| Upper GI endoscopy (EGD), diagnostic (43235) |
$1,900 |
$4,750 |
2.1× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$2,494.80 |
$6,237 |
2.7× |
| Epidural injection, lumbar/sacral (with imaging) (62322) |
$702 |
$1,755 |
0.8× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$1,772 |
$4,430 |
2.0× |
| CT head/brain without contrast (70450) |
$2,453.20 |
$6,133 |
23.4× |
| MRI brain without contrast (70551) |
$3,773.60 |
$9,434 |
15.7× |
| MRI brain with contrast (70552) |
$4,655.40 |
$11,638.50 |
13.3× |
| MRI brain without and with contrast (70553) |
$5,318.80 |
$13,297 |
15.2× |
| X-ray lower spine, 4+ views (72110) |
$361.20 |
$903 |
3.4× |
| MRI lumbar spine without contrast (72148) |
$4,004 |
$10,010 |
16.7× |
| CT pelvis with contrast (72193) |
$3,165.60 |
$7,914 |
18.0× |
| MRI lower-extremity joint without contrast (73721) |
$4,447.20 |
$11,118 |
18.6× |
| CT abdomen and pelvis with contrast (74177) |
$8,081.60 |
$20,204 |
23.1× |
| Ultrasound, abdomen complete (76700) |
$747.80 |
$1,869.50 |
7.1× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$1,126.40 |
$2,816 |
10.7× |
| Ultrasound, transvaginal (76830) |
$633.20 |
$1,583 |
6.0× |
| Mammography, one breast (diagnostic) (77065) |
$485.20 |
$1,213 |
5.6× |
| Mammography, both breasts (diagnostic) (77066) |
$627.20 |
$1,568 |
5.7× |
| Mammography, screening (bilateral) (77067) |
$485.20 |
$1,213 |
5.3× |
| Basic metabolic panel (80048) |
$210.20 |
$525.50 |
24.8× |
| Comprehensive metabolic panel (80053) |
$264 |
$660 |
25.0× |
| Obstetric panel (80055) |
$197.40 |
$493.50 |
4.1× |
| Lipid panel (80061) |
$161 |
$402.50 |
12.0× |
| Renal function panel (80069) |
$160.40 |
$401 |
18.5× |
| Hepatic function panel (80076) |
$158.60 |
$396.50 |
19.4× |
| Urinalysis, non-automated, with microscopy (81000) |
$70.80 |
$177 |
17.6× |
| Urinalysis, non-automated, without microscopy (81002) |
$58.40 |
$146 |
16.8× |
| PSA, total (84153) |
$150.60 |
$376.50 |
8.2× |
| Thyroid stimulating hormone (TSH) (84443) |
$205.60 |
$514 |
12.2× |
| CBC with automated differential (85025) |
$180 |
$450 |
23.2× |
| CBC, automated (85027) |
$155.20 |
$388 |
24.0× |
| Prothrombin time (PT) (85610) |
$61.20 |
$153 |
14.3× |
| Partial thromboplastin time (PTT) (85730) |
$86.40 |
$216 |
14.4× |
| Psychotherapy, 30 minutes (90832) |
$170 |
$425 |
1.0× |
| Psychotherapy, 45 minutes (90834) |
$256 |
$640 |
1.4× |
| Psychotherapy, 60 minutes (90837) |
$256 |
$640 |
1.4× |
| Family psychotherapy, without patient (50 min) (90846) |
$140 |
$350 |
0.8× |
| Family psychotherapy, with patient (50 min) (90847) |
$317.60 |
$794 |
1.8× |
| Group psychotherapy (90853) |
$263.80 |
$659.50 |
2.6× |
| Left heart catheterization (93452) |
$9,641.60 |
$24,104 |
3.0× |
| Sleep study (attended polysomnography) (95810) |
$3,049.20 |
$7,623 |
3.5× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$191.60 |
$479 |
6.6× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$522.80 |
$1,307 |
3.9× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$575.60 |
$1,439 |
4.3× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$555 |
$1,387.50 |
4.1× |