| Breast lesion removal (open) (19120) |
$776 |
$970 |
0.2× |
Tonsillectomy and adenoidectomy (under age 12) (42820)
likely a partial charge, not the full procedure |
$500.80 |
$626 |
0.1× |
| Upper GI endoscopy (EGD), diagnostic (43235) |
$1,266.40 |
$1,583 |
1.4× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$1,571.60 |
$1,964.50 |
1.8× |
| Diagnostic colonoscopy (45378) |
$1,607.60 |
$2,009.50 |
1.7× |
| Colonoscopy with biopsy (45380) |
$1,695.60 |
$2,119.50 |
1.4× |
| Colonoscopy with lesion removal (45385) |
$1,679.20 |
$2,099 |
1.4× |
| Inguinal hernia repair (age 5+) (49505) |
$9,081.60 |
$11,352 |
2.6× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$392 |
$490 |
0.4× |
| CT head/brain without contrast (70450) |
$1,360 |
$1,700 |
13.2× |
| MRI brain without contrast (70551) |
$1,700 |
$2,125 |
7.2× |
| MRI brain with contrast (70552) |
$2,140 |
$2,675 |
6.2× |
| MRI brain without and with contrast (70553) |
$2,520 |
$3,150 |
7.3× |
| X-ray lower spine, 4+ views (72110) |
$460 |
$575 |
4.5× |
| MRI lumbar spine without contrast (72148) |
$1,720 |
$2,150 |
7.3× |
| CT pelvis with contrast (72193) |
$1,660 |
$2,075 |
9.6× |
| MRI lower-extremity joint without contrast (73721) |
$1,720 |
$2,150 |
7.3× |
| CT abdomen and pelvis with contrast (74177) |
$2,800 |
$3,500 |
8.1× |
| Ultrasound, abdomen complete (76700) |
$660 |
$825 |
6.4× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$560 |
$700 |
5.4× |
| Ultrasound, transvaginal (76830) |
$540 |
$675 |
5.2× |
| Basic metabolic panel (80048) |
$71.20 |
$89 |
8.4× |
| Comprehensive metabolic panel (80053) |
$93.60 |
$117 |
8.9× |
| Obstetric panel (80055) |
$222.40 |
$278 |
4.7× |
| Lipid panel (80061) |
$80 |
$100 |
6.0× |
| Renal function panel (80069) |
$80 |
$100 |
9.2× |
| Hepatic function panel (80076) |
$76.80 |
$96 |
9.4× |
| Urinalysis, non-automated, with microscopy (81000) |
$18 |
$22.50 |
4.5× |
| Urinalysis, non-automated, without microscopy (81002) |
$16 |
$20 |
4.6× |
| PSA, total (84153) |
$113.60 |
$142 |
6.2× |
| Thyroid stimulating hormone (TSH) (84443) |
$86.40 |
$108 |
5.1× |
| CBC with automated differential (85025) |
$66.40 |
$83 |
8.5× |
| CBC, automated (85027) |
$55.20 |
$69 |
8.5× |
| Prothrombin time (PT) (85610) |
$38.40 |
$48 |
9.0× |
| Partial thromboplastin time (PTT) (85730) |
$42.40 |
$53 |
7.1× |
| Psychotherapy, 30 minutes (90832) |
$121.60 |
$152 |
0.7× |
| Psychotherapy, 45 minutes (90834) |
$159.20 |
$199 |
0.9× |
| Psychotherapy, 60 minutes (90837) |
$235.20 |
$294 |
1.3× |
| Electrocardiogram (ECG), complete (93000) |
$200.40 |
$250.50 |
3.4× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$60.40 |
$75.50 |
2.1× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$159.20 |
$199 |
1.2× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$248.80 |
$311 |
1.9× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$320 |
$400 |
2.4× |
| Preventive visit, new patient (age 18–39) (99385) |
$217.60 |
$272 |
— |
| Preventive visit, new patient (age 40–64) (99386) |
$253.60 |
$317 |
— |