| Breast lesion removal (open) (19120) |
$510.09 |
$1,083 |
0.1× |
| Upper GI endoscopy (EGD), diagnostic (43235) |
$150.72 |
$320 |
0.2× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$169.56 |
$360 |
0.2× |
| Diagnostic colonoscopy (45378) |
$227.49 |
$483 |
0.2× |
| Colonoscopy with biopsy (45380) |
$246.33 |
$523 |
0.2× |
| Colonoscopy with lesion removal (45385) |
$312.74 |
$664 |
0.2× |
Laparoscopic gallbladder removal (47562)
likely a partial charge, not the full procedure |
$509.86 |
$1,082.50 |
0.1× |
| Inguinal hernia repair (age 5+) (49505) |
$443.44 |
$941.50 |
0.1× |
| Epidural injection, lumbar/sacral (with imaging) (62322) |
$108.46 |
$220 |
0.1× |
| CT head/brain without contrast (70450) |
$457.50 |
$761.50 |
4.1× |
| MRI brain without contrast (70551) |
$1,179.22 |
$1,938 |
4.6× |
| MRI brain with contrast (70552) |
$1,472.10 |
$2,418 |
4.0× |
| MRI brain without and with contrast (70553) |
$1,770.66 |
$2,911 |
4.8× |
| X-ray lower spine, 4+ views (72110) |
$336.64 |
$528 |
3.0× |
| MRI lumbar spine without contrast (72148) |
$1,391.43 |
$2,250.50 |
5.5× |
| CT pelvis with contrast (72193) |
$1,014.26 |
$1,769 |
5.4× |
| MRI lower-extremity joint without contrast (73721) |
$154.51 |
$348 |
0.6× |
| CT abdomen and pelvis with contrast (74177) |
$1,479.76 |
$2,583 |
4.0× |
| Ultrasound, abdomen complete (76700) |
$410.21 |
$582.50 |
3.7× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$475.54 |
$676.50 |
4.3× |
| Ultrasound, transvaginal (76830) |
$367.24 |
$520.50 |
3.3× |
| Mammography, one breast (diagnostic) (77065) |
$139.74 |
$199.50 |
1.6× |
| Mammography, both breasts (diagnostic) (77066) |
$204.86 |
$287 |
1.9× |
| Mammography, screening (bilateral) (77067) |
$155.13 |
$249 |
1.7× |
| Basic metabolic panel (80048) |
$62.27 |
$111 |
7.4× |
| Comprehensive metabolic panel (80053) |
$76.86 |
$137 |
7.3× |
| Lipid panel (80061) |
$42.36 |
$75.50 |
3.2× |
| Renal function panel (80069) |
$87.52 |
$156 |
10.1× |
| Hepatic function panel (80076) |
$60.59 |
$108 |
7.4× |
| Urinalysis, non-automated, without microscopy (81002) |
$6.31 |
$11 |
1.8× |
| PSA, total (84153) |
$31.42 |
$56 |
1.7× |
| Thyroid stimulating hormone (TSH) (84443) |
$29.45 |
$52.50 |
1.8× |
| CBC with automated differential (85025) |
$24.38 |
$44.50 |
3.1× |
| CBC, automated (85027) |
$10.96 |
$20 |
1.7× |
| Prothrombin time (PT) (85610) |
$27.95 |
$51 |
6.5× |
| Partial thromboplastin time (PTT) (85730) |
$10.41 |
$19 |
1.7× |
| Sleep study (attended polysomnography) (95810) |
$3,827.36 |
$5,507 |
4.2× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$87.67 |
$153 |
3.0× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$266.76 |
$390 |
1.9× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$362.52 |
$530 |
2.6× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$417.24 |
$610 |
2.9× |
| Office consultation (low complexity, ~30 min) (99243) |
$124.25 |
$248 |
0.9× |
| Office consultation (moderate complexity, ~40 min) (99244) |
$199.40 |
$398 |
1.4× |