| Breast lesion removal (open) (19120) |
$1,722.98 |
$8,614.91 |
0.5× |
| Shoulder arthroscopy with decompression (29826) |
$4,338.50 |
$21,692.50 |
— |
| Knee arthroscopy with meniscectomy (29881) |
$1,558.73 |
$7,793.63 |
0.5× |
Tonsillectomy and adenoidectomy (under age 12) (42820)
likely a partial charge, not the full procedure |
$1,185.73 |
$5,928.63 |
0.2× |
| Upper GI endoscopy (EGD), diagnostic (43235) |
$765.33 |
$3,826.65 |
0.9× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$1,245.22 |
$6,226.08 |
1.5× |
| Diagnostic colonoscopy (45378) |
$765.26 |
$3,826.29 |
0.9× |
| Colonoscopy with biopsy (45380) |
$1,245.22 |
$6,226.08 |
1.1× |
| Colonoscopy with lesion removal (45385) |
$1,126.64 |
$5,633.19 |
1.0× |
| Inguinal hernia repair (age 5+) (49505) |
$2,323.64 |
$11,618.21 |
0.7× |
| Laparoscopic radical prostatectomy (55866) |
$12,472.88 |
$62,364.42 |
1.2× |
| Epidural injection, lumbar/sacral (with imaging) (62322) |
$238.60 |
$1,193 |
0.3× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$456 |
$2,280 |
0.5× |
| After-cataract laser surgery (YAG capsulotomy) (66821) |
$284 |
$1,420 |
0.5× |
| CT head/brain without contrast (70450) |
$480.80 |
$2,404 |
4.9× |
| MRI brain without contrast (70551) |
$503.80 |
$2,519 |
2.2× |
| MRI brain with contrast (70552) |
$515.40 |
$2,577 |
1.6× |
| MRI brain without and with contrast (70553) |
$629.80 |
$3,149 |
1.9× |
| X-ray lower spine, 4+ views (72110) |
$62.40 |
$312 |
0.6× |
| MRI lumbar spine without contrast (72148) |
$806 |
$4,030 |
3.6× |
| CT pelvis with contrast (72193) |
$599.20 |
$2,996 |
3.6× |
| MRI lower-extremity joint without contrast (73721) |
$680 |
$3,400 |
3.0× |
| CT abdomen and pelvis with contrast (74177) |
$1,007.60 |
$5,038 |
3.1× |
| Ultrasound, abdomen complete (76700) |
$352.60 |
$1,763 |
3.6× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$120.40 |
$602 |
1.2× |
| Ultrasound, transvaginal (76830) |
$216.60 |
$1,083 |
2.2× |
| Mammography, one breast (diagnostic) (77065) |
$105.40 |
$527 |
1.2× |
| Mammography, both breasts (diagnostic) (77066) |
$210.80 |
$1,054 |
1.9× |
| Mammography, screening (bilateral) (77067) |
$108 |
$540 |
1.2× |
| Basic metabolic panel (80048) |
$34.50 |
$172.50 |
4.1× |
| Comprehensive metabolic panel (80053) |
$9.70 |
$48.50 |
0.9× |
| Lipid panel (80061) |
$12.60 |
$63 |
0.9× |
| Renal function panel (80069) |
$24.50 |
$122.50 |
2.8× |
| Hepatic function panel (80076) |
$17.50 |
$87.50 |
2.1× |
| Urinalysis, non-automated, without microscopy (81002) |
$3.80 |
$19 |
1.1× |
| PSA, total (84153) |
$17.70 |
$88.50 |
1.0× |
| Thyroid stimulating hormone (TSH) (84443) |
$20.50 |
$102.50 |
1.2× |
| CBC with automated differential (85025) |
$7.40 |
$37 |
1.0× |
| CBC, automated (85027) |
$6 |
$30 |
0.9× |
| Prothrombin time (PT) (85610) |
$18.40 |
$92 |
4.3× |
| Partial thromboplastin time (PTT) (85730) |
$36.40 |
$182 |
6.1× |
| Psychotherapy, 30 minutes (90832) |
$78 |
$390 |
0.5× |
| Psychotherapy, 45 minutes (90834) |
$78 |
$390 |
0.5× |
| Psychotherapy, 60 minutes (90837) |
$78 |
$390 |
0.5× |
| Family psychotherapy, without patient (50 min) (90846) |
$78 |
$390 |
0.5× |
| Family psychotherapy, with patient (50 min) (90847) |
$78 |
$390 |
0.5× |
| Group psychotherapy (90853) |
$40.60 |
$203 |
0.4× |
| Left heart catheterization (93452) |
$1,845.60 |
$9,228 |
0.6× |
| Sleep study (attended polysomnography) (95810) |
$888.60 |
$4,443 |
1.1× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$54.40 |
$272 |
1.9× |
| Preventive visit, new patient (age 18–39) (99385) |
$12 |
$60 |
— |
| Preventive visit, new patient (age 40–64) (99386) |
$11.80 |
$59 |
— |