| Upper GI endoscopy (EGD), diagnostic (43235) |
$1,372.50 |
$2,745 |
1.5× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$1,372.50 |
$2,745 |
1.5× |
| Diagnostic colonoscopy (45378) |
$1,386.50 |
$2,773 |
1.4× |
| Colonoscopy with biopsy (45380) |
$1,386.50 |
$2,773 |
1.1× |
| Colonoscopy with lesion removal (45385) |
$1,386.50 |
$2,773 |
1.1× |
| Colonoscopy with endoscopic ultrasound (45391) |
$1,386.50 |
$2,773 |
1.1× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$421 |
$842 |
0.5× |
| CT head/brain without contrast (70450) |
$942.50 |
$1,885 |
8.7× |
| MRI brain without contrast (70551) |
$1,214.50 |
$2,429 |
4.9× |
| MRI brain with contrast (70552) |
$1,172 |
$2,344 |
3.2× |
| MRI brain without and with contrast (70553) |
$1,832 |
$3,664 |
5.1× |
| X-ray lower spine, 4+ views (72110) |
$393.50 |
$787 |
3.6× |
| MRI lumbar spine without contrast (72148) |
$1,844.50 |
$3,689 |
7.5× |
| CT pelvis with contrast (72193) |
$1,107.50 |
$2,215 |
6.1× |
| MRI lower-extremity joint without contrast (73721) |
$2,022 |
$4,044 |
8.2× |
| CT abdomen and pelvis with contrast (74177) |
$1,421.50 |
$2,843 |
3.9× |
| Ultrasound, abdomen complete (76700) |
$476 |
$952 |
4.4× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$454.50 |
$909 |
4.2× |
| Ultrasound, transvaginal (76830) |
$414 |
$828 |
3.8× |
| Basic metabolic panel (80048) |
$39 |
$78 |
4.6× |
| Comprehensive metabolic panel (80053) |
$56 |
$112 |
5.3× |
| Lipid panel (80061) |
$61.50 |
$123 |
4.6× |
| Renal function panel (80069) |
$27 |
$54 |
3.1× |
| Hepatic function panel (80076) |
$57 |
$114 |
7.0× |
| Urinalysis, non-automated, without microscopy (81002) |
$6 |
$12 |
1.7× |
| PSA, total (84153) |
$55 |
$110 |
3.0× |
| Thyroid stimulating hormone (TSH) (84443) |
$78.50 |
$157 |
4.7× |
| CBC with automated differential (85025) |
$36.50 |
$73 |
4.7× |
| CBC, automated (85027) |
$22.50 |
$45 |
3.5× |
| Prothrombin time (PT) (85610) |
$19 |
$38 |
4.4× |
| Partial thromboplastin time (PTT) (85730) |
$38.50 |
$77 |
6.4× |
| Psychotherapy, 30 minutes (90832) |
$200 |
$400 |
1.1× |
| Psychotherapy, 45 minutes (90834) |
$200 |
$400 |
1.1× |
| Psychotherapy, 60 minutes (90837) |
$200 |
$400 |
1.1× |
| Family psychotherapy, without patient (50 min) (90846) |
$200 |
$400 |
1.1× |
| Family psychotherapy, with patient (50 min) (90847) |
$200 |
$400 |
1.1× |
| Group psychotherapy (90853) |
$200 |
$400 |
1.9× |
| Left heart catheterization (93452) |
$6,393 |
$12,786 |
1.9× |
| Sleep study (attended polysomnography) (95810) |
$2,442.50 |
$4,885 |
2.7× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$63 |
$126 |
2.2× |