| Breast lesion removal (open) (19120) |
$2,000 |
$2,000 |
0.5× |
| Knee arthroscopy with meniscectomy (29881) |
$2,000 |
$2,000 |
0.6× |
| Upper GI endoscopy (EGD), diagnostic (43235) |
$1,679.62 |
$1,679.62 |
1.7× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$1,200 |
$1,200 |
1.2× |
| Diagnostic colonoscopy (45378) |
$1,200 |
$1,200 |
1.2× |
| Colonoscopy with biopsy (45380) |
$1,200 |
$1,200 |
0.9× |
| Colonoscopy with lesion removal (45385) |
$1,200 |
$1,200 |
0.9× |
Laparoscopic gallbladder removal (47562)
unusually low: confirm this is the full procedure |
$2,000 |
$2,000 |
0.3× |
| Cataract removal with lens insertion (66984) |
$2,000 |
$2,000 |
0.8× |
| CT head/brain without contrast (70450) |
$1,024 |
$1,024 |
9.2× |
| MRI brain without contrast (70551) |
$2,145 |
$2,145 |
8.5× |
| MRI brain with contrast (70552) |
$2,463 |
$2,463 |
6.7× |
| X-ray lower spine, 4+ views (72110) |
$366 |
$366 |
3.3× |
| MRI lumbar spine without contrast (72148) |
$2,145 |
$2,145 |
8.5× |
| CT pelvis with contrast (72193) |
$1,487 |
$1,487 |
8.0× |
| MRI lower-extremity joint without contrast (73721) |
$2,145 |
$2,145 |
8.5× |
| CT abdomen and pelvis with contrast (74177) |
$2,048 |
$2,048 |
5.5× |
| Ultrasound, abdomen complete (76700) |
$792 |
$792 |
7.1× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$865 |
$865 |
7.8× |
| Ultrasound, transvaginal (76830) |
$512 |
$512 |
4.6× |
| Mammography, one breast (diagnostic) (77065) |
$176 |
$176 |
2.0× |
| Mammography, both breasts (diagnostic) (77066) |
$188 |
$188 |
1.7× |
| Mammography, screening (bilateral) (77067) |
$175 |
$175 |
1.9× |
| Basic metabolic panel (80048) |
$110 |
$110 |
13.0× |
| Comprehensive metabolic panel (80053) |
$135 |
$135 |
12.8× |
| Lipid panel (80061) |
$170 |
$170 |
12.7× |
| Renal function panel (80069) |
$97 |
$97 |
11.2× |
| Hepatic function panel (80076) |
$110 |
$110 |
13.5× |
| Urinalysis, non-automated, without microscopy (81002) |
$33 |
$33 |
9.5× |
| PSA, total (84153) |
$78 |
$78 |
4.2× |
| Thyroid stimulating hormone (TSH) (84443) |
$208 |
$208 |
12.4× |
| CBC with automated differential (85025) |
$97 |
$97 |
12.5× |
| CBC, automated (85027) |
$73 |
$73 |
11.3× |
| Prothrombin time (PT) (85610) |
$48 |
$48 |
11.2× |
| Partial thromboplastin time (PTT) (85730) |
$73 |
$73 |
12.1× |
| Psychotherapy, 45 minutes (90834) |
$379.78 |
$379.78 |
2.0× |
| Psychotherapy, 60 minutes (90837) |
$379.78 |
$379.78 |
2.0× |
| Family psychotherapy, with patient (50 min) (90847) |
$379.78 |
$379.78 |
2.0× |
| Group psychotherapy (90853) |
$212.33 |
$212.33 |
2.0× |
| Left heart catheterization (93452) |
$7,761.83 |
$7,761.83 |
2.3× |
| Sleep study (attended polysomnography) (95810) |
$2,490.45 |
$2,490.45 |
2.7× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$72.05 |
$72.05 |
2.5× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$314.88 |
$314.88 |
2.2× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$314.88 |
$314.88 |
2.2× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$314.88 |
$314.88 |
2.2× |
| Preventive visit, new patient (age 18–39) (99385) |
$201 |
$201 |
— |