| Shoulder arthroscopy with decompression (29826) |
$940 |
$940 |
— |
| Knee arthroscopy with meniscectomy (29881) |
$3,060 |
$3,060 |
0.8× |
| Upper GI endoscopy (EGD), diagnostic (43235) |
$3,288 |
$3,288 |
3.0× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$3,288 |
$3,288 |
3.0× |
| Diagnostic colonoscopy (45378) |
$3,225 |
$3,225 |
2.9× |
| Colonoscopy with biopsy (45380) |
$4,214 |
$4,214 |
2.9× |
| Colonoscopy with lesion removal (45385) |
$4,214 |
$4,214 |
2.9× |
| Epidural injection, lumbar/sacral (with imaging) (62322) |
$1,881 |
$1,881 |
1.8× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$3,375.62 |
$3,375.62 |
3.2× |
| MRI brain without contrast (70551) |
$1,486 |
$1,486 |
5.2× |
| X-ray lower spine, 4+ views (72110) |
$567 |
$567 |
4.5× |
| CT pelvis with contrast (72193) |
$2,192 |
$2,192 |
10.4× |
| MRI lower-extremity joint without contrast (73721) |
$1,619 |
$1,619 |
5.7× |
| Ultrasound, abdomen complete (76700) |
$378 |
$378 |
3.0× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$420 |
$420 |
3.4× |
| Ultrasound, transvaginal (76830) |
$413 |
$413 |
3.3× |
| Mammography, one breast (diagnostic) (77065) |
$407 |
$407 |
4.7× |
| Mammography, both breasts (diagnostic) (77066) |
$521 |
$521 |
4.7× |
| Mammography, screening (bilateral) (77067) |
$430 |
$430 |
4.7× |
| Basic metabolic panel (80048) |
$232 |
$232 |
27.4× |
| Comprehensive metabolic panel (80053) |
$418 |
$418 |
39.6× |
| Lipid panel (80061) |
$109 |
$109 |
8.1× |
| Renal function panel (80069) |
$290 |
$290 |
33.4× |
| Hepatic function panel (80076) |
$216 |
$216 |
26.4× |
| Thyroid stimulating hormone (TSH) (84443) |
$101 |
$101 |
6.0× |
| CBC with automated differential (85025) |
$47 |
$47 |
6.0× |
| CBC, automated (85027) |
$39 |
$39 |
6.0× |
| Prothrombin time (PT) (85610) |
$32.78 |
$32.78 |
7.6× |
| Partial thromboplastin time (PTT) (85730) |
$50.03 |
$50.03 |
8.3× |
| Psychotherapy, 30 minutes (90832) |
$260 |
$260 |
1.2× |
| Psychotherapy, 45 minutes (90834) |
$342.50 |
$342.50 |
1.6× |
| Psychotherapy, 60 minutes (90837) |
$505 |
$505 |
2.4× |
| Family psychotherapy, with patient (50 min) (90847) |
$385 |
$385 |
1.8× |
| Group psychotherapy (90853) |
$92.50 |
$92.50 |
0.8× |
| Sleep study (attended polysomnography) (95810) |
$5,288 |
$5,288 |
5.1× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$123.12 |
$123.12 |
4.2× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$205 |
$205 |
1.3× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$332.50 |
$332.50 |
2.1× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$450 |
$450 |
2.8× |
| Office consultation (moderate complexity, ~40 min) (99244) |
$492.50 |
$492.50 |
3.1× |
| Preventive visit, new patient (age 18–39) (99385) |
$280 |
$280 |
— |