| Shoulder arthroscopy with decompression (29826) |
$2,182.88 |
$13,643 |
— |
| Upper GI endoscopy (EGD), diagnostic (43235) |
$396.64 |
$2,479 |
0.5× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$396.64 |
$2,479 |
0.5× |
| Diagnostic colonoscopy (45378) |
$378.72 |
$2,367 |
0.4× |
| Colonoscopy with biopsy (45380) |
$499.52 |
$3,122 |
0.4× |
| Colonoscopy with lesion removal (45385) |
$499.52 |
$3,122 |
0.4× |
Laparoscopic gallbladder removal (47562)
unusually low: confirm this is the full procedure |
$2,393.60 |
$14,960 |
0.4× |
Laparoscopic radical prostatectomy (55866)
unusually low: confirm this is the full procedure |
$4,275.68 |
$26,723 |
0.4× |
| Cataract removal with lens insertion (66984) |
$998.08 |
$6,238 |
0.5× |
| CT head/brain without contrast (70450) |
$411.52 |
$2,572 |
4.2× |
| MRI brain without contrast (70551) |
$560.48 |
$3,503 |
2.5× |
| MRI brain with contrast (70552) |
$163.36 |
$1,021 |
0.5× |
| MRI brain without and with contrast (70553) |
$1,077.76 |
$6,736 |
3.3× |
| X-ray lower spine, 4+ views (72110) |
$212.32 |
$1,327 |
2.2× |
| MRI lumbar spine without contrast (72148) |
$656 |
$4,100 |
2.9× |
| CT pelvis with contrast (72193) |
$163.36 |
$1,021 |
1.0× |
| MRI lower-extremity joint without contrast (73721) |
$650.08 |
$4,063 |
2.9× |
| CT abdomen and pelvis with contrast (74177) |
$1,058.08 |
$6,613 |
3.2× |
| Ultrasound, abdomen complete (76700) |
$264.64 |
$1,654 |
2.7× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$202.24 |
$1,264 |
2.1× |
| Ultrasound, transvaginal (76830) |
$159.68 |
$998 |
1.6× |
| Mammography, one breast (diagnostic) (77065) |
$64.48 |
$403 |
0.7× |
| Mammography, both breasts (diagnostic) (77066) |
$67.36 |
$421 |
0.6× |
| Mammography, screening (bilateral) (77067) |
$78.40 |
$490 |
0.9× |
| Basic metabolic panel (80048) |
$61.76 |
$386 |
7.3× |
| Comprehensive metabolic panel (80053) |
$64 |
$400 |
6.1× |
| Lipid panel (80061) |
$84 |
$525 |
6.3× |
| Renal function panel (80069) |
$71.84 |
$449 |
8.3× |
| Hepatic function panel (80076) |
$72.64 |
$454 |
8.9× |
| Urinalysis, non-automated, with microscopy (81000) |
$2.08 |
$13 |
0.5× |
| Urinalysis, non-automated, without microscopy (81002) |
$1.60 |
$10 |
0.5× |
| PSA, total (84153) |
$44.80 |
$280 |
2.4× |
| Thyroid stimulating hormone (TSH) (84443) |
$72.48 |
$453 |
4.3× |
| CBC with automated differential (85025) |
$29.28 |
$183 |
3.8× |
| CBC, automated (85027) |
$26.24 |
$164 |
4.1× |
| Prothrombin time (PT) (85610) |
$17.28 |
$108 |
4.0× |
| Partial thromboplastin time (PTT) (85730) |
$20.32 |
$127 |
3.4× |
| Electrocardiogram (ECG), complete (93000) |
$86.08 |
$538 |
1.6× |
| Sleep study (attended polysomnography) (95810) |
$496.80 |
$3,105 |
0.6× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$31.36 |
$196 |
1.1× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$24 |
$150 |
0.2× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$24 |
$150 |
0.2× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$24 |
$150 |
0.2× |