| Breast lesion removal (open) (19120) |
$3,326 |
$6,652 |
0.9× |
| Shoulder arthroscopy with decompression (29826) |
$2,411.66 |
$4,823.33 |
— |
| Knee arthroscopy with meniscectomy (29881) |
$5,057 |
$10,114 |
1.6× |
| Tonsillectomy and adenoidectomy (under age 12) (42820) |
$3,587 |
$7,174 |
0.6× |
| Upper GI endoscopy (EGD), diagnostic (43235) |
$1,408 |
$2,816 |
1.6× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$652.33 |
$1,304.66 |
0.7× |
| Diagnostic colonoscopy (45378) |
$2,201 |
$4,402 |
2.5× |
| Colonoscopy with biopsy (45380) |
$1,142 |
$2,284 |
1.0× |
| Colonoscopy with lesion removal (45385) |
$2,556 |
$5,112 |
2.2× |
| Laparoscopic gallbladder removal (47562) |
$7,552.50 |
$15,105 |
1.3× |
| Inguinal hernia repair (age 5+) (49505) |
$5,183 |
$10,366 |
1.5× |
| Laparoscopic radical prostatectomy (55866) |
$22,756.34 |
$45,512.67 |
2.2× |
| Epidural injection, lumbar/sacral (with imaging) (62322) |
$1,076.50 |
$2,153 |
1.3× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$1,695.25 |
$3,390.50 |
2.0× |
| After-cataract laser surgery (YAG capsulotomy) (66821) |
$805.50 |
$1,611 |
1.5× |
| CT head/brain without contrast (70450) |
$675.50 |
$1,351 |
6.7× |
| MRI brain without contrast (70551) |
$1,800.50 |
$3,601 |
7.9× |
| MRI brain with contrast (70552) |
$2,757 |
$5,514 |
8.2× |
| MRI brain without and with contrast (70553) |
$2,784.75 |
$5,569.50 |
8.3× |
| X-ray lower spine, 4+ views (72110) |
$322.50 |
$645 |
3.2× |
| MRI lumbar spine without contrast (72148) |
$1,724.50 |
$3,449 |
7.5× |
| CT pelvis with contrast (72193) |
$110.75 |
$221.50 |
0.7× |
| MRI lower-extremity joint without contrast (73721) |
$1,724.50 |
$3,449 |
7.5× |
| CT abdomen and pelvis with contrast (74177) |
$2,050 |
$4,100 |
6.1× |
| Ultrasound, abdomen complete (76700) |
$563.75 |
$1,127.50 |
5.6× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$563.75 |
$1,127.50 |
5.6× |
| Ultrasound, transvaginal (76830) |
$563.75 |
$1,127.50 |
5.6× |
| Mammography, one breast (diagnostic) (77065) |
$229.50 |
$459 |
2.7× |
| Mammography, both breasts (diagnostic) (77066) |
$295.50 |
$591 |
2.7× |
| Mammography, screening (bilateral) (77067) |
$247 |
$494 |
2.7× |
| Basic metabolic panel (80048) |
$65.25 |
$130.50 |
7.7× |
| Comprehensive metabolic panel (80053) |
$55 |
$110 |
5.2× |
| Lipid panel (80061) |
$37.95 |
$75.90 |
2.8× |
| Renal function panel (80069) |
$44.50 |
$89 |
5.1× |
| Hepatic function panel (80076) |
$22.54 |
$45.09 |
2.8× |
| Urinalysis, non-automated, without microscopy (81002) |
$12.50 |
$25 |
3.6× |
| PSA, total (84153) |
$30.50 |
$61 |
1.7× |
| Thyroid stimulating hormone (TSH) (84443) |
$52.50 |
$105 |
3.1× |
| CBC with automated differential (85025) |
$40.75 |
$81.50 |
5.2× |
| CBC, automated (85027) |
$35 |
$70 |
5.4× |
| Prothrombin time (PT) (85610) |
$21.25 |
$42.50 |
5.0× |
| Partial thromboplastin time (PTT) (85730) |
$32.50 |
$65 |
5.4× |
| Electrocardiogram (ECG), complete (93000) |
$21.50 |
$43 |
0.4× |
| Sleep study (attended polysomnography) (95810) |
$2,905 |
$5,810 |
3.5× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$181.25 |
$362.50 |
6.2× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$63 |
$126 |
0.5× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$109 |
$218 |
0.9× |
| Preventive visit, new patient (age 18–39) (99385) |
$63.75 |
$127.50 |
— |
| Preventive visit, new patient (age 40–64) (99386) |
$85.50 |
$171 |
— |