| Breast lesion removal (open) (19120) |
$833.20 |
$1,041.50 |
0.2× |
| Shoulder arthroscopy with decompression (29826) |
$539.60 |
$674.50 |
— |
| Knee arthroscopy with meniscectomy (29881) |
$1,046.40 |
$1,308 |
0.3× |
Tonsillectomy and adenoidectomy (under age 12) (42820)
likely a partial charge, not the full procedure |
$739.20 |
$924 |
0.1× |
| Upper GI endoscopy (EGD), diagnostic (43235) |
$522 |
$652.50 |
0.6× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$739.20 |
$924 |
0.9× |
| Diagnostic colonoscopy (45378) |
$786.40 |
$983 |
0.9× |
| Colonoscopy with biopsy (45380) |
$786.40 |
$983 |
0.7× |
| Colonoscopy with lesion removal (45385) |
$786.40 |
$983 |
0.7× |
Laparoscopic gallbladder removal (47562)
likely a partial charge, not the full procedure |
$1,548 |
$1,935 |
0.3× |
| Inguinal hernia repair (age 5+) (49505) |
$1,174 |
$1,467.50 |
0.4× |
Laparoscopic radical prostatectomy (55866)
unusually low: confirm this is the full procedure |
$3,286 |
$4,107.50 |
0.3× |
| Obstetric care, vaginal delivery (global) (59400) |
$2,999.60 |
$3,749.50 |
— |
| Obstetric care, cesarean delivery (global) (59510) |
$3,182.40 |
$3,978 |
— |
| Obstetric care, VBAC delivery (global) (59610) |
$2,869.20 |
$3,586.50 |
— |
| Epidural injection, lumbar/sacral (with imaging) (62322) |
$564.20 |
$705.25 |
0.7× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$630.40 |
$788 |
0.8× |
| CT head/brain without contrast (70450) |
$1,046.60 |
$1,308.25 |
10.9× |
| MRI brain without contrast (70551) |
$3,199.60 |
$3,999.50 |
14.6× |
| MRI brain with contrast (70552) |
$3,518.40 |
$4,398 |
11.0× |
| MRI brain without and with contrast (70553) |
$3,999.60 |
$4,999.50 |
12.5× |
| X-ray lower spine, 4+ views (72110) |
$58.80 |
$73.50 |
0.6× |
| MRI lumbar spine without contrast (72148) |
$1,509.60 |
$1,887 |
6.9× |
| CT pelvis with contrast (72193) |
$1,325 |
$1,656.25 |
8.2× |
| MRI lower-extremity joint without contrast (73721) |
$2,574.80 |
$3,218.50 |
11.7× |
| CT abdomen and pelvis with contrast (74177) |
$2,394 |
$2,992.50 |
7.5× |
| Ultrasound, abdomen complete (76700) |
$121.60 |
$152 |
1.3× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$263.20 |
$329 |
2.7× |
| Ultrasound, transvaginal (76830) |
$259.20 |
$324 |
2.7× |
| Mammography, one breast (diagnostic) (77065) |
$245 |
$306.25 |
2.8× |
| Mammography, both breasts (diagnostic) (77066) |
$402.80 |
$503.50 |
3.6× |
| Mammography, screening (bilateral) (77067) |
$153.20 |
$191.50 |
1.7× |
| Basic metabolic panel (80048) |
$133.60 |
$167 |
15.8× |
| Comprehensive metabolic panel (80053) |
$117.60 |
$147 |
11.1× |
| Lipid panel (80061) |
$189.40 |
$236.75 |
14.1× |
| Hepatic function panel (80076) |
$244.40 |
$305.50 |
29.9× |
| Urinalysis, non-automated, with microscopy (81000) |
$50.80 |
$63.50 |
12.6× |
| Urinalysis, non-automated, without microscopy (81002) |
$26.40 |
$33 |
7.6× |
| PSA, total (84153) |
$135.60 |
$169.50 |
7.4× |
| Thyroid stimulating hormone (TSH) (84443) |
$103.60 |
$129.50 |
6.2× |
| CBC with automated differential (85025) |
$139.60 |
$174.50 |
18.0× |
| CBC, automated (85027) |
$128.40 |
$160.50 |
19.8× |
| Prothrombin time (PT) (85610) |
$48 |
$60 |
11.2× |
| Partial thromboplastin time (PTT) (85730) |
$71.80 |
$89.75 |
11.9× |
| Electrocardiogram (ECG), complete (93000) |
$52.40 |
$65.50 |
1.0× |
| Sleep study (attended polysomnography) (95810) |
$5,311.60 |
$6,639.50 |
6.7× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$237.40 |
$296.75 |
8.2× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$186.20 |
$232.75 |
1.5× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$274.60 |
$343.25 |
2.2× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$306 |
$382.50 |
2.5× |
| Office consultation (low complexity, ~30 min) (99243) |
$180.80 |
$226 |
1.5× |
| Office consultation (moderate complexity, ~40 min) (99244) |
$264.40 |
$330.50 |
2.2× |
| Preventive visit, new patient (age 18–39) (99385) |
$204.80 |
$256 |
— |
| Preventive visit, new patient (age 40–64) (99386) |
$204.80 |
$256 |
— |