| Breast lesion removal (open) (19120) |
— |
$16,666.46 |
— |
Shoulder arthroscopy with decompression (29826)
range across 2 matching MRF lines |
— |
$35,529.66–$40,848.63 |
— |
| Knee arthroscopy with meniscectomy (29881) |
— |
$19,746.05 |
— |
Tonsillectomy and adenoidectomy (under age 12) (42820)
range across 2 matching MRF lines |
— |
$12,929.07–$13,138.20 |
— |
| Upper GI endoscopy (EGD), diagnostic (43235) |
— |
$11,617.46 |
— |
| Upper GI endoscopy (EGD) with biopsy (43239) |
— |
$13,497.93 |
— |
| Diagnostic colonoscopy (45378) |
— |
$11,482.46 |
— |
| Colonoscopy with biopsy (45380) |
— |
$13,668.59 |
— |
| Colonoscopy with lesion removal (45385) |
— |
$13,213.33 |
— |
| Colonoscopy with endoscopic ultrasound (45391) |
— |
$49,602 |
— |
| Laparoscopic gallbladder removal (47562) |
— |
$29,526.61 |
— |
| Inguinal hernia repair (age 5+) (49505) |
— |
$28,529.08 |
— |
| Laparoscopic radical prostatectomy (55866) |
— |
$62,725.95 |
— |
| Obstetric care, vaginal delivery (global) (59400) |
— |
$24,701.55 |
— |
| Obstetric care, cesarean delivery (global) (59510) |
— |
$35,059.20 |
— |
| Obstetric care, VBAC delivery (global) (59610) |
— |
$24,702.88 |
— |
| Epidural injection, lumbar/sacral (with imaging) (62322) |
— |
$9,416.48 |
— |
| Transforaminal epidural injection, lumbar/sacral (64483) |
— |
$10,045.84 |
— |
Cataract removal with lens insertion (66984)
range across 3 matching MRF lines |
— |
$10,494.40–$10,824.52 |
— |
| CT head/brain without contrast (70450) |
— |
$4,031.32 |
— |
| MRI brain without contrast (70551) |
— |
$3,561.31 |
— |
| MRI brain with contrast (70552) |
— |
$6,420.31 |
— |
| MRI brain without and with contrast (70553) |
— |
$7,017.89 |
— |
| X-ray lower spine, 4+ views (72110) |
— |
$884.96 |
— |
| MRI lumbar spine without contrast (72148) |
— |
$5,865.70 |
— |
| CT pelvis with contrast (72193) |
— |
$3,895.69 |
— |
| MRI lower-extremity joint without contrast (73721) |
— |
$6,747.97 |
— |
| CT abdomen and pelvis with contrast (74177) |
— |
$8,170.08 |
— |
| Ultrasound, abdomen complete (76700) |
— |
$1,407.34 |
— |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
— |
$1,259.63 |
— |
| Ultrasound, transvaginal (76830) |
— |
$1,407.34 |
— |
| Mammography, one breast (diagnostic) (77065) |
— |
$416.29 |
— |
| Mammography, both breasts (diagnostic) (77066) |
— |
$498.21 |
— |
| Mammography, screening (bilateral) (77067) |
— |
$461.95 |
— |
| Lipid panel (80061) |
— |
$41.63 |
— |
| Hepatic function panel (80076) |
— |
$21.94 |
— |
| CBC with automated differential (85025) |
— |
$35.08 |
— |
| Prothrombin time (PT) (85610) |
— |
$205.47 |
— |
| Partial thromboplastin time (PTT) (85730) |
— |
$205.47 |
— |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
— |
$210.83 |
— |
| Office visit, new patient (low complexity, ~30 min) (99203) |
— |
$541.19 |
— |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
— |
$705.01 |
— |
| Office visit, new patient (high complexity, ~60 min) (99205) |
— |
$498.21 |
— |