| Upper GI endoscopy (EGD), diagnostic (43235) |
$1,320.90 |
$3,570 |
1.4× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$1,452.25 |
$3,925 |
1.5× |
| Diagnostic colonoscopy (45378) |
$1,320.90 |
$3,570 |
1.4× |
| Colonoscopy with biopsy (45380) |
$1,452.25 |
$3,925 |
1.2× |
| Colonoscopy with lesion removal (45385) |
$1,452.25 |
$3,925 |
1.2× |
| Epidural injection, lumbar/sacral (with imaging) (62322) |
$556.11 |
$1,503 |
0.6× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$743.70 |
$2,010 |
0.8× |
| CT head/brain without contrast (70450) |
$578.31 |
$1,563 |
5.3× |
| MRI brain without contrast (70551) |
$1,353.09 |
$3,657 |
5.4× |
| MRI brain with contrast (70552) |
$1,491.84 |
$4,032 |
4.1× |
| MRI brain without and with contrast (70553) |
$1,919.19 |
$5,187 |
5.3× |
| X-ray lower spine, 4+ views (72110) |
$315.24 |
$852 |
2.9× |
| MRI lumbar spine without contrast (72148) |
$1,219.15 |
$3,295 |
4.9× |
| CT pelvis with contrast (72193) |
$838.05 |
$2,265 |
4.6× |
| MRI lower-extremity joint without contrast (73721) |
$1,310.91 |
$3,543 |
5.2× |
| CT abdomen and pelvis with contrast (74177) |
$982.35 |
$2,655 |
2.7× |
| Ultrasound, abdomen complete (76700) |
$403.30 |
$1,090 |
3.7× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$403.30 |
$1,090 |
3.7× |
| Ultrasound, transvaginal (76830) |
$361.86 |
$978 |
3.3× |
| Mammography, one breast (diagnostic) (77065) |
$208.68 |
$564 |
2.4× |
| Mammography, both breasts (diagnostic) (77066) |
$287.86 |
$778 |
2.6× |
| Mammography, screening (bilateral) (77067) |
$276.39 |
$747 |
3.0× |
| Basic metabolic panel (80048) |
$76.96 |
$208 |
9.1× |
| Comprehensive metabolic panel (80053) |
$93.24 |
$252 |
8.8× |
| Lipid panel (80061) |
$131.72 |
$356 |
9.8× |
| Renal function panel (80069) |
$83.99 |
$227 |
9.7× |
| Hepatic function panel (80076) |
$93.98 |
$254 |
11.5× |
| Urinalysis, non-automated, without microscopy (81002) |
$44.40 |
$120 |
12.8× |
| PSA, total (84153) |
$83.99 |
$227 |
4.6× |
| Thyroid stimulating hormone (TSH) (84443) |
$61.98 |
$167.50 |
3.7× |
| CBC with automated differential (85025) |
$117.66 |
$318 |
15.1× |
| CBC, automated (85027) |
$96.20 |
$260 |
14.9× |
| Prothrombin time (PT) (85610) |
$45.14 |
$122 |
10.5× |
| Partial thromboplastin time (PTT) (85730) |
$66.60 |
$180 |
11.1× |
| Psychotherapy, 30 minutes (90832) |
$178.90 |
$483.50 |
1.0× |
| Left heart catheterization (93452) |
$4,066.30 |
$10,990 |
1.2× |
| Sleep study (attended polysomnography) (95810) |
$1,784.88 |
$4,824 |
2.0× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$75.85 |
$205 |
2.6× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$56.61 |
$153 |
0.4× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$78.81 |
$213 |
0.6× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$104.34 |
$282 |
0.7× |