| Upper GI endoscopy (EGD), diagnostic (43235) |
$2,711 |
$2,711 |
2.5× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$2,711 |
$2,711 |
2.5× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$4,381 |
$4,381 |
4.1× |
| CT head/brain without contrast (70450) |
$1,181 |
$1,181 |
9.4× |
| MRI brain without contrast (70551) |
$1,069 |
$1,069 |
3.7× |
| MRI brain with contrast (70552) |
$1,678 |
$1,678 |
4.0× |
| MRI brain without and with contrast (70553) |
$1,678 |
$1,678 |
4.0× |
| X-ray lower spine, 4+ views (72110) |
$246 |
$246 |
2.0× |
| MRI lumbar spine without contrast (72148) |
$1,083 |
$1,083 |
3.8× |
| CT pelvis with contrast (72193) |
$1,801 |
$1,801 |
8.6× |
| MRI lower-extremity joint without contrast (73721) |
$1,083 |
$1,083 |
3.8× |
| CT abdomen and pelvis with contrast (74177) |
$3,770 |
$3,770 |
9.0× |
| Ultrasound, abdomen complete (76700) |
$518 |
$518 |
4.1× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$518 |
$518 |
4.1× |
| Ultrasound, transvaginal (76830) |
$518 |
$518 |
4.1× |
| Mammography, one breast (diagnostic) (77065) |
$338 |
$338 |
3.9× |
| Mammography, both breasts (diagnostic) (77066) |
$507 |
$507 |
4.6× |
| Mammography, screening (bilateral) (77067) |
$312 |
$312 |
3.4× |
| Basic metabolic panel (80048) |
$35 |
$35 |
4.1× |
| Comprehensive metabolic panel (80053) |
$44 |
$44 |
4.2× |
| Obstetric panel (80055) |
$204 |
$204 |
4.3× |
| Lipid panel (80061) |
$57 |
$57 |
4.3× |
| Renal function panel (80069) |
$37 |
$37 |
4.3× |
| Hepatic function panel (80076) |
$34 |
$34 |
4.2× |
| Urinalysis, non-automated, without microscopy (81002) |
$13 |
$13 |
3.7× |
| PSA, total (84153) |
$78 |
$78 |
4.2× |
| Thyroid stimulating hormone (TSH) (84443) |
$72 |
$72 |
4.3× |
| CBC with automated differential (85025) |
$32 |
$32 |
4.1× |
| CBC, automated (85027) |
$27 |
$27 |
4.2× |
| Prothrombin time (PT) (85610) |
$17 |
$17 |
4.0× |
| Partial thromboplastin time (PTT) (85730) |
$25 |
$25 |
4.2× |
| Psychotherapy, 30 minutes (90832) |
$289 |
$289 |
1.4× |
| Psychotherapy, 45 minutes (90834) |
$428 |
$428 |
2.0× |
| Psychotherapy, 60 minutes (90837) |
$802 |
$802 |
3.8× |
| Family psychotherapy, without patient (50 min) (90846) |
$394 |
$394 |
1.9× |
| Family psychotherapy, with patient (50 min) (90847) |
$205 |
$205 |
1.0× |
| Group psychotherapy (90853) |
$1,015 |
$1,015 |
8.3× |
| Electrocardiogram (ECG), complete (93000) |
$73 |
$73 |
1.0× |
| Left heart catheterization (93452) |
$21,359 |
$21,359 |
5.5× |
| Sleep study (attended polysomnography) (95810) |
$5,501 |
$5,501 |
5.3× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$177 |
$177 |
6.1× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$395 |
$395 |
2.5× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$561 |
$561 |
3.5× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$1,120 |
$1,120 |
7.0× |
| Office consultation (low complexity, ~30 min) (99243) |
$302 |
$302 |
1.9× |
| Office consultation (moderate complexity, ~40 min) (99244) |
$452 |
$452 |
2.8× |
| Preventive visit, new patient (age 40–64) (99386) |
$427 |
$427 |
— |