| Breast lesion removal (open) (19120) |
— |
$7,235.95 |
— |
| Knee arthroscopy with meniscectomy (29881) |
— |
$9,809.50 |
— |
| Upper GI endoscopy (EGD), diagnostic (43235) |
— |
$5,972.92 |
— |
| Upper GI endoscopy (EGD) with biopsy (43239) |
— |
$6,132.39 |
— |
| Diagnostic colonoscopy (45378) |
— |
$4,039.78 |
— |
| Colonoscopy with biopsy (45380) |
— |
$5,702.97 |
— |
| Colonoscopy with lesion removal (45385) |
— |
$5,514.59 |
— |
| Colonoscopy with endoscopic ultrasound (45391) |
— |
$8,469.45 |
— |
| Laparoscopic gallbladder removal (47562) |
— |
$21,888.52 |
— |
| Inguinal hernia repair (age 5+) (49505) |
— |
$23,803.37 |
— |
| Transforaminal epidural injection, lumbar/sacral (64483) |
— |
$1,952 |
— |
| CT head/brain without contrast (70450) |
— |
$1,354.50 |
— |
| MRI brain without contrast (70551) |
— |
$1,941 |
— |
| MRI brain with contrast (70552) |
— |
$2,360 |
— |
| MRI brain without and with contrast (70553) |
— |
$3,262.50 |
— |
| X-ray lower spine, 4+ views (72110) |
— |
$611.50 |
— |
| MRI lumbar spine without contrast (72148) |
— |
$2,035 |
— |
| CT pelvis with contrast (72193) |
— |
$2,090.50 |
— |
| MRI lower-extremity joint without contrast (73721) |
— |
$2,110 |
— |
| CT abdomen and pelvis with contrast (74177) |
— |
$2,796.50 |
— |
| Ultrasound, abdomen complete (76700) |
— |
$839 |
— |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
— |
$918 |
— |
| Ultrasound, transvaginal (76830) |
— |
$752.50 |
— |
| Mammography, one breast (diagnostic) (77065) |
— |
$243 |
— |
| Mammography, both breasts (diagnostic) (77066) |
— |
$276 |
— |
| Mammography, screening (bilateral) (77067) |
— |
$243 |
— |
| Basic metabolic panel (80048) |
— |
$153 |
— |
| Comprehensive metabolic panel (80053) |
— |
$195 |
— |
| Lipid panel (80061) |
— |
$176.50 |
— |
| Renal function panel (80069) |
— |
$144 |
— |
| Hepatic function panel (80076) |
— |
$153.50 |
— |
| PSA, total (84153) |
— |
$182.50 |
— |
| Thyroid stimulating hormone (TSH) (84443) |
— |
$175.50 |
— |
| CBC with automated differential (85025) |
— |
$110.50 |
— |
| CBC, automated (85027) |
— |
$110.50 |
— |
| Prothrombin time (PT) (85610) |
— |
$48 |
— |
| Partial thromboplastin time (PTT) (85730) |
— |
$104.50 |
— |
| Electrocardiogram (ECG), complete (93000) |
— |
$298 |
— |
| Sleep study (attended polysomnography) (95810) |
— |
$3,500 |
— |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
— |
$117.50 |
— |
| Office visit, new patient (low complexity, ~30 min) (99203) |
— |
$258 |
— |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
— |
$350.82 |
— |
| Office visit, new patient (high complexity, ~60 min) (99205) |
— |
$464.40 |
— |