| Shoulder arthroscopy with decompression (29826) |
$6,042.24 |
$10,417.66 |
— |
| Knee arthroscopy with meniscectomy (29881) |
$5,643.11 |
$9,729.50 |
1.6× |
| Tonsillectomy and adenoidectomy (under age 12) (42820) |
$3,591.94 |
$6,193 |
0.6× |
| Upper GI endoscopy (EGD), diagnostic (43235) |
$1,593.84 |
$2,748 |
1.6× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$1,178.56 |
$2,032 |
1.2× |
| Diagnostic colonoscopy (45378) |
$856.95 |
$1,477.50 |
0.9× |
| Colonoscopy with biopsy (45380) |
$1,036.75 |
$1,787.50 |
0.8× |
| Colonoscopy with lesion removal (45385) |
$1,037.91 |
$1,789.50 |
0.8× |
| Laparoscopic gallbladder removal (47562) |
$11,613.34 |
$20,023 |
1.8× |
| Inguinal hernia repair (age 5+) (49505) |
$6,188.60 |
$10,670 |
1.6× |
| Cataract removal with lens insertion (66984) |
$3,669.66 |
$6,327 |
1.5× |
| CT head/brain without contrast (70450) |
$806.49 |
$1,390.50 |
7.2× |
| MRI brain without contrast (70551) |
$2,161.37 |
$3,726.50 |
8.5× |
| MRI brain with contrast (70552) |
$3,073.71 |
$5,299.50 |
8.3× |
| MRI brain without and with contrast (70553) |
$3,501.46 |
$6,037 |
9.4× |
| X-ray lower spine, 4+ views (72110) |
$428.04 |
$738 |
3.8× |
| MRI lumbar spine without contrast (72148) |
$2,409.90 |
$4,155 |
9.5× |
| CT pelvis with contrast (72193) |
$1,516.12 |
$2,614 |
8.1× |
| MRI lower-extremity joint without contrast (73721) |
$2,424.40 |
$4,180 |
9.5× |
| CT abdomen and pelvis with contrast (74177) |
$3,162.74 |
$5,453 |
8.5× |
| Ultrasound, abdomen complete (76700) |
$615.38 |
$1,061 |
5.5× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$573.62 |
$989 |
5.1× |
| Ultrasound, transvaginal (76830) |
$521.42 |
$899 |
4.7× |
| Mammography, one breast (diagnostic) (77065) |
$532.44 |
$918 |
6.2× |
| Mammography, both breasts (diagnostic) (77066) |
$678.02 |
$1,169 |
6.1× |
| Mammography, screening (bilateral) (77067) |
$562.60 |
$970 |
6.2× |
| Basic metabolic panel (80048) |
$69.31 |
$119.50 |
8.2× |
| Comprehensive metabolic panel (80053) |
$85.26 |
$147 |
8.1× |
| Lipid panel (80061) |
$93.96 |
$162 |
7.0× |
| Renal function panel (80069) |
$71.34 |
$123 |
8.2× |
| Hepatic function panel (80076) |
$73.66 |
$127 |
9.0× |
| Urinalysis, non-automated, with microscopy (81000) |
$11.02 |
$19 |
2.7× |
| Urinalysis, non-automated, without microscopy (81002) |
$7.54 |
$13 |
2.2× |
| PSA, total (84153) |
$127.31 |
$219.50 |
6.9× |
| Thyroid stimulating hormone (TSH) (84443) |
$111.07 |
$191.50 |
6.6× |
| CBC with automated differential (85025) |
$64.67 |
$111.50 |
8.3× |
| CBC, automated (85027) |
$64.96 |
$112 |
10.0× |
| Prothrombin time (PT) (85610) |
$49.88 |
$86 |
11.6× |
| Partial thromboplastin time (PTT) (85730) |
$78.30 |
$135 |
13.0× |
| Sleep study (attended polysomnography) (95810) |
$1,937.78 |
$3,341 |
2.1× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$101.63 |
$175.22 |
3.5× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$122.96 |
$212 |
0.9× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$144.42 |
$249 |
1.0× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$219.24 |
$378 |
1.5× |
| Office consultation (moderate complexity, ~40 min) (99244) |
$140.94 |
$243 |
1.0× |