| Breast lesion removal (open) (19120) |
$1,395.50 |
$5,581.50 |
0.4× |
| Shoulder arthroscopy with decompression (29826) |
$3,908.50 |
$15,633.50 |
— |
| Knee arthroscopy with meniscectomy (29881) |
$1,530.50 |
$6,120 |
0.5× |
Tonsillectomy and adenoidectomy (under age 12) (42820)
likely a partial charge, not the full procedure |
$177 |
$708 |
0.0× |
| Upper GI endoscopy (EGD), diagnostic (43235) |
$925.50 |
$3,702 |
1.0× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$1,015.50 |
$4,062.50 |
1.1× |
| Diagnostic colonoscopy (45378) |
$913 |
$3,650.50 |
1.0× |
| Colonoscopy with biopsy (45380) |
$952.50 |
$3,808.50 |
0.8× |
| Colonoscopy with lesion removal (45385) |
$1,021 |
$4,085 |
0.8× |
Laparoscopic gallbladder removal (47562)
unusually low: confirm this is the full procedure |
$2,010.50 |
$8,040.50 |
0.3× |
| Inguinal hernia repair (age 5+) (49505) |
$2,582 |
$10,327 |
0.7× |
| Obstetric care, vaginal delivery (global) (59400) |
$2,284.50 |
$9,138 |
— |
| Obstetric care, cesarean delivery (global) (59510) |
$2,752 |
$11,006.50 |
— |
| Obstetric care, VBAC delivery (global) (59610) |
$2,826.50 |
$11,305 |
— |
| Epidural injection, lumbar/sacral (with imaging) (62322) |
$131 |
$524 |
0.1× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$164 |
$654.50 |
0.2× |
| Cataract removal with lens insertion (66984) |
$1,888 |
$7,552 |
0.8× |
| CT head/brain without contrast (70450) |
$501 |
$2,002 |
4.8× |
| MRI brain without contrast (70551) |
$638 |
$2,550 |
2.7× |
| MRI brain with contrast (70552) |
$700 |
$2,800 |
2.0× |
| MRI brain without and with contrast (70553) |
$1,078 |
$4,311 |
3.1× |
| X-ray lower spine, 4+ views (72110) |
$94 |
$375 |
0.9× |
| MRI lumbar spine without contrast (72148) |
$666 |
$2,665 |
2.8× |
| CT pelvis with contrast (72193) |
$563 |
$2,252 |
3.2× |
| MRI lower-extremity joint without contrast (73721) |
$646 |
$2,583 |
2.7× |
| CT abdomen and pelvis with contrast (74177) |
$631 |
$2,525 |
1.8× |
| Ultrasound, abdomen complete (76700) |
$238 |
$950 |
2.3× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$128.50 |
$512 |
1.2× |
| Ultrasound, transvaginal (76830) |
$187 |
$747 |
1.8× |
| Mammography, one breast (diagnostic) (77065) |
$93 |
$372 |
1.1× |
| Mammography, both breasts (diagnostic) (77066) |
$114 |
$454 |
1.0× |
| Mammography, screening (bilateral) (77067) |
$86.50 |
$346.50 |
0.9× |
| Basic metabolic panel (80048) |
$17 |
$67 |
2.0× |
| Comprehensive metabolic panel (80053) |
$21 |
$84 |
2.0× |
| Obstetric panel (80055) |
$48 |
$191 |
1.0× |
| Lipid panel (80061) |
$21.50 |
$86 |
1.6× |
| Hepatic function panel (80076) |
$16 |
$65 |
2.0× |
| PSA, total (84153) |
$37 |
$147 |
2.0× |
| Thyroid stimulating hormone (TSH) (84443) |
$51.50 |
$204.50 |
3.1× |
| CBC with automated differential (85025) |
$12 |
$47 |
1.5× |
| CBC, automated (85027) |
$23.50 |
$92.50 |
3.6× |
| Prothrombin time (PT) (85610) |
$9 |
$34 |
2.1× |
| Partial thromboplastin time (PTT) (85730) |
$12 |
$48 |
2.0× |
| Psychotherapy, 30 minutes (90832) |
$48 |
$190 |
0.3× |
| Psychotherapy, 45 minutes (90834) |
$63 |
$250 |
0.4× |
| Psychotherapy, 60 minutes (90837) |
$86 |
$345 |
0.5× |
| Family psychotherapy, with patient (50 min) (90847) |
$72 |
$288 |
0.4× |
| Group psychotherapy (90853) |
$19 |
$75 |
0.2× |
| Electrocardiogram (ECG), complete (93000) |
$10 |
$40 |
0.2× |
| Sleep study (attended polysomnography) (95810) |
$2,463 |
$9,850 |
2.9× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$25 |
$99 |
0.9× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$66 |
$264 |
0.5× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$101 |
$403 |
0.8× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$127 |
$507 |
0.9× |
| Office consultation (low complexity, ~30 min) (99243) |
$57 |
$227 |
0.4× |
| Office consultation (moderate complexity, ~40 min) (99244) |
$80 |
$319 |
0.6× |
| Preventive visit, new patient (age 18–39) (99385) |
$63 |
$250 |
— |
| Preventive visit, new patient (age 40–64) (99386) |
$63 |
$250 |
— |