| Breast lesion removal (open) (19120) |
$6,175.40 |
$11,228 |
1.6× |
| Shoulder arthroscopy with decompression (29826) |
$3,886.85 |
$7,067 |
— |
| Knee arthroscopy with meniscectomy (29881) |
$10,530.58 |
$19,146.50 |
3.3× |
| Tonsillectomy and adenoidectomy (under age 12) (42820) |
$3,888.50 |
$7,070 |
0.7× |
| Upper GI endoscopy (EGD), diagnostic (43235) |
$1,171.50 |
$2,130 |
1.3× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$1,199 |
$2,180 |
1.4× |
| Epidural injection, lumbar/sacral (with imaging) (62322) |
$852.50 |
$1,550 |
1.0× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$3,683.62 |
$6,697.50 |
4.3× |
| CT head/brain without contrast (70450) |
$1,925 |
$3,500 |
19.1× |
| MRI brain without contrast (70551) |
$2,390.30 |
$4,346 |
10.4× |
| MRI brain with contrast (70552) |
$2,393.05 |
$4,351 |
7.1× |
| MRI brain without and with contrast (70553) |
$2,802.80 |
$5,096 |
8.4× |
| X-ray lower spine, 4+ views (72110) |
$575.85 |
$1,047 |
5.7× |
| MRI lumbar spine without contrast (72148) |
$2,131.80 |
$3,876 |
9.3× |
| CT pelvis with contrast (72193) |
$2,862.75 |
$5,205 |
17.0× |
| MRI lower-extremity joint without contrast (73721) |
$2,093.30 |
$3,806 |
9.1× |
| CT abdomen and pelvis with contrast (74177) |
$3,708.10 |
$6,742 |
11.1× |
| Ultrasound, abdomen complete (76700) |
$1,131.35 |
$2,057 |
11.3× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$683.65 |
$1,243 |
6.8× |
| Ultrasound, transvaginal (76830) |
$751.85 |
$1,367 |
7.5× |
| Mammography, one breast (diagnostic) (77065) |
$220 |
$400 |
2.6× |
| Mammography, both breasts (diagnostic) (77066) |
$440 |
$800 |
4.0× |
| Mammography, screening (bilateral) (77067) |
$259.88 |
$472.50 |
2.9× |
| Basic metabolic panel (80048) |
$160.32 |
$291.50 |
19.0× |
| Comprehensive metabolic panel (80053) |
$324.78 |
$590.50 |
30.8× |
| Obstetric panel (80055) |
$588.78 |
$1,070.50 |
12.3× |
| Lipid panel (80061) |
$74.25 |
$135 |
5.5× |
| Renal function panel (80069) |
$161.98 |
$294.50 |
18.7× |
| Hepatic function panel (80076) |
$264 |
$480 |
32.3× |
| Urinalysis, non-automated, without microscopy (81002) |
$34.65 |
$63 |
10.0× |
| PSA, total (84153) |
$154 |
$280 |
8.4× |
| Thyroid stimulating hormone (TSH) (84443) |
$146.02 |
$265.50 |
8.7× |
| CBC with automated differential (85025) |
$167.20 |
$304 |
21.5× |
| CBC, automated (85027) |
$97.08 |
$176.50 |
15.0× |
| Prothrombin time (PT) (85610) |
$29.70 |
$54 |
6.9× |
| Partial thromboplastin time (PTT) (85730) |
$41.80 |
$76 |
7.0× |
| Psychotherapy, 30 minutes (90832) |
$165.55 |
$301 |
1.0× |
| Psychotherapy, 45 minutes (90834) |
$353.65 |
$643 |
2.1× |
| Psychotherapy, 60 minutes (90837) |
$293.70 |
$534 |
1.7× |
| Family psychotherapy, without patient (50 min) (90846) |
$266.20 |
$484 |
1.6× |
| Group psychotherapy (90853) |
$436.70 |
$794 |
4.5× |
| Left heart catheterization (93452) |
$3,372.60 |
$6,132 |
1.1× |
| Sleep study (attended polysomnography) (95810) |
$4,859.25 |
$8,835 |
5.9× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$66 |
$120 |
2.3× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$481.25 |
$875 |
3.8× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$481.25 |
$875 |
3.8× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$481.25 |
$875 |
3.8× |
| Preventive visit, new patient (age 18–39) (99385) |
$132.26 |
$240.48 |
— |