| Breast lesion removal (open) (19120) |
$496 |
$620 |
0.1× |
| Upper GI endoscopy (EGD), diagnostic (43235) |
$488 |
$610 |
0.6× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$488 |
$610 |
0.6× |
| Diagnostic colonoscopy (45378) |
$448 |
$560 |
0.5× |
| Colonoscopy with biopsy (45380) |
$500 |
$625 |
0.5× |
| Colonoscopy with lesion removal (45385) |
$520 |
$650 |
0.5× |
Laparoscopic gallbladder removal (47562)
likely a partial charge, not the full procedure |
$520 |
$650 |
0.1× |
| Inguinal hernia repair (age 5+) (49505) |
$440 |
$550 |
0.1× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$1,680 |
$2,100 |
2.1× |
| CT head/brain without contrast (70450) |
$760 |
$950 |
7.9× |
| MRI brain without contrast (70551) |
$720 |
$900 |
3.3× |
| MRI brain with contrast (70552) |
$720 |
$900 |
2.2× |
| MRI brain without and with contrast (70553) |
$720 |
$900 |
2.2× |
| X-ray lower spine, 4+ views (72110) |
$256 |
$320 |
2.7× |
| MRI lumbar spine without contrast (72148) |
$720 |
$900 |
3.3× |
| CT pelvis with contrast (72193) |
$760 |
$950 |
4.7× |
| MRI lower-extremity joint without contrast (73721) |
$720 |
$900 |
3.3× |
| CT abdomen and pelvis with contrast (74177) |
$760 |
$950 |
2.4× |
| Ultrasound, abdomen complete (76700) |
$320 |
$400 |
3.3× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$180 |
$225 |
1.9× |
| Ultrasound, transvaginal (76830) |
$126.40 |
$158 |
1.3× |
| Mammography, one breast (diagnostic) (77065) |
$140 |
$175 |
1.6× |
| Mammography, both breasts (diagnostic) (77066) |
$156 |
$195 |
1.4× |
| Mammography, screening (bilateral) (77067) |
$132 |
$165 |
1.4× |
| Basic metabolic panel (80048) |
$56 |
$70 |
6.6× |
| Comprehensive metabolic panel (80053) |
$97.60 |
$122 |
9.2× |
| Lipid panel (80061) |
$112 |
$140 |
8.4× |
| Renal function panel (80069) |
$56 |
$70 |
6.5× |
| Hepatic function panel (80076) |
$44 |
$55 |
5.4× |
| Urinalysis, non-automated, without microscopy (81002) |
$20 |
$25 |
5.7× |
| PSA, total (84153) |
$116 |
$145 |
6.3× |
| Thyroid stimulating hormone (TSH) (84443) |
$72 |
$90 |
4.3× |
| CBC with automated differential (85025) |
$37.60 |
$47 |
4.8× |
| CBC, automated (85027) |
$24 |
$30 |
3.7× |
| Prothrombin time (PT) (85610) |
$25.20 |
$31.50 |
5.9× |
| Partial thromboplastin time (PTT) (85730) |
$49.60 |
$62 |
8.3× |
| Psychotherapy, 30 minutes (90832) |
$132.80 |
$166 |
0.8× |
| Psychotherapy, 45 minutes (90834) |
$160 |
$200 |
1.0× |
| Psychotherapy, 60 minutes (90837) |
$186.40 |
$233 |
1.1× |
| Family psychotherapy, without patient (50 min) (90846) |
$480 |
$600 |
2.9× |
| Family psychotherapy, with patient (50 min) (90847) |
$240 |
$300 |
1.5× |
| Group psychotherapy (90853) |
$331.20 |
$414 |
3.5× |
| Sleep study (attended polysomnography) (95810) |
$1,120 |
$1,400 |
1.4× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$66.40 |
$83 |
2.3× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$128 |
$160 |
1.0× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$164 |
$205 |
1.3× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$188 |
$235 |
1.5× |
| Preventive visit, new patient (age 18–39) (99385) |
$200 |
$250 |
— |
| Preventive visit, new patient (age 40–64) (99386) |
$208 |
$260 |
— |