| Breast lesion removal (open) (19120) |
$3,348 |
$4,185.50 |
0.8× |
| Shoulder arthroscopy with decompression (29826) |
$11,378 |
$14,222 |
— |
| Knee arthroscopy with meniscectomy (29881) |
$5,947 |
$7,434 |
1.8× |
| Tonsillectomy and adenoidectomy (under age 12) (42820) |
$3,587.50 |
$4,484 |
0.6× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$3,151.50 |
$3,939.50 |
3.3× |
| Diagnostic colonoscopy (45378) |
$2,290 |
$2,863 |
2.4× |
| Colonoscopy with biopsy (45380) |
$2,540.50 |
$3,175.50 |
2.0× |
| Colonoscopy with lesion removal (45385) |
$3,389 |
$4,236.50 |
2.7× |
| Laparoscopic gallbladder removal (47562) |
$7,427.50 |
$9,284.50 |
1.2× |
| Inguinal hernia repair (age 5+) (49505) |
$4,537 |
$5,671 |
1.2× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$1,661.50 |
$2,077 |
1.8× |
| CT head/brain without contrast (70450) |
$1,740 |
$2,175 |
16.0× |
| MRI brain without contrast (70551) |
$2,922 |
$3,653 |
11.8× |
| MRI brain with contrast (70552) |
$2,629 |
$3,286 |
7.3× |
| MRI brain without and with contrast (70553) |
$3,301 |
$4,126 |
9.1× |
| X-ray lower spine, 4+ views (72110) |
$446 |
$557 |
4.1× |
| MRI lumbar spine without contrast (72148) |
$2,794 |
$3,492 |
11.3× |
| CT pelvis with contrast (72193) |
$2,068 |
$2,585 |
11.4× |
| MRI lower-extremity joint without contrast (73721) |
$2,182 |
$2,727 |
8.8× |
| CT abdomen and pelvis with contrast (74177) |
$3,964 |
$4,955 |
10.9× |
| Ultrasound, abdomen complete (76700) |
$723 |
$904 |
6.7× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$549 |
$686 |
5.1× |
| Ultrasound, transvaginal (76830) |
$549 |
$686 |
5.1× |
| Mammography, one breast (diagnostic) (77065) |
$292 |
$365.50 |
3.4× |
| Mammography, both breasts (diagnostic) (77066) |
$339.50 |
$424.50 |
3.1× |
| Mammography, screening (bilateral) (77067) |
$297 |
$371 |
3.3× |
| Basic metabolic panel (80048) |
$120 |
$150 |
14.2× |
| Comprehensive metabolic panel (80053) |
$138 |
$172 |
13.1× |
| Lipid panel (80061) |
$104 |
$130 |
7.8× |
| Renal function panel (80069) |
$124 |
$155 |
14.3× |
| Hepatic function panel (80076) |
$119 |
$149 |
14.6× |
| Urinalysis, non-automated, without microscopy (81002) |
$20.50 |
$25.50 |
5.9× |
| PSA, total (84153) |
$108 |
$135 |
5.9× |
| Thyroid stimulating hormone (TSH) (84443) |
$99 |
$124 |
5.9× |
| CBC with automated differential (85025) |
$69 |
$86 |
8.9× |
| CBC, automated (85027) |
$52 |
$65 |
8.0× |
| Prothrombin time (PT) (85610) |
$57 |
$71 |
13.3× |
| Partial thromboplastin time (PTT) (85730) |
$80 |
$100 |
13.3× |
| Psychotherapy, 30 minutes (90832) |
$199.50 |
$249.50 |
1.1× |
| Psychotherapy, 45 minutes (90834) |
$242 |
$302.50 |
1.3× |
| Psychotherapy, 60 minutes (90837) |
$399 |
$499 |
2.2× |
| Family psychotherapy, without patient (50 min) (90846) |
$92 |
$115 |
0.5× |
| Family psychotherapy, with patient (50 min) (90847) |
$263.50 |
$329.50 |
1.4× |
| Group psychotherapy (90853) |
$375 |
$469 |
3.6× |
| Sleep study (attended polysomnography) (95810) |
$3,140 |
$3,925 |
3.5× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$77.50 |
$97 |
2.7× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$179 |
$224 |
1.3× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$255 |
$319 |
1.8× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$217 |
$271.50 |
1.6× |
| Preventive visit, new patient (age 18–39) (99385) |
$277 |
$346 |
— |
| Preventive visit, new patient (age 40–64) (99386) |
$301 |
$376 |
— |