| Upper GI endoscopy (EGD), diagnostic (43235) |
$1,484 |
$2,968 |
1.5× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$1,484 |
$2,968 |
1.5× |
| Diagnostic colonoscopy (45378) |
$1,443.50 |
$2,887 |
1.4× |
| Epidural injection, lumbar/sacral (with imaging) (62322) |
$1,415.50 |
$2,831 |
1.5× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$2,262.75 |
$4,525.50 |
2.4× |
| CT head/brain without contrast (70450) |
$627.50 |
$1,255 |
5.6× |
| MRI brain without contrast (70551) |
$833.50 |
$1,667 |
3.3× |
| MRI brain with contrast (70552) |
$886 |
$1,772 |
2.4× |
| MRI brain without and with contrast (70553) |
$1,479 |
$2,958 |
4.0× |
| X-ray lower spine, 4+ views (72110) |
$575.50 |
$1,151 |
5.1× |
| MRI lumbar spine without contrast (72148) |
$835 |
$1,670 |
3.3× |
| CT pelvis with contrast (72193) |
$796 |
$1,592 |
4.2× |
| MRI lower-extremity joint without contrast (73721) |
$835 |
$1,670 |
3.3× |
| CT abdomen and pelvis with contrast (74177) |
$1,064.50 |
$2,129 |
2.8× |
| Ultrasound, abdomen complete (76700) |
$867 |
$1,734 |
7.7× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$708 |
$1,416 |
6.3× |
| Ultrasound, transvaginal (76830) |
$575.50 |
$1,151 |
5.1× |
| Mammography, one breast (diagnostic) (77065) |
$270.50 |
$541 |
3.1× |
| Mammography, both breasts (diagnostic) (77066) |
$364.50 |
$729 |
3.3× |
| Mammography, screening (bilateral) (77067) |
$345.50 |
$691 |
3.8× |
| Basic metabolic panel (80048) |
$150.50 |
$301 |
17.8× |
| Comprehensive metabolic panel (80053) |
$194.50 |
$389 |
18.4× |
| Obstetric panel (80055) |
$508 |
$1,016 |
10.6× |
| Lipid panel (80061) |
$145 |
$290 |
10.8× |
| Renal function panel (80069) |
$188.50 |
$377 |
21.7× |
| Hepatic function panel (80076) |
$228 |
$456 |
27.9× |
| Urinalysis, non-automated, without microscopy (81002) |
$25 |
$50 |
7.2× |
| PSA, total (84153) |
$141 |
$282 |
7.7× |
| Thyroid stimulating hormone (TSH) (84443) |
$161.50 |
$323 |
9.6× |
| CBC with automated differential (85025) |
$100.50 |
$201 |
12.9× |
| CBC, automated (85027) |
$82.50 |
$165 |
12.8× |
| Prothrombin time (PT) (85610) |
$45 |
$90 |
10.5× |
| Partial thromboplastin time (PTT) (85730) |
$79 |
$158 |
13.1× |
| Psychotherapy, 30 minutes (90832) |
$283 |
$566 |
1.5× |
| Psychotherapy, 45 minutes (90834) |
$375.50 |
$751 |
2.0× |
| Psychotherapy, 60 minutes (90837) |
$396 |
$792 |
2.1× |
| Family psychotherapy, without patient (50 min) (90846) |
$462 |
$924 |
2.4× |
| Family psychotherapy, with patient (50 min) (90847) |
$350.50 |
$701 |
1.8× |
| Group psychotherapy (90853) |
$142 |
$284 |
1.3× |
| Left heart catheterization (93452) |
$5,586.50 |
$11,173 |
1.6× |
| Sleep study (attended polysomnography) (95810) |
$3,133.50 |
$6,267 |
3.4× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$124 |
$248 |
4.3× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$342.50 |
$685 |
2.4× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$401.50 |
$803 |
2.8× |