| Breast lesion removal (open) (19120) |
$622.70 |
$958 |
0.2× |
| Shoulder arthroscopy with decompression (29826) |
$269.47 |
$414.57 |
— |
| Knee arthroscopy with meniscectomy (29881) |
$690.30 |
$1,062 |
0.2× |
Tonsillectomy and adenoidectomy (under age 12) (42820)
likely a partial charge, not the full procedure |
$371.15 |
$571 |
0.1× |
| Upper GI endoscopy (EGD), diagnostic (43235) |
$321.10 |
$494 |
0.4× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$427.70 |
$658 |
0.5× |
| Diagnostic colonoscopy (45378) |
$199.55 |
$307 |
0.2× |
| Colonoscopy with biopsy (45380) |
$507.65 |
$781 |
0.4× |
| Colonoscopy with lesion removal (45385) |
$535.60 |
$824 |
0.4× |
Laparoscopic gallbladder removal (47562)
likely a partial charge, not the full procedure |
$845.65 |
$1,301 |
0.1× |
| Inguinal hernia repair (age 5+) (49505) |
$667.55 |
$1,027 |
0.2× |
| Obstetric care, vaginal delivery (global) (59400) |
$2,676.05 |
$4,117 |
— |
| Obstetric care, cesarean delivery (global) (59510) |
$4,071.16 |
$6,263.33 |
— |
| Obstetric care, VBAC delivery (global) (59610) |
$3,851.38 |
$5,925.20 |
— |
| Epidural injection, lumbar/sacral (with imaging) (62322) |
$196.30 |
$302 |
0.2× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$1,268.15 |
$1,951 |
1.4× |
| CT head/brain without contrast (70450) |
$1,815.45 |
$2,793 |
17.3× |
| MRI brain without contrast (70551) |
$2,786.55 |
$4,287 |
11.6× |
| MRI brain with contrast (70552) |
$2,660.11 |
$4,092.48 |
7.6× |
| MRI brain without and with contrast (70553) |
$3,187.60 |
$4,904 |
9.1× |
| X-ray lower spine, 4+ views (72110) |
$370.50 |
$570 |
3.5× |
| MRI lumbar spine without contrast (72148) |
$2,530.45 |
$3,893 |
10.6× |
| CT pelvis with contrast (72193) |
$2,391.35 |
$3,679 |
13.6× |
| MRI lower-extremity joint without contrast (73721) |
$2,460.25 |
$3,785 |
10.3× |
| CT abdomen and pelvis with contrast (74177) |
$5,009.55 |
$7,707 |
14.3× |
| Ultrasound, abdomen complete (76700) |
$865.15 |
$1,331 |
8.2× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$320.79 |
$493.52 |
3.1× |
| Ultrasound, transvaginal (76830) |
$422.60 |
$650.16 |
4.0× |
| Mammography, one breast (diagnostic) (77065) |
$315.25 |
$485 |
3.7× |
| Mammography, both breasts (diagnostic) (77066) |
$385.45 |
$593 |
3.5× |
| Mammography, screening (bilateral) (77067) |
$284.70 |
$438 |
3.1× |
| Basic metabolic panel (80048) |
$111.15 |
$171 |
13.1× |
| Comprehensive metabolic panel (80053) |
$195 |
$300 |
18.5× |
| Obstetric panel (80055) |
$585 |
$900 |
12.2× |
| Lipid panel (80061) |
$170.95 |
$263 |
12.8× |
| Renal function panel (80069) |
$170.30 |
$262 |
19.6× |
| Hepatic function panel (80076) |
$265.20 |
$408 |
32.5× |
| PSA, total (84153) |
$198.25 |
$305 |
10.8× |
| Thyroid stimulating hormone (TSH) (84443) |
$199.84 |
$307.44 |
11.9× |
| CBC with automated differential (85025) |
$112.45 |
$173 |
14.5× |
| CBC, automated (85027) |
$58.70 |
$90.30 |
9.1× |
| Prothrombin time (PT) (85610) |
$22.75 |
$35 |
5.3× |
| Partial thromboplastin time (PTT) (85730) |
$50.70 |
$78 |
8.4× |
| Psychotherapy, 30 minutes (90832) |
$82.55 |
$127 |
0.5× |
| Psychotherapy, 45 minutes (90834) |
$162.99 |
$250.75 |
0.9× |
| Psychotherapy, 60 minutes (90837) |
$214.18 |
$329.52 |
1.2× |
| Family psychotherapy, with patient (50 min) (90847) |
$249.52 |
$383.88 |
1.4× |
| Group psychotherapy (90853) |
$426.39 |
$655.99 |
4.2× |
| Electrocardiogram (ECG), complete (93000) |
$21.45 |
$33 |
0.4× |
| Left heart catheterization (93452) |
$4,598.30 |
$7,074.30 |
1.4× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$105.95 |
$163 |
3.6× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$177.19 |
$272.60 |
1.3× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$264.73 |
$407.28 |
2.0× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$314.92 |
$484.49 |
2.4× |
| Office consultation (low complexity, ~30 min) (99243) |
$297.70 |
$458 |
2.2× |
| Office consultation (moderate complexity, ~40 min) (99244) |
$440.70 |
$678 |
3.3× |
| Preventive visit, new patient (age 18–39) (99385) |
$318.50 |
$490 |
— |
| Preventive visit, new patient (age 40–64) (99386) |
$369.20 |
$568 |
— |