| Breast lesion removal (open) (19120) |
$4,000.24 |
— |
0.8× |
| Shoulder arthroscopy with decompression (29826) |
$140.36 |
— |
— |
| Knee arthroscopy with meniscectomy (29881) |
$3,342.87 |
— |
0.8× |
| Tonsillectomy and adenoidectomy (under age 12) (42820) |
$6,048.05 |
— |
0.8× |
| Upper GI endoscopy (EGD), diagnostic (43235) |
$926.63 |
— |
0.8× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$926.63 |
— |
0.8× |
| Diagnostic colonoscopy (45378) |
$950.10 |
— |
0.8× |
| Colonoscopy with biopsy (45380) |
$1,222.56 |
— |
0.8× |
| Colonoscopy with lesion removal (45385) |
$1,222.56 |
— |
0.8× |
| Colonoscopy with endoscopic ultrasound (45391) |
$1,222.56 |
— |
0.8× |
| Laparoscopic gallbladder removal (47562) |
$6,176.47 |
— |
0.8× |
| Inguinal hernia repair (age 5+) (49505) |
$3,657.95 |
— |
0.8× |
| Laparoscopic radical prostatectomy (55866) |
$10,860.07 |
— |
0.8× |
| Obstetric care, vaginal delivery (global) (59400) |
$2,078.59 |
— |
— |
| Obstetric care, cesarean delivery (global) (59510) |
$2,310.97 |
— |
— |
| Obstetric care, VBAC delivery (global) (59610) |
$2,176.20 |
— |
— |
| Epidural injection, lumbar/sacral (with imaging) (62322) |
$903.63 |
— |
0.8× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$903.63 |
— |
0.8× |
| After-cataract laser surgery (YAG capsulotomy) (66821) |
$561.91 |
— |
0.8× |
| Cataract removal with lens insertion (66984) |
$2,357.81 |
— |
0.8× |
| CT head/brain without contrast (70450) |
$106.81 |
$1,626 |
0.8× |
| MRI brain without contrast (70551) |
$243.77 |
$3,991 |
0.8× |
| MRI brain with contrast (70552) |
$356.43 |
$4,774 |
0.8× |
| MRI brain without and with contrast (70553) |
$356.43 |
$4,582 |
0.8× |
| X-ray lower spine, 4+ views (72110) |
$106.81 |
$359 |
0.8× |
| MRI lumbar spine without contrast (72148) |
$243.77 |
$5,324 |
0.8× |
| CT pelvis with contrast (72193) |
$179.20 |
$1,255 |
0.8× |
MRI lower-extremity joint without contrast (73721)
range across 9 matching MRF lines |
$243.77 |
$2,218–$3,330 |
0.8× |
| CT abdomen and pelvis with contrast (74177) |
$356.43 |
$3,015 |
0.8× |
| Ultrasound, abdomen complete (76700) |
$106.81 |
$908 |
0.8× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$106.81 |
$532 |
0.8× |
| Ultrasound, transvaginal (76830) |
$106.81 |
$532 |
0.8× |
| Mammography, one breast (diagnostic) (77065) |
$118.55 |
$988 |
1.4× |
| Mammography, both breasts (diagnostic) (77066) |
$150.11 |
$1,235 |
1.4× |
Mammography, screening (bilateral) (77067)
range across 5 matching MRF lines |
$120.77 |
$814–$864 |
1.3× |
| Basic metabolic panel (80048) |
$8.46 |
$161 |
1.0× |
| Comprehensive metabolic panel (80053) |
$10.56 |
$226 |
1.0× |
| Obstetric panel (80055) |
$47.81 |
— |
1.0× |
| Lipid panel (80061) |
$13.39 |
$147 |
1.0× |
| Renal function panel (80069) |
$8.68 |
— |
1.0× |
| Hepatic function panel (80076) |
$8.17 |
$255 |
1.0× |
| Urinalysis, non-automated, with microscopy (81000) |
$4.02 |
— |
1.0× |
| Urinalysis, non-automated, without microscopy (81002) |
$3.48 |
— |
1.0× |
PSA, total (84153)
range across 4 matching MRF lines |
$18.39 |
$118–$464 |
1.0× |
Thyroid stimulating hormone (TSH) (84443)
range across 4 matching MRF lines |
$16.80 |
$232–$245 |
1.0× |
CBC with automated differential (85025)
range across 4 matching MRF lines |
$7.77 |
$72–$106 |
1.0× |
| CBC, automated (85027) |
$6.47 |
— |
1.0× |
Prothrombin time (PT) (85610)
range across 4 matching MRF lines |
$4.29 |
$135–$169 |
1.0× |
| Partial thromboplastin time (PTT) (85730) |
$6.01 |
$88 |
1.0× |
| Psychotherapy, 30 minutes (90832) |
$181.34 |
$585 |
0.8× |
| Psychotherapy, 45 minutes (90834) |
$181.34 |
$789 |
0.8× |
| Psychotherapy, 60 minutes (90837) |
$181.34 |
$824 |
0.8× |
Family psychotherapy, without patient (50 min) (90846)
range across 5 matching MRF lines |
$181.34 |
$425–$773 |
0.8× |
| Family psychotherapy, with patient (50 min) (90847) |
$181.34 |
$1,172 |
0.8× |
Group psychotherapy (90853)
range across 5 matching MRF lines |
$103.79 |
$418–$1,321 |
0.8× |
| Electrocardiogram (ECG), complete (93000) |
$14.72 |
— |
0.2× |
| Left heart catheterization (93452) |
$3,312.15 |
— |
0.8× |
| Sleep study (attended polysomnography) (95810) |
$877.34 |
— |
0.8× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$28.27 |
$230 |
1.0× |
Office visit, new patient (low complexity, ~30 min) (99203)
range across 3 matching MRF lines |
$113.04 |
$1,036–$1,118 |
0.7× |
Office visit, new patient (moderate complexity, ~45 min) (99204)
range across 3 matching MRF lines |
$170.85 |
$1,485–$1,559 |
1.0× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$227.85 |
$1,692 |
1.4× |
| Office consultation (low complexity, ~30 min) (99243) |
$109.03 |
— |
0.7× |
| Office consultation (moderate complexity, ~40 min) (99244) |
$156.03 |
— |
0.9× |
| Preventive visit, new patient (age 18–39) (99385) |
$130.09 |
$1,894 |
— |
| Preventive visit, new patient (age 40–64) (99386) |
$150.52 |
$1,894 |
— |