| Breast lesion removal (open) (19120) |
$800.95 |
$8,009.50 |
0.2× |
| Shoulder arthroscopy with decompression (29826) |
$768.72 |
$7,687.16 |
— |
| Knee arthroscopy with meniscectomy (29881) |
$2,705.85 |
$27,058.50 |
0.9× |
Tonsillectomy and adenoidectomy (under age 12) (42820)
likely a partial charge, not the full procedure |
$698.60 |
$6,986 |
0.1× |
| Upper GI endoscopy (EGD), diagnostic (43235) |
$429.15 |
$4,291.50 |
0.5× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$442.80 |
$4,428 |
0.5× |
| Diagnostic colonoscopy (45378) |
$361.85 |
$3,618.50 |
0.4× |
| Colonoscopy with biopsy (45380) |
$443.89 |
$4,438.88 |
0.4× |
| Colonoscopy with lesion removal (45385) |
$538.66 |
$5,386.66 |
0.5× |
| Colonoscopy with endoscopic ultrasound (45391) |
$140.55 |
$1,405.45 |
0.1× |
Laparoscopic gallbladder removal (47562)
likely a partial charge, not the full procedure |
$1,450.65 |
$14,506.50 |
0.2× |
| Inguinal hernia repair (age 5+) (49505) |
$2,353.12 |
$23,531.17 |
0.7× |
Laparoscopic radical prostatectomy (55866)
likely a partial charge, not the full procedure |
$2,070.37 |
$20,703.66 |
0.2× |
| Epidural injection, lumbar/sacral (with imaging) (62322) |
$108.56 |
$1,085.56 |
0.1× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$479.60 |
$4,796 |
0.6× |
| Cataract removal with lens insertion (66984) |
$1,214.44 |
$12,144.33 |
0.5× |
| CT head/brain without contrast (70450) |
$13.09 |
$130.94 |
0.1× |
| MRI brain without contrast (70551) |
$29.18 |
$291.84 |
0.1× |
| MRI brain with contrast (70552) |
$45.80 |
$458.03 |
0.1× |
| MRI brain without and with contrast (70553) |
$45.80 |
$458.03 |
0.1× |
| X-ray lower spine, 4+ views (72110) |
$13.09 |
$130.94 |
0.1× |
| MRI lumbar spine without contrast (72148) |
$29.18 |
$291.84 |
0.1× |
| CT pelvis with contrast (72193) |
$21.88 |
$218.83 |
0.1× |
| MRI lower-extremity joint without contrast (73721) |
$561.60 |
$5,616 |
2.4× |
| CT abdomen and pelvis with contrast (74177) |
$45.80 |
$458.03 |
0.1× |
| Ultrasound, abdomen complete (76700) |
$13.09 |
$130.94 |
0.1× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$88.44 |
$884.47 |
0.9× |
| Ultrasound, transvaginal (76830) |
$13.09 |
$130.94 |
0.1× |
| Mammography, one breast (diagnostic) (77065) |
$38.50 |
$385 |
0.4× |
| Mammography, both breasts (diagnostic) (77066) |
$33.66 |
$336.59 |
0.3× |
| Mammography, screening (bilateral) (77067) |
$44.40 |
$444 |
0.5× |
| Basic metabolic panel (80048) |
$4.40 |
$41 |
0.5× |
| Comprehensive metabolic panel (80053) |
$5.25 |
$48 |
0.5× |
| Lipid panel (80061) |
$5.90 |
$54 |
0.4× |
| Renal function panel (80069) |
$5.50 |
$55 |
0.6× |
| Hepatic function panel (80076) |
$4.60 |
$9.19 |
0.6× |
| Urinalysis, non-automated, with microscopy (81000) |
$8.15 |
$40.52 |
2.0× |
| Urinalysis, non-automated, without microscopy (81002) |
$1.80 |
$17 |
0.5× |
| PSA, total (84153) |
$6.60 |
$55 |
0.4× |
| Thyroid stimulating hormone (TSH) (84443) |
$8.48 |
$84.50 |
0.5× |
| CBC with automated differential (85025) |
$5.68 |
$21.86 |
0.7× |
| CBC, automated (85027) |
$15.60 |
$54.75 |
2.4× |
| Prothrombin time (PT) (85610) |
$4.70 |
$40 |
1.1× |
| Partial thromboplastin time (PTT) (85730) |
$5.75 |
$48.50 |
1.0× |
| Left heart catheterization (93452) |
$1,388.80 |
$13,887.96 |
0.4× |
| Sleep study (attended polysomnography) (95810) |
$124.52 |
$1,245.23 |
0.2× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$43.60 |
$436 |
1.5× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$30.75 |
$307.50 |
0.2× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$40.90 |
$409 |
0.3× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$52 |
$520 |
0.4× |
| Office consultation (low complexity, ~30 min) (99243) |
$26.30 |
$263 |
0.2× |
| Office consultation (moderate complexity, ~40 min) (99244) |
$29.10 |
$291 |
0.2× |
| Preventive visit, new patient (age 18–39) (99385) |
$63.85 |
$638.50 |
— |
| Preventive visit, new patient (age 40–64) (99386) |
$54 |
$540 |
— |