| Upper GI endoscopy (EGD) with biopsy (43239) |
$483.80 |
$820 |
0.5× |
| Epidural injection, lumbar/sacral (with imaging) (62322) |
$880.87 |
$1,493 |
1.0× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$1,420.72 |
$2,408 |
1.5× |
| CT head/brain without contrast (70450) |
$1,564.09 |
$2,651 |
14.4× |
| MRI brain without contrast (70551) |
$2,312.21 |
$3,919 |
9.3× |
| MRI brain with contrast (70552) |
$2,703.38 |
$4,582 |
7.5× |
| MRI brain without and with contrast (70553) |
$3,256.80 |
$5,520 |
9.0× |
| X-ray lower spine, 4+ views (72110) |
$559.32 |
$948 |
5.2× |
| MRI lumbar spine without contrast (72148) |
$2,413.10 |
$4,090 |
9.7× |
| CT pelvis with contrast (72193) |
$1,794.19 |
$3,041 |
9.9× |
| MRI lower-extremity joint without contrast (73721) |
$2,575.94 |
$4,366 |
10.4× |
| CT abdomen and pelvis with contrast (74177) |
$3,558.88 |
$6,032 |
9.8× |
| Ultrasound, abdomen complete (76700) |
$792.37 |
$1,343 |
7.3× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$849.60 |
$1,440 |
7.8× |
| Ultrasound, transvaginal (76830) |
$643.10 |
$1,090 |
5.9× |
| Mammography, one breast (diagnostic) (77065) |
$234.23 |
$397 |
2.7× |
| Mammography, both breasts (diagnostic) (77066) |
$251.34 |
$426 |
2.3× |
| Mammography, screening (bilateral) (77067) |
$197.65 |
$335 |
2.2× |
| Basic metabolic panel (80048) |
$108.56 |
$184 |
12.8× |
| Comprehensive metabolic panel (80053) |
$138.06 |
$234 |
13.1× |
| Obstetric panel (80055) |
$125.67 |
$213 |
2.6× |
| Lipid panel (80061) |
$44.25 |
$75 |
3.3× |
| Renal function panel (80069) |
$106.20 |
$180 |
12.2× |
| Hepatic function panel (80076) |
$105.61 |
$179 |
12.9× |
| Urinalysis, non-automated, without microscopy (81002) |
$21.83 |
$37 |
6.3× |
| PSA, total (84153) |
$92.04 |
$156 |
5.0× |
| Thyroid stimulating hormone (TSH) (84443) |
$93.22 |
$158 |
5.5× |
| CBC with automated differential (85025) |
$75.52 |
$128 |
9.7× |
| CBC, automated (85027) |
$79.06 |
$134 |
12.2× |
| Prothrombin time (PT) (85610) |
$43.66 |
$74 |
10.2× |
| Partial thromboplastin time (PTT) (85730) |
$65.49 |
$111 |
10.9× |
| Left heart catheterization (93452) |
$10,781.66 |
$18,274 |
3.2× |
| Sleep study (attended polysomnography) (95810) |
$3,156.50 |
$5,350 |
3.5× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$80.83 |
$137 |
2.8× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$318.01 |
$539 |
2.3× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$549.88 |
$932 |
4.0× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$680.86 |
$1,154 |
4.9× |