| Breast lesion removal (open) (19120) |
$1,010 |
$1,010 |
0.3× |
| Upper GI endoscopy (EGD), diagnostic (43235) |
$725 |
$725 |
0.8× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$3,453.80 |
$4,934 |
3.8× |
| Diagnostic colonoscopy (45378) |
$3,229.80 |
$4,614 |
3.5× |
| Colonoscopy with biopsy (45380) |
$3,577.70 |
$5,111 |
3.0× |
| Colonoscopy with lesion removal (45385) |
$3,622.50 |
$5,175 |
3.0× |
| Laparoscopic gallbladder removal (47562) |
$14,004.20 |
$20,006 |
2.3× |
| Inguinal hernia repair (age 5+) (49505) |
$8,477 |
$12,110 |
2.4× |
| Epidural injection, lumbar/sacral (with imaging) (62322) |
$420 |
$420 |
0.5× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$845 |
$845 |
1.0× |
| Cataract removal with lens insertion (66984) |
$5,116.30 |
$7,309 |
2.2× |
| CT head/brain without contrast (70450) |
$1,654.80 |
$2,364 |
15.8× |
| MRI brain without contrast (70551) |
$2,884 |
$4,120 |
12.1× |
| MRI brain with contrast (70552) |
$3,157 |
$4,510 |
9.0× |
| MRI brain without and with contrast (70553) |
$3,591 |
$5,130 |
10.3× |
| X-ray lower spine, 4+ views (72110) |
$175 |
$175 |
1.7× |
| MRI lumbar spine without contrast (72148) |
$2,884 |
$4,120 |
12.1× |
| CT pelvis with contrast (72193) |
$1,961.40 |
$2,802 |
11.2× |
| MRI lower-extremity joint without contrast (73721) |
$2,884 |
$4,120 |
12.1× |
| CT abdomen and pelvis with contrast (74177) |
$2,937.20 |
$4,196 |
8.4× |
| Ultrasound, abdomen complete (76700) |
$921.90 |
$1,317 |
8.8× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$662.90 |
$947 |
6.3× |
| Ultrasound, transvaginal (76830) |
$644 |
$920 |
6.2× |
| Mammography, one breast (diagnostic) (77065) |
$126.90 |
$181.28 |
1.5× |
| Mammography, both breasts (diagnostic) (77066) |
$161.37 |
$230.52 |
1.5× |
| Mammography, screening (bilateral) (77067) |
$84.68 |
$120.97 |
0.9× |
| Basic metabolic panel (80048) |
$49.63 |
$70.90 |
5.9× |
| Comprehensive metabolic panel (80053) |
$81.66 |
$116.65 |
7.7× |
| Lipid panel (80061) |
$97.62 |
$139.45 |
7.3× |
| Renal function panel (80069) |
$57.51 |
$82.15 |
6.6× |
| Hepatic function panel (80076) |
$97.48 |
$139.25 |
11.9× |
| Urinalysis, non-automated, without microscopy (81002) |
$17 |
$17 |
4.9× |
| PSA, total (84153) |
$181.34 |
$259.05 |
9.9× |
| Thyroid stimulating hormone (TSH) (84443) |
$92.58 |
$132.25 |
5.5× |
| CBC with automated differential (85025) |
$49.42 |
$70.60 |
6.4× |
| CBC, automated (85027) |
$24.71 |
$35.30 |
3.8× |
| Prothrombin time (PT) (85610) |
$42 |
$42 |
9.8× |
| Partial thromboplastin time (PTT) (85730) |
$81.31 |
$116.15 |
13.5× |
| Sleep study (attended polysomnography) (95810) |
$1,316 |
$1,880 |
1.5× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$80.50 |
$115 |
2.8× |