| Breast lesion removal (open) (19120) |
$4,175 |
$12,224 |
1.0× |
Shoulder arthroscopy with decompression (29826)
range across 2 matching MRF lines |
— |
$10,080.10–$10,080.11 |
— |
| Knee arthroscopy with meniscectomy (29881) |
$3,489 |
$15,255.20 |
1.0× |
| Tonsillectomy and adenoidectomy (under age 12) (42820) |
$6,312 |
$14,107.50 |
1.0× |
Upper GI endoscopy (EGD), diagnostic (43235)
range across 2 matching MRF lines |
$967 |
$4,886.52–$5,408 |
1.0× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$967 |
$4,886.52 |
1.0× |
| Diagnostic colonoscopy (45378) |
$991 |
$4,751.79 |
1.0× |
| Colonoscopy with biopsy (45380) |
$1,276 |
$6,145.31 |
1.0× |
Colonoscopy with lesion removal (45385)
range across 2 matching MRF lines |
$1,276 |
$6,145.31–$11,608 |
1.0× |
| Colonoscopy with endoscopic ultrasound (45391) |
$1,276 |
$6,145.31 |
1.0× |
Laparoscopic gallbladder removal (47562)
range across 2 matching MRF lines |
$6,446 |
$22,004.20–$29,171.80 |
1.0× |
| Inguinal hernia repair (age 5+) (49505) |
$3,818 |
$14,683.10 |
1.0× |
| Laparoscopic radical prostatectomy (55866) |
$11,335 |
$85,129 |
1.0× |
| Obstetric care, vaginal delivery (global) (59400) |
— |
$18,617 |
— |
| Obstetric care, VBAC delivery (global) (59610) |
— |
$9,721.38 |
— |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$943 |
$4,451.45 |
1.0× |
| After-cataract laser surgery (YAG capsulotomy) (66821) |
$586 |
$2,859.28 |
1.0× |
| CT head/brain without contrast (70450) |
$111 |
$3,928.86 |
1.0× |
| MRI brain without contrast (70551) |
$254 |
$2,747.93 |
1.0× |
| MRI brain with contrast (70552) |
$372 |
$3,024.27 |
1.0× |
| MRI brain without and with contrast (70553) |
$372 |
$4,100.67 |
1.0× |
| X-ray lower spine, 4+ views (72110) |
$111 |
$1,193.36 |
1.0× |
| MRI lumbar spine without contrast (72148) |
$254 |
$3,450.69 |
1.0× |
| CT pelvis with contrast (72193) |
$187 |
$2,117.61 |
1.0× |
| MRI lower-extremity joint without contrast (73721) |
$254 |
$5,742.18 |
1.0× |
| CT abdomen and pelvis with contrast (74177) |
$372 |
$6,154.11 |
1.0× |
| Ultrasound, abdomen complete (76700) |
$111 |
$2,820.38 |
1.0× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$111 |
$1,673.60 |
1.0× |
| Ultrasound, transvaginal (76830) |
$111 |
$1,376.55 |
1.0× |
| Mammography, one breast (diagnostic) (77065) |
$87 |
$624.11 |
1.0× |
| Mammography, both breasts (diagnostic) (77066) |
$111 |
$844.56 |
1.0× |
| Mammography, screening (bilateral) (77067) |
$92 |
$347 |
1.0× |
| Basic metabolic panel (80048) |
$8 |
$406.76 |
0.9× |
| Comprehensive metabolic panel (80053) |
$10 |
$574.43 |
0.9× |
| Lipid panel (80061) |
$13 |
$168.71 |
1.0× |
| Renal function panel (80069) |
$8 |
$138.69 |
0.9× |
| Hepatic function panel (80076) |
$8 |
$198.72 |
1.0× |
| Urinalysis, non-automated, without microscopy (81002) |
$3 |
$17.40 |
0.9× |
| PSA, total (84153) |
$18 |
$153.18 |
1.0× |
| Thyroid stimulating hormone (TSH) (84443) |
$16 |
$175.95 |
1.0× |
| CBC with automated differential (85025) |
$7 |
$292.91 |
0.9× |
| CBC, automated (85027) |
$6 |
$50.72 |
0.9× |
| Prothrombin time (PT) (85610) |
$4 |
$60.03 |
0.9× |
| Partial thromboplastin time (PTT) (85730) |
$6 |
$87.98 |
1.0× |
| Left heart catheterization (93452) |
$3,457 |
$16,082 |
1.0× |
Physical therapy, therapeutic exercise (per 15 min) (97110)
range across 2 matching MRF lines |
$29 |
$198–$279.45 |
1.0× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
— |
$653.09 |
— |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
— |
$820.76 |
— |
| Office visit, new patient (high complexity, ~60 min) (99205) |
— |
$1,066.05 |
— |