| Shoulder arthroscopy with decompression (29826) |
$13,397 |
$19,139 |
— |
| Knee arthroscopy with meniscectomy (29881) |
$3,745 |
$5,350 |
1.1× |
| Tonsillectomy and adenoidectomy (under age 12) (42820) |
$3,924.50 |
$5,606.50 |
0.7× |
| Upper GI endoscopy (EGD), diagnostic (43235) |
$2,380 |
$3,400 |
2.6× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$3,290 |
$4,700 |
3.6× |
| Diagnostic colonoscopy (45378) |
$3,290 |
$4,700 |
3.5× |
| Colonoscopy with biopsy (45380) |
$3,290 |
$4,700 |
2.7× |
| Colonoscopy with lesion removal (45385) |
$3,360 |
$4,800 |
2.8× |
| Laparoscopic gallbladder removal (47562) |
$11,705 |
$16,721 |
1.9× |
| Inguinal hernia repair (age 5+) (49505) |
$9,400 |
$13,428 |
2.6× |
| Epidural injection, lumbar/sacral (with imaging) (62322) |
$3,150 |
$4,500 |
3.5× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$2,481 |
$3,544 |
2.8× |
| CT head/brain without contrast (70450) |
$1,005 |
$1,436 |
9.6× |
| MRI brain without contrast (70551) |
$2,640 |
$3,772 |
11.0× |
| MRI brain with contrast (70552) |
$3,004 |
$4,292 |
8.6× |
| MRI brain without and with contrast (70553) |
$3,466 |
$4,951 |
9.9× |
| X-ray lower spine, 4+ views (72110) |
$311 |
$444 |
3.0× |
| MRI lumbar spine without contrast (72148) |
$2,521 |
$3,601 |
10.5× |
| CT pelvis with contrast (72193) |
$1,015 |
$1,450 |
5.8× |
| MRI lower-extremity joint without contrast (73721) |
$2,090 |
$2,986 |
8.7× |
| CT abdomen and pelvis with contrast (74177) |
$2,190 |
$3,128 |
6.2× |
| Ultrasound, abdomen complete (76700) |
$455 |
$650 |
4.3× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$591 |
$844 |
5.6× |
| Ultrasound, transvaginal (76830) |
$364 |
$520 |
3.5× |
| Mammography, one breast (diagnostic) (77065) |
$329 |
$470 |
3.8× |
| Mammography, both breasts (diagnostic) (77066) |
$386 |
$552 |
3.5× |
| Mammography, screening (bilateral) (77067) |
$214 |
$305 |
2.3× |
| Basic metabolic panel (80048) |
$100 |
$143 |
11.8× |
| Comprehensive metabolic panel (80053) |
$143 |
$204 |
13.5× |
| Obstetric panel (80055) |
$552 |
$789 |
11.5× |
| Lipid panel (80061) |
$122 |
$175 |
9.1× |
| Renal function panel (80069) |
$101 |
$144 |
11.6× |
| Hepatic function panel (80076) |
$114 |
$163 |
14.0× |
| Urinalysis, non-automated, without microscopy (81002) |
$18 |
$26 |
5.2× |
| PSA, total (84153) |
$142 |
$203 |
7.7× |
| Thyroid stimulating hormone (TSH) (84443) |
$98 |
$140 |
5.8× |
| CBC with automated differential (85025) |
$67 |
$95 |
8.6× |
| Prothrombin time (PT) (85610) |
$54 |
$77 |
12.6× |
| Partial thromboplastin time (PTT) (85730) |
$57 |
$81.50 |
9.5× |
| Psychotherapy, 30 minutes (90832) |
$315 |
$450 |
1.8× |
| Psychotherapy, 45 minutes (90834) |
$315 |
$450 |
1.8× |
| Psychotherapy, 60 minutes (90837) |
$315 |
$450 |
1.8× |
| Family psychotherapy, without patient (50 min) (90846) |
$266 |
$380 |
1.5× |
| Family psychotherapy, with patient (50 min) (90847) |
$174.50 |
$249.50 |
1.0× |
| Group psychotherapy (90853) |
$177 |
$252.50 |
1.7× |
| Electrocardiogram (ECG), complete (93000) |
$197.50 |
$281.50 |
3.3× |
| Sleep study (attended polysomnography) (95810) |
$2,748 |
$3,925 |
3.2× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$109 |
$156 |
3.8× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$139 |
$198 |
1.0× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$190 |
$272 |
1.4× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$240 |
$343 |
1.8× |
| Preventive visit, new patient (age 18–39) (99385) |
$190 |
$272 |
— |
| Preventive visit, new patient (age 40–64) (99386) |
$190 |
$272 |
— |