| Breast lesion removal (open) (19120) |
$2,948 |
$14,740 |
0.9× |
| Shoulder arthroscopy with decompression (29826) |
$1,711.35 |
$8,556.75 |
— |
| Knee arthroscopy with meniscectomy (29881) |
$2,902.80 |
$14,514 |
1.0× |
| Tonsillectomy and adenoidectomy (under age 12) (42820) |
$3,118.80 |
$15,594 |
0.6× |
| Upper GI endoscopy (EGD), diagnostic (43235) |
$1,831.60 |
$9,158 |
2.3× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$1,039.60 |
$5,198 |
1.3× |
| Diagnostic colonoscopy (45378) |
$2,599 |
$12,995 |
3.2× |
| Colonoscopy with biopsy (45380) |
$1,559.40 |
$7,797 |
1.5× |
| Colonoscopy with lesion removal (45385) |
$3,118.80 |
$15,594 |
3.0× |
| Inguinal hernia repair (age 5+) (49505) |
$8,101.20 |
$40,506 |
2.6× |
| Laparoscopic radical prostatectomy (55866) |
$7,989.90 |
$39,949.50 |
0.9× |
| Epidural injection, lumbar/sacral (with imaging) (62322) |
$484 |
$2,420 |
0.6× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$489 |
$2,445 |
0.6× |
| CT head/brain without contrast (70450) |
$1,586.20 |
$7,931 |
17.3× |
| MRI brain without contrast (70551) |
$1,686.40 |
$8,432 |
8.1× |
| MRI brain with contrast (70552) |
$1,175.40 |
$5,877 |
3.9× |
| MRI brain without and with contrast (70553) |
$2,315.20 |
$11,576 |
7.6× |
| X-ray lower spine, 4+ views (72110) |
$435.20 |
$2,176 |
4.8× |
| MRI lumbar spine without contrast (72148) |
$2,023.80 |
$10,119 |
9.7× |
| CT pelvis with contrast (72193) |
$1,660.40 |
$8,302 |
10.8× |
| MRI lower-extremity joint without contrast (73721) |
$1,655.80 |
$8,279 |
7.9× |
| CT abdomen and pelvis with contrast (74177) |
$3,171.20 |
$15,856 |
10.4× |
| Ultrasound, abdomen complete (76700) |
$1,096.20 |
$5,481 |
12.0× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$882.20 |
$4,411 |
9.6× |
| Ultrasound, transvaginal (76830) |
$673.60 |
$3,368 |
7.4× |
| Mammography, one breast (diagnostic) (77065) |
$175.60 |
$878 |
2.0× |
| Mammography, both breasts (diagnostic) (77066) |
$211.40 |
$1,057 |
1.9× |
| Mammography, screening (bilateral) (77067) |
$16.40 |
$82 |
0.2× |
| Basic metabolic panel (80048) |
$118.90 |
$594.50 |
14.1× |
| Comprehensive metabolic panel (80053) |
$194.60 |
$973 |
18.4× |
| Obstetric panel (80055) |
$79.70 |
$398.50 |
1.7× |
| Lipid panel (80061) |
$23.40 |
$117 |
1.7× |
| Renal function panel (80069) |
$151 |
$755 |
17.4× |
| Hepatic function panel (80076) |
$189.30 |
$946.50 |
23.2× |
| Urinalysis, non-automated, with microscopy (81000) |
$11.80 |
$59 |
2.9× |
| Urinalysis, non-automated, without microscopy (81002) |
$14 |
$70 |
4.0× |
| PSA, total (84153) |
$55.60 |
$278 |
3.0× |
| Thyroid stimulating hormone (TSH) (84443) |
$28.90 |
$144.50 |
1.7× |
| CBC with automated differential (85025) |
$69.40 |
$347 |
8.9× |
| CBC, automated (85027) |
$65.70 |
$328.50 |
10.2× |
| Prothrombin time (PT) (85610) |
$3.40 |
$17 |
0.8× |
| Partial thromboplastin time (PTT) (85730) |
$20.60 |
$103 |
3.4× |
| Left heart catheterization (93452) |
$1,935.40 |
$9,677 |
0.7× |
| Sleep study (attended polysomnography) (95810) |
$1,700.80 |
$8,504 |
2.3× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$46.20 |
$231 |
1.6× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$146.40 |
$732 |
1.3× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$174.20 |
$871 |
1.5× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$196.80 |
$984 |
1.7× |
| Office consultation (low complexity, ~30 min) (99243) |
$87 |
$435 |
0.7× |
| Office consultation (moderate complexity, ~40 min) (99244) |
$96 |
$480 |
0.8× |