| Upper GI endoscopy (EGD) with biopsy (43239) |
$2,909 |
$2,909 |
3.1× |
| CT head/brain without contrast (70450) |
$1,827 |
$1,827 |
17.1× |
| MRI brain without contrast (70551) |
$2,749 |
$2,749 |
11.3× |
| MRI brain with contrast (70552) |
$4,236 |
$4,236 |
11.9× |
| MRI brain without and with contrast (70553) |
$3,998 |
$3,998 |
11.2× |
| X-ray lower spine, 4+ views (72110) |
$548 |
$548 |
5.1× |
| MRI lumbar spine without contrast (72148) |
$3,163 |
$3,163 |
13.0× |
| CT pelvis with contrast (72193) |
$2,069 |
$2,069 |
11.5× |
| MRI lower-extremity joint without contrast (73721) |
$2,487 |
$2,487 |
10.2× |
| CT abdomen and pelvis with contrast (74177) |
$4,719 |
$4,719 |
13.2× |
| Ultrasound, abdomen complete (76700) |
$1,344 |
$1,344 |
12.6× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$972 |
$972 |
9.1× |
| Ultrasound, transvaginal (76830) |
$746 |
$746 |
7.0× |
| Mammography, one breast (diagnostic) (77065) |
$352 |
$352 |
4.1× |
| Mammography, both breasts (diagnostic) (77066) |
$426 |
$426 |
3.9× |
| Mammography, screening (bilateral) (77067) |
$301 |
$301 |
3.3× |
| Basic metabolic panel (80048) |
$114 |
$114 |
13.5× |
| Comprehensive metabolic panel (80053) |
$219 |
$219 |
20.7× |
| Lipid panel (80061) |
$141 |
$141 |
10.5× |
| Renal function panel (80069) |
$167 |
$167 |
19.2× |
| Hepatic function panel (80076) |
$110 |
$110 |
13.5× |
| PSA, total (84153) |
$101 |
$101 |
5.5× |
| Thyroid stimulating hormone (TSH) (84443) |
$94 |
$94 |
5.6× |
| CBC with automated differential (85025) |
$81 |
$81 |
10.4× |
| CBC, automated (85027) |
$68 |
$68 |
10.5× |
| Prothrombin time (PT) (85610) |
$47 |
$47 |
11.0× |
| Partial thromboplastin time (PTT) (85730) |
$78 |
$78 |
13.0× |
| Sleep study (attended polysomnography) (95810) |
$4,364 |
$4,364 |
5.0× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$76 |
$76 |
2.6× |