| Breast lesion removal (open) (19120) |
$1,470.50 |
$1,730 |
0.4× |
| Knee arthroscopy with meniscectomy (29881) |
$3,060 |
$3,600 |
0.9× |
Tonsillectomy and adenoidectomy (under age 12) (42820)
likely a partial charge, not the full procedure |
$910.35 |
$1,071 |
0.1× |
| Upper GI endoscopy (EGD), diagnostic (43235) |
$413.10 |
$486 |
0.4× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$612 |
$720 |
0.7× |
| Diagnostic colonoscopy (45378) |
$652.80 |
$768 |
0.7× |
| Colonoscopy with biopsy (45380) |
$691.05 |
$813 |
0.6× |
| Colonoscopy with lesion removal (45385) |
$793.90 |
$934 |
0.6× |
Laparoscopic gallbladder removal (47562)
likely a partial charge, not the full procedure |
$1,517.25 |
$1,785 |
0.2× |
| Inguinal hernia repair (age 5+) (49505) |
$1,954.15 |
$2,299 |
0.5× |
| Epidural injection, lumbar/sacral (with imaging) (62322) |
$1,222.30 |
$1,438 |
1.3× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$1,757.80 |
$2,068 |
1.9× |
| CT head/brain without contrast (70450) |
$1,513 |
$1,780 |
14.0× |
| MRI brain without contrast (70551) |
$2,435.25 |
$2,865 |
9.9× |
| MRI brain with contrast (70552) |
$2,353.65 |
$2,769 |
6.5× |
| MRI brain without and with contrast (70553) |
$3,208.75 |
$3,775 |
8.9× |
| X-ray lower spine, 4+ views (72110) |
$373.15 |
$439 |
3.5× |
| MRI lumbar spine without contrast (72148) |
$2,358.75 |
$2,775 |
9.6× |
| CT pelvis with contrast (72193) |
$1,548.70 |
$1,822 |
8.6× |
| MRI lower-extremity joint without contrast (73721) |
$2,358.75 |
$2,775 |
9.6× |
| CT abdomen and pelvis with contrast (74177) |
$3,218.10 |
$3,786 |
8.9× |
| Ultrasound, abdomen complete (76700) |
$844.05 |
$993 |
7.8× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$659.60 |
$776 |
6.1× |
| Ultrasound, transvaginal (76830) |
$555.90 |
$654 |
5.2× |
| Mammography, one breast (diagnostic) (77065) |
$396.52 |
$466.50 |
4.6× |
| Mammography, both breasts (diagnostic) (77066) |
$481.10 |
$566 |
4.4× |
| Mammography, screening (bilateral) (77067) |
$416.50 |
$490 |
4.6× |
| Basic metabolic panel (80048) |
$84.58 |
$99.50 |
10.0× |
| Comprehensive metabolic panel (80053) |
$118.15 |
$139 |
11.2× |
| Lipid panel (80061) |
$131.75 |
$155 |
9.8× |
| Renal function panel (80069) |
$137.70 |
$162 |
15.9× |
| Hepatic function panel (80076) |
$77.78 |
$91.50 |
9.5× |
| PSA, total (84153) |
$131.75 |
$155 |
7.2× |
| Thyroid stimulating hormone (TSH) (84443) |
$73.95 |
$87 |
4.4× |
| CBC with automated differential (85025) |
$65.02 |
$76.50 |
8.4× |
| CBC, automated (85027) |
$51 |
$60 |
7.9× |
| Prothrombin time (PT) (85610) |
$51 |
$60 |
11.9× |
| Partial thromboplastin time (PTT) (85730) |
$91.80 |
$108 |
15.3× |
| Psychotherapy, 30 minutes (90832) |
$173.40 |
$204 |
0.9× |
| Psychotherapy, 45 minutes (90834) |
$232.90 |
$274 |
1.3× |
| Psychotherapy, 60 minutes (90837) |
$330.65 |
$389 |
1.8× |
| Family psychotherapy, without patient (50 min) (90846) |
$173.40 |
$204 |
0.9× |
| Family psychotherapy, with patient (50 min) (90847) |
$212.50 |
$250 |
1.2× |
| Sleep study (attended polysomnography) (95810) |
$3,933.80 |
$4,628 |
4.4× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$117.30 |
$138 |
4.0× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$229.50 |
$270 |
1.7× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$294.52 |
$346.50 |
2.1× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$479.40 |
$564 |
3.5× |
| Office consultation (low complexity, ~30 min) (99243) |
$182.75 |
$215 |
1.3× |
| Office consultation (moderate complexity, ~40 min) (99244) |
$407.15 |
$479 |
3.0× |
| Preventive visit, new patient (age 18–39) (99385) |
$266.90 |
$314 |
— |
| Preventive visit, new patient (age 40–64) (99386) |
$300.05 |
$353 |
— |