| Breast lesion removal (open) (19120) |
$1,636 |
$6,292.30 |
0.5× |
| Shoulder arthroscopy with decompression (29826) |
$216.50 |
$433 |
— |
| Knee arthroscopy with meniscectomy (29881) |
$2,569.50 |
$9,882.68 |
0.9× |
Tonsillectomy and adenoidectomy (under age 12) (42820)
likely a partial charge, not the full procedure |
$1,382.50 |
$5,317.32 |
0.3× |
| Upper GI endoscopy (EGD), diagnostic (43235) |
$793.52 |
$3,052 |
1.0× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$362.44 |
$1,394 |
0.4× |
| Diagnostic colonoscopy (45378) |
$336.23 |
$1,043.50 |
0.4× |
| Colonoscopy with biopsy (45380) |
$362.48 |
$1,096 |
0.3× |
| Colonoscopy with lesion removal (45385) |
$392.73 |
$1,156.50 |
0.4× |
| Laparoscopic gallbladder removal (47562) |
$2,952.28 |
$11,354.94 |
0.5× |
| Inguinal hernia repair (age 5+) (49505) |
$1,921.28 |
$7,389.54 |
0.6× |
| Epidural injection, lumbar/sacral (with imaging) (62322) |
$386.88 |
$1,488 |
0.5× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$610.35 |
$2,347.50 |
0.8× |
| After-cataract laser surgery (YAG capsulotomy) (66821) |
$449.80 |
$1,730 |
0.9× |
| Cataract removal with lens insertion (66984) |
$2,522.09 |
$9,700.33 |
1.2× |
| CT head/brain without contrast (70450) |
$412.62 |
$1,587 |
4.4× |
| MRI brain without contrast (70551) |
$694.46 |
$2,671 |
3.2× |
| MRI brain with contrast (70552) |
$881.14 |
$3,389 |
2.8× |
| MRI brain without and with contrast (70553) |
$1,305.72 |
$5,022 |
4.1× |
| X-ray lower spine, 4+ views (72110) |
$96.20 |
$370 |
1.0× |
| MRI lumbar spine without contrast (72148) |
$694.46 |
$2,671 |
3.2× |
| CT pelvis with contrast (72193) |
$494.52 |
$1,902 |
3.1× |
| MRI lower-extremity joint without contrast (73721) |
$718.90 |
$2,765 |
3.3× |
| CT abdomen and pelvis with contrast (74177) |
$744.12 |
$2,862 |
2.4× |
| Ultrasound, abdomen complete (76700) |
$215.28 |
$828 |
2.3× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$103.74 |
$399 |
1.1× |
| Ultrasound, transvaginal (76830) |
$184.34 |
$709 |
1.9× |
| Mammography, one breast (diagnostic) (77065) |
$73.62 |
$243 |
0.9× |
| Mammography, both breasts (diagnostic) (77066) |
$87.19 |
$285.50 |
0.8× |
| Mammography, screening (bilateral) (77067) |
$74.92 |
$248 |
0.8× |
| Basic metabolic panel (80048) |
$13.52 |
$52 |
1.6× |
| Comprehensive metabolic panel (80053) |
$17.68 |
$68 |
1.7× |
| Obstetric panel (80055) |
$70.20 |
$270 |
1.5× |
| Lipid panel (80061) |
$19.76 |
$76 |
1.5× |
| Renal function panel (80069) |
$14.04 |
$54 |
1.6× |
| Hepatic function panel (80076) |
$13.26 |
$51 |
1.6× |
| Urinalysis, non-automated, with microscopy (81000) |
$5.72 |
$22 |
1.4× |
| Urinalysis, non-automated, without microscopy (81002) |
$4.42 |
$17 |
1.3× |
| PSA, total (84153) |
$30.16 |
$116 |
1.6× |
| Thyroid stimulating hormone (TSH) (84443) |
$27.82 |
$107 |
1.7× |
| CBC with automated differential (85025) |
$12.74 |
$49 |
1.6× |
| CBC, automated (85027) |
$8.19 |
$31.50 |
1.3× |
| Prothrombin time (PT) (85610) |
$6.76 |
$26 |
1.6× |
| Partial thromboplastin time (PTT) (85730) |
$8.84 |
$34 |
1.5× |
| Psychotherapy, 30 minutes (90832) |
$47.88 |
$126 |
0.3× |
| Psychotherapy, 45 minutes (90834) |
$71.82 |
$189 |
0.4× |
| Psychotherapy, 60 minutes (90837) |
$108.68 |
$286 |
0.7× |
| Family psychotherapy, without patient (50 min) (90846) |
$52 |
$200 |
0.3× |
| Family psychotherapy, with patient (50 min) (90847) |
$61.10 |
$235 |
0.4× |
| Group psychotherapy (90853) |
$16.38 |
$63 |
0.2× |
| Sleep study (attended polysomnography) (95810) |
$550.68 |
$2,118 |
0.7× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$33.80 |
$130 |
1.2× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$54.30 |
$147 |
0.5× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$79.47 |
$199.50 |
0.7× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$97.14 |
$237 |
0.8× |
| Preventive visit, new patient (age 18–39) (99385) |
$86.50 |
$173 |
— |
| Preventive visit, new patient (age 40–64) (99386) |
$105 |
$210 |
— |