| Breast lesion removal (open) (19120) |
$4,716.75 |
$9,433.50 |
1.2× |
| Shoulder arthroscopy with decompression (29826) |
$7,016.88 |
$14,033.75 |
— |
| Knee arthroscopy with meniscectomy (29881) |
$5,236.25 |
$10,472.50 |
1.7× |
| Tonsillectomy and adenoidectomy (under age 12) (42820) |
$6,376.50 |
$12,753 |
1.1× |
| Upper GI endoscopy (EGD), diagnostic (43235) |
$1,260.50 |
$2,521 |
1.4× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$1,032 |
$2,064 |
1.2× |
| Diagnostic colonoscopy (45378) |
$744 |
$1,488 |
0.8× |
| Colonoscopy with biopsy (45380) |
$794.67 |
$1,589.33 |
0.7× |
| Colonoscopy with lesion removal (45385) |
$1,384 |
$2,768 |
1.2× |
| Colonoscopy with endoscopic ultrasound (45391) |
$1,285.34 |
$2,570.67 |
1.1× |
| Laparoscopic gallbladder removal (47562) |
$20,600.75 |
$41,201.50 |
3.5× |
| Inguinal hernia repair (age 5+) (49505) |
$6,791.88 |
$13,583.76 |
2.0× |
| Laparoscopic radical prostatectomy (55866) |
$21,877 |
$43,754 |
2.1× |
| Obstetric care, vaginal delivery (global) (59400) |
$5,700 |
$11,400 |
— |
| Obstetric care, VBAC delivery (global) (59610) |
$6,086 |
$12,172 |
— |
| Epidural injection, lumbar/sacral (with imaging) (62322) |
$1,374.25 |
$2,748.50 |
1.6× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$1,803 |
$3,606 |
2.1× |
| After-cataract laser surgery (YAG capsulotomy) (66821) |
$750.66 |
$1,501.33 |
1.4× |
| Cataract removal with lens insertion (66984) |
$2,923.84 |
$5,847.66 |
1.3× |
| CT head/brain without contrast (70450) |
$1,019.50 |
$2,039 |
10.1× |
| MRI brain without contrast (70551) |
$1,390.25 |
$2,780.50 |
6.0× |
| MRI brain with contrast (70552) |
$1,532 |
$3,064 |
4.5× |
| MRI brain without and with contrast (70553) |
$1,893 |
$3,786 |
5.6× |
| X-ray lower spine, 4+ views (72110) |
$285.50 |
$571 |
2.8× |
| MRI lumbar spine without contrast (72148) |
$1,012.75 |
$2,025.50 |
4.4× |
| CT pelvis with contrast (72193) |
$1,519.50 |
$3,039 |
9.0× |
| MRI lower-extremity joint without contrast (73721) |
$934.50 |
$1,869 |
4.0× |
| CT abdomen and pelvis with contrast (74177) |
$1,519.50 |
$3,039 |
4.5× |
| Ultrasound, abdomen complete (76700) |
$437.50 |
$875 |
4.3× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$379.75 |
$759.50 |
3.8× |
| Ultrasound, transvaginal (76830) |
$436 |
$872 |
4.3× |
| Mammography, one breast (diagnostic) (77065) |
$247.50 |
$495 |
2.9× |
| Mammography, both breasts (diagnostic) (77066) |
$304 |
$608 |
2.7× |
| Mammography, screening (bilateral) (77067) |
$220.50 |
$441 |
2.4× |
| Basic metabolic panel (80048) |
$39 |
$78 |
4.6× |
| Comprehensive metabolic panel (80053) |
$38.75 |
$77.50 |
3.7× |
| Obstetric panel (80055) |
$9 |
$18 |
0.2× |
| Lipid panel (80061) |
$65 |
$130 |
4.9× |
| Renal function panel (80069) |
$31.75 |
$63.50 |
3.7× |
| Hepatic function panel (80076) |
$31.50 |
$63 |
3.9× |
| Urinalysis, non-automated, with microscopy (81000) |
$16.75 |
$33.50 |
4.2× |
| Urinalysis, non-automated, without microscopy (81002) |
$13 |
$26 |
3.7× |
| PSA, total (84153) |
$55.50 |
$111 |
3.0× |
| Thyroid stimulating hormone (TSH) (84443) |
$60.50 |
$121 |
3.6× |
| CBC with automated differential (85025) |
$57.50 |
$115 |
7.4× |
| CBC, automated (85027) |
$43.25 |
$86.50 |
6.7× |
| Prothrombin time (PT) (85610) |
$42.50 |
$85 |
9.9× |
| Partial thromboplastin time (PTT) (85730) |
$51 |
$102 |
8.5× |
| Family psychotherapy, without patient (50 min) (90846) |
$305 |
$610 |
1.8× |
| Family psychotherapy, with patient (50 min) (90847) |
$305.50 |
$611 |
1.8× |
| Left heart catheterization (93452) |
$7,464.50 |
$14,929 |
2.4× |
| Sleep study (attended polysomnography) (95810) |
$3,481.50 |
$6,963 |
4.2× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$98.50 |
$197 |
3.4× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$66 |
$132 |
0.5× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$67.25 |
$134.50 |
0.5× |
| Office consultation (low complexity, ~30 min) (99243) |
$88.25 |
$176.50 |
0.7× |
| Office consultation (moderate complexity, ~40 min) (99244) |
$170.75 |
$341.50 |
1.3× |
| Preventive visit, new patient (age 18–39) (99385) |
$85 |
$170 |
— |
| Preventive visit, new patient (age 40–64) (99386) |
$108.50 |
$217 |
— |