| Shoulder arthroscopy with decompression (29826) |
$2,012.50 |
$2,875 |
— |
| Upper GI endoscopy (EGD), diagnostic (43235) |
$1,400 |
$2,000 |
1.5× |
| Diagnostic colonoscopy (45378) |
$2,172.56 |
$3,103.66 |
2.2× |
| Colonoscopy with biopsy (45380) |
$2,304.07 |
$3,291.53 |
1.8× |
| Colonoscopy with lesion removal (45385) |
$2,258.19 |
$3,225.98 |
1.8× |
| Colonoscopy with endoscopic ultrasound (45391) |
$2,479.12 |
$3,541.60 |
2.0× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$1,711.16 |
$2,444.50 |
1.8× |
| After-cataract laser surgery (YAG capsulotomy) (66821) |
$1,297.80 |
$1,854 |
2.2× |
| Cataract removal with lens insertion (66984) |
$3,962.70 |
$5,661 |
1.6× |
| CT head/brain without contrast (70450) |
$1,474.34 |
$2,106.20 |
13.4× |
| MRI brain without contrast (70551) |
$1,211.17 |
$1,730.24 |
4.8× |
| MRI brain with contrast (70552) |
$1,364.05 |
$1,948.64 |
3.7× |
| MRI brain without and with contrast (70553) |
$1,882.08 |
$2,688.69 |
5.1× |
| X-ray lower spine, 4+ views (72110) |
$329.88 |
$471.25 |
3.0× |
| MRI lumbar spine without contrast (72148) |
$1,211.17 |
$1,730.24 |
4.8× |
| CT pelvis with contrast (72193) |
$1,529.04 |
$2,184.34 |
8.3× |
| MRI lower-extremity joint without contrast (73721) |
$1,211.17 |
$1,730.24 |
4.8× |
| CT abdomen and pelvis with contrast (74177) |
$2,730.69 |
$3,900.99 |
7.4× |
| Ultrasound, abdomen complete (76700) |
$475.51 |
$679.30 |
4.3× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$438.77 |
$626.81 |
4.0× |
| Ultrasound, transvaginal (76830) |
$365.88 |
$522.69 |
3.3× |
| Mammography, one breast (diagnostic) (77065) |
$217.89 |
$311.27 |
2.5× |
| Mammography, both breasts (diagnostic) (77066) |
$243.02 |
$347.18 |
2.2× |
| Mammography, screening (bilateral) (77067) |
$214.37 |
$306.24 |
2.4× |
| Basic metabolic panel (80048) |
$83.50 |
$119.28 |
9.9× |
| Comprehensive metabolic panel (80053) |
$122.73 |
$175.33 |
11.6× |
| Obstetric panel (80055) |
$194.04 |
$277.20 |
4.1× |
| Lipid panel (80061) |
$102.32 |
$146.18 |
7.6× |
| Renal function panel (80069) |
$102.45 |
$146.35 |
11.8× |
| Hepatic function panel (80076) |
$86.49 |
$123.55 |
10.6× |
| Urinalysis, non-automated, with microscopy (81000) |
$46.20 |
$66 |
11.5× |
| Urinalysis, non-automated, without microscopy (81002) |
$28 |
$40 |
8.0× |
| PSA, total (84153) |
$117.74 |
$168.20 |
6.4× |
| Thyroid stimulating hormone (TSH) (84443) |
$85.32 |
$121.88 |
5.1× |
| CBC with automated differential (85025) |
$83.83 |
$119.75 |
10.8× |
| CBC, automated (85027) |
$58.23 |
$83.18 |
9.0× |
| Prothrombin time (PT) (85610) |
$53.24 |
$76.05 |
12.4× |
| Partial thromboplastin time (PTT) (85730) |
$88.40 |
$126.28 |
14.7× |
| Sleep study (attended polysomnography) (95810) |
$1,960 |
$2,800 |
2.2× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$172.20 |
$246 |
5.9× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$133 |
$190 |
0.9× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$197.40 |
$282 |
1.4× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$260.40 |
$372 |
1.9× |