| Breast lesion removal (open) (19120) |
$1,911 |
$1,911 |
0.5× |
| Shoulder arthroscopy with decompression (29826) |
$3,098.75 |
$3,098.75 |
— |
| Knee arthroscopy with meniscectomy (29881) |
$3,544.78 |
$3,544.78 |
1.2× |
| Tonsillectomy and adenoidectomy (under age 12) (42820) |
$9,694 |
$9,694 |
1.8× |
| Upper GI endoscopy (EGD), diagnostic (43235) |
$360.50 |
$360.50 |
0.4× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$680.83 |
$680.83 |
0.8× |
| Diagnostic colonoscopy (45378) |
$527.36 |
$527.36 |
0.6× |
| Colonoscopy with biopsy (45380) |
$573.71 |
$573.71 |
0.5× |
| Colonoscopy with lesion removal (45385) |
$1,500.33 |
$1,500.33 |
1.4× |
Laparoscopic gallbladder removal (47562)
likely a partial charge, not the full procedure |
$1,572.82 |
$1,572.82 |
0.3× |
| Inguinal hernia repair (age 5+) (49505) |
$6,255 |
$6,255 |
1.9× |
| Obstetric care, vaginal delivery (global) (59400) |
$3,911 |
$3,911 |
— |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$614.21 |
$614.21 |
0.8× |
| Cataract removal with lens insertion (66984) |
$4,107 |
$4,107 |
1.9× |
| CT head/brain without contrast (70450) |
$663 |
$663 |
6.9× |
| MRI brain without contrast (70551) |
$1,251.40 |
$1,251.40 |
5.7× |
| MRI brain with contrast (70552) |
$1,325 |
$1,325 |
4.1× |
| MRI brain without and with contrast (70553) |
$1,460 |
$1,460 |
4.6× |
| X-ray lower spine, 4+ views (72110) |
$345 |
$345 |
3.6× |
| MRI lumbar spine without contrast (72148) |
$1,210.70 |
$1,210.70 |
5.5× |
| CT pelvis with contrast (72193) |
$663 |
$663 |
4.1× |
| MRI lower-extremity joint without contrast (73721) |
$1,276.20 |
$1,276.20 |
5.8× |
| CT abdomen and pelvis with contrast (74177) |
$666 |
$666 |
2.1× |
| Ultrasound, abdomen complete (76700) |
$481.75 |
$481.75 |
5.0× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$322.50 |
$322.50 |
3.4× |
| Ultrasound, transvaginal (76830) |
$217 |
$217 |
2.3× |
| Mammography, one breast (diagnostic) (77065) |
$199 |
$199 |
2.3× |
| Mammography, both breasts (diagnostic) (77066) |
$227 |
$227 |
2.1× |
| Mammography, screening (bilateral) (77067) |
$213 |
$213 |
2.3× |
| Basic metabolic panel (80048) |
$60 |
$60 |
7.1× |
| Comprehensive metabolic panel (80053) |
$65 |
$65 |
6.2× |
| Lipid panel (80061) |
$59 |
$59 |
4.4× |
| Renal function panel (80069) |
$40 |
$40 |
4.6× |
| Hepatic function panel (80076) |
$60 |
$60 |
7.3× |
| PSA, total (84153) |
$100.50 |
$100.50 |
5.5× |
| Thyroid stimulating hormone (TSH) (84443) |
$74 |
$74 |
4.4× |
| CBC with automated differential (85025) |
$42.50 |
$42.50 |
5.5× |
| CBC, automated (85027) |
$41 |
$41 |
6.3× |
| Prothrombin time (PT) (85610) |
$27 |
$27 |
6.3× |
| Partial thromboplastin time (PTT) (85730) |
$42.50 |
$42.50 |
7.1× |
| Electrocardiogram (ECG), complete (93000) |
$270.61 |
$270.61 |
5.0× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$69 |
$69 |
2.4× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$167 |
$167 |
1.4× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$202.50 |
$202.50 |
1.7× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$358 |
$358 |
2.9× |
| Office consultation (low complexity, ~30 min) (99243) |
$252.50 |
$252.50 |
2.1× |
| Office consultation (moderate complexity, ~40 min) (99244) |
$368 |
$368 |
3.0× |
| Preventive visit, new patient (age 18–39) (99385) |
$235 |
$235 |
— |
| Preventive visit, new patient (age 40–64) (99386) |
$294 |
$294 |
— |