| Breast lesion removal (open) (19120) |
$1,056.90 |
$3,523 |
0.3× |
| Shoulder arthroscopy with decompression (29826) |
$1,006.88 |
$3,356.25 |
— |
| Knee arthroscopy with meniscectomy (29881) |
$1,239.35 |
$4,131.17 |
0.4× |
Tonsillectomy and adenoidectomy (under age 12) (42820)
likely a partial charge, not the full procedure |
$1,415.40 |
$4,718 |
0.3× |
| Upper GI endoscopy (EGD), diagnostic (43235) |
$599.10 |
$1,997 |
0.8× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$527.50 |
$1,758.34 |
0.7× |
| Diagnostic colonoscopy (45378) |
$700.80 |
$2,336 |
0.9× |
| Colonoscopy with biopsy (45380) |
$422 |
$1,406.66 |
0.4× |
| Colonoscopy with lesion removal (45385) |
$525.60 |
$1,752 |
0.5× |
Laparoscopic gallbladder removal (47562)
likely a partial charge, not the full procedure |
$1,521.30 |
$5,071 |
0.3× |
| Inguinal hernia repair (age 5+) (49505) |
$1,990.20 |
$6,634 |
0.6× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$563.40 |
$1,878 |
0.7× |
| Cataract removal with lens insertion (66984) |
$1,061.70 |
$3,539 |
0.5× |
| CT head/brain without contrast (70450) |
$632.10 |
$2,107 |
7.0× |
| MRI brain without contrast (70551) |
$785.70 |
$2,619 |
3.8× |
| MRI brain with contrast (70552) |
$447.30 |
$1,491 |
1.5× |
| MRI brain without and with contrast (70553) |
$1,012.95 |
$3,376.50 |
3.4× |
| X-ray lower spine, 4+ views (72110) |
$60.90 |
$203 |
0.7× |
| MRI lumbar spine without contrast (72148) |
$850.20 |
$2,834 |
4.1× |
| CT pelvis with contrast (72193) |
$859.20 |
$2,864 |
5.7× |
| MRI lower-extremity joint without contrast (73721) |
$849 |
$2,830 |
4.1× |
| CT abdomen and pelvis with contrast (74177) |
$746.85 |
$2,489.50 |
2.5× |
| Ultrasound, abdomen complete (76700) |
$237 |
$790 |
2.6× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$273 |
$910 |
3.0× |
| Ultrasound, transvaginal (76830) |
$103.80 |
$346 |
1.2× |
| Mammography, one breast (diagnostic) (77065) |
$105.30 |
$351 |
1.2× |
| Mammography, both breasts (diagnostic) (77066) |
$125.40 |
$418 |
1.1× |
| Mammography, screening (bilateral) (77067) |
$113.40 |
$378 |
1.2× |
| Basic metabolic panel (80048) |
$125.40 |
$418 |
14.8× |
| Comprehensive metabolic panel (80053) |
$78.60 |
$262 |
7.4× |
| Lipid panel (80061) |
$149.85 |
$499.50 |
11.2× |
| Renal function panel (80069) |
$95.85 |
$319.50 |
11.0× |
| Hepatic function panel (80076) |
$60.90 |
$203 |
7.5× |
| Urinalysis, non-automated, without microscopy (81002) |
$18.60 |
$62 |
5.3× |
| PSA, total (84153) |
$116.70 |
$389 |
6.3× |
| Thyroid stimulating hormone (TSH) (84443) |
$21.60 |
$72 |
1.3× |
| CBC with automated differential (85025) |
$51.60 |
$172 |
6.6× |
| CBC, automated (85027) |
$51.60 |
$172 |
8.0× |
| Prothrombin time (PT) (85610) |
$16.80 |
$56 |
3.9× |
| Partial thromboplastin time (PTT) (85730) |
$68.40 |
$228 |
11.4× |
| Sleep study (attended polysomnography) (95810) |
$1,021.95 |
$3,406.50 |
1.4× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$54.60 |
$182 |
1.9× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$82.50 |
$275 |
0.7× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$94.35 |
$314.50 |
0.8× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$77.70 |
$259 |
0.7× |
| Preventive visit, new patient (age 18–39) (99385) |
$48.90 |
$163 |
— |