| Breast lesion removal (open) (19120) |
$9,739.44 |
$16,232.40 |
2.7× |
| Shoulder arthroscopy with decompression (29826) |
$19,465.41 |
$32,442.34 |
— |
| Knee arthroscopy with meniscectomy (29881) |
$15,078.80 |
$24,864.93 |
5.1× |
| Tonsillectomy and adenoidectomy (under age 12) (42820) |
$6,330.04 |
$10,550.08 |
1.2× |
| Upper GI endoscopy (EGD), diagnostic (43235) |
$1,653 |
$2,755 |
2.0× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$2,478.60 |
$4,131 |
3.0× |
| Diagnostic colonoscopy (45378) |
$2,514.60 |
$4,191 |
3.0× |
| Colonoscopy with biopsy (45380) |
$2,754.60 |
$4,591 |
2.5× |
| Colonoscopy with lesion removal (45385) |
$1,791.93 |
$2,986.55 |
1.6× |
| Colonoscopy with endoscopic ultrasound (45391) |
$1,791.93 |
$2,986.55 |
1.6× |
| Laparoscopic gallbladder removal (47562) |
$13,102.80 |
$21,786.50 |
2.4× |
| Inguinal hernia repair (age 5+) (49505) |
$10,690.80 |
$17,818 |
3.3× |
| Laparoscopic radical prostatectomy (55866) |
$42,502.20 |
$70,837 |
4.4× |
| Epidural injection, lumbar/sacral (with imaging) (62322) |
$1,230.60 |
$2,051 |
1.5× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$1,929.60 |
$3,216 |
2.4× |
| Cataract removal with lens insertion (66984) |
$9,713.62 |
$16,189.38 |
4.6× |
| CT head/brain without contrast (70450) |
$1,203 |
$2,005 |
12.7× |
| MRI brain without contrast (70551) |
$2,038.20 |
$3,397 |
9.4× |
| MRI brain with contrast (70552) |
$2,329.20 |
$3,882 |
7.4× |
| MRI brain without and with contrast (70553) |
$2,646.60 |
$4,411 |
8.4× |
| X-ray lower spine, 4+ views (72110) |
$297.60 |
$496 |
3.1× |
| MRI lumbar spine without contrast (72148) |
$1,569 |
$2,615 |
7.2× |
| CT pelvis with contrast (72193) |
$1,246.20 |
$2,077 |
7.8× |
| MRI lower-extremity joint without contrast (73721) |
$1,543.20 |
$2,572 |
7.1× |
| CT abdomen and pelvis with contrast (74177) |
$2,982 |
$4,970 |
9.4× |
| Ultrasound, abdomen complete (76700) |
$524.40 |
$874 |
5.5× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$346.20 |
$577 |
3.6× |
| Ultrasound, transvaginal (76830) |
$514.20 |
$857 |
5.4× |
| Mammography, one breast (diagnostic) (77065) |
$225 |
$375 |
2.6× |
| Mammography, both breasts (diagnostic) (77066) |
$285 |
$475 |
2.6× |
| Mammography, screening (bilateral) (77067) |
$270 |
$450 |
3.0× |
| Basic metabolic panel (80048) |
$36 |
$60 |
4.3× |
| Comprehensive metabolic panel (80053) |
$44.40 |
$74 |
4.2× |
| Lipid panel (80061) |
$83.40 |
$139 |
6.2× |
| Renal function panel (80069) |
$220.20 |
$367 |
25.4× |
| Hepatic function panel (80076) |
$57 |
$95 |
7.0× |
| Urinalysis, non-automated, with microscopy (81000) |
$34.80 |
$58 |
8.7× |
| PSA, total (84153) |
$45 |
$75 |
2.4× |
| Thyroid stimulating hormone (TSH) (84443) |
$99 |
$165 |
5.9× |
| CBC with automated differential (85025) |
$65.40 |
$109 |
8.4× |
| CBC, automated (85027) |
$49.80 |
$83 |
7.7× |
| Prothrombin time (PT) (85610) |
$33 |
$55 |
7.7× |
| Partial thromboplastin time (PTT) (85730) |
$87.60 |
$146 |
14.6× |
| Group psychotherapy (90853) |
$195.60 |
$326 |
2.1× |
| Left heart catheterization (93452) |
$7,599.77 |
$12,666.28 |
2.6× |
| Sleep study (attended polysomnography) (95810) |
$2,557.80 |
$4,263 |
3.3× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$58.20 |
$97 |
2.0× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$186 |
$310 |
1.5× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$224.40 |
$374 |
1.9× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$224.40 |
$374 |
1.9× |