| Breast lesion removal (open) (19120) |
$3,652.61 |
$3,652.61 |
1.0× |
| Shoulder arthroscopy with decompression (29826) |
$6,270 |
$6,270 |
— |
| Knee arthroscopy with meniscectomy (29881) |
$4,850 |
$4,850 |
1.6× |
| Upper GI endoscopy (EGD), diagnostic (43235) |
$1,586.67 |
$1,586.67 |
1.9× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$1,771.24 |
$1,771.24 |
2.1× |
| Diagnostic colonoscopy (45378) |
$2,028.71 |
$2,028.71 |
2.4× |
| Colonoscopy with biopsy (45380) |
$2,093.85 |
$2,093.85 |
1.9× |
| Colonoscopy with lesion removal (45385) |
$2,283.07 |
$2,283.07 |
2.1× |
| Laparoscopic gallbladder removal (47562) |
$7,485.13 |
$7,485.13 |
1.3× |
| Inguinal hernia repair (age 5+) (49505) |
$5,853.47 |
$5,853.47 |
1.8× |
| Epidural injection, lumbar/sacral (with imaging) (62322) |
$902.12 |
$902.12 |
1.1× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$2,775 |
$2,775 |
3.4× |
| CT head/brain without contrast (70450) |
$702.60 |
$702.60 |
7.3× |
| MRI brain without contrast (70551) |
$975 |
$975 |
4.4× |
| MRI brain with contrast (70552) |
$1,050 |
$1,050 |
3.3× |
| MRI brain without and with contrast (70553) |
$1,025 |
$1,025 |
3.2× |
| X-ray lower spine, 4+ views (72110) |
$380.99 |
$380.99 |
4.0× |
| MRI lumbar spine without contrast (72148) |
$975 |
$975 |
4.4× |
| CT pelvis with contrast (72193) |
$702.60 |
$702.60 |
4.4× |
| MRI lower-extremity joint without contrast (73721) |
$975 |
$975 |
4.4× |
| CT abdomen and pelvis with contrast (74177) |
$702.60 |
$702.60 |
2.2× |
| Ultrasound, abdomen complete (76700) |
$365 |
$365 |
3.8× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$248 |
$248 |
2.6× |
| Ultrasound, transvaginal (76830) |
$256 |
$256 |
2.7× |
| Mammography, one breast (diagnostic) (77065) |
$189.22 |
$189.22 |
2.2× |
| Mammography, both breasts (diagnostic) (77066) |
$184.61 |
$184.61 |
1.7× |
| Mammography, screening (bilateral) (77067) |
$179.61 |
$179.61 |
2.0× |
| Basic metabolic panel (80048) |
$36 |
$36 |
4.3× |
| Comprehensive metabolic panel (80053) |
$43 |
$43 |
4.1× |
| Obstetric panel (80055) |
$137.26 |
$137.26 |
2.9× |
| Lipid panel (80061) |
$65 |
$65 |
4.9× |
| Renal function panel (80069) |
$40 |
$40 |
4.6× |
| Hepatic function panel (80076) |
$50 |
$50 |
6.1× |
| Urinalysis, non-automated, without microscopy (81002) |
$25 |
$25 |
7.2× |
| PSA, total (84153) |
$95 |
$95 |
5.2× |
| Thyroid stimulating hormone (TSH) (84443) |
$67.52 |
$67.52 |
4.0× |
| CBC with automated differential (85025) |
$40 |
$40 |
5.1× |
| CBC, automated (85027) |
$30 |
$30 |
4.6× |
| Prothrombin time (PT) (85610) |
$25 |
$25 |
5.8× |
| Partial thromboplastin time (PTT) (85730) |
$34.80 |
$34.80 |
5.8× |
| Electrocardiogram (ECG), complete (93000) |
$94.30 |
$94.30 |
1.7× |
| Sleep study (attended polysomnography) (95810) |
$1,622.35 |
$1,622.35 |
2.1× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$94 |
$94 |
3.2× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$220 |
$220 |
1.8× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$285 |
$285 |
2.3× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$415 |
$415 |
3.4× |