| Upper GI endoscopy (EGD), diagnostic (43235) |
$1,581 |
$2,108 |
1.5× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$1,686 |
$2,248 |
1.6× |
| Diagnostic colonoscopy (45378) |
$2,721.75 |
$3,629 |
2.4× |
| Colonoscopy with biopsy (45380) |
$1,764.75 |
$2,353 |
1.2× |
| Colonoscopy with lesion removal (45385) |
$1,903.50 |
$2,538 |
1.3× |
| Epidural injection, lumbar/sacral (with imaging) (62322) |
$1,009.12 |
$1,345.50 |
1.0× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$1,320 |
$1,760 |
1.2× |
| CT head/brain without contrast (70450) |
$1,106.25 |
$1,475 |
8.8× |
| MRI brain without contrast (70551) |
$3,159.75 |
$4,213 |
11.1× |
| MRI brain with contrast (70552) |
$3,465 |
$4,620 |
8.3× |
| MRI brain without and with contrast (70553) |
$4,116 |
$5,488 |
9.8× |
| X-ray lower spine, 4+ views (72110) |
$543.75 |
$725 |
4.3× |
| MRI lumbar spine without contrast (72148) |
$2,792.25 |
$3,723 |
9.8× |
| CT pelvis with contrast (72193) |
$1,649.25 |
$2,199 |
7.8× |
| MRI lower-extremity joint without contrast (73721) |
$3,036.75 |
$4,049 |
10.6× |
| CT abdomen and pelvis with contrast (74177) |
$1,754.25 |
$2,339 |
4.2× |
| Ultrasound, abdomen complete (76700) |
$619.50 |
$826 |
4.9× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$657.75 |
$877 |
5.2× |
| Ultrasound, transvaginal (76830) |
$430.50 |
$574 |
3.4× |
| Mammography, one breast (diagnostic) (77065) |
$412.50 |
$550 |
4.8× |
| Mammography, both breasts (diagnostic) (77066) |
$508.50 |
$678 |
4.6× |
| Mammography, screening (bilateral) (77067) |
$431.25 |
$575 |
4.7× |
| Basic metabolic panel (80048) |
$73.50 |
$98 |
8.7× |
| Comprehensive metabolic panel (80053) |
$90 |
$120 |
8.5× |
| Lipid panel (80061) |
$81.75 |
$109 |
6.1× |
| Renal function panel (80069) |
$81.75 |
$109 |
9.4× |
| Hepatic function panel (80076) |
$94.50 |
$126 |
11.6× |
| Urinalysis, non-automated, without microscopy (81002) |
$24.75 |
$33 |
7.1× |
| PSA, total (84153) |
$114 |
$152 |
6.2× |
| Thyroid stimulating hormone (TSH) (84443) |
$147.75 |
$197 |
8.8× |
| CBC with automated differential (85025) |
$69.75 |
$93 |
9.0× |
| CBC, automated (85027) |
$56.25 |
$75 |
8.7× |
| Prothrombin time (PT) (85610) |
$26.25 |
$35 |
6.1× |
| Partial thromboplastin time (PTT) (85730) |
$45.75 |
$61 |
7.6× |
| Psychotherapy, 45 minutes (90834) |
$295.12 |
$393.50 |
1.4× |
| Psychotherapy, 60 minutes (90837) |
$340.50 |
$454 |
1.6× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$129.75 |
$173 |
4.5× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$267.75 |
$357 |
1.7× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$621.38 |
$828.50 |
3.9× |
| Preventive visit, new patient (age 18–39) (99385) |
$168 |
$224 |
— |
| Preventive visit, new patient (age 40–64) (99386) |
$206.25 |
$275 |
— |