Pricing Transparency
Billed
  CPT Code
Billed CPT Name Self Pay Rate
43239 UPPER GI DIAGNOSTIC
  WITH BIOPSY, SINGLE OR MULTIPLE
$1,527.45
64493 JOINT INJECTION
  MIDDLE OR LOW SPINE-SINGLE LEVEL
$1,131.35
64483 INJECTION EPIDURAL
  MIDDLE OR LOW SPINE
$1,131.35
91035 ESOPHAGUS REFLUX TEST
  WITH ELECTRODE PLACEMENT AND RECORDING
$1,401.31
45385 COLONOSCOPY WITH
  LESION REMOVAL BY SNARE
$1,234.20
64494 JOINT INJECTION
  MIDDLE OR LOW SPINE-2ND LEVEL
$1,131.35
29823 SHOULDER
  ARTHROSCOPY/SURGERY, WITH REMOVAL OF DAMAGED TISSUE OR FOREIGN OBJECT,
  EXTENSIVE
$4,190.84
64635 DESTRUCTION BY
  NEUROLYTIC AGENT, INTERCOSTAL NERVE
$1,131.35
45378 DIAGNOSTIC
  COLONOSCOPY
$1,234.20
45380 COLONOSCOPY AND
  BIOPSY
$1,234.20
64490 JOINT INJECTION NECK
  OR UPPER SPINE-SINGLE LEVEL
$1,131.35
28285 REPAIR OF HAMMERTOE $2,202.18
64484 CATARACT SURGERY WITH
  LENS
$1,131.35
29880 KNEE SURGERY CRUCIATE
  LIGAMENT REPAIR
$4,190.84
G0121 COLONOSCOPY - NOT
  HIGH RISK PERSON
$1,234.20
G0260 INJECTION FOR
  SACROILIAC (SI) JOINT
$1,131.35
64636 DESTROY MIDDLE/LOWER
  SPINE JOINT NERVES-ADDITIONAL JOINTS
$1,131.35
49650 REPAIR INGUINAL
  HERNIA-LAPARASCOPIC
$3,574.76
23412 REPAIR ROTATOR CUFF
  CHRONIC
$3,206.37
64491 JOINT INJECTION NECK
  OR UPPER SPINE-2ND LEVEL
$1,131.35
G0105 COLONOSCOPY FOR HIGH
  RISK PERSON
$1,234.20
49505 REPAIR INGUINAL
  HERNIA OVER 5 YRS OLD
$2,584.17
66984 CATARACT SURGERY WITH
  LENS
$1,689.63
29881 KNEE SURGERY WITH
  MENISCUS REPAIR/REMOVAL
$4,190.84
62323 INJECTION OF
  DIAGNOSTIC OR THERAPEUTIC SUBSTANCES WITH IMAGING GUIDANCE
$1,234.20