| Breast lesion removal (open) (19120) |
$289 |
$963 |
0.1× |
| Shoulder arthroscopy with decompression (29826) |
$95 |
$316 |
— |
| Knee arthroscopy with meniscectomy (29881) |
$302 |
$1,006 |
0.1× |
Tonsillectomy and adenoidectomy (under age 12) (42820)
likely a partial charge, not the full procedure |
$165 |
$549 |
0.0× |
| Upper GI endoscopy (EGD), diagnostic (43235) |
$484.50 |
$1,614.50 |
0.5× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$223 |
$744 |
0.2× |
| Diagnostic colonoscopy (45378) |
$197 |
$657 |
0.2× |
| Colonoscopy with biopsy (45380) |
$256 |
$853 |
0.2× |
| Colonoscopy with lesion removal (45385) |
$264 |
$881 |
0.2× |
| Colonoscopy with endoscopic ultrasound (45391) |
$143 |
$475 |
0.1× |
Laparoscopic gallbladder removal (47562)
likely a partial charge, not the full procedure |
$363 |
$1,211 |
0.1× |
| Inguinal hernia repair (age 5+) (49505) |
$289 |
$962 |
0.1× |
Laparoscopic radical prostatectomy (55866)
likely a partial charge, not the full procedure |
$812 |
$2,708 |
0.1× |
| Obstetric care, vaginal delivery (global) (59400) |
$1,331 |
$4,435 |
— |
| Obstetric care, cesarean delivery (global) (59510) |
$1,463 |
$4,876 |
— |
| Obstetric care, VBAC delivery (global) (59610) |
$1,384 |
$4,613 |
— |
| Epidural injection, lumbar/sacral (with imaging) (62322) |
$83 |
$277 |
0.1× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$144 |
$481 |
0.2× |
| After-cataract laser surgery (YAG capsulotomy) (66821) |
$187 |
$624 |
0.3× |
| Cataract removal with lens insertion (66984) |
$301 |
$1,003 |
0.1× |
| CT head/brain without contrast (70450) |
$490.50 |
$1,634 |
4.7× |
| MRI brain without contrast (70551) |
$363 |
$1,209 |
1.5× |
| MRI brain with contrast (70552) |
$432.50 |
$1,441 |
1.2× |
| MRI brain without and with contrast (70553) |
$1,142 |
$3,806 |
3.3× |
| X-ray lower spine, 4+ views (72110) |
$180 |
$599.50 |
1.7× |
| MRI lumbar spine without contrast (72148) |
$412.50 |
$1,375.50 |
1.7× |
| CT pelvis with contrast (72193) |
$722.50 |
$2,408 |
4.1× |
| MRI lower-extremity joint without contrast (73721) |
$601 |
$2,002 |
2.5× |
| CT abdomen and pelvis with contrast (74177) |
$1,067 |
$3,556 |
3.0× |
| Ultrasound, abdomen complete (76700) |
$247.50 |
$824.50 |
2.4× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$105 |
$348.50 |
1.0× |
| Ultrasound, transvaginal (76830) |
$100 |
$332 |
1.0× |
| Mammography, one breast (diagnostic) (77065) |
$72 |
$241 |
0.8× |
| Mammography, both breasts (diagnostic) (77066) |
$92 |
$305 |
0.8× |
| Mammography, screening (bilateral) (77067) |
$91 |
$303 |
1.0× |
| Basic metabolic panel (80048) |
$5 |
$18 |
0.6× |
| Comprehensive metabolic panel (80053) |
$25 |
$82 |
2.4× |
| Lipid panel (80061) |
$20 |
$68 |
1.5× |
| Renal function panel (80069) |
$33 |
$111 |
3.8× |
| Hepatic function panel (80076) |
$14 |
$45 |
1.7× |
| Urinalysis, non-automated, with microscopy (81000) |
$10.50 |
$36 |
2.6× |
| Urinalysis, non-automated, without microscopy (81002) |
$6 |
$21 |
1.7× |
| PSA, total (84153) |
$31 |
$103 |
1.7× |
| Thyroid stimulating hormone (TSH) (84443) |
$31 |
$103 |
1.8× |
| CBC with automated differential (85025) |
$19 |
$62 |
2.4× |
| CBC, automated (85027) |
$14.50 |
$49 |
2.2× |
| Prothrombin time (PT) (85610) |
$6 |
$19 |
1.4× |
| Partial thromboplastin time (PTT) (85730) |
$9 |
$31 |
1.5× |
| Psychotherapy, 30 minutes (90832) |
$44 |
$146 |
0.2× |
| Psychotherapy, 45 minutes (90834) |
$58 |
$193 |
0.3× |
| Psychotherapy, 60 minutes (90837) |
$85 |
$283 |
0.5× |
| Family psychotherapy, without patient (50 min) (90846) |
$55 |
$184 |
0.3× |
| Family psychotherapy, with patient (50 min) (90847) |
$58 |
$192 |
0.3× |
| Group psychotherapy (90853) |
$16 |
$52 |
0.2× |
| Electrocardiogram (ECG), complete (93000) |
$8 |
$28 |
0.1× |
| Left heart catheterization (93452) |
$1,656.50 |
$5,521.50 |
0.5× |
| Sleep study (attended polysomnography) (95810) |
$356 |
$1,186 |
0.4× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$25.50 |
$85 |
0.9× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$46 |
$153 |
0.3× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$94 |
$314 |
0.7× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$125 |
$415 |
0.9× |
| Office consultation (low complexity, ~30 min) (99243) |
$184 |
$612 |
1.4× |
| Office consultation (moderate complexity, ~40 min) (99244) |
$223 |
$742 |
1.7× |
| Preventive visit, new patient (age 18–39) (99385) |
$170 |
$567 |
— |
| Preventive visit, new patient (age 40–64) (99386) |
$185 |
$618 |
— |