| Upper GI endoscopy (EGD), diagnostic (43235) |
$1,187.55 |
$1,696.50 |
1.1× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$1,652 |
$2,360 |
1.5× |
| Diagnostic colonoscopy (45378) |
$1,285.72 |
$1,836.75 |
1.2× |
| Colonoscopy with lesion removal (45385) |
$2,028.60 |
$2,898 |
1.4× |
| Epidural injection, lumbar/sacral (with imaging) (62322) |
$676.90 |
$967 |
0.6× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$1,305.50 |
$1,865 |
1.2× |
| CT head/brain without contrast (70450) |
$684.60 |
$978 |
5.5× |
| MRI brain without contrast (70551) |
$1,381.10 |
$1,973 |
4.8× |
| MRI brain with contrast (70552) |
$1,381.10 |
$1,973 |
3.3× |
| MRI brain without and with contrast (70553) |
$2,760.80 |
$3,944 |
6.6× |
| X-ray lower spine, 4+ views (72110) |
$506.10 |
$723 |
4.0× |
| MRI lumbar spine without contrast (72148) |
$1,381.10 |
$1,973 |
4.8× |
| CT pelvis with contrast (72193) |
$1,442 |
$2,060 |
6.9× |
| MRI lower-extremity joint without contrast (73721) |
$1,370.78 |
$1,958.25 |
4.8× |
| CT abdomen and pelvis with contrast (74177) |
$2,531.90 |
$3,617 |
6.1× |
| Ultrasound, abdomen complete (76700) |
$758.10 |
$1,083 |
6.1× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$364 |
$520 |
2.9× |
| Ultrasound, transvaginal (76830) |
$469 |
$670 |
3.7× |
| Mammography, one breast (diagnostic) (77065) |
$273.18 |
$390.25 |
3.2× |
| Mammography, both breasts (diagnostic) (77066) |
$694.40 |
$992 |
6.3× |
| Mammography, screening (bilateral) (77067) |
$315 |
$450 |
3.5× |
| Basic metabolic panel (80048) |
$21.70 |
$31 |
2.6× |
| Comprehensive metabolic panel (80053) |
$27.30 |
$39 |
2.6× |
| Obstetric panel (80055) |
$117.60 |
$168 |
2.5× |
| Lipid panel (80061) |
$35 |
$50 |
2.6× |
| Renal function panel (80069) |
$22.40 |
$32 |
2.6× |
| Hepatic function panel (80076) |
$20.30 |
$29 |
2.5× |
| Urinalysis, non-automated, without microscopy (81002) |
$32.20 |
$46 |
9.3× |
| PSA, total (84153) |
$45.50 |
$65 |
2.5× |
| Thyroid stimulating hormone (TSH) (84443) |
$43.40 |
$62 |
2.6× |
| CBC with automated differential (85025) |
$18.90 |
$27 |
2.4× |
| CBC, automated (85027) |
$16.10 |
$23 |
2.5× |
| Prothrombin time (PT) (85610) |
$10.50 |
$15 |
2.4× |
| Partial thromboplastin time (PTT) (85730) |
$14.70 |
$21 |
2.4× |
| Psychotherapy, 30 minutes (90832) |
$244.65 |
$349.50 |
1.2× |
| Psychotherapy, 45 minutes (90834) |
$221.20 |
$316 |
1.0× |
| Psychotherapy, 60 minutes (90837) |
$163.10 |
$233 |
0.8× |
| Family psychotherapy, without patient (50 min) (90846) |
$365.40 |
$522 |
1.7× |
| Family psychotherapy, with patient (50 min) (90847) |
$163.10 |
$233 |
0.8× |
| Group psychotherapy (90853) |
$190.05 |
$271.50 |
1.6× |
| Left heart catheterization (93452) |
$5,958.40 |
$8,512 |
1.5× |
| Sleep study (attended polysomnography) (95810) |
$1,792.88 |
$2,561.25 |
1.7× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$101.50 |
$145 |
3.5× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$175 |
$250 |
1.1× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$213.50 |
$305 |
1.3× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$301 |
$430 |
1.9× |
| Preventive visit, new patient (age 18–39) (99385) |
$184.80 |
$264 |
— |
| Preventive visit, new patient (age 40–64) (99386) |
$184.80 |
$264 |
— |