| Breast lesion removal (open) (19120) |
$4,738 |
$9,476 |
1.3× |
| Shoulder arthroscopy with decompression (29826) |
$3,117.63 |
$6,235.25 |
— |
| Knee arthroscopy with meniscectomy (29881) |
$4,456.38 |
$8,912.75 |
1.4× |
Tonsillectomy and adenoidectomy (under age 12) (42820)
unusually low: confirm this is the full procedure |
$2,557.34 |
$5,114.67 |
0.5× |
| Upper GI endoscopy (EGD), diagnostic (43235) |
$380.50 |
$761 |
0.4× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$483.67 |
$967.34 |
0.6× |
| Diagnostic colonoscopy (45378) |
$794.50 |
$1,589 |
0.9× |
| Colonoscopy with biopsy (45380) |
$552.29 |
$1,104.58 |
0.5× |
| Colonoscopy with lesion removal (45385) |
$1,173.50 |
$2,347 |
1.0× |
| Laparoscopic gallbladder removal (47562) |
$14,238 |
$28,476 |
2.5× |
| Epidural injection, lumbar/sacral (with imaging) (62322) |
$1,124 |
$2,248 |
1.3× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$723 |
$1,446 |
0.9× |
| After-cataract laser surgery (YAG capsulotomy) (66821) |
$727.50 |
$1,455 |
1.4× |
| CT head/brain without contrast (70450) |
$779.50 |
$1,559 |
7.8× |
| MRI brain without contrast (70551) |
$1,494.50 |
$2,989 |
6.5× |
| MRI brain with contrast (70552) |
$1,957 |
$3,914 |
5.8× |
| MRI brain without and with contrast (70553) |
$1,643.75 |
$3,287.50 |
4.9× |
| X-ray lower spine, 4+ views (72110) |
$326.50 |
$653 |
3.3× |
| MRI lumbar spine without contrast (72148) |
$1,464.50 |
$2,929 |
6.4× |
| CT pelvis with contrast (72193) |
$1,217.25 |
$2,434.50 |
7.2× |
| MRI lower-extremity joint without contrast (73721) |
$1,352 |
$2,704 |
5.9× |
| CT abdomen and pelvis with contrast (74177) |
$2,043.50 |
$4,087 |
6.1× |
| Ultrasound, abdomen complete (76700) |
$469.50 |
$939 |
4.7× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$460.25 |
$920.50 |
4.6× |
| Ultrasound, transvaginal (76830) |
$458.25 |
$916.50 |
4.6× |
| Mammography, one breast (diagnostic) (77065) |
$191 |
$382 |
2.2× |
| Mammography, both breasts (diagnostic) (77066) |
$293.75 |
$587.50 |
2.7× |
| Mammography, screening (bilateral) (77067) |
$240 |
$480 |
2.6× |
| Basic metabolic panel (80048) |
$39 |
$78 |
4.6× |
| Comprehensive metabolic panel (80053) |
$49 |
$98 |
4.6× |
| Obstetric panel (80055) |
$221.50 |
$443 |
4.6× |
| Lipid panel (80061) |
$63.50 |
$127 |
4.7× |
| Renal function panel (80069) |
$40 |
$80 |
4.6× |
| Hepatic function panel (80076) |
$38 |
$76 |
4.7× |
| Urinalysis, non-automated, with microscopy (81000) |
$6.50 |
$13 |
1.6× |
| Urinalysis, non-automated, without microscopy (81002) |
$11 |
$22 |
3.2× |
| PSA, total (84153) |
$62 |
$124 |
3.4× |
| Thyroid stimulating hormone (TSH) (84443) |
$82.50 |
$165 |
4.9× |
| CBC with automated differential (85025) |
$38.50 |
$77 |
5.0× |
| CBC, automated (85027) |
$46 |
$92 |
7.1× |
| Prothrombin time (PT) (85610) |
$51 |
$102 |
11.9× |
| Partial thromboplastin time (PTT) (85730) |
$58.75 |
$117.50 |
9.8× |
| Family psychotherapy, without patient (50 min) (90846) |
$217 |
$434 |
1.3× |
| Family psychotherapy, with patient (50 min) (90847) |
$217 |
$434 |
1.3× |
| Electrocardiogram (ECG), complete (93000) |
$149.50 |
$299 |
2.6× |
| Left heart catheterization (93452) |
$2,889.50 |
$5,779 |
0.9× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$139 |
$278 |
4.8× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$103.75 |
$207.50 |
0.8× |
| Office consultation (low complexity, ~30 min) (99243) |
$196 |
$392 |
1.5× |
| Office consultation (moderate complexity, ~40 min) (99244) |
$88.50 |
$177 |
0.7× |
| Preventive visit, new patient (age 18–39) (99385) |
$124.75 |
$249.50 |
— |
| Preventive visit, new patient (age 40–64) (99386) |
$124.75 |
$249.50 |
— |