| Shoulder arthroscopy with decompression (29826) |
$2,720 |
$3,200 |
— |
| Knee arthroscopy with meniscectomy (29881) |
$3,651.60 |
$4,296 |
1.1× |
Tonsillectomy and adenoidectomy (under age 12) (42820)
likely a partial charge, not the full procedure |
$1,190 |
$1,400 |
0.2× |
| Upper GI endoscopy (EGD), diagnostic (43235) |
$705.50 |
$830 |
0.8× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$929.48 |
$1,093.50 |
1.0× |
| Diagnostic colonoscopy (45378) |
$819.40 |
$964 |
0.9× |
| Colonoscopy with biopsy (45380) |
$990.25 |
$1,165 |
0.8× |
| Colonoscopy with lesion removal (45385) |
$1,294.12 |
$1,522.50 |
1.1× |
| Inguinal hernia repair (age 5+) (49505) |
$759.90 |
$894 |
0.2× |
| Epidural injection, lumbar/sacral (with imaging) (62322) |
$539.75 |
$635 |
0.6× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$1,100.32 |
$1,294.50 |
1.3× |
| CT head/brain without contrast (70450) |
$1,105 |
$1,300 |
10.7× |
| MRI brain without contrast (70551) |
$1,870 |
$2,200 |
7.9× |
| MRI brain with contrast (70552) |
$1,942.25 |
$2,285 |
5.6× |
| MRI brain without and with contrast (70553) |
$2,507.50 |
$2,950 |
7.3× |
| X-ray lower spine, 4+ views (72110) |
$425 |
$500 |
4.1× |
| MRI lumbar spine without contrast (72148) |
$1,700 |
$2,000 |
7.2× |
| CT pelvis with contrast (72193) |
$1,273.30 |
$1,498 |
7.3× |
| MRI lower-extremity joint without contrast (73721) |
$1,166.62 |
$1,372.50 |
4.9× |
| CT abdomen and pelvis with contrast (74177) |
$2,337.50 |
$2,750 |
6.8× |
| Ultrasound, abdomen complete (76700) |
$607.75 |
$715 |
5.9× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$510 |
$600 |
4.9× |
| Ultrasound, transvaginal (76830) |
$454.75 |
$535 |
4.4× |
| Mammography, screening (bilateral) (77067) |
$171.28 |
$201.50 |
1.9× |
| Basic metabolic panel (80048) |
$75.10 |
$88.36 |
8.9× |
| Comprehensive metabolic panel (80053) |
$104.55 |
$123 |
9.9× |
| Lipid panel (80061) |
$82.88 |
$97.50 |
6.2× |
| Renal function panel (80069) |
$72.25 |
$85 |
8.3× |
| Hepatic function panel (80076) |
$63.75 |
$75 |
7.8× |
| Urinalysis, non-automated, with microscopy (81000) |
$24.11 |
$28.37 |
6.0× |
| Urinalysis, non-automated, without microscopy (81002) |
$20.64 |
$24.28 |
5.9× |
| PSA, total (84153) |
$97.75 |
$115 |
5.3× |
| Thyroid stimulating hormone (TSH) (84443) |
$108.80 |
$128 |
6.5× |
| CBC with automated differential (85025) |
$64.60 |
$76 |
8.3× |
| CBC, automated (85027) |
$51.85 |
$61 |
8.0× |
| Prothrombin time (PT) (85610) |
$37.75 |
$44.41 |
8.8× |
| Partial thromboplastin time (PTT) (85730) |
$52.32 |
$61.56 |
8.7× |
| Electrocardiogram (ECG), complete (93000) |
$179 |
$210.59 |
3.1× |
| Sleep study (attended polysomnography) (95810) |
$1,725.50 |
$2,030 |
2.0× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$65.88 |
$77.50 |
2.3× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$179.78 |
$211.50 |
1.4× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$263.92 |
$310.50 |
2.0× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$365.50 |
$430 |
2.8× |
| Office consultation (moderate complexity, ~40 min) (99244) |
$246.50 |
$290 |
1.9× |