| Upper GI endoscopy (EGD), diagnostic (43235) |
$904.09 |
$1,291.55 |
1.1× |
| Epidural injection, lumbar/sacral (with imaging) (62322) |
$954.80 |
$1,364 |
1.2× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$831.16 |
$1,187.38 |
1.0× |
| CT head/brain without contrast (70450) |
$1,495.20 |
$2,136 |
15.6× |
| MRI brain without contrast (70551) |
$2,399.53 |
$3,427.90 |
10.9× |
| MRI brain with contrast (70552) |
$2,181.45 |
$3,116.35 |
6.8× |
| MRI brain without and with contrast (70553) |
$2,880.78 |
$4,115.40 |
9.0× |
| X-ray lower spine, 4+ views (72110) |
$391.20 |
$558.85 |
4.1× |
| MRI lumbar spine without contrast (72148) |
$2,356.62 |
$3,366.60 |
10.7× |
| CT pelvis with contrast (72193) |
$2,009.81 |
$2,871.15 |
12.5× |
| MRI lower-extremity joint without contrast (73721) |
$1,872.33 |
$2,674.75 |
8.5× |
| CT abdomen and pelvis with contrast (74177) |
$2,752.75 |
$3,932.50 |
8.6× |
| Ultrasound, abdomen complete (76700) |
$347.45 |
$496.35 |
3.6× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$235.10 |
$335.85 |
2.4× |
| Ultrasound, transvaginal (76830) |
$220.05 |
$314.35 |
2.3× |
| Mammography, one breast (diagnostic) (77065) |
$143.96 |
$205.65 |
1.7× |
| Mammography, both breasts (diagnostic) (77066) |
$198.56 |
$283.65 |
1.8× |
| Mammography, screening (bilateral) (77067) |
$146.72 |
$209.60 |
1.6× |
| Basic metabolic panel (80048) |
$83.30 |
$119 |
9.8× |
| Comprehensive metabolic panel (80053) |
$163.35 |
$233.35 |
15.5× |
| Obstetric panel (80055) |
$309.09 |
$441.55 |
6.5× |
| Lipid panel (80061) |
$103.67 |
$148.10 |
7.7× |
| Renal function panel (80069) |
$109.66 |
$156.65 |
12.6× |
| Hepatic function panel (80076) |
$94.71 |
$135.30 |
11.6× |
| Urinalysis, non-automated, without microscopy (81002) |
$20.41 |
$29.15 |
5.9× |
| PSA, total (84153) |
$148.47 |
$212.10 |
8.1× |
| Thyroid stimulating hormone (TSH) (84443) |
$122.40 |
$174.85 |
7.3× |
| CBC with automated differential (85025) |
$73.47 |
$104.95 |
9.5× |
| CBC, automated (85027) |
$57.96 |
$82.80 |
9.0× |
| Prothrombin time (PT) (85610) |
$43.89 |
$62.70 |
10.2× |
| Partial thromboplastin time (PTT) (85730) |
$52.78 |
$75.40 |
8.8× |
| Electrocardiogram (ECG), complete (93000) |
$28 |
$40 |
0.5× |
| Sleep study (attended polysomnography) (95810) |
$1,227.30 |
$1,753.28 |
1.6× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$88.52 |
$126.45 |
3.0× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$151.41 |
$216.30 |
1.2× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$232.61 |
$332.30 |
1.9× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$289.77 |
$413.95 |
2.4× |