| Colonoscopy with endoscopic ultrasound (45391) |
$952.80 |
$4,764 |
0.8× |
| Epidural injection, lumbar/sacral (with imaging) (62322) |
$411.20 |
$2,056 |
0.5× |
| CT head/brain without contrast (70450) |
$652.80 |
$3,264 |
6.3× |
| MRI brain without contrast (70551) |
$1,094.40 |
$5,472 |
4.6× |
| MRI brain with contrast (70552) |
$1,205 |
$6,025 |
3.5× |
| MRI brain without and with contrast (70553) |
$1,260.80 |
$6,304 |
3.6× |
| X-ray lower spine, 4+ views (72110) |
$186.60 |
$933 |
1.8× |
| MRI lumbar spine without contrast (72148) |
$1,189.60 |
$5,948 |
5.0× |
| CT pelvis with contrast (72193) |
$833.40 |
$4,167 |
4.8× |
| MRI lower-extremity joint without contrast (73721) |
$808.60 |
$4,043 |
3.4× |
| CT abdomen and pelvis with contrast (74177) |
$1,128.20 |
$5,641 |
3.3× |
| Ultrasound, abdomen complete (76700) |
$388.40 |
$1,942 |
3.7× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$257 |
$1,285 |
2.5× |
| Ultrasound, transvaginal (76830) |
$257.10 |
$1,285.50 |
2.5× |
| Mammography, one breast (diagnostic) (77065) |
$106.60 |
$533 |
1.2× |
| Mammography, both breasts (diagnostic) (77066) |
$181.20 |
$906 |
1.6× |
| Mammography, screening (bilateral) (77067) |
$92.40 |
$462 |
1.0× |
| Basic metabolic panel (80048) |
$61.20 |
$306 |
7.2× |
| Comprehensive metabolic panel (80053) |
$77 |
$385 |
7.3× |
| Lipid panel (80061) |
$105.80 |
$529 |
7.9× |
| Renal function panel (80069) |
$57.40 |
$287 |
6.6× |
| Hepatic function panel (80076) |
$63.60 |
$318 |
7.8× |
| Urinalysis, non-automated, with microscopy (81000) |
$21.50 |
$107.50 |
5.3× |
| Urinalysis, non-automated, without microscopy (81002) |
$31.60 |
$158 |
9.1× |
| PSA, total (84153) |
$67.80 |
$339 |
3.7× |
| Thyroid stimulating hormone (TSH) (84443) |
$45.50 |
$227.50 |
2.7× |
| CBC with automated differential (85025) |
$51.40 |
$257 |
6.6× |
| CBC, automated (85027) |
$34 |
$170 |
5.3× |
| Prothrombin time (PT) (85610) |
$40.40 |
$202 |
9.4× |
| Partial thromboplastin time (PTT) (85730) |
$95.40 |
$477 |
15.9× |
| Psychotherapy, 60 minutes (90837) |
$96.40 |
$482 |
0.5× |
| Left heart catheterization (93452) |
$4,181.20 |
$20,906 |
1.3× |
| Sleep study (attended polysomnography) (95810) |
$580.90 |
$2,904.50 |
0.7× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$46.80 |
$234 |
1.6× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$99.80 |
$499 |
0.8× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$112.60 |
$563 |
0.9× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$149.80 |
$749 |
1.1× |