| Upper GI endoscopy (EGD), diagnostic (43235) |
$1,240.20 |
$2,067 |
1.5× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$1,550.40 |
$2,584 |
1.9× |
| Diagnostic colonoscopy (45378) |
$1,633.80 |
$2,723 |
1.9× |
| Colonoscopy with biopsy (45380) |
$1,633.80 |
$2,723 |
1.5× |
| Colonoscopy with lesion removal (45385) |
$1,633.80 |
$2,723 |
1.5× |
| Epidural injection, lumbar/sacral (with imaging) (62322) |
$919.20 |
$1,532 |
1.1× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$1,456.04 |
$2,426.73 |
1.8× |
| CT head/brain without contrast (70450) |
$136.80 |
$228 |
1.4× |
| MRI brain without contrast (70551) |
$880.80 |
$1,468 |
4.1× |
| MRI brain with contrast (70552) |
$1,050 |
$1,750 |
3.3× |
| MRI brain without and with contrast (70553) |
$1,673.40 |
$2,789 |
5.3× |
| X-ray lower spine, 4+ views (72110) |
$157.52 |
$262.54 |
1.7× |
| MRI lumbar spine without contrast (72148) |
$1,101 |
$1,835 |
5.1× |
| CT pelvis with contrast (72193) |
$527.40 |
$879 |
3.3× |
| MRI lower-extremity joint without contrast (73721) |
$284.95 |
$474.92 |
1.3× |
| CT abdomen and pelvis with contrast (74177) |
$441 |
$735 |
1.4× |
| Ultrasound, abdomen complete (76700) |
$72 |
$120 |
0.8× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$257.40 |
$429 |
2.7× |
| Ultrasound, transvaginal (76830) |
$303 |
$505 |
3.2× |
| Mammography, one breast (diagnostic) (77065) |
$201 |
$335 |
2.3× |
| Mammography, both breasts (diagnostic) (77066) |
$249 |
$415 |
2.3× |
| Mammography, screening (bilateral) (77067) |
$218.40 |
$364 |
2.4× |
| Basic metabolic panel (80048) |
$53.40 |
$89 |
6.3× |
| Comprehensive metabolic panel (80053) |
$67.80 |
$113 |
6.4× |
| Obstetric panel (80055) |
$102.60 |
$171 |
2.1× |
| Lipid panel (80061) |
$79.20 |
$132 |
5.9× |
| Renal function panel (80069) |
$56.40 |
$94 |
6.5× |
| Hepatic function panel (80076) |
$64.20 |
$107 |
7.9× |
| Urinalysis, non-automated, with microscopy (81000) |
$22.25 |
$37.08 |
5.5× |
| Urinalysis, non-automated, without microscopy (81002) |
$14.90 |
$24.84 |
4.3× |
| PSA, total (84153) |
$47.40 |
$79 |
2.6× |
| Thyroid stimulating hormone (TSH) (84443) |
$73.80 |
$123 |
4.4× |
| CBC with automated differential (85025) |
$32.14 |
$53.56 |
4.1× |
| CBC, automated (85027) |
$39.60 |
$66 |
6.1× |
| Prothrombin time (PT) (85610) |
$19.78 |
$32.96 |
4.6× |
| Partial thromboplastin time (PTT) (85730) |
$36.60 |
$61 |
6.1× |
| Electrocardiogram (ECG), complete (93000) |
$25.96 |
$43.26 |
0.5× |
| Left heart catheterization (93452) |
$3,938.40 |
$6,564 |
1.3× |
| Sleep study (attended polysomnography) (95810) |
$1,139.10 |
$1,898.50 |
1.5× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$82.80 |
$138 |
2.8× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$151.41 |
$252.35 |
1.2× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$208.27 |
$347.11 |
1.7× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$281.19 |
$468.65 |
2.3× |
| Office consultation (moderate complexity, ~40 min) (99244) |
$188.49 |
$314.15 |
1.6× |
| Preventive visit, new patient (age 18–39) (99385) |
$129.78 |
$216.30 |
— |
| Preventive visit, new patient (age 40–64) (99386) |
$152.65 |
$254.41 |
— |