| Upper GI endoscopy (EGD) with biopsy (43239) |
$1,684.20 |
$2,807 |
1.9× |
| Epidural injection, lumbar/sacral (with imaging) (62322) |
$1,601.40 |
$2,669 |
1.9× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$1,839.60 |
$3,066 |
2.2× |
| CT head/brain without contrast (70450) |
$1,284 |
$2,140 |
12.8× |
| MRI brain without contrast (70551) |
$1,906.80 |
$3,178 |
8.4× |
| MRI brain with contrast (70552) |
$2,238.60 |
$3,731 |
6.7× |
| MRI brain without and with contrast (70553) |
$2,763.60 |
$4,606 |
8.3× |
| X-ray lower spine, 4+ views (72110) |
$337.20 |
$562 |
3.4× |
| MRI lumbar spine without contrast (72148) |
$2,080.80 |
$3,468 |
9.1× |
| CT pelvis with contrast (72193) |
$1,176 |
$1,960 |
7.0× |
| MRI lower-extremity joint without contrast (73721) |
$2,264.40 |
$3,774 |
9.9× |
| CT abdomen and pelvis with contrast (74177) |
$4,668.60 |
$7,781 |
14.0× |
| Ultrasound, abdomen complete (76700) |
$851.40 |
$1,419 |
8.5× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$767.40 |
$1,279 |
7.7× |
| Ultrasound, transvaginal (76830) |
$527.40 |
$879 |
5.3× |
| Mammography, one breast (diagnostic) (77065) |
$375.60 |
$626 |
4.4× |
| Mammography, both breasts (diagnostic) (77066) |
$568.80 |
$948 |
5.1× |
| Mammography, screening (bilateral) (77067) |
$412.20 |
$687 |
4.5× |
| Basic metabolic panel (80048) |
$89.40 |
$149 |
10.6× |
| Comprehensive metabolic panel (80053) |
$162 |
$270 |
15.3× |
| Lipid panel (80061) |
$115.80 |
$193 |
8.6× |
| Renal function panel (80069) |
$71.40 |
$119 |
8.2× |
| Hepatic function panel (80076) |
$114 |
$190 |
14.0× |
| Urinalysis, non-automated, without microscopy (81002) |
$18.60 |
$31 |
5.3× |
| PSA, total (84153) |
$77.70 |
$129.50 |
4.2× |
| Thyroid stimulating hormone (TSH) (84443) |
$85.20 |
$142 |
5.1× |
| CBC with automated differential (85025) |
$49.20 |
$82 |
6.3× |
| CBC, automated (85027) |
$42 |
$70 |
6.5× |
| Prothrombin time (PT) (85610) |
$31.80 |
$53 |
7.4× |
| Partial thromboplastin time (PTT) (85730) |
$41.40 |
$69 |
6.9× |
| Group psychotherapy (90853) |
$72 |
$120 |
0.7× |
| Left heart catheterization (93452) |
$4,086.60 |
$6,811 |
1.3× |
| Sleep study (attended polysomnography) (95810) |
$2,178.60 |
$3,631 |
2.7× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$68.40 |
$114 |
2.4× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$196.20 |
$327 |
1.5× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$270 |
$450 |
2.1× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$363.60 |
$606 |
2.9× |