| Upper GI endoscopy (EGD), diagnostic (43235) |
$1,605.29 |
$2,675.49 |
1.8× |
| Epidural injection, lumbar/sacral (with imaging) (62322) |
$967.76 |
$1,612.93 |
1.1× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$1,258.09 |
$2,096.82 |
1.5× |
| CT head/brain without contrast (70450) |
$453.97 |
$756.61 |
4.5× |
| MRI brain without contrast (70551) |
$1,411.36 |
$2,352.27 |
6.1× |
| MRI brain with contrast (70552) |
$1,626.14 |
$2,710.24 |
4.8× |
| MRI brain without and with contrast (70553) |
$3,660.14 |
$6,100.24 |
10.8× |
| X-ray lower spine, 4+ views (72110) |
$336.38 |
$560.64 |
3.3× |
| MRI lumbar spine without contrast (72148) |
$1,834.71 |
$3,057.85 |
7.9× |
| CT pelvis with contrast (72193) |
$1,100.36 |
$1,833.94 |
6.4× |
| MRI lower-extremity joint without contrast (73721) |
$1,804.45 |
$3,007.42 |
7.8× |
| CT abdomen and pelvis with contrast (74177) |
$2,298.76 |
$3,831.26 |
6.8× |
| Ultrasound, abdomen complete (76700) |
$572.96 |
$954.93 |
5.6× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$604.52 |
$1,007.54 |
5.9× |
| Ultrasound, transvaginal (76830) |
$500.91 |
$834.85 |
4.9× |
| Mammography, one breast (diagnostic) (77065) |
$393.37 |
$655.61 |
4.6× |
| Mammography, both breasts (diagnostic) (77066) |
$452.38 |
$753.96 |
4.1× |
| Mammography, screening (bilateral) (77067) |
$299.30 |
$498.84 |
3.3× |
| Basic metabolic panel (80048) |
$59.39 |
$98.98 |
7.0× |
| Comprehensive metabolic panel (80053) |
$95.89 |
$159.82 |
9.1× |
| Obstetric panel (80055) |
$166.95 |
$278.25 |
3.5× |
| Lipid panel (80061) |
$69.68 |
$116.13 |
5.2× |
| Renal function panel (80069) |
$107.98 |
$179.97 |
12.4× |
| Hepatic function panel (80076) |
$56.41 |
$94.02 |
6.9× |
| Urinalysis, non-automated, with microscopy (81000) |
$51.05 |
$85.09 |
12.7× |
| Urinalysis, non-automated, without microscopy (81002) |
$14.66 |
$24.43 |
4.2× |
| PSA, total (84153) |
$103.64 |
$172.73 |
5.6× |
| Thyroid stimulating hormone (TSH) (84443) |
$132.34 |
$220.56 |
7.9× |
| CBC with automated differential (85025) |
$60.98 |
$101.64 |
7.8× |
| CBC, automated (85027) |
$56.96 |
$94.93 |
8.8× |
| Prothrombin time (PT) (85610) |
$47.47 |
$79.12 |
11.1× |
| Partial thromboplastin time (PTT) (85730) |
$48.09 |
$80.15 |
8.0× |
| Sleep study (attended polysomnography) (95810) |
$3,106.88 |
$5,178.14 |
3.7× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$96.53 |
$160.89 |
3.3× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$186.02 |
$310.03 |
1.4× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$194.43 |
$324.05 |
1.5× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$263.33 |
$438.89 |
2.0× |