| Breast lesion removal (open) (19120) |
$5,271.75 |
$10,543.50 |
1.4× |
| Shoulder arthroscopy with decompression (29826) |
$3,424.38 |
$6,848.75 |
— |
| Knee arthroscopy with meniscectomy (29881) |
$6,139.25 |
$12,278.50 |
2.0× |
| Tonsillectomy and adenoidectomy (under age 12) (42820) |
$3,609.34 |
$7,218.67 |
0.6× |
| Upper GI endoscopy (EGD), diagnostic (43235) |
$693.67 |
$1,387.34 |
0.8× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$879 |
$1,758 |
1.0× |
| Diagnostic colonoscopy (45378) |
$2,813.42 |
$5,626.83 |
3.2× |
| Colonoscopy with biopsy (45380) |
$1,206.16 |
$2,412.33 |
1.1× |
| Colonoscopy with lesion removal (45385) |
$1,787 |
$3,574 |
1.6× |
| Laparoscopic gallbladder removal (47562) |
$12,906.50 |
$25,813 |
2.2× |
| Inguinal hernia repair (age 5+) (49505) |
$18,330.50 |
$36,661 |
5.3× |
| Laparoscopic radical prostatectomy (55866) |
$15,610.34 |
$31,220.67 |
1.5× |
| Epidural injection, lumbar/sacral (with imaging) (62322) |
$973.50 |
$1,947 |
1.1× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$1,609 |
$3,218 |
1.9× |
| After-cataract laser surgery (YAG capsulotomy) (66821) |
$749.25 |
$1,498.50 |
1.4× |
| Cataract removal with lens insertion (66984) |
$3,542.82 |
$7,085.62 |
1.6× |
| CT head/brain without contrast (70450) |
$948 |
$1,896 |
9.5× |
| MRI brain without contrast (70551) |
$1,860 |
$3,720 |
8.1× |
| MRI brain with contrast (70552) |
$3,062.50 |
$6,125 |
9.2× |
| MRI brain without and with contrast (70553) |
$2,955 |
$5,910 |
8.8× |
| X-ray lower spine, 4+ views (72110) |
$377 |
$754 |
3.8× |
| MRI lumbar spine without contrast (72148) |
$1,812 |
$3,624 |
7.9× |
| CT pelvis with contrast (72193) |
$1,849.50 |
$3,699 |
11.0× |
| MRI lower-extremity joint without contrast (73721) |
$1,811.50 |
$3,623 |
7.9× |
| CT abdomen and pelvis with contrast (74177) |
$2,704.50 |
$5,409 |
8.1× |
| Ultrasound, abdomen complete (76700) |
$686.50 |
$1,373 |
6.8× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$712 |
$1,424 |
7.1× |
| Ultrasound, transvaginal (76830) |
$499 |
$998 |
5.0× |
| Mammography, one breast (diagnostic) (77065) |
$266.25 |
$532.50 |
3.1× |
| Mammography, both breasts (diagnostic) (77066) |
$336.25 |
$672.50 |
3.0× |
| Mammography, screening (bilateral) (77067) |
$332.75 |
$665.50 |
3.6× |
| Basic metabolic panel (80048) |
$54 |
$108 |
6.4× |
| Comprehensive metabolic panel (80053) |
$67.50 |
$135 |
6.4× |
| Obstetric panel (80055) |
$585.50 |
$1,171 |
12.2× |
| Lipid panel (80061) |
$58 |
$116 |
4.3× |
| Renal function panel (80069) |
$55.50 |
$111 |
6.4× |
| Hepatic function panel (80076) |
$52.50 |
$105 |
6.4× |
| Urinalysis, non-automated, with microscopy (81000) |
$23.50 |
$47 |
5.8× |
| Urinalysis, non-automated, without microscopy (81002) |
$23.50 |
$47 |
6.8× |
| PSA, total (84153) |
$120.50 |
$241 |
6.6× |
| Thyroid stimulating hormone (TSH) (84443) |
$101.50 |
$203 |
6.0× |
| CBC with automated differential (85025) |
$51.50 |
$103 |
6.6× |
| CBC, automated (85027) |
$44.25 |
$88.50 |
6.8× |
| Prothrombin time (PT) (85610) |
$25.75 |
$51.50 |
6.0× |
| Partial thromboplastin time (PTT) (85730) |
$38.50 |
$77 |
6.4× |
| Family psychotherapy, without patient (50 min) (90846) |
$285 |
$570 |
1.7× |
| Family psychotherapy, with patient (50 min) (90847) |
$285 |
$570 |
1.7× |
| Electrocardiogram (ECG), complete (93000) |
$37 |
$74 |
0.7× |
| Left heart catheterization (93452) |
$4,502.50 |
$9,005 |
1.4× |
| Sleep study (attended polysomnography) (95810) |
$2,970.50 |
$5,941 |
3.6× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$71 |
$142 |
2.4× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$80.50 |
$161 |
0.6× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$206.50 |
$413 |
1.6× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$80.50 |
$161 |
0.6× |
| Office consultation (low complexity, ~30 min) (99243) |
$277.25 |
$554.50 |
2.2× |
| Office consultation (moderate complexity, ~40 min) (99244) |
$411.50 |
$823 |
3.2× |
| Preventive visit, new patient (age 18–39) (99385) |
$90 |
$180 |
— |
| Preventive visit, new patient (age 40–64) (99386) |
$90 |
$180 |
— |