| Breast lesion removal (open) (19120) |
$450.22 |
$450.22 |
0.1× |
| Shoulder arthroscopy with decompression (29826) |
$405 |
$405 |
— |
| Upper GI endoscopy (EGD), diagnostic (43235) |
$1,024 |
$1,024 |
1.1× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$865.24 |
$865.24 |
0.9× |
| Diagnostic colonoscopy (45378) |
$1,009.92 |
$1,009.92 |
1.1× |
| Colonoscopy with biopsy (45380) |
$1,018.45 |
$1,018.45 |
0.8× |
| Colonoscopy with lesion removal (45385) |
$1,046.66 |
$1,046.66 |
0.9× |
Laparoscopic gallbladder removal (47562)
likely a partial charge — not the full procedure |
$705.26 |
$705.26 |
0.1× |
| Inguinal hernia repair (age 5+) (49505) |
$560.94 |
$560.94 |
0.2× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$2,018 |
$2,018 |
2.2× |
| CT head/brain without contrast (70450) |
$1,144 |
$1,144 |
10.7× |
| MRI brain without contrast (70551) |
$1,608.50 |
$1,608.50 |
6.6× |
| MRI brain with contrast (70552) |
$2,086.50 |
$2,086.50 |
5.9× |
| MRI brain without and with contrast (70553) |
$2,360.50 |
$2,360.50 |
6.6× |
| X-ray lower spine, 4+ views (72110) |
$372.50 |
$372.50 |
3.5× |
| MRI lumbar spine without contrast (72148) |
$330 |
$330 |
1.4× |
| CT pelvis with contrast (72193) |
$1,240.50 |
$1,240.50 |
6.9× |
| MRI lower-extremity joint without contrast (73721) |
$2,605 |
$2,605 |
10.7× |
| CT abdomen and pelvis with contrast (74177) |
$2,518.50 |
$2,518.50 |
7.1× |
| Ultrasound, abdomen complete (76700) |
$648 |
$648 |
6.1× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$868 |
$868 |
8.1× |
| Ultrasound, transvaginal (76830) |
$421.50 |
$421.50 |
3.9× |
| Mammography, one breast (diagnostic) (77065) |
$148 |
$148 |
1.7× |
| Mammography, both breasts (diagnostic) (77066) |
$508 |
$508 |
4.6× |
| Mammography, screening (bilateral) (77067) |
$282 |
$282 |
3.1× |
| Basic metabolic panel (80048) |
$126.50 |
$126.50 |
15.0× |
| Comprehensive metabolic panel (80053) |
$246 |
$246 |
23.3× |
| Obstetric panel (80055) |
$282 |
$282 |
5.9× |
| Lipid panel (80061) |
$137 |
$137 |
10.2× |
| Renal function panel (80069) |
$194.50 |
$194.50 |
22.4× |
| Hepatic function panel (80076) |
$137.50 |
$137.50 |
16.8× |
| PSA, total (84153) |
$166 |
$166 |
9.0× |
| Thyroid stimulating hormone (TSH) (84443) |
$136 |
$136 |
8.1× |
| CBC with automated differential (85025) |
$1,302 |
$1,302 |
167.6× |
| CBC, automated (85027) |
$84 |
$84 |
13.0× |
| Prothrombin time (PT) (85610) |
$117 |
$117 |
27.3× |
| Partial thromboplastin time (PTT) (85730) |
$129 |
$129 |
21.5× |
| Psychotherapy, 30 minutes (90832) |
$610 |
$610 |
3.4× |
| Psychotherapy, 45 minutes (90834) |
$755 |
$755 |
4.2× |
| Psychotherapy, 60 minutes (90837) |
$770 |
$770 |
4.2× |
| Family psychotherapy, without patient (50 min) (90846) |
$805 |
$805 |
4.4× |
| Family psychotherapy, with patient (50 min) (90847) |
$845 |
$845 |
4.7× |
| Group psychotherapy (90853) |
$735 |
$735 |
7.1× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$31.95 |
$31.95 |
1.1× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$87.95 |
$87.95 |
0.6× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$143.29 |
$143.29 |
1.1× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$194.88 |
$194.88 |
1.4× |
| Office consultation (low complexity, ~30 min) (99243) |
$696 |
$696 |
5.1× |
| Office consultation (moderate complexity, ~40 min) (99244) |
$994 |
$994 |
7.3× |