| Shoulder arthroscopy with decompression (29826) |
$10,184 |
$20,368 |
— |
| Knee arthroscopy with meniscectomy (29881) |
$8,475 |
$16,949 |
2.5× |
| Upper GI endoscopy (EGD), diagnostic (43235) |
$1,183.50 |
$2,366 |
1.2× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$1,501.50 |
$3,002.50 |
1.6× |
| Diagnostic colonoscopy (45378) |
$2,087 |
$4,173 |
2.1× |
| Colonoscopy with biopsy (45380) |
$1,378.50 |
$2,757 |
1.1× |
| Colonoscopy with lesion removal (45385) |
$2,291 |
$4,582 |
1.8× |
| Laparoscopic gallbladder removal (47562) |
$6,041.50 |
$12,082.50 |
0.9× |
| Inguinal hernia repair (age 5+) (49505) |
$6,899 |
$13,797 |
1.8× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$1,576 |
$3,151 |
1.7× |
| Cataract removal with lens insertion (66984) |
$2,597 |
$5,194 |
1.1× |
| CT head/brain without contrast (70450) |
$805 |
$1,610 |
7.3× |
| MRI brain without contrast (70551) |
$1,807 |
$3,614 |
7.2× |
| MRI brain with contrast (70552) |
$1,854 |
$3,707 |
5.0× |
| MRI brain without and with contrast (70553) |
$2,507 |
$5,013 |
6.8× |
| X-ray lower spine, 4+ views (72110) |
$180 |
$359 |
1.6× |
| MRI lumbar spine without contrast (72148) |
$1,422 |
$2,843 |
5.6× |
| CT pelvis with contrast (72193) |
$1,095 |
$2,190 |
5.9× |
| CT abdomen and pelvis with contrast (74177) |
$1,750 |
$3,500 |
4.8× |
| Ultrasound, abdomen complete (76700) |
$433 |
$866 |
3.9× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$399 |
$797 |
3.6× |
| Ultrasound, transvaginal (76830) |
$373 |
$745 |
3.4× |
| Mammography, one breast (diagnostic) (77065) |
$135 |
$269 |
1.6× |
| Mammography, both breasts (diagnostic) (77066) |
$225 |
$449 |
2.0× |
| Mammography, screening (bilateral) (77067) |
$162.50 |
$324.50 |
1.8× |
| Basic metabolic panel (80048) |
$37 |
$73 |
4.4× |
| Comprehensive metabolic panel (80053) |
$46 |
$91 |
4.4× |
| Obstetric panel (80055) |
$171 |
$342 |
3.6× |
| Lipid panel (80061) |
$45 |
$90 |
3.4× |
| Renal function panel (80069) |
$75 |
$149 |
8.6× |
| Hepatic function panel (80076) |
$54 |
$107 |
6.6× |
| Urinalysis, non-automated, without microscopy (81002) |
$11 |
$22 |
3.2× |
| PSA, total (84153) |
$42 |
$84 |
2.3× |
| Thyroid stimulating hormone (TSH) (84443) |
$29.50 |
$58.50 |
1.8× |
| CBC with automated differential (85025) |
$30 |
$59 |
3.9× |
| CBC, automated (85027) |
$25 |
$49 |
3.9× |
| Prothrombin time (PT) (85610) |
$21 |
$41.50 |
4.9× |
| Partial thromboplastin time (PTT) (85730) |
$14 |
$27 |
2.3× |
| Psychotherapy, 30 minutes (90832) |
$138 |
$276 |
0.7× |
| Psychotherapy, 45 minutes (90834) |
$138 |
$276 |
0.7× |
| Psychotherapy, 60 minutes (90837) |
$138 |
$276 |
0.7× |
| Sleep study (attended polysomnography) (95810) |
$2,279 |
$4,557 |
2.5× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$40.50 |
$80.50 |
1.4× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$127.50 |
$254.50 |
0.9× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$204 |
$408 |
1.5× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$222 |
$444 |
1.6× |