| Breast lesion removal (open) (19120) |
$1,488.10 |
$6,470 |
0.4× |
| Knee arthroscopy with meniscectomy (29881) |
$2,539.17 |
$11,039.87 |
0.9× |
Tonsillectomy and adenoidectomy (under age 12) (42820)
likely a partial charge, not the full procedure |
$1,564 |
$6,800.01 |
0.3× |
| Upper GI endoscopy (EGD), diagnostic (43235) |
$278.76 |
$1,212 |
0.3× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$278.76 |
$1,212 |
0.3× |
| Diagnostic colonoscopy (45378) |
$308.89 |
$1,343 |
0.4× |
| Colonoscopy with biopsy (45380) |
$308.89 |
$1,343 |
0.3× |
| Colonoscopy with lesion removal (45385) |
$308.89 |
$1,343 |
0.3× |
| Laparoscopic gallbladder removal (47562) |
$3,937.28 |
$17,118.63 |
0.7× |
| Inguinal hernia repair (age 5+) (49505) |
$2,836.94 |
$12,334.51 |
0.9× |
| Epidural injection, lumbar/sacral (with imaging) (62322) |
$392.15 |
$1,705 |
0.5× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$517.27 |
$2,249 |
0.6× |
| CT head/brain without contrast (70450) |
$365.01 |
$1,587 |
3.9× |
| MRI brain without contrast (70551) |
$614.33 |
$2,671 |
2.8× |
| MRI brain with contrast (70552) |
$779.47 |
$3,389 |
2.5× |
| MRI brain without and with contrast (70553) |
$1,155.06 |
$5,022 |
3.7× |
| X-ray lower spine, 4+ views (72110) |
$85.10 |
$370 |
0.9× |
| MRI lumbar spine without contrast (72148) |
$614.33 |
$2,671 |
2.8× |
| CT pelvis with contrast (72193) |
$437.46 |
$1,902 |
2.8× |
| MRI lower-extremity joint without contrast (73721) |
$635.95 |
$2,765 |
2.9× |
| CT abdomen and pelvis with contrast (74177) |
$658.26 |
$2,862 |
2.1× |
| Ultrasound, abdomen complete (76700) |
$190.44 |
$828 |
2.0× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$91.77 |
$399 |
1.0× |
| Ultrasound, transvaginal (76830) |
$163.07 |
$709 |
1.7× |
| Mammography, one breast (diagnostic) (77065) |
$91.77 |
$399 |
1.1× |
| Mammography, both breasts (diagnostic) (77066) |
$106.49 |
$463 |
1.0× |
| Mammography, screening (bilateral) (77067) |
$94.07 |
$409 |
1.0× |
| Basic metabolic panel (80048) |
$29.21 |
$127 |
3.5× |
| Comprehensive metabolic panel (80053) |
$36.11 |
$157 |
3.4× |
| Obstetric panel (80055) |
$16.10 |
$70 |
0.3× |
| Lipid panel (80061) |
$40.71 |
$177 |
3.0× |
| Renal function panel (80069) |
$25.76 |
$112 |
3.0× |
| Hepatic function panel (80076) |
$16.56 |
$72 |
2.0× |
| Urinalysis, non-automated, with microscopy (81000) |
$4.60 |
$20 |
1.1× |
| Urinalysis, non-automated, without microscopy (81002) |
$2.53 |
$11 |
0.7× |
| PSA, total (84153) |
$25.76 |
$112 |
1.4× |
| Thyroid stimulating hormone (TSH) (84443) |
$20.93 |
$91 |
1.2× |
| CBC with automated differential (85025) |
$11.04 |
$48 |
1.4× |
| CBC, automated (85027) |
$7.82 |
$34 |
1.2× |
| Prothrombin time (PT) (85610) |
$2.76 |
$12 |
0.6× |
| Partial thromboplastin time (PTT) (85730) |
$5.98 |
$26 |
1.0× |
| Psychotherapy, 30 minutes (90832) |
$35.65 |
$155 |
0.2× |
| Psychotherapy, 45 minutes (90834) |
$46.46 |
$202 |
0.3× |
| Psychotherapy, 60 minutes (90837) |
$68.08 |
$296 |
0.4× |
| Family psychotherapy, without patient (50 min) (90846) |
$42.55 |
$185 |
0.3× |
| Family psychotherapy, with patient (50 min) (90847) |
$51.06 |
$222 |
0.3× |
| Group psychotherapy (90853) |
$27.60 |
$120 |
0.3× |
| Sleep study (attended polysomnography) (95810) |
$586.27 |
$2,549 |
0.8× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$18.17 |
$79 |
0.6× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$87.86 |
$382 |
0.7× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$92.46 |
$402 |
0.8× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$97.29 |
$423 |
0.8× |