| Breast lesion removal (open) (19120) |
$3,843.75 |
— |
0.9× |
| Knee arthroscopy with meniscectomy (29881) |
$3,256.87 |
— |
1.0× |
| Tonsillectomy and adenoidectomy (under age 12) (42820) |
$5,938.02 |
— |
1.0× |
| Upper GI endoscopy (EGD), diagnostic (43235) |
$941.10 |
$2,235 |
1.0× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$941.10 |
$2,235 |
1.0× |
| Diagnostic colonoscopy (45378) |
$915.16 |
$2,493 |
0.9× |
| Colonoscopy with biopsy (45380) |
$1,183.54 |
$2,370 |
0.9× |
| Colonoscopy with lesion removal (45385) |
$1,183.54 |
$2,370 |
0.9× |
| Colonoscopy with endoscopic ultrasound (45391) |
$1,183.54 |
— |
0.9× |
| Laparoscopic gallbladder removal (47562) |
$5,856.41 |
$12,900 |
0.9× |
| Inguinal hernia repair (age 5+) (49505) |
$3,542.40 |
— |
0.9× |
| Laparoscopic radical prostatectomy (55866) |
$10,450.57 |
— |
0.9× |
| Epidural injection, lumbar/sacral (with imaging) (62322) |
$893.66 |
— |
1.0× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$893.66 |
— |
1.0× |
| After-cataract laser surgery (YAG capsulotomy) (66821) |
$550.67 |
— |
1.0× |
| Cataract removal with lens insertion (66984) |
$2,289.35 |
— |
0.9× |
| CT head/brain without contrast (70450) |
$106.74 |
$1,375 |
1.0× |
| MRI brain without contrast (70551) |
$242.63 |
$1,600 |
1.0× |
| MRI brain with contrast (70552) |
$358.48 |
$1,105 |
1.0× |
| MRI brain without and with contrast (70553) |
$358.48 |
$3,858 |
1.0× |
| X-ray lower spine, 4+ views (72110) |
$106.74 |
$404 |
1.0× |
| MRI lumbar spine without contrast (72148) |
$242.63 |
$3,038 |
1.0× |
| CT pelvis with contrast (72193) |
$178.69 |
$1,652 |
1.0× |
| MRI lower-extremity joint without contrast (73721) |
$242.63 |
$1,947.50 |
1.0× |
| CT abdomen and pelvis with contrast (74177) |
$358.48 |
$3,255 |
1.0× |
| Ultrasound, abdomen complete (76700) |
$106.74 |
$1,045 |
1.0× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$106.74 |
$380.50 |
1.0× |
| Ultrasound, transvaginal (76830) |
$106.74 |
$1,375 |
1.0× |
| Mammography, one breast (diagnostic) (77065) |
$155.76 |
$147 |
1.8× |
| Mammography, both breasts (diagnostic) (77066) |
$187.98 |
$168 |
1.7× |
| Mammography, screening (bilateral) (77067) |
$147.53 |
$126 |
1.6× |
| Basic metabolic panel (80048) |
$8.46 |
$336 |
1.0× |
| Comprehensive metabolic panel (80053) |
$10.56 |
$453 |
1.0× |
| Obstetric panel (80055) |
$47.81 |
— |
1.0× |
| Lipid panel (80061) |
$13.39 |
$55 |
1.0× |
| Renal function panel (80069) |
$8.68 |
$188 |
1.0× |
| Hepatic function panel (80076) |
$8.17 |
$326 |
1.0× |
| Urinalysis, non-automated, with microscopy (81000) |
$4.02 |
— |
1.0× |
| Urinalysis, non-automated, without microscopy (81002) |
$3.48 |
— |
1.0× |
| PSA, total (84153) |
$18.39 |
$15 |
1.0× |
| Thyroid stimulating hormone (TSH) (84443) |
$16.80 |
$139 |
1.0× |
| CBC with automated differential (85025) |
$7.77 |
$151 |
1.0× |
| CBC, automated (85027) |
$6.47 |
$102 |
1.0× |
| Prothrombin time (PT) (85610) |
$4.29 |
$160 |
1.0× |
| Partial thromboplastin time (PTT) (85730) |
$6.01 |
$204 |
1.0× |
| Psychotherapy, 30 minutes (90832) |
$161.28 |
— |
0.9× |
| Psychotherapy, 45 minutes (90834) |
$161.28 |
— |
0.9× |
| Psychotherapy, 60 minutes (90837) |
$161.28 |
— |
0.9× |
| Family psychotherapy, without patient (50 min) (90846) |
$161.28 |
— |
0.9× |
| Family psychotherapy, with patient (50 min) (90847) |
$161.28 |
— |
0.9× |
| Group psychotherapy (90853) |
$92.85 |
— |
0.9× |
| Left heart catheterization (93452) |
$2,744.28 |
$2,260 |
0.8× |
| Sleep study (attended polysomnography) (95810) |
$1,021.24 |
— |
1.1× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$37.06 |
$78 |
1.3× |