| Breast lesion removal (open) (19120) |
— |
$29,011.50 |
— |
Shoulder arthroscopy with decompression (29826)
range across 2 matching MRF lines |
— |
$83,740.07–$87,264.45 |
— |
Knee arthroscopy with meniscectomy (29881)
range across 3 matching MRF lines |
— |
$37,559.11–$40,340.75 |
— |
| Upper GI endoscopy (EGD), diagnostic (43235) |
— |
$12,828.89 |
— |
| Upper GI endoscopy (EGD) with biopsy (43239) |
— |
$9,344.97 |
— |
| Diagnostic colonoscopy (45378) |
— |
$9,226.10 |
— |
| Colonoscopy with biopsy (45380) |
— |
$9,411.65 |
— |
| Colonoscopy with lesion removal (45385) |
— |
$9,293.15 |
— |
| Laparoscopic gallbladder removal (47562) |
— |
$52,617.72 |
— |
Inguinal hernia repair (age 5+) (49505)
range across 4 matching MRF lines |
— |
$45,745.94–$56,569 |
— |
| Obstetric care, vaginal delivery (global) (59400) |
— |
$34,903.95 |
— |
| Obstetric care, cesarean delivery (global) (59510) |
— |
$63,681.50 |
— |
| Obstetric care, VBAC delivery (global) (59610) |
— |
$34,903.95 |
— |
| CT head/brain without contrast (70450) |
— |
$3,336.50 |
— |
| MRI brain without contrast (70551) |
— |
$3,764 |
— |
| MRI brain with contrast (70552) |
— |
$4,156.50 |
— |
| MRI brain without and with contrast (70553) |
— |
$5,760.50 |
— |
| X-ray lower spine, 4+ views (72110) |
— |
$1,050.50 |
— |
| MRI lumbar spine without contrast (72148) |
— |
$5,071 |
— |
| CT pelvis with contrast (72193) |
— |
$2,447 |
— |
| CT abdomen and pelvis with contrast (74177) |
— |
$5,119 |
— |
| Ultrasound, abdomen complete (76700) |
— |
$2,134.50 |
— |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
— |
$1,876.50 |
— |
| Ultrasound, transvaginal (76830) |
— |
$839 |
— |
| Mammography, both breasts (diagnostic) (77066) |
— |
$1,148.50 |
— |
| Mammography, screening (bilateral) (77067) |
— |
$631 |
— |
| Basic metabolic panel (80048) |
— |
$148 |
— |
| Comprehensive metabolic panel (80053) |
— |
$208.50 |
— |
| Obstetric panel (80055) |
— |
$402.50 |
— |
| Lipid panel (80061) |
— |
$287 |
— |
| Renal function panel (80069) |
— |
$194.50 |
— |
| Hepatic function panel (80076) |
— |
$127 |
— |
| Urinalysis, non-automated, without microscopy (81002) |
— |
$90 |
— |
| PSA, total (84153) |
— |
$458 |
— |
| Thyroid stimulating hormone (TSH) (84443) |
— |
$328.50 |
— |
| CBC with automated differential (85025) |
— |
$179.50 |
— |
| CBC, automated (85027) |
— |
$132.50 |
— |
| Prothrombin time (PT) (85610) |
— |
$87 |
— |
| Partial thromboplastin time (PTT) (85730) |
— |
$170 |
— |
| Sleep study (attended polysomnography) (95810) |
— |
$5,498.50 |
— |
| Office visit, new patient (low complexity, ~30 min) (99203) |
— |
$653 |
— |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
— |
$1,011.50 |
— |
| Office visit, new patient (high complexity, ~60 min) (99205) |
— |
$1,090 |
— |