| Shoulder arthroscopy with decompression (29826) |
$6,868 |
$10,100 |
— |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$2,011.44 |
$2,958 |
2.1× |
| Colonoscopy with biopsy (45380) |
$2,444.60 |
$3,595 |
2.0× |
| Colonoscopy with lesion removal (45385) |
$2,426.24 |
$3,568 |
2.0× |
| Laparoscopic gallbladder removal (47562) |
$10,416.24 |
$15,318 |
1.7× |
| Epidural injection, lumbar/sacral (with imaging) (62322) |
$1,897.20 |
$2,790 |
2.1× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$1,514.36 |
$2,227 |
1.7× |
| Cataract removal with lens insertion (66984) |
$4,165.68 |
$6,126 |
1.7× |
| CT head/brain without contrast (70450) |
$772.18 |
$1,135.56 |
7.2× |
| MRI brain without contrast (70551) |
$1,280.44 |
$1,883 |
5.2× |
| MRI brain with contrast (70552) |
$1,306.48 |
$1,921.28 |
3.6× |
| MRI brain without and with contrast (70553) |
$1,709.54 |
$2,514.02 |
4.7× |
| X-ray lower spine, 4+ views (72110) |
$227.67 |
$334.80 |
2.1× |
| MRI lumbar spine without contrast (72148) |
$1,278.22 |
$1,879.72 |
5.2× |
| CT pelvis with contrast (72193) |
$1,160.06 |
$1,705.96 |
6.4× |
| MRI lower-extremity joint without contrast (73721) |
$1,284.82 |
$1,889.44 |
5.2× |
| CT abdomen and pelvis with contrast (74177) |
$2,030.20 |
$2,985.58 |
5.6× |
| Ultrasound, abdomen complete (76700) |
$448.44 |
$659.46 |
4.2× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$375.40 |
$552.06 |
3.5× |
| Ultrasound, transvaginal (76830) |
$434.32 |
$638.70 |
4.0× |
| Mammography, one breast (diagnostic) (77065) |
$747.32 |
$1,099 |
8.7× |
| Mammography, both breasts (diagnostic) (77066) |
$924.80 |
$1,360 |
8.4× |
| Mammography, screening (bilateral) (77067) |
$447.44 |
$658 |
4.9× |
| Basic metabolic panel (80048) |
$9.52 |
$14 |
1.1× |
| Comprehensive metabolic panel (80053) |
$16.32 |
$24 |
1.5× |
| Lipid panel (80061) |
$19.72 |
$29 |
1.5× |
| Renal function panel (80069) |
$16.32 |
$24 |
1.9× |
| Hepatic function panel (80076) |
$16.32 |
$24 |
2.0× |
| Urinalysis, non-automated, without microscopy (81002) |
$38.08 |
$56 |
10.9× |
| PSA, total (84153) |
$16.32 |
$24 |
0.9× |
| Thyroid stimulating hormone (TSH) (84443) |
$17.68 |
$26 |
1.1× |
| CBC with automated differential (85025) |
$13.60 |
$20 |
1.8× |
| CBC, automated (85027) |
$12.92 |
$19 |
2.0× |
| Prothrombin time (PT) (85610) |
$12.92 |
$19 |
3.0× |
| Partial thromboplastin time (PTT) (85730) |
$14.96 |
$22 |
2.5× |
| Psychotherapy, 30 minutes (90832) |
$35.36 |
$52 |
0.2× |
| Psychotherapy, 45 minutes (90834) |
$43.52 |
$64 |
0.2× |
| Psychotherapy, 60 minutes (90837) |
$53.04 |
$78 |
0.3× |
| Family psychotherapy, without patient (50 min) (90846) |
$35.36 |
$52 |
0.2× |
| Family psychotherapy, with patient (50 min) (90847) |
$35.36 |
$52 |
0.2× |
| Group psychotherapy (90853) |
$13.60 |
$20 |
0.1× |
| Sleep study (attended polysomnography) (95810) |
$2,774.40 |
$4,080 |
3.1× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$104.72 |
$154 |
3.6× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$216.92 |
$319 |
1.6× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$280.84 |
$413 |
2.0× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$375.36 |
$552 |
2.7× |
| Preventive visit, new patient (age 18–39) (99385) |
$51.68 |
$76 |
— |
| Preventive visit, new patient (age 40–64) (99386) |
$59.84 |
$88 |
— |