| Breast lesion removal (open) (19120) |
$4,789.98 |
$14,968.70 |
1.3× |
| Knee arthroscopy with meniscectomy (29881) |
$6,663.05 |
$20,822.04 |
2.2× |
| Tonsillectomy and adenoidectomy (under age 12) (42820) |
$8,956.83 |
$27,990.08 |
1.6× |
| Upper GI endoscopy (EGD), diagnostic (43235) |
$936 |
$2,925 |
1.1× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$936 |
$2,925 |
1.1× |
| Diagnostic colonoscopy (45378) |
$945.28 |
$2,954 |
1.1× |
| Colonoscopy with biopsy (45380) |
$945.28 |
$2,954 |
0.8× |
| Colonoscopy with lesion removal (45385) |
$961.92 |
$3,006 |
0.9× |
| Laparoscopic gallbladder removal (47562) |
$7,309.49 |
$22,842.14 |
1.3× |
| Epidural injection, lumbar/sacral (with imaging) (62322) |
$649.28 |
$2,029 |
0.8× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$756.96 |
$2,365.50 |
0.9× |
| CT head/brain without contrast (70450) |
$173.44 |
$542 |
1.8× |
| MRI brain without contrast (70551) |
$404.16 |
$1,263 |
1.8× |
| MRI brain with contrast (70552) |
$815.68 |
$2,549 |
2.5× |
| MRI brain without and with contrast (70553) |
$675.84 |
$2,112 |
2.1× |
| X-ray lower spine, 4+ views (72110) |
$124.80 |
$390 |
1.3× |
| MRI lumbar spine without contrast (72148) |
$404.16 |
$1,263 |
1.8× |
| CT pelvis with contrast (72193) |
$436.16 |
$1,363 |
2.6× |
| MRI lower-extremity joint without contrast (73721) |
$607.68 |
$1,899 |
2.7× |
| CT abdomen and pelvis with contrast (74177) |
$501.76 |
$1,568 |
1.5× |
| Ultrasound, abdomen complete (76700) |
$164.16 |
$513 |
1.7× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$168 |
$525 |
1.7× |
| Ultrasound, transvaginal (76830) |
$146.88 |
$459 |
1.5× |
| Mammography, one breast (diagnostic) (77065) |
$128 |
$400 |
1.5× |
| Mammography, both breasts (diagnostic) (77066) |
$163.52 |
$511 |
1.5× |
| Mammography, screening (bilateral) (77067) |
$119.68 |
$374 |
1.3× |
| Basic metabolic panel (80048) |
$15.36 |
$48 |
1.8× |
| Comprehensive metabolic panel (80053) |
$18.88 |
$59 |
1.8× |
| Lipid panel (80061) |
$15.68 |
$49 |
1.2× |
| Renal function panel (80069) |
$15.68 |
$49 |
1.8× |
| Hepatic function panel (80076) |
$14.72 |
$46 |
1.8× |
| PSA, total (84153) |
$24 |
$75 |
1.3× |
| Thyroid stimulating hormone (TSH) (84443) |
$21.76 |
$68 |
1.3× |
| CBC with automated differential (85025) |
$14.08 |
$44 |
1.8× |
| CBC, automated (85027) |
$11.52 |
$36 |
1.8× |
| Prothrombin time (PT) (85610) |
$7.04 |
$22 |
1.6× |
| Partial thromboplastin time (PTT) (85730) |
$11.36 |
$35.50 |
1.9× |
| Left heart catheterization (93452) |
$3,201.28 |
$10,004 |
1.1× |
| Sleep study (attended polysomnography) (95810) |
$1,635.52 |
$5,111 |
2.0× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$32.96 |
$103 |
1.1× |