| Upper GI endoscopy (EGD), diagnostic (43235) |
$396.33 |
$1,201 |
0.4× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$495.66 |
$1,502 |
0.5× |
| Diagnostic colonoscopy (45378) |
$998.91 |
$3,027 |
1.1× |
| Colonoscopy with biopsy (45380) |
$1,032.90 |
$3,130 |
0.9× |
| Colonoscopy with lesion removal (45385) |
$998.91 |
$3,027 |
0.8× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$836.55 |
$2,535 |
0.9× |
| CT head/brain without contrast (70450) |
$417.45 |
$1,265 |
4.0× |
| MRI brain without contrast (70551) |
$623.70 |
$1,890 |
2.6× |
| MRI brain with contrast (70552) |
$774.51 |
$2,347 |
2.2× |
| MRI brain without and with contrast (70553) |
$912.12 |
$2,764 |
2.6× |
| X-ray lower spine, 4+ views (72110) |
$877.80 |
$2,660 |
8.4× |
| MRI lumbar spine without contrast (72148) |
$2,167.28 |
$6,567.50 |
9.0× |
| CT pelvis with contrast (72193) |
$416.96 |
$1,263.50 |
2.4× |
| MRI lower-extremity joint without contrast (73721) |
$1,087.84 |
$3,296.50 |
4.5× |
| CT abdomen and pelvis with contrast (74177) |
$756.69 |
$2,293 |
2.2× |
| Ultrasound, abdomen complete (76700) |
$1,212.09 |
$3,673 |
11.5× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$709.83 |
$2,151 |
6.8× |
| Ultrasound, transvaginal (76830) |
$622.05 |
$1,885 |
5.9× |
| Mammography, one breast (diagnostic) (77065) |
$271.59 |
$823 |
3.2× |
| Mammography, both breasts (diagnostic) (77066) |
$330 |
$1,000 |
3.0× |
| Mammography, screening (bilateral) (77067) |
$221.10 |
$670 |
2.4× |
| Basic metabolic panel (80048) |
$98.67 |
$299 |
11.7× |
| Comprehensive metabolic panel (80053) |
$155.60 |
$471.50 |
14.7× |
| Obstetric panel (80055) |
$91.74 |
$278 |
1.9× |
| Lipid panel (80061) |
$102.30 |
$310 |
7.6× |
| Renal function panel (80069) |
$59.07 |
$179 |
6.8× |
| Hepatic function panel (80076) |
$124.58 |
$377.50 |
15.2× |
| Urinalysis, non-automated, without microscopy (81002) |
$6.27 |
$19 |
1.8× |
| PSA, total (84153) |
$214.83 |
$651 |
11.7× |
| Thyroid stimulating hormone (TSH) (84443) |
$163.02 |
$494 |
9.7× |
| CBC with automated differential (85025) |
$143.38 |
$434.50 |
18.5× |
| CBC, automated (85027) |
$109.89 |
$333 |
17.0× |
| Prothrombin time (PT) (85610) |
$78.87 |
$239 |
18.4× |
| Partial thromboplastin time (PTT) (85730) |
$102.63 |
$311 |
17.1× |
| Left heart catheterization (93452) |
$1,976.04 |
$5,988 |
0.6× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$110.22 |
$334 |
3.8× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$200.80 |
$608.50 |
1.5× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$220.60 |
$668.50 |
1.6× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$242.88 |
$736 |
1.8× |