| Breast lesion removal (open) (19120) |
$769.50 |
$1,026 |
0.2× |
| Shoulder arthroscopy with decompression (29826) |
$289.50 |
$386 |
— |
| Knee arthroscopy with meniscectomy (29881) |
$525 |
$700 |
0.2× |
Tonsillectomy and adenoidectomy (under age 12) (42820)
likely a partial charge, not the full procedure |
$416.25 |
$555 |
0.1× |
| Upper GI endoscopy (EGD), diagnostic (43235) |
$455.62 |
$607.50 |
0.6× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$470.25 |
$627 |
0.6× |
| Diagnostic colonoscopy (45378) |
$780 |
$1,040 |
0.9× |
| Colonoscopy with biopsy (45380) |
$780 |
$1,040 |
0.7× |
| Colonoscopy with lesion removal (45385) |
$780 |
$1,040 |
0.7× |
Laparoscopic gallbladder removal (47562)
likely a partial charge, not the full procedure |
$1,131 |
$1,508 |
0.2× |
| Inguinal hernia repair (age 5+) (49505) |
$1,782 |
$2,376 |
0.5× |
Laparoscopic radical prostatectomy (55866)
likely a partial charge, not the full procedure |
$2,252.25 |
$3,003 |
0.2× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$1,071.38 |
$1,428.50 |
1.3× |
| CT head/brain without contrast (70450) |
$281.25 |
$375 |
3.0× |
| MRI brain without contrast (70551) |
$472.50 |
$630 |
2.2× |
| MRI brain with contrast (70552) |
$772.50 |
$1,030 |
2.4× |
| MRI brain without and with contrast (70553) |
$810 |
$1,080 |
2.5× |
| X-ray lower spine, 4+ views (72110) |
$182.25 |
$243 |
1.9× |
| MRI lumbar spine without contrast (72148) |
$472.50 |
$630 |
2.2× |
| CT pelvis with contrast (72193) |
$351 |
$468 |
2.2× |
| MRI lower-extremity joint without contrast (73721) |
$472.50 |
$630 |
2.2× |
| CT abdomen and pelvis with contrast (74177) |
$720.75 |
$961 |
2.3× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$217.50 |
$290 |
2.3× |
| Ultrasound, transvaginal (76830) |
$180 |
$240 |
1.9× |
| Mammography, one breast (diagnostic) (77065) |
$243.75 |
$325 |
2.8× |
| Mammography, both breasts (diagnostic) (77066) |
$315 |
$420 |
2.8× |
| Mammography, screening (bilateral) (77067) |
$247.50 |
$330 |
2.7× |
| Basic metabolic panel (80048) |
$189.75 |
$253 |
22.4× |
| Comprehensive metabolic panel (80053) |
$244.50 |
$326 |
23.2× |
| Lipid panel (80061) |
$138.75 |
$185 |
10.4× |
| Renal function panel (80069) |
$122.25 |
$163 |
14.1× |
| Hepatic function panel (80076) |
$78.38 |
$104.50 |
9.6× |
| Urinalysis, non-automated, with microscopy (81000) |
$11.25 |
$15 |
2.8× |
| Urinalysis, non-automated, without microscopy (81002) |
$5.25 |
$7 |
1.5× |
| PSA, total (84153) |
$57.75 |
$77 |
3.1× |
| Thyroid stimulating hormone (TSH) (84443) |
$84 |
$112 |
5.0× |
| CBC with automated differential (85025) |
$52.50 |
$70 |
6.8× |
| Prothrombin time (PT) (85610) |
$37.50 |
$50 |
8.7× |
| Partial thromboplastin time (PTT) (85730) |
$46.12 |
$61.50 |
7.7× |
| Psychotherapy, 30 minutes (90832) |
$141 |
$188 |
0.9× |
| Psychotherapy, 45 minutes (90834) |
$196.50 |
$262 |
1.2× |
| Psychotherapy, 60 minutes (90837) |
$297 |
$396 |
1.8× |
| Family psychotherapy, without patient (50 min) (90846) |
$268.50 |
$358 |
1.7× |
| Family psychotherapy, with patient (50 min) (90847) |
$268.50 |
$358 |
1.7× |
| Group psychotherapy (90853) |
$144 |
$192 |
1.6× |
| Electrocardiogram (ECG), complete (93000) |
$131.25 |
$175 |
2.4× |
| Left heart catheterization (93452) |
$5,726.25 |
$7,635 |
1.9× |
| Sleep study (attended polysomnography) (95810) |
$1,783.50 |
$2,378 |
2.3× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$82.50 |
$110 |
2.8× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$155.25 |
$207 |
1.3× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$224.25 |
$299 |
1.8× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$303 |
$404 |
2.5× |
| Office consultation (low complexity, ~30 min) (99243) |
$164.25 |
$219 |
1.4× |
| Office consultation (moderate complexity, ~40 min) (99244) |
$245.25 |
$327 |
2.0× |