| Breast lesion removal (open) (19120) |
$3,712.80 |
$13,260 |
1.0× |
| Shoulder arthroscopy with decompression (29826) |
$14,333.33 |
$51,190.48 |
— |
| Knee arthroscopy with meniscectomy (29881) |
$7,377.21 |
$26,347.18 |
2.5× |
| Tonsillectomy and adenoidectomy (under age 12) (42820) |
$4,788.81 |
$17,102.91 |
0.9× |
| Upper GI endoscopy (EGD), diagnostic (43235) |
$609.84 |
$2,178 |
0.7× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$609.84 |
$2,178 |
0.7× |
| Diagnostic colonoscopy (45378) |
$609.84 |
$2,178 |
0.7× |
| Colonoscopy with biopsy (45380) |
$609.84 |
$2,178 |
0.6× |
| Colonoscopy with lesion removal (45385) |
$609.84 |
$2,178 |
0.6× |
| Colonoscopy with endoscopic ultrasound (45391) |
$609.84 |
$2,178 |
0.6× |
| Laparoscopic gallbladder removal (47562) |
$2,891 |
$10,325 |
0.5× |
| Epidural injection, lumbar/sacral (with imaging) (62322) |
$365.12 |
$1,304 |
0.5× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$547.68 |
$1,956 |
0.7× |
| After-cataract laser surgery (YAG capsulotomy) (66821) |
$264.32 |
$944 |
0.5× |
| Cataract removal with lens insertion (66984) |
$1,166.48 |
$4,166 |
0.6× |
| CT head/brain without contrast (70450) |
$176.40 |
$630 |
1.9× |
| MRI brain without contrast (70551) |
$515.48 |
$1,841 |
2.4× |
| MRI brain with contrast (70552) |
$624.96 |
$2,232 |
2.0× |
| MRI brain without and with contrast (70553) |
$631.68 |
$2,256 |
2.0× |
| X-ray lower spine, 4+ views (72110) |
$119.56 |
$427 |
1.3× |
| MRI lumbar spine without contrast (72148) |
$412.44 |
$1,473 |
1.9× |
| CT pelvis with contrast (72193) |
$268.80 |
$960 |
1.7× |
| MRI lower-extremity joint without contrast (73721) |
$618.66 |
$2,209.50 |
2.9× |
| CT abdomen and pelvis with contrast (74177) |
$439.88 |
$1,571 |
1.4× |
| Ultrasound, abdomen complete (76700) |
$108.36 |
$387 |
1.1× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$108.64 |
$388 |
1.1× |
| Ultrasound, transvaginal (76830) |
$97.16 |
$347 |
1.0× |
| Mammography, one breast (diagnostic) (77065) |
$91.84 |
$328 |
1.1× |
| Mammography, both breasts (diagnostic) (77066) |
$117.04 |
$418 |
1.1× |
| Mammography, screening (bilateral) (77067) |
$97.16 |
$347 |
1.1× |
| Basic metabolic panel (80048) |
$17.36 |
$62 |
2.1× |
| Comprehensive metabolic panel (80053) |
$19.04 |
$68 |
1.8× |
| Obstetric panel (80055) |
$65.52 |
$234 |
1.4× |
| Lipid panel (80061) |
$19.32 |
$69 |
1.4× |
| Renal function panel (80069) |
$16.52 |
$59 |
1.9× |
| Hepatic function panel (80076) |
$12.04 |
$43 |
1.5× |
| Urinalysis, non-automated, with microscopy (81000) |
$4.76 |
$17 |
1.2× |
| Urinalysis, non-automated, without microscopy (81002) |
$3.36 |
$12 |
1.0× |
| PSA, total (84153) |
$30.80 |
$110 |
1.7× |
| Thyroid stimulating hormone (TSH) (84443) |
$31.92 |
$114 |
1.9× |
| CBC with automated differential (85025) |
$13.72 |
$49 |
1.8× |
| CBC, automated (85027) |
$10.92 |
$39 |
1.7× |
| Prothrombin time (PT) (85610) |
$6.72 |
$24 |
1.6× |
| Partial thromboplastin time (PTT) (85730) |
$10.64 |
$38 |
1.8× |
| Family psychotherapy, with patient (50 min) (90847) |
$57.40 |
$205 |
0.4× |
| Left heart catheterization (93452) |
$5,835.20 |
$20,840 |
2.0× |
| Sleep study (attended polysomnography) (95810) |
$1,332.52 |
$4,759 |
1.7× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$33.60 |
$120 |
1.2× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$62.72 |
$224 |
0.5× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$66.08 |
$236 |
0.5× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$69.44 |
$248 |
0.6× |
| Preventive visit, new patient (age 18–39) (99385) |
$36.68 |
$131 |
— |
| Preventive visit, new patient (age 40–64) (99386) |
$36.68 |
$131 |
— |