| Breast lesion removal (open) (19120) |
$420.70 |
$1,202 |
0.1× |
| Knee arthroscopy with meniscectomy (29881) |
$4,441.93 |
$14,328.81 |
1.5× |
Tonsillectomy and adenoidectomy (under age 12) (42820)
unusually low: confirm this is the full procedure |
$2,109.01 |
$6,803.25 |
0.4× |
| Upper GI endoscopy (EGD), diagnostic (43235) |
$678.62 |
$2,189.10 |
0.8× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$706.34 |
$2,278.50 |
0.9× |
| Diagnostic colonoscopy (45378) |
$578 |
$1,864.50 |
0.7× |
| Colonoscopy with biopsy (45380) |
$512.96 |
$1,654.70 |
0.5× |
| Colonoscopy with lesion removal (45385) |
$810.43 |
$2,614.30 |
0.8× |
Laparoscopic gallbladder removal (47562)
likely a partial charge, not the full procedure |
$922.25 |
$2,635 |
0.2× |
| Inguinal hernia repair (age 5+) (49505) |
$3,730.84 |
$12,034.96 |
1.2× |
| Laparoscopic radical prostatectomy (55866) |
$10,387.47 |
$33,507.98 |
1.1× |
| Epidural injection, lumbar/sacral (with imaging) (62322) |
$429.97 |
$1,387 |
0.6× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$559.92 |
$1,712 |
0.7× |
| After-cataract laser surgery (YAG capsulotomy) (66821) |
$266.35 |
$761 |
0.5× |
| CT head/brain without contrast (70450) |
$374.59 |
$1,208.34 |
4.1× |
| MRI brain without contrast (70551) |
$637.07 |
$2,055.06 |
3.0× |
| MRI brain with contrast (70552) |
$732.77 |
$2,363.76 |
2.4× |
| MRI brain without and with contrast (70553) |
$879.73 |
$2,837.84 |
2.9× |
| X-ray lower spine, 4+ views (72110) |
$37.62 |
$107.50 |
0.4× |
| MRI lumbar spine without contrast (72148) |
$566.32 |
$1,826.84 |
2.7× |
| CT pelvis with contrast (72193) |
$523.26 |
$1,687.93 |
3.4× |
| MRI lower-extremity joint without contrast (73721) |
$412.86 |
$1,259.44 |
2.0× |
| CT abdomen and pelvis with contrast (74177) |
$634.72 |
$2,047.50 |
2.1× |
| Ultrasound, abdomen complete (76700) |
$57.40 |
$164 |
0.6× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$57.40 |
$164 |
0.6× |
| Ultrasound, transvaginal (76830) |
$60.20 |
$172 |
0.7× |
| Mammography, one breast (diagnostic) (77065) |
$67.55 |
$193 |
0.8× |
| Mammography, both breasts (diagnostic) (77066) |
$87.85 |
$251 |
0.8× |
| Mammography, screening (bilateral) (77067) |
$67.55 |
$193 |
0.7× |
| Basic metabolic panel (80048) |
$12.24 |
$36.50 |
1.4× |
| Comprehensive metabolic panel (80053) |
$10.89 |
$33 |
1.0× |
| Obstetric panel (80055) |
$51.45 |
$147 |
1.1× |
| Lipid panel (80061) |
$20.12 |
$59.50 |
1.5× |
| Renal function panel (80069) |
$44.98 |
$141.82 |
5.2× |
| Hepatic function panel (80076) |
$12.20 |
$36.50 |
1.5× |
| Urinalysis, non-automated, with microscopy (81000) |
$10.89 |
$33 |
2.7× |
| Urinalysis, non-automated, without microscopy (81002) |
$12.30 |
$39.69 |
3.5× |
| PSA, total (84153) |
$47.06 |
$145.36 |
2.6× |
| Thyroid stimulating hormone (TSH) (84443) |
$16.83 |
$51 |
1.0× |
| CBC with automated differential (85025) |
$7.70 |
$22 |
1.0× |
| CBC, automated (85027) |
$19.29 |
$59.84 |
3.0× |
| Prothrombin time (PT) (85610) |
$8.25 |
$25 |
1.9× |
| Partial thromboplastin time (PTT) (85730) |
$7 |
$20 |
1.2× |
| Psychotherapy, 30 minutes (90832) |
$80.16 |
$250.50 |
0.5× |
| Psychotherapy, 45 minutes (90834) |
$116.56 |
$376 |
0.7× |
| Psychotherapy, 60 minutes (90837) |
$64.17 |
$207 |
0.4× |
| Family psychotherapy, without patient (50 min) (90846) |
$90.66 |
$280.50 |
0.6× |
| Family psychotherapy, with patient (50 min) (90847) |
$57.66 |
$186 |
0.4× |
| Group psychotherapy (90853) |
$73.16 |
$236 |
0.8× |
| Left heart catheterization (93452) |
$2,524.95 |
$8,145 |
0.9× |
| Sleep study (attended polysomnography) (95810) |
$631.75 |
$2,005 |
0.8× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$47.85 |
$154.35 |
1.6× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$70.59 |
$215.41 |
0.6× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$90.07 |
$277.91 |
0.8× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$146.02 |
$439.76 |
1.2× |
| Preventive visit, new patient (age 18–39) (99385) |
$99.69 |
$284.82 |
— |
| Preventive visit, new patient (age 40–64) (99386) |
$103.71 |
$296.32 |
— |