| Upper GI endoscopy (EGD), diagnostic (43235) |
$1,324.80 |
$2,208 |
1.5× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$1,324.80 |
$2,208 |
1.5× |
| Diagnostic colonoscopy (45378) |
$1,338 |
$2,230 |
1.5× |
| Colonoscopy with biopsy (45380) |
$1,599.60 |
$2,666 |
1.4× |
| Colonoscopy with lesion removal (45385) |
$1,599.60 |
$2,666 |
1.4× |
| Colonoscopy with endoscopic ultrasound (45391) |
$1,590.60 |
$2,651 |
1.4× |
| Laparoscopic gallbladder removal (47562) |
$5,956.20 |
$9,927 |
1.0× |
| Inguinal hernia repair (age 5+) (49505) |
$3,273.30 |
$5,455.50 |
1.0× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$1,129.80 |
$1,883 |
1.3× |
| CT head/brain without contrast (70450) |
$1,314 |
$2,190 |
13.1× |
| MRI brain without contrast (70551) |
$3,276.60 |
$5,461 |
14.4× |
| MRI brain with contrast (70552) |
$3,768.60 |
$6,281 |
11.3× |
| MRI brain without and with contrast (70553) |
$4,130.40 |
$6,884 |
12.4× |
| X-ray lower spine, 4+ views (72110) |
$459.60 |
$766 |
4.6× |
| MRI lumbar spine without contrast (72148) |
$3,072 |
$5,120 |
13.5× |
| CT pelvis with contrast (72193) |
$1,751.40 |
$2,919 |
10.4× |
| MRI lower-extremity joint without contrast (73721) |
$2,135.40 |
$3,559 |
9.4× |
| CT abdomen and pelvis with contrast (74177) |
$3,610.20 |
$6,017 |
10.8× |
| Ultrasound, abdomen complete (76700) |
$805.20 |
$1,342 |
8.1× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$642 |
$1,070 |
6.4× |
| Ultrasound, transvaginal (76830) |
$544.20 |
$907 |
5.4× |
| Mammography, one breast (diagnostic) (77065) |
$217.20 |
$362 |
2.5× |
| Mammography, both breasts (diagnostic) (77066) |
$276.60 |
$461 |
2.5× |
| Mammography, screening (bilateral) (77067) |
$228.60 |
$381 |
2.5× |
| Basic metabolic panel (80048) |
$67.95 |
$113.25 |
8.0× |
| Comprehensive metabolic panel (80053) |
$17.61 |
$29.35 |
1.7× |
| Obstetric panel (80055) |
$123.84 |
$206.40 |
2.6× |
| Lipid panel (80061) |
$22.32 |
$37.20 |
1.7× |
| Renal function panel (80069) |
$14.48 |
$24.13 |
1.7× |
| Hepatic function panel (80076) |
$13.62 |
$22.70 |
1.7× |
| Urinalysis, non-automated, with microscopy (81000) |
$10.22 |
$17.02 |
2.5× |
| Urinalysis, non-automated, without microscopy (81002) |
$20.61 |
$34.35 |
5.9× |
| PSA, total (84153) |
$30.66 |
$51.10 |
1.7× |
| Thyroid stimulating hormone (TSH) (84443) |
$28.01 |
$46.68 |
1.7× |
| CBC with automated differential (85025) |
$12.95 |
$21.58 |
1.7× |
| CBC, automated (85027) |
$10.77 |
$17.95 |
1.7× |
| Prothrombin time (PT) (85610) |
$6.56 |
$10.93 |
1.5× |
| Partial thromboplastin time (PTT) (85730) |
$40.10 |
$66.84 |
6.7× |
| Left heart catheterization (93452) |
$4,213.80 |
$7,023 |
1.4× |
| Sleep study (attended polysomnography) (95810) |
$2,374.80 |
$3,958 |
2.9× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$135 |
$225 |
4.6× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$147.60 |
$246 |
1.2× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$243.60 |
$406 |
1.9× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$295.80 |
$493 |
2.3× |