| Breast lesion removal (open) (19120) |
$1,884 |
$3,140 |
0.5× |
| Shoulder arthroscopy with decompression (29826) |
$3,721.20 |
$6,202 |
— |
| Knee arthroscopy with meniscectomy (29881) |
$3,376.80 |
$5,628 |
1.0× |
Tonsillectomy and adenoidectomy (under age 12) (42820)
likely a partial charge, not the full procedure |
$1,710.60 |
$2,851 |
0.3× |
| Upper GI endoscopy (EGD), diagnostic (43235) |
$666 |
$1,110 |
0.7× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$666 |
$1,110 |
0.7× |
| Diagnostic colonoscopy (45378) |
$666 |
$1,110 |
0.7× |
| Colonoscopy with biopsy (45380) |
$666 |
$1,110 |
0.6× |
| Colonoscopy with lesion removal (45385) |
$666 |
$1,110 |
0.6× |
| Laparoscopic gallbladder removal (47562) |
$4,618.80 |
$7,698 |
0.8× |
| Inguinal hernia repair (age 5+) (49505) |
$2,503.20 |
$4,172 |
0.7× |
| Epidural injection, lumbar/sacral (with imaging) (62322) |
$666 |
$1,110 |
0.7× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$793.20 |
$1,322 |
0.9× |
| After-cataract laser surgery (YAG capsulotomy) (66821) |
$666 |
$1,110 |
1.2× |
| Cataract removal with lens insertion (66984) |
$1,884 |
$3,140 |
0.8× |
| CT head/brain without contrast (70450) |
$1,022.40 |
$1,704 |
9.7× |
| MRI brain without contrast (70551) |
$3,199.20 |
$5,332 |
13.3× |
| MRI brain with contrast (70552) |
$3,649.80 |
$6,083 |
10.4× |
| MRI brain without and with contrast (70553) |
$4,121.40 |
$6,869 |
11.8× |
| X-ray lower spine, 4+ views (72110) |
$585 |
$975 |
5.6× |
| MRI lumbar spine without contrast (72148) |
$3,199.20 |
$5,332 |
13.3× |
| CT pelvis with contrast (72193) |
$3,199.20 |
$5,332 |
18.2× |
| MRI lower-extremity joint without contrast (73721) |
$3,199.20 |
$5,332 |
13.3× |
| CT abdomen and pelvis with contrast (74177) |
$3,199.20 |
$5,332 |
9.1× |
| Ultrasound, abdomen complete (76700) |
$834 |
$1,390 |
7.9× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$704.40 |
$1,174 |
6.7× |
| Ultrasound, transvaginal (76830) |
$563.40 |
$939 |
5.4× |
| Basic metabolic panel (80048) |
$363 |
$605 |
42.9× |
| Comprehensive metabolic panel (80053) |
$538.20 |
$897 |
51.0× |
| Lipid panel (80061) |
$445.80 |
$743 |
33.3× |
| Hepatic function panel (80076) |
$445.80 |
$743 |
54.6× |
| PSA, total (84153) |
$177 |
$295 |
9.6× |
| Thyroid stimulating hormone (TSH) (84443) |
$363 |
$605 |
21.6× |
| CBC with automated differential (85025) |
$376.80 |
$628 |
48.5× |
| CBC, automated (85027) |
$130.20 |
$217 |
20.1× |
| Prothrombin time (PT) (85610) |
$140.40 |
$234 |
32.7× |
| Partial thromboplastin time (PTT) (85730) |
$177 |
$295 |
29.5× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$304.20 |
$507 |
10.5× |