| Breast lesion removal (open) (19120) |
$790.80 |
$7,908 |
0.2× |
| Upper GI endoscopy (EGD), diagnostic (43235) |
$214.30 |
$2,143 |
0.2× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$214.30 |
$2,143 |
0.2× |
| Diagnostic colonoscopy (45378) |
$216.50 |
$2,165 |
0.2× |
| Colonoscopy with biopsy (45380) |
$216.50 |
$2,165 |
0.2× |
| Colonoscopy with lesion removal (45385) |
$216.50 |
$2,165 |
0.2× |
| Colonoscopy with endoscopic ultrasound (45391) |
$216.50 |
$2,165 |
0.2× |
| Epidural injection, lumbar/sacral (with imaging) (62322) |
$248.90 |
$2,489 |
0.3× |
| CT head/brain without contrast (70450) |
$319.30 |
$3,193 |
3.0× |
| MRI brain without contrast (70551) |
$316 |
$3,160 |
1.3× |
| MRI brain with contrast (70552) |
$322.30 |
$3,223 |
0.9× |
| MRI brain without and with contrast (70553) |
$504.30 |
$5,043 |
1.4× |
| X-ray lower spine, 4+ views (72110) |
$53.40 |
$534 |
0.5× |
| MRI lumbar spine without contrast (72148) |
$337.80 |
$3,378 |
1.4× |
| CT pelvis with contrast (72193) |
$401.70 |
$4,017 |
2.3× |
| MRI lower-extremity joint without contrast (73721) |
$322.80 |
$3,228 |
1.3× |
| CT abdomen and pelvis with contrast (74177) |
$441.50 |
$4,415 |
1.3× |
| Ultrasound, abdomen complete (76700) |
$217.40 |
$2,174 |
2.1× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$168.10 |
$1,681 |
1.6× |
| Ultrasound, transvaginal (76830) |
$183.30 |
$1,833 |
1.7× |
| Mammography, one breast (diagnostic) (77065) |
$67.90 |
$679 |
0.8× |
| Mammography, both breasts (diagnostic) (77066) |
$84.60 |
$846 |
0.8× |
| Mammography, screening (bilateral) (77067) |
$74.80 |
$748 |
0.8× |
| Basic metabolic panel (80048) |
$36.30 |
$363 |
4.3× |
| Comprehensive metabolic panel (80053) |
$48.70 |
$487 |
4.6× |
| Lipid panel (80061) |
$36.70 |
$367 |
2.7× |
| Renal function panel (80069) |
$44.90 |
$449 |
5.2× |
| Hepatic function panel (80076) |
$38.20 |
$382 |
4.7× |
| Urinalysis, non-automated, with microscopy (81000) |
$9.30 |
$93 |
2.3× |
| Urinalysis, non-automated, without microscopy (81002) |
$6.90 |
$69 |
2.0× |
| PSA, total (84153) |
$22.70 |
$227 |
1.2× |
| Thyroid stimulating hormone (TSH) (84443) |
$24.60 |
$246 |
1.5× |
| CBC with automated differential (85025) |
$19.80 |
$198 |
2.5× |
| CBC, automated (85027) |
$18.20 |
$182 |
2.8× |
| Prothrombin time (PT) (85610) |
$14.40 |
$144 |
3.4× |
| Partial thromboplastin time (PTT) (85730) |
$16.20 |
$162 |
2.7× |
| Psychotherapy, 30 minutes (90832) |
$27.80 |
$278 |
0.2× |
| Psychotherapy, 45 minutes (90834) |
$51.30 |
$513 |
0.3× |
| Psychotherapy, 60 minutes (90837) |
$67.10 |
$671 |
0.4× |
| Family psychotherapy, without patient (50 min) (90846) |
$56.20 |
$562 |
0.3× |
| Family psychotherapy, with patient (50 min) (90847) |
$56.20 |
$562 |
0.3× |
| Group psychotherapy (90853) |
$26.90 |
$269 |
0.3× |
| Sleep study (attended polysomnography) (95810) |
$405.50 |
$4,055 |
0.5× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$19.50 |
$195 |
0.7× |