| Breast lesion removal (open) (19120) |
$4,175 |
$7,950 |
1.0× |
| Shoulder arthroscopy with decompression (29826) |
— |
$8,115.07 |
— |
| Knee arthroscopy with meniscectomy (29881) |
$3,489 |
$17,852 |
1.0× |
| Tonsillectomy and adenoidectomy (under age 12) (42820) |
$6,312 |
$11,677 |
1.0× |
| Colonoscopy with biopsy (45380) |
$1,276 |
$9,228 |
1.0× |
| Colonoscopy with lesion removal (45385) |
$1,276 |
$7,044 |
1.0× |
| Laparoscopic gallbladder removal (47562) |
$6,446 |
$23,879 |
1.0× |
| Inguinal hernia repair (age 5+) (49505) |
$3,818 |
$20,439 |
1.0× |
| Epidural injection, lumbar/sacral (with imaging) (62322) |
$943 |
$5,757 |
1.0× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$943 |
$4,032 |
1.0× |
| Cataract removal with lens insertion (66984) |
$2,460 |
$8,018 |
1.0× |
| CT head/brain without contrast (70450) |
$111 |
$4,161 |
1.0× |
MRI brain without contrast (70551)
range across 4 matching MRF lines |
$254 |
$3,522–$7,247 |
1.0× |
| MRI brain with contrast (70552) |
$372 |
$4,226 |
1.0× |
| MRI brain without and with contrast (70553) |
$372 |
$6,678 |
1.0× |
| X-ray lower spine, 4+ views (72110) |
$111 |
$1,573 |
1.0× |
| MRI lumbar spine without contrast (72148) |
$254 |
$4,058 |
1.0× |
| CT pelvis with contrast (72193) |
$187 |
$3,313 |
1.0× |
| MRI lower-extremity joint without contrast (73721) |
$254 |
$3,042 |
1.0× |
| CT abdomen and pelvis with contrast (74177) |
$372 |
$9,845 |
1.0× |
| Ultrasound, abdomen complete (76700) |
$111 |
$2,435 |
1.0× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$111 |
$2,061 |
1.0× |
| Ultrasound, transvaginal (76830) |
$111 |
$1,452 |
1.0× |
| Mammography, one breast (diagnostic) (77065) |
$78 |
$647 |
0.9× |
| Mammography, both breasts (diagnostic) (77066) |
$101 |
$841 |
0.9× |
| Mammography, screening (bilateral) (77067) |
$83 |
$687 |
0.9× |
| Basic metabolic panel (80048) |
$8 |
$501 |
0.9× |
| Comprehensive metabolic panel (80053) |
$10 |
$695 |
0.9× |
| Obstetric panel (80055) |
$47 |
$1,253 |
1.0× |
| Lipid panel (80061) |
$13 |
$281 |
1.0× |
| Renal function panel (80069) |
$8 |
$245 |
0.9× |
| Hepatic function panel (80076) |
$8 |
$249 |
1.0× |
| Urinalysis, non-automated, without microscopy (81002) |
$3 |
$76 |
0.9× |
| PSA, total (84153) |
$18 |
$243 |
1.0× |
| Thyroid stimulating hormone (TSH) (84443) |
$16 |
$243 |
1.0× |
| CBC with automated differential (85025) |
$7 |
$336 |
0.9× |
| CBC, automated (85027) |
$6 |
$123 |
0.9× |
Prothrombin time (PT) (85610)
range across 4 matching MRF lines |
$4 |
$86–$164 |
0.9× |
Partial thromboplastin time (PTT) (85730)
range across 6 matching MRF lines |
$6 |
$103–$158 |
1.0× |
Group psychotherapy (90853)
range across 2 matching MRF lines |
$108 |
$47–$749 |
1.0× |
| Sleep study (attended polysomnography) (95810) |
$915 |
$10,411 |
1.0× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$28 |
$351 |
1.0× |