| Breast lesion removal (open) (19120) |
$1,446 |
$1,446 |
0.4× |
Tonsillectomy and adenoidectomy (under age 12) (42820) likely a partial charge, not the full procedure |
$816 |
$816 |
0.1× |
| Upper GI endoscopy (EGD), diagnostic (43235) |
$1,770 |
$1,770 |
1.9× |
Upper GI endoscopy (EGD) with biopsy (43239) range across 2 matching MRF lines |
$1,050–$1,770 |
$1,050–$1,770 |
varies |
| Diagnostic colonoscopy (45378) |
$1,950 |
$1,950 |
2.1× |
| Colonoscopy with biopsy (45380) |
$2,160 |
$2,160 |
1.8× |
| Colonoscopy with lesion removal (45385) |
$2,160 |
$2,160 |
1.8× |
| After-cataract laser surgery (YAG capsulotomy) (66821) |
$2,088 |
$2,088 |
3.7× |
| CT head/brain without contrast (70450) |
$1,182 |
$1,182 |
11.1× |
| MRI brain without contrast (70551) |
$2,226 |
$2,226 |
9.1× |
| MRI brain with contrast (70552) |
$2,508 |
$2,508 |
7.0× |
| MRI brain without and with contrast (70553) |
$4,458 |
$4,458 |
12.5× |
| X-ray lower spine, 4+ views (72110) |
$294 |
$294 |
2.8× |
| MRI lumbar spine without contrast (72148) |
$2,784 |
$2,784 |
11.4× |
| CT pelvis with contrast (72193) |
$1,596 |
$1,596 |
8.9× |
| MRI lower-extremity joint without contrast (73721) |
$2,334 |
$2,334 |
9.6× |
| CT abdomen and pelvis with contrast (74177) |
$3,480 |
$3,480 |
9.8× |
| Ultrasound, abdomen complete (76700) |
$582 |
$582 |
5.4× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$552 |
$552 |
5.2× |
| Ultrasound, transvaginal (76830) |
$528 |
$528 |
4.9× |
| Mammography, one breast (diagnostic) (77065) |
$492 |
$492 |
5.7× |
| Mammography, both breasts (diagnostic) (77066) |
$624 |
$624 |
5.6× |
| Mammography, screening (bilateral) (77067) |
$486 |
$486 |
5.3× |
| Basic metabolic panel (80048) |
$120 |
$120 |
14.2× |
| Comprehensive metabolic panel (80053) |
$138 |
$138 |
13.1× |
| Obstetric panel (80055) |
$408 |
$408 |
8.5× |
| Lipid panel (80061) |
$120 |
$120 |
9.0× |
| Renal function panel (80069) |
$90 |
$90 |
10.4× |
| Hepatic function panel (80076) |
$120 |
$120 |
14.7× |
Urinalysis, non-automated, with microscopy (81000) range across 2 matching MRF lines |
$78–$84 |
$78–$84 |
varies |
| Urinalysis, non-automated, without microscopy (81002) |
$42 |
$42 |
12.1× |
| PSA, total (84153) |
$168 |
$168 |
9.1× |
Thyroid stimulating hormone (TSH) (84443) range across 2 matching MRF lines |
$132–$138 |
$132–$138 |
varies |
| CBC with automated differential (85025) |
$90 |
$90 |
11.6× |
| CBC, automated (85027) |
$90 |
$90 |
13.9× |
Prothrombin time (PT) (85610) range across 2 matching MRF lines |
$54–$60 |
$54–$60 |
varies |
| Partial thromboplastin time (PTT) (85730) |
$72 |
$72 |
12.0× |
| Electrocardiogram (ECG), complete (93000) |
$60 |
$60 |
1.0× |
| Sleep study (attended polysomnography) (95810) |
$2,652 |
$2,652 |
3.0× |
Physical therapy, therapeutic exercise (per 15 min) (97110) range across 2 matching MRF lines |
$90–$132 |
$90–$132 |
varies |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$290 |
$290 |
2.1× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$450 |
$450 |
3.3× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$555 |
$555 |
4.1× |
| Office consultation (low complexity, ~30 min) (99243) |
$342 |
$342 |
2.5× |
| Office consultation (moderate complexity, ~40 min) (99244) |
$504 |
$504 |
3.7× |
| Preventive visit, new patient (age 18–39) (99385) |
$366 |
$366 |
— |
| Preventive visit, new patient (age 40–64) (99386) |
$426 |
$426 |
— |