| Breast lesion removal (open) (19120) |
$4,175 |
$9,607 |
1.0× |
| Shoulder arthroscopy with decompression (29826) |
— |
$7,679.86 |
— |
| Knee arthroscopy with meniscectomy (29881) |
$3,489 |
$14,849 |
1.0× |
| Tonsillectomy and adenoidectomy (under age 12) (42820) |
$6,312 |
$8,198.75 |
1.0× |
| Upper GI endoscopy (EGD), diagnostic (43235) |
$967 |
$4,886 |
1.0× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$967 |
$3,966 |
1.0× |
| Diagnostic colonoscopy (45378) |
$991 |
$4,752 |
1.0× |
| Colonoscopy with biopsy (45380) |
$1,276 |
$6,145 |
1.0× |
Colonoscopy with lesion removal (45385)
range across 2 matching MRF lines |
$1,276 |
$6,145–$18,452 |
1.0× |
| Colonoscopy with endoscopic ultrasound (45391) |
$1,276 |
$4,783 |
1.0× |
| Laparoscopic gallbladder removal (47562) |
$6,446 |
$26,618 |
1.0× |
| Inguinal hernia repair (age 5+) (49505) |
$3,818 |
$23,139 |
1.0× |
Laparoscopic radical prostatectomy (55866)
range across 2 matching MRF lines |
$11,335 |
$117,092.75–$117,093 |
1.0× |
Transforaminal epidural injection, lumbar/sacral (64483)
range across 2 matching MRF lines |
$943 |
$2,516–$7,510 |
1.0× |
| CT head/brain without contrast (70450) |
$111 |
$4,076 |
1.0× |
| MRI brain without contrast (70551) |
$254 |
$2,851 |
1.0× |
| MRI brain without and with contrast (70553) |
$372 |
$4,255 |
1.0× |
| X-ray lower spine, 4+ views (72110) |
$111 |
$1,238 |
1.0× |
| MRI lumbar spine without contrast (72148) |
$254 |
$3,580 |
1.0× |
| CT pelvis with contrast (72193) |
$187 |
$2,197 |
1.0× |
| MRI lower-extremity joint without contrast (73721) |
$254 |
$5,957 |
1.0× |
| CT abdomen and pelvis with contrast (74177) |
$372 |
$6,385 |
1.0× |
| Ultrasound, abdomen complete (76700) |
$111 |
$2,926 |
1.0× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$111 |
$1,737 |
1.0× |
| Ultrasound, transvaginal (76830) |
$111 |
$1,429 |
1.0× |
| Mammography, one breast (diagnostic) (77065) |
$87 |
$647 |
1.0× |
| Mammography, both breasts (diagnostic) (77066) |
$111 |
$877 |
1.0× |
| Mammography, screening (bilateral) (77067) |
$92 |
$720 |
1.0× |
| Basic metabolic panel (80048) |
$8 |
$422 |
0.9× |
| Comprehensive metabolic panel (80053) |
$10 |
$596 |
0.9× |
| Lipid panel (80061) |
$13 |
$175 |
1.0× |
| Renal function panel (80069) |
$8 |
$144 |
0.9× |
| Hepatic function panel (80076) |
$8 |
$206 |
1.0× |
| Urinalysis, non-automated, without microscopy (81002) |
$3 |
$17 |
0.9× |
| PSA, total (84153) |
$18 |
$159 |
1.0× |
| Thyroid stimulating hormone (TSH) (84443) |
$16 |
$183 |
1.0× |
| CBC with automated differential (85025) |
$7 |
$304 |
0.9× |
| CBC, automated (85027) |
$6 |
$53 |
0.9× |
| Prothrombin time (PT) (85610) |
$4 |
$62 |
0.9× |
| Partial thromboplastin time (PTT) (85730) |
$6 |
$91 |
1.0× |
| Psychotherapy, 30 minutes (90832) |
$189 |
$217 |
1.0× |
| Psychotherapy, 45 minutes (90834) |
$189 |
$332 |
1.0× |
| Psychotherapy, 60 minutes (90837) |
$189 |
$473 |
1.0× |
| Family psychotherapy, without patient (50 min) (90846) |
$189 |
$261 |
1.0× |
| Family psychotherapy, with patient (50 min) (90847) |
$189 |
$287 |
1.0× |
| Group psychotherapy (90853) |
$108 |
$388 |
1.0× |
| Left heart catheterization (93452) |
$3,457 |
$10,602 |
1.0× |
| Sleep study (attended polysomnography) (95810) |
$915 |
$8,168 |
1.0× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$29 |
$289 |
1.0× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
— |
$677 |
— |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
— |
$852 |
— |
| Office visit, new patient (high complexity, ~60 min) (99205) |
— |
$1,106 |
— |