| Breast lesion removal (open) (19120) |
— |
$5,567 |
— |
| Upper GI endoscopy (EGD), diagnostic (43235) |
— |
$4,400 |
— |
| Upper GI endoscopy (EGD) with biopsy (43239) |
— |
$4,844 |
— |
| Diagnostic colonoscopy (45378) |
— |
$4,960 |
— |
| Colonoscopy with biopsy (45380) |
— |
$5,186 |
— |
| Colonoscopy with lesion removal (45385) |
— |
$5,635 |
— |
| Colonoscopy with endoscopic ultrasound (45391) |
— |
$3,919 |
— |
| Epidural injection, lumbar/sacral (with imaging) (62322) |
— |
$2,539 |
— |
| Transforaminal epidural injection, lumbar/sacral (64483) |
— |
$3,496 |
— |
| CT head/brain without contrast (70450) |
— |
$2,652 |
— |
| MRI brain without contrast (70551) |
— |
$3,894 |
— |
| MRI brain with contrast (70552) |
— |
$7,992 |
— |
| MRI brain without and with contrast (70553) |
— |
$5,949 |
— |
| X-ray lower spine, 4+ views (72110) |
— |
$1,246 |
— |
| MRI lumbar spine without contrast (72148) |
— |
$4,002 |
— |
| CT pelvis with contrast (72193) |
— |
$6,095.50 |
— |
| MRI lower-extremity joint without contrast (73721) |
— |
$3,677 |
— |
| CT abdomen and pelvis with contrast (74177) |
— |
$5,200 |
— |
| Ultrasound, abdomen complete (76700) |
— |
$1,082 |
— |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
— |
$1,577 |
— |
| Ultrasound, transvaginal (76830) |
— |
$1,170.50 |
— |
| Mammography, one breast (diagnostic) (77065) |
— |
$475 |
— |
| Mammography, both breasts (diagnostic) (77066) |
— |
$584 |
— |
| Mammography, screening (bilateral) (77067) |
— |
$319 |
— |
| Basic metabolic panel (80048) |
— |
$340 |
— |
| Comprehensive metabolic panel (80053) |
— |
$456 |
— |
| Lipid panel (80061) |
— |
$187 |
— |
| Renal function panel (80069) |
— |
$248 |
— |
| Hepatic function panel (80076) |
— |
$232 |
— |
| Urinalysis, non-automated, with microscopy (81000) |
— |
$147 |
— |
| Urinalysis, non-automated, without microscopy (81002) |
— |
$57 |
— |
| PSA, total (84153) |
— |
$361 |
— |
| Thyroid stimulating hormone (TSH) (84443) |
— |
$182.50 |
— |
| CBC with automated differential (85025) |
— |
$190 |
— |
| CBC, automated (85027) |
— |
$129 |
— |
| Prothrombin time (PT) (85610) |
— |
$121 |
— |
| Partial thromboplastin time (PTT) (85730) |
— |
$154 |
— |
| Psychotherapy, 30 minutes (90832) |
— |
$344 |
— |
| Psychotherapy, 45 minutes (90834) |
— |
$422 |
— |
| Psychotherapy, 60 minutes (90837) |
— |
$537 |
— |
| Family psychotherapy, without patient (50 min) (90846) |
— |
$398 |
— |
| Family psychotherapy, with patient (50 min) (90847) |
— |
$419 |
— |
| Group psychotherapy (90853) |
— |
$341.50 |
— |
| Left heart catheterization (93452) |
— |
$17,853 |
— |
| Sleep study (attended polysomnography) (95810) |
— |
$6,338 |
— |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
— |
$250 |
— |
| Office consultation (low complexity, ~30 min) (99243) |
— |
$378 |
— |
| Office consultation (moderate complexity, ~40 min) (99244) |
— |
$444 |
— |