| Breast lesion removal (open) (19120) |
$1,500 |
$1,500 |
0.3× |
| Shoulder arthroscopy with decompression (29826) |
$3,395 |
$3,395 |
— |
| Knee arthroscopy with meniscectomy (29881) |
$4,200 |
$4,200 |
1.2× |
| Upper GI endoscopy (EGD), diagnostic (43235) |
$134 |
$134 |
0.1× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$151 |
$151 |
0.1× |
| Diagnostic colonoscopy (45378) |
$135.35 |
$135.35 |
0.1× |
| Colonoscopy with biopsy (45380) |
$508.65 |
$508.65 |
0.4× |
| Colonoscopy with lesion removal (45385) |
$277 |
$277 |
0.2× |
Laparoscopic gallbladder removal (47562)
likely a partial charge, not the full procedure |
$725 |
$725 |
0.1× |
| Inguinal hernia repair (age 5+) (49505) |
$1,600 |
$1,600 |
0.4× |
Laparoscopic radical prostatectomy (55866)
likely a partial charge, not the full procedure |
$2,864 |
$2,864 |
0.2× |
| Obstetric care, vaginal delivery (global) (59400) |
$5,756 |
$5,756 |
— |
| Obstetric care, cesarean delivery (global) (59510) |
$8,685.50 |
$8,685.50 |
— |
| Obstetric care, VBAC delivery (global) (59610) |
$5,566 |
$5,566 |
— |
| CT head/brain without contrast (70450) |
$1,923 |
$1,923 |
16.5× |
| MRI brain without contrast (70551) |
$1,885 |
$1,885 |
7.1× |
| MRI brain with contrast (70552) |
$3,266 |
$3,266 |
8.4× |
| MRI brain without and with contrast (70553) |
$4,195 |
$4,195 |
10.8× |
| X-ray lower spine, 4+ views (72110) |
$620 |
$620 |
5.3× |
| MRI lumbar spine without contrast (72148) |
$2,284 |
$2,284 |
8.6× |
| CT pelvis with contrast (72193) |
$2,051 |
$2,051 |
10.5× |
| MRI lower-extremity joint without contrast (73721) |
$2,394 |
$2,394 |
9.0× |
| CT abdomen and pelvis with contrast (74177) |
$5,029 |
$5,029 |
12.9× |
| Ultrasound, abdomen complete (76700) |
$620 |
$620 |
5.3× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$620 |
$620 |
5.3× |
| Ultrasound, transvaginal (76830) |
$620 |
$620 |
5.3× |
| Mammography, one breast (diagnostic) (77065) |
$541 |
$541 |
6.3× |
| Mammography, both breasts (diagnostic) (77066) |
$704 |
$704 |
6.4× |
| Mammography, screening (bilateral) (77067) |
$451 |
$451 |
4.9× |
| Basic metabolic panel (80048) |
$174 |
$174 |
20.6× |
| Comprehensive metabolic panel (80053) |
$105 |
$105 |
9.9× |
| Obstetric panel (80055) |
$265 |
$265 |
5.5× |
| Lipid panel (80061) |
$125 |
$125 |
9.3× |
| Renal function panel (80069) |
$83 |
$83 |
9.6× |
| Hepatic function panel (80076) |
$74 |
$74 |
9.1× |
| Urinalysis, non-automated, without microscopy (81002) |
$53 |
$53 |
15.2× |
| PSA, total (84153) |
$154 |
$154 |
8.4× |
| Thyroid stimulating hormone (TSH) (84443) |
$129 |
$129 |
7.7× |
| CBC with automated differential (85025) |
$61 |
$61 |
7.9× |
| CBC, automated (85027) |
$53 |
$53 |
8.2× |
| Prothrombin time (PT) (85610) |
$59 |
$59 |
13.8× |
| Partial thromboplastin time (PTT) (85730) |
$122 |
$122 |
20.3× |
| Psychotherapy, 30 minutes (90832) |
$263 |
$263 |
1.3× |
| Psychotherapy, 45 minutes (90834) |
$419.50 |
$419.50 |
2.1× |
| Psychotherapy, 60 minutes (90837) |
$512 |
$512 |
2.6× |
| Family psychotherapy, without patient (50 min) (90846) |
$321 |
$321 |
1.6× |
| Family psychotherapy, with patient (50 min) (90847) |
$334 |
$334 |
1.7× |
| Group psychotherapy (90853) |
$124 |
$124 |
1.1× |
| Electrocardiogram (ECG), complete (93000) |
$220 |
$220 |
3.3× |
| Sleep study (attended polysomnography) (95810) |
$5,265 |
$5,265 |
5.5× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$152 |
$152 |
5.2× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$330 |
$330 |
2.2× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$510 |
$510 |
3.4× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$605 |
$605 |
4.1× |
| Office consultation (low complexity, ~30 min) (99243) |
$285 |
$285 |
1.9× |
| Office consultation (moderate complexity, ~40 min) (99244) |
$404 |
$404 |
2.7× |
| Preventive visit, new patient (age 18–39) (99385) |
$301 |
$301 |
— |
| Preventive visit, new patient (age 40–64) (99386) |
$350 |
$350 |
— |