| Upper GI endoscopy (EGD), diagnostic (43235) |
$418.83 |
$1,821 |
0.5× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$377.43 |
$1,641 |
0.5× |
| Colonoscopy with biopsy (45380) |
$474.95 |
$2,065 |
0.4× |
| CT head/brain without contrast (70450) |
$521.87 |
$2,269 |
5.5× |
| MRI brain without contrast (70551) |
$593.63 |
$2,581 |
2.7× |
| MRI brain with contrast (70552) |
$624.68 |
$2,716 |
2.0× |
| MRI brain without and with contrast (70553) |
$656.19 |
$2,853 |
2.1× |
| X-ray lower spine, 4+ views (72110) |
$67.85 |
$295 |
0.7× |
| MRI lumbar spine without contrast (72148) |
$593.63 |
$2,581 |
2.7× |
| CT pelvis with contrast (72193) |
$605.36 |
$2,632 |
3.8× |
| MRI lower-extremity joint without contrast (73721) |
$598.58 |
$2,602.50 |
2.8× |
| CT abdomen and pelvis with contrast (74177) |
$549.24 |
$2,388 |
1.7× |
| Ultrasound, abdomen complete (76700) |
$99.82 |
$434 |
1.1× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$99.82 |
$434 |
1.1× |
| Ultrasound, transvaginal (76830) |
$99.82 |
$434 |
1.1× |
| Mammography, one breast (diagnostic) (77065) |
$72.68 |
$316 |
0.8× |
| Mammography, both breasts (diagnostic) (77066) |
$83.95 |
$365 |
0.8× |
| Mammography, screening (bilateral) (77067) |
$70.96 |
$308.50 |
0.8× |
| Basic metabolic panel (80048) |
$14.26 |
$62 |
1.7× |
| Comprehensive metabolic panel (80053) |
$17.25 |
$75 |
1.6× |
| Obstetric panel (80055) |
$70.61 |
$307 |
1.5× |
| Lipid panel (80061) |
$23.23 |
$101 |
1.7× |
| Renal function panel (80069) |
$14.49 |
$63 |
1.7× |
| Hepatic function panel (80076) |
$13.57 |
$59 |
1.7× |
| Urinalysis, non-automated, with microscopy (81000) |
$3.45 |
$15 |
0.9× |
| Urinalysis, non-automated, without microscopy (81002) |
$4.37 |
$19 |
1.3× |
| PSA, total (84153) |
$31.74 |
$138 |
1.7× |
| Thyroid stimulating hormone (TSH) (84443) |
$28.98 |
$126 |
1.7× |
| CBC with automated differential (85025) |
$13.34 |
$58 |
1.7× |
| CBC, automated (85027) |
$11.04 |
$48 |
1.7× |
| Prothrombin time (PT) (85610) |
$6.67 |
$29 |
1.6× |
| Partial thromboplastin time (PTT) (85730) |
$10.35 |
$45 |
1.7× |
| Psychotherapy, 30 minutes (90832) |
$43.47 |
$189 |
0.3× |
| Psychotherapy, 45 minutes (90834) |
$43.93 |
$191 |
0.3× |
| Psychotherapy, 60 minutes (90837) |
$48.76 |
$212 |
0.3× |
| Family psychotherapy, without patient (50 min) (90846) |
$75.67 |
$329 |
0.5× |
| Family psychotherapy, with patient (50 min) (90847) |
$80.04 |
$348 |
0.5× |
| Group psychotherapy (90853) |
$48.76 |
$212 |
0.5× |
| Sleep study (attended polysomnography) (95810) |
$538.66 |
$2,342 |
0.7× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$30.36 |
$132 |
1.0× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$38.64 |
$168 |
0.3× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$50.14 |
$218 |
0.4× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$64.17 |
$279 |
0.5× |
| Preventive visit, new patient (age 18–39) (99385) |
$69.23 |
$301 |
— |
| Preventive visit, new patient (age 40–64) (99386) |
$71.99 |
$313 |
— |