Tonsillectomy and adenoidectomy (under age 12) (42820)
likely a partial charge — not the full procedure |
$1,524.80 |
$1,906 |
0.2× |
| Upper GI endoscopy (EGD), diagnostic (43235) |
$1,632 |
$2,040 |
1.7× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$1,960.80 |
$2,451 |
2.0× |
| Diagnostic colonoscopy (45378) |
$1,870 |
$2,337.50 |
1.9× |
| Colonoscopy with biopsy (45380) |
$1,906.75 |
$2,549.50 |
1.5× |
| Colonoscopy with lesion removal (45385) |
$1,906.75 |
$2,549.50 |
1.5× |
| CT head/brain without contrast (70450) |
$1,160 |
$1,450 |
10.5× |
| MRI brain without contrast (70551) |
$2,081.80 |
$2,974 |
8.3× |
| MRI brain with contrast (70552) |
$2,277.80 |
$3,254 |
6.2× |
| MRI brain without and with contrast (70553) |
$2,874.20 |
$4,106 |
7.8× |
| X-ray lower spine, 4+ views (72110) |
$578 |
$578 |
5.2× |
| MRI lumbar spine without contrast (72148) |
$2,230.20 |
$3,186 |
8.9× |
| CT pelvis with contrast (72193) |
$1,902.60 |
$2,718 |
10.3× |
| CT abdomen and pelvis with contrast (74177) |
$3,395 |
$4,850 |
9.2× |
| Ultrasound, abdomen complete (76700) |
$935 |
$935 |
8.5× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$922 |
$922 |
8.4× |
| Ultrasound, transvaginal (76830) |
$723 |
$723 |
6.6× |
| Mammography, both breasts (diagnostic) (77066) |
$484 |
$484 |
4.4× |
| Mammography, screening (bilateral) (77067) |
$358 |
$358 |
3.9× |
| Basic metabolic panel (80048) |
$158 |
$158 |
18.7× |
| Comprehensive metabolic panel (80053) |
$173 |
$173 |
16.4× |
| Obstetric panel (80055) |
$260.18 |
$260.18 |
5.4× |
| Lipid panel (80061) |
$166 |
$166 |
12.4× |
| Renal function panel (80069) |
$167 |
$167 |
19.2× |
| Hepatic function panel (80076) |
$167 |
$167 |
20.4× |
| Urinalysis, non-automated, with microscopy (81000) |
$60 |
$60 |
14.9× |
| PSA, total (84153) |
$152 |
$152 |
8.3× |
| Thyroid stimulating hormone (TSH) (84443) |
$138 |
$138 |
8.2× |
| CBC with automated differential (85025) |
$55 |
$55 |
7.1× |
| CBC, automated (85027) |
$74 |
$74 |
11.4× |
| Prothrombin time (PT) (85610) |
$71 |
$71 |
16.6× |
| Partial thromboplastin time (PTT) (85730) |
$118 |
$118 |
19.6× |
| Psychotherapy, 30 minutes (90832) |
$185 |
$185 |
1.0× |
| Psychotherapy, 45 minutes (90834) |
$245 |
$245 |
1.3× |
| Psychotherapy, 60 minutes (90837) |
$359 |
$359 |
1.9× |
| Sleep study (attended polysomnography) (95810) |
$2,375.80 |
$3,394 |
2.6× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$283 |
$283 |
2.0× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$421 |
$421 |
3.0× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$556 |
$556 |
4.0× |
| Office consultation (low complexity, ~30 min) (99243) |
$365 |
$365 |
2.6× |
| Office consultation (moderate complexity, ~40 min) (99244) |
$540 |
$540 |
3.8× |
| Preventive visit, new patient (age 18–39) (99385) |
$359 |
$359 |
— |
| Preventive visit, new patient (age 40–64) (99386) |
$312 |
$312 |
— |