| Breast lesion removal (open) (19120) |
$663.12 |
$2,456 |
0.2× |
| Upper GI endoscopy (EGD), diagnostic (43235) |
$812.70 |
$3,010 |
0.9× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$812.70 |
$3,010 |
0.9× |
| Diagnostic colonoscopy (45378) |
$838.89 |
$3,107 |
0.9× |
| Colonoscopy with biopsy (45380) |
$1,082.97 |
$4,011 |
0.9× |
| Colonoscopy with lesion removal (45385) |
$1,082.97 |
$4,011 |
0.9× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$1,369.31 |
$5,071.50 |
1.6× |
| CT head/brain without contrast (70450) |
$452.25 |
$1,675 |
4.3× |
| MRI brain without contrast (70551) |
$876.15 |
$3,245 |
3.7× |
| MRI brain with contrast (70552) |
$1,401.84 |
$5,192 |
4.0× |
| MRI brain without and with contrast (70553) |
$1,401.84 |
$5,192 |
4.0× |
| X-ray lower spine, 4+ views (72110) |
$138.51 |
$513 |
1.3× |
| MRI lumbar spine without contrast (72148) |
$876.15 |
$3,245 |
3.7× |
| CT pelvis with contrast (72193) |
$750.06 |
$2,778 |
4.3× |
| MRI lower-extremity joint without contrast (73721) |
$876.15 |
$3,245 |
3.7× |
| CT abdomen and pelvis with contrast (74177) |
$1,546.29 |
$5,727 |
4.5× |
| Ultrasound, abdomen complete (76700) |
$221.13 |
$819 |
2.1× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$221.13 |
$819 |
2.1× |
| Ultrasound, transvaginal (76830) |
$221.13 |
$819 |
2.1× |
| Mammography, one breast (diagnostic) (77065) |
$102.33 |
$379 |
1.2× |
| Mammography, both breasts (diagnostic) (77066) |
$130.14 |
$482 |
1.2× |
| Mammography, screening (bilateral) (77067) |
$107.73 |
$399 |
1.2× |
| Basic metabolic panel (80048) |
$74.25 |
$275 |
8.8× |
| Comprehensive metabolic panel (80053) |
$108 |
$400 |
10.2× |
| Lipid panel (80061) |
$59.94 |
$222 |
4.5× |
| Renal function panel (80069) |
$93.69 |
$347 |
10.8× |
| Hepatic function panel (80076) |
$70.74 |
$262 |
8.7× |
| Urinalysis, non-automated, without microscopy (81002) |
$14.04 |
$52 |
4.0× |
| PSA, total (84153) |
$63.45 |
$235 |
3.5× |
| Thyroid stimulating hormone (TSH) (84443) |
$54.54 |
$202 |
3.2× |
| CBC with automated differential (85025) |
$34.02 |
$126 |
4.4× |
| CBC, automated (85027) |
$27.81 |
$103 |
4.3× |
| Prothrombin time (PT) (85610) |
$23.22 |
$86 |
5.4× |
| Partial thromboplastin time (PTT) (85730) |
$26.19 |
$97 |
4.4× |
| Group psychotherapy (90853) |
$7.02 |
$26 |
0.1× |
| Left heart catheterization (93452) |
$3,227.31 |
$11,953 |
1.0× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$43.74 |
$162 |
1.5× |