| Breast lesion removal (open) (19120) |
$11,196 |
$11,196 |
2.8× |
| Shoulder arthroscopy with decompression (29826) |
$11,117.17 |
$11,117.17 |
— |
| Knee arthroscopy with meniscectomy (29881) |
$9,022.50 |
$9,022.50 |
2.7× |
| Tonsillectomy and adenoidectomy (under age 12) (42820) |
$7,950 |
$7,950 |
1.3× |
| Upper GI endoscopy (EGD), diagnostic (43235) |
$3,500 |
$3,500 |
3.7× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$2,750 |
$2,750 |
2.9× |
| Diagnostic colonoscopy (45378) |
$3,819 |
$3,819 |
4.0× |
| Colonoscopy with biopsy (45380) |
$2,373.33 |
$2,373.33 |
1.9× |
| Colonoscopy with lesion removal (45385) |
$3,135 |
$3,135 |
2.5× |
| Laparoscopic gallbladder removal (47562) |
$12,540 |
$12,540 |
2.0× |
| Inguinal hernia repair (age 5+) (49505) |
$8,634.25 |
$8,634.25 |
2.3× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$1,788 |
$1,788 |
2.0× |
| CT head/brain without contrast (70450) |
$642 |
$642 |
5.9× |
| MRI brain without contrast (70551) |
$1,611.50 |
$1,611.50 |
6.5× |
| MRI brain with contrast (70552) |
$1,742.50 |
$1,742.50 |
4.8× |
| MRI brain without and with contrast (70553) |
$1,985.50 |
$1,985.50 |
5.5× |
| X-ray lower spine, 4+ views (72110) |
$316 |
$316 |
2.9× |
| MRI lumbar spine without contrast (72148) |
$1,534.50 |
$1,534.50 |
6.2× |
| CT pelvis with contrast (72193) |
$963.50 |
$963.50 |
5.3× |
| MRI lower-extremity joint without contrast (73721) |
$2,511 |
$2,511 |
10.2× |
| CT abdomen and pelvis with contrast (74177) |
$1,646.50 |
$1,646.50 |
4.6× |
| Ultrasound, abdomen complete (76700) |
$585.50 |
$585.50 |
5.4× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$351 |
$351 |
3.2× |
| Ultrasound, transvaginal (76830) |
$404 |
$404 |
3.7× |
| Mammography, one breast (diagnostic) (77065) |
$307.50 |
$307.50 |
3.6× |
| Mammography, both breasts (diagnostic) (77066) |
$461.50 |
$461.50 |
4.2× |
| Mammography, screening (bilateral) (77067) |
$359 |
$359 |
3.9× |
| Basic metabolic panel (80048) |
$134.50 |
$134.50 |
15.9× |
| Comprehensive metabolic panel (80053) |
$161 |
$161 |
15.2× |
| Lipid panel (80061) |
$150 |
$150 |
11.2× |
| Renal function panel (80069) |
$122 |
$122 |
14.1× |
| Hepatic function panel (80076) |
$97 |
$97 |
11.9× |
| Urinalysis, non-automated, with microscopy (81000) |
$23 |
$23 |
5.7× |
| Urinalysis, non-automated, without microscopy (81002) |
$53 |
$53 |
15.2× |
| PSA, total (84153) |
$163 |
$163 |
8.9× |
| Thyroid stimulating hormone (TSH) (84443) |
$186 |
$186 |
11.1× |
| CBC with automated differential (85025) |
$108 |
$108 |
13.9× |
| CBC, automated (85027) |
$106 |
$106 |
16.4× |
| Prothrombin time (PT) (85610) |
$55 |
$55 |
12.8× |
| Partial thromboplastin time (PTT) (85730) |
$92 |
$92 |
15.3× |
| Electrocardiogram (ECG), complete (93000) |
$180.50 |
$180.50 |
3.0× |
| Sleep study (attended polysomnography) (95810) |
$3,128 |
$3,128 |
3.5× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$207.50 |
$207.50 |
7.1× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$161 |
$161 |
1.2× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$314 |
$314 |
2.3× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$483.50 |
$483.50 |
3.5× |
| Preventive visit, new patient (age 40–64) (99386) |
$308 |
$308 |
— |