| Breast lesion removal (open) (19120) |
$3,273 |
$4,364 |
0.9× |
| Shoulder arthroscopy with decompression (29826) |
$410.25 |
$547 |
— |
| Knee arthroscopy with meniscectomy (29881) |
$568.50 |
$758 |
0.2× |
| Upper GI endoscopy (EGD), diagnostic (43235) |
$1,524.75 |
$2,033 |
1.7× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$1,187.25 |
$1,583 |
1.4× |
| Diagnostic colonoscopy (45378) |
$1,567.88 |
$2,090.50 |
1.7× |
| Colonoscopy with biopsy (45380) |
$1,237.12 |
$1,649.50 |
1.1× |
| Colonoscopy with lesion removal (45385) |
$1,266 |
$1,688 |
1.1× |
Laparoscopic gallbladder removal (47562)
likely a partial charge, not the full procedure |
$687 |
$916 |
0.1× |
| Inguinal hernia repair (age 5+) (49505) |
$814.50 |
$1,086 |
0.2× |
| Obstetric care, vaginal delivery (global) (59400) |
$2,049.75 |
$2,733 |
— |
| Epidural injection, lumbar/sacral (with imaging) (62322) |
$1,032 |
$1,376 |
1.2× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$1,045.12 |
$1,393.50 |
1.2× |
| After-cataract laser surgery (YAG capsulotomy) (66821) |
$1,523.25 |
$2,031 |
2.9× |
| CT head/brain without contrast (70450) |
$1,127.25 |
$1,503 |
11.1× |
| MRI brain without contrast (70551) |
$1,302.75 |
$1,737 |
5.6× |
| MRI brain with contrast (70552) |
$1,302.75 |
$1,737 |
3.9× |
| MRI brain without and with contrast (70553) |
$1,302.75 |
$1,737 |
3.9× |
| X-ray lower spine, 4+ views (72110) |
$143.25 |
$191 |
1.4× |
| MRI lumbar spine without contrast (72148) |
$1,302.75 |
$1,737 |
5.6× |
| CT pelvis with contrast (72193) |
$1,127.25 |
$1,503 |
6.6× |
| MRI lower-extremity joint without contrast (73721) |
$1,302.75 |
$1,737 |
5.6× |
| CT abdomen and pelvis with contrast (74177) |
$1,127.25 |
$1,503 |
3.3× |
| Ultrasound, abdomen complete (76700) |
$563.62 |
$751.50 |
5.6× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$677.25 |
$903 |
6.7× |
| Ultrasound, transvaginal (76830) |
$513.75 |
$685 |
5.1× |
| Mammography, one breast (diagnostic) (77065) |
$428.25 |
$571 |
5.0× |
| Mammography, both breasts (diagnostic) (77066) |
$444.75 |
$593 |
4.0× |
| Mammography, screening (bilateral) (77067) |
$348 |
$464 |
3.8× |
| Basic metabolic panel (80048) |
$81.75 |
$109 |
9.7× |
| Comprehensive metabolic panel (80053) |
$65.25 |
$87 |
6.2× |
| Obstetric panel (80055) |
$227.25 |
$303 |
4.8× |
| Lipid panel (80061) |
$128.25 |
$171 |
9.6× |
| Renal function panel (80069) |
$107.25 |
$143 |
12.4× |
| Hepatic function panel (80076) |
$85.50 |
$114 |
10.5× |
| Urinalysis, non-automated, with microscopy (81000) |
$5.25 |
$7 |
1.3× |
| Urinalysis, non-automated, without microscopy (81002) |
$4.50 |
$6 |
1.3× |
| PSA, total (84153) |
$148.50 |
$198 |
8.1× |
| Thyroid stimulating hormone (TSH) (84443) |
$68.25 |
$91 |
4.1× |
| CBC with automated differential (85025) |
$33.38 |
$44.50 |
4.3× |
| CBC, automated (85027) |
$42.75 |
$57 |
6.6× |
| Prothrombin time (PT) (85610) |
$11.25 |
$15 |
2.6× |
| Partial thromboplastin time (PTT) (85730) |
$45 |
$60 |
7.5× |
| Psychotherapy, 30 minutes (90832) |
$187.88 |
$250.50 |
1.1× |
| Psychotherapy, 45 minutes (90834) |
$126 |
$168 |
0.7× |
| Psychotherapy, 60 minutes (90837) |
$153.75 |
$205 |
0.9× |
| Family psychotherapy, without patient (50 min) (90846) |
$129 |
$172 |
0.8× |
| Family psychotherapy, with patient (50 min) (90847) |
$126 |
$168 |
0.7× |
| Group psychotherapy (90853) |
$86.25 |
$115 |
0.9× |
| Electrocardiogram (ECG), complete (93000) |
$42 |
$56 |
0.7× |
| Left heart catheterization (93452) |
$3,502.50 |
$4,670 |
1.1× |
| Sleep study (attended polysomnography) (95810) |
$1,951.88 |
$2,602.50 |
2.3× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$152.25 |
$203 |
5.2× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$135 |
$180 |
1.0× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$193.50 |
$258 |
1.5× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$231.75 |
$309 |
1.8× |
| Office consultation (low complexity, ~30 min) (99243) |
$140.25 |
$187 |
1.1× |
| Office consultation (moderate complexity, ~40 min) (99244) |
$198 |
$264 |
1.5× |
| Preventive visit, new patient (age 18–39) (99385) |
$172.88 |
$230.50 |
— |
| Preventive visit, new patient (age 40–64) (99386) |
$132 |
$176 |
— |