| Breast lesion removal (open) (19120) |
— |
$1,861 |
— |
| Shoulder arthroscopy with decompression (29826) |
— |
$729.50 |
— |
| Knee arthroscopy with meniscectomy (29881) |
— |
$3,615.50 |
— |
| Upper GI endoscopy (EGD), diagnostic (43235) |
— |
$558.50 |
— |
| Upper GI endoscopy (EGD) with biopsy (43239) |
— |
$3,057 |
— |
| Diagnostic colonoscopy (45378) |
— |
$1,604 |
— |
| Colonoscopy with biopsy (45380) |
— |
$2,476.50 |
— |
| Colonoscopy with lesion removal (45385) |
— |
$1,810 |
— |
| Colonoscopy with endoscopic ultrasound (45391) |
— |
$1,132 |
— |
| Laparoscopic gallbladder removal (47562) |
— |
$7,676 |
— |
| Inguinal hernia repair (age 5+) (49505) |
— |
$4,096.50 |
— |
| Epidural injection, lumbar/sacral (with imaging) (62322) |
— |
$1,015 |
— |
| Transforaminal epidural injection, lumbar/sacral (64483) |
— |
$437 |
— |
| Cataract removal with lens insertion (66984) |
— |
$3,668 |
— |
| CT head/brain without contrast (70450) |
— |
$2,575.50 |
— |
| MRI brain without contrast (70551) |
— |
$3,441 |
— |
| MRI brain with contrast (70552) |
— |
$3,398 |
— |
| MRI brain without and with contrast (70553) |
— |
$5,143.50 |
— |
| X-ray lower spine, 4+ views (72110) |
— |
$800.50 |
— |
| MRI lumbar spine without contrast (72148) |
— |
$2,754.50 |
— |
| CT pelvis with contrast (72193) |
— |
$3,654.50 |
— |
| MRI lower-extremity joint without contrast (73721) |
— |
$3,289.50 |
— |
| CT abdomen and pelvis with contrast (74177) |
— |
$5,027 |
— |
| Ultrasound, abdomen complete (76700) |
— |
$1,402.50 |
— |
| Ultrasound, transvaginal (76830) |
— |
$816 |
— |
| Mammography, one breast (diagnostic) (77065) |
— |
$447.50 |
— |
| Mammography, both breasts (diagnostic) (77066) |
— |
$254.50 |
— |
| Mammography, screening (bilateral) (77067) |
— |
$289 |
— |
| Basic metabolic panel (80048) |
— |
$191.25 |
— |
| Comprehensive metabolic panel (80053) |
— |
$146.25 |
— |
| Lipid panel (80061) |
— |
$155.50 |
— |
| Renal function panel (80069) |
— |
$248.50 |
— |
| Hepatic function panel (80076) |
— |
$104.75 |
— |
| Urinalysis, non-automated, with microscopy (81000) |
— |
$85.50 |
— |
| Urinalysis, non-automated, without microscopy (81002) |
— |
$29 |
— |
| PSA, total (84153) |
— |
$66.50 |
— |
| Thyroid stimulating hormone (TSH) (84443) |
— |
$28 |
— |
| CBC with automated differential (85025) |
— |
$126 |
— |
| CBC, automated (85027) |
— |
$60 |
— |
| Prothrombin time (PT) (85610) |
— |
$77 |
— |
| Partial thromboplastin time (PTT) (85730) |
— |
$530.25 |
— |
| Sleep study (attended polysomnography) (95810) |
— |
$4,773.50 |
— |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$97.30 |
$139 |
3.3× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
— |
$262 |
— |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
— |
$405 |
— |
| Office visit, new patient (high complexity, ~60 min) (99205) |
— |
$619.50 |
— |
| Office consultation (low complexity, ~30 min) (99243) |
— |
$306 |
— |
| Office consultation (moderate complexity, ~40 min) (99244) |
— |
$338 |
— |
| Preventive visit, new patient (age 18–39) (99385) |
— |
$314.50 |
— |
| Preventive visit, new patient (age 40–64) (99386) |
— |
$362.25 |
— |