| Shoulder arthroscopy with decompression (29826) |
$5,870.83 |
$29,354.14 |
— |
| Knee arthroscopy with meniscectomy (29881) |
$1,397.65 |
$6,988.26 |
0.5× |
| Upper GI endoscopy (EGD), diagnostic (43235) |
$545.10 |
$2,725.50 |
0.7× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$790.87 |
$3,954.34 |
0.9× |
| Diagnostic colonoscopy (45378) |
$758.18 |
$3,790.89 |
0.9× |
| Colonoscopy with biopsy (45380) |
$1,333.98 |
$6,669.88 |
1.2× |
| Colonoscopy with lesion removal (45385) |
$1,112.65 |
$5,563.26 |
1.0× |
| Inguinal hernia repair (age 5+) (49505) |
$3,904.55 |
$19,522.73 |
1.2× |
| Epidural injection, lumbar/sacral (with imaging) (62322) |
$412.26 |
$2,061.28 |
0.5× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$347.68 |
$1,738.38 |
0.4× |
| Cataract removal with lens insertion (66984) |
$1,668.93 |
$8,344.65 |
0.8× |
| CT head/brain without contrast (70450) |
$311.20 |
$1,556 |
3.2× |
| MRI brain without contrast (70551) |
$584.20 |
$2,921 |
2.7× |
| MRI brain with contrast (70552) |
$568 |
$2,840 |
1.8× |
| MRI brain without and with contrast (70553) |
$701 |
$3,505 |
2.2× |
| X-ray lower spine, 4+ views (72110) |
$108.40 |
$542 |
1.1× |
| MRI lumbar spine without contrast (72148) |
$494.20 |
$2,471 |
2.3× |
| CT pelvis with contrast (72193) |
$302.60 |
$1,513 |
1.9× |
| MRI lower-extremity joint without contrast (73721) |
$539.80 |
$2,699 |
2.5× |
| CT abdomen and pelvis with contrast (74177) |
$504.80 |
$2,524 |
1.6× |
| Ultrasound, abdomen complete (76700) |
$188.40 |
$942 |
2.0× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$94.80 |
$474 |
1.0× |
| Ultrasound, transvaginal (76830) |
$146 |
$730 |
1.5× |
| Mammography, one breast (diagnostic) (77065) |
$45 |
$225 |
0.5× |
| Mammography, both breasts (diagnostic) (77066) |
$90 |
$450 |
0.8× |
| Mammography, screening (bilateral) (77067) |
$49.60 |
$248 |
0.5× |
| Basic metabolic panel (80048) |
$41.30 |
$206.50 |
4.9× |
| Comprehensive metabolic panel (80053) |
$19.60 |
$98 |
1.9× |
| Lipid panel (80061) |
$49.40 |
$247 |
3.7× |
| Renal function panel (80069) |
$27.60 |
$138 |
3.2× |
| Hepatic function panel (80076) |
$26.50 |
$132.50 |
3.2× |
| Urinalysis, non-automated, without microscopy (81002) |
$4 |
$20 |
1.1× |
| PSA, total (84153) |
$34.40 |
$172 |
1.9× |
| Thyroid stimulating hormone (TSH) (84443) |
$28.80 |
$144 |
1.7× |
| CBC with automated differential (85025) |
$18.80 |
$94 |
2.4× |
| CBC, automated (85027) |
$18 |
$90 |
2.8× |
| Prothrombin time (PT) (85610) |
$13.40 |
$67 |
3.1× |
| Partial thromboplastin time (PTT) (85730) |
$36.40 |
$182 |
6.1× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$22.60 |
$113 |
0.8× |