| Breast lesion removal (open) (19120) |
$471.20 |
$589 |
0.1× |
| Shoulder arthroscopy with decompression (29826) |
$2,236 |
$2,795 |
— |
| Knee arthroscopy with meniscectomy (29881) |
$1,650.40 |
$2,063 |
0.5× |
| Upper GI endoscopy (EGD), diagnostic (43235) |
$208 |
$260 |
0.2× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$289.20 |
$361.50 |
0.3× |
| Diagnostic colonoscopy (45378) |
$416 |
$520 |
0.4× |
| Colonoscopy with biopsy (45380) |
$524.80 |
$656 |
0.4× |
| Colonoscopy with lesion removal (45385) |
$441.60 |
$552 |
0.4× |
Laparoscopic gallbladder removal (47562)
likely a partial charge, not the full procedure |
$1,008.80 |
$1,261 |
0.2× |
| Inguinal hernia repair (age 5+) (49505) |
$718.40 |
$898 |
0.2× |
| Epidural injection, lumbar/sacral (with imaging) (62322) |
$882 |
$1,102.50 |
1.0× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$1,560.80 |
$1,951 |
1.7× |
| CT head/brain without contrast (70450) |
$2,455.20 |
$3,069 |
22.5× |
| MRI brain without contrast (70551) |
$2,484.80 |
$3,106 |
10.0× |
| MRI brain with contrast (70552) |
$2,636.80 |
$3,296 |
7.2× |
| MRI brain without and with contrast (70553) |
$3,220.80 |
$4,026 |
8.8× |
| X-ray lower spine, 4+ views (72110) |
$593.60 |
$742 |
5.4× |
| MRI lumbar spine without contrast (72148) |
$2,482.40 |
$3,103 |
10.0× |
| CT pelvis with contrast (72193) |
$2,316 |
$2,895 |
12.6× |
| MRI lower-extremity joint without contrast (73721) |
$2,760.80 |
$3,451 |
11.1× |
| CT abdomen and pelvis with contrast (74177) |
$2,686.40 |
$3,358 |
7.4× |
| Ultrasound, abdomen complete (76700) |
$844.80 |
$1,056 |
7.7× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$503.60 |
$629.50 |
4.6× |
| Ultrasound, transvaginal (76830) |
$494.40 |
$618 |
4.5× |
| Mammography, one breast (diagnostic) (77065) |
$248 |
$310 |
2.9× |
| Mammography, both breasts (diagnostic) (77066) |
$300 |
$375 |
2.7× |
| Mammography, screening (bilateral) (77067) |
$274.40 |
$343 |
3.0× |
| Basic metabolic panel (80048) |
$118.40 |
$148 |
14.0× |
| Comprehensive metabolic panel (80053) |
$172 |
$215 |
16.3× |
| Lipid panel (80061) |
$96 |
$120 |
7.2× |
| Renal function panel (80069) |
$105.60 |
$132 |
12.2× |
| Hepatic function panel (80076) |
$100 |
$125 |
12.2× |
| Urinalysis, non-automated, without microscopy (81002) |
$8.80 |
$11 |
2.5× |
| PSA, total (84153) |
$160.80 |
$201 |
8.7× |
| Thyroid stimulating hormone (TSH) (84443) |
$134.40 |
$168 |
8.0× |
| CBC with automated differential (85025) |
$108 |
$135 |
13.9× |
| Prothrombin time (PT) (85610) |
$59.20 |
$74 |
13.8× |
| Partial thromboplastin time (PTT) (85730) |
$110.40 |
$138 |
18.4× |
| Psychotherapy, 30 minutes (90832) |
$150.40 |
$188 |
0.8× |
| Psychotherapy, 45 minutes (90834) |
$180 |
$225 |
1.0× |
| Psychotherapy, 60 minutes (90837) |
$208 |
$260 |
1.1× |
| Family psychotherapy, without patient (50 min) (90846) |
$235.20 |
$294 |
1.3× |
| Family psychotherapy, with patient (50 min) (90847) |
$262.40 |
$328 |
1.4× |
| Group psychotherapy (90853) |
$159.20 |
$199 |
1.5× |
| Electrocardiogram (ECG), complete (93000) |
$256 |
$320 |
4.2× |
| Sleep study (attended polysomnography) (95810) |
$1,236.80 |
$1,546 |
1.4× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$47.20 |
$59 |
1.6× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$116.40 |
$145.50 |
0.8× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$207.20 |
$259 |
1.5× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$197.60 |
$247 |
1.4× |
| Office consultation (low complexity, ~30 min) (99243) |
$67.20 |
$84 |
0.5× |
| Office consultation (moderate complexity, ~40 min) (99244) |
$208 |
$260 |
1.5× |
| Preventive visit, new patient (age 18–39) (99385) |
$83.20 |
$104 |
— |
| Preventive visit, new patient (age 40–64) (99386) |
$83.20 |
$104 |
— |