| Upper GI endoscopy (EGD), diagnostic (43235) |
$954.66 |
$2,273 |
1.0× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$954.66 |
$2,273 |
1.0× |
| Diagnostic colonoscopy (45378) |
$960.96 |
$2,288 |
1.0× |
| Inguinal hernia repair (age 5+) (49505) |
$4,710.72 |
$11,216 |
1.3× |
| Epidural injection, lumbar/sacral (with imaging) (62322) |
$1,133.58 |
$2,699 |
1.3× |
| CT head/brain without contrast (70450) |
$747.60 |
$1,780 |
7.1× |
| MRI brain without contrast (70551) |
$1,101.87 |
$2,623.50 |
4.6× |
| MRI brain with contrast (70552) |
$1,762.53 |
$4,196.50 |
5.0× |
| MRI brain without and with contrast (70553) |
$2,056.32 |
$4,896 |
5.9× |
| X-ray lower spine, 4+ views (72110) |
$197.82 |
$471 |
1.9× |
| MRI lumbar spine without contrast (72148) |
$844.62 |
$2,011 |
3.5× |
| CT pelvis with contrast (72193) |
$836.22 |
$1,991 |
4.7× |
| MRI lower-extremity joint without contrast (73721) |
$1,012.62 |
$2,411 |
4.2× |
| CT abdomen and pelvis with contrast (74177) |
$1,723.26 |
$4,103 |
4.9× |
| Ultrasound, abdomen complete (76700) |
$270.06 |
$643 |
2.6× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$270.06 |
$643 |
2.6× |
| Ultrasound, transvaginal (76830) |
$270.06 |
$643 |
2.6× |
| Mammography, one breast (diagnostic) (77065) |
$205.80 |
$490 |
2.4× |
| Mammography, both breasts (diagnostic) (77066) |
$263.76 |
$628 |
2.4× |
| Mammography, screening (bilateral) (77067) |
$166.32 |
$396 |
1.8× |
| Basic metabolic panel (80048) |
$87.78 |
$209 |
10.4× |
| Comprehensive metabolic panel (80053) |
$109.62 |
$261 |
10.4× |
| Lipid panel (80061) |
$139.02 |
$331 |
10.4× |
| Renal function panel (80069) |
$89.88 |
$214 |
10.4× |
| Hepatic function panel (80076) |
$84.84 |
$202 |
10.4× |
| Urinalysis, non-automated, without microscopy (81002) |
$23.10 |
$55 |
6.6× |
| PSA, total (84153) |
$99.12 |
$236 |
5.4× |
| Thyroid stimulating hormone (TSH) (84443) |
$90.30 |
$215 |
5.4× |
| CBC with automated differential (85025) |
$47.46 |
$113 |
6.1× |
| CBC, automated (85027) |
$39.90 |
$95 |
6.2× |
| Prothrombin time (PT) (85610) |
$26.46 |
$63 |
6.2× |
| Partial thromboplastin time (PTT) (85730) |
$36.96 |
$88 |
6.1× |
| Electrocardiogram (ECG), complete (93000) |
$26.46 |
$63 |
0.4× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$42 |
$100 |
1.4× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$87.36 |
$208 |
0.7× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$118.86 |
$283 |
0.9× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$147 |
$350 |
1.1× |
| Preventive visit, new patient (age 18–39) (99385) |
$103.32 |
$246 |
— |
| Preventive visit, new patient (age 40–64) (99386) |
$121.38 |
$289 |
— |