| Upper GI endoscopy (EGD), diagnostic (43235) |
$345.60 |
$576 |
0.4× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$459.60 |
$766 |
0.5× |
| Diagnostic colonoscopy (45378) |
$408 |
$680 |
0.4× |
| Colonoscopy with biopsy (45380) |
$526.20 |
$877 |
0.4× |
| Colonoscopy with lesion removal (45385) |
$549.60 |
$916 |
0.4× |
Laparoscopic gallbladder removal (47562)
unusually low: confirm this is the full procedure |
$2,116.20 |
$3,527 |
0.3× |
| Inguinal hernia repair (age 5+) (49505) |
$1,674.60 |
$2,791 |
0.5× |
| Epidural injection, lumbar/sacral (with imaging) (62322) |
$267 |
$445 |
0.3× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$484.80 |
$808 |
0.5× |
| CT head/brain without contrast (70450) |
$1,492.20 |
$2,487 |
13.7× |
| MRI brain without contrast (70551) |
$2,408.40 |
$4,014 |
9.7× |
| MRI brain with contrast (70552) |
$2,421.60 |
$4,036 |
6.7× |
| MRI brain without and with contrast (70553) |
$2,831.40 |
$4,719 |
7.8× |
| X-ray lower spine, 4+ views (72110) |
$366.60 |
$611 |
3.4× |
| MRI lumbar spine without contrast (72148) |
$2,408.40 |
$4,014 |
9.7× |
| CT pelvis with contrast (72193) |
$1,785.60 |
$2,976 |
9.8× |
| MRI lower-extremity joint without contrast (73721) |
$1,821 |
$3,035 |
7.3× |
| CT abdomen and pelvis with contrast (74177) |
$3,314.40 |
$5,524 |
9.1× |
| Ultrasound, abdomen complete (76700) |
$611.40 |
$1,019 |
5.6× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$584.40 |
$974 |
5.4× |
| Ultrasound, transvaginal (76830) |
$430.80 |
$718 |
4.0× |
| Mammography, one breast (diagnostic) (77065) |
$240 |
$400 |
2.8× |
| Mammography, both breasts (diagnostic) (77066) |
$295.20 |
$492 |
2.7× |
| Mammography, screening (bilateral) (77067) |
$258.30 |
$430.50 |
2.8× |
| Basic metabolic panel (80048) |
$103.20 |
$172 |
12.2× |
| Comprehensive metabolic panel (80053) |
$103.80 |
$173 |
9.8× |
| Obstetric panel (80055) |
$193.20 |
$322 |
4.0× |
| Lipid panel (80061) |
$75 |
$125 |
5.6× |
| Renal function panel (80069) |
$103.20 |
$172 |
11.9× |
| Hepatic function panel (80076) |
$100.80 |
$168 |
12.3× |
| Urinalysis, non-automated, with microscopy (81000) |
$33.60 |
$56 |
8.4× |
| Urinalysis, non-automated, without microscopy (81002) |
$24 |
$40 |
6.9× |
| PSA, total (84153) |
$96.60 |
$161 |
5.3× |
| Thyroid stimulating hormone (TSH) (84443) |
$75.30 |
$125.50 |
4.5× |
| CBC with automated differential (85025) |
$66.60 |
$111 |
8.6× |
| CBC, automated (85027) |
$31.20 |
$52 |
4.8× |
| Prothrombin time (PT) (85610) |
$39.60 |
$66 |
9.2× |
| Partial thromboplastin time (PTT) (85730) |
$67.20 |
$112 |
11.2× |
| Psychotherapy, 30 minutes (90832) |
$169.80 |
$283 |
0.9× |
| Psychotherapy, 45 minutes (90834) |
$177 |
$295 |
1.0× |
| Psychotherapy, 60 minutes (90837) |
$184.20 |
$307 |
1.0× |
| Family psychotherapy, without patient (50 min) (90846) |
$184.20 |
$307 |
1.0× |
| Family psychotherapy, with patient (50 min) (90847) |
$184.20 |
$307 |
1.0× |
| Sleep study (attended polysomnography) (95810) |
$2,656.80 |
$4,428 |
3.0× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$66 |
$110 |
2.3× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$133.20 |
$222 |
1.0× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$203.40 |
$339 |
1.5× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$258 |
$430 |
1.9× |