| Breast lesion removal (open) (19120) |
$483.75 |
$1,935 |
0.1× |
| Shoulder arthroscopy with decompression (29826) |
$334.50 |
$1,338 |
— |
| Knee arthroscopy with meniscectomy (29881) |
$321.50 |
$1,286 |
0.1× |
Tonsillectomy and adenoidectomy (under age 12) (42820)
likely a partial charge, not the full procedure |
$149.50 |
$598 |
0.0× |
| Upper GI endoscopy (EGD), diagnostic (43235) |
$131.38 |
$525.50 |
0.2× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$416.62 |
$1,666.50 |
0.5× |
| Diagnostic colonoscopy (45378) |
$745 |
$2,980 |
0.9× |
| Colonoscopy with biopsy (45380) |
$641 |
$2,564 |
0.6× |
| Colonoscopy with lesion removal (45385) |
$651.50 |
$2,606 |
0.6× |
| Colonoscopy with endoscopic ultrasound (45391) |
$156.25 |
$625 |
0.1× |
Laparoscopic gallbladder removal (47562)
likely a partial charge, not the full procedure |
$371.25 |
$1,485 |
0.1× |
| Inguinal hernia repair (age 5+) (49505) |
$257.50 |
$1,030 |
0.1× |
Laparoscopic radical prostatectomy (55866)
likely a partial charge, not the full procedure |
$960.50 |
$3,842 |
0.1× |
| Obstetric care, vaginal delivery (global) (59400) |
$929 |
$3,716 |
— |
| Obstetric care, cesarean delivery (global) (59510) |
$1,053 |
$4,212 |
— |
| Obstetric care, VBAC delivery (global) (59610) |
$979.25 |
$3,917 |
— |
| Epidural injection, lumbar/sacral (with imaging) (62322) |
$346.25 |
$1,385 |
0.4× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$224.25 |
$897 |
0.3× |
| After-cataract laser surgery (YAG capsulotomy) (66821) |
$353 |
$1,412 |
0.7× |
| Cataract removal with lens insertion (66984) |
$371 |
$1,484 |
0.2× |
| CT head/brain without contrast (70450) |
$647.25 |
$2,589 |
6.8× |
| MRI brain without contrast (70551) |
$892.75 |
$3,571 |
4.1× |
| MRI brain with contrast (70552) |
$899.75 |
$3,599 |
2.8× |
| MRI brain without and with contrast (70553) |
$1,287.25 |
$5,149 |
4.1× |
| X-ray lower spine, 4+ views (72110) |
$165.25 |
$661 |
1.7× |
| MRI lumbar spine without contrast (72148) |
$839.25 |
$3,357 |
3.9× |
| CT pelvis with contrast (72193) |
$671.75 |
$2,687 |
4.2× |
| MRI lower-extremity joint without contrast (73721) |
$924.50 |
$3,698 |
4.3× |
| CT abdomen and pelvis with contrast (74177) |
$1,413.25 |
$5,653 |
4.4× |
| Ultrasound, abdomen complete (76700) |
$253.75 |
$1,015 |
2.7× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$163.25 |
$653 |
1.7× |
| Ultrasound, transvaginal (76830) |
$181.25 |
$725 |
1.9× |
| Mammography, one breast (diagnostic) (77065) |
$72.75 |
$291 |
0.8× |
| Mammography, both breasts (diagnostic) (77066) |
$95.50 |
$382 |
0.9× |
| Mammography, screening (bilateral) (77067) |
$62.50 |
$250 |
0.7× |
| Basic metabolic panel (80048) |
$103.75 |
$415 |
12.3× |
| Comprehensive metabolic panel (80053) |
$116.75 |
$467 |
11.1× |
| Obstetric panel (80055) |
$91.25 |
$365 |
1.9× |
| Lipid panel (80061) |
$86.25 |
$345 |
6.4× |
| Renal function panel (80069) |
$37.50 |
$150 |
4.3× |
| Hepatic function panel (80076) |
$98.75 |
$395 |
12.1× |
| Urinalysis, non-automated, with microscopy (81000) |
$2.25 |
$9 |
0.6× |
| Urinalysis, non-automated, without microscopy (81002) |
$10 |
$40 |
2.9× |
| PSA, total (84153) |
$35.25 |
$141 |
1.9× |
| Thyroid stimulating hormone (TSH) (84443) |
$33.50 |
$134 |
2.0× |
| CBC with automated differential (85025) |
$31 |
$124 |
4.0× |
| CBC, automated (85027) |
$18 |
$72 |
2.8× |
| Prothrombin time (PT) (85610) |
$19.25 |
$77 |
4.5× |
| Partial thromboplastin time (PTT) (85730) |
$26.25 |
$105 |
4.4× |
| Psychotherapy, 30 minutes (90832) |
$46.25 |
$185 |
0.3× |
| Psychotherapy, 45 minutes (90834) |
$51.50 |
$206 |
0.3× |
| Psychotherapy, 60 minutes (90837) |
$70.25 |
$281 |
0.4× |
| Family psychotherapy, without patient (50 min) (90846) |
$40.50 |
$162 |
0.3× |
| Family psychotherapy, with patient (50 min) (90847) |
$56.50 |
$226 |
0.3× |
| Group psychotherapy (90853) |
$46 |
$184 |
0.5× |
| Electrocardiogram (ECG), complete (93000) |
$25.25 |
$101 |
0.5× |
| Sleep study (attended polysomnography) (95810) |
$927.25 |
$3,709 |
1.2× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$27.25 |
$109 |
0.9× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$56.12 |
$224.50 |
0.5× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$77.88 |
$311.50 |
0.6× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$109.12 |
$436.50 |
0.9× |
| Preventive visit, new patient (age 18–39) (99385) |
$51.50 |
$206 |
— |
| Preventive visit, new patient (age 40–64) (99386) |
$60 |
$240 |
— |