| Breast lesion removal (open) (19120) |
$560.64 |
$876 |
0.2× |
| Shoulder arthroscopy with decompression (29826) |
$1,065.60 |
$1,665 |
— |
| Knee arthroscopy with meniscectomy (29881) |
$1,168 |
$1,825 |
0.4× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$501.12 |
$783 |
0.6× |
| Diagnostic colonoscopy (45378) |
$649.60 |
$1,015 |
0.8× |
| Colonoscopy with biopsy (45380) |
$739.20 |
$1,155 |
0.7× |
| Colonoscopy with lesion removal (45385) |
$808.32 |
$1,263 |
0.8× |
Laparoscopic gallbladder removal (47562)
likely a partial charge, not the full procedure |
$1,172.48 |
$1,832 |
0.2× |
| Obstetric care, vaginal delivery (global) (59400) |
$2,300 |
$3,593.75 |
— |
| Obstetric care, cesarean delivery (global) (59510) |
$2,319.20 |
$3,623.75 |
— |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$600.32 |
$938 |
0.8× |
| CT head/brain without contrast (70450) |
$672 |
$1,050 |
7.5× |
| MRI brain without contrast (70551) |
$934.40 |
$1,460 |
4.5× |
| MRI brain with contrast (70552) |
$998.40 |
$1,560 |
3.3× |
| MRI brain without and with contrast (70553) |
$1,161.60 |
$1,815 |
3.9× |
| X-ray lower spine, 4+ views (72110) |
$144.96 |
$226.50 |
1.6× |
| MRI lumbar spine without contrast (72148) |
$836.48 |
$1,307 |
4.1× |
| CT pelvis with contrast (72193) |
$915.20 |
$1,430 |
6.1× |
| MRI lower-extremity joint without contrast (73721) |
$876.16 |
$1,369 |
4.3× |
| CT abdomen and pelvis with contrast (74177) |
$1,699.84 |
$2,656 |
5.7× |
| Ultrasound, abdomen complete (76700) |
$266.88 |
$417 |
3.0× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$266.88 |
$417 |
3.0× |
| Ultrasound, transvaginal (76830) |
$266.88 |
$417 |
3.0× |
| Mammography, one breast (diagnostic) (77065) |
$119.68 |
$187 |
1.4× |
| Mammography, both breasts (diagnostic) (77066) |
$119.68 |
$187 |
1.1× |
| Mammography, screening (bilateral) (77067) |
$126.08 |
$197 |
1.4× |
| Basic metabolic panel (80048) |
$89.60 |
$140 |
10.6× |
| Comprehensive metabolic panel (80053) |
$105.60 |
$165 |
10.0× |
| Lipid panel (80061) |
$41.60 |
$65 |
3.1× |
| Renal function panel (80069) |
$89.60 |
$140 |
10.3× |
| Hepatic function panel (80076) |
$89.60 |
$140 |
11.0× |
| Urinalysis, non-automated, with microscopy (81000) |
$8.32 |
$13 |
2.1× |
| Urinalysis, non-automated, without microscopy (81002) |
$6.14 |
$9.60 |
1.8× |
| Thyroid stimulating hormone (TSH) (84443) |
$80.64 |
$126 |
4.8× |
| CBC with automated differential (85025) |
$60.80 |
$95 |
7.8× |
| Prothrombin time (PT) (85610) |
$28.80 |
$45 |
6.7× |
| Partial thromboplastin time (PTT) (85730) |
$28.80 |
$45 |
4.8× |
| Electrocardiogram (ECG), complete (93000) |
$24.32 |
$38 |
0.5× |
| Sleep study (attended polysomnography) (95810) |
$2,278.40 |
$3,560 |
3.1× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$38.40 |
$60 |
1.3× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$137.84 |
$215.38 |
1.2× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$190.24 |
$297.25 |
1.7× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$216.02 |
$337.52 |
1.9× |
| Office consultation (low complexity, ~30 min) (99243) |
$104.64 |
$163.50 |
0.9× |
| Office consultation (moderate complexity, ~40 min) (99244) |
$151.04 |
$236 |
1.3× |
| Preventive visit, new patient (age 18–39) (99385) |
$106.24 |
$166 |
— |
| Preventive visit, new patient (age 40–64) (99386) |
$124.16 |
$194 |
— |