| Breast lesion removal (open) (19120) |
$3,910.75 |
$7,821.50 |
1.0× |
| Upper GI endoscopy (EGD), diagnostic (43235) |
$792.67 |
$1,585.33 |
0.9× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$929.34 |
$1,858.67 |
1.1× |
| Diagnostic colonoscopy (45378) |
$861 |
$1,722 |
1.0× |
| Colonoscopy with biopsy (45380) |
$758.50 |
$1,517 |
0.7× |
| Colonoscopy with lesion removal (45385) |
$1,455.50 |
$2,911 |
1.3× |
| Laparoscopic gallbladder removal (47562) |
$10,842 |
$21,684 |
1.9× |
| Inguinal hernia repair (age 5+) (49505) |
$5,481 |
$10,962 |
1.6× |
| Epidural injection, lumbar/sacral (with imaging) (62322) |
$850.75 |
$1,701.50 |
1.0× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$1,154.84 |
$2,309.67 |
1.4× |
| After-cataract laser surgery (YAG capsulotomy) (66821) |
$760.50 |
$1,521 |
1.4× |
| Cataract removal with lens insertion (66984) |
$2,229.50 |
$4,459 |
1.0× |
| CT head/brain without contrast (70450) |
$1,334 |
$2,668 |
13.3× |
| MRI brain without contrast (70551) |
$1,544.50 |
$3,089 |
6.7× |
| MRI brain with contrast (70552) |
$1,800 |
$3,600 |
5.4× |
| MRI brain without and with contrast (70553) |
$2,415.50 |
$4,831 |
7.2× |
| X-ray lower spine, 4+ views (72110) |
$276.50 |
$553 |
2.8× |
| MRI lumbar spine without contrast (72148) |
$1,544.50 |
$3,089 |
6.7× |
| CT pelvis with contrast (72193) |
$1,408.50 |
$2,817 |
8.4× |
| MRI lower-extremity joint without contrast (73721) |
$1,544.50 |
$3,089 |
6.7× |
| CT abdomen and pelvis with contrast (74177) |
$1,442 |
$2,884 |
4.3× |
| Ultrasound, abdomen complete (76700) |
$313.25 |
$626.50 |
3.1× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$386 |
$772 |
3.8× |
| Ultrasound, transvaginal (76830) |
$494.50 |
$989 |
4.9× |
| Mammography, one breast (diagnostic) (77065) |
$175.25 |
$350.50 |
2.0× |
| Mammography, both breasts (diagnostic) (77066) |
$212.75 |
$425.50 |
1.9× |
| Mammography, screening (bilateral) (77067) |
$186.50 |
$373 |
2.0× |
| Basic metabolic panel (80048) |
$39 |
$78 |
4.6× |
| Comprehensive metabolic panel (80053) |
$49 |
$98 |
4.6× |
| Lipid panel (80061) |
$48 |
$96 |
3.6× |
| Renal function panel (80069) |
$40 |
$80 |
4.6× |
| Hepatic function panel (80076) |
$38 |
$76 |
4.7× |
| Urinalysis, non-automated, without microscopy (81002) |
$12 |
$24 |
3.4× |
| PSA, total (84153) |
$53.50 |
$107 |
2.9× |
| Thyroid stimulating hormone (TSH) (84443) |
$71.25 |
$142.50 |
4.2× |
| CBC with automated differential (85025) |
$41.50 |
$83 |
5.3× |
| CBC, automated (85027) |
$33 |
$66 |
5.1× |
| Prothrombin time (PT) (85610) |
$27.50 |
$55 |
6.4× |
| Partial thromboplastin time (PTT) (85730) |
$54.50 |
$109 |
9.1× |
| Family psychotherapy, with patient (50 min) (90847) |
$170 |
$340 |
1.0× |
| Electrocardiogram (ECG), complete (93000) |
$145.50 |
$291 |
2.6× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$92.25 |
$184.50 |
3.2× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$22.25 |
$44.50 |
0.2× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$23 |
$46 |
0.2× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$24 |
$48 |
0.2× |
| Office consultation (low complexity, ~30 min) (99243) |
$101.25 |
$202.50 |
0.8× |
| Office consultation (moderate complexity, ~40 min) (99244) |
$85.50 |
$171 |
0.7× |
| Preventive visit, new patient (age 18–39) (99385) |
$83 |
$166 |
— |
| Preventive visit, new patient (age 40–64) (99386) |
$96 |
$192 |
— |