| Upper GI endoscopy (EGD), diagnostic (43235) |
$1,084.50 |
$1,446 |
1.2× |
| Diagnostic colonoscopy (45378) |
$1,599 |
$2,132 |
1.8× |
| Epidural injection, lumbar/sacral (with imaging) (62322) |
$1,083.75 |
$1,445 |
1.3× |
| CT head/brain without contrast (70450) |
$782.25 |
$1,043 |
7.8× |
| MRI brain without contrast (70551) |
$1,923.75 |
$2,565 |
8.4× |
| MRI brain with contrast (70552) |
$2,233.88 |
$2,978.50 |
6.7× |
| MRI brain without and with contrast (70553) |
$2,823 |
$3,764 |
8.4× |
| X-ray lower spine, 4+ views (72110) |
$193.12 |
$257.50 |
1.9× |
| MRI lumbar spine without contrast (72148) |
$2,722.50 |
$3,630 |
11.9× |
| CT pelvis with contrast (72193) |
$711 |
$948 |
4.2× |
| MRI lower-extremity joint without contrast (73721) |
$2,318.25 |
$3,091 |
10.1× |
| CT abdomen and pelvis with contrast (74177) |
$1,962 |
$2,616 |
5.8× |
| Ultrasound, abdomen complete (76700) |
$406.12 |
$541.50 |
4.0× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$260.62 |
$347.50 |
2.6× |
| Ultrasound, transvaginal (76830) |
$184.12 |
$245.50 |
1.8× |
| Mammography, one breast (diagnostic) (77065) |
$144.75 |
$193 |
1.7× |
| Mammography, both breasts (diagnostic) (77066) |
$180.38 |
$240.50 |
1.6× |
| Mammography, screening (bilateral) (77067) |
$101.25 |
$135 |
1.1× |
| Basic metabolic panel (80048) |
$56.25 |
$75 |
6.6× |
| Comprehensive metabolic panel (80053) |
$81 |
$108 |
7.7× |
| Lipid panel (80061) |
$51.75 |
$69 |
3.9× |
| Renal function panel (80069) |
$54 |
$72 |
6.2× |
| Hepatic function panel (80076) |
$81 |
$108 |
9.9× |
| Urinalysis, non-automated, with microscopy (81000) |
$12 |
$16 |
3.0× |
| PSA, total (84153) |
$48.38 |
$64.50 |
2.6× |
| Thyroid stimulating hormone (TSH) (84443) |
$59.62 |
$79.50 |
3.5× |
| CBC with automated differential (85025) |
$105.38 |
$140.50 |
13.6× |
| CBC, automated (85027) |
$28.50 |
$38 |
4.4× |
| Prothrombin time (PT) (85610) |
$9 |
$12 |
2.1× |
| Partial thromboplastin time (PTT) (85730) |
$19.14 |
$25.52 |
3.2× |
| Left heart catheterization (93452) |
$4,381.50 |
$5,842 |
1.4× |
| Sleep study (attended polysomnography) (95810) |
$4,369.50 |
$5,826 |
5.3× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$66.38 |
$88.50 |
2.3× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$98.25 |
$131 |
0.8× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$116.62 |
$155.50 |
0.9× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$133.12 |
$177.50 |
1.0× |