| Breast lesion removal (open) (19120) |
— |
$4,060 |
— |
| Upper GI endoscopy (EGD) with biopsy (43239) |
— |
$2,792 |
— |
Transforaminal epidural injection, lumbar/sacral (64483)
range across 3 matching MRF lines |
— |
$2,341–$3,512 |
— |
| CT head/brain without contrast (70450) |
— |
$1,621 |
— |
| MRI brain without contrast (70551) |
— |
$2,948 |
— |
| MRI brain with contrast (70552) |
— |
$3,685 |
— |
| MRI brain without and with contrast (70553) |
— |
$5,928 |
— |
| X-ray lower spine, 4+ views (72110) |
— |
$587 |
— |
| MRI lumbar spine without contrast (72148) |
— |
$3,472 |
— |
| CT pelvis with contrast (72193) |
— |
$2,496 |
— |
MRI lower-extremity joint without contrast (73721)
range across 15 matching MRF lines |
— |
$3,472–$3,623 |
— |
| CT abdomen and pelvis with contrast (74177) |
— |
$4,050 |
— |
| Ultrasound, abdomen complete (76700) |
— |
$1,083 |
— |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
— |
$597 |
— |
| Ultrasound, transvaginal (76830) |
— |
$747 |
— |
| Mammography, one breast (diagnostic) (77065) |
— |
$404 |
— |
| Mammography, both breasts (diagnostic) (77066) |
— |
$533 |
— |
Mammography, screening (bilateral) (77067)
range across 10 matching MRF lines |
— |
$373–$480 |
— |
| Basic metabolic panel (80048) |
— |
$131 |
— |
| Comprehensive metabolic panel (80053) |
— |
$171 |
— |
| Obstetric panel (80055) |
— |
$162 |
— |
Lipid panel (80061)
range across 2 matching MRF lines |
— |
$75–$200 |
— |
| Renal function panel (80069) |
— |
$106 |
— |
| Hepatic function panel (80076) |
— |
$236 |
— |
| Urinalysis, non-automated, with microscopy (81000) |
— |
$11 |
— |
| Urinalysis, non-automated, without microscopy (81002) |
— |
$31 |
— |
PSA, total (84153)
range across 4 matching MRF lines |
— |
$30–$264 |
— |
Thyroid stimulating hormone (TSH) (84443)
range across 3 matching MRF lines |
— |
$54–$201 |
— |
| CBC with automated differential (85025) |
— |
$89 |
— |
| CBC, automated (85027) |
— |
$61 |
— |
Prothrombin time (PT) (85610)
range across 6 matching MRF lines |
— |
$42–$48 |
— |
Partial thromboplastin time (PTT) (85730)
range across 3 matching MRF lines |
— |
$42–$166 |
— |
| Psychotherapy, 30 minutes (90832) |
— |
$307 |
— |
| Psychotherapy, 45 minutes (90834) |
— |
$307 |
— |
| Psychotherapy, 60 minutes (90837) |
— |
$307 |
— |
| Group psychotherapy (90853) |
— |
$230 |
— |
| Electrocardiogram (ECG), complete (93000) |
— |
$279 |
— |
| Left heart catheterization (93452) |
— |
$10,338 |
— |
Sleep study (attended polysomnography) (95810)
range across 4 matching MRF lines |
— |
$1,324–$3,384 |
— |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
— |
$216 |
— |
| Office visit, new patient (low complexity, ~30 min) (99203) |
— |
$283 |
— |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
— |
$367 |
— |
| Office visit, new patient (high complexity, ~60 min) (99205) |
— |
$440 |
— |