| Breast lesion removal (open) (19120) |
— |
$15,266.58 |
— |
Shoulder arthroscopy with decompression (29826)
range across 2 matching MRF lines |
— |
$45,125–$63,468.42 |
— |
| Knee arthroscopy with meniscectomy (29881) |
— |
$26,707.33 |
— |
| Upper GI endoscopy (EGD), diagnostic (43235) |
— |
$4,444.26 |
— |
| Upper GI endoscopy (EGD) with biopsy (43239) |
— |
$7,899.79 |
— |
| Diagnostic colonoscopy (45378) |
— |
$4,614.23 |
— |
| Colonoscopy with biopsy (45380) |
— |
$7,268.30 |
— |
| Colonoscopy with lesion removal (45385) |
— |
$7,082.24 |
— |
| Colonoscopy with endoscopic ultrasound (45391) |
— |
$42,652.29 |
— |
| Laparoscopic gallbladder removal (47562) |
— |
$46,140.47 |
— |
| Inguinal hernia repair (age 5+) (49505) |
— |
$32,531.19 |
— |
| Laparoscopic radical prostatectomy (55866) |
— |
$138,413.37 |
— |
| Obstetric care, vaginal delivery (global) (59400) |
— |
$19,006.13 |
— |
| Obstetric care, cesarean delivery (global) (59510) |
— |
$33,708.70 |
— |
| Obstetric care, VBAC delivery (global) (59610) |
— |
$19,019.67 |
— |
| CT head/brain without contrast (70450) |
— |
$3,691.32 |
— |
| MRI brain without contrast (70551) |
— |
$6,775.85 |
— |
| MRI brain without and with contrast (70553) |
— |
$8,292.85 |
— |
| X-ray lower spine, 4+ views (72110) |
— |
$1,774.25 |
— |
| MRI lumbar spine without contrast (72148) |
— |
$5,358.23 |
— |
| CT pelvis with contrast (72193) |
— |
$4,441.26 |
— |
| MRI lower-extremity joint without contrast (73721) |
— |
$5,180.80 |
— |
| CT abdomen and pelvis with contrast (74177) |
— |
$7,499.51 |
— |
| Ultrasound, abdomen complete (76700) |
— |
$1,515.48 |
— |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
— |
$1,470.90 |
— |
| Ultrasound, transvaginal (76830) |
— |
$1,283.89 |
— |
| Mammography, one breast (diagnostic) (77065) |
— |
$567.75 |
— |
| Mammography, both breasts (diagnostic) (77066) |
— |
$709.68 |
— |
| Mammography, screening (bilateral) (77067) |
— |
$754.04 |
— |
| Basic metabolic panel (80048) |
— |
$208.83 |
— |
| Comprehensive metabolic panel (80053) |
— |
$309.05 |
— |
| Lipid panel (80061) |
— |
$251.07 |
— |
| Renal function panel (80069) |
— |
$212.16 |
— |
| Hepatic function panel (80076) |
— |
$288.57 |
— |
| PSA, total (84153) |
— |
$244.55 |
— |
| Thyroid stimulating hormone (TSH) (84443) |
— |
$313.82 |
— |
| CBC with automated differential (85025) |
— |
$194.36 |
— |
| CBC, automated (85027) |
— |
$170.20 |
— |
| Prothrombin time (PT) (85610) |
— |
$147.90 |
— |
| Partial thromboplastin time (PTT) (85730) |
— |
$195.52 |
— |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
— |
$205.65 |
— |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
— |
$821.59 |
— |
| Office visit, new patient (high complexity, ~60 min) (99205) |
— |
$821.59 |
— |