| Breast lesion removal (open) (19120) |
$1,295 |
$1,295 |
0.3× |
| Shoulder arthroscopy with decompression (29826) |
$5,263 |
$5,263 |
— |
| Knee arthroscopy with meniscectomy (29881) |
$5,263 |
$5,263 |
1.6× |
Tonsillectomy and adenoidectomy (under age 12) (42820)
likely a partial charge — not the full procedure |
$1,019 |
$1,019 |
0.2× |
| Upper GI endoscopy (EGD), diagnostic (43235) |
$1,291 |
$1,291 |
1.4× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$1,353 |
$1,353 |
1.5× |
| Diagnostic colonoscopy (45378) |
$1,410 |
$1,410 |
1.5× |
| Colonoscopy with biopsy (45380) |
$2,176 |
$2,176 |
1.8× |
| Colonoscopy with lesion removal (45385) |
$1,741 |
$1,741 |
1.4× |
Laparoscopic gallbladder removal (47562)
unusually low — confirm this is the full procedure |
$2,345 |
$2,345 |
0.4× |
| Inguinal hernia repair (age 5+) (49505) |
$2,246 |
$2,246 |
0.6× |
| Obstetric care, vaginal delivery (global) (59400) |
$7,513 |
$7,513 |
— |
| Obstetric care, cesarean delivery (global) (59510) |
$9,226 |
$9,226 |
— |
| Obstetric care, VBAC delivery (global) (59610) |
$7,810 |
$7,810 |
— |
| Epidural injection, lumbar/sacral (with imaging) (62322) |
$3,069 |
$3,069 |
3.4× |
| CT head/brain without contrast (70450) |
$1,605 |
$1,605 |
15.0× |
| MRI brain without contrast (70551) |
$3,331 |
$3,331 |
13.7× |
| MRI brain with contrast (70552) |
$4,473 |
$4,473 |
12.5× |
| MRI brain without and with contrast (70553) |
$5,393 |
$5,393 |
15.1× |
| X-ray lower spine, 4+ views (72110) |
$564 |
$564 |
5.3× |
| MRI lumbar spine without contrast (72148) |
$4,152 |
$4,152 |
17.0× |
| CT pelvis with contrast (72193) |
$2,783 |
$2,783 |
15.5× |
| MRI lower-extremity joint without contrast (73721) |
$4,152 |
$4,152 |
17.0× |
| CT abdomen and pelvis with contrast (74177) |
$5,235 |
$5,235 |
14.7× |
| Ultrasound, abdomen complete (76700) |
$1,225 |
$1,225 |
11.5× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$944 |
$944 |
8.8× |
| Ultrasound, transvaginal (76830) |
$935 |
$935 |
8.8× |
| Mammography, one breast (diagnostic) (77065) |
$548.50 |
$548.50 |
6.4× |
| Mammography, both breasts (diagnostic) (77066) |
$642.50 |
$642.50 |
5.8× |
| Mammography, screening (bilateral) (77067) |
$576 |
$576 |
6.3× |
| Basic metabolic panel (80048) |
$109 |
$109 |
12.9× |
| Comprehensive metabolic panel (80053) |
$201 |
$201 |
19.0× |
| Lipid panel (80061) |
$200 |
$200 |
14.9× |
| Renal function panel (80069) |
$191 |
$191 |
22.0× |
| Hepatic function panel (80076) |
$233 |
$233 |
28.5× |
| Urinalysis, non-automated, without microscopy (81002) |
$48 |
$48 |
13.8× |
| PSA, total (84153) |
$233 |
$233 |
12.7× |
| Thyroid stimulating hormone (TSH) (84443) |
$233 |
$233 |
13.9× |
| CBC with automated differential (85025) |
$172 |
$172 |
22.1× |
| CBC, automated (85027) |
$126 |
$126 |
19.5× |
| Prothrombin time (PT) (85610) |
$110 |
$110 |
25.6× |
| Partial thromboplastin time (PTT) (85730) |
$88 |
$88 |
14.6× |
| Psychotherapy, 30 minutes (90832) |
$247 |
$247 |
1.4× |
| Psychotherapy, 45 minutes (90834) |
$326 |
$326 |
1.8× |
| Psychotherapy, 60 minutes (90837) |
$487 |
$487 |
2.7× |
| Electrocardiogram (ECG), complete (93000) |
$603 |
$603 |
10.0× |
| Sleep study (attended polysomnography) (95810) |
$6,301 |
$6,301 |
7.2× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$115 |
$115 |
4.0× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$680 |
$680 |
5.0× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$982 |
$982 |
7.2× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$1,429.50 |
$1,429.50 |
10.5× |
| Office consultation (low complexity, ~30 min) (99243) |
$479 |
$479 |
3.5× |
| Office consultation (moderate complexity, ~40 min) (99244) |
$489 |
$489 |
3.6× |
| Preventive visit, new patient (age 18–39) (99385) |
$376 |
$376 |
— |
| Preventive visit, new patient (age 40–64) (99386) |
$427 |
$427 |
— |