| Breast lesion removal (open) (19120) |
$3,902 |
$11,304.80 |
1.0× |
| Shoulder arthroscopy with decompression (29826) |
— |
$4,378.88 |
— |
| Knee arthroscopy with meniscectomy (29881) |
$3,261 |
$11,547 |
1.0× |
| Tonsillectomy and adenoidectomy (under age 12) (42820) |
$5,900 |
$8,443.85 |
1.0× |
Upper GI endoscopy (EGD), diagnostic (43235)
range across 2 matching MRF lines |
$903 |
$4,631.91–$7,371.71 |
1.0× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$903 |
$2,438.15 |
1.0× |
Diagnostic colonoscopy (45378)
range across 4 matching MRF lines |
$926 |
$4,382.24–$7,371.71 |
1.0× |
| Colonoscopy with biopsy (45380) |
$1,192 |
$2,823.66 |
1.0× |
Colonoscopy with lesion removal (45385)
range across 2 matching MRF lines |
$1,192 |
$5,694.36–$7,371.71 |
1.0× |
| Laparoscopic gallbladder removal (47562) |
$6,025 |
$14,833.70 |
1.0× |
| Inguinal hernia repair (age 5+) (49505) |
$3,568 |
$11,402.30 |
1.0× |
| Epidural injection, lumbar/sacral (with imaging) (62322) |
$881 |
$2,675.65 |
1.0× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$881 |
$4,658.58 |
1.0× |
| CT head/brain without contrast (70450) |
$104 |
$4,170.67 |
1.0× |
| MRI brain without contrast (70551) |
$237 |
$4,924.48 |
1.0× |
| MRI brain with contrast (70552) |
$347 |
$3,253.91 |
1.0× |
| MRI brain without and with contrast (70553) |
$347 |
$6,224.44 |
1.0× |
| X-ray lower spine, 4+ views (72110) |
$104 |
$990.17 |
1.0× |
| MRI lumbar spine without contrast (72148) |
$237 |
$4,708.78 |
1.0× |
| CT pelvis with contrast (72193) |
$174 |
$3,623.38 |
1.0× |
| MRI lower-extremity joint without contrast (73721) |
$237 |
$7,327.06 |
1.0× |
| CT abdomen and pelvis with contrast (74177) |
$347 |
$7,745.86 |
1.0× |
| Ultrasound, abdomen complete (76700) |
$104 |
$1,799.06 |
1.0× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$104 |
$1,688.92 |
1.0× |
| Ultrasound, transvaginal (76830) |
$104 |
$1,046.40 |
1.0× |
| Mammography, one breast (diagnostic) (77065) |
$80 |
$517.46 |
0.9× |
| Mammography, both breasts (diagnostic) (77066) |
$103 |
$547.30 |
0.9× |
| Mammography, screening (bilateral) (77067) |
$85 |
$486.49 |
0.9× |
| Basic metabolic panel (80048) |
$8 |
$383.22 |
0.9× |
| Comprehensive metabolic panel (80053) |
$10 |
$540.41 |
0.9× |
| Lipid panel (80061) |
$13 |
$320.11 |
1.0× |
| Renal function panel (80069) |
$8 |
$332.74 |
0.9× |
| Hepatic function panel (80076) |
$8 |
$380.92 |
1.0× |
| Urinalysis, non-automated, without microscopy (81002) |
$3 |
$69.99 |
0.9× |
| PSA, total (84153) |
$18 |
$293.73 |
1.0× |
| Thyroid stimulating hormone (TSH) (84443) |
$16 |
$268.48 |
1.0× |
| CBC with automated differential (85025) |
$7 |
$359.13 |
0.9× |
| CBC, automated (85027) |
$6 |
$359.13 |
0.9× |
| Prothrombin time (PT) (85610) |
$4 |
$359.13 |
0.9× |
| Partial thromboplastin time (PTT) (85730) |
$6 |
$359.13 |
1.0× |
| Electrocardiogram (ECG), complete (93000) |
— |
$349.05 |
— |
| Left heart catheterization (93452) |
$3,231 |
$15,693.20 |
1.0× |
| Sleep study (attended polysomnography) (95810) |
$855 |
$9,049.25 |
1.0× |
Physical therapy, therapeutic exercise (per 15 min) (97110)
range across 3 matching MRF lines |
$28 |
$342.02–$359.13 |
1.0× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
— |
$898.38 |
— |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
— |
$898.38 |
— |
| Office visit, new patient (high complexity, ~60 min) (99205) |
— |
$1,163.43 |
— |
| Office consultation (low complexity, ~30 min) (99243) |
— |
$389.07 |
— |
| Office consultation (moderate complexity, ~40 min) (99244) |
— |
$530.08 |
— |