| Shoulder arthroscopy with decompression (29826) |
$668.14 |
$835.17 |
— |
| Knee arthroscopy with meniscectomy (29881) |
$1,726.91 |
$2,158.64 |
0.5× |
Tonsillectomy and adenoidectomy (under age 12) (42820)
likely a partial charge, not the full procedure |
$712.42 |
$890.52 |
0.1× |
| Colonoscopy with biopsy (45380) |
$1,024.08 |
$1,280.10 |
0.9× |
| Colonoscopy with lesion removal (45385) |
$1,079.38 |
$1,349.22 |
0.9× |
Laparoscopic gallbladder removal (47562)
likely a partial charge, not the full procedure |
$1,604.11 |
$2,005.14 |
0.3× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$582.67 |
$728.34 |
0.7× |
| CT head/brain without contrast (70450) |
$520.80 |
$651 |
5.2× |
| MRI brain without contrast (70551) |
$1,632 |
$2,040 |
7.1× |
| MRI brain with contrast (70552) |
$1,720 |
$2,150 |
5.1× |
| MRI brain without and with contrast (70553) |
$1,844 |
$2,305 |
5.5× |
| X-ray lower spine, 4+ views (72110) |
$320.80 |
$401 |
3.2× |
| MRI lumbar spine without contrast (72148) |
$1,041.60 |
$1,302 |
4.5× |
| CT pelvis with contrast (72193) |
$1,260 |
$1,575 |
7.5× |
| MRI lower-extremity joint without contrast (73721) |
$1,175.20 |
$1,469 |
5.1× |
| CT abdomen and pelvis with contrast (74177) |
$1,380 |
$1,725 |
4.1× |
| Ultrasound, abdomen complete (76700) |
$492 |
$615 |
4.9× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$461.60 |
$577 |
4.6× |
| Ultrasound, transvaginal (76830) |
$492 |
$615 |
4.9× |
| Mammography, screening (bilateral) (77067) |
$628.80 |
$786 |
6.9× |
| Basic metabolic panel (80048) |
$61.60 |
$77 |
7.3× |
| Comprehensive metabolic panel (80053) |
$61.60 |
$77 |
5.8× |
| Lipid panel (80061) |
$61.60 |
$77 |
4.6× |
| Renal function panel (80069) |
$69.60 |
$87 |
8.0× |
| Hepatic function panel (80076) |
$69.60 |
$87 |
8.5× |
| PSA, total (84153) |
$64.80 |
$81 |
3.5× |
| Thyroid stimulating hormone (TSH) (84443) |
$92.80 |
$116 |
5.5× |
| CBC with automated differential (85025) |
$42.40 |
$53 |
5.5× |
| CBC, automated (85027) |
$48 |
$60 |
7.4× |
| Prothrombin time (PT) (85610) |
$23.20 |
$29 |
5.4× |
| Partial thromboplastin time (PTT) (85730) |
$26.40 |
$33 |
4.4× |
| Psychotherapy, 30 minutes (90832) |
$488 |
$610 |
2.9× |
| Psychotherapy, 45 minutes (90834) |
$604 |
$755 |
3.5× |
| Psychotherapy, 60 minutes (90837) |
$616 |
$770 |
3.6× |
| Family psychotherapy, without patient (50 min) (90846) |
$644 |
$805 |
3.8× |
| Family psychotherapy, with patient (50 min) (90847) |
$676 |
$845 |
4.0× |
| Group psychotherapy (90853) |
$588 |
$735 |
6.0× |
| Sleep study (attended polysomnography) (95810) |
$3,736 |
$4,670 |
4.5× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$116 |
$145 |
4.0× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$206.40 |
$258 |
1.6× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$310.40 |
$388 |
2.4× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$408.80 |
$511 |
3.2× |