| Breast lesion removal (open) (19120) |
$2,670 |
$8,900 |
0.7× |
| Upper GI endoscopy (EGD), diagnostic (43235) |
$732.24 |
$1,681.97 |
0.9× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$877.86 |
$1,973.22 |
1.1× |
| Diagnostic colonoscopy (45378) |
$712.50 |
$2,500 |
0.8× |
| Colonoscopy with biopsy (45380) |
$755.61 |
$1,926.22 |
0.7× |
| Colonoscopy with lesion removal (45385) |
$850 |
$2,115 |
0.8× |
| Laparoscopic gallbladder removal (47562) |
$4,307.47 |
$6,796.04 |
0.8× |
| Inguinal hernia repair (age 5+) (49505) |
$2,894.99 |
$5,574.99 |
0.9× |
| Epidural injection, lumbar/sacral (with imaging) (62322) |
$316.25 |
$732.50 |
0.4× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$1,381.25 |
$3,475 |
1.7× |
| Cataract removal with lens insertion (66984) |
$1,747.50 |
$5,825 |
0.8× |
| CT head/brain without contrast (70450) |
$375 |
$1,500 |
3.9× |
| MRI brain without contrast (70551) |
$500 |
$2,000 |
2.3× |
| MRI brain with contrast (70552) |
$443.75 |
$1,775 |
1.4× |
| MRI brain without and with contrast (70553) |
$750 |
$3,000 |
2.3× |
| X-ray lower spine, 4+ views (72110) |
$100 |
$500 |
1.0× |
| MRI lumbar spine without contrast (72148) |
$500 |
$2,000 |
2.3× |
| CT pelvis with contrast (72193) |
$500 |
$2,000 |
3.1× |
| MRI lower-extremity joint without contrast (73721) |
$500 |
$2,000 |
2.3× |
| CT abdomen and pelvis with contrast (74177) |
$625 |
$2,500 |
1.9× |
| Ultrasound, abdomen complete (76700) |
$140 |
$700 |
1.5× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$140 |
$700 |
1.5× |
| Ultrasound, transvaginal (76830) |
$140 |
$700 |
1.5× |
| Mammography, one breast (diagnostic) (77065) |
$65 |
$325 |
0.8× |
| Mammography, both breasts (diagnostic) (77066) |
$65 |
$325 |
0.6× |
| Mammography, screening (bilateral) (77067) |
$65 |
$325 |
0.7× |
| Basic metabolic panel (80048) |
$20 |
$100 |
2.4× |
| Comprehensive metabolic panel (80053) |
$25 |
$125 |
2.4× |
| Obstetric panel (80055) |
$40 |
$200 |
0.8× |
| Lipid panel (80061) |
$30 |
$150 |
2.2× |
| Renal function panel (80069) |
$20 |
$100 |
2.3× |
| Hepatic function panel (80076) |
$25 |
$125 |
3.1× |
| Urinalysis, non-automated, with microscopy (81000) |
$10 |
$50 |
2.5× |
| Urinalysis, non-automated, without microscopy (81002) |
$6 |
$30 |
1.7× |
| PSA, total (84153) |
$50 |
$250 |
2.7× |
| Thyroid stimulating hormone (TSH) (84443) |
$30 |
$150 |
1.8× |
| CBC with automated differential (85025) |
$30 |
$150 |
3.9× |
| CBC, automated (85027) |
$30 |
$150 |
4.6× |
| Prothrombin time (PT) (85610) |
$7 |
$35 |
1.6× |
| Partial thromboplastin time (PTT) (85730) |
$15 |
$75 |
2.5× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$22 |
$110 |
0.8× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
— |
$265 |
— |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
— |
$390.50 |
— |
| Office visit, new patient (high complexity, ~60 min) (99205) |
— |
$502 |
— |