| Shoulder arthroscopy with decompression (29826) |
$22,561.47 |
$34,709.96 |
— |
| Knee arthroscopy with meniscectomy (29881) |
$8,710.88 |
$13,401.35 |
2.8× |
| Tonsillectomy and adenoidectomy (under age 12) (42820) |
$5,168.01 |
$7,950.78 |
0.9× |
| Upper GI endoscopy (EGD), diagnostic (43235) |
$2,392.64 |
$3,680.98 |
2.7× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$3,779.72 |
$5,814.95 |
4.3× |
| Diagnostic colonoscopy (45378) |
$2,174.72 |
$3,345.72 |
2.4× |
| Colonoscopy with biopsy (45380) |
$3,506.07 |
$5,393.96 |
3.0× |
| Colonoscopy with lesion removal (45385) |
$3,227.65 |
$4,965.61 |
2.8× |
| Laparoscopic gallbladder removal (47562) |
$12,082.14 |
$18,587.91 |
2.1× |
| Inguinal hernia repair (age 5+) (49505) |
$10,777.96 |
$16,581.48 |
3.1× |
| Epidural injection, lumbar/sacral (with imaging) (62322) |
$8,193.25 |
$12,605 |
9.6× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$2,509 |
$3,860 |
2.9× |
| CT head/brain without contrast (70450) |
$1,209.65 |
$1,861 |
12.0× |
| MRI brain without contrast (70551) |
$2,113.15 |
$3,251 |
9.2× |
| MRI brain with contrast (70552) |
$2,267.85 |
$3,489 |
6.8× |
| MRI brain without and with contrast (70553) |
$3,630.90 |
$5,586 |
10.8× |
| X-ray lower spine, 4+ views (72110) |
$496.60 |
$764 |
4.9× |
| MRI lumbar spine without contrast (72148) |
$2,639.65 |
$4,061 |
11.5× |
| CT pelvis with contrast (72193) |
$1,903.85 |
$2,929 |
11.3× |
| MRI lower-extremity joint without contrast (73721) |
$1,685.45 |
$2,593 |
7.3× |
| CT abdomen and pelvis with contrast (74177) |
$3,545.75 |
$5,455 |
10.6× |
| Ultrasound, abdomen complete (76700) |
$673.40 |
$1,036 |
6.7× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$344.50 |
$530 |
3.4× |
| Ultrasound, transvaginal (76830) |
$709.80 |
$1,092 |
7.1× |
| Mammography, one breast (diagnostic) (77065) |
$148.20 |
$228 |
1.7× |
| Mammography, both breasts (diagnostic) (77066) |
$206.70 |
$318 |
1.9× |
| Mammography, screening (bilateral) (77067) |
$238.88 |
$367.50 |
2.6× |
| Basic metabolic panel (80048) |
$18.85 |
$29 |
2.2× |
| Comprehensive metabolic panel (80053) |
$23.40 |
$36 |
2.2× |
| Obstetric panel (80055) |
$323.70 |
$498 |
6.8× |
| Lipid panel (80061) |
$83.85 |
$129 |
6.3× |
| Renal function panel (80069) |
$31.20 |
$48 |
3.6× |
| Hepatic function panel (80076) |
$22.10 |
$34 |
2.7× |
| Urinalysis, non-automated, with microscopy (81000) |
$16.90 |
$26 |
4.2× |
| Urinalysis, non-automated, without microscopy (81002) |
$29.90 |
$46 |
8.6× |
| PSA, total (84153) |
$96.20 |
$148 |
5.2× |
| Thyroid stimulating hormone (TSH) (84443) |
$35.42 |
$54.50 |
2.1× |
| CBC with automated differential (85025) |
$17.55 |
$27 |
2.3× |
| CBC, automated (85027) |
$14.30 |
$22 |
2.2× |
| Prothrombin time (PT) (85610) |
$47.45 |
$73 |
11.1× |
| Partial thromboplastin time (PTT) (85730) |
$53.30 |
$82 |
8.9× |
| Psychotherapy, 30 minutes (90832) |
$222.95 |
$343 |
1.3× |
| Psychotherapy, 45 minutes (90834) |
$270.40 |
$416 |
1.6× |
| Psychotherapy, 60 minutes (90837) |
$306.80 |
$472 |
1.8× |
| Family psychotherapy, without patient (50 min) (90846) |
$280.80 |
$432 |
1.6× |
| Family psychotherapy, with patient (50 min) (90847) |
$316.55 |
$487 |
1.9× |
| Group psychotherapy (90853) |
$552.50 |
$850 |
5.7× |
| Left heart catheterization (93452) |
$10,086.70 |
$15,518 |
3.2× |
| Sleep study (attended polysomnography) (95810) |
$5,191.22 |
$7,986.50 |
6.3× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$129.35 |
$199 |
4.5× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$221 |
$340 |
1.7× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$293.15 |
$451 |
2.3× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$434.85 |
$669 |
3.4× |