| Upper GI endoscopy (EGD), diagnostic (43235) |
$577.50 |
$825 |
0.6× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$616 |
$880 |
0.7× |
| Diagnostic colonoscopy (45378) |
$555.56 |
$793.65 |
0.6× |
| Colonoscopy with biopsy (45380) |
$847 |
$1,210 |
0.7× |
| Colonoscopy with lesion removal (45385) |
$924 |
$1,320 |
0.7× |
| CT head/brain without contrast (70450) |
$488.60 |
$698 |
4.5× |
| MRI brain without contrast (70551) |
$1,134.70 |
$1,621 |
4.6× |
| X-ray lower spine, 4+ views (72110) |
$273 |
$390 |
2.5× |
| MRI lumbar spine without contrast (72148) |
$1,134.70 |
$1,621 |
4.6× |
| CT pelvis with contrast (72193) |
$643.65 |
$919.50 |
3.5× |
| MRI lower-extremity joint without contrast (73721) |
$1,134.70 |
$1,621 |
4.6× |
| CT abdomen and pelvis with contrast (74177) |
$1,714.30 |
$2,449 |
4.7× |
| Ultrasound, abdomen complete (76700) |
$257.25 |
$367.50 |
2.4× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$396.20 |
$566 |
3.6× |
| Ultrasound, transvaginal (76830) |
$220.85 |
$315.50 |
2.0× |
| Mammography, one breast (diagnostic) (77065) |
$196.70 |
$281 |
2.3× |
| Mammography, both breasts (diagnostic) (77066) |
$273 |
$390 |
2.5× |
| Mammography, screening (bilateral) (77067) |
$210 |
$300 |
2.3× |
| Basic metabolic panel (80048) |
$71.18 |
$101.69 |
8.4× |
| Comprehensive metabolic panel (80053) |
$99.44 |
$142.06 |
9.4× |
| Obstetric panel (80055) |
$212.82 |
$304.03 |
4.5× |
| Lipid panel (80061) |
$157.92 |
$225.61 |
11.8× |
| Renal function panel (80069) |
$75.17 |
$107.38 |
8.7× |
| Hepatic function panel (80076) |
$65.82 |
$94.03 |
8.1× |
| Urinalysis, non-automated, with microscopy (81000) |
$40.95 |
$58.50 |
10.2× |
| Urinalysis, non-automated, without microscopy (81002) |
$11.55 |
$16.50 |
3.3× |
| PSA, total (84153) |
$95.63 |
$136.61 |
5.2× |
| Thyroid stimulating hormone (TSH) (84443) |
$79.72 |
$113.88 |
4.7× |
| CBC with automated differential (85025) |
$61.91 |
$88.44 |
8.0× |
| CBC, automated (85027) |
$42.46 |
$60.66 |
6.6× |
| Prothrombin time (PT) (85610) |
$47.60 |
$68 |
11.1× |
| Partial thromboplastin time (PTT) (85730) |
$78.67 |
$112.38 |
13.1× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$37.10 |
$53 |
1.3× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$80.85 |
$115.50 |
0.6× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$154 |
$220 |
1.1× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$196.35 |
$280.50 |
1.4× |
| Preventive visit, new patient (age 18–39) (99385) |
$142.45 |
$203.50 |
— |
| Preventive visit, new patient (age 40–64) (99386) |
$154 |
$220 |
— |