| Breast lesion removal (open) (19120) |
$432.30 |
$786 |
0.1× |
| Shoulder arthroscopy with decompression (29826) |
$514.80 |
$936 |
— |
| Knee arthroscopy with meniscectomy (29881) |
$493.35 |
$897 |
0.1× |
| Upper GI endoscopy (EGD), diagnostic (43235) |
$402.60 |
$732 |
0.4× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$513.70 |
$934 |
0.5× |
| Diagnostic colonoscopy (45378) |
$512.05 |
$931 |
0.5× |
| Colonoscopy with biopsy (45380) |
$632.50 |
$1,150 |
0.5× |
| Colonoscopy with lesion removal (45385) |
$663.30 |
$1,206 |
0.5× |
Laparoscopic gallbladder removal (47562)
likely a partial charge, not the full procedure |
$526.08 |
$956.50 |
0.1× |
| Inguinal hernia repair (age 5+) (49505) |
$491.15 |
$893 |
0.1× |
| Obstetric care, vaginal delivery (global) (59400) |
$2,104.30 |
$3,826 |
— |
| Obstetric care, cesarean delivery (global) (59510) |
$1,533.95 |
$2,789 |
— |
| Obstetric care, VBAC delivery (global) (59610) |
$2,244 |
$4,080 |
— |
| Epidural injection, lumbar/sacral (with imaging) (62322) |
$611.05 |
$1,111 |
0.6× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$482.35 |
$877 |
0.5× |
| CT head/brain without contrast (70450) |
$839.85 |
$1,527 |
7.5× |
| MRI brain without contrast (70551) |
$1,554.85 |
$2,827 |
6.1× |
| MRI brain with contrast (70552) |
$2,060.30 |
$3,746 |
5.5× |
| MRI brain without and with contrast (70553) |
$3,091.55 |
$5,621 |
8.3× |
| X-ray lower spine, 4+ views (72110) |
$313.50 |
$570 |
2.8× |
| MRI lumbar spine without contrast (72148) |
$2,019.05 |
$3,671 |
7.9× |
| CT pelvis with contrast (72193) |
$1,338.15 |
$2,433 |
7.1× |
| MRI lower-extremity joint without contrast (73721) |
$1,685.75 |
$3,065 |
6.6× |
| CT abdomen and pelvis with contrast (74177) |
$2,435.95 |
$4,429 |
6.5× |
| Ultrasound, abdomen complete (76700) |
$692.45 |
$1,259 |
6.2× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$584.10 |
$1,062 |
5.2× |
| Ultrasound, transvaginal (76830) |
$486.20 |
$884 |
4.4× |
| Mammography, one breast (diagnostic) (77065) |
$283.80 |
$516 |
3.3× |
| Mammography, both breasts (diagnostic) (77066) |
$501.05 |
$911 |
4.5× |
| Mammography, screening (bilateral) (77067) |
$203.50 |
$370 |
2.2× |
| Basic metabolic panel (80048) |
$64.90 |
$118 |
7.7× |
| Comprehensive metabolic panel (80053) |
$78.10 |
$142 |
7.4× |
| Obstetric panel (80055) |
$352 |
$640 |
7.4× |
| Lipid panel (80061) |
$99 |
$180 |
7.4× |
| Renal function panel (80069) |
$47.30 |
$86 |
5.4× |
| Hepatic function panel (80076) |
$90.20 |
$164 |
11.0× |
| Urinalysis, non-automated, with microscopy (81000) |
$19.25 |
$35 |
4.8× |
| Urinalysis, non-automated, without microscopy (81002) |
$10.45 |
$19 |
3.0× |
| PSA, total (84153) |
$107.80 |
$196 |
5.9× |
| Thyroid stimulating hormone (TSH) (84443) |
$71.22 |
$129.50 |
4.2× |
| CBC with automated differential (85025) |
$63.52 |
$115.50 |
8.2× |
| CBC, automated (85027) |
$58.30 |
$106 |
9.0× |
| Prothrombin time (PT) (85610) |
$18.70 |
$34 |
4.4× |
| Partial thromboplastin time (PTT) (85730) |
$28.60 |
$52 |
4.8× |
| Psychotherapy, 30 minutes (90832) |
$62.15 |
$113 |
0.3× |
| Psychotherapy, 45 minutes (90834) |
$81.95 |
$149 |
0.4× |
| Psychotherapy, 60 minutes (90837) |
$121 |
$220 |
0.6× |
| Family psychotherapy, without patient (50 min) (90846) |
$88 |
$160 |
0.5× |
| Family psychotherapy, with patient (50 min) (90847) |
$141.35 |
$257 |
0.7× |
| Group psychotherapy (90853) |
$33.55 |
$61 |
0.3× |
| Electrocardiogram (ECG), complete (93000) |
$83.60 |
$152 |
1.3× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$78.10 |
$142 |
2.7× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$72.60 |
$132 |
0.5× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$134.75 |
$245 |
0.9× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$135.85 |
$247 |
1.0× |
| Office consultation (low complexity, ~30 min) (99243) |
$145.20 |
$264 |
1.0× |
| Office consultation (moderate complexity, ~40 min) (99244) |
$204.60 |
$372 |
1.4× |
| Preventive visit, new patient (age 18–39) (99385) |
$150.70 |
$274 |
— |
| Preventive visit, new patient (age 40–64) (99386) |
$173.80 |
$316 |
— |