| Upper GI endoscopy (EGD), diagnostic (43235) |
$892.09 |
$2,500 |
1.0× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$892.09 |
$2,500 |
1.0× |
| Colonoscopy with biopsy (45380) |
$1,143.31 |
$3,204 |
1.0× |
| Colonoscopy with lesion removal (45385) |
$766.13 |
$2,147 |
0.7× |
| Epidural injection, lumbar/sacral (with imaging) (62322) |
$486.37 |
$1,363 |
0.6× |
| CT head/brain without contrast (70450) |
$1,231.80 |
$3,452 |
12.6× |
| MRI brain without contrast (70551) |
$1,354.91 |
$3,797 |
6.1× |
| MRI brain with contrast (70552) |
$1,300.67 |
$3,645 |
4.0× |
| MRI brain without and with contrast (70553) |
$1,314.23 |
$3,683 |
4.0× |
| X-ray lower spine, 4+ views (72110) |
$539.54 |
$1,512 |
5.5× |
| MRI lumbar spine without contrast (72148) |
$1,224.66 |
$3,432 |
5.5× |
| CT pelvis with contrast (72193) |
$1,059.45 |
$2,969 |
6.4× |
| MRI lower-extremity joint without contrast (73721) |
$1,003.07 |
$2,811 |
4.5× |
| CT abdomen and pelvis with contrast (74177) |
$2,552.45 |
$7,153 |
7.8× |
| Ultrasound, abdomen complete (76700) |
$1,018.77 |
$2,855 |
10.4× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$807.17 |
$2,262 |
8.2× |
| Ultrasound, transvaginal (76830) |
$550.60 |
$1,543 |
5.6× |
| Mammography, one breast (diagnostic) (77065) |
$122.76 |
$344 |
1.4× |
| Mammography, both breasts (diagnostic) (77066) |
$291.90 |
$818 |
2.6× |
| Mammography, screening (bilateral) (77067) |
$103.84 |
$291 |
1.1× |
| Basic metabolic panel (80048) |
$93.14 |
$261 |
11.0× |
| Comprehensive metabolic panel (80053) |
$145.24 |
$407 |
13.8× |
| Obstetric panel (80055) |
$43.18 |
$121 |
0.9× |
| Lipid panel (80061) |
$56.03 |
$157 |
4.2× |
| Renal function panel (80069) |
$71.37 |
$200 |
8.2× |
| Hepatic function panel (80076) |
$91.35 |
$256 |
11.2× |
| Urinalysis, non-automated, with microscopy (81000) |
$11.07 |
$31 |
2.8× |
| Urinalysis, non-automated, without microscopy (81002) |
$17.13 |
$48 |
4.9× |
| PSA, total (84153) |
$95.64 |
$268 |
5.2× |
| Thyroid stimulating hormone (TSH) (84443) |
$54.96 |
$154 |
3.3× |
| CBC with automated differential (85025) |
$61.74 |
$173 |
7.9× |
| CBC, automated (85027) |
$47.46 |
$133 |
7.3× |
| Prothrombin time (PT) (85610) |
$54.96 |
$154 |
12.8× |
| Partial thromboplastin time (PTT) (85730) |
$57.10 |
$160 |
9.5× |
| Psychotherapy, 30 minutes (90832) |
$60.67 |
$170 |
0.4× |
| Psychotherapy, 45 minutes (90834) |
$60.67 |
$170 |
0.4× |
| Psychotherapy, 60 minutes (90837) |
$60.67 |
$170 |
0.4× |
| Family psychotherapy, without patient (50 min) (90846) |
$60.67 |
$170 |
0.4× |
| Family psychotherapy, with patient (50 min) (90847) |
$60.67 |
$170 |
0.4× |
| Group psychotherapy (90853) |
$33.90 |
$95 |
0.4× |
| Left heart catheterization (93452) |
$4,891.86 |
$13,709 |
1.6× |
| Sleep study (attended polysomnography) (95810) |
$1,982.58 |
$5,556 |
2.5× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$97.42 |
$273 |
3.4× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$94.92 |
$266 |
0.8× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$129.89 |
$364 |
1.0× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$208.40 |
$584 |
1.7× |