| Breast lesion removal (open) (19120) |
$457.50 |
$762.50 |
0.1× |
| Upper GI endoscopy (EGD), diagnostic (43235) |
$274.80 |
$458 |
0.3× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$1,128.60 |
$1,881 |
1.1× |
| Epidural injection, lumbar/sacral (with imaging) (62322) |
$525 |
$875 |
0.5× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$829.80 |
$1,383 |
0.8× |
| After-cataract laser surgery (YAG capsulotomy) (66821) |
$644.10 |
$1,073.50 |
1.0× |
| CT head/brain without contrast (70450) |
$908.10 |
$1,513.50 |
7.4× |
| MRI brain without contrast (70551) |
$1,344.60 |
$2,241 |
4.8× |
| MRI brain with contrast (70552) |
$1,586.40 |
$2,644 |
3.8× |
| MRI brain without and with contrast (70553) |
$1,827 |
$3,045 |
4.4× |
| X-ray lower spine, 4+ views (72110) |
$340.80 |
$568 |
2.8× |
| MRI lumbar spine without contrast (72148) |
$1,494.60 |
$2,491 |
5.3× |
| CT pelvis with contrast (72193) |
$941.10 |
$1,568.50 |
4.5× |
| MRI lower-extremity joint without contrast (73721) |
$1,489.20 |
$2,482 |
5.3× |
| CT abdomen and pelvis with contrast (74177) |
$2,277.90 |
$3,796.50 |
5.5× |
| Ultrasound, abdomen complete (76700) |
$507.60 |
$846 |
4.1× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$348.60 |
$581 |
2.8× |
| Ultrasound, transvaginal (76830) |
$281.40 |
$469 |
2.3× |
| Mammography, one breast (diagnostic) (77065) |
$299.40 |
$499 |
3.5× |
| Mammography, both breasts (diagnostic) (77066) |
$417 |
$695 |
3.8× |
| Mammography, screening (bilateral) (77067) |
$238.20 |
$397 |
2.6× |
| Basic metabolic panel (80048) |
$54 |
$90 |
6.4× |
| Comprehensive metabolic panel (80053) |
$66.90 |
$111.50 |
6.3× |
| Obstetric panel (80055) |
$393 |
$655 |
8.2× |
| Lipid panel (80061) |
$34.20 |
$57 |
2.6× |
| Renal function panel (80069) |
$54.60 |
$91 |
6.3× |
| Hepatic function panel (80076) |
$54 |
$90 |
6.6× |
| Urinalysis, non-automated, with microscopy (81000) |
$19.20 |
$32 |
4.8× |
| Urinalysis, non-automated, without microscopy (81002) |
$43.80 |
$73 |
12.6× |
| PSA, total (84153) |
$66.60 |
$111 |
3.6× |
| Thyroid stimulating hormone (TSH) (84443) |
$81 |
$135 |
4.8× |
| CBC with automated differential (85025) |
$42.60 |
$71 |
5.5× |
| CBC, automated (85027) |
$36.60 |
$61 |
5.7× |
| Prothrombin time (PT) (85610) |
$30.60 |
$51 |
7.1× |
| Partial thromboplastin time (PTT) (85730) |
$32.10 |
$53.50 |
5.3× |
| Psychotherapy, 30 minutes (90832) |
$30.60 |
$51 |
0.1× |
| Psychotherapy, 45 minutes (90834) |
$33 |
$55 |
0.2× |
| Psychotherapy, 60 minutes (90837) |
$30.60 |
$51 |
0.1× |
| Family psychotherapy, without patient (50 min) (90846) |
$37.80 |
$63 |
0.2× |
| Family psychotherapy, with patient (50 min) (90847) |
$42 |
$70 |
0.2× |
| Left heart catheterization (93452) |
$4,191 |
$6,985 |
1.1× |
| Sleep study (attended polysomnography) (95810) |
$1,602.90 |
$2,671.50 |
1.6× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$96 |
$160 |
3.3× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$81.30 |
$135.50 |
0.5× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$108.30 |
$180.50 |
0.7× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$170.40 |
$284 |
1.1× |
| Office consultation (low complexity, ~30 min) (99243) |
$75 |
$125 |
0.5× |
| Office consultation (moderate complexity, ~40 min) (99244) |
$101.40 |
$169 |
0.6× |
| Preventive visit, new patient (age 18–39) (99385) |
$49.80 |
$83 |
— |
| Preventive visit, new patient (age 40–64) (99386) |
$49.80 |
$83 |
— |