| Breast lesion removal (open) (19120) |
$5,538.80 |
$13,847 |
1.2× |
| Upper GI endoscopy (EGD), diagnostic (43235) |
$4,088.80 |
$10,222 |
3.9× |
| Epidural injection, lumbar/sacral (with imaging) (62322) |
$1,879.20 |
$4,698 |
1.8× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$1,418.40 |
$3,546 |
1.4× |
| After-cataract laser surgery (YAG capsulotomy) (66821) |
$1,180.80 |
$2,952 |
1.9× |
| CT head/brain without contrast (70450) |
$1,569.60 |
$3,924 |
13.0× |
| MRI brain without contrast (70551) |
$1,900.40 |
$4,751 |
6.9× |
| MRI brain with contrast (70552) |
$2,479.20 |
$6,198 |
6.1× |
| MRI brain without and with contrast (70553) |
$3,369.60 |
$8,424 |
8.3× |
| X-ray lower spine, 4+ views (72110) |
$427.20 |
$1,068 |
3.5× |
| MRI lumbar spine without contrast (72148) |
$2,332.40 |
$5,831 |
8.4× |
| CT pelvis with contrast (72193) |
$1,829.60 |
$4,574 |
9.0× |
| MRI lower-extremity joint without contrast (73721) |
$2,211.20 |
$5,528 |
8.0× |
| CT abdomen and pelvis with contrast (74177) |
$3,554 |
$8,885 |
8.8× |
| Ultrasound, abdomen complete (76700) |
$808.80 |
$2,022 |
6.7× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$652.80 |
$1,632 |
5.4× |
| Ultrasound, transvaginal (76830) |
$455 |
$1,137.50 |
3.8× |
| Mammography, one breast (diagnostic) (77065) |
$340.80 |
$852 |
4.0× |
| Mammography, both breasts (diagnostic) (77066) |
$421.20 |
$1,053 |
3.8× |
| Mammography, screening (bilateral) (77067) |
$378.80 |
$947 |
4.2× |
| Basic metabolic panel (80048) |
$178.40 |
$446 |
21.1× |
| Comprehensive metabolic panel (80053) |
$228.40 |
$571 |
21.6× |
| Obstetric panel (80055) |
$106.40 |
$266 |
2.2× |
| Lipid panel (80061) |
$166.40 |
$416 |
12.4× |
| Renal function panel (80069) |
$60.80 |
$152 |
7.0× |
| Hepatic function panel (80076) |
$164.80 |
$412 |
20.2× |
| Urinalysis, non-automated, with microscopy (81000) |
$7.20 |
$18 |
1.8× |
| Urinalysis, non-automated, without microscopy (81002) |
$5.20 |
$13 |
1.5× |
| PSA, total (84153) |
$105.60 |
$264 |
5.7× |
| Thyroid stimulating hormone (TSH) (84443) |
$33.60 |
$84 |
2.0× |
| CBC with automated differential (85025) |
$90.40 |
$226 |
11.6× |
| CBC, automated (85027) |
$17.60 |
$44 |
2.7× |
| Prothrombin time (PT) (85610) |
$36.40 |
$91 |
8.5× |
| Partial thromboplastin time (PTT) (85730) |
$75.60 |
$189 |
12.6× |
| Psychotherapy, 30 minutes (90832) |
$199.60 |
$499 |
1.0× |
| Psychotherapy, 45 minutes (90834) |
$308.80 |
$772 |
1.5× |
| Psychotherapy, 60 minutes (90837) |
$308.80 |
$772 |
1.5× |
| Family psychotherapy, without patient (50 min) (90846) |
$130.80 |
$327 |
0.6× |
| Family psychotherapy, with patient (50 min) (90847) |
$130.80 |
$327 |
0.6× |
| Left heart catheterization (93452) |
$7,516.80 |
$18,792 |
2.0× |
| Sleep study (attended polysomnography) (95810) |
$2,611.20 |
$6,528 |
2.6× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$76 |
$190 |
2.6× |