| Breast lesion removal (open) (19120) |
$2,137.50 |
$4,275 |
0.5× |
Tonsillectomy and adenoidectomy (under age 12) (42820)
unusually low: confirm this is the full procedure |
$2,137.50 |
$4,275 |
0.4× |
| Upper GI endoscopy (EGD), diagnostic (43235) |
$1,743.50 |
$3,487 |
1.9× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$1,743.50 |
$3,487 |
1.9× |
| Diagnostic colonoscopy (45378) |
$1,743.50 |
$3,487 |
1.9× |
| Colonoscopy with biopsy (45380) |
$1,743.50 |
$3,487 |
1.5× |
| Colonoscopy with lesion removal (45385) |
$1,743.50 |
$3,487 |
1.5× |
| Laparoscopic gallbladder removal (47562) |
$3,317 |
$6,634 |
0.5× |
| Inguinal hernia repair (age 5+) (49505) |
$2,531 |
$5,062 |
0.7× |
| Cataract removal with lens insertion (66984) |
$2,137.50 |
$4,275 |
0.9× |
| CT head/brain without contrast (70450) |
$1,198.50 |
$2,397 |
11.4× |
| MRI brain without contrast (70551) |
$1,420.50 |
$2,841 |
5.9× |
| MRI brain with contrast (70552) |
$1,622 |
$3,244 |
4.6× |
| MRI brain without and with contrast (70553) |
$1,850 |
$3,700 |
5.3× |
| X-ray lower spine, 4+ views (72110) |
$320 |
$640 |
3.0× |
| MRI lumbar spine without contrast (72148) |
$1,619.50 |
$3,239 |
6.8× |
| CT pelvis with contrast (72193) |
$1,550.50 |
$3,101 |
8.8× |
| MRI lower-extremity joint without contrast (73721) |
$1,409 |
$2,818 |
5.9× |
| CT abdomen and pelvis with contrast (74177) |
$2,114 |
$4,228 |
6.0× |
| Ultrasound, abdomen complete (76700) |
$491 |
$982 |
4.7× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$407 |
$814 |
3.9× |
| Ultrasound, transvaginal (76830) |
$216 |
$432 |
2.1× |
| Mammography, one breast (diagnostic) (77065) |
$217.50 |
$435 |
2.5× |
| Mammography, both breasts (diagnostic) (77066) |
$232 |
$464 |
2.1× |
| Mammography, screening (bilateral) (77067) |
$196.50 |
$393 |
2.2× |
| Basic metabolic panel (80048) |
$94.50 |
$189 |
11.2× |
| Comprehensive metabolic panel (80053) |
$65 |
$130 |
6.2× |
| Obstetric panel (80055) |
$150 |
$300 |
3.1× |
| Lipid panel (80061) |
$55.56 |
$111.11 |
4.1× |
| Renal function panel (80069) |
$109 |
$218 |
12.6× |
| Hepatic function panel (80076) |
$84 |
$168 |
10.3× |
| Urinalysis, non-automated, with microscopy (81000) |
$19.50 |
$39 |
4.9× |
| Urinalysis, non-automated, without microscopy (81002) |
$20.50 |
$41 |
5.9× |
| PSA, total (84153) |
$94 |
$188 |
5.1× |
| Thyroid stimulating hormone (TSH) (84443) |
$85 |
$170 |
5.1× |
| CBC with automated differential (85025) |
$50.50 |
$101 |
6.5× |
| CBC, automated (85027) |
$41.75 |
$83.50 |
6.5× |
| Prothrombin time (PT) (85610) |
$33 |
$66 |
7.7× |
| Partial thromboplastin time (PTT) (85730) |
$56.50 |
$113 |
9.4× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$45.75 |
$91.50 |
1.6× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$109.50 |
$219 |
0.8× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$139.50 |
$279 |
1.0× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$133.25 |
$266.50 |
1.0× |