| Breast lesion removal (open) (19120) |
$636.84 |
$1,098 |
0.2× |
| Shoulder arthroscopy with decompression (29826) |
$273.76 |
$472 |
— |
| Knee arthroscopy with meniscectomy (29881) |
$1,798 |
$3,100 |
0.5× |
| Upper GI endoscopy (EGD), diagnostic (43235) |
$473.28 |
$816 |
0.5× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$613.64 |
$1,058 |
0.7× |
| Diagnostic colonoscopy (45378) |
$558.54 |
$963 |
0.6× |
| Colonoscopy with biopsy (45380) |
$708.76 |
$1,222 |
0.6× |
| Colonoscopy with lesion removal (45385) |
$742.40 |
$1,280 |
0.6× |
Laparoscopic gallbladder removal (47562)
likely a partial charge, not the full procedure |
$1,057.92 |
$1,824 |
0.2× |
| Inguinal hernia repair (age 5+) (49505) |
$843.32 |
$1,454 |
0.2× |
| Epidural injection, lumbar/sacral (with imaging) (62322) |
$720.36 |
$1,242 |
0.8× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$961.93 |
$1,658.50 |
1.1× |
| CT head/brain without contrast (70450) |
$1,219.16 |
$2,102 |
11.3× |
| MRI brain without contrast (70551) |
$2,134.40 |
$3,680 |
8.7× |
| MRI brain with contrast (70552) |
$2,134.40 |
$3,680 |
5.9× |
| MRI brain without and with contrast (70553) |
$3,180.14 |
$5,483 |
8.8× |
| X-ray lower spine, 4+ views (72110) |
$227.94 |
$393 |
2.1× |
| MRI lumbar spine without contrast (72148) |
$2,123.38 |
$3,661 |
8.6× |
| CT pelvis with contrast (72193) |
$1,317.76 |
$2,272 |
7.3× |
| CT abdomen and pelvis with contrast (74177) |
$2,336.24 |
$4,028 |
6.5× |
| Ultrasound, abdomen complete (76700) |
$603.78 |
$1,041 |
5.6× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$386.28 |
$666 |
3.6× |
| Ultrasound, transvaginal (76830) |
$276.08 |
$476 |
2.6× |
| Mammography, one breast (diagnostic) (77065) |
$296.96 |
$512 |
3.4× |
| Mammography, both breasts (diagnostic) (77066) |
$377.58 |
$651 |
3.4× |
| Mammography, screening (bilateral) (77067) |
$317.26 |
$547 |
3.5× |
| Basic metabolic panel (80048) |
$175.16 |
$302 |
20.7× |
| Comprehensive metabolic panel (80053) |
$201.26 |
$347 |
19.1× |
| Lipid panel (80061) |
$47.27 |
$81.50 |
3.5× |
| Renal function panel (80069) |
$186.18 |
$321 |
21.4× |
| Hepatic function panel (80076) |
$186.18 |
$321 |
22.8× |
| Urinalysis, non-automated, without microscopy (81002) |
$12.18 |
$21 |
3.5× |
| PSA, total (84153) |
$75.98 |
$131 |
4.1× |
| Thyroid stimulating hormone (TSH) (84443) |
$75.40 |
$130 |
4.5× |
| CBC with automated differential (85025) |
$93.96 |
$162 |
12.1× |
| CBC, automated (85027) |
$59.16 |
$102 |
9.1× |
| Prothrombin time (PT) (85610) |
$40.60 |
$70 |
9.5× |
| Partial thromboplastin time (PTT) (85730) |
$69.60 |
$120 |
11.6× |
| Psychotherapy, 30 minutes (90832) |
$102.66 |
$177 |
0.6× |
| Psychotherapy, 45 minutes (90834) |
$135.14 |
$233 |
0.7× |
| Psychotherapy, 60 minutes (90837) |
$200.10 |
$345 |
1.1× |
| Family psychotherapy, without patient (50 min) (90846) |
$187.92 |
$324 |
1.0× |
| Family psychotherapy, with patient (50 min) (90847) |
$194.88 |
$336 |
1.1× |
| Group psychotherapy (90853) |
$646.70 |
$1,115 |
6.2× |
| Sleep study (attended polysomnography) (95810) |
$3,236.40 |
$5,580 |
3.7× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$162.40 |
$280 |
1.2× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$243.31 |
$419.50 |
1.8× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$320.45 |
$552.50 |
2.3× |
| Office consultation (low complexity, ~30 min) (99243) |
$311.17 |
$536.50 |
2.3× |
| Office consultation (moderate complexity, ~40 min) (99244) |
$423.11 |
$729.50 |
3.1× |
| Preventive visit, new patient (age 18–39) (99385) |
$151.38 |
$261 |
— |
| Preventive visit, new patient (age 40–64) (99386) |
$174 |
$300 |
— |