| Breast lesion removal (open) (19120) |
$1,747.02 |
$5,294 |
0.4× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$1,308.78 |
$3,966 |
1.3× |
| Epidural injection, lumbar/sacral (with imaging) (62322) |
$443.85 |
$1,345 |
0.5× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$830.28 |
$2,516 |
0.9× |
| After-cataract laser surgery (YAG capsulotomy) (66821) |
$394.68 |
$1,196 |
0.7× |
| CT head/brain without contrast (70450) |
$1,345.08 |
$4,076 |
12.0× |
| MRI brain without contrast (70551) |
$940.83 |
$2,851 |
3.7× |
| MRI brain with contrast (70552) |
$1,035.21 |
$3,137 |
2.8× |
| MRI brain without and with contrast (70553) |
$1,404.15 |
$4,255 |
3.8× |
| X-ray lower spine, 4+ views (72110) |
$408.54 |
$1,238 |
3.6× |
| MRI lumbar spine without contrast (72148) |
$1,181.40 |
$3,580 |
4.6× |
| CT pelvis with contrast (72193) |
$725.01 |
$2,197 |
3.9× |
| MRI lower-extremity joint without contrast (73721) |
$1,965.81 |
$5,957 |
7.7× |
| CT abdomen and pelvis with contrast (74177) |
$2,107.05 |
$6,385 |
5.6× |
| Ultrasound, abdomen complete (76700) |
$965.58 |
$2,926 |
8.6× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$573.21 |
$1,737 |
5.1× |
| Ultrasound, transvaginal (76830) |
$471.57 |
$1,429 |
4.2× |
| Mammography, one breast (diagnostic) (77065) |
$213.51 |
$647 |
2.5× |
| Mammography, both breasts (diagnostic) (77066) |
$289.41 |
$877 |
2.6× |
| Mammography, screening (bilateral) (77067) |
$237.60 |
$720 |
2.6× |
| Basic metabolic panel (80048) |
$139.26 |
$422 |
16.5× |
| Comprehensive metabolic panel (80053) |
$196.68 |
$596 |
18.6× |
| Lipid panel (80061) |
$57.75 |
$175 |
4.3× |
| Renal function panel (80069) |
$47.52 |
$144 |
5.5× |
| Hepatic function panel (80076) |
$67.98 |
$206 |
8.3× |
| Urinalysis, non-automated, with microscopy (81000) |
$7.26 |
$22 |
1.8× |
| Urinalysis, non-automated, without microscopy (81002) |
$2.97 |
$9 |
0.9× |
| PSA, total (84153) |
$52.47 |
$159 |
2.9× |
| Thyroid stimulating hormone (TSH) (84443) |
$60.39 |
$183 |
3.6× |
| CBC with automated differential (85025) |
$100.32 |
$304 |
12.9× |
| CBC, automated (85027) |
$17.49 |
$53 |
2.7× |
| Prothrombin time (PT) (85610) |
$20.46 |
$62 |
4.8× |
| Partial thromboplastin time (PTT) (85730) |
$30.03 |
$91 |
5.0× |
| Psychotherapy, 30 minutes (90832) |
$71.61 |
$217 |
0.4× |
| Psychotherapy, 45 minutes (90834) |
$109.56 |
$332 |
0.6× |
| Psychotherapy, 60 minutes (90837) |
$156.09 |
$473 |
0.8× |
| Family psychotherapy, without patient (50 min) (90846) |
$86.13 |
$261 |
0.5× |
| Family psychotherapy, with patient (50 min) (90847) |
$94.71 |
$287 |
0.5× |
Group psychotherapy (90853)
range across 5 matching MRF lines |
$64.02–$128.04 |
$194–$388 |
varies |
| Left heart catheterization (93452) |
$3,498.66 |
$10,602 |
1.0× |
| Sleep study (attended polysomnography) (95810) |
$2,695.44 |
$8,168 |
2.9× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$95.37 |
$289 |
3.3× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$223.41 |
$677 |
1.6× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$281.16 |
$852 |
2.0× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$364.98 |
$1,106 |
2.6× |