| Breast lesion removal (open) (19120) |
$5,383.86 |
$3,528 |
1.4× |
| Shoulder arthroscopy with decompression (29826) |
$220.61 |
— |
— |
| Knee arthroscopy with meniscectomy (29881) |
$4,499.12 |
— |
1.4× |
| Tonsillectomy and adenoidectomy (under age 12) (42820) |
$8,139.99 |
— |
1.4× |
| Upper GI endoscopy (EGD), diagnostic (43235) |
$1,247.13 |
$2,148 |
1.4× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$1,247.13 |
$2,016 |
1.4× |
| Diagnostic colonoscopy (45378) |
$1,278.72 |
$1,756 |
1.4× |
| Colonoscopy with biopsy (45380) |
$1,645.43 |
$2,184 |
1.4× |
| Colonoscopy with lesion removal (45385) |
$1,645.43 |
$2,204 |
1.4× |
| Colonoscopy with endoscopic ultrasound (45391) |
$1,645.43 |
$2,446 |
1.4× |
| Laparoscopic gallbladder removal (47562) |
$8,312.83 |
— |
1.4× |
| Inguinal hernia repair (age 5+) (49505) |
$4,923.19 |
— |
1.4× |
| Laparoscopic radical prostatectomy (55866) |
$14,616.42 |
— |
1.4× |
| Obstetric care, vaginal delivery (global) (59400) |
$3,358.99 |
— |
— |
| Obstetric care, cesarean delivery (global) (59510) |
$3,792.01 |
— |
— |
| Obstetric care, VBAC delivery (global) (59610) |
$3,579.68 |
— |
— |
| Epidural injection, lumbar/sacral (with imaging) (62322) |
$1,216.18 |
$1,143 |
1.4× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$1,216.18 |
$991 |
1.4× |
| After-cataract laser surgery (YAG capsulotomy) (66821) |
$756.27 |
$1,107 |
1.4× |
| Cataract removal with lens insertion (66984) |
$3,173.34 |
— |
1.4× |
| CT head/brain without contrast (70450) |
$143.75 |
$1,327 |
1.4× |
| MRI brain without contrast (70551) |
$328.08 |
$2,953 |
1.4× |
| MRI brain with contrast (70552) |
$479.72 |
$4,369 |
1.4× |
| MRI brain without and with contrast (70553) |
$479.72 |
$4,982 |
1.4× |
X-ray lower spine, 4+ views (72110)
range across 2 matching MRF lines |
$143.75 |
$348–$398 |
1.4× |
| MRI lumbar spine without contrast (72148) |
$328.08 |
$2,834 |
1.4× |
| CT pelvis with contrast (72193) |
$241.18 |
$2,278 |
1.4× |
| MRI lower-extremity joint without contrast (73721) |
$328.08 |
$2,940 |
1.4× |
| CT abdomen and pelvis with contrast (74177) |
$479.72 |
$3,981 |
1.4× |
Ultrasound, abdomen complete (76700)
range across 2 matching MRF lines |
$143.75 |
$783–$833 |
1.4× |
Ultrasound, pregnant uterus (≥14 weeks) (76805)
range across 2 matching MRF lines |
$143.75 |
$827–$877 |
1.4× |
| Ultrasound, transvaginal (76830) |
$143.75 |
$739 |
1.4× |
| Mammography, one breast (diagnostic) (77065) |
$115.09 |
$410 |
1.3× |
| Mammography, both breasts (diagnostic) (77066) |
$147.89 |
$469 |
1.3× |
Mammography, screening (bilateral) (77067)
range across 2 matching MRF lines |
$121.76 |
$374–$393 |
1.3× |
| Basic metabolic panel (80048) |
$11.67 |
$56 |
1.4× |
| Comprehensive metabolic panel (80053) |
$14.57 |
$69 |
1.4× |
| Obstetric panel (80055) |
$65.98 |
— |
1.4× |
| Lipid panel (80061) |
$18.48 |
$81 |
1.4× |
| Renal function panel (80069) |
$11.98 |
$57 |
1.4× |
| Hepatic function panel (80076) |
$11.27 |
$54 |
1.4× |
| Urinalysis, non-automated, with microscopy (81000) |
$5.55 |
— |
1.4× |
| Urinalysis, non-automated, without microscopy (81002) |
$4.80 |
$18 |
1.4× |
| PSA, total (84153) |
$25.38 |
$124 |
1.4× |
| Thyroid stimulating hormone (TSH) (84443) |
$23.18 |
$113 |
1.4× |
| CBC with automated differential (85025) |
$10.72 |
$52 |
1.4× |
| CBC, automated (85027) |
$8.93 |
$43 |
1.4× |
| Prothrombin time (PT) (85610) |
$5.92 |
$25 |
1.4× |
| Partial thromboplastin time (PTT) (85730) |
$8.29 |
$57 |
1.4× |
Psychotherapy, 30 minutes (90832)
range across 3 matching MRF lines |
$244.07 |
$44–$112 |
1.4× |
| Psychotherapy, 45 minutes (90834) |
$244.07 |
$60 |
1.4× |
| Psychotherapy, 60 minutes (90837) |
$244.07 |
$126 |
1.4× |
| Family psychotherapy, without patient (50 min) (90846) |
$244.07 |
— |
1.4× |
| Family psychotherapy, with patient (50 min) (90847) |
$244.07 |
$85 |
1.4× |
| Group psychotherapy (90853) |
$139.68 |
— |
1.4× |
| Electrocardiogram (ECG), complete (93000) |
$21.40 |
— |
0.4× |
| Left heart catheterization (93452) |
$4,457.77 |
$6,388 |
1.4× |
| Sleep study (attended polysomnography) (95810) |
$1,180.80 |
$3,173 |
1.4× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$39.76 |
$118 |
1.4× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$103.09 |
$105 |
0.8× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$167.85 |
$135 |
1.3× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$231.11 |
$165 |
1.7× |