| Breast lesion removal (open) (19120) |
$3,908 |
$20,514.50 |
1.0× |
| Shoulder arthroscopy with decompression (29826) |
— |
$17,120.61 |
— |
| Knee arthroscopy with meniscectomy (29881) |
$3,265 |
$33,837.10 |
1.0× |
| Upper GI endoscopy (EGD), diagnostic (43235) |
$905 |
$4,131.95 |
1.0× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$905 |
$4,131.95 |
1.0× |
| Diagnostic colonoscopy (45378) |
$928 |
$4,052.40 |
1.0× |
| Colonoscopy with biopsy (45380) |
$1,194 |
$3,657 |
1.0× |
| Colonoscopy with lesion removal (45385) |
$1,194 |
$4,194.75 |
1.0× |
Laparoscopic gallbladder removal (47562)
range across 2 matching MRF lines |
$6,034 |
$25,838.50–$46,272.30 |
1.0× |
| Inguinal hernia repair (age 5+) (49505) |
$3,573 |
$38,583.80 |
1.0× |
| Laparoscopic radical prostatectomy (55866) |
$10,609 |
$104,171 |
1.0× |
| Obstetric care, vaginal delivery (global) (59400) |
— |
$4,725.79 |
— |
| Obstetric care, cesarean delivery (global) (59510) |
— |
$6,318.90 |
— |
| Obstetric care, VBAC delivery (global) (59610) |
— |
$4,993.54 |
— |
| Epidural injection, lumbar/sacral (with imaging) (62322) |
$882 |
$3,242.60 |
1.0× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$882 |
$4,203.65 |
1.0× |
| CT head/brain without contrast (70450) |
$104 |
$2,594.31 |
1.0× |
| MRI brain without contrast (70551) |
$238 |
$4,017.78 |
1.0× |
| MRI brain with contrast (70552) |
$348 |
$4,937.94 |
1.0× |
| MRI brain without and with contrast (70553) |
$348 |
$6,082.89 |
1.0× |
| X-ray lower spine, 4+ views (72110) |
$104 |
$994.16 |
1.0× |
| MRI lumbar spine without contrast (72148) |
$238 |
$4,072.74 |
1.0× |
| CT pelvis with contrast (72193) |
$175 |
$3,980.72 |
1.0× |
| MRI lower-extremity joint without contrast (73721) |
$238 |
$4,023.64 |
1.0× |
| CT abdomen and pelvis with contrast (74177) |
$348 |
$5,682.68 |
1.0× |
| Ultrasound, abdomen complete (76700) |
$104 |
$1,739 |
1.0× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$104 |
$1,117.30 |
1.0× |
| Ultrasound, transvaginal (76830) |
$104 |
$1,099.34 |
1.0× |
| Mammography, one breast (diagnostic) (77065) |
$87 |
$655.81 |
1.0× |
| Mammography, both breasts (diagnostic) (77066) |
$112 |
$730.36 |
1.0× |
| Mammography, screening (bilateral) (77067) |
$92 |
$814.71 |
1.0× |
| Basic metabolic panel (80048) |
$8 |
$280.35 |
0.9× |
| Comprehensive metabolic panel (80053) |
$10 |
$399.60 |
0.9× |
| Lipid panel (80061) |
$13 |
$272.95 |
1.0× |
| Renal function panel (80069) |
$8 |
$43.40 |
0.9× |
| Hepatic function panel (80076) |
$8 |
$364.94 |
1.0× |
| Urinalysis, non-automated, without microscopy (81002) |
$3 |
$101.79 |
0.9× |
| PSA, total (84153) |
$18 |
$284.22 |
1.0× |
| Thyroid stimulating hormone (TSH) (84443) |
$16 |
$195.78 |
1.0× |
| CBC with automated differential (85025) |
$7 |
$152.25 |
0.9× |
| CBC, automated (85027) |
$6 |
$154.76 |
0.9× |
| Prothrombin time (PT) (85610) |
$4 |
$134.60 |
0.9× |
| Partial thromboplastin time (PTT) (85730) |
$6 |
$164.19 |
1.0× |
| Left heart catheterization (93452) |
$3,235 |
$16,082 |
1.0× |
| Sleep study (attended polysomnography) (95810) |
$857 |
$6,877.25 |
1.0× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$29 |
$251.26 |
1.0× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
— |
$634.50 |
— |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
— |
$746.47 |
— |
| Office visit, new patient (high complexity, ~60 min) (99205) |
— |
$786.25 |
— |