| Breast lesion removal (open) (19120) |
$6,075.63 |
$17,368 |
1.2× |
| Shoulder arthroscopy with decompression (29826) |
$195 |
$8,012 |
— |
| Knee arthroscopy with meniscectomy (29881) |
$4,030.62 |
$16,660 |
1.0× |
| Tonsillectomy and adenoidectomy (under age 12) (42820) |
$9,436.80 |
$14,521 |
1.2× |
| Upper GI endoscopy (EGD), diagnostic (43235) |
$962.15 |
$5,600 |
0.8× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$857.82 |
$13,411 |
0.7× |
| Diagnostic colonoscopy (45378) |
$1,004.88 |
$5,600 |
0.8× |
| Colonoscopy with biopsy (45380) |
$1,533.90 |
$11,421 |
1.0× |
| Colonoscopy with lesion removal (45385) |
$930.77 |
$8,400 |
0.6× |
| Laparoscopic gallbladder removal (47562) |
$7,159.47 |
$22,192 |
0.9× |
| Inguinal hernia repair (age 5+) (49505) |
$4,636.61 |
$22,192 |
1.0× |
| Laparoscopic radical prostatectomy (55866) |
$13,376.12 |
$29,307.50 |
1.0× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$1,188.59 |
$6,440 |
1.0× |
| Cataract removal with lens insertion (66984) |
$2,972.82 |
$14,521 |
1.0× |
| CT head/brain without contrast (70450) |
$180.77 |
$17,091 |
1.3× |
| MRI brain without contrast (70551) |
$380.49 |
$6,995 |
1.2× |
| MRI brain without and with contrast (70553) |
$525.89 |
$13,990 |
1.2× |
| X-ray lower spine, 4+ views (72110) |
$133.62 |
$1,754 |
1.0× |
| MRI lumbar spine without contrast (72148) |
$316.31 |
$6,995 |
1.0× |
| CT pelvis with contrast (72193) |
$250.11 |
$5,696 |
1.1× |
| MRI lower-extremity joint without contrast (73721) |
$359.52 |
$13,990 |
1.2× |
| CT abdomen and pelvis with contrast (74177) |
$507.81 |
$21,390 |
1.1× |
| Ultrasound, abdomen complete (76700) |
$149.06 |
$3,169 |
1.1× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$148.10 |
$2,735 |
1.1× |
| Ultrasound, transvaginal (76830) |
$146.60 |
$2,448 |
1.1× |
| Mammography, one breast (diagnostic) (77065) |
$116.07 |
$501 |
1.3× |
| Mammography, both breasts (diagnostic) (77066) |
$156.41 |
$1,051 |
1.4× |
| Mammography, screening (bilateral) (77067) |
$163.70 |
$734 |
1.8× |
| Basic metabolic panel (80048) |
$12.69 |
$3,708 |
1.5× |
| Comprehensive metabolic panel (80053) |
$15.54 |
$1,532 |
1.5× |
| Lipid panel (80061) |
$19.70 |
$572 |
1.5× |
| Renal function panel (80069) |
$12.77 |
$661 |
1.5× |
| Hepatic function panel (80076) |
$12.02 |
$1,658 |
1.5× |
| PSA, total (84153) |
$20.64 |
$289.50 |
1.1× |
| Thyroid stimulating hormone (TSH) (84443) |
$24.71 |
$490 |
1.5× |
| CBC with automated differential (85025) |
$11.45 |
$2,822 |
1.5× |
| CBC, automated (85027) |
$9.51 |
$618 |
1.5× |
| Prothrombin time (PT) (85610) |
$6.30 |
$514 |
1.5× |
| Partial thromboplastin time (PTT) (85730) |
$8.84 |
$1,276 |
1.5× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$50.37 |
$4,050 |
1.7× |