| Upper GI endoscopy (EGD), diagnostic (43235) |
$1,055.68 |
$3,299 |
1.2× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$1,468.16 |
$4,588 |
1.6× |
| Diagnostic colonoscopy (45378) |
$1,468.16 |
$4,588 |
1.6× |
| Colonoscopy with biopsy (45380) |
$1,468.16 |
$4,588 |
1.2× |
| Colonoscopy with lesion removal (45385) |
$1,468.16 |
$4,588 |
1.2× |
| Colonoscopy with endoscopic ultrasound (45391) |
$1,061.52 |
$3,317.25 |
0.9× |
| Epidural injection, lumbar/sacral (with imaging) (62322) |
$1,287.84 |
$4,024.50 |
1.4× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$737.92 |
$2,306 |
0.8× |
| CT head/brain without contrast (70450) |
$1,026.88 |
$3,209 |
9.8× |
| MRI brain without contrast (70551) |
$1,312.32 |
$4,101 |
5.5× |
| MRI brain with contrast (70552) |
$1,675.04 |
$5,234.50 |
4.8× |
| MRI brain without and with contrast (70553) |
$2,093.20 |
$6,541.25 |
6.0× |
| X-ray lower spine, 4+ views (72110) |
$744.48 |
$2,326.50 |
7.1× |
| MRI lumbar spine without contrast (72148) |
$1,515.12 |
$4,734.75 |
6.3× |
| CT pelvis with contrast (72193) |
$1,986.72 |
$6,208.50 |
11.3× |
| MRI lower-extremity joint without contrast (73721) |
$2,012.70 |
$6,289.69 |
8.4× |
| CT abdomen and pelvis with contrast (74177) |
$3,033.20 |
$9,478.75 |
8.7× |
| Ultrasound, abdomen complete (76700) |
$1,177.60 |
$3,680 |
11.2× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$917.76 |
$2,868 |
8.7× |
| Ultrasound, transvaginal (76830) |
$757.04 |
$2,365.75 |
7.2× |
| Mammography, one breast (diagnostic) (77065) |
$145.92 |
$456 |
1.7× |
| Mammography, both breasts (diagnostic) (77066) |
$153.20 |
$478.75 |
1.4× |
| Mammography, screening (bilateral) (77067) |
$144.16 |
$450.50 |
1.6× |
| Basic metabolic panel (80048) |
$183.28 |
$572.75 |
21.7× |
| Comprehensive metabolic panel (80053) |
$251.36 |
$785.50 |
23.8× |
| Lipid panel (80061) |
$261.08 |
$815.88 |
19.5× |
| Renal function panel (80069) |
$53.72 |
$167.88 |
6.2× |
| Hepatic function panel (80076) |
$112.40 |
$351.25 |
13.8× |
| Urinalysis, non-automated, without microscopy (81002) |
$114.08 |
$356.50 |
32.8× |
| PSA, total (84153) |
$54.04 |
$168.88 |
2.9× |
| Thyroid stimulating hormone (TSH) (84443) |
$46.40 |
$145 |
2.8× |
| CBC with automated differential (85025) |
$91.36 |
$285.50 |
11.8× |
| CBC, automated (85027) |
$43.20 |
$135 |
6.7× |
| Prothrombin time (PT) (85610) |
$29.60 |
$92.50 |
6.9× |
| Partial thromboplastin time (PTT) (85730) |
$22.16 |
$69.25 |
3.7× |
| Psychotherapy, 30 minutes (90832) |
$192.08 |
$600.25 |
1.1× |
| Psychotherapy, 45 minutes (90834) |
$250 |
$781.25 |
1.4× |
| Psychotherapy, 60 minutes (90837) |
$274.08 |
$856.50 |
1.5× |
| Family psychotherapy, without patient (50 min) (90846) |
$258.40 |
$807.50 |
1.4× |
| Family psychotherapy, with patient (50 min) (90847) |
$281.92 |
$881 |
1.6× |
| Group psychotherapy (90853) |
$251.36 |
$785.50 |
2.5× |
| Left heart catheterization (93452) |
$2,988.40 |
$9,338.75 |
0.9× |
| Sleep study (attended polysomnography) (95810) |
$1,339.08 |
$4,184.62 |
1.6× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$105.88 |
$330.88 |
3.6× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$35.28 |
$110.25 |
0.3× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$51.20 |
$160 |
0.4× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$54.40 |
$170 |
0.4× |
| Office consultation (low complexity, ~30 min) (99243) |
$89.36 |
$279.25 |
0.7× |
| Office consultation (moderate complexity, ~40 min) (99244) |
$162.32 |
$507.25 |
1.2× |