| Breast lesion removal (open) (19120) |
$8,250 |
$13,750 |
2.4× |
| Knee arthroscopy with meniscectomy (29881) |
$7,800 |
$13,000 |
2.7× |
| Laparoscopic gallbladder removal (47562) |
$12,510 |
$20,850 |
2.4× |
| Epidural injection, lumbar/sacral (with imaging) (62322) |
$364.72 |
$607.88 |
0.5× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$594 |
$990 |
0.8× |
| Cataract removal with lens insertion (66984) |
$3,032.78 |
$5,054.63 |
1.5× |
| CT head/brain without contrast (70450) |
$398.40 |
$664 |
4.3× |
| MRI brain without contrast (70551) |
$509.48 |
$849.12 |
2.4× |
| MRI brain with contrast (70552) |
$997.65 |
$1,662.75 |
3.3× |
| MRI brain without and with contrast (70553) |
$850.20 |
$1,417 |
2.8× |
| X-ray lower spine, 4+ views (72110) |
$208.65 |
$347.75 |
2.3× |
| MRI lumbar spine without contrast (72148) |
$470.40 |
$784 |
2.2× |
| CT pelvis with contrast (72193) |
$675 |
$1,125 |
4.4× |
| MRI lower-extremity joint without contrast (73721) |
$929.85 |
$1,549.75 |
4.4× |
| CT abdomen and pelvis with contrast (74177) |
$1,333.80 |
$2,223 |
4.4× |
| Ultrasound, abdomen complete (76700) |
$433.12 |
$721.88 |
4.7× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$345.08 |
$575.12 |
3.8× |
| Ultrasound, transvaginal (76830) |
$322.50 |
$537.50 |
3.5× |
| Mammography, one breast (diagnostic) (77065) |
$194.40 |
$324 |
2.3× |
| Mammography, both breasts (diagnostic) (77066) |
$61.58 |
$102.62 |
0.6× |
| Mammography, screening (bilateral) (77067) |
$68.40 |
$114 |
0.8× |
| Basic metabolic panel (80048) |
$20.63 |
$34.38 |
2.4× |
| Comprehensive metabolic panel (80053) |
$35.97 |
$59.95 |
3.4× |
| Obstetric panel (80055) |
$15 |
$25 |
0.3× |
| Lipid panel (80061) |
$18.14 |
$30.23 |
1.4× |
| Renal function panel (80069) |
$32.39 |
$53.98 |
3.7× |
| Hepatic function panel (80076) |
$32.41 |
$54.02 |
4.0× |
| Urinalysis, non-automated, without microscopy (81002) |
$23.25 |
$38.75 |
6.7× |
| PSA, total (84153) |
$49.42 |
$82.38 |
2.7× |
| Thyroid stimulating hormone (TSH) (84443) |
$24.90 |
$41.50 |
1.5× |
| CBC with automated differential (85025) |
$28.85 |
$48.08 |
3.7× |
| CBC, automated (85027) |
$15.45 |
$25.76 |
2.4× |
| Prothrombin time (PT) (85610) |
$24.90 |
$41.50 |
5.8× |
| Partial thromboplastin time (PTT) (85730) |
$37.35 |
$62.25 |
6.2× |
| Sleep study (attended polysomnography) (95810) |
$1,519.12 |
$2,531.88 |
2.0× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$37.73 |
$62.88 |
1.3× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$228.60 |
$381 |
2.0× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$233.40 |
$389 |
2.0× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$336.60 |
$561 |
2.9× |