| Tonsillectomy and adenoidectomy (under age 12) (42820) |
— |
$8,899.26 |
— |
| Upper GI endoscopy (EGD), diagnostic (43235) |
$1,164.15 |
$2,587 |
1.4× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$1,164.15 |
$2,587 |
1.4× |
| Diagnostic colonoscopy (45378) |
$1,290.15 |
$2,867 |
1.5× |
| Colonoscopy with biopsy (45380) |
$1,290.15 |
$2,867 |
1.2× |
| Colonoscopy with lesion removal (45385) |
$1,290.15 |
$2,867 |
1.2× |
| Laparoscopic gallbladder removal (47562) |
— |
$17,595.27 |
— |
| Inguinal hernia repair (age 5+) (49505) |
— |
$12,358.14 |
— |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$1,019.25 |
$2,265 |
1.3× |
| CT head/brain without contrast (70450) |
$714.15 |
$1,587 |
7.5× |
| MRI brain without contrast (70551) |
$1,201.95 |
$2,671 |
5.6× |
| MRI brain without and with contrast (70553) |
$2,259.90 |
$5,022 |
7.2× |
| X-ray lower spine, 4+ views (72110) |
$166.50 |
$370 |
1.8× |
| MRI lumbar spine without contrast (72148) |
$1,201.95 |
$2,671 |
5.6× |
| CT pelvis with contrast (72193) |
$855.90 |
$1,902 |
5.4× |
| MRI lower-extremity joint without contrast (73721) |
$1,244.25 |
$2,765 |
5.8× |
| CT abdomen and pelvis with contrast (74177) |
$1,287.90 |
$2,862 |
4.1× |
| Ultrasound, abdomen complete (76700) |
$372.60 |
$828 |
3.9× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$179.55 |
$399 |
1.9× |
| Ultrasound, transvaginal (76830) |
$319.05 |
$709 |
3.4× |
| Mammography, screening (bilateral) (77067) |
$184.05 |
$409 |
2.0× |
| Basic metabolic panel (80048) |
$36.90 |
$82 |
4.4× |
| Comprehensive metabolic panel (80053) |
$45.45 |
$101 |
4.3× |
| Obstetric panel (80055) |
$20.25 |
$45 |
0.4× |
| Lipid panel (80061) |
$44.55 |
$99 |
3.3× |
| Renal function panel (80069) |
$43.20 |
$96 |
5.0× |
| Hepatic function panel (80076) |
$45.45 |
$101 |
5.6× |
| Urinalysis, non-automated, with microscopy (81000) |
$13.50 |
$30 |
3.4× |
| Urinalysis, non-automated, without microscopy (81002) |
$4.95 |
$11 |
1.4× |
| PSA, total (84153) |
$36.90 |
$82 |
2.0× |
| Thyroid stimulating hormone (TSH) (84443) |
$37.35 |
$83 |
2.2× |
| CBC with automated differential (85025) |
$22.95 |
$51 |
3.0× |
| CBC, automated (85027) |
$11.02 |
$24.50 |
1.7× |
| Prothrombin time (PT) (85610) |
$5.85 |
$13 |
1.4× |
| Partial thromboplastin time (PTT) (85730) |
$13.50 |
$30 |
2.2× |
| Psychotherapy, 30 minutes (90832) |
$54.45 |
$121 |
0.3× |
| Psychotherapy, 45 minutes (90834) |
$72.45 |
$161 |
0.5× |
| Psychotherapy, 60 minutes (90837) |
$117.90 |
$262 |
0.7× |
| Family psychotherapy, without patient (50 min) (90846) |
$117.90 |
$262 |
0.7× |
| Family psychotherapy, with patient (50 min) (90847) |
$117.90 |
$262 |
0.7× |
| Group psychotherapy (90853) |
$117.90 |
$262 |
1.3× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$35.55 |
$79 |
1.2× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$80.10 |
$178 |
0.7× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$105.52 |
$234.50 |
0.9× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$80.55 |
$179 |
0.7× |
| Preventive visit, new patient (age 18–39) (99385) |
$62.10 |
$138 |
— |
| Preventive visit, new patient (age 40–64) (99386) |
$74.70 |
$166 |
— |