| Upper GI endoscopy (EGD), diagnostic (43235) |
$916.21 |
$2,500 |
1.0× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$904.11 |
$2,467 |
1.0× |
| Colonoscopy with biopsy (45380) |
$1,315.30 |
$3,589 |
1.1× |
| Colonoscopy with lesion removal (45385) |
$881.39 |
$2,405 |
0.8× |
| Epidural injection, lumbar/sacral (with imaging) (62322) |
$509.05 |
$1,389 |
0.6× |
| CT head/brain without contrast (70450) |
$713.54 |
$1,947 |
7.1× |
| MRI brain without contrast (70551) |
$1,327.03 |
$3,621 |
5.7× |
| MRI brain with contrast (70552) |
$1,082.59 |
$2,954 |
3.2× |
| MRI brain without and with contrast (70553) |
$1,092.85 |
$2,982 |
3.2× |
| X-ray lower spine, 4+ views (72110) |
$392.87 |
$1,072 |
3.9× |
| MRI lumbar spine without contrast (72148) |
$998.66 |
$2,725 |
4.3× |
| CT pelvis with contrast (72193) |
$756.05 |
$2,063 |
4.5× |
| MRI lower-extremity joint without contrast (73721) |
$942.78 |
$2,572.50 |
4.1× |
| CT abdomen and pelvis with contrast (74177) |
$1,665.29 |
$4,544 |
4.9× |
| Ultrasound, abdomen complete (76700) |
$826.05 |
$2,254 |
8.2× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$311.51 |
$850 |
3.1× |
| Ultrasound, transvaginal (76830) |
$587.11 |
$1,602 |
5.8× |
| Mammography, one breast (diagnostic) (77065) |
$118.38 |
$323 |
1.4× |
| Mammography, both breasts (diagnostic) (77066) |
$146.23 |
$399 |
1.3× |
| Mammography, screening (bilateral) (77067) |
$105.92 |
$289 |
1.2× |
| Basic metabolic panel (80048) |
$83.56 |
$228 |
9.9× |
| Comprehensive metabolic panel (80053) |
$86.49 |
$236 |
8.2× |
| Obstetric panel (80055) |
$86.49 |
$236 |
1.8× |
| Lipid panel (80061) |
$48.38 |
$132 |
3.6× |
| Renal function panel (80069) |
$91.26 |
$249 |
10.5× |
| Hepatic function panel (80076) |
$47.65 |
$130 |
5.8× |
| Urinalysis, non-automated, without microscopy (81002) |
— |
$2 |
— |
| PSA, total (84153) |
$77.70 |
$212 |
4.2× |
| Thyroid stimulating hormone (TSH) (84443) |
$61.94 |
$169 |
3.7× |
| CBC with automated differential (85025) |
$45.08 |
$123 |
5.8× |
| CBC, automated (85027) |
$25.66 |
$70 |
4.0× |
| Prothrombin time (PT) (85610) |
$37.02 |
$101 |
8.6× |
| Partial thromboplastin time (PTT) (85730) |
$44.35 |
$121 |
7.4× |
| Sleep study (attended polysomnography) (95810) |
$2,127.06 |
$5,804 |
2.6× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$53.51 |
$146 |
1.8× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$120.21 |
$328 |
0.9× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$159.06 |
$434 |
1.2× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$218.06 |
$595 |
1.7× |