| Upper GI endoscopy (EGD) with biopsy (43239) |
$263.34 |
$1,254 |
0.3× |
| Epidural injection, lumbar/sacral (with imaging) (62322) |
$174.72 |
$832 |
0.2× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$442.89 |
$2,109 |
0.6× |
| CT head/brain without contrast (70450) |
$613.41 |
$2,921 |
6.5× |
| MRI brain without contrast (70551) |
$516.39 |
$2,459 |
2.4× |
| MRI brain with contrast (70552) |
$857.85 |
$4,085 |
2.7× |
| MRI brain without and with contrast (70553) |
$1,267.98 |
$6,038 |
4.0× |
| X-ray lower spine, 4+ views (72110) |
$191.10 |
$910 |
2.0× |
| MRI lumbar spine without contrast (72148) |
$567.10 |
$2,700.50 |
2.6× |
| CT pelvis with contrast (72193) |
$717.78 |
$3,418 |
4.5× |
| MRI lower-extremity joint without contrast (73721) |
$786.24 |
$3,744 |
3.6× |
| CT abdomen and pelvis with contrast (74177) |
$1,884.75 |
$8,975 |
6.0× |
| Ultrasound, abdomen complete (76700) |
$319.83 |
$1,523 |
3.4× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$333.48 |
$1,588 |
3.5× |
| Ultrasound, transvaginal (76830) |
$172.83 |
$823 |
1.8× |
| Mammography, one breast (diagnostic) (77065) |
$131.46 |
$626 |
1.5× |
| Mammography, both breasts (diagnostic) (77066) |
$107.10 |
$510 |
1.0× |
| Mammography, screening (bilateral) (77067) |
$102.27 |
$487 |
1.1× |
| Basic metabolic panel (80048) |
$136.71 |
$651 |
16.2× |
| Comprehensive metabolic panel (80053) |
$181.65 |
$865 |
17.2× |
| Obstetric panel (80055) |
$34.44 |
$164 |
0.7× |
| Lipid panel (80061) |
$70.14 |
$334 |
5.2× |
| Renal function panel (80069) |
$114.24 |
$544 |
13.2× |
| Hepatic function panel (80076) |
$158.55 |
$755 |
19.4× |
| Urinalysis, non-automated, without microscopy (81002) |
$18.90 |
$90 |
5.4× |
| PSA, total (84153) |
$114.87 |
$547 |
6.2× |
| Thyroid stimulating hormone (TSH) (84443) |
$26.56 |
$126.50 |
1.6× |
| CBC with automated differential (85025) |
$35.91 |
$171 |
4.6× |
| CBC, automated (85027) |
$30.87 |
$147 |
4.8× |
| Prothrombin time (PT) (85610) |
$43.68 |
$208 |
10.2× |
| Partial thromboplastin time (PTT) (85730) |
$34.65 |
$165 |
5.8× |
| Left heart catheterization (93452) |
$2,887.29 |
$13,749 |
1.0× |
| Sleep study (attended polysomnography) (95810) |
$1,334.34 |
$6,354 |
1.7× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$47.14 |
$224.50 |
1.6× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$86.52 |
$412 |
0.7× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$102.48 |
$488 |
0.8× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$117.70 |
$560.50 |
1.0× |