| Breast lesion removal (open) (19120) |
$656.50 |
$1,010 |
0.2× |
| Knee arthroscopy with meniscectomy (29881) |
$724.75 |
$1,115 |
0.2× |
| Upper GI endoscopy (EGD), diagnostic (43235) |
$320.45 |
$493 |
0.4× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$315.25 |
$485 |
0.4× |
| Diagnostic colonoscopy (45378) |
$562.25 |
$865 |
0.6× |
| Colonoscopy with biopsy (45380) |
$357.50 |
$550 |
0.3× |
| Colonoscopy with lesion removal (45385) |
$455 |
$700 |
0.4× |
Laparoscopic gallbladder removal (47562)
likely a partial charge, not the full procedure |
$559.32 |
$860.50 |
0.1× |
| Inguinal hernia repair (age 5+) (49505) |
$423.15 |
$651 |
0.1× |
Laparoscopic radical prostatectomy (55866)
likely a partial charge, not the full procedure |
$2,567.50 |
$3,950 |
0.3× |
| Obstetric care, vaginal delivery (global) (59400) |
$2,622.75 |
$4,035 |
— |
| Obstetric care, cesarean delivery (global) (59510) |
$3,003 |
$4,620 |
— |
| Obstetric care, VBAC delivery (global) (59610) |
$2,291.25 |
$3,525 |
— |
| Epidural injection, lumbar/sacral (with imaging) (62322) |
$107.25 |
$165 |
0.1× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$1,127.75 |
$1,735 |
1.4× |
| CT head/brain without contrast (70450) |
$136.50 |
$210 |
1.4× |
| MRI brain without contrast (70551) |
$302.25 |
$465 |
1.4× |
| MRI brain with contrast (70552) |
$477.75 |
$735 |
1.5× |
| MRI brain without and with contrast (70553) |
$477.75 |
$735 |
1.5× |
| X-ray lower spine, 4+ views (72110) |
$91.98 |
$141.50 |
0.9× |
| MRI lumbar spine without contrast (72148) |
$303.88 |
$467.50 |
1.4× |
| CT pelvis with contrast (72193) |
$227.50 |
$350 |
1.4× |
| MRI lower-extremity joint without contrast (73721) |
$302.25 |
$465 |
1.4× |
| CT abdomen and pelvis with contrast (74177) |
$347.42 |
$534.50 |
1.1× |
| Ultrasound, abdomen complete (76700) |
$139.75 |
$215 |
1.4× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$146.25 |
$225 |
1.5× |
| Ultrasound, transvaginal (76830) |
$136.50 |
$210 |
1.4× |
| Mammography, one breast (diagnostic) (77065) |
$84.50 |
$130 |
1.0× |
| Mammography, both breasts (diagnostic) (77066) |
$110.50 |
$170 |
1.0× |
| Mammography, screening (bilateral) (77067) |
$91 |
$140 |
1.0× |
| Basic metabolic panel (80048) |
$14.62 |
$22.50 |
1.7× |
| Comprehensive metabolic panel (80053) |
$19.50 |
$30 |
1.8× |
| Obstetric panel (80055) |
$113.75 |
$175 |
2.4× |
| Lipid panel (80061) |
$24.38 |
$37.50 |
1.8× |
| Renal function panel (80069) |
$34.12 |
$52.50 |
3.9× |
| Hepatic function panel (80076) |
$32.50 |
$50 |
4.0× |
| Urinalysis, non-automated, with microscopy (81000) |
$11.05 |
$17 |
2.7× |
| Urinalysis, non-automated, without microscopy (81002) |
$6.50 |
$10 |
1.9× |
| PSA, total (84153) |
$42.25 |
$65 |
2.3× |
| Thyroid stimulating hormone (TSH) (84443) |
$29.25 |
$45 |
1.7× |
| CBC with automated differential (85025) |
$13 |
$20 |
1.7× |
| CBC, automated (85027) |
$16.25 |
$25 |
2.5× |
| Prothrombin time (PT) (85610) |
$9.75 |
$15 |
2.3× |
| Partial thromboplastin time (PTT) (85730) |
$13 |
$20 |
2.2× |
| Psychotherapy, 30 minutes (90832) |
$162.50 |
$250 |
1.0× |
| Psychotherapy, 45 minutes (90834) |
$162.50 |
$250 |
1.0× |
| Psychotherapy, 60 minutes (90837) |
$162.50 |
$250 |
1.0× |
| Family psychotherapy, without patient (50 min) (90846) |
$162.50 |
$250 |
1.0× |
| Family psychotherapy, with patient (50 min) (90847) |
$162.50 |
$250 |
1.0× |
| Group psychotherapy (90853) |
$104 |
$160 |
1.1× |
| Electrocardiogram (ECG), complete (93000) |
$84.50 |
$130 |
1.5× |
| Left heart catheterization (93452) |
$2,239.25 |
$3,445 |
0.7× |
| Sleep study (attended polysomnography) (95810) |
$1,322.75 |
$2,035 |
1.6× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$39 |
$60 |
1.3× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$123.50 |
$190 |
1.0× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$143 |
$220 |
1.1× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$162.50 |
$250 |
1.3× |
| Office consultation (low complexity, ~30 min) (99243) |
$144.62 |
$222.50 |
1.2× |
| Office consultation (moderate complexity, ~40 min) (99244) |
$136.50 |
$210 |
1.1× |
| Preventive visit, new patient (age 18–39) (99385) |
$120.25 |
$185 |
— |
| Preventive visit, new patient (age 40–64) (99386) |
$140.40 |
$216 |
— |