| Breast lesion removal (open) (19120) |
$1,335 |
$2,670 |
0.3× |
| Shoulder arthroscopy with decompression (29826) |
$910.50 |
$1,821 |
— |
| Knee arthroscopy with meniscectomy (29881) |
$788 |
$1,576 |
0.2× |
Tonsillectomy and adenoidectomy (under age 12) (42820)
likely a partial charge, not the full procedure |
$283.50 |
$567 |
0.0× |
| Upper GI endoscopy (EGD), diagnostic (43235) |
$388 |
$776 |
0.4× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$387.50 |
$775 |
0.4× |
| Diagnostic colonoscopy (45378) |
$508.50 |
$1,017 |
0.5× |
| Colonoscopy with biopsy (45380) |
$500.75 |
$1,001.50 |
0.4× |
| Colonoscopy with lesion removal (45385) |
$706 |
$1,412 |
0.6× |
Laparoscopic gallbladder removal (47562)
likely a partial charge, not the full procedure |
$979.50 |
$1,959 |
0.2× |
| Inguinal hernia repair (age 5+) (49505) |
$774 |
$1,548 |
0.2× |
| Obstetric care, vaginal delivery (global) (59400) |
$2,310.50 |
$4,621 |
— |
| Obstetric care, cesarean delivery (global) (59510) |
$2,705 |
$5,410 |
— |
| Obstetric care, VBAC delivery (global) (59610) |
$2,520 |
$5,040 |
— |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$650 |
$1,300 |
0.7× |
| CT head/brain without contrast (70450) |
$125.10 |
$250.20 |
1.2× |
| MRI brain without contrast (70551) |
$256.85 |
$513.70 |
1.1× |
| MRI brain with contrast (70552) |
$295.32 |
$590.65 |
0.8× |
| MRI brain without and with contrast (70553) |
$403.15 |
$806.30 |
1.2× |
| X-ray lower spine, 4+ views (72110) |
$76.50 |
$153 |
0.7× |
| MRI lumbar spine without contrast (72148) |
$184.18 |
$368.35 |
0.8× |
| CT pelvis with contrast (72193) |
$243.12 |
$486.25 |
1.4× |
| MRI lower-extremity joint without contrast (73721) |
$256.85 |
$513.70 |
1.1× |
| CT abdomen and pelvis with contrast (74177) |
$438.75 |
$877.50 |
1.3× |
| Ultrasound, abdomen complete (76700) |
$91.92 |
$183.85 |
0.9× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$110.50 |
$221 |
1.1× |
| Ultrasound, transvaginal (76830) |
$97.50 |
$195 |
0.9× |
| Mammography, one breast (diagnostic) (77065) |
$85.50 |
$171 |
1.0× |
| Mammography, both breasts (diagnostic) (77066) |
$166.50 |
$333 |
1.5× |
| Mammography, screening (bilateral) (77067) |
$103.62 |
$207.25 |
1.1× |
| Basic metabolic panel (80048) |
$13.75 |
$27.50 |
1.6× |
| Comprehensive metabolic panel (80053) |
$17.60 |
$35.20 |
1.7× |
| Lipid panel (80061) |
$17.50 |
$35 |
1.3× |
| Renal function panel (80069) |
$11.40 |
$22.80 |
1.3× |
| Hepatic function panel (80076) |
$12.50 |
$25 |
1.5× |
| Urinalysis, non-automated, with microscopy (81000) |
$4 |
$8 |
1.0× |
| Urinalysis, non-automated, without microscopy (81002) |
$31 |
$62 |
8.9× |
| PSA, total (84153) |
$30.25 |
$60.50 |
1.6× |
| Thyroid stimulating hormone (TSH) (84443) |
$25 |
$50 |
1.5× |
| CBC with automated differential (85025) |
$9.82 |
$19.65 |
1.3× |
| CBC, automated (85027) |
$9.50 |
$19 |
1.5× |
| Prothrombin time (PT) (85610) |
$7.15 |
$14.30 |
1.7× |
| Partial thromboplastin time (PTT) (85730) |
$9.90 |
$19.80 |
1.6× |
| Psychotherapy, 30 minutes (90832) |
$76 |
$152 |
0.4× |
| Psychotherapy, 45 minutes (90834) |
$91.75 |
$183.50 |
0.5× |
| Psychotherapy, 60 minutes (90837) |
$82.50 |
$165 |
0.5× |
| Electrocardiogram (ECG), complete (93000) |
$31.50 |
$63 |
0.5× |
| Left heart catheterization (93452) |
$3,523.50 |
$7,047 |
1.1× |
| Sleep study (attended polysomnography) (95810) |
$144 |
$288 |
0.2× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$44.55 |
$89.10 |
1.5× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$100.50 |
$201 |
0.8× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$148.50 |
$297 |
1.1× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$185.50 |
$371 |
1.4× |
| Office consultation (low complexity, ~30 min) (99243) |
$112.50 |
$225 |
0.8× |
| Office consultation (moderate complexity, ~40 min) (99244) |
$160 |
$320 |
1.2× |
| Preventive visit, new patient (age 18–39) (99385) |
$58.11 |
$116.21 |
— |
| Preventive visit, new patient (age 40–64) (99386) |
$129.38 |
$258.75 |
— |