| Shoulder arthroscopy with decompression (29826) |
$1,592.64 |
$3,318 |
— |
| Knee arthroscopy with meniscectomy (29881) |
$2,416.80 |
$5,035 |
0.7× |
| Upper GI endoscopy (EGD), diagnostic (43235) |
$1,021.68 |
$2,128.50 |
1.0× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$1,099.20 |
$2,290 |
1.1× |
| Diagnostic colonoscopy (45378) |
$1,156.32 |
$2,409 |
1.1× |
| Colonoscopy with biopsy (45380) |
$1,156.32 |
$2,409 |
0.9× |
| Colonoscopy with lesion removal (45385) |
$1,189.44 |
$2,478 |
0.9× |
| Laparoscopic gallbladder removal (47562) |
$4,625.04 |
$9,635.50 |
0.7× |
| Inguinal hernia repair (age 5+) (49505) |
$2,671.20 |
$5,565 |
0.7× |
| Epidural injection, lumbar/sacral (with imaging) (62322) |
$543.12 |
$1,131.50 |
0.6× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$360 |
$750 |
0.4× |
| CT head/brain without contrast (70450) |
$604.32 |
$1,259 |
5.2× |
| MRI brain without contrast (70551) |
$923.52 |
$1,924 |
3.5× |
| MRI brain with contrast (70552) |
$1,198.56 |
$2,497 |
3.1× |
| MRI brain without and with contrast (70553) |
$1,355.04 |
$2,823 |
3.5× |
| X-ray lower spine, 4+ views (72110) |
$203.52 |
$424 |
1.7× |
| MRI lumbar spine without contrast (72148) |
$969.36 |
$2,019.50 |
3.6× |
| CT pelvis with contrast (72193) |
$682.08 |
$1,421 |
3.5× |
| MRI lower-extremity joint without contrast (73721) |
$1,055.76 |
$2,199.50 |
4.0× |
| CT abdomen and pelvis with contrast (74177) |
$1,563.60 |
$3,257.50 |
4.0× |
| Ultrasound, abdomen complete (76700) |
$330.96 |
$689.50 |
2.8× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$330.96 |
$689.50 |
2.8× |
| Ultrasound, transvaginal (76830) |
$295.20 |
$615 |
2.5× |
| Mammography, one breast (diagnostic) (77065) |
$272.64 |
$568 |
3.2× |
| Mammography, both breasts (diagnostic) (77066) |
$231.60 |
$482.50 |
2.1× |
| Mammography, screening (bilateral) (77067) |
$188.40 |
$392.50 |
2.1× |
| Basic metabolic panel (80048) |
$55.20 |
$115 |
6.5× |
| Comprehensive metabolic panel (80053) |
$42.24 |
$88 |
4.0× |
| Lipid panel (80061) |
$38.64 |
$80.50 |
2.9× |
| Renal function panel (80069) |
$64.80 |
$135 |
7.5× |
| Hepatic function panel (80076) |
$60 |
$125 |
7.3× |
| Urinalysis, non-automated, without microscopy (81002) |
$15.36 |
$32 |
4.4× |
| PSA, total (84153) |
$42 |
$87.50 |
2.3× |
| Thyroid stimulating hormone (TSH) (84443) |
$50.40 |
$105 |
3.0× |
| CBC with automated differential (85025) |
$33.60 |
$70 |
4.3× |
| CBC, automated (85027) |
$43.20 |
$90 |
6.7× |
| Prothrombin time (PT) (85610) |
$34.32 |
$71.50 |
8.0× |
| Partial thromboplastin time (PTT) (85730) |
$52.80 |
$110 |
8.8× |
| Psychotherapy, 30 minutes (90832) |
$134.88 |
$281 |
0.7× |
| Psychotherapy, 45 minutes (90834) |
$155.52 |
$324 |
0.8× |
| Psychotherapy, 60 minutes (90837) |
$180.96 |
$377 |
0.9× |
| Family psychotherapy, without patient (50 min) (90846) |
$152.64 |
$318 |
0.8× |
| Family psychotherapy, with patient (50 min) (90847) |
$277.44 |
$578 |
1.4× |
| Group psychotherapy (90853) |
$96.96 |
$202 |
0.9× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$53.76 |
$112 |
1.8× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$180 |
$375 |
1.2× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$216 |
$450 |
1.5× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$264 |
$550 |
1.8× |
| Office consultation (low complexity, ~30 min) (99243) |
$336 |
$700 |
2.3× |
| Preventive visit, new patient (age 18–39) (99385) |
$170.88 |
$356 |
— |
| Preventive visit, new patient (age 40–64) (99386) |
$178.08 |
$371 |
— |