| Breast lesion removal (open) (19120) |
— |
$5,788 |
— |
| Upper GI endoscopy (EGD), diagnostic (43235) |
— |
$2,088 |
— |
| Upper GI endoscopy (EGD) with biopsy (43239) |
— |
$2,334 |
— |
| Diagnostic colonoscopy (45378) |
— |
$2,616 |
— |
| Colonoscopy with biopsy (45380) |
— |
$2,823 |
— |
| Colonoscopy with lesion removal (45385) |
— |
$3,550 |
— |
| Colonoscopy with endoscopic ultrasound (45391) |
— |
$3,592 |
— |
| Epidural injection, lumbar/sacral (with imaging) (62322) |
— |
$1,313 |
— |
| Transforaminal epidural injection, lumbar/sacral (64483) |
— |
$2,549 |
— |
| After-cataract laser surgery (YAG capsulotomy) (66821) |
— |
$1,255 |
— |
| CT head/brain without contrast (70450) |
— |
$2,064 |
— |
| MRI brain without contrast (70551) |
— |
$1,782 |
— |
| MRI brain with contrast (70552) |
— |
$2,612 |
— |
| MRI brain without and with contrast (70553) |
— |
$2,957 |
— |
| X-ray lower spine, 4+ views (72110) |
— |
$569 |
— |
| MRI lumbar spine without contrast (72148) |
— |
$2,580 |
— |
| CT pelvis with contrast (72193) |
— |
$2,673 |
— |
| MRI lower-extremity joint without contrast (73721) |
— |
$2,957 |
— |
| CT abdomen and pelvis with contrast (74177) |
— |
$2,650 |
— |
| Ultrasound, abdomen complete (76700) |
— |
$853 |
— |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
— |
$739 |
— |
| Ultrasound, transvaginal (76830) |
— |
$988 |
— |
| Mammography, one breast (diagnostic) (77065) |
— |
$758 |
— |
| Mammography, both breasts (diagnostic) (77066) |
— |
$905 |
— |
| Mammography, screening (bilateral) (77067) |
— |
$239 |
— |
| Basic metabolic panel (80048) |
— |
$188 |
— |
| Comprehensive metabolic panel (80053) |
— |
$266 |
— |
| Obstetric panel (80055) |
— |
$397 |
— |
Lipid panel (80061)
range across 2 matching MRF lines |
— |
$67–$69 |
— |
| Renal function panel (80069) |
— |
$52 |
— |
| Hepatic function panel (80076) |
— |
$149 |
— |
| Urinalysis, non-automated, with microscopy (81000) |
— |
$45 |
— |
| Urinalysis, non-automated, without microscopy (81002) |
— |
$44 |
— |
| PSA, total (84153) |
— |
$221 |
— |
| Thyroid stimulating hormone (TSH) (84443) |
— |
$128 |
— |
| CBC with automated differential (85025) |
— |
$131 |
— |
| CBC, automated (85027) |
— |
$65 |
— |
| Prothrombin time (PT) (85610) |
— |
$75 |
— |
| Partial thromboplastin time (PTT) (85730) |
— |
$83 |
— |
| Psychotherapy, 30 minutes (90832) |
— |
$263 |
— |
| Psychotherapy, 45 minutes (90834) |
— |
$312 |
— |
| Psychotherapy, 60 minutes (90837) |
— |
$386 |
— |
| Family psychotherapy, without patient (50 min) (90846) |
— |
$295 |
— |
| Family psychotherapy, with patient (50 min) (90847) |
— |
$325 |
— |
Group psychotherapy (90853)
range across 8 matching MRF lines |
— |
$284–$1,438 |
— |
| Left heart catheterization (93452) |
— |
$9,518 |
— |
| Sleep study (attended polysomnography) (95810) |
— |
$5,018 |
— |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
— |
$150 |
— |
| Office visit, new patient (low complexity, ~30 min) (99203) |
— |
$255 |
— |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
— |
$350 |
— |
| Office visit, new patient (high complexity, ~60 min) (99205) |
— |
$447 |
— |
| Preventive visit, new patient (age 18–39) (99385) |
— |
$159 |
— |
| Preventive visit, new patient (age 40–64) (99386) |
— |
$171 |
— |