| Upper GI endoscopy (EGD), diagnostic (43235) |
$1,207.68 |
$3,264 |
1.4× |
| Epidural injection, lumbar/sacral (with imaging) (62322) |
$994.56 |
$2,688 |
1.2× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$994.56 |
$2,688 |
1.2× |
| CT head/brain without contrast (70450) |
$972.73 |
$2,629 |
10.0× |
| MRI brain without contrast (70551) |
$1,586.56 |
$4,288 |
7.1× |
| MRI brain with contrast (70552) |
$1,687.94 |
$4,562 |
5.2× |
| MRI brain without and with contrast (70553) |
$1,790.43 |
$4,839 |
5.5× |
| X-ray lower spine, 4+ views (72110) |
$216.08 |
$584 |
2.2× |
| MRI lumbar spine without contrast (72148) |
$1,534.76 |
$4,148 |
6.9× |
| CT pelvis with contrast (72193) |
$1,023.42 |
$2,766 |
6.3× |
| MRI lower-extremity joint without contrast (73721) |
$1,484.07 |
$4,011 |
6.7× |
| CT abdomen and pelvis with contrast (74177) |
$1,216.93 |
$3,289 |
3.8× |
| Ultrasound, abdomen complete (76700) |
$502.46 |
$1,358 |
5.2× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$384.06 |
$1,038 |
3.9× |
| Ultrasound, transvaginal (76830) |
$298.22 |
$806 |
3.1× |
| Mammography, one breast (diagnostic) (77065) |
$132.09 |
$357 |
1.5× |
| Mammography, both breasts (diagnostic) (77066) |
$170.57 |
$461 |
1.5× |
| Mammography, screening (bilateral) (77067) |
$132.09 |
$357 |
1.4× |
| Basic metabolic panel (80048) |
$152.44 |
$412 |
18.0× |
| Comprehensive metabolic panel (80053) |
$179.82 |
$486 |
17.0× |
| Obstetric panel (80055) |
$122.10 |
$330 |
2.6× |
| Lipid panel (80061) |
$56.24 |
$152 |
4.2× |
| Renal function panel (80069) |
$173.90 |
$470 |
20.0× |
| Hepatic function panel (80076) |
$82.14 |
$222 |
10.1× |
| PSA, total (84153) |
$43.10 |
$116.50 |
2.3× |
| Thyroid stimulating hormone (TSH) (84443) |
$40.52 |
$109.50 |
2.4× |
| CBC with automated differential (85025) |
$68.45 |
$185 |
8.8× |
| CBC, automated (85027) |
$11.47 |
$31 |
1.8× |
| Prothrombin time (PT) (85610) |
$41.81 |
$113 |
9.7× |
| Partial thromboplastin time (PTT) (85730) |
$53.84 |
$145.50 |
9.0× |
| Psychotherapy, 30 minutes (90832) |
$98.79 |
$267 |
0.6× |
| Psychotherapy, 45 minutes (90834) |
$137.27 |
$371 |
0.8× |
| Family psychotherapy, with patient (50 min) (90847) |
$163.17 |
$441 |
1.0× |
| Group psychotherapy (90853) |
$111 |
$300 |
1.2× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$62.90 |
$170 |
2.2× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$85.28 |
$230.50 |
0.7× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$135.60 |
$366.50 |
1.1× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$178.71 |
$483 |
1.4× |