| Breast lesion removal (open) (19120) |
$2,073.28 |
$5,456 |
0.6× |
| Knee arthroscopy with meniscectomy (29881) |
$3,534.36 |
$9,300.95 |
1.2× |
| Tonsillectomy and adenoidectomy (under age 12) (42820) |
$2,760.99 |
$7,265.76 |
0.5× |
| Upper GI endoscopy (EGD), diagnostic (43235) |
$565.06 |
$1,487 |
0.7× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$565.06 |
$1,487 |
0.7× |
| Diagnostic colonoscopy (45378) |
$539.60 |
$1,420 |
0.6× |
| Colonoscopy with biopsy (45380) |
$711.74 |
$1,873 |
0.6× |
| Colonoscopy with lesion removal (45385) |
$711.74 |
$1,873 |
0.6× |
| Laparoscopic gallbladder removal (47562) |
$3,411.26 |
$8,977 |
0.6× |
| Inguinal hernia repair (age 5+) (49505) |
$5,309.75 |
$13,973.02 |
1.6× |
| Epidural injection, lumbar/sacral (with imaging) (62322) |
$413.06 |
$1,087 |
0.5× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$766.65 |
$2,017.50 |
0.9× |
| CT head/brain without contrast (70450) |
$625.48 |
$1,646 |
6.4× |
| MRI brain without contrast (70551) |
$792.68 |
$2,086 |
3.6× |
| MRI brain with contrast (70552) |
$792.68 |
$2,086 |
2.4× |
| MRI brain without and with contrast (70553) |
$1,198.52 |
$3,154 |
3.7× |
| X-ray lower spine, 4+ views (72110) |
$136.04 |
$358 |
1.4× |
| MRI lumbar spine without contrast (72148) |
$792.68 |
$2,086 |
3.6× |
| CT pelvis with contrast (72193) |
$715.54 |
$1,883 |
4.4× |
| MRI lower-extremity joint without contrast (73721) |
$728.46 |
$1,917 |
3.3× |
| CT abdomen and pelvis with contrast (74177) |
$900.22 |
$2,369 |
2.8× |
| Ultrasound, abdomen complete (76700) |
$220.40 |
$580 |
2.3× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$191.14 |
$503 |
2.0× |
| Ultrasound, transvaginal (76830) |
$271.70 |
$715 |
2.8× |
| Mammography, one breast (diagnostic) (77065) |
$90.82 |
$239 |
1.1× |
| Mammography, both breasts (diagnostic) (77066) |
$107.92 |
$284 |
1.0× |
| Mammography, screening (bilateral) (77067) |
$57.95 |
$152.50 |
0.6× |
| Basic metabolic panel (80048) |
$15.20 |
$40 |
1.8× |
| Comprehensive metabolic panel (80053) |
$18.62 |
$49 |
1.8× |
| Lipid panel (80061) |
$22.80 |
$60 |
1.7× |
| Renal function panel (80069) |
$96.52 |
$254 |
11.1× |
| Hepatic function panel (80076) |
$14.06 |
$37 |
1.7× |
| Urinalysis, non-automated, with microscopy (81000) |
$10.64 |
$28 |
2.6× |
| Urinalysis, non-automated, without microscopy (81002) |
$7.22 |
$19 |
2.1× |
| PSA, total (84153) |
$26.98 |
$71 |
1.5× |
| Thyroid stimulating hormone (TSH) (84443) |
$21.85 |
$57.50 |
1.3× |
| CBC with automated differential (85025) |
$14.06 |
$37 |
1.8× |
| CBC, automated (85027) |
$36.86 |
$97 |
5.7× |
| Prothrombin time (PT) (85610) |
$12.16 |
$32 |
2.8× |
| Partial thromboplastin time (PTT) (85730) |
$36.86 |
$97 |
6.1× |
| Sleep study (attended polysomnography) (95810) |
$760 |
$2,000 |
1.0× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$51.68 |
$136 |
1.8× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$46.74 |
$123 |
0.4× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$49.40 |
$130 |
0.4× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$52.06 |
$137 |
0.4× |