| Breast lesion removal (open) (19120) |
$490.75 |
$823 |
0.1× |
Shoulder arthroscopy with decompression (29826)
range across 2 matching MRF lines |
$135–$2,474 |
— |
varies |
Knee arthroscopy with meniscectomy (29881)
range across 2 matching MRF lines |
$436–$6,168 |
— |
varies |
Tonsillectomy and adenoidectomy (under age 12) (42820)
likely a partial charge, not the full procedure |
$279.07 |
$468 |
0.0× |
| Upper GI endoscopy (EGD), diagnostic (43235) |
$1,782 |
— |
1.6× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$1,782 |
— |
1.6× |
| Diagnostic colonoscopy (45378) |
$317.83 |
$533 |
0.3× |
| Colonoscopy with biopsy (45380) |
$401.31 |
$673 |
0.3× |
| Colonoscopy with lesion removal (45385) |
$422.78 |
$709 |
0.3× |
Laparoscopic gallbladder removal (47562)
likely a partial charge, not the full procedure |
$623.13 |
$1,045 |
0.1× |
Inguinal hernia repair (age 5+) (49505)
range across 2 matching MRF lines |
$415–$6,710 |
— |
varies |
| Obstetric care, vaginal delivery (global) (59400) |
$2,256.40 |
$3,784 |
— |
| Obstetric care, cesarean delivery (global) (59510) |
$2,498.50 |
$4,190 |
— |
| Obstetric care, VBAC delivery (global) (59610) |
$2,354.79 |
$3,949 |
— |
| Epidural injection, lumbar/sacral (with imaging) (62322) |
$124.63 |
$209 |
0.1× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$228.98 |
$384 |
0.2× |
| CT head/brain without contrast (70450) |
$202 |
— |
1.5× |
| MRI brain without contrast (70551) |
$459 |
— |
1.5× |
| MRI brain with contrast (70552) |
$680 |
— |
1.6× |
| MRI brain without and with contrast (70553) |
$680 |
— |
1.6× |
| X-ray lower spine, 4+ views (72110) |
$202 |
— |
1.5× |
| MRI lumbar spine without contrast (72148) |
$459 |
— |
1.5× |
| CT pelvis with contrast (72193) |
$339 |
— |
1.5× |
| MRI lower-extremity joint without contrast (73721) |
$459 |
— |
1.5× |
| CT abdomen and pelvis with contrast (74177) |
$680 |
— |
1.6× |
| Ultrasound, abdomen complete (76700) |
$202 |
— |
1.5× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$202 |
— |
1.5× |
Ultrasound, transvaginal (76830)
range across 2 matching MRF lines |
$93–$202 |
— |
varies |
| Mammography, one breast (diagnostic) (77065) |
$106 |
— |
1.2× |
| Mammography, both breasts (diagnostic) (77066) |
$136 |
— |
1.2× |
| Mammography, screening (bilateral) (77067) |
$112 |
— |
1.2× |
| Basic metabolic panel (80048) |
$58 |
— |
6.9× |
| Comprehensive metabolic panel (80053) |
$34 |
— |
3.2× |
| Obstetric panel (80055) |
$146.09 |
$245 |
3.1× |
| Lipid panel (80061) |
$44 |
— |
3.3× |
| Renal function panel (80069) |
$10 |
— |
1.2× |
| Hepatic function panel (80076) |
$22 |
— |
2.7× |
| Urinalysis, non-automated, with microscopy (81000) |
$4 |
— |
1.0× |
| Urinalysis, non-automated, without microscopy (81002) |
$12 |
— |
3.4× |
| PSA, total (84153) |
$58 |
— |
3.2× |
| Thyroid stimulating hormone (TSH) (84443) |
$54 |
— |
3.2× |
| CBC with automated differential (85025) |
$24 |
— |
3.1× |
| CBC, automated (85027) |
$24 |
— |
3.7× |
| Prothrombin time (PT) (85610) |
$14 |
— |
3.3× |
| Partial thromboplastin time (PTT) (85730) |
$21 |
— |
3.5× |
Electrocardiogram (ECG), complete (93000)
range across 2 matching MRF lines |
$13.71 |
$23–$33 |
0.2× |
| Sleep study (attended polysomnography) (95810) |
$1,934 |
— |
1.8× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$62 |
— |
2.1× |
Office visit, new patient (low complexity, ~30 min) (99203)
range across 2 matching MRF lines |
$106.14 |
$178–$244 |
0.6× |
Office visit, new patient (moderate complexity, ~45 min) (99204)
range across 2 matching MRF lines |
$159.81 |
$268–$373 |
1.0× |
Office visit, new patient (high complexity, ~60 min) (99205)
range across 2 matching MRF lines |
$211.09 |
$354–$472 |
1.3× |
| Preventive visit, new patient (age 18–39) (99385) |
$118 |
— |
— |
| Preventive visit, new patient (age 40–64) (99386) |
$118 |
— |
— |