| Breast lesion removal (open) (19120) |
$3,256.20 |
$5,427 |
0.8× |
| Knee arthroscopy with meniscectomy (29881) |
$3,676.80 |
$6,128 |
1.1× |
| Tonsillectomy and adenoidectomy (under age 12) (42820) |
$6,603 |
$11,005 |
1.1× |
| Upper GI endoscopy (EGD), diagnostic (43235) |
$1,131.60 |
$1,886 |
1.3× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$1,131.60 |
$1,886 |
1.3× |
| Diagnostic colonoscopy (45378) |
$1,110 |
$1,850 |
1.2× |
| Colonoscopy with biopsy (45380) |
$1,450.20 |
$2,417 |
1.2× |
| Colonoscopy with lesion removal (45385) |
$1,450.20 |
$2,417 |
1.2× |
| Laparoscopic gallbladder removal (47562) |
$6,382.20 |
$10,637 |
1.1× |
| Inguinal hernia repair (age 5+) (49505) |
$3,891 |
$6,485 |
1.1× |
| Epidural injection, lumbar/sacral (with imaging) (62322) |
$905.40 |
$1,509 |
1.0× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$1,023.90 |
$1,706.50 |
1.2× |
| Cataract removal with lens insertion (66984) |
$2,871.60 |
$4,786 |
1.2× |
| CT head/brain without contrast (70450) |
$1,270.80 |
$2,118 |
12.2× |
| MRI brain without contrast (70551) |
$2,091.60 |
$3,486 |
8.8× |
| MRI brain with contrast (70552) |
$1,987.20 |
$3,312 |
5.7× |
| MRI brain without and with contrast (70553) |
$3,054 |
$5,090 |
8.8× |
| X-ray lower spine, 4+ views (72110) |
$917.40 |
$1,529 |
8.8× |
| MRI lumbar spine without contrast (72148) |
$2,716.80 |
$4,528 |
11.4× |
| CT pelvis with contrast (72193) |
$1,899 |
$3,165 |
10.9× |
| MRI lower-extremity joint without contrast (73721) |
$2,666.40 |
$4,444 |
11.2× |
| CT abdomen and pelvis with contrast (74177) |
$3,629.40 |
$6,049 |
10.4× |
| Ultrasound, abdomen complete (76700) |
$808.20 |
$1,347 |
7.8× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$486.60 |
$811 |
4.7× |
| Ultrasound, transvaginal (76830) |
$526.20 |
$877 |
5.1× |
| Mammography, one breast (diagnostic) (77065) |
$184.20 |
$307 |
2.1× |
| Mammography, both breasts (diagnostic) (77066) |
$267 |
$445 |
2.4× |
| Mammography, screening (bilateral) (77067) |
$267.30 |
$445.50 |
2.9× |
| Basic metabolic panel (80048) |
$63 |
$105 |
7.4× |
| Comprehensive metabolic panel (80053) |
$156.60 |
$261 |
14.8× |
| Lipid panel (80061) |
$168 |
$280 |
12.5× |
| Renal function panel (80069) |
$70.20 |
$117 |
8.1× |
| Hepatic function panel (80076) |
$95.40 |
$159 |
11.7× |
| Urinalysis, non-automated, without microscopy (81002) |
$21.60 |
$36 |
6.2× |
| PSA, total (84153) |
$114 |
$190 |
6.2× |
| Thyroid stimulating hormone (TSH) (84443) |
$119.40 |
$199 |
7.1× |
| CBC with automated differential (85025) |
$49.20 |
$82 |
6.3× |
| CBC, automated (85027) |
$35.40 |
$59 |
5.5× |
| Prothrombin time (PT) (85610) |
$46.20 |
$77 |
10.8× |
| Partial thromboplastin time (PTT) (85730) |
$104.40 |
$174 |
17.4× |
| Left heart catheterization (93452) |
$8,506.20 |
$14,177 |
2.6× |
| Sleep study (attended polysomnography) (95810) |
$2,180.40 |
$3,634 |
2.6× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$86.40 |
$144 |
3.0× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$160.80 |
$268 |
1.2× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$299.40 |
$499 |
2.3× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$308.40 |
$514 |
2.3× |