| Upper GI endoscopy (EGD), diagnostic (43235) |
$1,272.85 |
$3,000 |
1.4× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$1,272.85 |
$3,000 |
1.4× |
| Colonoscopy with biopsy (45380) |
$1,631.37 |
$3,845 |
1.4× |
| Colonoscopy with lesion removal (45385) |
$1,093.38 |
$2,577 |
0.9× |
| Epidural injection, lumbar/sacral (with imaging) (62322) |
$413.25 |
$974 |
0.5× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$1,431.53 |
$3,374 |
1.6× |
| CT head/brain without contrast (70450) |
$967.37 |
$2,280 |
9.4× |
| MRI brain without contrast (70551) |
$1,622.24 |
$3,823.50 |
6.9× |
| MRI brain with contrast (70552) |
$1,860.05 |
$4,384 |
5.4× |
| MRI brain without and with contrast (70553) |
$2,162.99 |
$5,098 |
6.3× |
| X-ray lower spine, 4+ views (72110) |
$633.03 |
$1,492 |
6.1× |
| MRI lumbar spine without contrast (72148) |
$1,339.88 |
$3,158 |
5.7× |
| CT pelvis with contrast (72193) |
$972.88 |
$2,293 |
5.6× |
| MRI lower-extremity joint without contrast (73721) |
$1,461.65 |
$3,445 |
6.2× |
| CT abdomen and pelvis with contrast (74177) |
$1,780.71 |
$4,197 |
5.2× |
| Ultrasound, abdomen complete (76700) |
$1,188.84 |
$2,802 |
11.5× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$748.86 |
$1,765 |
7.3× |
| Ultrasound, transvaginal (76830) |
$707.28 |
$1,667 |
6.9× |
| Mammography, one breast (diagnostic) (77065) |
$159.96 |
$377 |
1.9× |
| Mammography, both breasts (diagnostic) (77066) |
$190.51 |
$449 |
1.7× |
| Mammography, screening (bilateral) (77067) |
$133.65 |
$315 |
1.5× |
| Basic metabolic panel (80048) |
$134.93 |
$318 |
15.9× |
| Comprehensive metabolic panel (80053) |
$158.26 |
$373 |
15.0× |
| Lipid panel (80061) |
$115.83 |
$273 |
8.7× |
| Renal function panel (80069) |
$80.62 |
$190 |
9.3× |
| Hepatic function panel (80076) |
$103.53 |
$244 |
12.7× |
| Urinalysis, non-automated, with microscopy (81000) |
$11.46 |
$27 |
2.9× |
| Urinalysis, non-automated, without microscopy (81002) |
$53.46 |
$126 |
15.4× |
| PSA, total (84153) |
$55.59 |
$131 |
3.0× |
| Thyroid stimulating hormone (TSH) (84443) |
$65.34 |
$154 |
3.9× |
| CBC with automated differential (85025) |
$86.56 |
$204 |
11.1× |
| CBC, automated (85027) |
$86.13 |
$203 |
13.3× |
| Prothrombin time (PT) (85610) |
$66.19 |
$156 |
15.4× |
| Partial thromboplastin time (PTT) (85730) |
$80.62 |
$190 |
13.4× |
| Sleep study (attended polysomnography) (95810) |
$2,539.33 |
$5,985 |
3.0× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$67.68 |
$159.50 |
2.3× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$230.81 |
$544 |
1.8× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$218.51 |
$515 |
1.7× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$336.88 |
$794 |
2.6× |