| Breast lesion removal (open) (19120) |
$1,285.75 |
$2,571.50 |
0.4× |
| Shoulder arthroscopy with decompression (29826) |
$850 |
$1,700 |
— |
| Knee arthroscopy with meniscectomy (29881) |
$762.50 |
$1,525 |
0.3× |
| Upper GI endoscopy (EGD), diagnostic (43235) |
$550 |
$1,100 |
0.7× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$650 |
$1,300 |
0.8× |
| Diagnostic colonoscopy (45378) |
$550 |
$1,100 |
0.7× |
| Colonoscopy with biopsy (45380) |
$650 |
$1,300 |
0.6× |
| Colonoscopy with lesion removal (45385) |
$650 |
$1,300 |
0.6× |
| Laparoscopic gallbladder removal (47562) |
$2,850 |
$5,700 |
0.5× |
| Inguinal hernia repair (age 5+) (49505) |
$1,718.75 |
$3,437.50 |
0.6× |
| Epidural injection, lumbar/sacral (with imaging) (62322) |
$367.50 |
$735 |
0.5× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$187.50 |
$375 |
0.2× |
| CT head/brain without contrast (70450) |
$339.50 |
$679 |
3.8× |
| MRI brain without contrast (70551) |
$160 |
$320 |
0.8× |
| MRI brain with contrast (70552) |
$217.50 |
$435 |
0.7× |
| MRI brain without and with contrast (70553) |
$239.25 |
$478.50 |
0.8× |
| X-ray lower spine, 4+ views (72110) |
$42.50 |
$85 |
0.5× |
| MRI lumbar spine without contrast (72148) |
$155 |
$310 |
0.8× |
| CT pelvis with contrast (72193) |
$244.25 |
$488.50 |
1.6× |
| MRI lower-extremity joint without contrast (73721) |
$165 |
$330 |
0.8× |
| CT abdomen and pelvis with contrast (74177) |
$647.75 |
$1,295.50 |
2.2× |
| Ultrasound, abdomen complete (76700) |
$76.50 |
$153 |
0.8× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$147.75 |
$295.50 |
1.6× |
| Ultrasound, transvaginal (76830) |
$114 |
$228 |
1.3× |
| Mammography, one breast (diagnostic) (77065) |
$125 |
$250 |
1.5× |
| Mammography, both breasts (diagnostic) (77066) |
$137.50 |
$275 |
1.2× |
| Mammography, screening (bilateral) (77067) |
$125 |
$250 |
1.4× |
| Basic metabolic panel (80048) |
$43.50 |
$87 |
5.1× |
| Comprehensive metabolic panel (80053) |
$44.50 |
$89 |
4.2× |
| Lipid panel (80061) |
$35.25 |
$70.50 |
2.6× |
| Renal function panel (80069) |
$27 |
$54 |
3.1× |
| Hepatic function panel (80076) |
$22 |
$44 |
2.7× |
| PSA, total (84153) |
$21.25 |
$42.50 |
1.2× |
| Thyroid stimulating hormone (TSH) (84443) |
$19.50 |
$39 |
1.2× |
| CBC with automated differential (85025) |
$20 |
$40 |
2.6× |
| CBC, automated (85027) |
$24 |
$48 |
3.7× |
| Prothrombin time (PT) (85610) |
$166.50 |
$333 |
38.8× |
| Partial thromboplastin time (PTT) (85730) |
$17.50 |
$35 |
2.9× |
| Psychotherapy, 30 minutes (90832) |
$59.25 |
$118.50 |
0.4× |
| Psychotherapy, 45 minutes (90834) |
$82 |
$164 |
0.5× |
| Psychotherapy, 60 minutes (90837) |
$90 |
$180 |
0.6× |
| Family psychotherapy, without patient (50 min) (90846) |
$84.25 |
$168.50 |
0.6× |
| Family psychotherapy, with patient (50 min) (90847) |
$140.75 |
$281.50 |
0.9× |
| Group psychotherapy (90853) |
$78 |
$156 |
0.9× |
| Sleep study (attended polysomnography) (95810) |
$1,000 |
$2,000 |
1.4× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$74 |
$148 |
2.5× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$67.75 |
$135.50 |
0.6× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$104.50 |
$209 |
0.9× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$130 |
$260 |
1.1× |
| Office consultation (low complexity, ~30 min) (99243) |
$100 |
$200 |
0.9× |
| Office consultation (moderate complexity, ~40 min) (99244) |
$137.50 |
$275 |
1.2× |
| Preventive visit, new patient (age 18–39) (99385) |
$83.50 |
$167 |
— |
| Preventive visit, new patient (age 40–64) (99386) |
$87.50 |
$175 |
— |