| Upper GI endoscopy (EGD), diagnostic (43235) |
$225 |
$300 |
0.3× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$692.62 |
$923.50 |
0.9× |
| Diagnostic colonoscopy (45378) |
$341.25 |
$455 |
0.4× |
| Colonoscopy with biopsy (45380) |
$964.50 |
$1,286 |
0.9× |
| Colonoscopy with lesion removal (45385) |
$470.25 |
$627 |
0.5× |
Laparoscopic gallbladder removal (47562)
likely a partial charge, not the full procedure |
$618.75 |
$825 |
0.1× |
| Inguinal hernia repair (age 5+) (49505) |
$1,239 |
$1,652 |
0.4× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$205.50 |
$274 |
0.3× |
| CT head/brain without contrast (70450) |
$201 |
$268 |
2.2× |
| MRI brain without contrast (70551) |
$387.75 |
$517 |
1.9× |
| MRI brain with contrast (70552) |
$534.75 |
$713 |
1.8× |
| MRI brain without and with contrast (70553) |
$633.75 |
$845 |
2.1× |
| X-ray lower spine, 4+ views (72110) |
$84 |
$112 |
0.9× |
| MRI lumbar spine without contrast (72148) |
$378.75 |
$505 |
1.8× |
| CT pelvis with contrast (72193) |
$267.75 |
$357 |
1.8× |
| MRI lower-extremity joint without contrast (73721) |
$396.75 |
$529 |
1.9× |
| CT abdomen and pelvis with contrast (74177) |
$566.25 |
$755 |
1.9× |
| Ultrasound, abdomen complete (76700) |
$213.75 |
$285 |
2.4× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$243.75 |
$325 |
2.7× |
| Ultrasound, transvaginal (76830) |
$213.75 |
$285 |
2.4× |
| Mammography, one breast (diagnostic) (77065) |
$233.25 |
$311 |
2.7× |
| Mammography, both breasts (diagnostic) (77066) |
$293.25 |
$391 |
2.7× |
| Mammography, screening (bilateral) (77067) |
$237.75 |
$317 |
2.6× |
| Basic metabolic panel (80048) |
$15.75 |
$21 |
1.9× |
| Comprehensive metabolic panel (80053) |
$19.88 |
$26.50 |
1.9× |
| Lipid panel (80061) |
$24.75 |
$33 |
1.8× |
| Renal function panel (80069) |
$16.50 |
$22 |
1.9× |
| Hepatic function panel (80076) |
$15 |
$20 |
1.8× |
| Urinalysis, non-automated, without microscopy (81002) |
$6 |
$8 |
1.7× |
| PSA, total (84153) |
$37.94 |
$50.58 |
2.1× |
| Thyroid stimulating hormone (TSH) (84443) |
$31.50 |
$42 |
1.9× |
| CBC with automated differential (85025) |
$14.62 |
$19.50 |
1.9× |
| CBC, automated (85027) |
$13.28 |
$17.70 |
2.1× |
| Prothrombin time (PT) (85610) |
$7.50 |
$10 |
1.7× |
| Partial thromboplastin time (PTT) (85730) |
$11.25 |
$15 |
1.9× |
| Sleep study (attended polysomnography) (95810) |
$1,051.50 |
$1,402 |
1.4× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$41.25 |
$55 |
1.4× |