| Upper GI endoscopy (EGD), diagnostic (43235) |
$1,332.50 |
$1,332.50 |
1.4× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$1,423.50 |
$1,423.50 |
1.5× |
| Diagnostic colonoscopy (45378) |
$1,459.50 |
$1,459.50 |
1.5× |
| Colonoscopy with biopsy (45380) |
$1,505.50 |
$1,505.50 |
1.2× |
| Colonoscopy with lesion removal (45385) |
$1,598 |
$1,598 |
1.3× |
| Epidural injection, lumbar/sacral (with imaging) (62322) |
$1,460 |
$1,460 |
1.6× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$2,291 |
$2,291 |
2.5× |
| CT head/brain without contrast (70450) |
$947 |
$947 |
8.8× |
| MRI brain without contrast (70551) |
$1,808.50 |
$1,808.50 |
7.3× |
| MRI brain with contrast (70552) |
$1,980.50 |
$1,980.50 |
5.5× |
| MRI brain without and with contrast (70553) |
$2,294 |
$2,294 |
6.4× |
| X-ray lower spine, 4+ views (72110) |
$325 |
$325 |
3.0× |
| MRI lumbar spine without contrast (72148) |
$1,744.50 |
$1,744.50 |
7.1× |
| CT pelvis with contrast (72193) |
$1,272.50 |
$1,272.50 |
7.0× |
| MRI lower-extremity joint without contrast (73721) |
$1,750 |
$1,750 |
7.1× |
| CT abdomen and pelvis with contrast (74177) |
$2,027.50 |
$2,027.50 |
5.6× |
| Ultrasound, abdomen complete (76700) |
$472 |
$472 |
4.4× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$473.50 |
$473.50 |
4.4× |
| Ultrasound, transvaginal (76830) |
$364 |
$364 |
3.4× |
| Mammography, one breast (diagnostic) (77065) |
$286 |
$286 |
3.3× |
| Mammography, both breasts (diagnostic) (77066) |
$353 |
$353 |
3.2× |
| Mammography, screening (bilateral) (77067) |
$289.50 |
$289.50 |
3.2× |
| Basic metabolic panel (80048) |
$177 |
$177 |
20.9× |
| Comprehensive metabolic panel (80053) |
$212 |
$212 |
20.1× |
| Lipid panel (80061) |
$164 |
$164 |
12.2× |
| Renal function panel (80069) |
$183 |
$183 |
21.1× |
| Hepatic function panel (80076) |
$212 |
$212 |
25.9× |
| PSA, total (84153) |
$292 |
$292 |
15.9× |
| Thyroid stimulating hormone (TSH) (84443) |
$164 |
$164 |
9.8× |
| CBC with automated differential (85025) |
$148 |
$148 |
19.0× |
| CBC, automated (85027) |
$116 |
$116 |
17.9× |
| Prothrombin time (PT) (85610) |
$75 |
$75 |
17.5× |
| Partial thromboplastin time (PTT) (85730) |
$102 |
$102 |
17.0× |
| Psychotherapy, 30 minutes (90832) |
$470.50 |
$470.50 |
2.6× |
| Psychotherapy, 45 minutes (90834) |
$578.50 |
$578.50 |
3.2× |
| Psychotherapy, 60 minutes (90837) |
$674 |
$674 |
3.7× |
| Family psychotherapy, without patient (50 min) (90846) |
$609.50 |
$609.50 |
3.3× |
| Family psychotherapy, with patient (50 min) (90847) |
$651 |
$651 |
3.6× |
| Group psychotherapy (90853) |
$870.50 |
$870.50 |
8.3× |
| Electrocardiogram (ECG), complete (93000) |
$300 |
$300 |
4.9× |
| Sleep study (attended polysomnography) (95810) |
$4,326 |
$4,326 |
4.9× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$154 |
$154 |
5.3× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$330 |
$330 |
2.4× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$485 |
$485 |
3.5× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$630 |
$630 |
4.6× |
| Office consultation (low complexity, ~30 min) (99243) |
$474 |
$474 |
3.4× |
| Office consultation (moderate complexity, ~40 min) (99244) |
$643 |
$643 |
4.7× |
| Preventive visit, new patient (age 18–39) (99385) |
$560 |
$560 |
— |
| Preventive visit, new patient (age 40–64) (99386) |
$620 |
$620 |
— |