| Breast lesion removal (open) (19120) |
$699.75 |
$933 |
0.2× |
| Shoulder arthroscopy with decompression (29826) |
$2,152.65 |
$2,870.20 |
— |
| Knee arthroscopy with meniscectomy (29881) |
$2,152.65 |
$2,870.20 |
0.7× |
Tonsillectomy and adenoidectomy (under age 12) (42820)
likely a partial charge, not the full procedure |
$404.25 |
$539 |
0.1× |
| Upper GI endoscopy (EGD), diagnostic (43235) |
$355.50 |
$474 |
0.4× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$474 |
$632 |
0.6× |
| Diagnostic colonoscopy (45378) |
$441 |
$588 |
0.5× |
| Colonoscopy with biopsy (45380) |
$562.50 |
$750 |
0.5× |
| Colonoscopy with lesion removal (45385) |
$594.75 |
$793 |
0.5× |
Laparoscopic gallbladder removal (47562)
likely a partial charge, not the full procedure |
$1,474.50 |
$1,966 |
0.3× |
| Inguinal hernia repair (age 5+) (49505) |
$737.25 |
$983 |
0.2× |
| Obstetric care, vaginal delivery (global) (59400) |
$2,135.87 |
$2,847.83 |
— |
| Obstetric care, cesarean delivery (global) (59510) |
$2,357.54 |
$3,143.39 |
— |
| Obstetric care, VBAC delivery (global) (59610) |
$1,965 |
$2,620 |
— |
| After-cataract laser surgery (YAG capsulotomy) (66821) |
$418.77 |
$558.36 |
0.8× |
| Cataract removal with lens insertion (66984) |
$1,764.09 |
$2,352.12 |
0.8× |
| CT head/brain without contrast (70450) |
$1,473.75 |
$1,965 |
15.4× |
| MRI brain without contrast (70551) |
$2,203.50 |
$2,938 |
10.1× |
| MRI brain with contrast (70552) |
$3,306 |
$4,408 |
10.4× |
| MRI brain without and with contrast (70553) |
$3,306 |
$4,408 |
10.4× |
| X-ray lower spine, 4+ views (72110) |
$154.12 |
$205.50 |
1.6× |
| MRI lumbar spine without contrast (72148) |
$2,203.50 |
$2,938 |
10.1× |
| CT pelvis with contrast (72193) |
$2,126.25 |
$2,835 |
13.3× |
| MRI lower-extremity joint without contrast (73721) |
$2,203.50 |
$2,938 |
10.1× |
| CT abdomen and pelvis with contrast (74177) |
$3,961.50 |
$5,282 |
12.4× |
| Ultrasound, abdomen complete (76700) |
$119.25 |
$159 |
1.2× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$366.38 |
$488.50 |
3.8× |
| Ultrasound, transvaginal (76830) |
$505.12 |
$673.50 |
5.3× |
| Mammography, one breast (diagnostic) (77065) |
$74.25 |
$99 |
0.9× |
| Mammography, both breasts (diagnostic) (77066) |
$149.25 |
$199 |
1.3× |
| Mammography, screening (bilateral) (77067) |
$120 |
$160 |
1.3× |
| Comprehensive metabolic panel (80053) |
$264.75 |
$353 |
25.1× |
| Lipid panel (80061) |
$46.88 |
$62.50 |
3.5× |
| Renal function panel (80069) |
$667.50 |
$890 |
76.9× |
| Hepatic function panel (80076) |
$86.25 |
$115 |
10.6× |
| Urinalysis, non-automated, without microscopy (81002) |
$41.52 |
$55.36 |
11.9× |
| PSA, total (84153) |
$135 |
$180 |
7.3× |
| Thyroid stimulating hormone (TSH) (84443) |
$99 |
$132 |
5.9× |
| CBC with automated differential (85025) |
$44.25 |
$59 |
5.7× |
| CBC, automated (85027) |
$61.50 |
$82 |
9.5× |
| Prothrombin time (PT) (85610) |
$39.75 |
$53 |
9.3× |
| Partial thromboplastin time (PTT) (85730) |
$82.50 |
$110 |
13.7× |
| Family psychotherapy, without patient (50 min) (90846) |
$134.25 |
$179 |
0.8× |
| Family psychotherapy, with patient (50 min) (90847) |
$139.50 |
$186 |
0.9× |
| Group psychotherapy (90853) |
$37.50 |
$50 |
0.4× |
| Electrocardiogram (ECG), complete (93000) |
$21 |
$28 |
0.4× |
| Left heart catheterization (93452) |
$6,156 |
$8,208 |
2.1× |
| Sleep study (attended polysomnography) (95810) |
$2,049.38 |
$2,732.50 |
2.6× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$49.88 |
$66.50 |
1.7× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$152.25 |
$203 |
1.3× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$211.88 |
$282.50 |
1.7× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$282.75 |
$377 |
2.3× |
| Office consultation (low complexity, ~30 min) (99243) |
$105.75 |
$141 |
0.9× |
| Office consultation (moderate complexity, ~40 min) (99244) |
$136.50 |
$182 |
1.1× |
| Preventive visit, new patient (age 18–39) (99385) |
$81.75 |
$109 |
— |
| Preventive visit, new patient (age 40–64) (99386) |
$86.25 |
$115 |
— |