| Upper GI endoscopy (EGD), diagnostic (43235) |
$1,119.60 |
$3,732 |
1.3× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$1,132.20 |
$3,774 |
1.3× |
| Diagnostic colonoscopy (45378) |
$1,256.10 |
$4,187 |
1.4× |
| Colonoscopy with biopsy (45380) |
$1,536.30 |
$5,121 |
1.3× |
| Colonoscopy with lesion removal (45385) |
$1,536.30 |
$5,121 |
1.3× |
| Epidural injection, lumbar/sacral (with imaging) (62322) |
$978 |
$3,260 |
1.1× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$1,675.12 |
$5,583.75 |
2.0× |
| CT head/brain without contrast (70450) |
$1,402.50 |
$4,675 |
13.9× |
| MRI brain without contrast (70551) |
$1,002.90 |
$3,343 |
4.4× |
| MRI brain with contrast (70552) |
$1,103.10 |
$3,677 |
3.3× |
| MRI brain without and with contrast (70553) |
$1,376.10 |
$4,587 |
4.1× |
| X-ray lower spine, 4+ views (72110) |
$428.10 |
$1,427 |
4.3× |
| MRI lumbar spine without contrast (72148) |
$1,105.80 |
$3,686 |
4.8× |
| CT pelvis with contrast (72193) |
$845.70 |
$2,819 |
5.0× |
| MRI lower-extremity joint without contrast (73721) |
$2,061 |
$6,870 |
9.0× |
| CT abdomen and pelvis with contrast (74177) |
$2,208 |
$7,360 |
6.6× |
| Ultrasound, abdomen complete (76700) |
$622.80 |
$2,076 |
6.2× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$447.30 |
$1,491 |
4.4× |
| Ultrasound, transvaginal (76830) |
$293.70 |
$979 |
2.9× |
| Mammography, one breast (diagnostic) (77065) |
$290.70 |
$969 |
3.4× |
| Mammography, both breasts (diagnostic) (77066) |
$339.90 |
$1,133 |
3.1× |
| Mammography, screening (bilateral) (77067) |
$274.20 |
$914 |
3.0× |
| Basic metabolic panel (80048) |
$109.80 |
$366 |
13.0× |
| Comprehensive metabolic panel (80053) |
$117.60 |
$392 |
11.1× |
| Lipid panel (80061) |
$97.50 |
$325 |
7.3× |
| Renal function panel (80069) |
$110.70 |
$369 |
12.8× |
| Hepatic function panel (80076) |
$61.80 |
$206 |
7.6× |
| Urinalysis, non-automated, without microscopy (81002) |
$4.80 |
$16 |
1.4× |
| PSA, total (84153) |
$96 |
$320 |
5.2× |
| Thyroid stimulating hormone (TSH) (84443) |
$186.90 |
$623 |
11.1× |
| CBC with automated differential (85025) |
$113.10 |
$377 |
14.6× |
| CBC, automated (85027) |
$79.20 |
$264 |
12.2× |
| Prothrombin time (PT) (85610) |
$76.50 |
$255 |
17.8× |
| Partial thromboplastin time (PTT) (85730) |
$110.40 |
$368 |
18.4× |
| Left heart catheterization (93452) |
$2,934.30 |
$9,781 |
0.9× |
| Sleep study (attended polysomnography) (95810) |
$2,522.40 |
$8,408 |
3.1× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$57.15 |
$190.50 |
2.0× |