| Breast lesion removal (open) (19120) |
$1,030 |
$1,030 |
0.3× |
Tonsillectomy and adenoidectomy (under age 12) (42820)
likely a partial charge, not the full procedure |
$595 |
$595 |
0.1× |
| Upper GI endoscopy (EGD), diagnostic (43235) |
$607 |
$607 |
0.6× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$777 |
$777 |
0.8× |
| Diagnostic colonoscopy (45378) |
$758 |
$758 |
0.8× |
| Colonoscopy with biopsy (45380) |
$979 |
$979 |
0.8× |
| Colonoscopy with lesion removal (45385) |
$1,018 |
$1,018 |
0.8× |
Laparoscopic gallbladder removal (47562)
likely a partial charge, not the full procedure |
$1,288 |
$1,288 |
0.2× |
| Inguinal hernia repair (age 5+) (49505) |
$1,025 |
$1,025 |
0.3× |
| Obstetric care, vaginal delivery (global) (59400) |
$4,690 |
$4,690 |
— |
| Obstetric care, cesarean delivery (global) (59510) |
$5,163 |
$5,163 |
— |
| Obstetric care, VBAC delivery (global) (59610) |
$4,862 |
$4,862 |
— |
| Cataract removal with lens insertion (66984) |
$1,108 |
$1,108 |
0.5× |
| CT head/brain without contrast (70450) |
$2,014 |
$2,014 |
18.6× |
| MRI brain without contrast (70551) |
$4,040 |
$4,040 |
16.3× |
| MRI brain with contrast (70552) |
$4,440 |
$4,440 |
12.3× |
| MRI brain without and with contrast (70553) |
$4,935 |
$4,935 |
13.6× |
| X-ray lower spine, 4+ views (72110) |
$553 |
$553 |
5.1× |
| MRI lumbar spine without contrast (72148) |
$2,940 |
$2,940 |
11.9× |
| CT pelvis with contrast (72193) |
$3,322 |
$3,322 |
18.2× |
| MRI lower-extremity joint without contrast (73721) |
$2,410 |
$2,410 |
9.7× |
| CT abdomen and pelvis with contrast (74177) |
$3,855 |
$3,855 |
10.6× |
| Ultrasound, abdomen complete (76700) |
$949 |
$949 |
8.7× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$693 |
$693 |
6.4× |
| Ultrasound, transvaginal (76830) |
$777 |
$777 |
7.2× |
| Mammography, one breast (diagnostic) (77065) |
$370 |
$370 |
4.3× |
| Mammography, both breasts (diagnostic) (77066) |
$456.50 |
$456.50 |
4.1× |
| Mammography, screening (bilateral) (77067) |
$314 |
$314 |
3.4× |
| Basic metabolic panel (80048) |
$146 |
$146 |
17.3× |
| Comprehensive metabolic panel (80053) |
$161 |
$161 |
15.2× |
| Obstetric panel (80055) |
$672 |
$672 |
14.1× |
| Lipid panel (80061) |
$114 |
$114 |
8.5× |
| Renal function panel (80069) |
$175 |
$175 |
20.2× |
| Hepatic function panel (80076) |
$182 |
$182 |
22.3× |
| Urinalysis, non-automated, without microscopy (81002) |
$39 |
$39 |
11.2× |
| PSA, total (84153) |
$129 |
$129 |
7.0× |
| Thyroid stimulating hormone (TSH) (84443) |
$114.50 |
$114.50 |
6.8× |
| CBC with automated differential (85025) |
$102 |
$102 |
13.1× |
| CBC, automated (85027) |
$105 |
$105 |
16.2× |
| Prothrombin time (PT) (85610) |
$55 |
$55 |
12.8× |
| Partial thromboplastin time (PTT) (85730) |
$111 |
$111 |
18.5× |
| Sleep study (attended polysomnography) (95810) |
$4,579 |
$4,579 |
5.1× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$100 |
$100 |
3.4× |