| Breast lesion removal (open) (19120) |
$2,741.40 |
$4,569 |
0.8× |
| Upper GI endoscopy (EGD), diagnostic (43235) |
$1,280.40 |
$2,134 |
1.5× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$1,300.20 |
$2,167 |
1.6× |
| Diagnostic colonoscopy (45378) |
$1,470 |
$2,450 |
1.7× |
| Colonoscopy with biopsy (45380) |
$1,589.40 |
$2,649 |
1.4× |
| Colonoscopy with lesion removal (45385) |
$1,860.60 |
$3,101 |
1.7× |
| Laparoscopic gallbladder removal (47562) |
$7,525.80 |
$12,543 |
1.4× |
| Inguinal hernia repair (age 5+) (49505) |
$3,801.60 |
$6,336 |
1.2× |
| Epidural injection, lumbar/sacral (with imaging) (62322) |
$1,404 |
$2,340 |
1.7× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$1,325.40 |
$2,209 |
1.6× |
| After-cataract laser surgery (YAG capsulotomy) (66821) |
$1,509.90 |
$2,516.50 |
3.0× |
| Cataract removal with lens insertion (66984) |
$3,306 |
$5,510 |
1.6× |
| CT head/brain without contrast (70450) |
$1,158.60 |
$1,931 |
12.0× |
| MRI brain without contrast (70551) |
$1,504.80 |
$2,508 |
6.9× |
| MRI brain with contrast (70552) |
$1,755.60 |
$2,926 |
5.5× |
| MRI brain without and with contrast (70553) |
$2,315.40 |
$3,859 |
7.2× |
| X-ray lower spine, 4+ views (72110) |
$489.60 |
$816 |
5.1× |
| MRI lumbar spine without contrast (72148) |
$1,804.80 |
$3,008 |
8.2× |
| CT pelvis with contrast (72193) |
$1,285.20 |
$2,142 |
8.0× |
| MRI lower-extremity joint without contrast (73721) |
$1,789.20 |
$2,982 |
8.2× |
| CT abdomen and pelvis with contrast (74177) |
$2,588.40 |
$4,314 |
8.1× |
| Ultrasound, abdomen complete (76700) |
$659.40 |
$1,099 |
6.9× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$572.40 |
$954 |
6.0× |
| Ultrasound, transvaginal (76830) |
$406.80 |
$678 |
4.2× |
| Mammography, one breast (diagnostic) (77065) |
$201 |
$335 |
2.3× |
| Mammography, both breasts (diagnostic) (77066) |
$247.20 |
$412 |
2.2× |
| Mammography, screening (bilateral) (77067) |
$195.60 |
$326 |
2.1× |
| Basic metabolic panel (80048) |
$92.40 |
$154 |
10.9× |
| Comprehensive metabolic panel (80053) |
$141 |
$235 |
13.4× |
| Obstetric panel (80055) |
$430.80 |
$718 |
9.0× |
| Lipid panel (80061) |
$120 |
$200 |
9.0× |
| Renal function panel (80069) |
$108.60 |
$181 |
12.5× |
| Hepatic function panel (80076) |
$123 |
$205 |
15.1× |
| PSA, total (84153) |
$103.20 |
$172 |
5.6× |
| Thyroid stimulating hormone (TSH) (84443) |
$118.20 |
$197 |
7.0× |
| CBC with automated differential (85025) |
$69 |
$115 |
8.9× |
| CBC, automated (85027) |
$60 |
$100 |
9.3× |
| Prothrombin time (PT) (85610) |
$47.40 |
$79 |
11.0× |
| Partial thromboplastin time (PTT) (85730) |
$73.80 |
$123 |
12.3× |
| Electrocardiogram (ECG), complete (93000) |
$158.40 |
$264 |
2.9× |
| Sleep study (attended polysomnography) (95810) |
$1,241.40 |
$2,069 |
1.6× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$66.60 |
$111 |
2.3× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$87 |
$145 |
0.7× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$120 |
$200 |
1.0× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$150 |
$250 |
1.2× |