| Breast lesion removal (open) (19120) |
$2,791.84 |
$5,583.66 |
0.7× |
| Shoulder arthroscopy with decompression (29826) |
$3,248.75 |
$6,497.50 |
— |
| Knee arthroscopy with meniscectomy (29881) |
$5,302.50 |
$10,605 |
1.7× |
| Tonsillectomy and adenoidectomy (under age 12) (42820) |
$5,865.25 |
$11,730.50 |
1.0× |
| Upper GI endoscopy (EGD), diagnostic (43235) |
$949 |
$1,898 |
1.1× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$1,336.50 |
$2,673 |
1.5× |
| Diagnostic colonoscopy (45378) |
$1,259 |
$2,518 |
1.4× |
| Colonoscopy with biopsy (45380) |
$1,117.17 |
$2,234.33 |
1.0× |
| Colonoscopy with lesion removal (45385) |
$1,614.34 |
$3,228.67 |
1.4× |
| Laparoscopic gallbladder removal (47562) |
$8,429.75 |
$16,859.50 |
1.4× |
| Inguinal hernia repair (age 5+) (49505) |
$8,450 |
$16,900 |
2.4× |
| Epidural injection, lumbar/sacral (with imaging) (62322) |
$1,138.50 |
$2,277 |
1.3× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$1,813 |
$3,626 |
2.1× |
| After-cataract laser surgery (YAG capsulotomy) (66821) |
$744.50 |
$1,489 |
1.4× |
| CT head/brain without contrast (70450) |
$814.50 |
$1,629 |
8.1× |
| MRI brain without contrast (70551) |
$1,478 |
$2,956 |
6.4× |
| MRI brain with contrast (70552) |
$1,768.25 |
$3,536.50 |
5.2× |
| MRI brain without and with contrast (70553) |
$1,964.75 |
$3,929.50 |
5.8× |
| X-ray lower spine, 4+ views (72110) |
$292.25 |
$584.50 |
2.9× |
| MRI lumbar spine without contrast (72148) |
$1,497.75 |
$2,995.50 |
6.5× |
| CT pelvis with contrast (72193) |
$1,097.25 |
$2,194.50 |
6.5× |
| MRI lower-extremity joint without contrast (73721) |
$1,576 |
$3,152 |
6.8× |
| CT abdomen and pelvis with contrast (74177) |
$1,657 |
$3,314 |
4.9× |
| Ultrasound, abdomen complete (76700) |
$624.75 |
$1,249.50 |
6.2× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$719 |
$1,438 |
7.1× |
| Ultrasound, transvaginal (76830) |
$520 |
$1,040 |
5.1× |
| Mammography, one breast (diagnostic) (77065) |
$295 |
$590 |
3.4× |
| Mammography, both breasts (diagnostic) (77066) |
$572 |
$1,144 |
5.2× |
| Mammography, screening (bilateral) (77067) |
$455 |
$910 |
5.0× |
| Basic metabolic panel (80048) |
$38 |
$76 |
4.5× |
| Comprehensive metabolic panel (80053) |
$48.25 |
$96.50 |
4.6× |
| Obstetric panel (80055) |
$215 |
$430 |
4.5× |
| Lipid panel (80061) |
$60.50 |
$121 |
4.5× |
| Renal function panel (80069) |
$39 |
$78 |
4.5× |
| Hepatic function panel (80076) |
$37 |
$74 |
4.5× |
| Urinalysis, non-automated, with microscopy (81000) |
$14.75 |
$29.50 |
3.7× |
| Urinalysis, non-automated, without microscopy (81002) |
$15 |
$30 |
4.3× |
| PSA, total (84153) |
$73 |
$146 |
4.0× |
| Thyroid stimulating hormone (TSH) (84443) |
$66.75 |
$133.50 |
4.0× |
| CBC with automated differential (85025) |
$50 |
$100 |
6.4× |
| CBC, automated (85027) |
$37 |
$74 |
5.7× |
| Prothrombin time (PT) (85610) |
$32 |
$64 |
7.5× |
| Partial thromboplastin time (PTT) (85730) |
$38 |
$76 |
6.3× |
| Sleep study (attended polysomnography) (95810) |
$2,973 |
$5,946 |
3.6× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$109.50 |
$219 |
3.8× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$72 |
$144 |
0.6× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$72.50 |
$145 |
0.6× |
| Preventive visit, new patient (age 18–39) (99385) |
$72.75 |
$145.50 |
— |
| Preventive visit, new patient (age 40–64) (99386) |
$38 |
$76 |
— |