| Upper GI endoscopy (EGD), diagnostic (43235) |
$679.38 |
$1,358.75 |
0.8× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$664.63 |
$1,329.25 |
0.7× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$438.38 |
$876.75 |
0.5× |
| CT head/brain without contrast (70450) |
$1,078.75 |
$2,157.50 |
10.3× |
| MRI brain without contrast (70551) |
$1,697.38 |
$3,394.75 |
7.1× |
| MRI brain with contrast (70552) |
$1,413.63 |
$2,827.25 |
4.1× |
| MRI brain without and with contrast (70553) |
$2,315.38 |
$4,630.75 |
6.7× |
| X-ray lower spine, 4+ views (72110) |
$245 |
$490 |
2.4× |
| MRI lumbar spine without contrast (72148) |
$1,516.88 |
$3,033.75 |
6.4× |
| CT pelvis with contrast (72193) |
$1,224.88 |
$2,449.75 |
7.0× |
| MRI lower-extremity joint without contrast (73721) |
$1,557.50 |
$3,115 |
6.5× |
| CT abdomen and pelvis with contrast (74177) |
$2,470.06 |
$4,940.12 |
7.1× |
| Ultrasound, abdomen complete (76700) |
$449 |
$898 |
4.3× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$352.94 |
$705.88 |
3.4× |
| Ultrasound, transvaginal (76830) |
$291.75 |
$583.50 |
2.8× |
| Mammography, one breast (diagnostic) (77065) |
$146.63 |
$293.25 |
1.7× |
| Mammography, both breasts (diagnostic) (77066) |
$180.38 |
$360.75 |
1.6× |
| Mammography, screening (bilateral) (77067) |
$172.88 |
$345.75 |
1.9× |
| Basic metabolic panel (80048) |
$105.13 |
$210.25 |
12.4× |
| Comprehensive metabolic panel (80053) |
$54.88 |
$109.75 |
5.2× |
| Obstetric panel (80055) |
$501.25 |
$1,002.50 |
10.5× |
| Lipid panel (80061) |
$36.13 |
$72.25 |
2.7× |
| Renal function panel (80069) |
$117.50 |
$235 |
13.5× |
| Hepatic function panel (80076) |
$102.88 |
$205.75 |
12.6× |
| Urinalysis, non-automated, without microscopy (81002) |
$15.88 |
$31.75 |
4.6× |
| PSA, total (84153) |
$80 |
$160 |
4.4× |
| Thyroid stimulating hormone (TSH) (84443) |
$59.38 |
$118.75 |
3.5× |
| CBC with automated differential (85025) |
$33.82 |
$67.62 |
4.4× |
| CBC, automated (85027) |
$42.25 |
$84.50 |
6.5× |
| Prothrombin time (PT) (85610) |
$31.32 |
$62.62 |
7.3× |
| Partial thromboplastin time (PTT) (85730) |
$83.75 |
$167.50 |
13.9× |
| Psychotherapy, 60 minutes (90837) |
$92.75 |
$185.50 |
0.5× |
| Electrocardiogram (ECG), complete (93000) |
$55.50 |
$111 |
0.9× |
| Left heart catheterization (93452) |
$2,843.38 |
$5,686.75 |
0.9× |
| Sleep study (attended polysomnography) (95810) |
$1,203.38 |
$2,406.75 |
1.4× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$48.13 |
$96.25 |
1.7× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$72.75 |
$145.50 |
0.5× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$87.75 |
$175.50 |
0.7× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$152.25 |
$304.50 |
1.1× |
| Office consultation (low complexity, ~30 min) (99243) |
$118.25 |
$236.50 |
0.9× |
| Office consultation (moderate complexity, ~40 min) (99244) |
$152.25 |
$304.50 |
1.1× |