| Breast lesion removal (open) (19120) |
$3,631.60 |
$9,079 |
1.0× |
| Upper GI endoscopy (EGD), diagnostic (43235) |
$832 |
$2,080 |
1.0× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$832 |
$2,080 |
1.0× |
| Diagnostic colonoscopy (45378) |
$832 |
$2,080 |
1.0× |
| Colonoscopy with biopsy (45380) |
$1,102.40 |
$2,756 |
1.0× |
| Colonoscopy with lesion removal (45385) |
$1,102.40 |
$2,756 |
1.0× |
| Colonoscopy with endoscopic ultrasound (45391) |
$1,060 |
$2,650 |
1.0× |
| Inguinal hernia repair (age 5+) (49505) |
$3,687.20 |
$9,218 |
1.1× |
| Epidural injection, lumbar/sacral (with imaging) (62322) |
$520 |
$1,300 |
0.7× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$840 |
$2,100 |
1.1× |
| After-cataract laser surgery (YAG capsulotomy) (66821) |
$514 |
$1,285 |
1.0× |
| CT head/brain without contrast (70450) |
$438.80 |
$1,097 |
4.6× |
| MRI brain without contrast (70551) |
$787.60 |
$1,969 |
3.7× |
| MRI brain with contrast (70552) |
$1,229.80 |
$3,074.50 |
3.9× |
| MRI brain without and with contrast (70553) |
$772.80 |
$1,932 |
2.5× |
| X-ray lower spine, 4+ views (72110) |
$390 |
$975 |
4.1× |
| MRI lumbar spine without contrast (72148) |
$747 |
$1,867.50 |
3.5× |
| CT pelvis with contrast (72193) |
$600 |
$1,500 |
3.8× |
| MRI lower-extremity joint without contrast (73721) |
$787.60 |
$1,969 |
3.7× |
| CT abdomen and pelvis with contrast (74177) |
$772.80 |
$1,932 |
2.5× |
| Ultrasound, abdomen complete (76700) |
$398.80 |
$997 |
4.2× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$398.80 |
$997 |
4.2× |
| Ultrasound, transvaginal (76830) |
$398.80 |
$997 |
4.2× |
| Mammography, one breast (diagnostic) (77065) |
$176.80 |
$442 |
2.1× |
| Mammography, both breasts (diagnostic) (77066) |
$191.20 |
$478 |
1.7× |
| Mammography, screening (bilateral) (77067) |
$172 |
$430 |
1.9× |
| Basic metabolic panel (80048) |
$177.20 |
$443 |
20.9× |
| Comprehensive metabolic panel (80053) |
$105.60 |
$264 |
10.0× |
| Obstetric panel (80055) |
$47.60 |
$119 |
1.0× |
| Lipid panel (80061) |
$42.40 |
$106 |
3.2× |
| Renal function panel (80069) |
$72.80 |
$182 |
8.4× |
| Hepatic function panel (80076) |
$72 |
$180 |
8.8× |
| Urinalysis, non-automated, with microscopy (81000) |
$8 |
$20 |
2.0× |
| Urinalysis, non-automated, without microscopy (81002) |
$14.40 |
$36 |
4.1× |
| PSA, total (84153) |
$68.40 |
$171 |
3.7× |
| Thyroid stimulating hormone (TSH) (84443) |
$71.20 |
$178 |
4.2× |
| CBC with automated differential (85025) |
$52 |
$130 |
6.7× |
| CBC, automated (85027) |
$64.80 |
$162 |
10.0× |
| Prothrombin time (PT) (85610) |
$32.40 |
$81 |
7.6× |
| Partial thromboplastin time (PTT) (85730) |
$60 |
$150 |
10.0× |
| Psychotherapy, 30 minutes (90832) |
$136 |
$340 |
0.8× |
| Psychotherapy, 45 minutes (90834) |
$136 |
$340 |
0.8× |
| Psychotherapy, 60 minutes (90837) |
$131.20 |
$328 |
0.8× |
| Family psychotherapy, without patient (50 min) (90846) |
$136 |
$340 |
0.8× |
| Family psychotherapy, with patient (50 min) (90847) |
$136 |
$340 |
0.8× |
| Group psychotherapy (90853) |
$76.40 |
$191 |
0.8× |
| Left heart catheterization (93452) |
$2,880 |
$7,200 |
1.0× |
| Sleep study (attended polysomnography) (95810) |
$893.60 |
$2,234 |
1.2× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$28 |
$70 |
1.0× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$114.40 |
$286 |
1.0× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$158.40 |
$396 |
1.3× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$186 |
$465 |
1.5× |
| Office consultation (low complexity, ~30 min) (99243) |
$19.60 |
$49 |
0.2× |
| Office consultation (moderate complexity, ~40 min) (99244) |
$34 |
$85 |
0.3× |
| Preventive visit, new patient (age 18–39) (99385) |
$44.40 |
$111 |
— |
| Preventive visit, new patient (age 40–64) (99386) |
$54.40 |
$136 |
— |