| Upper GI endoscopy (EGD), diagnostic (43235) |
$633.60 |
$4,224 |
0.7× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$415.95 |
$2,773 |
0.5× |
| CT head/brain without contrast (70450) |
$815.40 |
$5,436 |
7.8× |
| MRI brain without contrast (70551) |
$1,335.72 |
$8,904.80 |
5.6× |
| MRI brain with contrast (70552) |
$1,843.35 |
$12,289 |
5.3× |
| MRI brain without and with contrast (70553) |
$2,177.25 |
$14,515 |
6.2× |
| X-ray lower spine, 4+ views (72110) |
$514.95 |
$3,433 |
4.9× |
| MRI lumbar spine without contrast (72148) |
$1,177.20 |
$7,847.94 |
4.9× |
| CT pelvis with contrast (72193) |
$1,482.30 |
$9,882 |
8.4× |
| MRI lower-extremity joint without contrast (73721) |
$1,606.80 |
$10,712 |
6.7× |
| CT abdomen and pelvis with contrast (74177) |
$2,042.40 |
$13,616 |
5.8× |
| Ultrasound, abdomen complete (76700) |
$520.50 |
$3,470 |
5.0× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$561.75 |
$3,745 |
5.3× |
| Ultrasound, transvaginal (76830) |
$308.55 |
$2,057 |
2.9× |
| Mammography, one breast (diagnostic) (77065) |
$100.35 |
$669 |
1.2× |
| Mammography, both breasts (diagnostic) (77066) |
$152.10 |
$1,014 |
1.4× |
| Mammography, screening (bilateral) (77067) |
$118.35 |
$789 |
1.3× |
| Basic metabolic panel (80048) |
$45.02 |
$300.07 |
5.3× |
| Comprehensive metabolic panel (80053) |
$4.65 |
$31 |
0.4× |
| Lipid panel (80061) |
$3.75 |
$25 |
0.3× |
| Renal function panel (80069) |
$73.78 |
$491.88 |
8.5× |
| Hepatic function panel (80076) |
$60.22 |
$401.50 |
7.4× |
| PSA, total (84153) |
$8.70 |
$58 |
0.5× |
| Thyroid stimulating hormone (TSH) (84443) |
$4.35 |
$29 |
0.3× |
| CBC with automated differential (85025) |
$53.86 |
$359.04 |
6.9× |
| CBC, automated (85027) |
$22.47 |
$149.77 |
3.5× |
| Prothrombin time (PT) (85610) |
$37.18 |
$247.86 |
8.7× |
| Partial thromboplastin time (PTT) (85730) |
$29.10 |
$194 |
4.8× |
| Left heart catheterization (93452) |
$6,062.55 |
$40,417 |
1.9× |
| Sleep study (attended polysomnography) (95810) |
$1,122.51 |
$7,483.34 |
1.3× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$42.90 |
$286 |
1.5× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$59.70 |
$398 |
0.4× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$98.30 |
$655.35 |
0.7× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$142.22 |
$948.13 |
1.1× |