| Breast lesion removal (open) (19120) |
— |
$8,034 |
— |
| Tonsillectomy and adenoidectomy (under age 12) (42820) |
— |
$11,991 |
— |
| Upper GI endoscopy (EGD), diagnostic (43235) |
— |
$2,596 |
— |
| Upper GI endoscopy (EGD) with biopsy (43239) |
— |
$2,916 |
— |
| Diagnostic colonoscopy (45378) |
— |
$2,922 |
— |
| Colonoscopy with biopsy (45380) |
— |
$3,602 |
— |
| Laparoscopic gallbladder removal (47562) |
— |
$14,250 |
— |
Epidural injection, lumbar/sacral (with imaging) (62322)
range across 2 matching MRF lines |
— |
$1,892–$2,470 |
— |
| Transforaminal epidural injection, lumbar/sacral (64483) |
— |
$1,942 |
— |
| CT head/brain without contrast (70450) |
— |
$2,500 |
— |
| MRI brain without contrast (70551) |
— |
$3,917 |
— |
| MRI brain with contrast (70552) |
— |
$4,421 |
— |
| MRI brain without and with contrast (70553) |
— |
$6,025 |
— |
| X-ray lower spine, 4+ views (72110) |
— |
$975 |
— |
| MRI lumbar spine without contrast (72148) |
— |
$3,080 |
— |
| CT pelvis with contrast (72193) |
— |
$3,729 |
— |
MRI lower-extremity joint without contrast (73721)
range across 3 matching MRF lines |
— |
$4,594–$6,891 |
— |
| CT abdomen and pelvis with contrast (74177) |
— |
$5,015 |
— |
| Ultrasound, abdomen complete (76700) |
— |
$1,080 |
— |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
— |
$958 |
— |
| Ultrasound, transvaginal (76830) |
— |
$721 |
— |
| Basic metabolic panel (80048) |
— |
$448 |
— |
| Comprehensive metabolic panel (80053) |
— |
$1,115 |
— |
| Lipid panel (80061) |
— |
$204 |
— |
| Renal function panel (80069) |
— |
$260 |
— |
| Hepatic function panel (80076) |
— |
$214 |
— |
| Urinalysis, non-automated, with microscopy (81000) |
— |
$46 |
— |
| Urinalysis, non-automated, without microscopy (81002) |
— |
$44 |
— |
| Thyroid stimulating hormone (TSH) (84443) |
— |
$240 |
— |
| CBC with automated differential (85025) |
— |
$190 |
— |
| CBC, automated (85027) |
— |
$98 |
— |
Prothrombin time (PT) (85610)
range across 4 matching MRF lines |
— |
$6–$100 |
— |
Partial thromboplastin time (PTT) (85730)
range across 4 matching MRF lines |
— |
$12–$150 |
— |
| Psychotherapy, 30 minutes (90832) |
— |
$372 |
— |
| Psychotherapy, 45 minutes (90834) |
— |
$388 |
— |
| Psychotherapy, 60 minutes (90837) |
— |
$569 |
— |
| Family psychotherapy, without patient (50 min) (90846) |
— |
$473 |
— |
| Family psychotherapy, with patient (50 min) (90847) |
— |
$551 |
— |
| Group psychotherapy (90853) |
— |
$202 |
— |
| Left heart catheterization (93452) |
— |
$15,750 |
— |
| Sleep study (attended polysomnography) (95810) |
— |
$10,079 |
— |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
— |
$345 |
— |
Office visit, new patient (low complexity, ~30 min) (99203)
range across 2 matching MRF lines |
— |
$260–$267 |
— |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
— |
$351 |
— |
Office visit, new patient (high complexity, ~60 min) (99205)
range across 2 matching MRF lines |
— |
$416–$520 |
— |
Office consultation (low complexity, ~30 min) (99243)
range across 2 matching MRF lines |
— |
$266–$354 |
— |
Office consultation (moderate complexity, ~40 min) (99244)
range across 2 matching MRF lines |
— |
$410–$546 |
— |
| Preventive visit, new patient (age 18–39) (99385) |
— |
$330 |
— |