| Breast lesion removal (open) (19120) |
$669.60 |
$1,116 |
0.2× |
| Knee arthroscopy with meniscectomy (29881) |
$1,960.80 |
$3,268 |
0.6× |
Tonsillectomy and adenoidectomy (under age 12) (42820)
likely a partial charge, not the full procedure |
$571.20 |
$952 |
0.1× |
| Upper GI endoscopy (EGD), diagnostic (43235) |
$623.40 |
$1,039 |
0.7× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$589.80 |
$983 |
0.7× |
| Diagnostic colonoscopy (45378) |
$745.20 |
$1,242 |
0.9× |
| Colonoscopy with biopsy (45380) |
$847.20 |
$1,412 |
0.8× |
| Colonoscopy with lesion removal (45385) |
$1,038.60 |
$1,731 |
0.9× |
Laparoscopic gallbladder removal (47562)
unusually low: confirm this is the full procedure |
$1,827.60 |
$3,046 |
0.3× |
| Inguinal hernia repair (age 5+) (49505) |
$995.40 |
$1,659 |
0.3× |
| CT head/brain without contrast (70450) |
$1,687.20 |
$2,812 |
17.2× |
| MRI brain without contrast (70551) |
$4,136.40 |
$6,894 |
18.5× |
| MRI brain with contrast (70552) |
$4,713.60 |
$7,856 |
14.4× |
| MRI brain without and with contrast (70553) |
$5,937.60 |
$9,896 |
18.1× |
| X-ray lower spine, 4+ views (72110) |
$646.80 |
$1,078 |
6.6× |
| MRI lumbar spine without contrast (72148) |
$3,648.60 |
$6,081 |
16.3× |
| CT pelvis with contrast (72193) |
$2,760 |
$4,600 |
16.8× |
| MRI lower-extremity joint without contrast (73721) |
$3,388.20 |
$5,647 |
15.1× |
| CT abdomen and pelvis with contrast (74177) |
$4,973.40 |
$8,289 |
15.2× |
| Ultrasound, abdomen complete (76700) |
$1,003.80 |
$1,673 |
10.2× |
| Ultrasound, transvaginal (76830) |
$863.40 |
$1,439 |
8.8× |
| Mammography, one breast (diagnostic) (77065) |
$647.40 |
$1,079 |
7.5× |
| Mammography, both breasts (diagnostic) (77066) |
$647.40 |
$1,079 |
5.9× |
| Mammography, screening (bilateral) (77067) |
$259.80 |
$433 |
2.8× |
| Basic metabolic panel (80048) |
$134.40 |
$224 |
15.9× |
| Comprehensive metabolic panel (80053) |
$158.40 |
$264 |
15.0× |
| Lipid panel (80061) |
$221.40 |
$369 |
16.5× |
| Renal function panel (80069) |
$208.80 |
$348 |
24.1× |
| Hepatic function panel (80076) |
$184.20 |
$307 |
22.5× |
| Urinalysis, non-automated, with microscopy (81000) |
$58.20 |
$97 |
14.5× |
| Urinalysis, non-automated, without microscopy (81002) |
$13.80 |
$23 |
4.0× |
| PSA, total (84153) |
$184.20 |
$307 |
10.0× |
| Thyroid stimulating hormone (TSH) (84443) |
$168 |
$280 |
10.0× |
| CBC with automated differential (85025) |
$75.60 |
$126 |
9.7× |
| CBC, automated (85027) |
$57.60 |
$96 |
8.9× |
| Prothrombin time (PT) (85610) |
$50.40 |
$84 |
11.7× |
| Partial thromboplastin time (PTT) (85730) |
$89.40 |
$149 |
14.9× |
| Electrocardiogram (ECG), complete (93000) |
$143.40 |
$239 |
2.6× |
| Sleep study (attended polysomnography) (95810) |
$2,021.40 |
$3,369 |
2.5× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$210.60 |
$351 |
7.2× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$178.80 |
$298 |
1.4× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$440.70 |
$734.50 |
3.5× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$584.40 |
$974 |
4.7× |
| Office consultation (low complexity, ~30 min) (99243) |
$75 |
$125 |
0.6× |
| Office consultation (moderate complexity, ~40 min) (99244) |
$90 |
$150 |
0.7× |