| Breast lesion removal (open) (19120) |
$4,258 |
$11,737 |
1.0× |
| Shoulder arthroscopy with decompression (29826) |
— |
$34,195.87 |
— |
| Knee arthroscopy with meniscectomy (29881) |
$3,559 |
$32,500 |
1.0× |
| Upper GI endoscopy (EGD), diagnostic (43235) |
$986 |
$4,885.53 |
1.0× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$986 |
$4,885.53 |
1.0× |
| Diagnostic colonoscopy (45378) |
$1,011 |
$2,755 |
1.0× |
| Colonoscopy with biopsy (45380) |
$1,301 |
$3,686.44 |
1.0× |
| Colonoscopy with lesion removal (45385) |
$1,301 |
$3,686.44 |
1.0× |
| Colonoscopy with endoscopic ultrasound (45391) |
$1,301 |
$2,580 |
1.0× |
| Laparoscopic gallbladder removal (47562) |
$6,575 |
$15,821.74 |
1.0× |
| Inguinal hernia repair (age 5+) (49505) |
$3,894 |
$16,988.22 |
1.0× |
| Epidural injection, lumbar/sacral (with imaging) (62322) |
$962 |
$2,060.95 |
1.0× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$962 |
$6,817.28 |
1.0× |
| After-cataract laser surgery (YAG capsulotomy) (66821) |
$598 |
$2,128.58 |
1.0× |
| CT head/brain without contrast (70450) |
$113 |
$3,878 |
1.0× |
| MRI brain without contrast (70551) |
$259 |
$6,636.72 |
1.0× |
| MRI brain with contrast (70552) |
$379 |
$8,947.48 |
1.0× |
| MRI brain without and with contrast (70553) |
$379 |
$16,198.60 |
1.0× |
| X-ray lower spine, 4+ views (72110) |
$113 |
$2,238.24 |
1.0× |
| MRI lumbar spine without contrast (72148) |
$259 |
$11,369.80 |
1.0× |
| CT pelvis with contrast (72193) |
$190 |
$5,775.48 |
1.0× |
| MRI lower-extremity joint without contrast (73721) |
$259 |
$14,562.80 |
1.0× |
| CT abdomen and pelvis with contrast (74177) |
$379 |
$12,735.80 |
1.0× |
| Ultrasound, abdomen complete (76700) |
$113 |
$1,910.85 |
1.0× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$113 |
$1,960.61 |
1.0× |
| Ultrasound, transvaginal (76830) |
$113 |
$810 |
1.0× |
| Mammography, one breast (diagnostic) (77065) |
$86 |
$743.80 |
1.0× |
| Mammography, both breasts (diagnostic) (77066) |
$110 |
$906.90 |
1.0× |
| Mammography, screening (bilateral) (77067) |
$91 |
$242.62 |
1.0× |
| Basic metabolic panel (80048) |
$8 |
$878.04 |
0.9× |
| Comprehensive metabolic panel (80053) |
$10 |
$917.10 |
0.9× |
| Lipid panel (80061) |
$13 |
$590.33 |
1.0× |
| Renal function panel (80069) |
$8 |
$94.80 |
0.9× |
| Hepatic function panel (80076) |
$8 |
$712.49 |
1.0× |
| Urinalysis, non-automated, with microscopy (81000) |
$4 |
$59 |
1.0× |
| Urinalysis, non-automated, without microscopy (81002) |
$3 |
$95 |
0.9× |
| PSA, total (84153) |
$18 |
$200.62 |
1.0× |
| Thyroid stimulating hormone (TSH) (84443) |
$16 |
$874.24 |
1.0× |
| CBC with automated differential (85025) |
$7 |
$250.34 |
0.9× |
| CBC, automated (85027) |
$6 |
$139 |
0.9× |
| Prothrombin time (PT) (85610) |
$4 |
$176 |
0.9× |
| Partial thromboplastin time (PTT) (85730) |
$6 |
$218 |
1.0× |
| Psychotherapy, 30 minutes (90832) |
$193 |
$528.70 |
1.0× |
| Psychotherapy, 45 minutes (90834) |
$193 |
$375.12 |
1.0× |
| Psychotherapy, 60 minutes (90837) |
$193 |
$335.48 |
1.0× |
| Family psychotherapy, without patient (50 min) (90846) |
$193 |
$282.03 |
1.0× |
| Family psychotherapy, with patient (50 min) (90847) |
$193 |
$167.45 |
1.0× |
| Group psychotherapy (90853) |
$110 |
$96.40 |
1.0× |
| Left heart catheterization (93452) |
$3,526 |
$16,760.40 |
1.0× |
| Sleep study (attended polysomnography) (95810) |
$934 |
$1,060.30 |
1.0× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$29 |
$223.79 |
1.0× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
— |
$206 |
— |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
— |
$277.58 |
— |
| Office visit, new patient (high complexity, ~60 min) (99205) |
— |
$379.50 |
— |