| Breast lesion removal (open) (19120) |
$563.50 |
$1,610 |
0.1× |
| Shoulder arthroscopy with decompression (29826) |
$203.35 |
$581 |
— |
| Knee arthroscopy with meniscectomy (29881) |
$622.65 |
$1,779 |
0.2× |
Tonsillectomy and adenoidectomy (under age 12) (42820)
likely a partial charge, not the full procedure |
$337.75 |
$965 |
0.1× |
| Upper GI endoscopy (EGD), diagnostic (43235) |
$353.15 |
$1,009 |
0.4× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$450.80 |
$1,288 |
0.5× |
| Diagnostic colonoscopy (45378) |
$430.15 |
$1,229 |
0.4× |
| Colonoscopy with biopsy (45380) |
$531.65 |
$1,519 |
0.4× |
| Colonoscopy with lesion removal (45385) |
$557.55 |
$1,593 |
0.4× |
Laparoscopic gallbladder removal (47562)
likely a partial charge, not the full procedure |
$761.25 |
$2,175 |
0.1× |
| Inguinal hernia repair (age 5+) (49505) |
$602 |
$1,720 |
0.2× |
| Obstetric care, vaginal delivery (global) (59400) |
$2,402.75 |
$6,865 |
— |
| Obstetric care, cesarean delivery (global) (59510) |
$3,008.08 |
$8,594.50 |
— |
| Obstetric care, VBAC delivery (global) (59610) |
$2,528.05 |
$7,223 |
— |
| Epidural injection, lumbar/sacral (with imaging) (62322) |
$545.82 |
$1,559.50 |
0.6× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$502.60 |
$1,436 |
0.5× |
| After-cataract laser surgery (YAG capsulotomy) (66821) |
$734.30 |
$2,098 |
1.3× |
| Cataract removal with lens insertion (66984) |
$2,151.45 |
$6,147 |
0.9× |
| CT head/brain without contrast (70450) |
$1,004.32 |
$2,869.50 |
9.0× |
| MRI brain without contrast (70551) |
$1,328.60 |
$3,796 |
5.2× |
| MRI brain with contrast (70552) |
$1,544.72 |
$4,413.50 |
4.1× |
| MRI brain without and with contrast (70553) |
$1,871.10 |
$5,346 |
5.0× |
| X-ray lower spine, 4+ views (72110) |
$47.60 |
$136 |
0.4× |
| MRI lumbar spine without contrast (72148) |
$1,526 |
$4,360 |
6.0× |
| CT pelvis with contrast (72193) |
$1,391.08 |
$3,974.50 |
7.4× |
| MRI lower-extremity joint without contrast (73721) |
$1,141 |
$3,260 |
4.5× |
| CT abdomen and pelvis with contrast (74177) |
$2,235.28 |
$6,386.50 |
6.0× |
| Ultrasound, abdomen complete (76700) |
$503.82 |
$1,439.50 |
4.5× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$92.05 |
$263 |
0.8× |
| Ultrasound, transvaginal (76830) |
$231.35 |
$661 |
2.1× |
| Mammography, one breast (diagnostic) (77065) |
$178.50 |
$510 |
2.1× |
| Mammography, both breasts (diagnostic) (77066) |
$243.42 |
$695.50 |
2.2× |
| Mammography, screening (bilateral) (77067) |
$128.98 |
$368.50 |
1.4× |
| Basic metabolic panel (80048) |
$152.25 |
$435 |
18.0× |
| Comprehensive metabolic panel (80053) |
$183.40 |
$524 |
17.4× |
| Obstetric panel (80055) |
$37.80 |
$108 |
0.8× |
| Lipid panel (80061) |
$140 |
$400 |
10.5× |
| Renal function panel (80069) |
$121.10 |
$346 |
14.0× |
| Hepatic function panel (80076) |
$203 |
$580 |
24.8× |
| Urinalysis, non-automated, with microscopy (81000) |
$5.08 |
$14.50 |
1.3× |
| Urinalysis, non-automated, without microscopy (81002) |
$6.30 |
$18 |
1.8× |
| PSA, total (84153) |
$131.25 |
$375 |
7.1× |
| Thyroid stimulating hormone (TSH) (84443) |
$70 |
$200 |
4.2× |
| CBC with automated differential (85025) |
$13.12 |
$37.50 |
1.7× |
| CBC, automated (85027) |
$64.75 |
$185 |
10.0× |
| Prothrombin time (PT) (85610) |
$7.35 |
$21 |
1.7× |
| Partial thromboplastin time (PTT) (85730) |
$137.20 |
$392 |
22.8× |
| Psychotherapy, 30 minutes (90832) |
$75.95 |
$217 |
0.4× |
| Psychotherapy, 45 minutes (90834) |
$142.45 |
$407 |
0.8× |
| Psychotherapy, 60 minutes (90837) |
$157.85 |
$451 |
0.8× |
| Electrocardiogram (ECG), complete (93000) |
$19.25 |
$55 |
0.3× |
| Left heart catheterization (93452) |
$960.05 |
$2,743 |
0.3× |
| Sleep study (attended polysomnography) (95810) |
$1,112.30 |
$3,178 |
1.2× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$38.32 |
$109.50 |
1.3× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$88.90 |
$254 |
0.6× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$175.70 |
$502 |
1.2× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$219.98 |
$628.50 |
1.5× |
| Office consultation (low complexity, ~30 min) (99243) |
$120.05 |
$343 |
0.8× |
| Office consultation (moderate complexity, ~40 min) (99244) |
$209.48 |
$598.50 |
1.5× |
| Preventive visit, new patient (age 18–39) (99385) |
$147.70 |
$422 |
— |
| Preventive visit, new patient (age 40–64) (99386) |
$171.50 |
$490 |
— |