| Breast lesion removal (open) (19120) |
— |
$35,015.51 |
— |
| Shoulder arthroscopy with decompression (29826) |
— |
$84,298.71 |
— |
| Knee arthroscopy with meniscectomy (29881) |
— |
$34,190.45 |
— |
| Tonsillectomy and adenoidectomy (under age 12) (42820) |
— |
$27,215.50 |
— |
| Upper GI endoscopy (EGD), diagnostic (43235) |
— |
$22,149.18 |
— |
| Upper GI endoscopy (EGD) with biopsy (43239) |
— |
$23,930.64 |
— |
| Diagnostic colonoscopy (45378) |
— |
$16,294.55 |
— |
| Colonoscopy with biopsy (45380) |
— |
$25,902.35 |
— |
| Colonoscopy with lesion removal (45385) |
— |
$16,607.38 |
— |
| Laparoscopic gallbladder removal (47562) |
— |
$62,124.06 |
— |
| Inguinal hernia repair (age 5+) (49505) |
— |
$55,954.56 |
— |
| Cataract removal with lens insertion (66984) |
— |
$16,929.63 |
— |
| CT head/brain without contrast (70450) |
— |
$4,700.68 |
— |
| MRI brain without contrast (70551) |
— |
$5,415.15 |
— |
| MRI brain with contrast (70552) |
— |
$6,647.50 |
— |
| MRI brain without and with contrast (70553) |
— |
$8,377.85 |
— |
| X-ray lower spine, 4+ views (72110) |
— |
$2,278.82 |
— |
| MRI lumbar spine without contrast (72148) |
— |
$5,415.15 |
— |
| CT pelvis with contrast (72193) |
— |
$7,443.06 |
— |
MRI lower-extremity joint without contrast (73721)
range across 2 matching MRF lines |
— |
$5,415.15–$8,377.85 |
— |
| CT abdomen and pelvis with contrast (74177) |
— |
$14,889.18 |
— |
| Ultrasound, abdomen complete (76700) |
— |
$3,251.84 |
— |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
— |
$3,003.23 |
— |
| Ultrasound, transvaginal (76830) |
— |
$1,785.42 |
— |
| Mammography, one breast (diagnostic) (77065) |
— |
$729.77 |
— |
| Mammography, both breasts (diagnostic) (77066) |
— |
$1,079.36 |
— |
| Mammography, screening (bilateral) (77067) |
— |
$1,014.34 |
— |
| Basic metabolic panel (80048) |
— |
$535.47 |
— |
| Comprehensive metabolic panel (80053) |
— |
$978.38 |
— |
Lipid panel (80061)
range across 2 matching MRF lines |
— |
$4.34–$338.11 |
— |
| Renal function panel (80069) |
— |
$699.17 |
— |
| Hepatic function panel (80076) |
— |
$488.05 |
— |
| Urinalysis, non-automated, without microscopy (81002) |
— |
$56.61 |
— |
PSA, total (84153)
range across 2 matching MRF lines |
— |
$3.50–$421.49 |
— |
Thyroid stimulating hormone (TSH) (84443)
range across 2 matching MRF lines |
— |
$244.19–$406.96 |
— |
| CBC with automated differential (85025) |
— |
$327.40 |
— |
| CBC, automated (85027) |
— |
$228.73 |
— |
Prothrombin time (PT) (85610)
range across 2 matching MRF lines |
— |
$28.60–$257.79 |
— |
| Partial thromboplastin time (PTT) (85730) |
— |
$171.35 |
— |
| Left heart catheterization (93452) |
— |
$11,697.77 |
— |
| Sleep study (attended polysomnography) (95810) |
— |
$4,745.81 |
— |
Physical therapy, therapeutic exercise (per 15 min) (97110)
range across 3 matching MRF lines |
— |
$294–$375.59 |
— |