| Breast lesion removal (open) (19120) |
$2,057.15 |
$4,114.30 |
0.5× |
| Knee arthroscopy with meniscectomy (29881) |
$3,287.57 |
$6,575.14 |
1.0× |
| Upper GI endoscopy (EGD), diagnostic (43235) |
$945.18 |
$1,890.35 |
1.1× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$979.50 |
$1,959 |
1.1× |
| Diagnostic colonoscopy (45378) |
$1,277.70 |
$2,555.40 |
1.4× |
| Colonoscopy with biopsy (45380) |
$1,406.63 |
$2,813.25 |
1.2× |
| Colonoscopy with lesion removal (45385) |
$1,292.50 |
$2,585 |
1.1× |
| Colonoscopy with endoscopic ultrasound (45391) |
$1,414.02 |
$2,828.03 |
1.2× |
| Epidural injection, lumbar/sacral (with imaging) (62322) |
$858.63 |
$1,717.25 |
1.0× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$738 |
$1,476 |
0.9× |
| CT head/brain without contrast (70450) |
$1,055.50 |
$2,111 |
10.3× |
| MRI brain without contrast (70551) |
$1,430.63 |
$2,861.25 |
6.1× |
| MRI brain with contrast (70552) |
$1,430.63 |
$2,861.25 |
4.2× |
| MRI brain without and with contrast (70553) |
$2,582.90 |
$5,165.80 |
7.6× |
| X-ray lower spine, 4+ views (72110) |
$313 |
$626 |
3.1× |
| MRI lumbar spine without contrast (72148) |
$1,430.63 |
$2,861.25 |
6.1× |
| CT pelvis with contrast (72193) |
$1,272.50 |
$2,545 |
7.4× |
| MRI lower-extremity joint without contrast (73721) |
$1,430.63 |
$2,861.25 |
6.1× |
| CT abdomen and pelvis with contrast (74177) |
$1,983.50 |
$3,967 |
5.8× |
| Ultrasound, abdomen complete (76700) |
$613.75 |
$1,227.50 |
6.0× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$406.25 |
$812.50 |
4.0× |
| Ultrasound, transvaginal (76830) |
$472.38 |
$944.75 |
4.6× |
| Mammography, one breast (diagnostic) (77065) |
$262.26 |
$524.51 |
3.0× |
| Mammography, both breasts (diagnostic) (77066) |
$336.05 |
$672.09 |
3.0× |
| Mammography, screening (bilateral) (77067) |
$272.47 |
$544.94 |
3.0× |
| Basic metabolic panel (80048) |
$63.94 |
$127.87 |
7.6× |
| Comprehensive metabolic panel (80053) |
$97.91 |
$195.81 |
9.3× |
| Obstetric panel (80055) |
$102.25 |
$204.49 |
2.1× |
| Lipid panel (80061) |
$74.09 |
$148.17 |
5.5× |
| Renal function panel (80069) |
$62.48 |
$124.95 |
7.2× |
| Hepatic function panel (80076) |
$60.11 |
$120.21 |
7.4× |
| Urinalysis, non-automated, with microscopy (81000) |
$10.29 |
$20.57 |
2.6× |
| Urinalysis, non-automated, without microscopy (81002) |
$8.50 |
$16.99 |
2.4× |
| PSA, total (84153) |
$61.71 |
$123.42 |
3.4× |
| Thyroid stimulating hormone (TSH) (84443) |
$62.38 |
$124.75 |
3.7× |
| CBC with automated differential (85025) |
$47.03 |
$94.05 |
6.1× |
| CBC, automated (85027) |
$27.69 |
$55.37 |
4.3× |
| Prothrombin time (PT) (85610) |
$21.73 |
$43.45 |
5.1× |
| Partial thromboplastin time (PTT) (85730) |
$34.50 |
$69 |
5.7× |
| Psychotherapy, 30 minutes (90832) |
$84.38 |
$168.75 |
0.5× |
| Psychotherapy, 45 minutes (90834) |
$84.38 |
$168.75 |
0.5× |
| Psychotherapy, 60 minutes (90837) |
$251.15 |
$502.30 |
1.5× |
| Group psychotherapy (90853) |
$100 |
$200 |
1.0× |
| Left heart catheterization (93452) |
$4,824.75 |
$9,649.50 |
1.5× |
| Sleep study (attended polysomnography) (95810) |
$2,117 |
$4,234 |
2.5× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$82.50 |
$165 |
2.8× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$161.74 |
$323.47 |
1.2× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$211.50 |
$423 |
1.6× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$267.11 |
$534.22 |
2.1× |
| Office consultation (low complexity, ~30 min) (99243) |
$260.39 |
$520.77 |
2.0× |
| Office consultation (moderate complexity, ~40 min) (99244) |
$341.64 |
$683.27 |
2.6× |
| Preventive visit, new patient (age 18–39) (99385) |
$154.57 |
$309.13 |
— |
| Preventive visit, new patient (age 40–64) (99386) |
$190.40 |
$380.80 |
— |