| Breast lesion removal (open) (19120) |
$1,493.60 |
$1,867 |
0.3× |
| Shoulder arthroscopy with decompression (29826) |
$644 |
$805 |
— |
| Knee arthroscopy with meniscectomy (29881) |
$2,019.20 |
$2,524 |
0.6× |
Tonsillectomy and adenoidectomy (under age 12) (42820)
likely a partial charge, not the full procedure |
$1,066.40 |
$1,333 |
0.2× |
| Upper GI endoscopy (EGD), diagnostic (43235) |
$898 |
$1,122.50 |
0.9× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$516.80 |
$646 |
0.5× |
| Diagnostic colonoscopy (45378) |
$690.40 |
$863 |
0.7× |
| Colonoscopy with biopsy (45380) |
$748.80 |
$936 |
0.6× |
| Colonoscopy with lesion removal (45385) |
$949.60 |
$1,187 |
0.7× |
Laparoscopic gallbladder removal (47562)
unusually low: confirm this is the full procedure |
$2,372.80 |
$2,966 |
0.4× |
| Inguinal hernia repair (age 5+) (49505) |
$1,938.40 |
$2,423 |
0.5× |
| Obstetric care, vaginal delivery (global) (59400) |
$7,793.60 |
$9,742 |
— |
| Obstetric care, cesarean delivery (global) (59510) |
$8,640 |
$10,800 |
— |
| Obstetric care, VBAC delivery (global) (59610) |
$8,347.20 |
$10,434 |
— |
| Epidural injection, lumbar/sacral (with imaging) (62322) |
$448 |
$560 |
0.5× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$385.60 |
$482 |
0.4× |
| CT head/brain without contrast (70450) |
$1,379.20 |
$1,724 |
11.8× |
| MRI brain without contrast (70551) |
$2,528.80 |
$3,161 |
9.5× |
| MRI brain with contrast (70552) |
$3,115.20 |
$3,894 |
8.0× |
| MRI brain without and with contrast (70553) |
$3,472 |
$4,340 |
8.9× |
| X-ray lower spine, 4+ views (72110) |
$314.40 |
$393 |
2.7× |
| MRI lumbar spine without contrast (72148) |
$2,059.20 |
$2,574 |
7.7× |
| CT pelvis with contrast (72193) |
$1,752 |
$2,190 |
9.0× |
| MRI lower-extremity joint without contrast (73721) |
$1,655.20 |
$2,069 |
6.2× |
| CT abdomen and pelvis with contrast (74177) |
$1,988 |
$2,485 |
5.1× |
| Ultrasound, abdomen complete (76700) |
$726.40 |
$908 |
6.2× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$726.40 |
$908 |
6.2× |
| Ultrasound, transvaginal (76830) |
$671.20 |
$839 |
5.8× |
| Mammography, one breast (diagnostic) (77065) |
$441.60 |
$552 |
5.1× |
| Mammography, both breasts (diagnostic) (77066) |
$552 |
$690 |
5.0× |
| Mammography, screening (bilateral) (77067) |
$384 |
$480 |
4.2× |
| Basic metabolic panel (80048) |
$67.20 |
$84 |
7.9× |
| Comprehensive metabolic panel (80053) |
$74.40 |
$93 |
7.0× |
| Lipid panel (80061) |
$72.80 |
$91 |
5.4× |
| Renal function panel (80069) |
$69.60 |
$87 |
8.0× |
| Hepatic function panel (80076) |
$65.60 |
$82 |
8.0× |
| Urinalysis, non-automated, without microscopy (81002) |
$17.60 |
$22 |
5.1× |
| PSA, total (84153) |
$80 |
$100 |
4.4× |
| Thyroid stimulating hormone (TSH) (84443) |
$64 |
$80 |
3.8× |
| CBC with automated differential (85025) |
$61.60 |
$77 |
7.9× |
| CBC, automated (85027) |
$52 |
$65 |
8.0× |
| Prothrombin time (PT) (85610) |
$32 |
$40 |
7.5× |
| Partial thromboplastin time (PTT) (85730) |
$103.20 |
$129 |
17.2× |
| Psychotherapy, 30 minutes (90832) |
$128 |
$160 |
0.6× |
| Psychotherapy, 45 minutes (90834) |
$168.80 |
$211 |
0.9× |
| Psychotherapy, 60 minutes (90837) |
$252.80 |
$316 |
1.3× |
| Electrocardiogram (ECG), complete (93000) |
$47.20 |
$59 |
0.7× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$136.80 |
$171 |
4.7× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$174.40 |
$218 |
1.2× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$296 |
$370 |
2.0× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$384 |
$480 |
2.6× |
| Office consultation (low complexity, ~30 min) (99243) |
$184 |
$230 |
1.2× |
| Office consultation (moderate complexity, ~40 min) (99244) |
$295.20 |
$369 |
2.0× |
| Preventive visit, new patient (age 18–39) (99385) |
$209.60 |
$262 |
— |
| Preventive visit, new patient (age 40–64) (99386) |
$254.40 |
$318 |
— |