| Upper GI endoscopy (EGD), diagnostic (43235) |
$1,004.19 |
$2,500 |
1.1× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$1,205.03 |
$3,000 |
1.4× |
| Colonoscopy with biopsy (45380) |
$1,433.58 |
$3,569 |
1.2× |
| Colonoscopy with lesion removal (45385) |
$530.62 |
$1,321 |
0.5× |
| Epidural injection, lumbar/sacral (with imaging) (62322) |
$664.37 |
$1,654 |
0.8× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$1,037.53 |
$2,583 |
1.2× |
| CT head/brain without contrast (70450) |
$718.20 |
$1,788 |
7.0× |
| MRI brain without contrast (70551) |
$1,400.04 |
$3,485.50 |
6.0× |
| MRI brain with contrast (70552) |
$985.71 |
$2,454 |
2.9× |
| MRI brain without and with contrast (70553) |
$1,428.36 |
$3,556 |
4.2× |
| X-ray lower spine, 4+ views (72110) |
$367.14 |
$914 |
3.6× |
| MRI lumbar spine without contrast (72148) |
$829.46 |
$2,065 |
3.6× |
| CT pelvis with contrast (72193) |
$815.40 |
$2,030 |
4.8× |
| MRI lower-extremity joint without contrast (73721) |
$955.19 |
$2,378 |
4.1× |
| CT abdomen and pelvis with contrast (74177) |
$1,606.70 |
$4,000 |
4.7× |
| Ultrasound, abdomen complete (76700) |
$759.57 |
$1,891 |
7.4× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$407.70 |
$1,015 |
4.0× |
| Ultrasound, transvaginal (76830) |
$700.93 |
$1,745 |
6.9× |
| Mammography, one breast (diagnostic) (77065) |
$179.96 |
$448 |
2.1× |
| Mammography, both breasts (diagnostic) (77066) |
$219.72 |
$547 |
2.0× |
| Mammography, screening (bilateral) (77067) |
$138.98 |
$346 |
1.5× |
| Basic metabolic panel (80048) |
$89.98 |
$224 |
10.6× |
| Comprehensive metabolic panel (80053) |
$171.52 |
$427 |
16.2× |
| Lipid panel (80061) |
$51.82 |
$129 |
3.9× |
| Renal function panel (80069) |
$153.44 |
$382 |
17.7× |
| Hepatic function panel (80076) |
$100.02 |
$249 |
12.2× |
| Urinalysis, non-automated, without microscopy (81002) |
$24.11 |
$60 |
6.9× |
| PSA, total (84153) |
$102.03 |
$254 |
5.5× |
| Thyroid stimulating hormone (TSH) (84443) |
$67.89 |
$169 |
4.0× |
| CBC with automated differential (85025) |
$70.70 |
$176 |
9.1× |
| CBC, automated (85027) |
$48.21 |
$120 |
7.5× |
| Prothrombin time (PT) (85610) |
$48.21 |
$120 |
11.2× |
| Partial thromboplastin time (PTT) (85730) |
$65.08 |
$162 |
10.8× |
| Psychotherapy, 30 minutes (90832) |
$249.44 |
$621 |
1.4× |
| Psychotherapy, 45 minutes (90834) |
$249.44 |
$621 |
1.4× |
| Psychotherapy, 60 minutes (90837) |
$249.44 |
$621 |
1.4× |
| Left heart catheterization (93452) |
$1,906.75 |
$4,747 |
0.6× |
| Sleep study (attended polysomnography) (95810) |
$2,624.55 |
$6,534 |
3.1× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$85.56 |
$213 |
2.9× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$161.48 |
$402 |
1.2× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$211.29 |
$526 |
1.6× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$234.18 |
$583 |
1.8× |