| Upper GI endoscopy (EGD), diagnostic (43235) |
$718.06 |
$1,561 |
0.8× |
| Epidural injection, lumbar/sacral (with imaging) (62322) |
$1,920.50 |
$4,175 |
2.2× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$1,607.24 |
$3,494 |
1.8× |
| CT head/brain without contrast (70450) |
$746.35 |
$1,622.50 |
7.3× |
| MRI brain without contrast (70551) |
$1,150.46 |
$2,501 |
4.9× |
| MRI brain with contrast (70552) |
$1,390.12 |
$3,022 |
4.0× |
| MRI brain without and with contrast (70553) |
$1,859.09 |
$4,041.50 |
5.4× |
| X-ray lower spine, 4+ views (72110) |
$674.59 |
$1,466.50 |
6.6× |
| MRI lumbar spine without contrast (72148) |
$885.96 |
$1,926 |
3.8× |
| CT pelvis with contrast (72193) |
$1,087.21 |
$2,363.50 |
6.3× |
| MRI lower-extremity joint without contrast (73721) |
$902.75 |
$1,962.50 |
3.8× |
| CT abdomen and pelvis with contrast (74177) |
$2,185.92 |
$4,752 |
6.4× |
| Ultrasound, abdomen complete (76700) |
$1,156.90 |
$2,515 |
11.2× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$674.82 |
$1,467 |
6.6× |
| Ultrasound, transvaginal (76830) |
$803.62 |
$1,747 |
7.8× |
| Mammography, one breast (diagnostic) (77065) |
$288.19 |
$626.50 |
3.3× |
| Mammography, both breasts (diagnostic) (77066) |
$421.82 |
$917 |
3.8× |
| Mammography, screening (bilateral) (77067) |
$411.93 |
$895.50 |
4.5× |
| Basic metabolic panel (80048) |
$119.14 |
$259 |
14.1× |
| Comprehensive metabolic panel (80053) |
$218.04 |
$474 |
20.6× |
| Obstetric panel (80055) |
$390.08 |
$848 |
8.2× |
| Lipid panel (80061) |
$176.64 |
$384 |
13.2× |
| Renal function panel (80069) |
$131.56 |
$286 |
15.2× |
| Hepatic function panel (80076) |
$170.66 |
$371 |
20.9× |
| Urinalysis, non-automated, without microscopy (81002) |
$34.27 |
$74.50 |
9.8× |
| PSA, total (84153) |
$109.02 |
$237 |
5.9× |
| Thyroid stimulating hormone (TSH) (84443) |
$115.46 |
$251 |
6.9× |
| CBC with automated differential (85025) |
$76.82 |
$167 |
9.9× |
| CBC, automated (85027) |
$38.18 |
$83 |
5.9× |
| Prothrombin time (PT) (85610) |
$68.54 |
$149 |
16.0× |
| Partial thromboplastin time (PTT) (85730) |
$78.20 |
$170 |
13.0× |
| Psychotherapy, 30 minutes (90832) |
$518.88 |
$1,128 |
3.0× |
| Psychotherapy, 45 minutes (90834) |
$203.78 |
$443 |
1.2× |
| Psychotherapy, 60 minutes (90837) |
$480.24 |
$1,044 |
2.7× |
| Family psychotherapy, without patient (50 min) (90846) |
$480.24 |
$1,044 |
2.7× |
| Family psychotherapy, with patient (50 min) (90847) |
$480.24 |
$1,044 |
2.7× |
| Group psychotherapy (90853) |
$198.26 |
$431 |
2.0× |
| Left heart catheterization (93452) |
$6,604.22 |
$14,357 |
2.1× |
| Sleep study (attended polysomnography) (95810) |
$3,672.64 |
$7,984 |
4.3× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$21.16 |
$46 |
0.7× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$160.31 |
$348.50 |
1.2× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$240.12 |
$522 |
1.8× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$305.44 |
$664 |
2.3× |
| Office consultation (low complexity, ~30 min) (99243) |
$139.84 |
$304 |
1.1× |
| Office consultation (moderate complexity, ~40 min) (99244) |
$195.04 |
$424 |
1.5× |