| Breast lesion removal (open) (19120) |
$1,373 |
$3,432.50 |
0.4× |
| Shoulder arthroscopy with decompression (29826) |
$242 |
$605 |
— |
| Knee arthroscopy with meniscectomy (29881) |
$4,000 |
$1,758 |
1.3× |
Tonsillectomy and adenoidectomy (under age 12) (42820)
likely a partial charge, not the full procedure |
$332.80 |
$832 |
0.1× |
| Upper GI endoscopy (EGD), diagnostic (43235) |
$1,500 |
$339 |
1.8× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$1,500 |
$382 |
1.8× |
| Diagnostic colonoscopy (45378) |
$1,500 |
$458 |
1.7× |
| Colonoscopy with biopsy (45380) |
$1,700 |
$2,438 |
1.5× |
| Colonoscopy with lesion removal (45385) |
$1,013.80 |
$2,534.50 |
0.9× |
| Laparoscopic gallbladder removal (47562) |
$6,500 |
$1,725 |
1.2× |
| Inguinal hernia repair (age 5+) (49505) |
$4,200 |
$2,538 |
1.3× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$766.80 |
$1,917 |
0.9× |
| CT head/brain without contrast (70450) |
$750 |
$1,048 |
7.7× |
| MRI brain without contrast (70551) |
$900 |
$336 |
4.0× |
| MRI brain with contrast (70552) |
$900 |
$3,665 |
2.8× |
| MRI brain without and with contrast (70553) |
$900 |
$2,025 |
2.8× |
| X-ray lower spine, 4+ views (72110) |
$216 |
$540 |
2.2× |
| MRI lumbar spine without contrast (72148) |
$900 |
$1,335.50 |
4.0× |
| CT pelvis with contrast (72193) |
$750 |
$1,751 |
4.6× |
| MRI lower-extremity joint without contrast (73721) |
$900 |
$2,335 |
4.0× |
| CT abdomen and pelvis with contrast (74177) |
$750 |
$1,901.50 |
2.3× |
| Ultrasound, abdomen complete (76700) |
$450 |
$561.50 |
4.6× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$247.40 |
$618.50 |
2.5× |
| Ultrasound, transvaginal (76830) |
$450 |
$590.50 |
4.6× |
| Basic metabolic panel (80048) |
$55 |
$56.50 |
6.5× |
| Comprehensive metabolic panel (80053) |
$70 |
$35 |
6.6× |
| Obstetric panel (80055) |
$191.60 |
$479 |
4.0× |
| Lipid panel (80061) |
$85 |
$89 |
6.3× |
| Renal function panel (80069) |
$34.80 |
$87 |
4.0× |
| Hepatic function panel (80076) |
$55 |
$82 |
6.7× |
| PSA, total (84153) |
$115 |
$184 |
6.3× |
| Thyroid stimulating hormone (TSH) (84443) |
$105 |
$168 |
6.3× |
| CBC with automated differential (85025) |
$50 |
$73.50 |
6.4× |
| CBC, automated (85027) |
$45 |
$24 |
7.0× |
| Prothrombin time (PT) (85610) |
$30 |
$43 |
7.0× |
| Partial thromboplastin time (PTT) (85730) |
$24.40 |
$61 |
4.1× |
| Psychotherapy, 30 minutes (90832) |
$100 |
$435 |
0.6× |
| Psychotherapy, 45 minutes (90834) |
$100 |
$462.50 |
0.6× |
| Psychotherapy, 60 minutes (90837) |
$100 |
$518 |
0.6× |
| Family psychotherapy, without patient (50 min) (90846) |
$128.40 |
$321 |
0.8× |
| Family psychotherapy, with patient (50 min) (90847) |
$172.40 |
$431 |
1.0× |
| Group psychotherapy (90853) |
$31.20 |
$78 |
0.3× |
| Electrocardiogram (ECG), complete (93000) |
$130 |
$325 |
2.4× |
| Sleep study (attended polysomnography) (95810) |
$120 |
$300 |
0.1× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$115 |
$142 |
4.0× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$100 |
$256 |
0.8× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$100 |
$433 |
0.8× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$100 |
$554 |
0.8× |
| Office consultation (low complexity, ~30 min) (99243) |
$142.80 |
$357 |
1.1× |
| Office consultation (moderate complexity, ~40 min) (99244) |
$395.20 |
$988 |
3.2× |
| Preventive visit, new patient (age 18–39) (99385) |
$100 |
$547 |
— |
| Preventive visit, new patient (age 40–64) (99386) |
$100 |
$582 |
— |