| Breast lesion removal (open) (19120) |
$1,050 |
$1,500 |
0.3× |
| Upper GI endoscopy (EGD), diagnostic (43235) |
$1,397.50 |
$1,996 |
1.5× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$727 |
$1,038 |
0.8× |
| Diagnostic colonoscopy (45378) |
$1,508.50 |
$2,155 |
1.6× |
| Colonoscopy with biopsy (45380) |
$1,475 |
$2,107.50 |
1.2× |
| Colonoscopy with lesion removal (45385) |
$1,664.50 |
$2,377.50 |
1.4× |
| Laparoscopic gallbladder removal (47562) |
$5,031.50 |
$7,187.50 |
0.8× |
| Inguinal hernia repair (age 5+) (49505) |
$4,716 |
$6,737 |
1.3× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$1,960 |
$2,800 |
2.2× |
| CT head/brain without contrast (70450) |
$1,988 |
$2,840 |
18.9× |
| MRI brain without contrast (70551) |
$3,003 |
$4,290 |
12.5× |
| MRI brain with contrast (70552) |
$3,128 |
$4,469 |
8.9× |
| MRI brain without and with contrast (70553) |
$3,675 |
$5,250 |
10.5× |
| X-ray lower spine, 4+ views (72110) |
$715 |
$1,021 |
6.8× |
| MRI lumbar spine without contrast (72148) |
$2,937 |
$4,196 |
12.3× |
| CT pelvis with contrast (72193) |
$2,572 |
$3,674 |
14.6× |
| MRI lower-extremity joint without contrast (73721) |
$2,754 |
$3,934 |
11.5× |
| CT abdomen and pelvis with contrast (74177) |
$3,347.50 |
$4,782.50 |
9.6× |
| Ultrasound, abdomen complete (76700) |
$1,048 |
$1,497 |
10.0× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$410 |
$586 |
3.9× |
| Ultrasound, transvaginal (76830) |
$792 |
$1,132 |
7.5× |
| Mammography, one breast (diagnostic) (77065) |
$438 |
$625 |
5.1× |
| Mammography, both breasts (diagnostic) (77066) |
$438 |
$625 |
4.0× |
| Mammography, screening (bilateral) (77067) |
$298.50 |
$426 |
3.3× |
| Basic metabolic panel (80048) |
$246 |
$351 |
29.1× |
| Comprehensive metabolic panel (80053) |
$361 |
$515 |
34.2× |
| Lipid panel (80061) |
$230 |
$328 |
17.2× |
| Renal function panel (80069) |
$248 |
$355 |
28.6× |
| Hepatic function panel (80076) |
$250 |
$357 |
30.6× |
| Urinalysis, non-automated, without microscopy (81002) |
$18 |
$25 |
5.2× |
| PSA, total (84153) |
$167 |
$238 |
9.1× |
| Thyroid stimulating hormone (TSH) (84443) |
$221 |
$315 |
13.2× |
| CBC with automated differential (85025) |
$120 |
$172 |
15.4× |
| CBC, automated (85027) |
$134 |
$191 |
20.7× |
| Prothrombin time (PT) (85610) |
$104 |
$148 |
24.2× |
| Partial thromboplastin time (PTT) (85730) |
$129 |
$184 |
21.5× |
| Psychotherapy, 30 minutes (90832) |
$190 |
$272 |
1.1× |
| Psychotherapy, 45 minutes (90834) |
$244 |
$348 |
1.4× |
| Psychotherapy, 60 minutes (90837) |
$336 |
$480 |
1.9× |
| Sleep study (attended polysomnography) (95810) |
$1,377.50 |
$1,967.50 |
1.6× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$120 |
$172 |
4.1× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$175 |
$250 |
1.3× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$293 |
$418 |
2.2× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$295 |
$421 |
2.2× |
| Office consultation (low complexity, ~30 min) (99243) |
$175 |
$250 |
1.3× |
| Office consultation (moderate complexity, ~40 min) (99244) |
$207 |
$296 |
1.5× |
| Preventive visit, new patient (age 18–39) (99385) |
$120 |
$171 |
— |
| Preventive visit, new patient (age 40–64) (99386) |
$169 |
$241 |
— |