| Shoulder arthroscopy with decompression (29826) |
— |
$5,310.16 |
— |
| Knee arthroscopy with meniscectomy (29881) |
— |
$5,024.40 |
— |
| Upper GI endoscopy (EGD), diagnostic (43235) |
— |
$1,851.75 |
— |
| Upper GI endoscopy (EGD) with biopsy (43239) |
— |
$1,562.23 |
— |
| Diagnostic colonoscopy (45378) |
— |
$1,727.53 |
— |
| Colonoscopy with biopsy (45380) |
— |
$2,331.87 |
— |
| Colonoscopy with lesion removal (45385) |
— |
$2,569.06 |
— |
| Epidural injection, lumbar/sacral (with imaging) (62322) |
— |
$949 |
— |
| Transforaminal epidural injection, lumbar/sacral (64483) |
— |
$977 |
— |
| CT head/brain without contrast (70450) |
— |
$2,224 |
— |
| MRI brain without contrast (70551) |
— |
$1,352 |
— |
| MRI brain without and with contrast (70553) |
— |
$1,620.21 |
— |
| X-ray lower spine, 4+ views (72110) |
— |
$532 |
— |
| MRI lumbar spine without contrast (72148) |
— |
$1,352 |
— |
| CT pelvis with contrast (72193) |
— |
$2,669 |
— |
| MRI lower-extremity joint without contrast (73721) |
— |
$1,326.65 |
— |
| CT abdomen and pelvis with contrast (74177) |
— |
$5,304.92 |
— |
| Ultrasound, abdomen complete (76700) |
— |
$1,147 |
— |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
— |
$841 |
— |
| Ultrasound, transvaginal (76830) |
— |
$518 |
— |
| Mammography, one breast (diagnostic) (77065) |
— |
$366.03 |
— |
| Mammography, both breasts (diagnostic) (77066) |
— |
$709.82 |
— |
| Mammography, screening (bilateral) (77067) |
— |
$523.21 |
— |
| Basic metabolic panel (80048) |
— |
$234.87 |
— |
| Comprehensive metabolic panel (80053) |
— |
$294.59 |
— |
| Lipid panel (80061) |
— |
$142 |
— |
| Renal function panel (80069) |
— |
$229 |
— |
| Hepatic function panel (80076) |
— |
$234 |
— |
| PSA, total (84153) |
— |
$139 |
— |
| Thyroid stimulating hormone (TSH) (84443) |
— |
$191.34 |
— |
| CBC with automated differential (85025) |
— |
$113.66 |
— |
| CBC, automated (85027) |
— |
$112 |
— |
| Prothrombin time (PT) (85610) |
— |
$44.30 |
— |
| Partial thromboplastin time (PTT) (85730) |
— |
$50 |
— |
| Psychotherapy, 30 minutes (90832) |
— |
$200 |
— |
| Psychotherapy, 45 minutes (90834) |
— |
$267 |
— |
| Psychotherapy, 60 minutes (90837) |
— |
$400 |
— |
| Family psychotherapy, without patient (50 min) (90846) |
— |
$292 |
— |
| Family psychotherapy, with patient (50 min) (90847) |
— |
$302 |
— |
| Group psychotherapy (90853) |
— |
$81 |
— |
| Electrocardiogram (ECG), complete (93000) |
— |
$339.94 |
— |
| Sleep study (attended polysomnography) (95810) |
— |
$4,797 |
— |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
— |
$214.60 |
— |
| Office visit, new patient (low complexity, ~30 min) (99203) |
— |
$258.78 |
— |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
— |
$370 |
— |
| Office visit, new patient (high complexity, ~60 min) (99205) |
— |
$489 |
— |
| Office consultation (low complexity, ~30 min) (99243) |
— |
$194 |
— |
| Office consultation (moderate complexity, ~40 min) (99244) |
— |
$263 |
— |
| Preventive visit, new patient (age 18–39) (99385) |
— |
$274 |
— |
| Preventive visit, new patient (age 40–64) (99386) |
— |
$293 |
— |