| Breast lesion removal (open) (19120) |
— |
$15,715.20 |
— |
| Shoulder arthroscopy with decompression (29826) |
— |
$36,572.28 |
— |
| Knee arthroscopy with meniscectomy (29881) |
— |
$20,782.40 |
— |
| Upper GI endoscopy (EGD), diagnostic (43235) |
— |
$6,157.94 |
— |
| Upper GI endoscopy (EGD) with biopsy (43239) |
— |
$6,222.18 |
— |
| Diagnostic colonoscopy (45378) |
— |
$5,505.88 |
— |
| Colonoscopy with biopsy (45380) |
— |
$7,202.04 |
— |
| Colonoscopy with lesion removal (45385) |
— |
$6,169.18 |
— |
| Colonoscopy with endoscopic ultrasound (45391) |
— |
$55,299.65 |
— |
| Laparoscopic gallbladder removal (47562) |
— |
$26,293.41 |
— |
| Inguinal hernia repair (age 5+) (49505) |
— |
$24,228.60 |
— |
| Obstetric care, vaginal delivery (global) (59400) |
— |
$15,778.68 |
— |
| Obstetric care, cesarean delivery (global) (59510) |
— |
$27,589.30 |
— |
| Obstetric care, VBAC delivery (global) (59610) |
— |
$15,778.68 |
— |
| CT head/brain without contrast (70450) |
— |
$2,256.27 |
— |
| MRI brain without contrast (70551) |
— |
$4,551.72 |
— |
| MRI brain with contrast (70552) |
— |
$4,896.63 |
— |
| MRI brain without and with contrast (70553) |
— |
$7,435.32 |
— |
| X-ray lower spine, 4+ views (72110) |
— |
$640.07 |
— |
| MRI lumbar spine without contrast (72148) |
— |
$5,314.49 |
— |
| CT pelvis with contrast (72193) |
— |
$2,830.54 |
— |
| MRI lower-extremity joint without contrast (73721) |
— |
$6,045.77 |
— |
| CT abdomen and pelvis with contrast (74177) |
— |
$6,202.83 |
— |
| Ultrasound, abdomen complete (76700) |
— |
$1,502.33 |
— |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
— |
$800.91 |
— |
| Ultrasound, transvaginal (76830) |
— |
$1,150.78 |
— |
| Mammography, one breast (diagnostic) (77065) |
— |
$364.38 |
— |
| Mammography, both breasts (diagnostic) (77066) |
— |
$465.51 |
— |
| Mammography, screening (bilateral) (77067) |
— |
$384.88 |
— |
| Basic metabolic panel (80048) |
— |
$454.63 |
— |
| Comprehensive metabolic panel (80053) |
— |
$512.59 |
— |
| Obstetric panel (80055) |
— |
$344.91 |
— |
| Lipid panel (80061) |
— |
$295.17 |
— |
| Renal function panel (80069) |
— |
$490.83 |
— |
| Hepatic function panel (80076) |
— |
$469.27 |
— |
| PSA, total (84153) |
— |
$213.90 |
— |
| Thyroid stimulating hormone (TSH) (84443) |
— |
$260.34 |
— |
| CBC with automated differential (85025) |
— |
$126.01 |
— |
| CBC, automated (85027) |
— |
$99.50 |
— |
| Prothrombin time (PT) (85610) |
— |
$81.25 |
— |
| Partial thromboplastin time (PTT) (85730) |
— |
$126.01 |
— |
| Sleep study (attended polysomnography) (95810) |
— |
$4,226.71 |
— |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
— |
$132.65 |
— |
| Office visit, new patient (low complexity, ~30 min) (99203) |
— |
$437.78 |
— |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
— |
$548.87 |
— |
| Office visit, new patient (high complexity, ~60 min) (99205) |
— |
$704.73 |
— |