| Upper GI endoscopy (EGD) with biopsy (43239) |
$910 |
$1,820 |
1.1× |
| Epidural injection, lumbar/sacral (with imaging) (62322) |
$744.50 |
$1,489 |
0.9× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$1,662 |
$3,324 |
2.1× |
| After-cataract laser surgery (YAG capsulotomy) (66821) |
$709 |
$1,418 |
1.4× |
| CT head/brain without contrast (70450) |
$1,059 |
$2,118 |
11.2× |
| MRI brain without contrast (70551) |
$1,729 |
$3,458 |
8.0× |
| MRI brain with contrast (70552) |
$2,104 |
$4,208 |
6.7× |
| MRI brain without and with contrast (70553) |
$2,290 |
$4,580 |
7.2× |
| X-ray lower spine, 4+ views (72110) |
$290 |
$580 |
3.1× |
| MRI lumbar spine without contrast (72148) |
$946.50 |
$1,893 |
4.4× |
| CT pelvis with contrast (72193) |
$1,376 |
$2,752 |
8.7× |
| MRI lower-extremity joint without contrast (73721) |
$1,074.50 |
$2,149 |
5.0× |
| CT abdomen and pelvis with contrast (74177) |
$1,673 |
$3,346 |
5.3× |
| Ultrasound, abdomen complete (76700) |
$592.50 |
$1,185 |
6.3× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$418 |
$836 |
4.4× |
| Ultrasound, transvaginal (76830) |
$438.50 |
$877 |
4.6× |
| Mammography, one breast (diagnostic) (77065) |
$203 |
$406 |
2.4× |
| Mammography, both breasts (diagnostic) (77066) |
$306.50 |
$613 |
2.8× |
| Mammography, screening (bilateral) (77067) |
$153.75 |
$307.50 |
1.7× |
| Basic metabolic panel (80048) |
$147.50 |
$295 |
17.4× |
| Comprehensive metabolic panel (80053) |
$154.50 |
$309 |
14.6× |
| Obstetric panel (80055) |
$176.50 |
$353 |
3.7× |
| Lipid panel (80061) |
$89 |
$178 |
6.6× |
| Renal function panel (80069) |
$123.50 |
$247 |
14.2× |
| Hepatic function panel (80076) |
$109.50 |
$219 |
13.4× |
| Urinalysis, non-automated, with microscopy (81000) |
$15 |
$30 |
3.7× |
| Urinalysis, non-automated, without microscopy (81002) |
$15 |
$30 |
4.3× |
| PSA, total (84153) |
$94.50 |
$189 |
5.1× |
| Thyroid stimulating hormone (TSH) (84443) |
$70 |
$140 |
4.2× |
| CBC with automated differential (85025) |
$53 |
$106 |
6.8× |
| CBC, automated (85027) |
$58.50 |
$117 |
9.0× |
| Prothrombin time (PT) (85610) |
$23.50 |
$47 |
5.5× |
| Partial thromboplastin time (PTT) (85730) |
$43.75 |
$87.50 |
7.3× |
| Psychotherapy, 30 minutes (90832) |
$80.50 |
$161 |
0.5× |
| Psychotherapy, 45 minutes (90834) |
$112 |
$224 |
0.7× |
| Psychotherapy, 60 minutes (90837) |
$143.50 |
$287 |
0.9× |
| Family psychotherapy, with patient (50 min) (90847) |
$169.50 |
$339 |
1.1× |
| Left heart catheterization (93452) |
$8,295.50 |
$16,591 |
2.8× |
| Sleep study (attended polysomnography) (95810) |
$2,654.50 |
$5,309 |
3.4× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$70 |
$140 |
2.4× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$115.75 |
$231.50 |
1.0× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$150.50 |
$301 |
1.2× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$177.50 |
$355 |
1.5× |
| Preventive visit, new patient (age 18–39) (99385) |
$144 |
$288 |
— |
| Preventive visit, new patient (age 40–64) (99386) |
$175.50 |
$351 |
— |