| Breast lesion removal (open) (19120) |
$451 |
$1,504.80 |
0.1× |
| Upper GI endoscopy (EGD), diagnostic (43235) |
$211.20 |
$706.20 |
0.2× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$580.80 |
$1,937.10 |
0.6× |
| Diagnostic colonoscopy (45378) |
$719.40 |
$2,398 |
0.8× |
| Colonoscopy with biopsy (45380) |
$750.20 |
$2,499.20 |
0.6× |
| Colonoscopy with lesion removal (45385) |
$949.30 |
$3,165.80 |
0.8× |
Laparoscopic gallbladder removal (47562)
likely a partial charge, not the full procedure |
$1,031.80 |
$3,438.60 |
0.2× |
| Inguinal hernia repair (age 5+) (49505) |
$768.90 |
$2,565.20 |
0.2× |
| Epidural injection, lumbar/sacral (with imaging) (62322) |
$789.80 |
$2,633.40 |
0.9× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$688.60 |
$2,296.80 |
0.8× |
| CT head/brain without contrast (70450) |
$1,085.70 |
$3,620.10 |
10.3× |
| MRI brain without contrast (70551) |
$2,205.50 |
$7,352.40 |
9.2× |
| MRI brain with contrast (70552) |
$4,642 |
$15,473.70 |
13.2× |
| MRI brain without and with contrast (70553) |
$2,702.70 |
$9,011.20 |
7.7× |
| X-ray lower spine, 4+ views (72110) |
$559.90 |
$1,864.50 |
5.3× |
| MRI lumbar spine without contrast (72148) |
$2,175.80 |
$7,251.20 |
9.1× |
| CT pelvis with contrast (72193) |
$1,516.90 |
$5,055.60 |
8.6× |
| MRI lower-extremity joint without contrast (73721) |
$2,330.90 |
$7,768.20 |
9.7× |
| CT abdomen and pelvis with contrast (74177) |
$1,551 |
$5,171.10 |
4.4× |
| Ultrasound, abdomen complete (76700) |
$709.50 |
$2,363.90 |
6.8× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$773.30 |
$2,577.30 |
7.4× |
| Ultrasound, transvaginal (76830) |
$734.80 |
$2,449.70 |
7.0× |
| Mammography, one breast (diagnostic) (77065) |
$235.40 |
$784.30 |
2.7× |
| Mammography, both breasts (diagnostic) (77066) |
$265.10 |
$884.40 |
2.4× |
| Mammography, screening (bilateral) (77067) |
$219.45 |
$733.70 |
2.4× |
| Basic metabolic panel (80048) |
$88.55 |
$295.35 |
10.5× |
| Comprehensive metabolic panel (80053) |
$165 |
$550 |
15.6× |
| Lipid panel (80061) |
$100.65 |
$336.05 |
7.5× |
| Renal function panel (80069) |
$257.40 |
$856.90 |
29.7× |
| Hepatic function panel (80076) |
$191.40 |
$636.90 |
23.4× |
| Urinalysis, non-automated, without microscopy (81002) |
$5.50 |
$18.70 |
1.6× |
| PSA, total (84153) |
$45.10 |
$149.05 |
2.5× |
| Thyroid stimulating hormone (TSH) (84443) |
$36.30 |
$119.90 |
2.2× |
| CBC with automated differential (85025) |
$55 |
$183.70 |
7.1× |
| CBC, automated (85027) |
$68.20 |
$227.70 |
10.5× |
| Prothrombin time (PT) (85610) |
$31.90 |
$106.70 |
7.4× |
| Partial thromboplastin time (PTT) (85730) |
$16.50 |
$55 |
2.7× |
| Sleep study (attended polysomnography) (95810) |
$1,713.25 |
$5,710.65 |
2.0× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$30.80 |
$104.50 |
1.1× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$154 |
$511.50 |
1.2× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$231 |
$768.90 |
1.7× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$235.40 |
$785.40 |
1.8× |
| Office consultation (low complexity, ~30 min) (99243) |
$190.30 |
$633.60 |
1.4× |
| Office consultation (moderate complexity, ~40 min) (99244) |
$103.40 |
$345.40 |
0.8× |
| Preventive visit, new patient (age 18–39) (99385) |
$135.30 |
$449.90 |
— |
| Preventive visit, new patient (age 40–64) (99386) |
$139.70 |
$466.40 |
— |