| Upper GI endoscopy (EGD), diagnostic (43235) |
$276.30 |
$2,763 |
0.3× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$519.90 |
$5,199 |
0.6× |
| Diagnostic colonoscopy (45378) |
$619.80 |
$6,198 |
0.7× |
| Colonoscopy with biopsy (45380) |
$681.60 |
$6,816 |
0.6× |
| Colonoscopy with lesion removal (45385) |
$756.50 |
$7,565 |
0.6× |
| Colonoscopy with endoscopic ultrasound (45391) |
$681.60 |
$6,816 |
0.6× |
| Epidural injection, lumbar/sacral (with imaging) (62322) |
$213.90 |
$2,139 |
0.2× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$250.60 |
$2,506 |
0.3× |
| CT head/brain without contrast (70450) |
$242 |
$2,420 |
2.3× |
| MRI brain without contrast (70551) |
$634.40 |
$6,344 |
2.6× |
| MRI brain with contrast (70552) |
$729.60 |
$7,296 |
2.1× |
| MRI brain without and with contrast (70553) |
$839.20 |
$8,392 |
2.4× |
| X-ray lower spine, 4+ views (72110) |
$138.20 |
$1,382 |
1.3× |
| MRI lumbar spine without contrast (72148) |
$766.50 |
$7,665 |
3.2× |
| CT pelvis with contrast (72193) |
$189.30 |
$1,893 |
1.1× |
| MRI lower-extremity joint without contrast (73721) |
$828.25 |
$8,282.50 |
3.5× |
| CT abdomen and pelvis with contrast (74177) |
$893.40 |
$8,934 |
2.5× |
| Ultrasound, abdomen complete (76700) |
$273.60 |
$2,736 |
2.6× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$132.70 |
$1,327 |
1.3× |
| Ultrasound, transvaginal (76830) |
$224.30 |
$2,243 |
2.1× |
| Mammography, one breast (diagnostic) (77065) |
$98 |
$980 |
1.1× |
| Mammography, both breasts (diagnostic) (77066) |
$129.80 |
$1,298 |
1.2× |
| Mammography, screening (bilateral) (77067) |
$87.20 |
$872 |
1.0× |
| Basic metabolic panel (80048) |
$18.50 |
$185 |
2.2× |
| Comprehensive metabolic panel (80053) |
$27.70 |
$277 |
2.6× |
| Lipid panel (80061) |
$15.60 |
$156 |
1.2× |
| Renal function panel (80069) |
$29.70 |
$297 |
3.4× |
| Hepatic function panel (80076) |
$18.50 |
$185 |
2.3× |
| Urinalysis, non-automated, with microscopy (81000) |
$5 |
$50 |
1.2× |
| Urinalysis, non-automated, without microscopy (81002) |
$7.20 |
$72 |
2.1× |
| PSA, total (84153) |
$19.60 |
$196 |
1.1× |
| Thyroid stimulating hormone (TSH) (84443) |
$35.20 |
$352 |
2.1× |
| CBC with automated differential (85025) |
$13.40 |
$134 |
1.7× |
| CBC, automated (85027) |
$8.90 |
$89 |
1.4× |
| Prothrombin time (PT) (85610) |
$5.10 |
$51 |
1.2× |
| Partial thromboplastin time (PTT) (85730) |
$10.90 |
$109 |
1.8× |
| Sleep study (attended polysomnography) (95810) |
$864.90 |
$8,649 |
1.0× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$21.80 |
$218 |
0.8× |