| Upper GI endoscopy (EGD) with biopsy (43239) |
$656.37 |
$2,577 |
0.8× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$565.95 |
$2,222 |
0.7× |
| CT head/brain without contrast (70450) |
$727.17 |
$2,855 |
7.6× |
| MRI brain without contrast (70551) |
$1,473.44 |
$5,785 |
6.8× |
| MRI brain with contrast (70552) |
$1,671.09 |
$6,561 |
5.3× |
| MRI brain without and with contrast (70553) |
$1,796.91 |
$7,055 |
5.7× |
| X-ray lower spine, 4+ views (72110) |
$166.58 |
$654 |
1.7× |
| MRI lumbar spine without contrast (72148) |
$1,014.48 |
$3,983 |
4.7× |
| CT pelvis with contrast (72193) |
$551.94 |
$2,167 |
3.5× |
| MRI lower-extremity joint without contrast (73721) |
$1,005.56 |
$3,948 |
4.6× |
| CT abdomen and pelvis with contrast (74177) |
$1,531.26 |
$6,012 |
4.8× |
| Ultrasound, abdomen complete (76700) |
$348.69 |
$1,369 |
3.7× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$160.47 |
$630 |
1.7× |
| Ultrasound, transvaginal (76830) |
$195.36 |
$767 |
2.1× |
| Mammography, one breast (diagnostic) (77065) |
$139.07 |
$546 |
1.6× |
| Mammography, both breasts (diagnostic) (77066) |
$183.14 |
$719 |
1.7× |
| Mammography, screening (bilateral) (77067) |
$72.98 |
$286.50 |
0.8× |
| Basic metabolic panel (80048) |
$42.42 |
$166.50 |
5.0× |
| Comprehensive metabolic panel (80053) |
$39.36 |
$154.50 |
3.7× |
| Lipid panel (80061) |
$22.93 |
$90 |
1.7× |
| Renal function panel (80069) |
$34.64 |
$136 |
4.0× |
| Hepatic function panel (80076) |
$25.22 |
$99 |
3.1× |
| Urinalysis, non-automated, with microscopy (81000) |
$12.23 |
$48 |
3.0× |
| Urinalysis, non-automated, without microscopy (81002) |
$5.35 |
$21 |
1.5× |
| PSA, total (84153) |
$14.52 |
$57 |
0.8× |
| Thyroid stimulating hormone (TSH) (84443) |
$20.38 |
$80 |
1.2× |
| CBC with automated differential (85025) |
$9.43 |
$37 |
1.2× |
| CBC, automated (85027) |
$8.16 |
$32 |
1.3× |
| Prothrombin time (PT) (85610) |
$7.65 |
$30 |
1.8× |
| Partial thromboplastin time (PTT) (85730) |
$13.63 |
$53.50 |
2.3× |
| Psychotherapy, 30 minutes (90832) |
$97.05 |
$381 |
0.6× |
| Psychotherapy, 45 minutes (90834) |
$107.49 |
$422 |
0.7× |
| Psychotherapy, 60 minutes (90837) |
$117.17 |
$460 |
0.7× |
| Family psychotherapy, without patient (50 min) (90846) |
$206.44 |
$810.50 |
1.3× |
| Family psychotherapy, with patient (50 min) (90847) |
$158.68 |
$623 |
1.0× |
| Group psychotherapy (90853) |
$121.37 |
$476.50 |
1.3× |
| Electrocardiogram (ECG), complete (93000) |
$58.84 |
$231 |
1.1× |
| Sleep study (attended polysomnography) (95810) |
$1,216.20 |
$4,775 |
1.6× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$66.86 |
$262.50 |
0.6× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$98.58 |
$387 |
0.8× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$125.70 |
$493.50 |
1.0× |
| Office consultation (low complexity, ~30 min) (99243) |
$70.30 |
$276 |
0.6× |
| Office consultation (moderate complexity, ~40 min) (99244) |
$100.36 |
$394 |
0.8× |
| Preventive visit, new patient (age 18–39) (99385) |
$64.44 |
$253 |
— |
| Preventive visit, new patient (age 40–64) (99386) |
$70.81 |
$278 |
— |