25 |
$191.25 |
2.2× |
| Mammography, both breasts (diagnostic) (77066) |
$245.25 |
$245.25 |
2.2× |
| Basic metabolic panel (80048) |
$34.80 |
$34.80 |
4.1× |
| Comprehensive metabolic panel (80053) |
$44.94 |
$44.94 |
4.3× |
| Lipid panel (80061) |
$53.19 |
$53.19 |
4.0× |
| Renal function panel (80069) |
$40.86 |
$40.86 |
4.7× |
| Hepatic function panel (80076) |
$35.82 |
$35.82 |
4.4× |
| Urinalysis, non-automated, with microscopy (81000) |
$8 |
$8 |
2.0× |
| Urinalysis, non-automated, without microscopy (81002) |
$8 |
$8 |
2.3× |
| PSA, total (84153) |
$50 |
$50 |
2.7× |
| Thyroid stimulating hormone (TSH) (84443) |
$71.40 |
$71.40 |
4.3× |
| CBC with automated differential (85025) |
$31.98 |
$31.98 |
4.1× |
| Prothrombin time (PT) (85610) |
$16.68 |
$16.68 |
3.9× |
| Electrocardiogram (ECG), complete (93000) |
$39 |
$39 |
0.7× |
| Left heart catheterization (93452) |
$566 |
$566 |
0.2× |
| Sleep study (attended polysomnography) (95810) |
$1,424 |
$1,424 |
1.8× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$166 |
$166 |
1.3× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$255.50 |
$255.50 |
2.1× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$318 |
$318 |
2.6× |
| Office consultation (low complexity, ~30 min) (99243) |
$235 |
$235 |
1.9× |
| Office consultation (moderate complexity, ~40 min) (99244) |
$299 |
$299 |
2.4× |
| Preventive visit, new patient (age 18–39) (99385) |
$341 |
$341 |
— |
| Preventive visit, new patient (age 40–64) (99386) |
$394 |
$394 |
— |