| Upper GI endoscopy (EGD), diagnostic (43235) |
$2,070.90 |
$3,186 |
2.4× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$1,929.20 |
$2,968 |
2.3× |
| CT head/brain without contrast (70450) |
$1,976 |
$3,040 |
20.1× |
| MRI brain without contrast (70551) |
$2,609.75 |
$4,015 |
11.7× |
| MRI brain with contrast (70552) |
$2,855.45 |
$4,393 |
8.7× |
| MRI brain without and with contrast (70553) |
$3,367 |
$5,180 |
10.3× |
| X-ray lower spine, 4+ views (72110) |
$687.05 |
$1,057 |
7.0× |
| MRI lumbar spine without contrast (72148) |
$2,605.85 |
$4,009 |
11.6× |
| CT pelvis with contrast (72193) |
$2,102.10 |
$3,234 |
12.8× |
| MRI lower-extremity joint without contrast (73721) |
$2,893.48 |
$4,451.50 |
12.9× |
| CT abdomen and pelvis with contrast (74177) |
$4,238 |
$6,520 |
12.9× |
| Ultrasound, abdomen complete (76700) |
$897 |
$1,380 |
9.1× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$735.15 |
$1,131 |
7.5× |
| Ultrasound, transvaginal (76830) |
$735.15 |
$1,131 |
7.5× |
| Mammography, one breast (diagnostic) (77065) |
$330.85 |
$509 |
3.8× |
| Mammography, both breasts (diagnostic) (77066) |
$408.20 |
$628 |
3.7× |
| Mammography, screening (bilateral) (77067) |
$363.68 |
$559.50 |
4.0× |
| Basic metabolic panel (80048) |
$154.05 |
$237 |
18.2× |
| Comprehensive metabolic panel (80053) |
$183.30 |
$282 |
17.4× |
| Obstetric panel (80055) |
$439.40 |
$676 |
9.2× |
| Lipid panel (80061) |
$167.05 |
$257 |
12.5× |
| Renal function panel (80069) |
$188.50 |
$290 |
21.7× |
| Hepatic function panel (80076) |
$180.05 |
$277 |
22.0× |
| PSA, total (84153) |
$206.38 |
$317.50 |
11.2× |
| Thyroid stimulating hormone (TSH) (84443) |
$152.42 |
$234.50 |
9.1× |
| CBC with automated differential (85025) |
$132.28 |
$203.50 |
17.0× |
| CBC, automated (85027) |
$96.20 |
$148 |
14.9× |
| Prothrombin time (PT) (85610) |
$83.85 |
$129 |
19.5× |
| Partial thromboplastin time (PTT) (85730) |
$143 |
$220 |
23.8× |
| Electrocardiogram (ECG), complete (93000) |
$22.75 |
$35 |
0.4× |
| Sleep study (attended polysomnography) (95810) |
$5,779.48 |
$8,891.50 |
7.2× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$165.10 |
$254 |
5.7× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$107.90 |
$166 |
0.9× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$159.90 |
$246 |
1.3× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$211.25 |
$325 |
1.7× |