| Breast lesion removal (open) (19120) |
$2,140.60 |
$3,058 |
0.6× |
| Shoulder arthroscopy with decompression (29826) |
$3,608.50 |
$5,155 |
— |
| Knee arthroscopy with meniscectomy (29881) |
$3,823.40 |
$5,462 |
1.3× |
| Tonsillectomy and adenoidectomy (under age 12) (42820) |
$3,895.50 |
$5,565 |
0.7× |
| Upper GI endoscopy (EGD), diagnostic (43235) |
$645.75 |
$922.50 |
0.8× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$726.25 |
$1,037.50 |
0.9× |
| Diagnostic colonoscopy (45378) |
$883.75 |
$1,262.50 |
1.0× |
| Colonoscopy with biopsy (45380) |
$904.75 |
$1,292.50 |
0.8× |
| Colonoscopy with lesion removal (45385) |
$1,023.75 |
$1,462.50 |
0.9× |
| Laparoscopic gallbladder removal (47562) |
$3,547.25 |
$5,067.50 |
0.6× |
| Inguinal hernia repair (age 5+) (49505) |
$2,054.50 |
$2,935 |
0.6× |
| Obstetric care, vaginal delivery (global) (59400) |
$2,803.50 |
$4,005 |
— |
| Obstetric care, cesarean delivery (global) (59510) |
$4,203.50 |
$6,005 |
— |
| Epidural injection, lumbar/sacral (with imaging) (62322) |
$602 |
$860 |
0.7× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$1,172.50 |
$1,675 |
1.4× |
| After-cataract laser surgery (YAG capsulotomy) (66821) |
$854 |
$1,220 |
1.7× |
| Cataract removal with lens insertion (66984) |
$2,541 |
$3,630 |
1.2× |
| CT head/brain without contrast (70450) |
$337.75 |
$482.50 |
3.5× |
| MRI brain without contrast (70551) |
$325.50 |
$465 |
1.5× |
| MRI brain without and with contrast (70553) |
$733.60 |
$1,048 |
2.3× |
| X-ray lower spine, 4+ views (72110) |
$145.25 |
$207.50 |
1.5× |
| MRI lumbar spine without contrast (72148) |
$481.25 |
$687.50 |
2.2× |
| CT pelvis with contrast (72193) |
$355.25 |
$507.50 |
2.2× |
| MRI lower-extremity joint without contrast (73721) |
$336 |
$480 |
1.5× |
| CT abdomen and pelvis with contrast (74177) |
$505.75 |
$722.50 |
1.6× |
| Ultrasound, abdomen complete (76700) |
$103.25 |
$147.50 |
1.1× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$162.75 |
$232.50 |
1.7× |
| Ultrasound, transvaginal (76830) |
$134.75 |
$192.50 |
1.4× |
| Mammography, one breast (diagnostic) (77065) |
$115.50 |
$165 |
1.3× |
| Mammography, both breasts (diagnostic) (77066) |
$115.50 |
$165 |
1.0× |
| Mammography, screening (bilateral) (77067) |
$115.50 |
$165 |
1.3× |
| Basic metabolic panel (80048) |
$21 |
$30 |
2.5× |
| Comprehensive metabolic panel (80053) |
$25.20 |
$36 |
2.4× |
| Lipid panel (80061) |
$40.60 |
$58 |
3.0× |
| Renal function panel (80069) |
$63 |
$90 |
7.3× |
| Hepatic function panel (80076) |
$32.90 |
$47 |
4.0× |
| Urinalysis, non-automated, without microscopy (81002) |
$13.30 |
$19 |
3.8× |
| PSA, total (84153) |
$79.10 |
$113 |
4.3× |
| Thyroid stimulating hormone (TSH) (84443) |
$44.80 |
$64 |
2.7× |
| CBC with automated differential (85025) |
$16.80 |
$24 |
2.2× |
| CBC, automated (85027) |
$16.80 |
$24 |
2.6× |
| Prothrombin time (PT) (85610) |
$18.20 |
$26 |
4.2× |
| Partial thromboplastin time (PTT) (85730) |
$24.50 |
$35 |
4.1× |
| Psychotherapy, 30 minutes (90832) |
$87.50 |
$125 |
0.5× |
| Psychotherapy, 45 minutes (90834) |
$110.60 |
$158 |
0.7× |
| Psychotherapy, 60 minutes (90837) |
$164.50 |
$235 |
1.0× |
| Electrocardiogram (ECG), complete (93000) |
$175.70 |
$251 |
3.2× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$49 |
$70 |
1.7× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$112 |
$160 |
0.9× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$142.80 |
$204 |
1.2× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$227.50 |
$325 |
1.9× |
| Office consultation (low complexity, ~30 min) (99243) |
$101.50 |
$145 |
0.8× |
| Office consultation (moderate complexity, ~40 min) (99244) |
$156.80 |
$224 |
1.3× |
| Preventive visit, new patient (age 18–39) (99385) |
$189 |
$270 |
— |
| Preventive visit, new patient (age 40–64) (99386) |
$180.60 |
$258 |
— |