| Breast lesion removal (open) (19120) |
— |
$916 |
— |
| Upper GI endoscopy (EGD), diagnostic (43235) |
— |
$2,938 |
— |
| Upper GI endoscopy (EGD) with biopsy (43239) |
— |
$3,432 |
— |
| Diagnostic colonoscopy (45378) |
— |
$3,247 |
— |
| Colonoscopy with biopsy (45380) |
— |
$3,438 |
— |
| Colonoscopy with lesion removal (45385) |
— |
$3,833 |
— |
| Colonoscopy with endoscopic ultrasound (45391) |
— |
$2,898 |
— |
| Epidural injection, lumbar/sacral (with imaging) (62322) |
— |
$2,169 |
— |
| Transforaminal epidural injection, lumbar/sacral (64483) |
— |
$1,076 |
— |
| After-cataract laser surgery (YAG capsulotomy) (66821) |
— |
$1,370 |
— |
| CT head/brain without contrast (70450) |
— |
$2,422 |
— |
| MRI brain without contrast (70551) |
— |
$4,619 |
— |
| MRI brain with contrast (70552) |
— |
$5,185 |
— |
| MRI brain without and with contrast (70553) |
— |
$6,731 |
— |
| X-ray lower spine, 4+ views (72110) |
— |
$657 |
— |
| MRI lumbar spine without contrast (72148) |
— |
$4,619 |
— |
| CT pelvis with contrast (72193) |
— |
$3,606 |
— |
| MRI lower-extremity joint without contrast (73721) |
— |
$4,340 |
— |
| CT abdomen and pelvis with contrast (74177) |
— |
$6,866 |
— |
| Ultrasound, abdomen complete (76700) |
— |
$1,238 |
— |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
— |
$519 |
— |
| Ultrasound, transvaginal (76830) |
— |
$872 |
— |
| Mammography, one breast (diagnostic) (77065) |
— |
$537 |
— |
| Mammography, both breasts (diagnostic) (77066) |
— |
$771 |
— |
| Mammography, screening (bilateral) (77067) |
— |
$595 |
— |
| Basic metabolic panel (80048) |
— |
$420 |
— |
| Comprehensive metabolic panel (80053) |
— |
$787 |
— |
Lipid panel (80061)
range across 2 matching MRF lines |
— |
$265–$287 |
— |
| Renal function panel (80069) |
— |
$510 |
— |
| Hepatic function panel (80076) |
— |
$468 |
— |
Urinalysis, non-automated, without microscopy (81002)
range across 5 matching MRF lines |
— |
$25–$262 |
— |
PSA, total (84153)
range across 3 matching MRF lines |
— |
$56–$222 |
— |
| Thyroid stimulating hormone (TSH) (84443) |
— |
$309 |
— |
| CBC with automated differential (85025) |
— |
$131 |
— |
| CBC, automated (85027) |
— |
$105 |
— |
Prothrombin time (PT) (85610)
range across 3 matching MRF lines |
— |
$41–$105 |
— |
Partial thromboplastin time (PTT) (85730)
range across 2 matching MRF lines |
— |
$56–$89 |
— |
| Psychotherapy, 30 minutes (90832) |
— |
$361 |
— |
| Psychotherapy, 45 minutes (90834) |
— |
$524 |
— |
| Psychotherapy, 60 minutes (90837) |
— |
$634 |
— |
| Family psychotherapy, without patient (50 min) (90846) |
— |
$457 |
— |
| Family psychotherapy, with patient (50 min) (90847) |
— |
$461 |
— |
| Group psychotherapy (90853) |
— |
$302 |
— |
| Left heart catheterization (93452) |
— |
$18,577 |
— |
| Sleep study (attended polysomnography) (95810) |
— |
$5,120 |
— |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
— |
$136 |
— |
| Office visit, new patient (low complexity, ~30 min) (99203) |
— |
$297 |
— |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
— |
$396 |
— |
| Office visit, new patient (high complexity, ~60 min) (99205) |
— |
$493 |
— |
| Office consultation (low complexity, ~30 min) (99243) |
— |
$297 |
— |
| Office consultation (moderate complexity, ~40 min) (99244) |
— |
$396 |
— |
| Preventive visit, new patient (age 18–39) (99385) |
— |
$206 |
— |
| Preventive visit, new patient (age 40–64) (99386) |
— |
$206 |
— |