| Breast lesion removal (open) (19120) |
$4,905 |
$8,175 |
1.0× |
| Upper GI endoscopy (EGD), diagnostic (43235) |
$1,423.20 |
$2,372 |
1.3× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$1,470.60 |
$2,451 |
1.4× |
| Epidural injection, lumbar/sacral (with imaging) (62322) |
$4,494 |
$7,490 |
4.2× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$4,173 |
$6,955 |
3.9× |
| CT head/brain without contrast (70450) |
$966.60 |
$1,611 |
7.7× |
| MRI brain without contrast (70551) |
$2,122.20 |
$3,537 |
7.4× |
| MRI brain with contrast (70552) |
$2,607 |
$4,345 |
6.2× |
| MRI brain without and with contrast (70553) |
$3,085.20 |
$5,142 |
7.4× |
| X-ray lower spine, 4+ views (72110) |
$444.60 |
$741 |
3.5× |
| MRI lumbar spine without contrast (72148) |
$2,122.20 |
$3,537 |
7.4× |
| CT pelvis with contrast (72193) |
$1,271.40 |
$2,119 |
6.0× |
| MRI lower-extremity joint without contrast (73721) |
$2,122.20 |
$3,537 |
7.4× |
| CT abdomen and pelvis with contrast (74177) |
$2,157.60 |
$3,596 |
5.2× |
| Ultrasound, abdomen complete (76700) |
$523.80 |
$873 |
4.2× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$542.70 |
$904.50 |
4.3× |
| Ultrasound, transvaginal (76830) |
$757.80 |
$1,263 |
6.0× |
| Mammography, one breast (diagnostic) (77065) |
$382.20 |
$637 |
4.4× |
| Mammography, both breasts (diagnostic) (77066) |
$456 |
$760 |
4.1× |
| Mammography, screening (bilateral) (77067) |
$360 |
$600 |
3.9× |
| Basic metabolic panel (80048) |
$140.40 |
$234 |
16.6× |
| Comprehensive metabolic panel (80053) |
$281.40 |
$469 |
26.6× |
| Lipid panel (80061) |
$65.40 |
$109 |
4.9× |
| Renal function panel (80069) |
$179.40 |
$299 |
20.7× |
| Hepatic function panel (80076) |
$135 |
$225 |
16.5× |
| Urinalysis, non-automated, without microscopy (81002) |
$17.10 |
$28.50 |
4.9× |
| PSA, total (84153) |
$81.60 |
$136 |
4.4× |
| Thyroid stimulating hormone (TSH) (84443) |
$51.60 |
$86 |
3.1× |
| CBC with automated differential (85025) |
$35.40 |
$59 |
4.6× |
| CBC, automated (85027) |
$21.60 |
$36 |
3.3× |
| Prothrombin time (PT) (85610) |
$18.60 |
$31 |
4.3× |
| Partial thromboplastin time (PTT) (85730) |
$39.60 |
$66 |
6.6× |
| Psychotherapy, 30 minutes (90832) |
$183 |
$305 |
0.9× |
| Psychotherapy, 45 minutes (90834) |
$231.60 |
$386 |
1.1× |
| Psychotherapy, 60 minutes (90837) |
$273 |
$455 |
1.3× |
| Family psychotherapy, without patient (50 min) (90846) |
$260.40 |
$434 |
1.2× |
| Family psychotherapy, with patient (50 min) (90847) |
$256.80 |
$428 |
1.2× |
| Group psychotherapy (90853) |
$158.40 |
$264 |
1.3× |
| Left heart catheterization (93452) |
$10,320.60 |
$17,201 |
2.7× |
| Sleep study (attended polysomnography) (95810) |
$4,507.20 |
$7,512 |
4.4× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$156.60 |
$261 |
5.4× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$204 |
$340 |
1.3× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$265.80 |
$443 |
1.7× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$321.60 |
$536 |
2.0× |