| Breast lesion removal (open) (19120) |
$803.25 |
$1,071 |
0.2× |
| Shoulder arthroscopy with decompression (29826) |
$807.75 |
$1,077 |
— |
| Knee arthroscopy with meniscectomy (29881) |
$837.75 |
$1,117 |
0.2× |
Tonsillectomy and adenoidectomy (under age 12) (42820)
likely a partial charge, not the full procedure |
$471 |
$628 |
0.1× |
| Upper GI endoscopy (EGD), diagnostic (43235) |
$461.62 |
$615.50 |
0.5× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$606 |
$808 |
0.6× |
| Diagnostic colonoscopy (45378) |
$537.75 |
$717 |
0.6× |
| Colonoscopy with biopsy (45380) |
$693 |
$924 |
0.6× |
| Colonoscopy with lesion removal (45385) |
$728.62 |
$971.50 |
0.6× |
Laparoscopic gallbladder removal (47562)
likely a partial charge, not the full procedure |
$1,050 |
$1,400 |
0.2× |
| CT head/brain without contrast (70450) |
$1,917 |
$2,556 |
17.7× |
| MRI brain without contrast (70551) |
$3,006 |
$4,008 |
12.1× |
| MRI brain with contrast (70552) |
$3,069.75 |
$4,093 |
8.5× |
| MRI brain without and with contrast (70553) |
$3,666.75 |
$4,889 |
10.1× |
| X-ray lower spine, 4+ views (72110) |
$465.75 |
$621 |
4.3× |
| MRI lumbar spine without contrast (72148) |
$3,074.25 |
$4,099 |
12.4× |
| CT pelvis with contrast (72193) |
$2,268.75 |
$3,025 |
12.5× |
| MRI lower-extremity joint without contrast (73721) |
$2,319.75 |
$3,093 |
9.4× |
| CT abdomen and pelvis with contrast (74177) |
$4,098 |
$5,464 |
11.3× |
| Ultrasound, abdomen complete (76700) |
$799.50 |
$1,066 |
7.4× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$651.75 |
$869 |
6.0× |
| Ultrasound, transvaginal (76830) |
$603 |
$804 |
5.6× |
| Mammography, one breast (diagnostic) (77065) |
$307.50 |
$410 |
3.6× |
| Mammography, both breasts (diagnostic) (77066) |
$372.75 |
$497 |
3.4× |
| Mammography, screening (bilateral) (77067) |
$280.50 |
$374 |
3.1× |
| Basic metabolic panel (80048) |
$137.25 |
$183 |
16.2× |
| Comprehensive metabolic panel (80053) |
$151.50 |
$202 |
14.3× |
| Lipid panel (80061) |
$113.25 |
$151 |
8.5× |
| Renal function panel (80069) |
$133.50 |
$178 |
15.4× |
| Hepatic function panel (80076) |
$136.50 |
$182 |
16.7× |
| PSA, total (84153) |
$114.75 |
$153 |
6.2× |
| Thyroid stimulating hormone (TSH) (84443) |
$108 |
$144 |
6.4× |
| CBC with automated differential (85025) |
$93.75 |
$125 |
12.1× |
| CBC, automated (85027) |
$71.25 |
$95 |
11.0× |
| Prothrombin time (PT) (85610) |
$54 |
$72 |
12.6× |
| Partial thromboplastin time (PTT) (85730) |
$77.25 |
$103 |
12.9× |
| Psychotherapy, 30 minutes (90832) |
$122.25 |
$163 |
0.7× |
| Psychotherapy, 45 minutes (90834) |
$161.25 |
$215 |
0.9× |
| Psychotherapy, 60 minutes (90837) |
$237 |
$316 |
1.3× |
| Family psychotherapy, without patient (50 min) (90846) |
$154.50 |
$206 |
0.8× |
| Family psychotherapy, with patient (50 min) (90847) |
$161.25 |
$215 |
0.9× |
| Group psychotherapy (90853) |
$43.50 |
$58 |
0.4× |
| Sleep study (attended polysomnography) (95810) |
$3,574.50 |
$4,766 |
4.0× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$81.75 |
$109 |
2.8× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$176.25 |
$235 |
1.3× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$268.50 |
$358 |
1.9× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$340.50 |
$454 |
2.5× |
| Office consultation (low complexity, ~30 min) (99243) |
$203.25 |
$271 |
1.5× |
| Office consultation (moderate complexity, ~40 min) (99244) |
$303.75 |
$405 |
2.2× |
| Preventive visit, new patient (age 18–39) (99385) |
$218.25 |
$291 |
— |
| Preventive visit, new patient (age 40–64) (99386) |
$252.75 |
$337 |
— |