| Upper GI endoscopy (EGD), diagnostic (43235) |
$386.55 |
$859 |
0.4× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$438.30 |
$974 |
0.5× |
| Diagnostic colonoscopy (45378) |
$108.90 |
$242 |
0.1× |
| Colonoscopy with biopsy (45380) |
$207 |
$460 |
0.2× |
| Colonoscopy with lesion removal (45385) |
$262.35 |
$583 |
0.2× |
Laparoscopic gallbladder removal (47562)
likely a partial charge, not the full procedure |
$409.50 |
$910 |
0.1× |
| CT head/brain without contrast (70450) |
$68.85 |
$153 |
0.6× |
| MRI brain without contrast (70551) |
$977.40 |
$2,172 |
3.9× |
| MRI brain with contrast (70552) |
$1,155.60 |
$2,568 |
3.2× |
| MRI brain without and with contrast (70553) |
$1,202.85 |
$2,673 |
3.3× |
| X-ray lower spine, 4+ views (72110) |
$41.85 |
$93 |
0.4× |
| MRI lumbar spine without contrast (72148) |
$977.40 |
$2,172 |
3.9× |
| CT pelvis with contrast (72193) |
$68.85 |
$153 |
0.4× |
| MRI lower-extremity joint without contrast (73721) |
$977.40 |
$2,172 |
3.9× |
| CT abdomen and pelvis with contrast (74177) |
$68.85 |
$153 |
0.2× |
| Ultrasound, abdomen complete (76700) |
$295.65 |
$657 |
2.7× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$247.72 |
$550.50 |
2.3× |
| Ultrasound, transvaginal (76830) |
$318.15 |
$707 |
2.9× |
| Mammography, one breast (diagnostic) (77065) |
$217.80 |
$484 |
2.5× |
| Mammography, both breasts (diagnostic) (77066) |
$217.80 |
$484 |
2.0× |
| Mammography, screening (bilateral) (77067) |
$217.80 |
$484 |
2.4× |
| Basic metabolic panel (80048) |
$60.30 |
$134 |
7.1× |
| Comprehensive metabolic panel (80053) |
$82.80 |
$184 |
7.8× |
| Obstetric panel (80055) |
$125.10 |
$278 |
2.6× |
| Lipid panel (80061) |
$44.10 |
$98 |
3.3× |
| Renal function panel (80069) |
$67.50 |
$150 |
7.8× |
| Hepatic function panel (80076) |
$49.50 |
$110 |
6.1× |
| Urinalysis, non-automated, without microscopy (81002) |
$9.90 |
$22 |
2.8× |
| PSA, total (84153) |
$94.50 |
$210 |
5.1× |
| Thyroid stimulating hormone (TSH) (84443) |
$28.80 |
$64 |
1.7× |
| CBC with automated differential (85025) |
$67.05 |
$149 |
8.6× |
| CBC, automated (85027) |
$60.98 |
$135.50 |
9.4× |
| Prothrombin time (PT) (85610) |
$41.40 |
$92 |
9.7× |
| Partial thromboplastin time (PTT) (85730) |
$50.85 |
$113 |
8.5× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$60.30 |
$134 |
2.1× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$116.10 |
$258 |
0.8× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$119.02 |
$264.50 |
0.9× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$128.48 |
$285.50 |
0.9× |
| Office consultation (low complexity, ~30 min) (99243) |
$107.55 |
$239 |
0.8× |
| Office consultation (moderate complexity, ~40 min) (99244) |
$107.55 |
$239 |
0.8× |
| Preventive visit, new patient (age 18–39) (99385) |
$110.25 |
$245 |
— |