| Upper GI endoscopy (EGD), diagnostic (43235) |
$1,615.50 |
$5,385 |
1.9× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$1,720.20 |
$5,734 |
2.0× |
| Diagnostic colonoscopy (45378) |
$1,458.30 |
$4,861 |
1.6× |
| Colonoscopy with biopsy (45380) |
$1,591.80 |
$5,306 |
1.4× |
| Colonoscopy with lesion removal (45385) |
$1,730.10 |
$5,767 |
1.5× |
| Epidural injection, lumbar/sacral (with imaging) (62322) |
$639.30 |
$2,131 |
0.8× |
| CT head/brain without contrast (70450) |
$856.80 |
$2,856 |
8.5× |
| MRI brain without contrast (70551) |
$999 |
$3,330 |
4.4× |
| MRI brain with contrast (70552) |
$1,640.10 |
$5,467 |
4.9× |
| MRI brain without and with contrast (70553) |
$1,488.90 |
$4,963 |
4.4× |
| X-ray lower spine, 4+ views (72110) |
$437.10 |
$1,457 |
4.3× |
| MRI lumbar spine without contrast (72148) |
$1,365 |
$4,550 |
5.9× |
| CT pelvis with contrast (72193) |
$1,021.20 |
$3,404 |
6.1× |
| MRI lower-extremity joint without contrast (73721) |
$1,566.75 |
$5,222.50 |
6.8× |
| CT abdomen and pelvis with contrast (74177) |
$1,370.10 |
$4,567 |
4.1× |
| Ultrasound, abdomen complete (76700) |
$536.10 |
$1,787 |
5.3× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$496.20 |
$1,654 |
4.9× |
| Ultrasound, transvaginal (76830) |
$350.40 |
$1,168 |
3.5× |
| Mammography, one breast (diagnostic) (77065) |
$124.80 |
$416 |
1.4× |
| Mammography, both breasts (diagnostic) (77066) |
$171 |
$570 |
1.5× |
| Mammography, screening (bilateral) (77067) |
$148.80 |
$496 |
1.6× |
| Basic metabolic panel (80048) |
$140.10 |
$467 |
16.6× |
| Comprehensive metabolic panel (80053) |
$173.70 |
$579 |
16.4× |
| Lipid panel (80061) |
$176.40 |
$588 |
13.2× |
| Renal function panel (80069) |
$139.50 |
$465 |
16.1× |
| Hepatic function panel (80076) |
$106.80 |
$356 |
13.1× |
| Urinalysis, non-automated, without microscopy (81002) |
$4.20 |
$14 |
1.2× |
| PSA, total (84153) |
$85.20 |
$284 |
4.6× |
| Thyroid stimulating hormone (TSH) (84443) |
$79.50 |
$265 |
4.7× |
| CBC with automated differential (85025) |
$141.90 |
$473 |
18.3× |
| CBC, automated (85027) |
$63.30 |
$211 |
9.8× |
| Prothrombin time (PT) (85610) |
$101.10 |
$337 |
23.6× |
| Partial thromboplastin time (PTT) (85730) |
$134.70 |
$449 |
22.4× |
| Sleep study (attended polysomnography) (95810) |
$2,297.40 |
$7,658 |
2.8× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$69.90 |
$233 |
2.4× |