| Breast lesion removal (open) (19120) |
$2,831 |
$3,330 |
0.7× |
| Shoulder arthroscopy with decompression (29826) |
$4,045.50 |
$4,759.50 |
— |
| Knee arthroscopy with meniscectomy (29881) |
$4,584 |
$5,393 |
1.3× |
| Tonsillectomy and adenoidectomy (under age 12) (42820) |
$4,007.50 |
$4,714.50 |
0.7× |
| Upper GI endoscopy (EGD), diagnostic (43235) |
$1,157.50 |
$1,362 |
1.2× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$1,275 |
$1,499.50 |
1.4× |
| Diagnostic colonoscopy (45378) |
$2,158 |
$2,539 |
2.2× |
| Colonoscopy with biopsy (45380) |
$2,389 |
$2,810 |
1.9× |
| Colonoscopy with lesion removal (45385) |
$2,791 |
$3,283 |
2.2× |
| Laparoscopic gallbladder removal (47562) |
$6,272 |
$7,378.50 |
1.0× |
| Inguinal hernia repair (age 5+) (49505) |
$5,438 |
$6,397.50 |
1.5× |
| Laparoscopic radical prostatectomy (55866) |
$6,726.50 |
$7,913.50 |
0.6× |
| Obstetric care, vaginal delivery (global) (59400) |
$2,795 |
$3,288 |
— |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$1,087 |
$1,279 |
1.2× |
| CT head/brain without contrast (70450) |
$1,752 |
$2,061 |
16.1× |
| MRI brain without contrast (70551) |
$3,363 |
$3,957 |
13.6× |
| MRI brain with contrast (70552) |
$3,326 |
$3,913 |
9.2× |
| MRI brain without and with contrast (70553) |
$3,728 |
$4,386 |
10.3× |
| X-ray lower spine, 4+ views (72110) |
$275 |
$323 |
2.5× |
| MRI lumbar spine without contrast (72148) |
$3,014 |
$3,546 |
12.2× |
| CT pelvis with contrast (72193) |
$2,377 |
$2,797 |
13.1× |
| MRI lower-extremity joint without contrast (73721) |
$2,396.50 |
$2,819 |
9.7× |
| CT abdomen and pelvis with contrast (74177) |
$4,157 |
$4,891 |
11.5× |
| Ultrasound, abdomen complete (76700) |
$854.50 |
$1,005 |
7.9× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$747 |
$879 |
6.9× |
| Ultrasound, transvaginal (76830) |
$619 |
$728 |
5.7× |
| Mammography, one breast (diagnostic) (77065) |
$366 |
$431 |
4.2× |
| Mammography, both breasts (diagnostic) (77066) |
$440 |
$518 |
4.0× |
| Mammography, screening (bilateral) (77067) |
$381 |
$448 |
4.2× |
| Basic metabolic panel (80048) |
$167 |
$197 |
19.7× |
| Comprehensive metabolic panel (80053) |
$184 |
$216 |
17.4× |
| Obstetric panel (80055) |
$184 |
$217 |
3.8× |
| Lipid panel (80061) |
$153 |
$180 |
11.4× |
| Renal function panel (80069) |
$172 |
$202 |
19.8× |
| Hepatic function panel (80076) |
$163 |
$192 |
20.0× |
| PSA, total (84153) |
$120 |
$141 |
6.5× |
| Thyroid stimulating hormone (TSH) (84443) |
$132.50 |
$155.50 |
7.9× |
| CBC with automated differential (85025) |
$128 |
$151 |
16.5× |
| CBC, automated (85027) |
$85 |
$100 |
13.1× |
| Prothrombin time (PT) (85610) |
$89 |
$105 |
20.7× |
| Partial thromboplastin time (PTT) (85730) |
$101.50 |
$119.50 |
16.9× |
| Family psychotherapy, without patient (50 min) (90846) |
$268 |
$315 |
1.5× |
| Family psychotherapy, with patient (50 min) (90847) |
$263 |
$309 |
1.4× |
| Group psychotherapy (90853) |
$446 |
$525 |
4.2× |
| Electrocardiogram (ECG), complete (93000) |
$229.50 |
$270 |
3.7× |
| Sleep study (attended polysomnography) (95810) |
$3,652 |
$4,297 |
4.1× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$92.50 |
$108.50 |
3.2× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$166.50 |
$196 |
1.2× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$213 |
$250.50 |
1.5× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$251.50 |
$296 |
1.8× |
| Preventive visit, new patient (age 18–39) (99385) |
$291 |
$342 |
— |
| Preventive visit, new patient (age 40–64) (99386) |
$329 |
$387 |
— |