| Upper GI endoscopy (EGD), diagnostic (43235) |
$964.60 |
$1,484 |
1.2× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$997.10 |
$1,534 |
1.2× |
| Diagnostic colonoscopy (45378) |
$1,030.58 |
$1,585.50 |
1.2× |
| Colonoscopy with biopsy (45380) |
$1,582.10 |
$2,434 |
1.5× |
| Colonoscopy with lesion removal (45385) |
$1,180.40 |
$1,816 |
1.1× |
| CT head/brain without contrast (70450) |
$580.78 |
$893.50 |
6.1× |
| MRI brain without contrast (70551) |
$1,652.30 |
$2,542 |
7.6× |
| MRI brain with contrast (70552) |
$603.52 |
$928.50 |
1.9× |
| MRI brain without and with contrast (70553) |
$1,673.75 |
$2,575 |
5.3× |
| X-ray lower spine, 4+ views (72110) |
$117.98 |
$181.50 |
1.2× |
| MRI lumbar spine without contrast (72148) |
$1,109.55 |
$1,707 |
5.1× |
| CT pelvis with contrast (72193) |
$1,443.65 |
$2,221 |
9.1× |
| MRI lower-extremity joint without contrast (73721) |
$1,069.58 |
$1,645.50 |
5.0× |
| CT abdomen and pelvis with contrast (74177) |
$1,856.40 |
$2,856 |
5.9× |
| Ultrasound, abdomen complete (76700) |
$100.75 |
$155 |
1.1× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$198.25 |
$305 |
2.1× |
| Ultrasound, transvaginal (76830) |
$147.88 |
$227.50 |
1.6× |
| Mammography, one breast (diagnostic) (77065) |
$135.52 |
$208.50 |
1.6× |
| Mammography, both breasts (diagnostic) (77066) |
$210.92 |
$324.50 |
1.9× |
| Mammography, screening (bilateral) (77067) |
$190.12 |
$292.50 |
2.1× |
| Basic metabolic panel (80048) |
$52 |
$80 |
6.1× |
| Comprehensive metabolic panel (80053) |
$76.70 |
$118 |
7.3× |
| Lipid panel (80061) |
$38.35 |
$59 |
2.9× |
| Renal function panel (80069) |
$61.10 |
$94 |
7.0× |
| Hepatic function panel (80076) |
$49.40 |
$76 |
6.0× |
| PSA, total (84153) |
$88.40 |
$136 |
4.8× |
| Thyroid stimulating hormone (TSH) (84443) |
$52 |
$80 |
3.1× |
| CBC with automated differential (85025) |
$23.40 |
$36 |
3.0× |
| CBC, automated (85027) |
$20.80 |
$32 |
3.2× |
| Prothrombin time (PT) (85610) |
$12.02 |
$18.50 |
2.8× |
| Partial thromboplastin time (PTT) (85730) |
$20.15 |
$31 |
3.4× |
| Psychotherapy, 30 minutes (90832) |
$141.05 |
$217 |
0.9× |
| Psychotherapy, 45 minutes (90834) |
$182.65 |
$281 |
1.1× |
| Psychotherapy, 60 minutes (90837) |
$273.65 |
$421 |
1.7× |
| Family psychotherapy, with patient (50 min) (90847) |
$182.65 |
$281 |
1.1× |
| Group psychotherapy (90853) |
$182.65 |
$281 |
2.0× |
| Sleep study (attended polysomnography) (95810) |
$1,206.08 |
$1,855.50 |
1.6× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$56.22 |
$86.50 |
1.9× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$217.75 |
$335 |
1.8× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$355.55 |
$547 |
2.9× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$479.70 |
$738 |
4.0× |