| Breast lesion removal (open) (19120) |
$372 |
$465 |
0.1× |
| Shoulder arthroscopy with decompression (29826) |
$2,500 |
$3,125 |
— |
| Knee arthroscopy with meniscectomy (29881) |
$2,372 |
$2,965 |
0.7× |
| Upper GI endoscopy (EGD), diagnostic (43235) |
$320 |
$400 |
0.4× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$657.60 |
$822 |
0.7× |
| Diagnostic colonoscopy (45378) |
$400 |
$500 |
0.4× |
| Colonoscopy with biopsy (45380) |
$400 |
$500 |
0.3× |
| Colonoscopy with lesion removal (45385) |
$480 |
$600 |
0.4× |
Laparoscopic gallbladder removal (47562)
likely a partial charge, not the full procedure |
$1,686.40 |
$2,108 |
0.3× |
| Inguinal hernia repair (age 5+) (49505) |
$1,200 |
$1,500 |
0.3× |
| Epidural injection, lumbar/sacral (with imaging) (62322) |
$795.20 |
$994 |
0.9× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$941.60 |
$1,177 |
1.1× |
| CT head/brain without contrast (70450) |
$303.12 |
$378.90 |
2.9× |
| MRI brain without contrast (70551) |
$379.43 |
$474.29 |
1.6× |
| MRI brain with contrast (70552) |
$536.32 |
$670.40 |
1.6× |
| MRI brain without and with contrast (70553) |
$607 |
$758.76 |
1.8× |
| X-ray lower spine, 4+ views (72110) |
$73.52 |
$91.90 |
0.7× |
| MRI lumbar spine without contrast (72148) |
$368.52 |
$460.65 |
1.6× |
| CT pelvis with contrast (72193) |
$472.40 |
$590.50 |
2.7× |
| MRI lower-extremity joint without contrast (73721) |
$399.50 |
$499.38 |
1.7× |
| CT abdomen and pelvis with contrast (74177) |
$1,008 |
$1,260 |
2.9× |
| Ultrasound, abdomen complete (76700) |
$161.60 |
$202 |
1.6× |
| Ultrasound, transvaginal (76830) |
$170.40 |
$213 |
1.6× |
| Mammography, one breast (diagnostic) (77065) |
$156 |
$195 |
1.8× |
| Mammography, both breasts (diagnostic) (77066) |
$200 |
$250 |
1.8× |
| Mammography, screening (bilateral) (77067) |
$240.80 |
$301 |
2.6× |
| Basic metabolic panel (80048) |
$54.40 |
$68 |
6.4× |
| Comprehensive metabolic panel (80053) |
$67.20 |
$84 |
6.4× |
| Lipid panel (80061) |
$73.20 |
$91.50 |
5.5× |
| Renal function panel (80069) |
$55.20 |
$69 |
6.4× |
| Hepatic function panel (80076) |
$52 |
$65 |
6.4× |
| Urinalysis, non-automated, with microscopy (81000) |
$25.60 |
$32 |
6.4× |
| Urinalysis, non-automated, without microscopy (81002) |
$25.60 |
$32 |
7.4× |
| PSA, total (84153) |
$78.08 |
$97.60 |
4.2× |
| Thyroid stimulating hormone (TSH) (84443) |
$83.20 |
$104 |
5.0× |
| CBC with automated differential (85025) |
$44 |
$55 |
5.7× |
| CBC, automated (85027) |
$41.60 |
$52 |
6.4× |
| Prothrombin time (PT) (85610) |
$27.20 |
$34 |
6.3× |
| Partial thromboplastin time (PTT) (85730) |
$32 |
$40 |
5.3× |
| Psychotherapy, 30 minutes (90832) |
$117.60 |
$147 |
0.7× |
| Psychotherapy, 45 minutes (90834) |
$109.60 |
$137 |
0.6× |
| Psychotherapy, 60 minutes (90837) |
$128 |
$160 |
0.7× |
| Family psychotherapy, without patient (50 min) (90846) |
$128 |
$160 |
0.7× |
| Family psychotherapy, with patient (50 min) (90847) |
$136 |
$170 |
0.8× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$72 |
$90 |
2.5× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$140.80 |
$176 |
1.1× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$216 |
$270 |
1.6× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$240 |
$300 |
1.8× |
| Office consultation (low complexity, ~30 min) (99243) |
$93.60 |
$117 |
0.7× |
| Office consultation (moderate complexity, ~40 min) (99244) |
$288 |
$360 |
2.2× |
| Preventive visit, new patient (age 18–39) (99385) |
$208 |
$260 |
— |
| Preventive visit, new patient (age 40–64) (99386) |
$217.60 |
$272 |
— |