| Upper GI endoscopy (EGD), diagnostic (43235) |
$1,925.60 |
$4,814 |
2.3× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$1,977.20 |
$4,943 |
2.3× |
| Inguinal hernia repair (age 5+) (49505) |
$5,961.60 |
$14,904 |
1.8× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$3,146 |
$7,865 |
3.8× |
| CT head/brain without contrast (70450) |
$2,160 |
$5,400 |
22.2× |
| MRI brain without contrast (70551) |
$3,620 |
$9,050 |
16.3× |
| MRI brain with contrast (70552) |
$3,652 |
$9,130 |
11.3× |
| MRI brain without and with contrast (70553) |
$5,346 |
$13,365 |
16.5× |
| X-ray lower spine, 4+ views (72110) |
$718 |
$1,795 |
7.4× |
| MRI lumbar spine without contrast (72148) |
$3,634.80 |
$9,087 |
16.4× |
| CT pelvis with contrast (72193) |
$2,874.40 |
$7,186 |
17.6× |
| MRI lower-extremity joint without contrast (73721) |
$3,630.40 |
$9,076 |
16.4× |
| CT abdomen and pelvis with contrast (74177) |
$5,456.40 |
$13,641 |
16.8× |
| Ultrasound, abdomen complete (76700) |
$1,285.20 |
$3,213 |
13.2× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$988.40 |
$2,471 |
10.2× |
| Ultrasound, transvaginal (76830) |
$675.60 |
$1,689 |
6.9× |
| Mammography, one breast (diagnostic) (77065) |
$302.40 |
$756 |
3.5× |
| Mammography, both breasts (diagnostic) (77066) |
$458 |
$1,145 |
4.1× |
| Mammography, screening (bilateral) (77067) |
$394.40 |
$986 |
4.3× |
| Basic metabolic panel (80048) |
$47.60 |
$119 |
5.6× |
| Comprehensive metabolic panel (80053) |
$49.60 |
$124 |
4.7× |
| Lipid panel (80061) |
$28 |
$70 |
2.1× |
| Renal function panel (80069) |
$75.60 |
$189 |
8.7× |
| Hepatic function panel (80076) |
$58.80 |
$147 |
7.2× |
| Urinalysis, non-automated, with microscopy (81000) |
$45.60 |
$114 |
11.3× |
| Urinalysis, non-automated, without microscopy (81002) |
$38.40 |
$96 |
11.0× |
| PSA, total (84153) |
$88.80 |
$222 |
4.8× |
| Thyroid stimulating hormone (TSH) (84443) |
$70.80 |
$177 |
4.2× |
| CBC with automated differential (85025) |
$39.20 |
$98 |
5.0× |
| CBC, automated (85027) |
$43.20 |
$108 |
6.7× |
| Prothrombin time (PT) (85610) |
$64.40 |
$161 |
15.0× |
| Partial thromboplastin time (PTT) (85730) |
$91.60 |
$229 |
15.2× |
| Psychotherapy, 30 minutes (90832) |
$212.80 |
$532 |
1.3× |
| Psychotherapy, 45 minutes (90834) |
$281.20 |
$703 |
1.7× |
| Psychotherapy, 60 minutes (90837) |
$281.20 |
$703 |
1.7× |
| Family psychotherapy, without patient (50 min) (90846) |
$517.20 |
$1,293 |
3.1× |
| Family psychotherapy, with patient (50 min) (90847) |
$497.20 |
$1,243 |
3.0× |
| Group psychotherapy (90853) |
$255.60 |
$639 |
2.7× |
| Left heart catheterization (93452) |
$4,953.20 |
$12,383 |
1.6× |
| Sleep study (attended polysomnography) (95810) |
$2,489.20 |
$6,223 |
3.1× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$83.20 |
$208 |
2.9× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$91.60 |
$229 |
0.7× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$118 |
$295 |
1.0× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$123.60 |
$309 |
1.0× |
| Preventive visit, new patient (age 18–39) (99385) |
$60.80 |
$152 |
— |