| Breast lesion removal (open) (19120) |
$1,918.50 |
$1,918.50 |
0.5× |
| Shoulder arthroscopy with decompression (29826) |
$679.50 |
$679.50 |
— |
| Knee arthroscopy with meniscectomy (29881) |
$2,109 |
$2,109 |
0.6× |
Tonsillectomy and adenoidectomy (under age 12) (42820)
likely a partial charge — not the full procedure |
$908 |
$908 |
0.2× |
| Upper GI endoscopy (EGD), diagnostic (43235) |
$750 |
$750 |
0.8× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$926 |
$926 |
1.0× |
| Diagnostic colonoscopy (45378) |
$859 |
$859 |
0.9× |
| Colonoscopy with biopsy (45380) |
$1,156.50 |
$1,156.50 |
0.9× |
| Colonoscopy with lesion removal (45385) |
$1,700 |
$1,700 |
1.4× |
| Colonoscopy with endoscopic ultrasound (45391) |
$764 |
$764 |
0.6× |
Laparoscopic gallbladder removal (47562)
unusually low — confirm this is the full procedure |
$2,748 |
$2,748 |
0.4× |
| Inguinal hernia repair (age 5+) (49505) |
$2,908.50 |
$2,908.50 |
0.8× |
Laparoscopic radical prostatectomy (55866)
unusually low — confirm this is the full procedure |
$4,326 |
$4,326 |
0.4× |
| Obstetric care, vaginal delivery (global) (59400) |
$7,327 |
$7,327 |
— |
| Obstetric care, cesarean delivery (global) (59510) |
$8,572 |
$8,572 |
— |
| Obstetric care, VBAC delivery (global) (59610) |
$5,828 |
$5,828 |
— |
| Epidural injection, lumbar/sacral (with imaging) (62322) |
$1,003 |
$1,003 |
1.1× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$1,052 |
$1,052 |
1.2× |
| After-cataract laser surgery (YAG capsulotomy) (66821) |
$1,309.50 |
$1,309.50 |
2.3× |
| Cataract removal with lens insertion (66984) |
$2,544 |
$2,544 |
1.1× |
| CT head/brain without contrast (70450) |
$1,619 |
$1,619 |
15.2× |
| MRI brain without contrast (70551) |
$2,534 |
$2,534 |
10.4× |
| MRI brain with contrast (70552) |
$3,061 |
$3,061 |
8.6× |
| MRI brain without and with contrast (70553) |
$3,441 |
$3,441 |
9.7× |
| X-ray lower spine, 4+ views (72110) |
$386 |
$386 |
3.6× |
| MRI lumbar spine without contrast (72148) |
$2,455 |
$2,455 |
10.1× |
| CT pelvis with contrast (72193) |
$2,287 |
$2,287 |
12.8× |
| MRI lower-extremity joint without contrast (73721) |
$750 |
$750 |
3.1× |
| CT abdomen and pelvis with contrast (74177) |
$3,387 |
$3,387 |
9.5× |
| Ultrasound, abdomen complete (76700) |
$630.50 |
$630.50 |
5.9× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$520 |
$520 |
4.9× |
| Ultrasound, transvaginal (76830) |
$470 |
$470 |
4.4× |
| Mammography, one breast (diagnostic) (77065) |
$379.50 |
$379.50 |
4.4× |
| Mammography, both breasts (diagnostic) (77066) |
$481.50 |
$481.50 |
4.4× |
| Mammography, screening (bilateral) (77067) |
$339.50 |
$339.50 |
3.7× |
| Basic metabolic panel (80048) |
$128 |
$128 |
15.1× |
| Comprehensive metabolic panel (80053) |
$160 |
$160 |
15.2× |
| Lipid panel (80061) |
$108 |
$108 |
8.1× |
| Renal function panel (80069) |
$133 |
$133 |
15.3× |
| Hepatic function panel (80076) |
$92.75 |
$92.75 |
11.4× |
| Urinalysis, non-automated, without microscopy (81002) |
$29 |
$29 |
8.3× |
| PSA, total (84153) |
$105.80 |
$105.80 |
5.8× |
| Thyroid stimulating hormone (TSH) (84443) |
$140 |
$140 |
8.3× |
| CBC with automated differential (85025) |
$87.50 |
$87.50 |
11.3× |
| CBC, automated (85027) |
$77 |
$77 |
11.9× |
| Prothrombin time (PT) (85610) |
$55 |
$55 |
12.8× |
| Partial thromboplastin time (PTT) (85730) |
$88 |
$88 |
14.6× |
| Psychotherapy, 30 minutes (90832) |
$176.50 |
$176.50 |
1.0× |
| Psychotherapy, 45 minutes (90834) |
$229 |
$229 |
1.3× |
| Psychotherapy, 60 minutes (90837) |
$341 |
$341 |
1.9× |
| Family psychotherapy, without patient (50 min) (90846) |
$186 |
$186 |
1.0× |
| Family psychotherapy, with patient (50 min) (90847) |
$223 |
$223 |
1.2× |
| Group psychotherapy (90853) |
$62 |
$62 |
0.6× |
| Electrocardiogram (ECG), complete (93000) |
$46 |
$46 |
0.8× |
| Left heart catheterization (93452) |
$2,288 |
$2,288 |
0.7× |
| Sleep study (attended polysomnography) (95810) |
$1,619 |
$1,619 |
1.8× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$109.50 |
$109.50 |
3.8× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$325 |
$325 |
2.4× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$407.50 |
$407.50 |
3.0× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$495 |
$495 |
3.6× |
| Office consultation (low complexity, ~30 min) (99243) |
$275 |
$275 |
2.0× |
| Office consultation (moderate complexity, ~40 min) (99244) |
$409.50 |
$409.50 |
3.0× |
| Preventive visit, new patient (age 18–39) (99385) |
$397.50 |
$397.50 |
— |
| Preventive visit, new patient (age 40–64) (99386) |
$400 |
$400 |
— |